[Congressional Record Volume 155, Number 187 (Saturday, December 12, 2009)]
[Senate]
[Pages S13068-S13096]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 DEPARTMENTS OF TRANSPORTATION AND HOUSING AND URBAN DEVELOPMENT, AND 
      RELATED AGENCIES APPROPRIATIONS ACT, 2010--CONFERENCE REPORT

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will resume consideration of the conference report to accompany 
H.R. 3288, which the clerk will report.
  The assistant legislative clerk read as follows:

       Conference report to accompany H.R. 3288, making 
     appropriations for the Departments of Transportation and 
     Housing and Urban Development, and related agencies for the 
     fiscal year ending September 30, 2010, and for other 
     purposes.

  The ACTING PRESIDENT pro tempore. Under the previous order, the time 
until 9:30 will be equally divided and controlled between the leaders 
or their designees.
  The Senator from Oklahoma is recognized.
  Mr. INHOFE. Mr. President, this morning I will vote no on the cloture 
motion to H.R. 3288. I oppose H.R. 3288 and will not be able to be 
present to vote no on final passage. The reason I will not be here is 
that tomorrow my wife and I will be celebrating our 50th wedding 
anniversary with our 20 kids and grandkids.
  Mr. DURBIN. Mr. President, let me congratulate my colleague from 
Oklahoma on 50 years of marriage. Your wife must be a saint.
  Mr. INHOFE. Indeed, she is.
  The ACTING PRESIDENT pro tempore. The Senator from Illinois is 
recognized.
  Mr. DURBIN. Mr. President, H.R. 3288 is a consolidated appropriations 
bill which contains almost all of the remaining spending bills for the 
fiscal year 2010. This is a process we had not anticipated. We had 
hoped we could take each bill individually and consider them on the 
floor and bring them to conclusion. Unfortunately, we ran out of time.
  We had over 90 different efforts made to stop debate on the Senate 
floor on a variety of measures. It took us literally 4 weeks to extend 
unemployment benefits. This is something usually done routinely on a 
bipartisan basis, but unfortunately, because of delays and threats of 
filibusters, it took us 4 weeks to finally come to a vote to extend 
unemployment benefits in the midst of the worst recession the United 
States has experienced in over 75 years. It is unthinkable, at a time 
people were sending us e-mails and letters saying: I can't believe the 
Senate won't provide a helping hand. It isn't as if the bill itself was 
controversial. When it finally came to a vote, it passed 97 to nothing. 
There was no controversy associated with it. The controversy was 
manufactured on the floor of the Senate to delay consideration of such 
a very basic bill for 4 weeks.
  Those 4 weeks could have been spent calling up these appropriations 
bills so we could have had what was needed--a healthy, open debate on 
the bills. Instead, we were forced to wait until toward the end of the 
session and consolidate the unpassed bills in one measure and bring it 
to the floor of the Senate today.
  I will tell Members of the Senate who wonder if these bills have been 
carefully reviewed that each and every one of them passed 
overwhelmingly from the Appropriations Committee. There was one 
dissenting vote on two or three of these measures, but by and large 
they passed unanimously. There was little controversy in the 
Appropriations Committee from either side of the aisle.
  The Senate Appropriations Committee, on which I am honored to serve, 
had been working spring and summer to pass all 12 appropriations bills. 
Chairman Danny Inouye is not only a great America hero, he is a great 
American chairman. As the Senate Appropriations Committee chairman, 
this man has taken up a responsibility which few would shoulder and has 
done it with an extraordinary amount of talent and dedication. At his 
side has been Senator Thad Cochran, Republican of Mississippi, who 
works just as hard to try to make sure what we produce is a great 
credit to this institution and meets the needs of this great country.
  There is one bill remaining after these six pass. It may be one of 
the most important--the Defense appropriations bill. It was passed by 
the committee in September and represents the only remaining bill left 
for us to pass this year, which we certainly want to do before we 
adjourn at the end of this period before Christmas.
  These bills were reported out of committee with overwhelming 
bipartisan votes. Nine of the 12 were reported unanimously. However, 
when we moved these bills to the floor, we ran into these obstacles. At 
one point when we were considering, for example, the question of 
extending unemployment benefits to millions of Americans who have lost 
their jobs, exhausted their savings, lost their health insurance, and 
stand to lose their homes, there was an argument made by one Senator on 
the other side of the aisle that he didn't want us to call this bill 
until he had a chance to offer another amendment--another amendment on 
the ACORN organization. We have had a series of these amendments. We 
have flogged this group mercilessly for month after weary month. Yet 
they were going to hold up unemployment benefits for this Senator to 
have one more chance, one more swing at this organization. That, to me, 
is not responsible. The responsible thing to do is to recognize all of 
these families who were counting on us.
  Time was lost that could have been used not only to provide 
unemployment benefits in a more expeditious manner but also to consider 
these appropriations bills. Appropriations bills in the past, and not 
too distant past, used to take 1 or 2 days before the Senate. Members 
would come to the floor, amendments would be offered, debated, end of 
story. We would have a final vote, and we would move on. Now even 
routine bills with no controversy take weeks because of amendments to 
be offered which, frankly, have little or no relevance to the nature of 
the bill before us.
  We brought up the Commerce-Justice-Science appropriations bill on 
October 6. We didn't finish that bill until November 5. This is a 
critically important one, one for which most Members would gladly 
endorse its mission.

[[Page S13069]]

  These appropriations bills have taken longer because, unfortunately, 
the minority will not agree to reasonable time limits to consider 
amendments and finish debate. Instead, we find ourselves consistently 
sidetracked.
  So here we are. We have 21 days before the end of the calendar year, 
and we need to finish the business of the Congress. To do so, we 
engaged Republican Members of the Appropriations Committee and worked 
on reasonable compromises on the differing bills in the House and 
Senate. I am troubled that some of the very Republican Members of the 
Senate Appropriations Committee--not all of them; three of them stood 
up and voted to move this process forward--some of the very Members of 
the Senate Appropriations Committee who have sat through the 
subcommittee hearings, the full committee deliberations, have made 
valuable contributions to the bills themselves, now want to stop the 
process. It makes no sense. If we are going to do this in an orderly 
fashion, we should do it in a bipartisan fashion. I hope that is what 
will happen today.
  This package of appropriations bills is a result of a truly bicameral 
and bipartisan effort. It represents the priorities of our Nation. It 
invests in students, veterans, and law enforcement, just to name a few. 
It makes college education more affordable for students by increasing 
Pell grants to $5,500 a year. Is there a better time for us to do that, 
to say to children and families that don't have a lot of money: Now is 
the time to hone your skills, to create new talents in a more 
challenging economy. Go to school. If you will go to school, we will 
help you. This package of bills increases the amount of money available 
for the children in those families. I hope Members on both sides of the 
aisle will support it.
  The conference report also helps local governments fight crime and 
put more police on our streets. Take a look at the budgets of cities 
and towns, of counties, of States, and you will realize they are in a 
death struggle to provide basic services. We have increased grants for 
local law enforcement by $480 million over last year. Many of the 
critics of our efforts say: You are spending more money. Yes, we are 
spending more money to keep cops on the street, to keep neighborhoods 
safe so that families feel secure. I think it is money well spent. 
Money spent to help our first responders, firefighters, and policemen 
is a critical investment. This bill makes that investment. That grant 
program was cut by almost $2 billion by the previous administration. We 
are trying to restore that money so we can put more people on the 
street protecting our citizens. This conference report sets the right 
priorities by helping States and local police departments fight crime. 
We also include $298 million for the COPS Program to put more cops on 
the beat. This funding will help hire and retain approximately 1,400 
police officers. The COPS Program has helped train nearly 500,000 law 
enforcement personnel.
  The conference report also helps veterans. It is not enough to give 
speeches on the floor about how much we love our men and women in 
uniform and honor our veterans. It is not enough to wear a lapel pin 
and participate in parades and then come to the floor and vote against 
the bills that provide the money for the Veterans' Administration.
  What we provide here is increased funding to the Veterans Affairs 
Department of $5.3 billion over last year's level. Those who come and 
criticize the level of spending in this package of bills are 
criticizing the additional investment to help our veterans when we need 
to more than ever. Returning from Iraq and Afghanistan with post-
traumatic stress disorder, traumatic brain injuries, amputations, these 
men and women need our help. This package of bills provides that help. 
We will provide increased access to quality care for all of our 
veterans. The conference report increases discretionary spending at the 
VA by more than $5 billion to help them care for 6.1 million veterans 
they expect to see in 2010.
  If I understood the unanimous consent order, we were equally dividing 
time between now and 9:30. I ask how much time I have remaining on the 
majority side.
  The ACTING PRESIDENT pro tempore. There is 3\1/2\ minutes.
  Mr. DURBIN. I reserve the remainder of my time.


                   Recognition of the Minority Leader

  The ACTING PRESIDENT pro tempore. The Republican leader is 
recognized.
  Mr. McCONNELL. Mr. President, I will proceed under my leader time.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. McCONNELL. Mr. President, yesterday may well have been a seminal 
moment in this debate. We heard from CMS. And for those who do not know 
what that is, who may be watching C-SPAN 2, that is the Centers for 
Medicare & Medicaid Services. They did an analysis of the Reid health 
care bill, a rather detailed analysis. The important part I will 
summarize. It says: We estimate that total national health expenditures 
under this bill would increase by an estimated $234 billion during the 
calendar years 2010 to 2019. In other words, it will increase the 
deficit. We know there was a letter to Chairman Baucus from six 
Democrats on September 17, 2009, saying:

       There are many, wide-ranging options to address the broad 
     and complicated issue of runaway health care costs, and we 
     pledge our support to you in making the necessary and tough 
     decisions. This is our number one priority. If we pass health 
     [care] reform legislation without addressing the issue of 
     health care spending, we will have failed.

  That letter was signed by Senator Kohl of Wisconsin, Senator 
McCaskill of Missouri, Senator Pryor of Arkansas, Senator Begich of 
Alaska, Senator Bayh of Indiana, and Senator Klobuchar of Minnesota to 
the chairman of the Finance Committee, saying: ``If we pass health care 
reform legislation without addressing the issue of health [care] 
spending, we will have failed.''
  We know from CMS, the actuary at the Department of Health and Human 
Services, that the Reid bill fails the test of Senators Kohl, 
McCaskill, Pryor, Begich, Bayh, and Klobuchar. So we know what CMS 
thinks.
  We also know what CNN thinks. We know where the American people are. 
We have watched the public opinion polls dramatically shift against the 
Reid proposal. The well-respected Quinnipiac poll a week or so ago had 
the proposal disapproved by 14 percent; the week before that, Gallup 
had it disapproved by 9 percent. And now CNN, just yesterday, the 
latest poll: people oppose the Senate bill 61 to 36.
  We have heard from both CMS and CNN. When will our colleagues on the 
other side of the aisle respond to either cold, hard facts or the 
American people? They argue: ``to make history.'' It is clear this 
would be a historical mistake of gargantuan proportions--a historical 
mistake of gargantuan proportions. The only history we would be making 
here is a historical mistake.
  We know from the experts it will not achieve the goal. We know from 
the American people they do not want us to pass it. It is time to stop 
this effort and to start over and go step by step to fix the problems 
the American people sent us here to fix regarding the American health 
care system.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. Who yields time?
  If no one yields time, time will be charged equally.
  The Senator from Arizona is recognized.
  Mr. KYL. Mr. President, I want to speak for a moment about the vote 
we are about to take here to proceed with the so-called Omnibus 
Appropriations Act, H.R. 3288. This is the bill which for those who 
have not been following closely cleans up a little bit of a mess that 
the Congress has created because we did not do our work earlier in the 
year.
  We are supposed to pass appropriations bills to run the government, 
to run the various Departments, and we did not get around to doing 
that. So right here, at the very end, we have to combine all kinds of 
those bills together in what is called an omnibus bill--six bills in 
total.
  I find it ironic we are talking about a bill which is nearly $500 
billion--to be exact, it is $446.8 billion in new spending--at a time 
when our national deficit is $1.4 trillion, the health care bill we are 
debating in its first 10 years of implementation is $2.5 trillion and, 
next week, we are going to be asked to raise the debt ceiling in this 
country by something like $1.8 trillion.

[[Page S13070]]

  I saw a bumper sticker that said, ``Don't Tell Them What Comes After 
A Trillion.'' We used to think in billions. When I first came to 
Congress, millions were a big deal. Now we are talking trillions, and 
it is being tossed around as if it is nothing. Now another $\1/2\ 
trillion spending bill.
  Well, obviously we need to run the government. But do you suppose the 
government could be a little bit like families and be a little bit 
prudent in how much it spends or how much it increases its spending 
over the previous year?
  Let me give you some examples. The bill for Transportation and HUD 
receives a 23-percent increase over last year--23 percent. The State 
Foreign Operations bill receives a 33-percent increase over last year. 
Included in that bill is a 24-percent increase for the State 
Department's salaries and operations. A lot of Americans would like to 
see their salaries and operations increased by 24 percent. Commerce, 
State, and Justice receives a 12-percent increase over last year.
  You might say, well, the government is in tough shape. We need, for 
some reason, to increase our spending by 33 percent. No, not with what 
is in this bill.
  My colleagues have done a little bit of a check to see if there are 
any earmarks in this bill, for example. And guess what--5,224 earmarks 
and those earmarks alone are over $3.8 billion.
  I gave some examples of those earmarks, and I do not want to 
embarrass any of my colleagues by citing them today. But I think it 
would be appropriate for us to at least have the opportunity to strike 
some of these earmarks and save a little bit of money. Because the 
argument is always made: Well, we can't save money. We have to keep 
spending what we are spending. There is nothing in there to cut.
  There is a lot in there to cut. So the point I want to make to my 
colleagues here today, before we vote to proceed with this legislation, 
is we could do better. There is no argument that we have to spend 33 
percent more on the State Foreign Operations bill or 23 percent more on 
what we call affectionately around here the THUD bill, when we have 
this deficit of $1.4 trillion, when we have to increase the national 
debt by $1.8 trillion, when we are talking about spending another $2.5 
trillion, and that is just for the first 10 years of operation on the 
health care bill. I have not even mentioned the bills earlier this 
year--bailing out AIG, the insurance companies, General Motors, 
Chrysler, and the stimulus package, and well over $1 trillion when you 
add in the interest.
  By the way, I did not mention interest. Part of the problem is we do 
not have this money. We are borrowing it. We have to borrow this money 
in order to pay it to these folks, and that means you have to pay 
interest. I have not even included the interest cost, which for all 
these bills amounts to several hundreds of billions of dollars.
  There is a point at which, if you are talking about your own family 
and your own credit card, instead of asking the credit card company to 
expand the limit so you can put even more money on your credit card--
which is what we are doing here--you would start paying that credit 
card down and you would be a little bit more careful about your 
spending.
  All I am asking is: Can't we be a little more careful about our 
spending so we do not have to increase Departments of government by 23 
percent, 33 percent over last year's spending? I do not think that is 
too much to ask on behalf of our taxpayers.
  The ACTING PRESIDENT pro tempore. The majority whip is recognized.
  Mr. DURBIN. Mr. President, I want to make a point of pulling out the 
calendar here and reading the membership on the Senate Appropriations 
Committee. I thought for sure there were Republicans serving on that 
committee, and it turns out there are 12 of them. They serve on the 
committee. They are on the subcommittees. They sat on the full 
committee deliberations, and they include the Republican minority 
leader.
  Of the six appropriations bills which have come before us today for a 
vote, they were voted out of the Appropriations Committee by 
overwhelming votes. In fact, three of the bills were unanimous, meaning 
that at least the minority leader was counted as voting for the bills 
which the Senator from Arizona has just criticized, and three of them 
had a 29-to-1 vote, so I will not suppose what the minority leader's 
vote was.
  But to come before us today and argue that the majority is cramming 
these votes and bills down the throats of Members without giving them 
opportunity is to ignore what came before it: the fact that there were 
subcommittee hearings, the fact that there was a vote in the 
Appropriations Committee on each of the bills, and they passed 
overwhelmingly.
  So at least at an early stage, an important stage in this process, 11 
or 12 Republican Senators signed on and approved the bills. To argue 
that we are bringing something before the Senate, pushing it through 
quickly without deliberation, on a partisan basis, does not stand up.
  And to listen to the Senator from Arizona, I would tell you, bluntly, 
the increases in spending in this bill--some of them I hope the Senator 
from Arizona would not characterize as unwise. I know he feels as I do 
about veterans in this country. There is a substantial increase in 
money for veterans for their care. We want to do that. I will be honest 
with you, we need to pay the real cost of war, and that includes the 
commitment we have made to men and women who serve our country.
  The same thing, I am sure, is true when it comes to law enforcement. 
I am sure the Senator from Arizona feels as I do.
  The ACTING PRESIDENT pro tempore. The majority's time has expired.
  Mr. DURBIN. I urge my colleagues--when this comes for a vote in a few 
moments--to support the cloture motion. Let's move this forward. Thank 
you.
  Mr. KYL. Mr. President, how much time is remaining on our side?
  The ACTING PRESIDENT pro tempore. The Senator from Arizona has 5 
minutes.
  Mr. KYL. Thank you, Mr. President.
  Let me respond to my friend, the majority whip now. Two plain points. 
First of all: that Republicans also serve on the Appropriations 
Committee. That is true. If the majority whip, however, wants to defend 
this bill, that is his prerogative. He can do that. I have the right to 
vote against it.
  I do not serve on the Appropriations Committee, and I do not think it 
is a good bill. There may be some Republicans who do. I did not contend 
this was strictly a partisan activity, but I said it was wrong. When 
our constituents, who pay the taxes in this country, ask us to be more 
frugal, we could be more frugal than this.
  Secondly, undoubtedly, in a bill of almost $500 billion, there are 
good things. In fact, I know there are some good things in this bill. 
And I certainly suspect that the increase in veterans spending the 
majority whip referred to is probably supported by everybody in this 
body. That is the problem, however. When you do not do these 
appropriations bills one at a time, so you can vote on each one on its 
own merits, you are relegated to combining them into one giant bill. 
That is why it is called an omnibus bill, and you cannot differentiate 
between the things you support and the things you oppose. So what you 
have to end up doing is accepting all of the bad stuff in order to be 
able to support the good things.
  That is a time-honored tradition around here. If you cannot get it 
all passed on its own merits, then bundle it up with a whole bunch of 
other stuff, and we will have to accept a lot of bad policy and bad 
spending because we do not want be accused of not supporting our 
Nation's veterans.
  Some of us are willing to say--and I, in fact, have had this 
conversation with veterans before: Would you rather have us vote 
against a bill which includes veterans spending but is way more than we 
should be spending or vote for that bill simply because it has veterans 
spending in it? I used to have this conversation with veterans when I 
was in the House of Representatives because they always combine 
veterans spending with HUD, and it was hard to pass the HUD bill but 
easy to pass the veterans bill. That is why they did it that way. My 
veterans were very understanding when I voted against that bill.
  We have to be a little bit more courageous around here and a little 
bit more honest with our constituents in the way we set these bills up, 
so we do not argue to them: Oh, you don't want to

[[Page S13071]]

vote against veterans, do you? No, nobody wants to vote against 
veterans. But if you get to the point in the year where you have not 
done your work, and you have to combine all these bills together--and 
you have some good spending, for example, for veterans, but you are 
also raising the State Department by 33 percent--I think a lot of folks 
would say: That is too much. And we could actually save money by being 
more discreet in supporting some things and opposing others.
  That is why it would have been better if the majority could have 
gotten these bills to us one at a time rather than combined into one 
omnibus bill.
  So, I do think, at a certain point in time, our constituents can 
demand of us more fiscal prudence, more responsibility in the way we 
vote. The only way Republicans have to oppose a process by which all of 
these things came together at once, and the only way other Democrats 
who wish to demonstrate their prudence in spending to their 
constituents can do that, is to vote ``no'' so we do not proceed to 
this bill, so we could try to break it apart and vote on veterans, if 
you want to vote for veterans, but not a 33-percent increase in the 
State Department bill.
  I urge my colleagues to vote ``no'' and to do this in a more 
responsible way so we do not have to go home and say to our 
constituents: Well, we voted for a 33-percent increase in the State 
Department over last year. I know it is tough for you, but the State 
Department needed that money. So I hope you will forgive us for doing 
that.
  I do not think we want to do that. I hope my colleagues will vote 
``no.''


                     Project Attribution Correction

  Mrs. MURRAY. Mr. President, I wish to join with my ranking member, 
Senator Bond, in a colloquy to correct clerical errors in the 
attribution table accompanying division A of H.R. 3288. Senator Merkley 
and Senator Wyden are listed as having requested the Oak Street 
Extension, Schereville, IN, project under surface transportation 
priorities. My staff has confirmed that this project was not requested 
by Senator Merkley or Senator Wyden, and, as such, Senator Merkley and 
Senator Wyden's names should not be listed as requestors.
  Mr. BOND. My colleague and chair, Senator Murray, is correct. The 
names were added as a result of a clerical error, and Senators Wyden 
and Merkley should not be listed as sponsors.
  In addition to this project, there are additional projects for which 
Senate names were inadvertently left off of the attribution table. I 
have confirmed with my staff that the Senators listed below did request 
the following projects, which have been properly disclosed and for 
which they have certified that they have no pecuniary interest. 
Specifically, the projects, the account in which they are funded, and 
the additional sponsors are as follows:

       I-49 North, LA, interstate maintenance, Senator Vitter;
       Interstate 69, LA, interstate maintenance, Senator Vitter;
       I-12 Interchange at LA-16, LA, interstate maintenance, 
     Senator Vitter;
       I-20 Lincoln Parish, LA, Delta Regional Transportation 
     Development Program, Senator Vitter;
       Clearview at Earhart drainage, LA, Delta Regional 
     Transportation Development Program, Senator Vitter;
       Rail spur extension--Greater Ouachita Parish, LA, rail line 
     relocation and improvement, Senator Vitter;
       Greater Ouachita Port Surface Development Project, LA, 
     Economic Development Initiative, Senator Vitter;
       Earthworks Engineering Research Center--EERC, Iowa State 
     University, IA, transportation planning, research, and 
     development, Senator Grassley;
       Jet engine technology inspection to support continued 
     airworthiness--JET, Iowa State University, IA, transportation 
     planning, research, and development, Senator Grassley;
       Interstate 74 corridor construction, IA, interstate 
     maintenance, Senator Grassley;
       Alice's road extension/Ashworth Road to University Avenue, 
     IA, surface transportation priorities, Senator Grassley;
       Construct four lane highway 20 West of U.S. 71, IA, surface 
     transportation priorities, Senator Grassley;
       Iowa Highway 92 reconstruction, surface transportation 
     priorities, Senator Grassley;
       Roger Snedden Dr. extension/grade separation--phase 1, IA, 
     surface transportation priorities, Senator Grassley;
       University Boulevard widening, Clive, IA, surface 
     transportation priorities, Senator Grassley;
       Iowa Highway 100 extension and improvements, Cedar Rapids, 
     IA, surface transportation priorities, Senator Grassley;
       I-480/Tiedeman Road interchange modification, OH, 
     interstate maintenance, Senator Voinovich;
       I-76 Access/Martha Avenue connection, Akron, OH, surface 
     transportation priorities, Senator Voinovich; and
       Warrensville/Van Aken Transit Oriented, OH, surface 
     transportation priorities, Senator Voinovich.

  Mrs. MURRAY. Mr. President, Senator Bond, is correct. My staff has 
confirmed that the changes to the attribution table should be made so 
that the Senators listed above can be appropriately recognized as 
having requested the projects cited above.
  Mr. BOND. I thank the chair for her assistance in this matter.
  Ms. COLLINS. Mr. President, I rise today to discuss the conference 
report before us, which contains six of the seven remaining 
appropriations bills. Division D of the conference report contains the 
Financial Services and General Government appropriations bill. As 
ranking member of the subcommittee responsible for writing this 
division, I want to thank Senator Durbin for his leadership and 
collegiality throughout the past year. Since joining this subcommittee, 
I have seen Senator Durbin demonstrate the kind of bipartisan 
cooperation that is the hallmark of the Appropriations Committee. He 
and I worked in a collaborative fashion to produce a bipartisan bill.
  The Financial Services and General Government Subcommittee has 
jurisdiction over a diverse group of agencies, many of which have a 
profound impact on the financial stability of our economy and on the 
lives of most Americans. This appropriations bill is a key part of 
efforts to restore the stability of, and the public confidence in, 
America's financial institutions. It makes needed investments to 
strengthen the Securities and Exchange Commission's ability to enforce 
rules governing our financial markets and to detect and prosecute 
fraudulent schemes. It also increases the Federal Trade Commission's 
capacity to protect consumers from scams and anticompetitive behavior.
  Senator Durbin and I share many of the same concerns about the 
ability of our financial regulatory institutions to protect small 
investors and market participants. For years, the SEC's funding and 
staffing levels had declined, even as its oversight responsibilities 
rapidly increased. As a result, staffing shortages and an environment 
of lax oversight and enforcement at the SEC contributed to our current 
financial crisis. Funding shortfalls have hampered the ability of this 
agency to fulfill its mission of protecting the public through 
enforcement of securities laws.
  We have included a 16-percent increase in funding for the SEC that 
will help the agency better fulfill its mission by giving it the 
resources to increase staffing levels and to make information 
technology upgrades.
  The conference report also provides important increases above the 
President's budget request for the Consumer Product Safety Commission 
and the Federal Trade Commission. The CPSC protects American consumers 
from defective and unsafe products, while the FTC protects consumers 
from unscrupulous marketing scams.
  The bill also provides ample funding for the Small Business 
Administration. Our economic strength and future are tied to the 
strength of small businesses. The conference report funds important SBA 
programs like Women's Business Centers, Veterans' Programs, Native 
American Outreach, and HUBZones above the President's budget request. 
As a former regional administrator of the SBA, I am particularly 
supportive of the increase of $16 million over the President's request 
for the Small Business Development Center Program. Each year, the SBDC 
network of over 900 service centers provides management and technical 
assistance to an estimated 1.2 million small business owners and 
aspiring entrepreneurs.
  The conference agreement includes an important provision that 
protects the due process rights of auto dealers. The auto dealers are 
essential to the success of the auto manufacturers because the dealers 
facilitate distribution, sales, and servicing of hundreds of millions 
of vehicles annually. It is in the best interest of the public to have 
a competitive and viable automobile distribution network throughout the 
country, including in urban, suburban,

[[Page S13072]]

and rural areas. It is also in the interest of the local economies, the 
national economy, and our economic recovery to preserve jobs at 
successful small businesses.
  Senator Durbin and I share similar views about the funding priorities 
for most of the agencies within this bill. One of the few areas where 
he and I disagree is the DC school voucher program. We both respect one 
another's different positions on this issue, but I am disappointed that 
this bill effectively ends this successful program.
  The DC Opportunity Scholarship Program has provided additional 
educational options for some of the District's most at-risk, low-income 
children who had previously attended some of the lowest-performing 
schools in the country.
  Sadly, DC's public schools continue to underperform despite a per-
pupil expenditure rate that is the third highest in the Nation. Experts 
have carefully studied the DC Opportunity Scholarship Program and 
concluded that the educational success of the program's participants in 
reading has outpaced those in DC public schools.
  Of the $75.4 million for DC public schools in this bill, $42.2 
million is to improve the District's public schools, $20 million is to 
support DC public charter schools, and $13.2 million is for Opportunity 
Scholarships. Unfortunately, the conference report contains language 
that would only allow currently enrolled students to remain in the 
program. No new students would be permitted, despite the fact that the 
$7,500 per student cost for scholarship children is less than one-half 
the $15,511 per student cost for DC public schools.
  In May, Senator Lieberman and I held a hearing in the Homeland 
Security and Governmental Affairs Committee during which we heard 
compelling success stories of current and former participants in the 
program. Their testimony helped to highlight the real world 
implications of discontinuing the program. The fear about this program 
ending was poignantly stated by a little girl wearing a T-shirt asking: 
``What About Me?''
  By all accounts, students are succeeding and thriving in their 
scholarship schools, and their parents are overwhelmingly satisfied 
with the education that their children are receiving. So I do not see 
the wisdom of blocking new students from participating in this 
successful program.
  I am disappointed that the full Senate never had an opportunity to 
take up, debate, and amend the Financial Services and General 
Government appropriations bill when it was reported out of committee.
  This is unfortunate, especially since Senator Durbin and I worked 
hard to write a bipartisan bill which had overwhelming support in the 
committee. The Senate has had time to consider all 12 Appropriations 
bills. Chairman Inouye and Vice Chairman Cochran both worked hard to 
complete and report all 12 bills out of committee by September. For the 
record, the Financial Services bill was reported out of committee on 
July 9.
  Next year we must return to regular order so that all Senators can 
have an opportunity to debate these important bills.
  I thank the Financial Services and General Government Subcommittee 
staff: Marianne Upton, Diana Hamilton, Melissa Petersen, and Richard 
Burkard with the majority; and Mary Dietrich and Rachel Jones with the 
minority.
  Turning to Division A of the conference report, I would like to speak 
in support of a provision I authored. This provision will increase 
safety, save energy, and decrease vehicle emissions by creating a 1-
year pilot project to allow trucks weighing up to 100,000 pounds to 
travel on Maine's interstates. This provision also requires an analysis 
by the U.S. Department of Transportation and the State of Maine of 
provision's impact on safety, road and bridge durability, energy use, 
and commerce.
  By way of background, let me explain why this pilot project is 
needed. Under current law, trucks weighing 100,000 pounds are allowed 
to travel on the portion of Interstate 95 designated as the Maine 
Turnpike, which runs from Maine's border with New Hampshire to Augusta, 
our capital city. At Augusta, the Turnpike designation ends, but I-95 
proceeds another 200 miles north to Houlton. At Augusta, however, heavy 
trucks must exit the modern four-lane, limited-access highway and are 
forced onto smaller, two-lane secondary roads that pass through cities, 
towns, and villages. The same problem occurs for Maine's other 
Interstates like I-295 out of Portland and I-395 in the Bangor-Brewer 
area.
  Diverting trucks onto these secondary roads raises critical safety 
concerns. In fact, there have been several accidents, some of which 
have tragically resulted in death, which have occurred after these 
large trucks were diverted onto secondary roads and through smaller 
communities. For example, In May 2007, a 17-year-old high school 
student from Hampden, ME, lost her life when her car was struck by a 
heavy truck on Route 9. The truck driver could not see the car turning 
onto that two-lane road as he rounded a corner. Interstate 95 runs less 
than three-quarters of a mile away, but Federal law prevented the truck 
from using that modern, divided highway, a highway that was designed to 
provide ample views of the road ahead.
  A year earlier, Lena Gray, an 80-year-old resident of Bangor, was 
struck and killed by a tractor-trailer as she was crossing a downtown 
street. Again, that accident would not have occurred had that truck 
been allowed to use I-95, which runs directly through Bangor.
  While improving safety is the key objective, a uniform truck weight 
limit of 100,000 pounds on Maine's interstate highways also would 
reduce highway miles, as well as the travel time necessary to transport 
freight through Maine, resulting in economic and environmental 
benefits. Moreover, Maine's extensive network of local roads would be 
better preserved without the wear and tear of heavy truck traffic.
  Interstate 95 north of Augusta, ME, where trucks are currently 
limited at 80,000 pounds, was originally designed and built for 
military freight movements to Loring Air Force Base at weights much 
heavier than 100,000 pounds. Raising the truck weight limit would keep 
heavy trucks on the interstates, which are designed to carry more 
weight than the rural State roads.
  Current Maine law requires that vehicles carrying up to 100,000 
pounds on state roads be six-axle combination vehicles. Current Federal 
law requires that vehicles carrying 80,000 pounds be five-axle. 
Contrary to erroneous assumptions, six-axle 100,000 pound vehicles are 
not longer, wider or taller than the five-axle 80,000 pound vehicles. 
The six-axle 100,000 pound vehicles, which include an additional set of 
brakes, allow for greater weight distribution thereby not increasing 
road wear and tear. Further, stopping distances and safety are in no 
way diminished, and preliminary data from studies conducted by the 
Maine State Police support this statement. That is why Maine's 
Commissioner of Public Safety, the Maine State Troopers Association, 
and the Maine Association of Police all support this pilot project.
  A higher weight limit in Maine will not only preserve our rapidly 
deteriorating roads, but will provide economic relief to an already 
struggling trucking industry. Trucks weighing up to 100,000 pounds are 
permitted on interstate highways in New Hampshire, Massachusetts, and 
New York as well as the Canadian Provinces of New Brunswick and Quebec. 
Maine truck drivers and the businesses they serve are at a competitive 
disadvantage.
  Last year, I met with Kurt Babineau, a small business owner and 
second generation logger and trucker from Maine. Like so many of our 
truckers, Kurt has been struggling with the increasing costs of running 
his operation. All of the pulpwood his business produces is transported 
to Verso Paper in Jay, ME, a 165-mile roundtrip. This would be a 
considerably shorter trip if his trucks were permitted at 100,000 
pounds to remain on Interstate 95. Instead, his trucks must travel a 
less direct route through cities and towns. Kurt estimated that 
permitting his trucks to travel on all of Interstate 95 would save him 
118 gallons of fuel each week. At last year's diesel cost of 
approximately $4.50 a gallon, and including savings from his drivers 
spending less time on the trip, he could have saved more than $700 a 
week, and more than $33,000 and 5,600 gallons of fuel annually. These 
savings would not only be beneficial to

[[Page S13073]]

Kurt's bottom line, but also to his employees, his customers, and to 
our nation as we look for ways to decrease the overall fuel 
consumption.
  An increase of the Federal truck weight limit in Maine is widely 
supported by public officials throughout Maine, including the Governor, 
the Maine Association of Police, and the Maine Department of Public 
Safety, which includes the State Bureau of Highway Safety, the Maine 
State Police, and the Bureau of Emergency Communications. The Maine 
Legislature also has expressed its support for the change having passed 
resolutions over the past several years calling on Congress to raise 
the Federal truck weight limit to 100,000 pounds in Maine. I look 
forward to passage of this important provision, which has been long 
awaited in my State.


                             Cloture Motion

  The ACTING PRESIDENT pro tempore. Pursuant to rule XXII, the Chair 
lays before the Senate the pending cloture motion, which the clerk will 
state.
  The assistant legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     hereby move to bring to a close debate on the conference 
     report to accompany H.R. 3288, the Transportation, HUD, 
     Related Agencies Appropriations Act for Fiscal Year 2010.
         Daniel K. Inouye, Al Franken, Jon Tester, Paul G. Kirk, 
           Jr., Roland W. Burris, Edward E. Kaufman, Jack Reed, 
           Daniel K. Akaka, Mark Begich, Patty Murray, Jeff 
           Bingaman, Robert P. Casey, Jr., Sherrod Brown, Thomas 
           R. Carper, Byron L. Dorgan, Richard J. Durbin, Harry 
           Reid.

  The ACTING PRESIDENT pro tempore. By unanimous consent, the mandatory 
quorum call is waived.
  The question is, Is it the sense of the Senate that debate on the 
conference report to accompany H.R. 3288, the Transportation, Housing 
and Urban Development and Related Agencies Appropriations Act of 2010 
shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. KYL. The following Senators are necessarily absent: the Senator 
from Missouri (Mr. Bond), the Senator from Kentucky (Mr. Bunning), the 
Senator from Oklahoma (Mr. Coburn), the Senator from South Carolina 
(Mr. Graham), the Senator from South Carolina (Mr. DeMint), and the 
Senator from Indiana (Mr. Lugar).
  Further, if present and voting, the Senator from South Carolina (Mr. 
DeMint) would have voted ``nay'' and the Senator from Kentucky (Mr. 
Bunning) would have voted ``nay.''
  The PRESIDING OFFICER (Mrs. Gillibrand). Are there any other Senators 
in the Chamber desiring to vote?
  The result was announced--yeas 60, nays 34, as follows:

                      [Rollcall Vote No. 373 Leg.]

                                YEAS--60

     Akaka
     Baucus
     Begich
     Bennet
     Bingaman
     Boxer
     Brown
     Burris
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Cochran
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Feinstein
     Franken
     Gillibrand
     Hagan
     Harkin
     Inouye
     Johnson
     Kaufman
     Kerry
     Kirk
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Menendez
     Merkley
     Mikulski
     Murray
     Nelson (NE)
     Nelson (FL)
     Pryor
     Reed
     Reid
     Rockefeller
     Sanders
     Schumer
     Shaheen
     Shelby
     Specter
     Stabenow
     Tester
     Udall (CO)
     Udall (NM)
     Warner
     Webb
     Whitehouse
     Wyden

                                NAYS--34

     Alexander
     Barrasso
     Bayh
     Bennett
     Brownback
     Burr
     Chambliss
     Corker
     Cornyn
     Crapo
     Ensign
     Enzi
     Feingold
     Grassley
     Gregg
     Hatch
     Hutchison
     Inhofe
     Isakson
     Johanns
     Kyl
     LeMieux
     McCain
     McCaskill
     McConnell
     Murkowski
     Risch
     Roberts
     Sessions
     Snowe
     Thune
     Vitter
     Voinovich
     Wicker

                             NOT VOTING--6

     Bond
     Bunning
     Coburn
     DeMint
     Graham
     Lugar
  The PRESIDING OFFICER. On this vote, the yeas are 60, the nays are 
34. Three-fifths of the Senators duly chosen and sworn having voted in 
the affirmative, the motion is agreed to.
  The Senator from Minnesota is recognized.
  Mr. FRANKEN. Madam President, I rise today to speak in support of 
amendment No. 2795, which would repeal the antitrust exemption for 
health insurance and medical malpractice insurance. I thank my 
colleague Chairman Leahy for championing this legislation, which is 
crucial to health reform and to working families around the country who 
pay too much in health insurance premiums.
  We are on the verge of expanding health insurance to 31 million more 
Americans--an accomplishment that would be truly historic. But as 
heartened as I am about the relief this will bring to families, I am 
deeply concerned that this expansion could be a windfall for insurance 
companies if we don't include additional checks and balances. We should 
be putting significant Federal funds towards health insurance--but that 
money should go towards helping people afford health insurance, not 
towards lining the pockets of insurance companies and their CEOs.
  As a country, we have long understood the profound importance of 
economic competition. Competition leads to greater entrepreneurship, 
creativity, and productivity for businesses. It leads to lower prices 
and higher quality for consumers. Competition is why America has 
created so many of the most innovative businesses in the world. It is 
also why we enacted antitrust laws--because we need to protect this 
value we hold dear, and we know that competition won't always happen on 
its own.
  Because I understand the value of competition, I am extremely 
concerned about the antitrust exemption in current law for health 
insurance and malpractice insurance. It is indisputable that health 
insurance premiums have gone through the roof in recent years. From 
1999 to 2008, median income rose about 24 percent, but insurance 
premiums grew by 131 percent. It is no wonder that so many American 
families are struggling to afford insurance.
  These high premiums are directly connected to the lack of competition 
in statewide health insurance markets. Ninety-four percent of State 
health insurance markets are considered ``highly concentrated,'' 
according to the U.S. Department of Justice. In 16 States, the two 
biggest health care insurance companies controlled 75 percent or more 
of the market in 2007. In Hawaii, that figure was 98 percent. In Rhode 
Island and Alaska, it was 95.
  But while American families suffer, insurance company profits 
continue to rise. From 2000 to 2008, the major insurance companies made 
over $59\1/2\ billion. Their profits rose by 428 percent from 2000 to 
2007. And their CEOs are making big bucks themselves--in 2007, the CEO 
of Aetna took home $23 million, while the CEO of CIGNA took home $25.8 
million.
  The antitrust exemption for health insurance and malpractice 
insurance may have had a purpose at one point in time--it gave the 
health insurance companies time to respond to a major change in the 
law. When Congress passed the McCarran Ferguson Act in 1945, it was 
responding to a 1944 Supreme Court case that upended the insurance 
industry as they knew it. The bill passed without any hearings in the 
Senate and with very little debate in the House.
  Most indications suggest that both the House and the Senate expected 
the antitrust exemption to be temporary. But somehow, through the 
conference report, this ``temporary fix'' became permanent--and health 
insurance markets have become more and more concentrated as a result.
  This cannot continue. Senator Leahy's amendment gives us the 
opportunity to further the American ideal of competition, and help 
working people in the process. I urge my colleagues to bring this 
amendment up for a vote, and to vote to repeal the antitrust exemption. 
This issue is just too important for us to wait any longer.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Madam President, I rise to speak on the pending bill 
before us, one of the great porkbarrel, earmark-filled pieces of 
legislation I have seen come before this body.
  I would like to quote from ABC News, by Jonathan Karl and Devin 
Dwyer, ``Tis the Season of `Pork': Congress Gifts $4 Billion in 
Earmarks.''


[[Page S13074]]


       Just weeks before returning to their districts for 
     Christmas, Congress is poised to give the gift of pork--
     roughly $4 billion of it.
       More than 5,000 earmarks were included in the $447 billion 
     omnibus spending bill passed yesterday by the House, funding 
     ``pet projects'' of key members of Congress from both parties 
     and all regions of the country. The Senate will vote on the 
     bill this weekend. . . .
       Independent analyses of the bill reveal a whopping 12 
     percent increase in government spending for 2010 while the 
     inflation rate in the country remains near zero.

  Really, isn't that remarkable? A 12-percent increase in spending when 
people are out of jobs, out of their homes. They cannot afford, 
basically, what they need to sustain their lives, and we have increased 
spending by 12 percent and 4,500 earmarks, about $4 billion of it.

       ``This Congress has not shown that they are at all serious 
     about the budget deficit in any way,'' said Brian Riedl of 
     the Heritage Foundation. ``The spending spree is continuing 
     even as the deficit escalates to $2 trillion.''
       The earmarks are all explicitly listed in the bill--right 
     next to the members of Congress who inserted them: $800,000 
     for jazz at New York's Lincoln Center, for Rep. Jerold 
     Nadler, D-N.Y., and Sen. Tom Harkin, D-Iowa. Harkin, and Rep. 
     Leonard Boswell, D-Iowa, got $750,000 for exhibits at the 
     World Food Prize Hall in Iowa. Hawaii Democratic senators Dan 
     Inouye and Daniel Akaka helped get $3.4 million for a rural 
     bus program in Hawaii.
       ``The country needs to be tightening its belt, just like 
     the rest of America,'' said Steve Ellis of Taxpayers for 
     Common Sense.
       Republicans have criticized the spending package, but many 
     Democrats say it funds key priorities.
       Two of the biggest earmarks are from Republican senators 
     Thad Cochran and Roger Wicker of Mississippi at a cost of $8 
     million for improvements to four rural State airports. One 
     airport serves fewer than 100 passengers a day and another--
     the Mid-Delta Regional Airport--sees even less.

  By the way, I have seen the pork extended to both of those airports 
over the years.

       The new funds would come on top of $4.4 million the 
     airports just received from the stimulus package.

  I am not making this up.

       ``We obviously have huge aviation and transportation needs 
     in this country and stuffing millions of dollars in small, 
     little-used airports in Mississippi is not a wise use of 
     funds,'' said Ellis.
       President Obama had promised to curb the inclusion of 
     earmarks in government spending bills but he has yet to issue 
     the threat of a veto.

  My friends, do not wait for the threat of a veto.

       In March, Obama signed a $410 billion spending package that 
     contained nearly 8,000 pet projects.
       ``I am signing an imperfect omnibus bill because it's 
     necessary for the ongoing functions of government,'' Obama 
     said at the time. ``But I also view this as a departure point 
     for more far-reaching change.''

  What has changed? What has changed? Nothing. Nothing has changed.
  Senate majority leader Harry Reid said about the last omnibus: We 
have a lot of issues we need to get to after we fund the government--
something we should have done last year but could not because of the 
difficulty we had working with President Bush.
  Difficulty working with President Bush? Whom did the majority leader 
have trouble working with this time?
  Again, I repeat, a 1,350-page Omnibus appropriations conference 
report, 6 bills, spends $450 billion, 4,752 earmarks totaling $3.7 
billion, and a full 409 pages of this conference report are dedicated 
to listing congressional pork-barrel spending. Spending on domestic 
programs in this bill is increased 14 percent over the last fiscal 
year, while spending on military construction and care for veterans has 
increased by only 5 percent.
  Let's look at a little bit of it. Transportation, Housing and Urban 
Development contains 1,400 earmarks totaling over $1 billion. Commerce-
Justice-Science contains 1,511 earmarks totaling $715 million. The list 
goes on and on. Here we are with a deficit of $1.4 trillion, a debt of 
$12 trillion, unemployment at 10 percent, nearly 900,000 families lost 
their homes in 2008, yet there is every indication that the aggregate 
numbers for 2009 will be worse. With all this, we continue to spend and 
spend and spend. Every time we pass an appropriations bill with 
increased spending and load it up with earmarks, we are robbing future 
generations of Americans of the ability to obtain the American dream. 
Forty-three cents out of every dollar spent in this bill is borrowed 
from our children and our grandchildren and, unfortunately, generations 
after theirs. This is the greatest act of generational theft committed 
in the history of this country.
  Let me go through a few of these, if I might, and remind people of 
the context this is in. In my home State of Arizona, 48 percent of the 
homes are ``underwater,'' meaning they are worth less than the mortgage 
payments people have to pay. We have small businesspeople losing credit 
everywhere. Instead of trying to fix their problems and helping them 
out, it is business as usual in the Senate of the United States of 
America and the Congress.
  For example: $200,000 for the Washington National Opera, Washington, 
DC, for set design, installation and performing arts at libraries and 
schools; $13.9 million on fisheries in Hawaii--there is always Hawaii--
nine projects throughout the islands ranging from funding bigeye tuna 
quotas, marine education and training, and coral research; $2.7 
million--one of my favorites--to support surgical operations in outer 
space at the University of Nebraska. As I have said many times--the 
common theme--you will always have a location designated for these 
projects. That is why some of them may be worthwhile, but we will never 
know because they don't compete them. They earmark them for the 
particular place they want to help. Unfortunately, that shuts out other 
people. There may be other places besides the University of Nebraska 
that can support surgical operations in outer space. I suggest we get 
Dr. Spock and Bones out there to help at the university. I don't know 
if they live in Omaha or not. I am sure to them and all the others on 
``Star Trek,'' surgical operations in outer space may be one of their 
priorities. It certainly isn't a priority of the citizens of my State.
  One of the great cultural events that took place in the 20th century 
was the Woodstock Festival. In order to do a lot more research on that 
great cultural moment, we are going to spend $30,000 for the Woodstock 
Film Festival Youth Initiative; $200,000 to renovate and construct the 
Laredo Little Theater in Texas--people from all over America are 
flocking to the Laredo Little Theater, and they want to invest $200,000 
of their tax dollars into the Laredo Little Theater. The money would be 
used to replace worn auditorium seating and soundproofing materials. 
Anybody got a little theater that warrants soundproofing? Maybe they 
should apply to the Senator from Texas.
  Continuing: $665,000--I am not making this one up--for the Cedars-
Sinai Medical Center in Los Angeles for equipment and supplies for the 
Institute for Irritable Bowel Syndrome Research. I have a lot of 
comments on that issue, but I think I will pass so as not to violate 
the rules of the Senate. There is $500,000 for the Botanical Research 
Institute of Texas in Fort Worth. I am sure the Botanical Research 
Institute in Fort Worth is a good one. I would like to see other 
botanical research institutes able to compete. There is $600,000 for 
water storage tower construction in Ada, OK, population 16,008; 
$200,000 for a visitor center in Bastrop, TX, the population is 5,340; 
$292,200 for elimination of slum and blight in Scranton, PA--that may 
have been put in by the cast of the office--$229,000 for elimination of 
slum and blight in Scranton; $200,000 for design and construction of 
the Garapan Public Market in the Northern Mariana Islands; $500,000 for 
development of a community center--$\1/2\ million--in Custer County, 
ID, population 4,343; $100,000 for the Cleveland Municipal School 
District--they just picked one and gave them $100,000--$800,000 for 
jazz at the Lincoln Center; $300,000 for music programs at Carnegie 
Hall; $400,000 for Orchestra Iowa Music Education, Cedar Rapids, IA, to 
support a music education program; $2.5 million for the Fayette County 
Schools in Lexington, KY, for a foreign language program; $100,000 to 
the Cleveland Municipal School District in Cleveland, OH, to improve 
math and language skills through music education; $700,000 for the 
National Marine Fisheries Service for the project Shrimp Industry 
Fishing Effort Research Continuation; $1.6 million to build a tram 
between the Huntsville Botanical Garden and the

[[Page S13075]]

Marshall Flight Center in Alabama--how many places need $1.6 million to 
build a tram, it will probably go out to the statue of Vulcan--$250,000 
for the Monroe County Fiscal Court for the Monroe County Farmers Market 
in Kentucky; $750,000 for the design and fabrication of exhibits to be 
placed in the World Food Prize Hall of Laureates in Iowa; $500,000 to 
support creation of a center to honor the contribution of Senator 
Culver, an Iowa State Senator, at Simpson College; $400,000 to recruit 
and train closed captioners and court reporters at the AIB College of 
Business in Iowa; $250,000 for renovating the Murphy Theatre Community 
Center in Ohio.
  There is a lot more, and I will go through them briefly. The point 
is, you will notice several things. One, the preponderance of these 
pork-barrel and earmark projects is allocated to members of the 
Appropriations Committee, which is fundamentally unfair. Second, you 
will find these are designated to a certain place, to make sure none of 
that money is spent somewhere else where the need may be greater. 
Third, it breeds corruption. It is a gateway drug. What we are talking 
about is a gateway drug. It is especially egregious now.
  Continuing: $300,000 to monitor and research herring in Maine; 
$200,000 to study Maine lobsters; $250,000 for a Father's Day rally 
parade in Philadelphia. I scoff and make fun of a lot of these but 
$250,000 for a Father's Day rally parade in Philadelphia. There is 
$100,000 for the Kentler International Drawing Space, an art education 
program in Brooklyn. Here is a deprived area, $75,000 for art projects 
in Hollywood Los Angeles Park; $100,000 for a performing arts training 
program at the New Freedom Theater in Philadelphia; $100,000 to teach 
tennis at the New York junior tennis league in Woodside, NY; $2.8 
million to study the health effects of space radiation on humans at the 
Loma Linda University, Loma Linda, CA; $200,000 for the Aquatic 
Adventures Science Education Foundation in San Diego; $100,000 to 
archive newspaper and digital media at the Mississippi Gulf Coast 
Community College in Perkinston, MS; $3.9 million on researching 
weaving and knitting at Clemson University, Raleigh, NC, Philadelphia 
University, UC Davis in Davis, CA; $90,000 for a commercial kitchen 
business incubator at the El Pajaro Community Development Corporation 
in Watsonville, CA; $500,000 to study vapor mercury in the atmosphere 
at Florida State; $1 million to examine sea scallops fisheries at the 
Massachusetts Marine Fisheries in Bedford; $300,000 for seal and 
stellar sea lion biological research; $300,000 for Bering Sea crab 
management; $500,000 to upgrade the Baldwin County Courthouse security 
in Fairhope, AL; $900,000 for the operational costs and capital 
supporting the Alien Species Action Plan cargo inspection facility in 
Maui; $2 million to streetscape the city of Tuscaloosa, AL; $100,000 
for an engineering feasibility study of a bike connector in Hiran, OH; 
$400,000 for a pedestrian overpass in Des Moines; $300,000 for a bike 
path in Cuellar, TX; $900,000 for a river freight development study in 
Missouri; $800,000 for a scenic trail in Monterey Bay, CA, another 
deprived area; $750,000 for the Philadelphia Museum of Art 
Transportation Improvement Program, Brady, PA; $500,000 for park-and-
ride lots at Broward County, Meek, FL; $487,000 to restore walkways in 
Newport Cliff, RI, another low-income area; $974,000 for Regional East-
West and Bikeway in Albuquerque.
  The list goes on and on and on, up to nearly $4 billion. The problem 
is, among other problems, in the last campaign, the President 
campaigned for change, change you can believe in. There is no change 
here. It is worse. It is worse because of the conditions Americans find 
themselves in--out of their homes, out of jobs, high unemployment, 
tough economic conditions. It is business as usual, spending money like 
a drunken sailor, and the bar is still open.
  I tell my colleagues, again, what I keep saying over and over: There 
is a peaceful revolution going on. They are sick and tired of the way 
we do business in Washington. They don't think their tax dollars should 
be spent on these pork-barrel earmarked projects. They are mad about 
it. We are not getting the message. We are not hearing them. We are not 
responding to the problems and the enormous challenges the American 
people have. We are continuing this kind of obscene process, which not 
only is wrong on its face but breeds corruption in Washington.
  I ask unanimous consent that the AP story ``Senate Set to Advance 
$1.1 trillion Spending Bill'' be printed in the Record, as well as the 
ABC News story and the FOX News story ``Watchdogs Cry Foul Over 
Thousands of Earmarks in Spending Bills.''
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

               Senate Set To Advance $1.1T Spending Bill

                           (By Andrew Taylor)

       Washington.--The Senate is poised to clear away a 
     Republican filibuster of a huge end-of-year spending bill 
     rewarding most federal agencies with generous budget boosts.
       The $1.1 trillion measure combines much of the year's 
     unfinished budget work--only a $626 billion Pentagon spending 
     measure would remain--into a 1,000-plus-page catchall 
     spending bill that would give Cabinet departments such as 
     Education, Health and Human Services and State increases far 
     exceeding inflation.
       After a 60-36 test vote on Friday in which Democrats and a 
     handful of Republicans helped the measure clear another GOP 
     obstacle, the bill was expected to win on Saturday the 60 
     Senate votes necessary to guarantee passage. A final vote is 
     expected Sunday.
       The measure provides spending increases averaging about 10 
     percent to programs under immediate control of Congress, 
     blending increases for veterans' programs, NASA and the FBI 
     with a pay raise for federal workers and help for car 
     dealers.
       It bundles six of the 12 annual spending bills, capping a 
     dysfunctional appropriations process in which House leaders 
     blocked Republicans from debating key issues while Senate 
     Republicans dragged out debates.
       Just the $626 billion defense bill would remain. That's 
     being held back to serve as a vehicle to advance must-pass 
     legislation such as the debt increase.
       Saturday's bill would offer an improved binding arbitration 
     process to challenge General Motors' and Chrysler's decisions 
     to close more than 2,000 dealerships, which often anchor 
     fading small town business districts. It also renewed for two 
     more years a federal loan guarantee program for steel 
     companies.
       The bill also caps a heated debate over Obama's order to 
     close the military-run prison for terrorist suspects at 
     Guantanamo Bay, Cuba. It would permit detainees held there to 
     be transferred to the United States to stand trial but not to 
     be released.
       The bill would also void a long-standing ban on the funding 
     of abortion by the District of Columbia government and 
     overturns a ban on federal money for needle exchange programs 
     in the city. It also phases out a D.C. school voucher program 
     favored by Republicans and opens the door for the city to 
     permit medical marijuana.
       It would also lift a nationwide ban on the use of federal 
     funds for needle-exchange programs.
       Federal workers would receive pay increases averaging 2 
     percent, with people in areas with higher living costs 
     receiving slightly higher increases.
       Once the bill clears the Senate, it would advance to 
     President Barack Obama's desk.
                                  ____


     Watchdogs Cry Foul Over Thousands of Earmarks in Spending Bill

       Republicans and taxpayer watchdogs are railing against the 
     thousands of earmarks included in the omnibus spending bill 
     that passed the House Thursday and is awaiting a vote in the 
     Senate.
       Republicans and tax watchdog groups are railing against the 
     thousands of earmarks included in the omnibus spending bill 
     that the House passed Thursday and is awaiting a vote in the 
     Senate.
       The $1.1 trillion bill includes $447 billion in operating 
     budgets for 10 Cabinet departments. Mixed in are more than 
     5,000 earmarks totaling $3.9 billion, according to watchdog 
     Taxpayers for Common Sense.
       Pork-watchers are only just beginning to sort through the 
     earmarks, which typically are goodies set aside for the 
     districts of members of Congress, as the bill tracks toward a 
     final vote. So far, they've uncovered gems ranging from 
     $700,000 for a shrimp fishing project in Maryland to $30,000 
     for the Woodstock Film Festival Youth Initiative to $200,000 
     for a visitor's center in a Texas town with a population of 
     about 8,000.
       ``Let's stop the madness,'' House Republican Leader John 
     Boehner said, before the bill passed without any GOP support. 
     Twenty-eight House Democrats also opposed it.
       House Minority Whip Eric Cantor, R-Va., wrote to President 
     Obama urging him to veto the bill, and pledging that 
     Republicans would stand by him if he did.
       Obama in March waved off controversy over a $410 billion 
     spending bill that also was riddled with earmarks, arguing 
     that it represented ``last year's business.'' This time 
     around, Boehner said, the president needs to crack down on 
     the pork under his watch.
       Republicans, though, have hardly shied away from the 
     earmarks. Sen. Thad Cochran, R-Miss., is pushing $200,000 for 
     the Washington National Opera. Sen. Judd Gregg, a fiscal 
     hawk, is behind a $1 million earmark for renovation at the 
     Portsmouth Music Hall.

[[Page S13076]]

       Taxpayers for Common Sense reports a total of 5,224 
     earmarks in the 2010 spending bill, which also includes 
     funding for Medicare and Medicaid. Groups like Citizens 
     Against Government Waste, as well as Sen. John McCain's 
     staff, have drawn attention to dozens of items they consider 
     questionable. Here's just a sampling:
       --$150,000 for educational programs and exhibitions at the 
     National Building Museum.
       --$400,000 for renovation of the Brooklyn Botanical Garden.
       --$150,000 for exhibits at the Theodore Roosevelt Inaugural 
     Site Foundation in Buffalo, N.Y.
       --$500,000 for Mississippi River exhibits at the National 
     Mississippi River Museum and Aquarium in Dubuque, Iowa.
       --$200,000 for the Washington National Opera.
       --$30,000 for the Woodstock Film Festival Youth Initiative.
       --$2.7 million for the University of Nebraska Medical 
     Center, to support surgical operations in space.
       --$200,000 for a visitor's center in Bastrop, Texas.
       --$700,000 for a project called, ``Shrimp Industry Fishing 
     Effort Research Continuation,'' at the National Marine 
     Fisheries Service in Silver Spring, Md.
       --$292,200 for the elimination of blight in Scranton, Pa.
       --$750,000 for exhibits at the World Food Prize Hall of 
     Laureates in Iowa.
       --$1.6 million for a tram between the Marshall Flight 
     Center and Huntsville Botanical Garden in Alabama.
       --$655,000 for equipment at the Institute for Irritable 
     Bowel Syndrome Research in Los Angeles.
       Republicans have been on a tear over earmarks and excessive 
     spending over the past week, particularly as Congress 
     prepares to take up a new jobs-creation package and raise the 
     debt ceiling by nearly $2 trillion.
       Rep. Mark Kirk, R-Ill., and Rep. Tom Price, R-Ga., on 
     Thursday named what they called the 11 most wasteful spending 
     projects considered by Congress so far this year.
       On Wednesday, four Republican lawmakers demanded an audit 
     of the $787 billion stimulus program following reports of 
     exaggerated or inaccurate accounts of the number of jobs 
     created.
       McCain, R-Ariz., and Sen. Tom Coburn, R-Okla., on Tuesday 
     released a report on 100 ``questionable'' stimulus projects 
     worth nearly $7 billion.

  Mr. McCAIN. Madam President, I am sorry to be repetitive. I know my 
colleague is waiting, so I will end with this: This is wrong. We all 
know it is wrong. The American people know it is wrong. People who vote 
for this kind of porkbarrel spending are going to be punished by the 
voters, and we are going to end this obscene process, and we are going 
to end it soon, as early as the next election.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Madam President, we are now considering a bill that 
represents a dramatic expansion in government spending, as the Senator 
from Arizona has so eloquently stated. This Omnibus appropriations bill 
represents a 12-percent increase over last year--a fiscal year that 
ended with the largest deficit in American history of $1.4 trillion.
  I do not know of any other area in the economy where people are 
spending 12 percent over what they spent last year. Certainly no family 
budget in America, no business in America is spending 12 percent more 
this year than they did last year--while we see 10 percent of our 
people unemployed.
  Millions of families across the country and small businesses are, in 
fact, tightening their budgets. But the budgets of these Federal 
agencies and of the Federal Government itself keep expanding. There is 
a 33-percent increase in spending for foreign operations, a 23-percent 
increase in Transportation, Housing, and Urban Development.
  One of the worst things this spending is doing is creating tremendous 
uncertainty, both here at home and in other places such as China which 
are buying our debt, about whether we are ever going to get serious 
about our fiscal responsibility.
  The President asked last week why job creators were not stepping up 
and creating jobs. Well, the fact is, people are watching what we are 
doing in Congress, and they do not know what the rules will be 6 months 
from now or a year from now or whether Congress will ever recover from 
this binge it has been on when it comes to spending.
  But it is clear we cannot spend--we cannot spend--our way out of this 
recession. Job creators are scared. They are scared, and they are 
sitting on the sidelines because all of the spending, all of the tax 
increases, all of the government takeovers coming out of Washington, 
DC, these days leave them with the sense that they do not know what the 
rules are going to be. And why in the world would you want to create a 
job, expand your business, or make an investment when the very premise 
upon which you did so would change because of all the chaos in 
Washington?
  The facts of our debt crisis are not in dispute. The total public 
debt stands at about $12 trillion. We have, in 2009, a $1.4 trillion 
fiscal deficit. In other words, we have spent more than $1.4 trillion 
than the Treasury brought in in fiscal year 2009. Then we are 
accumulating debt even faster during this year than we did last year.
  According to the Treasury Department, the deficit for the first 2 
months--2 months--of the new fiscal year was almost $300 billion--$300 
billion for 2 months--a total larger than the full-year deficits in 
2002, 2006, or 2007. So in 2 months, the deficit was worse than it was 
for the entire years of 2002, 2006, and 2007.
  Our deficits will average nearly $1 trillion every year for the next 
decade--$1 trillion every year for the next decade--according to the 
administration. This ought to be a shot across our bow.
  Moody's Investors Service said its debt rating on U.S. Treasury 
securities may ``test the Triple-A boundaries.'' The translation of 
that is they are beginning to doubt whether at some point the U.S. 
Government will be able to pay its bills or will default on those bills 
at some point hopefully not any time soon. But this is the sort of 
pressure we are putting not only on our ability to create jobs but on 
our future and particularly on our children's future, if we cause 
Moody's Investors Service and others to rate U.S. Treasury securities 
less than a Triple-A rating.
  Well, we know soon our colleagues on the other side of the aisle are 
going to ask Congress to vote to lift the debt ceiling. In other words, 
this is like the credit limit on your credit card. Once Congress is 
bumped up against that $12 trillion debt ceiling, Congress is going to 
have a vote on whether to ask the American people and people buying our 
debt whether we can increase the limit of our credit card because we 
have maxed it out.
  Media reports indicate that the majority intends to slip this 
provision into a bill on funding our troops in Afghanistan because, 
frankly, they are embarrassed to have a stand-alone vote on raising the 
debt ceiling, especially because they know there are many of us on both 
sides of the aisle who will insist on some measure to effect some 
discipline on this spending binge as a condition to voting on the debt 
ceiling. But whatever the vehicle the majority leader decides upon, 
they cannot hide the fact that we are borrowing money so fast that we 
will have to raise the debt ceiling another 15 percent.
  Conveniently, this increase will get the government through the next 
midterm elections, it is reported according to some experts. Not a 
coincidence. No one, particularly those in control of the Congress, 
wants to have another vote on lifting the debt ceiling or asking the 
American people to raise the credit card limit before the next election 
because they know the American people are increasingly angry and 
frightened by the spending binge they see here, and particularly the 
accumulating debt.
  That is not even getting to the financial crisis that entitlement 
programs are facing, such as Medicare and Social Security. We know 
Medicare's unfunded liabilities are roughly $38 trillion. I realize 
that number is so big that there are perhaps none of us who can fully 
comprehend how much money that is--but $38 trillion in unfunded 
liabilities for Medicare alone. Yet the proposed Medicare 
``compromise'' among 10 Democrats would roughly double the burden of 
Medicare and not fix it but actually make things worse.
  Well, I want to mention one other item of fiscal irresponsibility I 
have witnessed. I think we need to cancel one of the credit cards that 
has been used by the administration--not just this administration but 
the past administration--and Congress for purposes Congress never 
intended when it authorized this program, the Troubled Asset Relief 
Program or TARP.
  I know the Senator from South Dakota is on the Senate floor. He has 
been one of the leaders in this effort

[[Page S13077]]

because he believes, I think, as I do, that we cannot amend it, so we 
need to end it. We need to cut out this revolving credit account that 
is being used for inappropriate purposes known as TARP, the Troubled 
Asset Relief Program.
  Let's go back and look at why TARP was authorized by Congress in 
October of 2008. It is important to remember what the situation was at 
that time. Treasury Secretary Henry Paulson and Federal Reserve 
Chairman Ben Bernanke had many conversations with legislators on both 
ends of the Capitol on both sides of the aisle, and they said in their 
public testimony--on September 23, Secretary Paulson said that Congress 
must act ``in order to avoid a continuing series of financial 
institution failures and frozen credit markets that threaten . . . the 
very health of our economy.''
  In private, their diagnosis was even more dire. We were told ``that 
we're literally maybe days away from a complete [financial] meltdown of 
our financial system'' in the United States unless Congress acts to 
authorize the Troubled Asset Relief Program.
  Many of us, including myself, voted for TARP because we were told by 
the smartest people on the planet that unless we did this, our economy 
would suffer an economic meltdown. But I must tell you, I am extremely 
disappointed that the very nature of the program was changed after 
Congress authorized it. For example, we were told by Secretary Paulson 
and others that the money would be used for one purpose, and one 
purpose only; that is, to purchase toxic assets.
  Well, there is a saying that says: ``Fool me once, shame on you. Fool 
me twice, shame on me.'' And we were fooled into believing that the 
TARP would be used to purchase these toxic assets and get them off the 
books as a way of protecting pensions, savings, and investments of 
hard-working American taxpayers.
  Unfortunately, the very people who promised us and told us what 
purpose the TARP would be used for misled us because two 
administrations now--the previous administration and this 
administration--have used TARP as if it were a big government slush 
fund. They ignored the clear language of the TARP legislation, and they 
have repeatedly defied the will of Congress.
  Let me briefly mention how the TARP funds have been used in a way 
that Congress never authorized and never intended.
  Only weeks after TARP was enacted, the Bush administration abandoned 
this stated goal of purchasing toxic assets. Instead, the 
administration funneled billions of dollars directly into some of the 
Nation's largest financial institutions, making huge purchases of stock 
and warrants of some of the Nation's largest financial institutions.
  The Federal Government, in other words, began acquiring ownership, 
stakes in banks, financial institutions, and, yes, even car 
manufacturers, with the full support of the Obama administration. In 
fact, the Obama administration has even gone so far as to use TARP to 
set executive pay at several companies. During the reorganization of 
General Motors, the Obama administration has used that leverage to 
benefit its union allies over the rights of secured bondholders who had 
loaned their money to these companies. I have been a vocal opponent of 
this misuse of TARP by both administrations.
  In December 2008, I joined my colleagues in voting against the 
government bailout of the auto industry, a vote ignored by both the 
previous administration and the current administration.
  Earlier this year, I supported a TARP disapproval resolution that 
would have stopped the program dead in its tracks because of this 
misrepresentation of the purpose for which these funds would be used. I 
have also supported several initiatives that would have increased TARP 
transparency and congressional oversight.
  Then, in September, I joined many of our colleagues in sending a 
letter to Secretary Tim Geithner, at Treasury, asking him not to extend 
his TARP authority beyond the end of this year, as the law allows him 
to do. This would have eliminated the need for the government to borrow 
more money through this program. But, unfortunately, Secretary Geithner 
notified Congress that he has extended TARP authority until next 
October.
  Now we read that the administration is proposing using repaid TARP 
funds; that is, money that was loaned to these large financial 
institutions that is now being repaid--that Treasury anticipates using 
this for a second stimulus plan. Well, I guess that is because they 
think the first stimulus plan worked so well.
  You will recall, the stated objective was to hold unemployment below 
8 percent. Well, it has gone above 10 percent and, frankly, I think we 
need to learn from our mistakes as well as things we have done right. 
It would be a mistake to put more money, particularly TARP money, into 
a new stimulus plan and have it work so ineffectively, as the first 
stimulus plan did.
  Repaid TARP dollars cannot pay for anything. TARP is like a credit 
card. Every dollar spent is a borrowed dollar, adding up additional 
deficits, additional debt. Using TARP on new spending would break the 
promise the President made when he voted for TARP in this very Chamber. 
At that time, then-Senator Obama said:

       [I]f American taxpayers are financing this solution, then 
     they have to be treated like investors. They should get every 
     penny of their tax dollars back once the economy recovers.

  That was then-Senator Obama, now President of the United States.
  I would just conclude by saying, Congress should help the President 
keep his promises, even when it seems he has changed his mind now, by 
suggesting that we extend TARP and use TARP on a purpose that Congress 
has never authorized and never intended.
  It seems like the bad ideas never end when it comes to spending and 
debt out of Washington, DC, these days. In addition to all of these 
other problems I have mentioned, I have not talked about this health 
care bill, which would exacerbate and make much worse the deficits and 
debt situation, and not make it better--all the time while not bending 
the cost curve down but making things worse, raising premiums, raising 
taxes, cutting Medicare.
  We need to end TARP because, frankly, it is being misused in ways 
that Congress has never authorized and never intended and, indeed, over 
the very objections of Congress. We need to learn from our mistakes. 
Frankly, the stimulus spending, which I voted against because I thought 
it was based on an academic theory which had not been proven, which was 
that Congress knew better than the American people how to get the 
economy working again--by direct spending, by spending borrowed money, 
the $1.1 trillion in the stimulus plan--we need to end these free-
spending ways and show some fiscal responsibility. The best way we 
could do that, in my opinion, would be to end this program which has 
been the subject of so much abuse and misuse.
  I ask unanimous consent that the following letter, dated January 15, 
2009, from then-Director-Designate of the National Economic Council, 
Lawrence H. Summers, be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                            The Office of the President Elect,

                                 Washington, DC, January 15, 2009.
     Hon. Nancy Pelosi,
     Speaker,
     House of Representatives.
     Hon. John Boehner,
     Republican Leader,
     House of Representatives.
     Hon. Harry Reid,
     Majority Leader,
     U.S. Senate.
     Hon. Mitch McConnell,
     Republican Leader,
     U.S. Senate.
       Dear Madam Speaker, Leader Boehner, Leader Reid and Leader 
     McConnell: Thank you for the extraordinary efforts you have 
     made this week to work with President-Elect Obama in 
     implementing the Emergency Economic Stabilization Act of 
     2008. In addition to the commitments I made in my letter of 
     January 12, 2009, the President-Elect asked me to respond to 
     a number of valuable recommendations made by members of the 
     House and Senate as well as the Congressional Oversight 
     Panel. We completely agree that this program must promote the 
     stability of the financial system and increase lending, 
     preserve home ownership, promote jobs and economic recovery, 
     safeguard taxpayer interests, and have the maximum degree of 
     accountability and transparency possible.
       As part of that approach, no substantial new investments 
     will be made under this program unless President elect Obama 
     has reviewed the recommendation and agreed

[[Page S13078]]

     that it should proceed. If the President elect concludes that 
     a substantial new commitment of funds is necessary to 
     forestall a serious economic dislocation, he will certify 
     that decision to Congress before any final action is taken.
       As the Obama Administration carries out the Emergency 
     Economic Stabilization Act, our actions will reflect the 
     Act's original purpose of preventing systemic consequences in 
     the financial and housing markets. The incoming Obama 
     Administration has no intention of using any funds to 
     implement an industrial policy.
       The Obama Administration will commit substantial resources 
     of $50-100B to a sweeping effort to address the foreclosure 
     crisis. We will implement smart, aggressive policies to 
     reduce the number of preventable foreclosures by helping to 
     reduce mortgage payments for economically stressed but 
     responsible homeowners, while also reforming our bankruptcy 
     laws and strengthening existing housing initiatives like Hope 
     for Homeowners. Banks receiving support under the Emergency 
     Economic Stabilization Act will be required to implement 
     mortgage foreclosure mitigation programs. In addition to this 
     action, the Federal Reserve has announced a $500B program of 
     support, which is already having a significant beneficial 
     impact in reducing the cost of new conforming mortgages. 
     Together these efforts will constitute a major effort to 
     address this critical problem.
       In addition to these commitments, I would like to summarize 
     some of the additional reforms we will be implementing.
       1. Provide a Clear and Transparent Explanation for 
     Investments:
       For each investment, the Treasury will make public the 
     amount of assistance provided, the value of the investment, 
     the quantity and strike price of warrants received, and the 
     schedule of required payments to the government.
       For each investment, the Treasury will report on the terms 
     or pricing of that investment compared to recent market 
     transactions.
       The above information will be posted as quickly as possible 
     on the Treasury's website so that the American people readily 
     can monitor the status of each investment.
       2. Measure, Monitor and Track the Impact on Lending:
       As a condition of federal assistance, healthy banks without 
     major capital shortfalls will increase lending above baseline
     levels.
       The Treasury will require detailed and timely information 
     from recipients of government investments on their lending 
     patterns broken down by category. Public companies will 
     report this information quarterly in conjunction with the 
     release of their 10Q reports.
       The Treasury will report quarterly on overall lending 
     activity and on the terms and availability of credit in the 
     economy.
       3. Impose Clear Conditions on Firms Receiving Government 
     Support:
       Require that executive compensation above a specified 
     threshold amount be paid in restricted stock or similar form 
     that cannot be liquidated or sold until the government has 
     been repaid.
       Prevent shareholders from being unduly rewarded at taxpayer 
     expense. Payment of dividends by firms receiving support must 
     be approved by their primary federal regulator. For firms 
     receiving exceptional assistance, quarterly dividend payments 
     will be restricted to $0.01 until the government has been 
     repaid.
       Preclude use of government funds to purchase healthy firms 
     rather than to boost lending.
       Ensure terms of investments are appropriately designed to 
     promote early repayment and to encourage private capital to 
     replace public investments as soon as economic conditions 
     permit. Public assistance to the financial system will be 
     temporary, not permanent.
       4. Focus Support on Increasing the Flow of Credit:
       The President will certify to Congress that any substantial 
     new initiative under this program will contribute to 
     forestalling a significant economic dislocation.
       Implement a sweeping foreclosure mitigation plan for 
     responsible families including helping to reduce mortgage 
     payment for economically stressed but responsible homeowners, 
     reforming our bankruptcy laws, and strengthening existing 
     housing initiatives like Hope for Homeowners.
       Undertake special efforts to restart lending to the small 
     businesses responsible for over two-thirds of recent job 
     creation.
       Ensure the soundness of community banks throughout the 
     country.
       Limit assistance under the EESA to financial institutions 
     eligible under that Act. Firms in the auto industry, which 
     were provided assistance under the EESA, will only receive 
     additional assistance in the context of a comprehensive 
     restructuring designed to achieve long-term viability.
       The incoming Obama Administration is committed to these 
     undertakings. With these safeguards, it should be possible to 
     improve the effectiveness of our financial stabilization 
     efforts. As I stressed in my letter the other day, we must 
     act with urgency to stabilize and repair the financial system 
     and maintain the flow of credit to families and businesses to 
     restore economic growth. While progress will take time, we 
     are confident that, working closely with the Congress, we can 
     secure America's future.
           Sincerely,

                                          Lawrence H. Summers,

                                               Director-Designate,
                                        National Economic Council.

  The PRESIDING OFFICER. The Senator from Florida.
  Mr. NELSON of Florida. Madam President, I ask unanimous consent to 
speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. NELSON of Florida. Madam President, we have in front of us 
appropriations bills. We have heavy matters of the deficit. We have 
heavy matters of how we are going to get the U.S. Government to get its 
fiscal house in order.
  I remind the Senate the last time we had a surplus was in 2001. If we 
had been wise and had not cut the revenue of this country so 
significantly, we could have been good stewards of that healthy surplus 
and we could have paid off the national debt over a 12-year period, and 
we wouldn't be where we are today, but we are. While these matters are 
weighing heavily on us, it seems our attention is being continuously 
diverted to other things, such as White House party crashers and the 
unfortunate circumstance that one of the most famous athletes, Tiger 
Woods, finds himself in.
  We have a debate about the health care bill and it seems that during 
the course of last summer, the whole health care debate was about one 
subject and that was the question of the public option. We now know, 
because all the experts are telling us, that if we have a public option 
as a part of this health insurance exchange, the exchange itself will 
only cover something like 15 to 20 percent max of the people, and the 
public option would only include something like 4 million or 5 million 
people, and that we are talking about 1.5 percent of the total folks in 
the country. Yet the debate raged all summer as if that were the only 
issue about health reform.
  So here we find ourselves trying to pass a health reform bill with so 
much attention diverted elsewhere, with people pushing and pulling and 
tugging--all the special interests--how in the world can we bring this 
together? How do we bring it together so we can get the high threshold 
of 60 votes in the Senate?
  On the one hand, there are the insurance companies. The insurance 
companies have a huge stake. Now the insurance companies are running TV 
advertisements all over the country trying to kill this bill because 
they realize there is going to be a limitation on their ability to do 
everything they want to do and to charge what they want to charge and 
to cancel at will, and to have frivolous reasons such as a skin rash as 
a preexisting condition and therefore we are not going to insure you. 
That is what has led to us getting to the point of saying, ``Enough. We 
are going to pass a health insurance reform bill.''
  Then, of course, what comes to light is suddenly, in this package 
that was not in the package that came out of the Senate Finance 
Committee but is in this package, there is actually a nod to the 
insurance industry in the form of a limitation on the amount of 
payments that could be made on anyone's insurance policy in one year. 
Well, again, there is a lot of opportunity for mischief and abuse. We 
have to correct things such as that.
  Is there anyone who doubts that we don't need health insurance reform 
and health care reform, even though we are getting the opposite 
messages from the insurance companies; that we are getting the opposite 
messages from anybody who is a special interest that doesn't get 
entirely what they want? What are some of those? Hospitals, doctors, 
all kinds of health providers, medical device manufacturers, and the 
various interests of patients. But if you look at it, you can't get all 
that you want, Mr. Special Interest, and instead, keep in mind the goal 
we are trying to achieve, and that is take a system that is near tilt 
and get it on the road to reform.
  There is another part of this reform we have to do and that is that 
the U.S. Government cannot afford the cost escalation that is going on 
in its payment of Medicare and Medicaid. So there are reforms we can 
enact, many of which are in this bill, such as accountable care 
organizations that will follow the patient; electronic records

[[Page S13079]]

that will modernize records so that any doctor or health care provider 
who sees the patient will have up-to-date access to what has been the 
care so that records are not lost; emphasis on a primary care physician 
who can do a lot of preventive care before the emergency ever gets 
there; then, of course, utilizing a lot of the miracles of modern 
medicine including pharmaceuticals to hold off conditions so that we 
don't get to that emergency; so that if you are not insured you end up 
at the emergency room, or even if you are insured you end up at the 
emergency room, which is the most expensive place to get care.
  Is there a lot we can do? Yes. It is what we must do. With the hurdle 
in this Senate being so high that we have to get 60 votes to close off 
debate, we have to be successful. It will not be pretty and it will not 
be perfect, but it will be a step in the right direction.
  There are portions of this proposed law that will take effect not 
immediately but a year or two or three down the road, and if we have 
made mistakes, we can correct those mistakes, but we must be 
successful. For us to turn back now, no matter who is arguing against 
it, for us to protect a special interest, no matter who is arguing for 
it, at the expense of the greater good of health care reform, would be 
a drastic mistake. Not one of us will be happy going home to our 
families for Christmas if we don't enact this. It is for those reasons 
that I feel very strongly we will be successful, as difficult and as 
tortuous as this process is. This Senator will keep pressing forward 
until we get that final passage.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. GRASSLEY. Madam President, I understand that maybe I will have my 
speech interrupted by a unanimous consent request from the leadership, 
so if that happens, I ask that my remarks be continuous throughout the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRASSLEY. There has been a lot of talk over the past few days 
about Senator Reid's so-called compromise. Although he said he has 
broad agreement, I have yet to see any specific details. In fact, it 
sounds as though Members of his very own caucus, the Democratic caucus, 
aren't aware of these details either.
  I find it quite hard to understand how there can be ``broad 
agreement'' on something when they don't know what is in it. Of course, 
I hope we will see details very soon. An issue such as health care 
reform affecting 306 million Americans and restructuring one-sixth of 
our economy is something that should not be done in secret. And when 
the so-called compromises come out, I would expect we would have the 
same 72 hours on the Internet for the public and the 99 Members of this 
body other than the leader to review them in the totally transparent 
way we have always been promised, and as this 2,074-page bill has been 
transparent, as well as all of the amendments. Because this is one of 
the biggest and most important pieces of legislation I have worked on 
in all of my years in the Congress. So I hope Senator Reid is not 
planning to keep the details of his compromise under wraps and then ask 
us to vote on it. This piece of legislation is going to touch the lives 
of every single American, from the cradle to the grave, so we owe it to 
our constituents to make sure we have sufficient time to study any 
changes to the underlying bill. We all need to remember that it is 
their money, the taxpayers' money, that is being spent on this bill, 
not ours.
  As I have said, so far, Senator Reid is keeping this ``broad 
agreement'' under wraps. So today I can only talk about what I have 
heard from my colleagues or read in the newspaper, and who knows 
whether what the newspaper or our colleagues are surmising what this 
compromise might be actually is.
  I have heard the majority leader is planning to expand the already 
unsustainable Medicare Program. The idea has been met with, of course, 
strong opposition, as we would expect from hospitals, doctors, and 
other health care providers, particularly from rural America, because 
expanding Medicare to people ages 55 to 64 and paying Medicare rates is 
going to make it even more difficult for our hospitals to survive 
because the Federal Government only reimburses 80 percent of costs.
  Today, with people over 65, with the government not paying more than 
80 percent, it can be offset by private sector charges by the hospitals 
to a greater amount to make it up. But if you load another tens of 
millions of people on Medicare--and it is just about broke anyway--you 
can see that this deficit of our hospitals is going to be greater and 
it is going to be even more difficult to make up because there will be 
fewer private-paying people to make up the deficit.
  I said the hospital, doctors, and health care providers are bringing 
strong opposition to this idea of expanding the Medicare Program 
because they fear that the largest expansion of Medicaid in history and 
an expansion of Medicare to people age 55 to 64 will drive providers 
out of business. And then what, of course, does that do for our 
seniors? It makes it even harder for low-income Americans under 
Medicaid and seniors under Medicare to have access to care. What are 
the promises of the Federal Government in Medicare worth if you don't 
have doctors to provide the services to the seniors when they get sick?
  I have already spoken over the last few days about why I agree with 
these providers and why I oppose that part of Senator Reid's so-called 
compromise. Of course, now we have the administration's own Chief 
Actuary confirming that the Medicare cuts already in this bill--in 
other words, the 2,074-page bill, without even considering the so-
called Reid compromise, which we don't know what it is--the Chief 
Actuary confirmed that the Medicare cuts already in the bill are so 
severe that providers might, even now, end their participation in the 
program, even before you add on all the people who are 55 to 64. If the 
compromise expands Medicare even further, then this is going to make 
this problem even worse.
  I also find it curious that some would even consider this a 
compromise. For instance, Speaker Pelosi could not convince House 
Democrats to support a government-run plan paying Medicare rates, but 
that is exactly what Senator Reid's compromise is proposing, I have 
been told. That doesn't sound like much of a compromise to me.
  In fact, let me quote another Congressman, Anthony Weiner of New 
York, who doesn't see it as a compromise either. In fact, he sees it as 
a big step toward their ultimate goal of a single-payer health plan 
where government is going to run everything. And you will have one 
choice: the government plan. You won't have choices the way we have in 
America today.
  Congressman Weiner said this:

       This exchange would perhaps get us on the path to a single-
     payer model.

  I don't see this as a compromise to a government-run plan. In fact, 
in some ways, it is worse because this could harm seniors' access to 
care starting not down the road but on day one.
  I don't want to spend too much time today talking about Medicare 
expansion. I think I have made my feelings on this idea pretty clear. 
Instead, I would like to focus on another aspect of the supposed new 
Reid compromise we are hearing about.
  This is what we are hearing about--that the newest Reid proposal 
would have the Office of Personnel Management operate a national health 
insurance plan. This may sound pretty harmless at first glance, 
especially since Senator Reid has refused to release any details, but 
there are some very big problems with a proposal like having the Office 
of Personnel Management take over.
  Around here, we use the term ``OPM'' for the Office of Personnel 
Management. It is the office in charge of the Federal Government's 2 
million-person workforce. One could consider OPM as the human resource 
agency or department for all of the Federal Government, dealing with 
everything from salaries to the operation of the Federal Employees 
Health Benefits Program, which I think is the reason Senator Reid 
thinks this agency would be well equipped to run the largest insurance 
company in the country.
  Unfortunately, a former Director of OPM disagrees. He was asked about 
giving new responsibilities to the Office of Personnel Management. This 
former Director, Linda Springer, said this:

       I flatout think that OPM doesn't have the capacity to do 
     this type of role.


[[Page S13080]]


  Federal employees have also expressed concern. People in this body--
particularly the other party--ought to be listening to the National 
Treasury Employees Union or the National Active and Retired Federal 
Employees Association. They have come out in opposition to this 
proposal of OPM running a national health insurance company.
  In a Washington Post story highlighting union opposition, the author 
writes that unions raise these concerns:

       . . . legitimate concerns about expanding the size and 
     scope of OPM beyond its capacity.

  So there are already concerns from a former Director and more than 5 
million Federal workers and retirees and dependents that OPM is not 
equipped to handle this new responsibility. That alone should make any 
Member pause before signing on to this so-called broad agreement.
  I also think it is important that Members are aware of some of the 
challenges the Office of Personnel Management faces with its current 
responsibility, without loading it down with a lot more, because being 
the human resources department for the Federal Government is, 
obviously, no easy task. In fact, I would imagine it is a pretty 
thankless job that entails a lot of long hours.
  Please don't misconstrue my comments as an attack on OPM, its 
Director, or any of its employees. They do the best job they can under 
difficult circumstances. But they are going to have real problems if 
Senator Reid's compromise does include a government-run insurance plan 
operated by OPM. If he is going to come out of nowhere with a new 
proposal to hastily hand the American health insurance system over to 
this government agency, I think it is important for the American people 
to know what they are getting into.
  We need to be asking some hard questions. Is this expansion of the 
Federal Government necessary? We are about to vote to raise the debt 
ceiling by $1.8 trillion because the national credit card has maxed 
out. Some Members of the Senate seem intent upon increasing the size of 
the Federal Government even more.
  There is a second question beyond the generic one of, can you afford 
to expand the Federal Government role and expenditures. It is, should 
the OPM, a government agency, be handed the key to the largest health 
insurance plan in the entire country? I don't know that the current OPM 
Director--and I would imagine he is a very nice person, and since I 
don't know him, I don't want him to take offense to what I say. But I 
think it is fair to point out that his position, just prior to taking 
over at OPM, was running the National Zoo. Does this really mean we 
should put him in charge of the national health insurance plan?
  The Office of Personnel Management has been consistently criticized 
for being out of date and being inefficient on everything from 
processing national security projects to administering Federal 
benefits. We have all heard about the massive backlog in people waiting 
for Social Security disability benefits. Some 833,000 Americans are 
currently on a waiting list to see if they qualify for government 
disability benefits, and some Members blame OPM for this backlog.
  I am going to put a chart up here from a person whom I trust in the 
House of Representatives, Representative Earl Pomeroy. I think he does 
very excellent work. He heard about this backlog. He made some comments 
about OPM. Congressman Pomeroy is a Democrat from North Dakota and a 
member of the very powerful House Ways and Means Committee. He said:

       The Office of Personnel Management is fiddling around, 
     years go by before they can even get around to all the things 
     they have to get around to. . . .

  This seems to reinforce what the government unions and the former 
Director have expressed about OPM's ability to handle this new 
responsibility.
  I want to continue to quote Congressman Pomeroy:

       People are being hurt, some of the most vulnerable people 
     in this country are being hurt every day because of 
     bureaucratic bungling at OPM. . . .

  Senator Reid hasn't provided enough details, but Congressman 
Pomeroy's comments certainly raise concerns.
  Undermining the availability of disability benefits is bad enough, 
but do my colleagues want to also be responsible for setting up an 
unworkable system that leaves hundreds of thousands of Americans on the 
waiting list for their health care benefits?
  Government agencies, whether it is the Office of Personnel Management 
or some other agency, do not have an impeccable track record. As 
President Reagan often said, the nine most terrifying words in the 
English language are ``I'm from the government and I'm here to help.'' 
Think of a health care system with the responsiveness of Hurricane 
Katrina or think of the efficiency of the Internal Revenue Service or 
the customer service at the department of motor vehicles. That doesn't 
sound like a recipe for real health reform to me.
  The OPM has also taken considerable criticism for its handling of 
retiree benefits. The agency's own 2008 financial report stated:

       [The Office of Personnel Management] had increased 
     difficulty keeping up with retirement claims and had a 
     decrease in the number of customers satisfied with their 
     services.

  That is coming directly from the agency, saying how it is coming up 
short responding to the needs of the American people, and particularly 
government employees, and that is before we are talking about adding a 
new government health insurance program to the responsibilities of OPM.
  The Hill newspaper wrote this last week:

       Watchdogs maintain the program is riddled with 
     inefficiencies that ultimately cost both the agency and the 
     Federal Government money.

  So I think there are legitimate concerns about whether this Federal 
agency is even equipped to take on the additional responsibilities of a 
whole new government countrywide program that is obviously a massive 
undertaking.
  I also wonder why this proposal is even necessary. The bill already 
sets up government-run exchanges that would offer a choice of competing 
for-profit or not-for-profit plans. My colleagues on the other side of 
the aisle have compared this system to the Federal Employees Health 
Benefits Program. This bill already has provisions that encourage 
national health plans. This leads me to ask the question: Why does this 
bill need another layer of bureaucracy to create a national plan run by 
a government agency?
  Some have suggested this is just another backdoor attempt to end up 
with a government-run plan. Another detail that has been reported 
supports this claim. We have been told that if not enough not-for-
profit plans agree to contract with the Office of Personnel Management 
or if they do not meet certain affordability standards, the Office of 
Personnel Management will have the authority to establish its own 
government-run plan.
  With some of the other provisions that are in this bill, this trigger 
approach seems to be rigged. There are at least two reasons why this is 
the case. First, the bill undermines any ability to avoid the first 
government plan trigger to make health coverage more affordable. The 
bill puts in place a bunch of new regulatory reforms, a bunch of fees, 
and a lot of taxes that will drive up premiums, making it impossible 
for health plans to meet new affordability requirements.
  Again, you are going to say you question this Senator's judgment 
saying that. Do not take my word for it. The nonpartisan Congressional 
Budget Office, a group of professionals who do not care about politics, 
predicts premiums will be 10 to 13 percent more expensive as a result 
of this bill.
  Then, of course, we have the second government plan trigger which 
gives the Office of Personnel Management the authority to create a 
government-run plan if not enough not-for-profit national plans 
contract with OPM.
  Senator Reid failed to mention in announcing his broad agreement that 
there is not one national plan in existence today, for-profit or not-
for-profit--not one national plan--that is offered in all 50 States. It 
does not exist.
  Once again, it sounds to me like this so-called trigger is being 
rigged to shoot. I can only assume this backdoor attempt to shoehorn in 
a government-run plan at the last minute happens to be an act of 
desperation. Senator Reid and his colleagues have seen the facts. You 
have heard them from our distinguished Republican leader. According

[[Page S13081]]

to a CNN poll from December 2 and 3, 61 percent of Americans oppose 
this 2,074-page bill. At a time when the Democratic leadership is 
pushing a $1.8 trillion increase in the debt limit, we learn from the 
White House's own Actuary that this $2.5 trillion bill, this 2,074-page 
bill bends the cost curve up by increasing health care spending. If you 
go back to day one of this year, when we first started talking about 
health care reform, one of the overriding goals was to bend that cost 
curve down. After 11 months of activity, we have a bill with that cost 
curve going up--not one of the major goals we set out to do 11 months 
ago.
  This bill is also under pressure from opposition by the National 
Federation of Independent Business, speaking for the small businesses 
of America, the ones that do 70 percent of the net hiring. It is also 
opposed by the National Association of Manufacturers, the Chamber of 
Commerce, the National Retail Federation, and almost every other 
business group across the country.
  Because of this last-minute, desperate attempt to appease the far 
left, this rumored new compromise now is being opposed by hospitals, 
doctors, and other health care providers. These people were on board 
through most of these 11 months promising their support, and now they 
see it going in the wrong direction.
  With all those factors, I do not see how anyone, let alone 60 
Senators, can vote for this bill, this last-minute, desperate attempt 
to expand Medicare and hand over private health insurance systems over 
to a Federal agency, the Office of Personnel Management. This step, if 
it materializes, has made a bad bill even worse.
  I have another part of the bill to which I wish to speak. We have 
this 2,074-page bill before us, and I wish to refer to just a few words 
on page 2,034, way at the tail end of the bill, in section 9012 of the 
Reid bill. It only takes up eight lines, but it could have a major 
impact on millions of retirees and even on the entire U.S. economy.
  Listen to this. The AFL-CIO, the Americans Benefits Council, and the 
Business Roundtable have all joined in opposition to this provision, 
section 9012. How often do we have the AFL-CIO, the American Benefits 
Council, and the Business Roundtable--that roundtable is the big 
corporations in America--joining in opposition to anything? But they 
are in opposition to section 9012 of the bill.
  This would prohibit businesses from fully deducting a subsidy they 
receive to maintain retiree drug coverage. The Medicare Modernization 
Act of 2003 created this subsidy to encourage businesses to keep 
offering retiree drug coverage once the Part D benefit was established 
because back in 2003, our goal in passing the prescription drug bill 
for seniors was not to disturb people who already had drug coverage and 
they liked what they had and they wanted to keep it. We did not want 
these big corporations dumping these people off into something with 
which they were unfamiliar. So we helped to encourage companies and 
save the taxpayers money. I will refer to those specific dollar figures 
in a minute.
  In Federal tax policy, it is very unusual to provide a deduction for 
a business expense, such as retiree health costs, if that expense is 
subsidized by a Federal program. But in this case, the conferees 
decided to provide this unusual tax treatment for compelling health 
policy purposes, some to which I have already referred.
  If people are satisfied with what they have, we should not pass a 
bill pushing people out of a plan they like. But it was also to save 
taxpayers' dollars because the rationale was, it was cheaper to pay a 
$600 subsidy than to have these people forced out of their corporate 
plan and then to have the taxpayers pay an average of $1,100 that it 
will cost if the retiree joined the Part D government plan.
  You know what. After 6 years, so far it has worked. Millions of 
seniors have been able to keep their retiree coverage as a result of 
this subsidy, and the Part D Program continues to come in under budget 
and also to receive high marks from our senior citizens.
  But the provision tucked away in this 2,074-page bill on page 2034 
could change all that and, in fact, have severe consequences and, let 
me say, unintended consequences not just on those retirees but for the 
entire U.S. economy.
  In an effort to pay for this massive expansion of a government-run 
health plan, the Reid bill proposes to eliminate the tax deductibility 
of this provision. This could cause employers all across the country to 
drop retiree coverage. This will not only break the President's promise 
by preventing millions of seniors from keeping what they have--remember 
that promise during the campaign--it will also cause the costs of the 
Part D Program to go up.
  In addition, accounting rules for retiree benefits require that the 
businesses that do keep offering plans, offering these benefits, will 
have to report the total revised cost on the day the bill becomes law.
  We have an op-ed written in the Wall Street Journal about this point. 
This could cause businesses to post billions of dollars in losses and 
significantly impact an already struggling economy.
  Is this something we want to do when we still have 10-percent 
unemployment? I think the majority ought to give second thought to 
that.

  A letter sent on December 11 from the chief financial officers of 
some of the largest employers in the country stated:

       The impact of the proposed Medicare Part D changes would be 
     felt throughout the overall U.S. economy as corporate 
     entities and investors would be forced to react.

  Another letter signed by the AFL-CIO stated this provision would 
``unnecessarily destabilize employer-sponsored benefits for millions of 
retirees.''
  Once again, how often do we get these large corporations and the AFL-
CIO singing off the same song sheet?
  This simple provision tucked away on page 2034 is just one more in a 
long list of policies that could have serious unintended consequences 
for American businesses and retirees.
  At this point, it appears the majority is so determined to get a bill 
at any cost that they will put in place bad policies and promises to 
somehow clean up the mess later on. That is not the way to write 
legislation. That is not what the American people were hoping for when 
they were told Congress was going to fix the health care system. This 
provision is just one more reason we need to scrap this product and go 
back to the drawing board.
  In finishing, I will say what I have probably said two or three times 
before. We are trying to fix the health care system, health care 
reform. The word ``reform'' implies all of that. If you were having a 
coffee klatch in rural New York or rural Iowa this very morning and one 
of us Senators dropped in on it and they started asking us about a bill 
because they were already talking about health care reform and any one 
of us told them it would increase taxes, it would increase health 
insurance premiums, that it would not do anything about decreasing 
inflation of health care--in other words, costs are going to go up 
yet--and we are going to take $464 billion out of Medicare, a program 
that is already in distress, to set up a whole new government program, 
you know what. Every one of those people around the table would say: 
That doesn't sound like health care reform to me. Let's not denigrate 
the word ``reform.''
  I ask unanimous consent to have printed in the Record a letter from 
the AFL-CIO.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                 November 2, 2009.
     Re Retiree health coverage

     Hon. Nancy Pelosi,
     Speaker, House of Representatives,
     Washington, DC.
       Dear Madam Speaker: We are writing to express our serious 
     concerns regarding two provisions included in H.R. 3200, The 
     Affordable Health Care for America Act, and urge that they 
     not be included in legislation approved by Congress. Section 
     110 would curtail the ability to change retiree health 
     coverage and Section 534 would change the tax treatment of 
     subsidies provided to employers who provide retiree drug 
     coverage. Both provisions would likely have the unintended 
     effect of discouraging the provision of employer-sponsored 
     retiree health coverage, thereby undermining one of the goals 
     of health reform legislation and placing the cost and burden 
     of providing this vital coverage onto the federal government.


                              Section 110

       Retiree health coverage has long been the subject of 
     collective bargaining and is an important part of the overall 
     package of benefits and compensation negotiated between

[[Page S13082]]

     labor and management. By severely restricting the ability to 
     modify retiree health coverage this provision limits the 
     flexibility that parties have during negotiations. In some 
     situations, existing labor agreements already contain cost 
     sharing arrangements that would be unilaterally overridden by 
     this provision.
       This restriction could unintentionally result in employers 
     dropping sponsorship of retiree health coverage altogether to 
     avoid future restrictions. Rising health costs and financial 
     accounting rules have resulted in a steady erosion of 
     employer-sponsored retiree coverage; and no doubt this 
     decline is the motivation for this provision. It would be 
     disastrous for millions of Americans still covered by retiree 
     health plans to see those plans severely limited or 
     eliminated altogether as employers seek to avoid being locked 
     into a particular benefit in perpetuity.


                              Section 534

       This provision of the bill would cease the current tax 
     excludability of the 28% subsidy provided to employers who 
     continue to provide prescription drug coverage to their 
     retirees. The $3 billion in federal tax revenue estimated to 
     be raised from this provision is highly unlikely to be 
     realized. The current tax treatment was included in the 
     Medicare Modernization Act of 2003 precisely to encourage 
     employers to continue sponsoring drug coverage--not only 
     helping to preserve this important benefit, but also 
     resulting in savings to the federal government by avoiding 
     the necessity of many retirees to obtain Medicare Part D 
     coverage. If only the tax revenue to be collected is 
     calculated, but not also the federal outlays to provide the 
     comparable benefit, then the actual cost to the government is 
     not being accurately considered.
       Moreover, Congress must consider the impact of this 
     provision in the context of a
     reformed health system, as opposed to the current system. 
     Other features of H.R. 3200, including the aforementioned 
     limits on the ability to modify retiree health coverage, 
     could well lead to an unintended and precipitous decline in 
     some of the most comprehensive health coverage protection for 
     retirees available today.
       Finally, Congress has not considered at all the negative 
     impact, required under Financial Accounting Standard 106, on 
     the financial statements of companies that currently provide 
     retiree health coverage. Regardless of the ultimate effective 
     dates of Sections 110 and 534, accounting rules dictate that 
     immediately upon being signed into law, these provisions 
     would substantially increase the FAS 106 liability for the 
     very companies providing the most comprehensive coverage to 
     current and future retirees. In the current economic 
     environment, this would be particularly ill-advised and 
     disruptive.
       Health care reform must be about stabilizing and expanding 
     the employer-sponsored health benefits system. These two 
     provisions would unnecessarily destabilize employer sponsored 
     benefits for millions of retirees at a time of unprecedented 
     changes in health coverage. Whatever differences the 
     undersigned organizations may have on other aspects of 
     pending health care reform legislation, on these two matters 
     both labor and management are in full agreement. We 
     respectfully urge that both these provisions be deleted from 
     the legislation under consideration.
           Sincerely,
     Diann Howland,
       Vice President, Legislative Affairs, American Benefits 
     Council.
     William Samuel,
       Director, Department of Legislation, AFL-CIO.

  Mr. GRASSLEY. I yield the floor.
  The PRESIDING OFFICER (Mr. Begich). The Republican leader is 
recognized.
  Mr. McCONNELL. Mr. President, we had indicated to Senators Reid and 
Durbin that we wanted to see if there was a way to develop some path 
forward on the health care bill, and I wish to at this point propound a 
consent agreement that might well give us a way to move forward on some 
of the amendments that have been pending for quite some time, some of 
which are both supported and opposed on each side.
  Having said that, I ask unanimous consent that after the vote on the 
adoption of the pending conference report, the Senate resume 
consideration of H.R. 3590 under the following order; there be 2 hours 
of debate equally divided between the two leaders or their designees 
and following the use or yielding back of that time, the Senate proceed 
to a series of stacked votes in relation to the following amendments or 
motions; a Baucus sense-of-the-Senate amendment related to taxes, the 
pending Crapo motion--which I might add parenthetically has been out 
there since last Tuesday--the Crapo motion to commit the bill related 
to taxes, then the Dorgan amendment, which is on the drug importation 
issue, No. 2793, and then a McCain amendment, No. 3200, on the same 
subject.
  I further ask unanimous consent that the above referenced motion and 
amendments be subject to an affirmative 60-vote threshold, and if they 
achieve that threshold, they become agreed to; further, if they do not 
achieve that threshold, they be withdrawn; finally, I ask that no 
amendments be in order to any of the mentioned amendments and motion.
  Before the Chair rules, I wish to make a quick point. The majority 
leader has been proposing a series of votes, which regretfully has not 
held to our pattern of alternating back and forth. We have many people 
interested in the pending amendments, and under the agreement I put 
forward, each side would get two votes, as we have tried to operate 
throughout the health care debate, and then we would move forward.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Illinois.
  Mr. DURBIN. Mr. President, reserving the right to object, I ask 
unanimous consent to engage in a colloquy with the minority leader. 
Perhaps there will be a better understanding of his unanimous consent 
request before I make my final decision.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. I wish to ask, as I understand it now, when it comes to--
and let's set aside Crapo-Baucus and assume there is commonality in 
that. As I understand it now, the Dorgan amendment, which would allow 
for the importation of pharmaceuticals and drugs into the United 
States, has been offered on our side as well as a Lautenberg amendment, 
which has some history in the Senate. It was previously offered by 
Senator Cochran of Mississippi and establishes a standard for 
certification of safety of the drugs coming in.
  Could the Senator from Kentucky describe to me what the new McCain 
amendment No. 3200 does?
  Mr. McCONNELL. Well, fortunately, Senator McCain is on the floor at 
this time, and I will ask him to describe it.
  Mr. McCAIN. I wish to say to my colleague, first of all, as is well 
known, side-by-sides have been one side of the aisle and the other side 
of the aisle. If the Lautenberg amendment were in order on the Dorgan 
amendment as a side-by-side, that would obviously be a change from what 
we have been doing.
  Basically, what my amendment does is make some perfecting changes to 
the underlying Dorgan amendment. It has some sense-of-the-Senate 
provisions and several other provisions which I think would help make 
it more effective. I have to be very honest with my friend from 
Illinois, it doesn't undermine the Dorgan amendment. I think it 
supplements the Dorgan amendment, just as the Bennet amendment to 
Medicare costs supplemented the position we had that Medicare benefits 
wouldn't be cut.
  So side-by-side amendments aren't necessarily in contrast with each 
other; sometimes they perfect, and I think my amendment makes it a 
better amendment--makes the Dorgan amendment a better proposal.
  Mr. DURBIN. I ask unanimous consent to expand the colloquy to include 
Senator McCain.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. Does the amendment of the Senator from Arizona, No. 3200, 
include the existing language of the Dorgan amendment?
  Mr. McCAIN. Yes, plus some perfecting language, as far as the Senate 
is concerned, about other procedures that would expedite the Dorgan 
amendment as well.
  Mr. DURBIN. Is the Senator from Arizona prepared to offer the 
Lautenberg language in his amendment?
  Mr. McCAIN. No, obviously not, because I don't agree with the 
Lautenberg language in my amendment, as you know. But what we are 
trying to do is, obviously, make the Dorgan amendment better, just as 
other amendments that are side-by-sides have tried to make amendments 
better. They do not necessarily cancel them out but make them better.
  Mr. DURBIN. Is the Senator from Arizona a cosponsor of the Dorgan 
amendment?
  Mr. McCAIN. Yes, a proud cosponsor.

[[Page S13083]]

  Mr. DURBIN. Would the Senator from Arizona consider offering whatever 
is different in 3200 as a separate amendment to the Dorgan amendment?
  Mr. McCAIN. I guess what I am not sure--if I understand my friend, I 
am offering an amendment as a side-by-side in order to, in my view, 
improve the Dorgan amendment; again, in all candor, not to undermine 
but to make it better.
  Mr. DURBIN. Well, Mr. President, I have an obligation to not only my 
leader but obviously to Senator Lautenberg, who is being dealt out of 
the picture here with this unanimous consent request, and he has been 
offering an amendment which is well known and has been offered 
previously by Senator Cochran of Mississippi, a Republican. At this 
point, if Senator Lautenberg is offering--I think at this point I am 
constrained to object based on this new McCain amendment, and we will 
discuss it with Senate leadership as to whether we can find a path 
through this.
  This is the third day we have been struggling with this. It appears 
there is a lot of credence put in the belief that we have to have 
exactly the same number of Republican and Democratic amendments, and I 
understand that from the minority point of view.
  Mr. McCONNELL. Maybe I have a solution to the problem. It actually 
involves my side agreeing to a procedure we have not followed 
throughout this bill, but let me suggest the following, which I think 
would get us out of this conundrum we seem to be in: that even though 
we have alternated from side to side, we would agree to both Dorgan and 
Lautenberg in conjunction, right after Crapo and Baucus; and then we 
get in the queue our next two--which I believe you are already familiar 
with, because they have been discussed on the floor--the Hutchison-
Thune amendment, and then a Snowe amendment.
  Mr. McCAIN. And I withdraw, with great reluctance and great anger, my 
amendment, because I think the Lautenberg amendment would be in 
violation of what we have agreed to.
  Mr. McCONNELL. In other words, Mr. President, putting it another way, 
we are basically conceding to what the Senator had earlier proffered as 
a way to get moving on the bill, and then we would get back into our 
process of going side to side. And we want you to know that our next 
two--as we have been letting each side know what the other side was 
going to offer--our next two would be the Snowe amendment and the 
Hutchison-Thune amendment.
  Mr. DURBIN. Let me suggest this. I will formally object to the 
original unanimous consent request, and I will then take what I 
consider to be a good-faith offer from your side as to the next two 
amendments to the majority leader. We will review the amendments, and I 
hope even today we will be back to Senators and suggest whether that is 
a path out of this.
  Mr. McCAIN. Could I be clear with the Senator from Illinois that what 
this means is we would move forward with the side-by-side Dorgan and 
Lautenberg--we would agree to that--and then we would also expect 
agreement on following amendments so that we could lock those in for 
debate and votes?
  Mr. DURBIN. May I ask whether the two amendments the minority leader 
mentioned, which would be Thune and Hutchison, and the other amendment, 
Snowe, we would be allowed to have side-by-sides to those?
  Mr. McCONNELL. Of course.
  Mr. DURBIN. If you would be kind enough----
  Mr. McCONNELL. If you so chose.
  Mr. DURBIN. If you are kind enough to give us time to review that 
proposal, we will be sure to get back to you.
  Mr. McCONNELL. I understand capitulation when we do it, and we have 
essentially said to the majority we will go along with what you had 
earlier requested and we would like for you to take ``yes'' for an 
answer and for us to wrap this up and have a sense of where we are 
going from here.
  Mr. DURBIN. I promise we will get back in a timely fashion.
  I object to the initial unanimous consent request.
  The PRESIDING OFFICER. Objection is noted.
  Mr. SESSIONS. Mr. President, the vote we had earlier this morning, 
moving forward onto the omnibus spending bill that is before us, is a 
stunning statement that we are not listening to the American people; 
that we are unaware or indifferent to the level of spending that is 
occurring in this country, which is unlike anything that has occurred 
before. Many have complained that President Bush overspent, and on some 
occasions he did. One expert told me recently that they have compared 
President Bush's misdemeanors to felony murder when you look at the 
seriousness of the spending levels that we are now undertaking in the 
baseline budgets of the various Federal agencies.
  This is different from the stimulus package that is already out 
there--to spend $800 billion in stimulus funding that has been poured 
into this economy--on top of the baseline budget spending items. So not 
only do we have this unprecedented stimulus package from earlier this 
year--the largest single spending bill in the history of the American 
Republic--but we are now moving forward with baseline budget items that 
have increases that are stunning, unjustified, irresponsible, and put 
us on a pathway to double domestic spending in far less than 10 years. 
This is unthinkable.
  I have to go back to the core threat we are facing, as more and more 
experts and economists are reminding us of it. This is based on the 
Congressional Budget Office study; it is based on the budget presented 
by the President of the United States over 10 years. Earlier this year, 
he presented us a budget. And what did it show? It showed our total 
American debt in 2008 was $5.8 trillion. That is a tremendous amount of 
money. That is what the total debt from the founding of the American 
Republic was--$5.8 trillion. They project that by 2013 that debt will 
increase to $11.8 trillion--doubling in 5 years--and increasing to 
$17.3 trillion in the year 10 of the President's budget--tripling the 
national debt.
  They say: Well, we have an economic recession. Well, we have had 
recessions before. We have a recession more often than every decade. We 
had thought that, hopefully, we could maybe figure a way to avoid them, 
but we haven't done that yet. I guess blame can go around to a lot of 
different people. But I would say this does not project another 
recession in the 10 years we are tripling the debt.
  As I have said, we are on an unprecedented course of spending that 
has never been seen in our country before. The only thing like it was 
during World War II and we were in a life-and-death struggle, fighting 
wars on both the Pacific and Atlantic, and Africa--around the world. 
Virtually every able-bodied person was either in the military or 
building ships and airplanes and weaponry to send to our soldiers. The 
whole country was mobilized.
  We never did this to our deficit then, and we did it in a way that 
commenced a pay-down of those debts after it was over. What I wanted to 
emphasize was--many of my colleagues have heard it stated, people seem 
to all admit it--we are on an unsustainable path. This is not a 
sustainable spending schedule. Then how do we get off of it? When do we 
get off of it, if it is unsustainable?
  Is it by producing a bill that we just voted on that increases 
spending at 12 percent, a rate of spending that would double those six 
discretionary spending bills' accounts in 5, 6, or 7 years? It would 
double it. Is that the way to get spending under control? I don't think 
so.
  Remember, I am not counting in this 12-percent increase the stimulus 
package that was passed. I would also note, under the budget the 
President submitted, the deficits in the outyears are not going down. 
There is no projection in those 10 years that we would have a 
recession, but there is also no projection that the deficits would be 
falling. In fact, the deficit, in 1 year, in 2019, would be over $1 
trillion. So these are stunning numbers.
  The highest deficit we have ever had was at $450 billion. The year 
before this year--we just concluded in September 30 of this year--$1.4 
trillion. Next year it will be $1.5 trillion. There should be some dip, 
we hope, for a few years, and then it is going back up on an 
unsustainable path. It is just stunning. We cannot do this. That is one 
of the big things that is occurring in the streets of America with our 
tea parties and others. People are saying: Congress, what is the matter 
with you? Don't you understand you are mortgaging our children's 
future; you are

[[Page S13084]]

devaluing the dollar; you are placing our economy at risk, as virtually 
every expert economist you talk to says, including Mr. Bernanke--not 
very aggressively, in my view, but he said that recently. This is a bad 
path.
  What does that mean when you have a big debt? The debt goes up. How 
do you get the money? Where does the money come from? You have to 
borrow it. We put on the market Treasury bills and notes, and we ask 
people to loan us the money so we can spend, spend, spend more than we 
take in, year after year.
  Some say it is the entitlements that are causing this, and 
entitlements are growing. That is our Social Security and our Medicare. 
One reason those are growing is, frankly--it is a very serious reason--
we have more seniors and they are living longer. They have been going 
up 6 or 7 percent a year. We are troubled by that. But the truth is, 
Social Security and Medicare have been in surplus.
  What has happened to the surplus? It has been spent on discretionary 
spending. We are spending the Social Security surplus and Medicare 
surplus--but it is going caput. Medicare is fading fast, and by 2017 
the trust fund will be exhausted. So we are not going to have a surplus 
to spend. So you borrow the money; this is what you do.
  In 2009, we paid interest on the money that people loaned us--much of 
it from China and oil-rich States, many of which are not friendly to 
us. We are paying them huge amounts of interest--$170 billion. How much 
is that? That is a lot of money. My State of Alabama is about an 
average size State. We are a frugal State. We don't have huge 
government. We have some pretty good economic growth as a result of 
that. But we have a $2 billion annual general fund budget--$2 billion. 
We paid $170 billion, the United States of America, in interest alone 
in 2009.
  Look what CBO says, our objective Budget Office. It is under the 
control, really, of the Democratic majority, but they take pride in 
giving us numbers that are valid and reliable. I think they do that for 
the most part.
  Look at this. They say by 2019, the interest we will be paying on the 
debt will not be $170 billion but $799 billion because we cannot stop 
spending. It is just unthinkable.
  People say we have to do better. This is unsustainable. We need to do 
something.
  When? We just voted this morning for a bill. I don't have a chart on 
that, but I will just read the numbers to you. It increases spending on 
6 of the 13 appropriations bills. We try to pass them individually, 13 
appropriations bills that fund the Federal Government. When we get to 
the end, it is easier sometimes for the leadership just to cobble all 
six of them together in a big package and put it out there and say vote 
up or down. That is what we have done. That is not a good policy. We 
need to do better than that. We really need 2-year budgeting, and then 
we would have time to bring up these bills one by one and give them the 
scrutiny they deserve. But if we look at the overall spending in these 
6 bills, 6 of the 13 that have been put together in a package, it shows 
that the percentage of growth in spending on the baseline level is 12 
percent.
  That is a stunning figure, when you think about it. What is the 
inflation rate today? Zero. We do not have inflation. The last number 
was .2 percent deflation over the past year. The average family is 
containing their spending. Ask the average city mayor. Aren't they 
trying to contain spending and be more efficient and be leaner and more 
effective? What about our State governments? The same thing. They are 
facing real problems, and they are trying to contain the growth of 
spending and we increase it by 12 percent.
  What kind of increase did the average working American get in their 
salary? Probably zero and lucky to hold it. If they had been getting 
overtime, they are probably not getting overtime today. Maybe in the 
family two people were working, maybe now only one is working.
  What about the State Department and foreign operations, what kind of 
increase did they get? A 33-percent increase in spending, most of which 
I assume will be spent around the world somewhere.
  What about Transportation and HUD? I have a chart on that. I just 
have the last 2 years since our colleagues have been in the majority. 
Last year it was a 12.3-percent increase--a stunning increase. Look at 
this year, 2010--23-percent increase on HUD, Housing and Urban 
Development, and Transportation; 23 percent on top of 12. This is the 
kind of spending that would double the HUD budget in 3 to 4 years. The 
foreign operations, I just mentioned, at the rate of increase we have, 
it would double in 2 to 3 years. The whole budget would double in 2 to 
3 years.

  Let's talk about Transportation/HUD. Did they get any money out of 
the stimulus package? You are counting that in here, aren't you, 
Senator Sessions, the money that Transportation/HUD got out of it?
  No, I am not. This is baseline spending. What did they get? The total 
Transportation/HUD budget--I hope my colleagues will think about these 
numbers--is $68 billion this year. Remember, I just noted interest in 
2019 would be $800 billion. That gives some perspective on the level of 
spending we have. But, again, that is just the baseline spending, and 
it does not count the $62 billion of spending that came out of the 
stimulus package, according to this chart. Remember, only a small 
percentage of the stimulus package went to highways. They said it was 
for bridges and infrastructure and highways, and I think about 4 
percent of the overall amount went to highways. Now they are claiming 
we don't have enough money for highways and they talk about another 
stimulus bill of another couple of hundred billion dollars--just 
another $100 billion, $200 billion.
  Remember, $100 billion--the entire Transportation-HUD expenditure 
this year is $68 billion.
  I don't think this is any kind of exaggeration. I am not an alarmist, 
but I am alarmed because I am telling the truth about these numbers.
  What have we done on previous spending bills that have come through 
the Senate? Two other bills have already come through the Senate and 
had stunning increases in them. Look at this. This is Interior and the 
Environment expenditures--Department of the Interior and the 
Environment--EPA, basically. Look at that: 16.6 percent increase in 1 
year. It had a tight budget last year, but it had a 16-percent increase 
this year. The EPA, the Environmental Protection Agency, which now is 
claiming the ability to regulate CO2, they got a 33-percent 
increase in spending. EPA got a 33-percent increase in spending. We 
have never seen those kinds of numbers before.
  Look at these expenditure growth items over the last number of years. 
When President Bush was in, everybody said he was a spendthrift, that 
President Bush put us in debt.
  Democrats say: We are not doing anything. This is a President Bush--
it is all his fault. He was a big spender.
  I criticized him some for overspending. A lot of Republicans have. 
But look at his averages for those Interior and Environment 
appropriations.
  It averaged 1 percent from 2001 to 2009, so he was holding the line. 
He had some 5-percent years, 5.6, but some negative years too. So the 
average was a modest 1 percent. Remember, 16 percent growth in spending 
at a time when inflation is zero.
  Another example of that--let's take the Agriculture bill. I believe 
in agriculture. I have tried to support most of these bills. I have 
worried sometimes that we were spending too much on agriculture. But I 
can't vote for this. We have already moved this legislation through the 
Senate, the Agriculture appropriations discretionary spending. Here we 
had in 2004 a minus 1 percent, zero in 2005, zero in 2006, a 6-percent 
jump in 2007, 1.1 percent in 2008, now 15 and 14.5 percent increases. 
How can we say we are responsible when we are doing that? We were 
having deficits through these years.
  We have never seen deficits averaging $1 trillion a year, which is 
basically what is going to occur under President Obama's budget. I wish 
it weren't so. I wish I didn't have to make this speech, because these 
deficits are dangerous to the American economy.
  These numbers remain here are stunning numbers. The only one that got 
a modest increase was for the men and women in uniform of the Defense 
Department. But State and Foreign Ops,

[[Page S13085]]

32.8-33 percent; Interior, 16.6; Commerce-Justice-Science, 12.3 
percent; T-HUD, 23 percent; Agriculture, 14 percent; Defense, 4.1. That 
should tell us something about maybe where the priorities are around 
here. It is troubling to me.
  What do the American people think about this? I have heard a lot of 
my colleagues say: We have a recession and we have this war that is 
going on. We just have to spend more. The American people understand 
that. It is all right. We just want to do this, and let's do it.
  Look at this poll that came out recently. Actually, it was November, 
last month, a CNN poll. The question was, Which of the following comes 
close to your view of the budget deficit: The government should run a 
deficit, if necessary, when the country is in a recession and at war or 
the government should balance the budget even when the country is in a 
recession and is at war. Sixty-seven percent say balance the budget. 
First, they know this isn't World War II. We have a very expensive war. 
We need to make sure our men and women are well funded. But it is not 
the driving factor in the deficits we are having today. Only 30 percent 
said, run a deficit. Four percent had no opinion. Sixty-seven percent 
said we ought to have a balanced budget, even in a time of war and 
recession.
  There are other problems. There are ramifications that arise from 
this kind of reckless spending. It has been a catch line for a number 
of our colleagues who support this health care bill that it would 
reduce the deficit. Past history with entitlements has shown that is 
not so. Estimates don't prove to be accurate, No. 1. No. 2, there are 
gimmicks in this health care bill that hide its true cost. I will 
mention one of them for the moment.
  One of the big ones is that we don't pay the doctors. The doctors are 
projected, after this next year and for 9 years under this budget 
scheme, to take a 23-percent cut in their payments for the work they do 
for Medicare--a 23-percent cut. Many doctors already are leaving 
Medicare and Medicaid because they are not paid enough. They are paid 
substantially less by the U.S. Government for Medicare and Medicaid 
than private insurance companies pay them for the work they do.
  That was part of the plan to fix Medicare, to fix permanently the 
payments for our physicians. When the numbers didn't add up--and if you 
paid the physicians what you are supposed to pay them, it would cost 
$250 billion over 10 years--they attempted to take the doctor fix 
payment and put it in a separate bill, every penny of it going to the 
debt, saying: Our health care bill is deficit neutral. The health care 
bill is deficit neutral. I am voting for a bill that is not going to 
impact the debt.
  Well, when you move a $250 billion hole out of your bill and put it 
over here, that is one way to hide what you are doing. If you count 
that, we have a $120 billion deficit in the bill by the scoring of our 
own colleagues. They just took that out because the numbers wouldn't 
add up if it were in. It is wrong. It is the kind of gimmicks and 
manipulation the American people are getting tired of. Some people are 
going to pay at the ballot box for continuing this kind of thing.
  Let me give some examples of how even the estimates of these bills 
fundamentally turn out to be wrong. In 1967, the estimate for how much 
Medicare would cost in 1990 was $12 billion. They projected how much 
Medicare would cost in 1990. What was the actual cost in 1990? It was 
$98 billion, not $12 billion. That means the estimates were off by a 
factor of 8. In 1987, Congress estimated that Medicaid payments to 
hospitals would cost $1 billion in 1992. That was just 5 years out. The 
5-year projection was Medicaid payments to hospitals would be $1 
billion. What was the actual cost? It was $17 billion, meaning the 
estimate was off by a factor of 17 in only 5 years.
  This kind of recklessness jeopardizes our economy. I don't think this 
spending is helping our economy because I think what is occurring is 
that people who invest in the future, hundreds of millions, maybe 
billions of dollars in big factories, are worried about our 
recklessness. They are worried about future economic stability. They 
are not as willing to invest because we are not acting responsibly.
  Stanford University economist Michael Boskin stated in a recent 
editorial in the Wall Street Journal:

       The explosion of spending, deficits and debt foreshadows 
     even higher prospective taxes on work, saving, investment and 
     employment. That not only will damage our economic future but 
     is harming jobs and growth now.

  There is too much truth in that.
  Brian Riedl at the Heritage Foundation, on October 6, in the 
Washington Times, did an op-ed that said that estimates on the size of 
the deficits I have just given are likely to be wildly optimistic. When 
I said the debt triples from $5.8 to $17.3 trillion, I am not including 
health care in those numbers. It hasn't passed. That is not current 
law. They didn't count that in the numbers when they were scoring it. 
He notes that the President assumed that spending would only increase 
at the rate of inflation for 9 years after 2010, after he included an 
8-percent increase for spending in 2010.
  The President's deficit estimates also assume interest rates lower 
than those in the 1980s or 1990s. Once all the factors in Mr. Riedl's 
analysis are added up, he projects a total deficit for the next 10 
years to be $13 trillion--an unsustainable level for sure and well 
above what CBO has scored. He is projecting higher interest rates on 
the debt because so much money would be borrowed worldwide. How do you 
induce people to loan you money? You have to offer them higher interest 
rates to get them to loan you money. They will not be loaning money at 
the low interest rates we have today because of this economic slowdown. 
Interest rates are going up. CBO acknowledges that in their score. The 
Heritage scholar said it is going to go up higher than CBO had scored.
  An October 14 New York Times article said that the reason we are not 
pressing China to appreciate its currency, to stop devaluing its 
currency against ours is because we rely on them to purchase our debt.
  Dong Tao, an economist at Credit Suisse, said:

       Obama's interest is not to push China to appreciate its 
     currency, but to get them to pay the bills.

  In other words, to get them to keep buying our Treasury bills so we 
can keep borrowing money.
  Small manufacturers all over the country, including Alabama, have 
suffered from China's undervalued currency. They not only have a wage 
advantage over us to a significant degree, they also don't have the 
environmental laws we have. They also devalue their currency--all of 
which makes them more able to undercut American companies' 
manufacturing and adversely compete against them. I am constantly 
hearing about it from my State. I know others are hearing the same 
thing.
  However, China and other countries may not be able to keep financing 
our debt in the future. Professor Allan Meltzer, a well-known scholar 
on the Federal Reserve and monetary policy, noted in a column in the 
Wall Street Journal that our current and projected deficits are too 
large relative to current and prospective world savings to rely on 
other countries being able to finance them for the next 10 years. We 
just can't expect to be able to have that much wealth out there in 
terms of our own citizens saving money to buy the Treasury bills and 
debt of the United States. Other countries are not going to have it 
either.
  In a Budget Committee hearing on budget reform, November 10, former 
Comptroller of the Currency and GAO David Walker testified that by 
2040--time flies faster than we like to admit--we will have to double 
taxes to keep current with our commitments. This is the former 
Comptroller General of the United States, the head of the GAO, the 
Government Accountability Office. He knows these numbers, and he has 
been very concerned about our reckless spending for quite a number of 
years. He is basically committing himself to trying to get this country 
on a sound financial track. Mr. Walker stated that in 12 years, 
interest will be the single biggest line item in the budget, even 
assuming interest rates don't change from today's low rates. But 
interest rates are going to go up, at least some. He also said that 
debt and deficits are the public's largest concern by 20 points in the 
opinion polls.
  That is what I am hearing from my constituents. They want some 
leadership up here. They want us to say: We would like to be able to 
provide more

[[Page S13086]]

for this, that, and the other. But we simply have to get our house in 
order. And in the long run, if we hold the line now, we can get this 
house back into order. I believe we can. But we cannot on the path we 
are today. In a Financial Times editorial in May of this year, Mr. 
Walker warned that the United States is in danger of losing its triple-
A financial credit rating. Well, is that possible that the United 
States of America would not have the highest credit rating in the 
world? Mr. Walker said it is possible. He made that comment in May of 
this year.

  Of course, if you do not have the highest credit rating, you have to 
pay higher interest rates to get people to buy your debt, to loan you 
money. So if you want to loan two people money, and one is rock solid, 
you might loan it to them for 4 percent. But if another person is 
risky, you may want 5, 6, 7, 8, 9 percent from them.
  So Moody's rates people to see how reliable they are in paying their 
debt back with dollars worth the same as you loan them. Mr. Walker 
warned that our reckless spending was putting us on a path where we 
would no longer have our triple-a credit rating.
  Well, sure enough, in a report just this week, the big rating 
service, Moody's, stated that the U.S. is in danger of losing its 
triple-A credit rating. Pierre Cailleteau, chief international 
economist at Moody's, stated that unlike several years ago, ``now the 
question of a potential downgrade of the U.S. is not inconceivable.''
  Well, that would make the interest payment of $799 billion for 1 
year, in 2019, be low. If we get downgraded, that interest payment is 
going to go up.
  So under the most pessimistic scenario put forward by Moody's, the 
United States would lose its top rating in 2013.
  This is a great country. We have such dynamic people and economy. 
They are willing to work. They are willing to compete. They are willing 
to save and all. But we need some leadership, and we need some 
leadership from Congress. We are oblivious to what the American people 
are telling us, and we are oblivious to the massive debt increases we 
are putting on the American people.
  Therefore, this bill that cloture was invoked on today, should not 
pass because having a 12-percent increase in spending, which would 
double that whole bill's financial spending in--what?--5, 6, or 7 
years, is unthinkable at this point in time, and I am against it. I 
hate to be against it. I see a lot of things in there I like. But I do 
not believe the Republic is going to sink into the ocean if we would 
have a 1- or 2-percent increase in spending for these six bills. I do 
not believe everything is going to collapse if we were to have a little 
frugality around here--give up some of our pork spending, give up some 
of our special projects and focus on what is the national interest for 
a change, and try to contain the surging growth of spending.
  I do not know when it is going to occur. Everybody says we have to 
stop. So when? I say now. I say, let's send this bill back. Let's do 
not pass this bill. Let's send it back to the conferees and the 
appropriators and say: Come back with a bill that is more responsible. 
Then we will pass it. We are not going to not pass legislation to fund 
these things. Don't let anybody say that.
  But the question is, What kind of increases can we justify? I am 
worried about it. The American people are worried about it. Soon 
Congress needs to get worried about it. If not, we are going to have 
some new people in Congress, and some new people are going to fix it 
because it can be fixed if we show determination.
  I thank the Chair and yield the floor.
  The PRESIDING OFFICER (Mr. Whitehouse). The Senator from 
Pennsylvania.
  Mr. CASEY. Mr. President, I rise this afternoon to speak about health 
care and the bill that is on the Senate floor that we have been 
debating now for a number of days, the Patient Protection and 
Affordable Care Act. I want to provide, first, a brief overview, but in 
particular to focus on provisions that relate to our children and then 
get into some detail about those provisions and the important programs 
that are contained within those parts of the bill.
  First of all, as we all know from the debate, what this side of the 
aisle has been trying to do is not just to pass legislation, but to do 
it in a way that meets the goals we set forth many months ago and, as 
well, what President Obama indicated much earlier this year in terms of 
some basic goals.
  I will just cite a few of those: To make sure when we are enacting 
legislation that we do not add to the deficit; that we at least break 
even, so to speak. But the good news is, on the scoring done by the 
Congressional Budget Office, the Patient Protection and Affordable Care 
Act will actually lower--lower--the deficit over 10 years by some $130 
billion, and then lower it even further over the course of the next 10 
years, by one estimate, over $600 billion. So that is good news about 
deficit reduction as it relates to this bill. Even if we broke even, it 
would be significant.
  Also, we are obviously trying to cover tens of millions of Americans 
who do not have coverage. The foundation of the bill on that issue is 
that some 94 percent of the American people will be covered, adding 
some 30 million to 31 million in terms of coverage. That is also a 
goal. I think we are going to be able to meet that.
  Then there are a whole series of things we have talked and talked 
about for years and have never done. We talk about how we have to 
enhance health care quality. We have not done much about it, and we are 
going to be able to make changes in this bill to do that.
  Certainly prevention. Everyone knows--the studies on this are, in a 
word, irrefutable--that prevention is not only good for a patient and 
good for his or her own family, and good for the economy long term 
because you are going to have a healthier worker, but it is also a 
giant cost saver, sometimes in a way that you cannot quantify or even 
often get credit for from the Congressional Budget Office.
  I have no doubt--and I think I join a lot of other people who know a 
lot more about prevention than I do--that this will be a huge cost 
saver in addition to being something that leads to better health 
outcomes. So in terms of quality and prevention and deficit reduction 
and coverage, it is a very strong bill.
  It is also a strong bill in terms of dealing with what we can call, 
in two words, consumer protections. That does not even begin to 
describe what this bill will do in terms of helping at least one 
category of Americans. We saw a study a couple months ago that 
indicated over a several-year period of time--if my recollection serves 
me, 3 years--millions of Americans--not thousands or tens of thousands, 
but millions of Americans--have been denied coverage because of a 
preexisting condition. That is because we have allowed insurance 
companies to do it year after year, and in some cases a lot longer than 
that.
  Well, we do not need to just talk about it and decry it and condemn 
it, we need to make it illegal. But we also have to make sure we do not 
just pass legislation--a lot of which has to be implemented down the 
road--and then say to those with preexisting conditions: We have 
changed the law, but you have to wait several years.
  One of the immediate benefits under the Patient Protection and 
Affordable Care Act relates to those Americans who have preexisting 
conditions. The act will provide $5 billion in immediate Federal 
support for a new program to provide affordable coverage to uninsured 
Americans with preexisting conditions. Coverage under the program will 
continue until the new exchanges are operational. That is good news for 
millions of Americans who have been denied coverage.
  I cannot tell you--I think every Senator in this Chamber on both 
sides of the aisle, Democrat, Republican, Independent--has received 
letters from Americans, horrific, tragic stories, in many instances, 
where they have been denied coverage, sometimes leading to death, 
sometimes leading to, even if it is not death, the worst of health care 
outcomes. So that high-risk pool, as it is called, for those with 
preexisting conditions will mean immediate benefit under the bill.
  I will mention a couple of other things that will happen immediately, 
and then I will move to the provisions on children. We hear a lot about 
business on this floor and arguments about who is stronger or who is 
more of an advocate for small business especially. But what we do not 
say enough is, this

[[Page S13087]]

act, the Patient Protection and Affordable Care Act, will offer tax 
credits to small businesses to make employee coverage more affordable, 
and those tax credits will go up to 50 percent of premiums, which will 
be available to firms that choose to offer coverage.

  That is another not just good reform--good for the small businesses, 
good for the employee, and really good for our economy short term and 
long term--but it is one of those immediate benefits.
  I will cite one more, and then I will move on.
  This Congress, a couple years ago, passed Medicare Part D, as it is 
known, adding prescription drug coverage. One of the adverse impacts 
from that legislation is, an older citizen gets the benefit of that and 
is able to benefit from the prescription drug coverage, but then they 
fall into the so-called doughnut hole. That is a very innocent-sounding 
phrase, ``doughnut hole.'' It does not sound that bad. It is a 
nightmare for someone.
  Basically, what it means is that an older citizen has to carry the 
whole freight for a long time and pay a lot of money at a certain 
period of time when they fall within that category.
  The Patient Protection and Affordable Care Act will reduce the size 
of the so-called doughnut hole by raising the ceiling on the initial 
coverage period by $500 in 2010. That is another immediate benefit of 
the enactment of this bill.
  The act will also guarantee 50-percent price discounts on brand-name 
drugs and biologics purchased by low-income and middle-income 
beneficiaries up to the coverage cap. That is another immediate 
benefit.
  These are benefits in terms of small business, in terms of covering 
those with preexisting conditions immediately, as well as helping older 
citizens deal with and manage the difficult doughnut hole problem so 
many of them have been suffering from.
  Let me do a quick summary. I will start with this chart. As shown on 
this chart, this is just a summary of some of the challenges of where 
we are now and what happens if we do nothing. It says: Status Quo is 
Unacceptable and Unsustainable. That is an understatement.
  The first bullet point on there: Every week, 44,230 people are losing 
their health insurance coverage. So every week that goes by, every day 
that goes by, we have Americans losing their coverage--bad for the 
individual and their family, and it is real bad for our economy.
  The second bullet point: Between January 2008 and December 2010--
roughly you are looking there at a 3-year type period--178,520 
individuals in Pennsylvania are projected to lose their health care 
coverage. There is no way to adequately describe the adverse impact 
that projection and that data point has on the people of Pennsylvania. 
You cannot have a growing economy if people are losing their health 
coverage. The numbers are spiraling out of control, not only in 
Pennsylvania but across the country. You cannot sustain any economy 
that way long term.
  The third and final bullet point: Without reform, family coverage 
will cost $26,679 in 2016--just 7 years from now--consuming 51.7 
percent of projected Pennsylvania family median income. The cite is the 
New American Foundation.
  That same number for the country--in other words, the percentage of 
median family income going to pay for health care--for health care, 
something so fundamental and basic in our society--it is 51.7 percent 
in Pennsylvania in 2016. The good news for the rest of the country is 
that the national average is only--only--a little more than 45 percent.
  I have not met a person in Pennsylvania or anywhere else in this 
country, but I know I have not met a person in Pennsylvania who says: 
Do you know what. Don't worry about it. Don't worry about passing any 
health care reform bill. Don't worry about getting it done because in 
2016--I am living in Pennsylvania--I can come up with 51.7 percent of 
my income for health care. Don't worry about it. I can handle it.
  We know no one can afford that. Even a family of tremendous means 
might have trouble affording more than half their income--half their 
income--to pay for health care.
  What if the projection is wrong? What if it is off by 10 percentage 
points? That is 40 percent. What if it is wrong even more? What if it 
is only 30 percent? I do not know of a family who can afford that.
  So we have a lot of reasons to get this right and to pass the bill. 
That projection is one of the most horrific.
  Now I will move to the chart on children.
  I will give just a quick summary of what the bill does for children, 
and then we will walk through the Children's Health Insurance Program.
  A couple of basic points: pediatric benefit package; that comes with 
this legislation, including oral and vision coverage for children. Many 
health plans do not provide that kind of coverage. It is one of those 
unwritten stories--or if it has been written, it has not been written 
about enough--where children lose out, sometimes even in a good health 
care plan for their parents. So it is not good enough to say, well, we 
have some coverage here and kids will be just OK. Children, as the 
advocates remind us all the time--these are not my words--are not small 
adults. They have different health care needs, and they have different 
health care problems and challenges.
  Pediatric benefits, as part of the benefit package, is a dramatic 
change and a very important change.
  This bill will not only require coverage for basic pediatric services 
under all health plans but also oral and vision needs, which improve a 
child's ability to learn and perform in school. So we can't talk about 
getting better test scores in school and doing all kinds of things that 
are in our education system if a child is not given the basic health 
care a child needs, not the health care an adult needs.

  The second point under what the bill would do is more pediatric 
providers. We have to have strategies in place to recruit and 
incentivize and train more pediatricians. You can't just say you want 
more coverage for kids and throw more money at it; you need to have the 
workforce to do it. The Patient Protection and Affordable Care Act will 
expand the workforce, including pediatricians, pediatric nurse 
practitioners, specialists in pediatrics, and pediatric oral health 
professionals to give kids what they should have in this country of 
ours where we know what works. We know exactly what works when it comes 
to children's health insurance.
  Then, providing greater quality, improving the quality of coverage 
for children. The preventive health care we are going to provide for 
children is dramatic.
  Finally, let me make a point about children overall. We hear a lot of 
discussion about where health care--what part of the country benefits 
the most and who will benefit the most. Well, under this legislation, 
there is not an American, I believe, who will not be positively 
impacted one way or another, sometimes directly. But one message came 
out loudly and clearly during the debate on children's health insurance 
going back a number of years in the Senate. Often, most people think of 
children under the benefit of the Children's Health Insurance Program 
as living in urban areas maybe or in a big city because that is where 
poverty is highest and, therefore, lower and middle-income families 
benefit from Medicaid or children's health insurance. That is largely 
true, for sure. But what came through to me in that debate many years 
ago--several years ago now--is something I never knew before, which is 
that one-third of rural children in America are the beneficiaries of 
either Medicaid or the Children's Health Insurance Program. Not many 
people heard that until a couple years ago. So this isn't about one 
specific demographic--or geographic, I should say--location where 
children are and who need these benefits, where there is Medicaid or 
the Children's Health Insurance Program. We know this is a problem for 
rural children, for urban children, for children who live in small 
towns, and even in suburban communities that are perceived to be a 
little more secure economically.
  When I have been talking about what we have to do for children, I 
often point to a line from the Scriptures, a very simple line, but I 
think it holds us accountable in this debate as it relates to children. 
There is a line in the Scriptures that says, ``A faithful friend is a 
sturdy shelter.'' The question we

[[Page S13088]]

have to ask when we are debating how we are going to help our children 
in this legislation is: Will we be a faithful friend to children? It is 
actually a pretty simple question, with profound, almost incalculable 
implications. Are we going to be that sturdy shelter for children, 
children who don't have a voice, who don't have economic power, who 
don't have a lobbyist showing up on Capitol Hill every day saying: Take 
care of this child or help this group of children. So the question for 
the Senate, one of many questions we have to answer by the end of this 
debate is: Will we be a sturdy shelter for children? Will we be a 
faithful friend to children?
  Let me conclude with a couple remarks about the Children's Health 
Insurance Program, in particular. My colleagues can see up here, in 
Pennsylvania--this is typical of a number of States but not every 
State--through Pennsylvania's Children's Health Insurance Program 
benefits, children are guaranteed to receive comprehensive insurance 
coverage, including the following:
  Every child should have this. I don't care who they are or where they 
live or what their economic status is, they should have immunizations. 
They should have routine checkups, prescription drugs, dental care, 
maternity care for their mothers, mental health benefits, up to 90 
days' hospitalization per year, durable medical equipment, substance 
abuse treatment, partial hospitalization for mental health services, 
and, finally, rehabilitation therapies and home health care. That whole 
menu of benefits for children is not some theory or some hope, in a 
sense; this is what the Children's Health Insurance Program means to 
America's children, their parents, their family, and, I would argue, 
this is about economic development in the long run.
  This is about developing a high-skilled workforce. If a child has 
these benefits in place, they can make it in life, with a couple other 
breaks and some other incentives. But if they don't have this list and 
they don't have the best possible health care, they are going to be in 
a lot of trouble. All of us will be in trouble because our economy will 
never be as strong as it can be and must be unless we do that.
  Let me go to the next chart, which is a subset of that. This chart 
depicts what is in children's health insurance now: Well-child visits. 
I have talked about that a lot. It is not a real glitzy subject for 
people to debate but a critically important part of what children's 
health insurance means and the benefits mean, a well-child visit. In 
the course of 1 year, under the Children's Health Insurance Program--
under the program we put in place and Congress enacted almost 15 years 
ago and then we reauthorized it just this year and President Obama 
signed the legislation--it means, instead of 7 million kids covered--
that is a great amount and that is great, but in a couple years, we are 
going to be able to expand that to 14 million children. I wish to make 
sure--and I am sure this view is shared across the aisle as well--that 
every child should have six of those well-child visits in a year. It is 
a key time for a parent and physician to communicate. Doctors recommend 
six visits in the first year. They get a complete physical examination, 
including height, weight, and other developmental milestones are 
measured. Hearing and vision are checked. We have all had the 
experience where a child doesn't get those kinds of basic checks and 
they have a hearing problem because it wasn't detected early or a 
vision problem. One of my four daughters had a vision problem. It 
wasn't caught at an early enough stage and we had some real 
difficulties making sure she had the right care.
  Important topics discussed, including normal development. What does 
that mean? A doctor should be able to talk to a parent about that, and 
the program covers that. Nutrition, sleep, safety, infectious diseases, 
and then general preventive care. Why should there even be a debate 
about whether children get this? The good news is, we have a program 
that does that and the good news is also that we have just expanded 
that program.
  Here is where the challenge comes in. In the midst of health care 
reform, the House of Representatives did a lot of good things in their 
bill. One thing they did not do well is make sure the Children's Health 
Insurance Program is as strong as it needs to be and must be, and that 
is the reason why I received the following letter. I will not read the 
whole letter, but this letter came from Barbara Ellis. She is in 
Broomall, PA. I spoke to her a couple days ago about her letter. I will 
not read all of it, but I think it describes pretty aptly what we are 
talking about.
  Barbara and her husband Ben live in Delaware County, PA, in Broomall. 
She says:

       We are a one income family with two sons, ages 6 and 8. Due 
     to the high price of health insurance my children are 
     currently covered under the free Pennsylvania Children's 
     Health Insurance Program.

  That is the good news. But here is the part where she is worried:

       We qualify for free Children's Health Insurance coverage in 
     Pennsylvania, but my husband's income is greater than 150 
     percent of the Federal poverty level which means our children 
     won't qualify for the coverage under the House's proposed 
     plan.

  Then she says--probably the most important part of this whole letter: 
``This has us terrified.''
  So it would any parent who does not have the peace of mind to know, 
when they fall asleep at night, they don't have to worry about whether 
their children have health insurance. But if we don't do the right 
thing, she will have that sense of terror. She says this as she 
concludes the letter:

       It would help us tremendously if you could support keeping 
     the Children's Health Insurance provisions intact which 
     would, in turn, support families like ours.

  That is what I have done by way of an amendment to our bill to make 
sure we strengthen what the House did and strengthen even our own bill. 
Our children's health insurance amendment, which I will not go through 
today, strengthens and safeguards the program through 2019 and beyond 
to address any changes health care reform may bring.
  We will talk more about it, but this is key to be able to make sure 
we have not just a set of benefits for children that are directly tied 
to their care and will help them for decades afterward and help our 
economy and give their families peace of mind but also that in the 
process of making sure we keep these kinds of benefits, we keep the 
program strong, not just until 2013 but at least all the way to 2019. I 
think we can do that. I think we can do that in the midst of this 
debate and get it right and give families and especially children that 
kind of protection.
  In a word, what we have to make sure we do is to ensure that the 
Senate and the Congress and this administration do everything they can 
to prove and to demonstrate that we are a faithful friend to children, 
that we will always be their sturdy shelter.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Alaska.
  Ms. MURKOWSKI. Mr. President, I appreciate the good Senator from 
Pennsylvania and his discussion and his clear and constant focus on 
children and children's health. I wish to commend him for his good work 
and for always reminding us of the importance of our children in so 
many aspects of our policies. So I thank him for that.
  I, too, rise this afternoon to talk about the debate on health care 
and the debate we seem to have ongoing with the numbers. Whether it is 
numbers that are coming out from the Congressional Budget Office, the 
CBO, or from our States or from other noteworthy entities, there is a 
great deal of back and forth as to whose numbers are right, whose 
numbers are wrong.
  There has been a great deal of discussion in the past day or so about 
the numbers we have received and the analysis we received from the 
Office of the Actuary, from CMS, the Centers for Medicare and Medicaid 
Services. The Chief Actuary is Mr. Richard Foster. A good deal of 
discussion has been had as to these numbers, and the question that 
needs to be asked is: Why would the numbers from the CMS Actuary be any 
more significant than, say, what we have seen coming out of the 
Congressional Budget Office?
  The Chief Actuary of CMS is kind of the independent arbiter, if you 
will. They look at both the private and public health care 
expenditures. The Chief Actuary provides actuarial details that I think 
we recognize can be critically important for certainly my State and

[[Page S13089]]

for any of our States' economists to develop individual State estimates 
of the financial impacts, the effects of the health care reform 
proposal.
  As important as discussion on the broader scale is, the people back 
in my State want to know: Well, what does it mean for us in Alaska? 
What does it mean for increased access? What does it mean for us in 
terms of our premiums? Are they going up? Are they going down? How do 
we as a State that is very unique in its markets--geographically 
dislocated, smaller population--how does this health care reform 
proposal impact us? So the numbers and the assessment we have received 
from the Office of the Actuary are very important.
  I have mentioned we all want to know what this Democratic health care 
proposal will mean to us as individuals in terms of the increase to 
premiums, the impact on the long-term sustainability of Medicare, 
whether it is going to restrict access to care in a State such as 
Alaska or throughout rural America. And ultimately, will this $2.5 
trillion bill bend this cost curve down on health care expenses that 
are pricing so many Americans out of the market on health insurance.

  I think it is so important that we be focused on the cost side and on 
the spending side. That is a bipartisan thing. We haven't done a lot 
that is bipartisan of late, but it is clear we all want to know we are 
doing all we can effectively to reduce those costs.
  I will note a letter that came from six colleagues on the Democratic 
side. This was sent when the Finance Committee bill was being 
considered. A letter went out to Chairman Baucus that provided that:

       There are many wide-ranging options to address the broad 
     and complicated issues of runaway health care costs, and we 
     pledge our support to you in making the necessary and tough 
     decisions.

  ``This is our No. 1 priority,'' the letter states. ``If we pass 
health care reform without addressing the issue of health care 
spending, we have failed.''
  I couldn't agree more with my Democratic colleagues who signed that 
letter. We will have failed if we have not addressed the issue of cost, 
the issue of spending.
  Again, this takes me back to the report from CMS, the Actuary's 
report. I want to highlight some of the very important points that were 
raised by the Chief Actuary.
  First, the Reid bill reduces payment updates to health care 
providers, which are unlikely to be sustainable on a permanent basis. 
If you go through the report, on page 9 is a statement that:

       As a result, providers could find it difficult to remain 
     profitable, and absent legislative intervention might end 
     their participation in the Medicare Program. The Reid bill is 
     especially likely to result in providers who are unwilling to 
     treat Medicare or Medicaid patients.

  On page 18, the statement is:

       Providers might tend to accept more patients who have 
     private insurance and fewer Medicare and Medicaid patients, 
     exacerbating existing access problems for the latter group. 
     Either outcome, or a combination of both, should be 
     considered plausible and even probable.

  I can tell you for a fact this is not just some maybe or if, in fact, 
these things happen; this is happening.
  I received a call 1 week ago from a practitioner in Alaska, in 
Anchorage, a family care practitioner. I was told that this 
practitioner, who has been practicing for many years in the family care 
practice--that the decision had been made to opt out of Medicare. In 
the e-mail we received and the followup conversation that was had with 
this practitioner, it was specifically cited that it is due to what 
is--I am reading from the e-mail we received--``due to what is in the 
Reid bill, as it will collapse my practice.''
  This is incredibly important to us not only in a State such as 
Alaska, where we are in a crisis situation when it comes to providers 
who are willing to take new Medicare individuals. Right now, in our 
State's largest city, we have 13 providers who will take new Medicare 
individuals--13. Well, if this individual whom we have communicated 
with a week ago is making the decision to opt out of Medicare because 
of the low reimbursement rates, because of what is seen developing here 
on the floor of the Senate, and the impact that will have on that 
family care practice--talk about not being able to sustain things--it 
is not acceptable.
  When I read the language in the Actuary report that says that 
providers might tend to accept more patients or might find it more 
difficult to remain profitable and might end their participation in the 
Medicare Program--to me, I am saying it is not ``might,'' it is 
happening, it is now, and it is impacting Alaskans' access to care in 
my State.
  This is something we should all be concerned about. It is not just 
this one practitioner. We have heard this has caused a great deal of 
anxiety within Alaska, primarily because that is where I am checking in 
with folks. But the anxiety about their ability to sustain a practice, 
again, with Medicare reimbursement rates as low as they are--in our 
State, we don't have a medical school, so it is not as if we are 
growing more practitioners to come in. It is very costly to have a 
practice in Alaska. We have a lot of strikes against us.
  We have to figure out a way we can continue to receive care from 
these fine professionals. But right now, from a policy perspective, it 
seems as if we are doing everything possible to drive them out.
  I am talking a lot about the situation in Alaska, but don't think for 
a minute that it is isolated to my State. The statement that is made by 
the Actuary is devastating news for States that are also facing 
problems of access, in terms of finding a general care doctor to see 
them, such as Oregon, Nevada, Colorado, and New Mexico.
  There was a GAO report--granted, this is a 2006 GAO report, but it 
did an assessment of what is happening in locations across the country, 
and those areas where access is compromised. You look at the statistics 
coming out of GAO, and their wording is:

       This suggests the distinct possibility of a deepening 
     problem in many of our Western States.

  So it is not just in a few isolated communities. We have States that 
are looking at this and calling the crisis for what it is. What we are 
doing in this health care bill currently before us is we are using 
Medicare as kind of this guinea pig, if you will, cutting from the 
Medicare--from the health program, even though we all recognize 
Medicare is slated to go broke by 2017--and using the Medicare money to 
expand Medicaid and, if the Medicare reports are true, expanding 
Medicare as well. So the end result is to harm Medicare patients as we 
expand Medicaid.
  Alaska is a little bit unique. We are one of two States where 
Medicaid is actually a better payer, or better in terms of the 
reimbursements, than Medicare. But even still, the economists we have 
at the University of Alaska's Institute for Social and Economic 
Research have said that Medicare patients will lose access and, as they 
have suggested, kind of go to the back of the bus, if we expand 
Medicare.
  I want to use their language specifically. This is from the analyst 
at ISER. He has stated that:

       We can continue to be concerned that the newly enrolled 
     through the Medicaid expansion and the new exchange will 
     create a big surge in demand that could easily create a 
     traffic jam in the health care system and send the Medicare 
     beneficiaries to the back of the line in Alaska due to 
     Medicare's low reimbursement rate. Expanding Medicaid is bad 
     for Alaska.

  The Chief Actuary at CMS is saying Medicare and Medicaid patients 
will both face limited access to care under this bill. While in Alaska 
Medicaid patients may fare better, what is happening is at the cost, or 
expense, if you will, of Medicare patients. So you are robbing Peter to 
pay Paul.
  Keep in mind that, as we look at the CMS letter--the Chief Actuary's 
letter--it doesn't even address the Democratic leader's desire to bring 
to the floor the provision that would expand Medicare to those 10 years 
younger than the current threshold age for Medicare. So what we are 
seeing within this analysis is probably just the floor in terms of what 
the impact will be if we allow for this expanded Medicare provision, 
this buy-in, if you will.
  Again, my State's seniors are absolutely suffering on Medicare, with 
virtually no primary doctors who will see them in our State's largest 
city. Now we have experts saying Medicare's patient access to care is 
going to suffer.
  We simply cannot expand broken health care systems. We have to fix 
the systems. You don't expand a broken thing and hope it will fix 
itself.

[[Page S13090]]

  Yesterday, in our State's largest newspaper, the headline at the 
bottom of the fold was:

       ``Health Bills May Hurt Some Alaskans,'' consultant says.

  And it says:

       Older residents could have more trouble seeing doctors.

  If you don't think that sends chills up and down the seniors in my 
State, knowing that the difficulty they are facing now could be made 
worse--a point that I think is important to add to the conversation 
here. You might think, well, Alaska, you don't typically have a lot of 
seniors, you are a younger population. We are that, but it should be 
noted that we are, per capita, the State with the fastest growing 
senior population in the Nation. We have a situation where, as we have 
our baby boomers aging in, the numbers are increasing dramatically, as 
far as those who will require the care. The number of patients who are 
65 and older at the health care facilities, Anchorage Neighborhood 
Health Center, has jumped on the order of 50 percent within a few 
years. The neighborhood health center saw twice as many Medicare 
patients in 2007 as in 2001.
  The report also found that older Alaskans have been visiting the 
emergency room in growing numbers. What we are seeing is an expansion 
of those who will be our Medicare consumers. In 2008, there were 49,455 
Alaskans 65 and older; but by 2015, 5 years from now, the number is 
expected to increase 50 percent. By 2020, 10 years from now, the number 
is projected to increase to over 86,000 individuals in Anchorage. Yet, 
we have fewer and fewer primary care doctors who are willing to accept 
these Medicare patients.
  The proposal out there is that we are going to cut $\1/2\ trillion 
from Medicare to pay for a new government entitlement. That doesn't add 
up.
  Back to the Actuary's report. It goes on to state that:

       We estimate that total national health expenditures under 
     this bill would increase by an estimated total of $234 
     billion during calendar years 2010 to 2019.

  We know that bending down the cost curve, which has been so essential 
to the health care reform bill, according to our own government's 
expert, is not going to be achieved in the Democratic leader's health 
care proposal.
  Contrary to what Senator Baucus said last week, that Senator 
McConnell's statement that this bill raises costs was ``a false 
statement,'' this bill does, in fact, raise health care expenditures, 
and all you need to do is go to the Actuary's statement to determine 
that.
  The Actuary's report goes on to provide:

       The new fees for drugs, devices, and insurance plans in the 
     Reid bill will increase prices and health insurance premium 
     costs for consumer. This will increase national health 
     expenditures by approximately $11 billion per year.

  We know this bill is going to raise money on the backs of patient 
consumers. This is going to happen in my State. It is going to happen 
in every other State. And it is going to be done by taxing the 
industries that provide us with the prescription drugs, the medical 
devices, such as tongue depressors, medical thermometers, blood sugar 
meters, x-ray machines, and the like.
  Whether or not you agree on taxing these industries, what the CMS 
Actuary is telling us is that these additional taxes are going to be 
passed on to the patient consumer to the tune of $11 billion every 
year. Again, the American people should know that their costs on drugs, 
thermometers, diabetes test strips, labs, and x rays are all going to 
go up because new penalties imposed by the Federal Government will be 
passed on to the patients.
  I appreciate the work Mr. Foster, the Chief Actuary, has done in 
getting us this report. I wrote him a letter on Monday asking if we 
could get the report so the folks in our respective States could look 
through it and better assess and understand. They want to know that 
they are relying on a good, sound assessment. But I will tell you, 
after reviewing the Actuary's report, I do not know how anyone could 
come to a different conclusion other than that these proposals, these 
bills, do not look good for my State, they do not look good for the 
medically underserved areas of the country, such as urban areas with 
limited access to care because of their high Medicaid populations or 
for rural America where general-care doctors just simply are not taking 
Medicare patients.
  This is just a bad bill. It is a bad bill. It hurts our seniors, it 
does not bend down the cost curve, it spends $2.5 trillion, and it 
raises health care costs. We have to figure out a path forward that is 
reform that does not increase the cost to our constituents around this 
country, that truly does make a difference when it comes to the 
delivery of health care costs in this Nation, and that really does 
provide for expanded access.
  I have said numerous times that just by giving an individual a card 
that says: OK, now you are part of a health care plan but you don't 
have access to a provider, we really haven't done what we have promised 
to do to help you receive good health care.
  There is a great deal that is floating out there in terms of ``he 
said, she said'' type of conversation on the numbers. It is incumbent 
on us in the Senate to give thorough vetting, thorough assessment. We 
have to rely on the experts. We hope we rely on those experts who have 
been able to look at the proposals fairly and evenly and give their 
best assessment. I have a great deal of confidence in our independent 
entity in the State of Alaska, the Institute for Social Economic 
Research at the University of Alaska. I appreciate what they have done 
to provide more focus on what this national proposal will do to access 
to care in my State and costs that will be borne by my constituents.
  I think the more time we spend understanding what we have in front of 
us, the more we realize this is a bad deal for America.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The distinguished Senator from Utah.
  Mr. HATCH. Mr. President, yesterday the administration's own 
Department of Health and Human Services health analysis warned 
Americans about the impact of this bill. According to the official 
scorekeepers at CMS, the Centers for Medicare and Medicaid Services, 
the Reid health care bill will actually not only increase our national 
health care costs by $234 billion over the next 10 years but will also 
reduce access and cut benefits for our seniors. This nonbiased report 
simply proves what we have been saying all along: You cannot reform a 
$2.4 trillion health care system simply by spending another $2.5 
trillion of hard-earned taxpayer money. Despite all the rhetoric from 
the other side about this historic legislation, the only thing this 
bill accomplishes, after imposing $\1/2\ trillion in new taxes and $\1/
2\ trillion in Medicare cuts, is to simply bend our Nation's health 
care cost curve up.
  As a longtime supporter of the Medicare Advantage Program, I offered 
an amendment on the Senate floor to strip nearly $120 billion in cuts 
to the Medicare Advantage Program that provides comprehensive health 
benefits, including vision, dental, and reduced cost-sharing, to almost 
11 million seniors.
  Unfortunately, despite statements from the Congressional Budget 
Office that these cuts would result in reduced cuts for seniors 
enrolled in Medicare Advantage, Democrats in the Senate voted to keep 
the cuts in the package to finance more Federal spending--$500 billion 
in cuts in Medicare. Whom are they kidding? Medicare has $38 trillion 
in unfunded liabilities.
  This report is another reminder of why it was a mistake to not adopt 
my amendment. The CMS Actuary found that the cuts to the Medicare 
Advantage Program in the Reid bill would not only result in ``less 
generous benefit packages'' for our seniors but, more important, it 
would decrease enrollment in Medicare Advantage plans by 33 percent.
  Clearly, health care spending continues to grow too fast. This year 
will mark the largest ever 1-year jump in the health care share of our 
GDP. This jump is a full percentage point to 17.6 percent. You can 
think of this as a horse race between costs and resources to cover 
those costs. The sad reality is that costs win year after year.
  Growing health care costs translate directly into higher coverage 
costs. Since the last decade, the cost of health coverage has increased 
by 120 percent, three times the growth of inflation and four times the 
growth of wages. Rising costs is the primary driver behind why we 
continue to see a rising number of uninsured in our country

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and why increasing numbers of businesses find it hard to compete in a 
global market.
  Without addressing this central problem, we cannot have a real and 
sustainable health care reform bill. So what does this $2.5 trillion 
tax-and-spend bill do to address health care costs? Absolutely nothing. 
According to the Congressional Budget Office, the premiums for 
Americans who buy insurance on their own will actually increase by 10 
to 13 percent, while premiums for small and large groups will largely 
remain unchanged and continue to rise between 5 to 6 percent a year.
  Furthermore, according to the CMS report, the new fees on 
prescription drugs, medical devices, such as wheelchairs and hearing 
aids, and health care plans will not only increase overall health care 
prices but also health insurance premiums for millions of Americans.
  Let me make this point as clearly as I can. This bill does not 
address the underlying problem of slowing down the growth of health 
care costs. It simply spends hundreds of billions of dollars in new 
subsidies to buy out the cost of these increases for families making up 
to $80,000 a year. Instead of fixing the real problems, this bill 
simply tries to spend its way out of the problems. Does that sound new 
to you? This administration seems to think that just throwing money at 
things is going to help.
  We have been hearing a lot recently about how Democrats are throwing 
the government-run plan out of their bill to quickly jam this bill 
through the Senate before Christmas. The American people need to be 
careful about believing this propaganda. The Democratic solution to the 
government plan is a Ponzi scheme that would embarrass even Bernie 
Madoff himself.

  I have to be fair here. I have to rely on news reports to discuss 
these provisions. You heard me right--news reports. Why is that? 
Because no one knows what is actually in the bill they have sent to the 
CBO. Not even my friends on the Democratic side, by and large, know. 
The Reid bill was put together by very few Democrats with the White 
House in the back rooms of the Capitol. Nobody really knew what they 
were doing until they came out with it.
  Once we all saw it, we all realized what a mess that is. They found 
themselves in trouble, so they have gone and done another bill and 
submitted it to CBO, and hardly anybody on the floor knows exactly what 
the features are in that bill. No one knows actually what is in the 
bill. And despite the continuous claims of transparency our friends on 
the other side are always talking about, the real bill continues to 
change on a daily basis behind the closed doors of the majority 
leader's office.
  I am really glad to know that it is not just the Republicans who are 
in the dark about what is actually in this bill. Democratic Members of 
Congress in this body are also in the same boat. It is really 
unbelievable. We are being asked to move forward on legislation that 
will reform one-sixth of the American economy and impact every American 
life and business without knowing what is actually in the bill. We have 
to rely on news reports. I have never seen anything like this in my 33 
years of Senate service.
  One proposal that has come to the floor in recent days is the idea of 
expanding Medicare to include coverage for Americans 55 and over. 
Currently, we all know Medicare is for Americans 65 and over. It is a 
bankrupt program. It is well intentioned, it does a lot of good, but it 
is bankrupt. It is a program that can barely pay for the benefits of 
the 40 million seniors in it today. Medicare is on a path to fiscal 
meltdown, with Part A facing bankruptcy by 2017. I don't think anybody 
denies that. It underpays doctors by 20 percent and hospitals by 30 
percent compared to the private sector, forcing an increasing number of 
providers to simply stop seeing our Nation's seniors.
  According to the June 2008 MedPAC report, 9 out of 10 Medicare 
beneficiaries have to get additional benefits beyond their Medicare 
coverage.
  What is Washington's solution to address this problem and crisis? 
Take up to $500 billion out of this bankrupt program and at the same 
time push millions of Americans into it. Does that sound logical to 
you?
  The CMS report states in clear terms that the Medicare cuts in this 
bill could jeopardize our seniors' access to care. The cuts would 
result in nearly 20 percent of all Part A providers, such as hospitals 
and nursing homes, operating in the red within the next 10 years as a 
result of these cuts. Twenty percent--that is a pretty big number.
  It should come as no surprise that this proposal faces strong 
opposition from a wide variety of provider groups, from doctors and 
hospitals that are already under tremendous financial pressure due to 
underpayments from Medicare.
  Keep in mind, the AMA here in Washington has backed this monstrosity. 
Now some people think that AMA represents all the doctors. It does 
not. The average doctor out there is incensed about this. Adding more 
lives to this insolvent Medicare Program will only further limit their 
ability to see all Medicare patients, not just the new ones.

  Even more troubling is the impact of this expansion on the premiums 
of our Medicare seniors from this ill-conceived policy. This expansion 
would encourage an influx of sick Americans in private coverage into 
Medicare, which will simply raise premiums for seniors already enrolled 
in Medicare. So seniors, expect your cost of Medicare to go up.
  So why are Democrats pushing this idea? Congressman Anthony Weiner 
said it best. I think he was very honest; very upfront. He said this:

       Extending this successful program to those between 55 and 
     64, a plan I proposed in July, would be the largest expansion 
     of Medicare in 44 years and would perhaps get us on the path 
     to a single-payer model.

  Well, the Democratic endgame on health care reform is crystal clear: 
Make as many Americans as possible dependent on the Federal Government 
programs. Democrats believe by making millions of Americans dependent 
on big government programs, on the backs of their grandchildren's 
future, they are taking a huge leap toward creating a permanent 
majority for themselves. Why, it would be a natural constituency for 
them.
  Well, let me tell you this--America is built on the spirit of self-
reliance, not government handouts. Poll after poll, especially the CNN 
poll, has said 61 percent of Americans are now opposed to the bill, and 
study after study is warning us this is the wrong solution for our 
Nation. This unknown bill, which continues to change by the day behind 
closed doors, is a direct violation of the President's own pledge to 
only support a reform that would reduce costs, protect benefits, and 
not raise taxes.
  I sincerely hope the Democrats will step away from their arrogance of 
power and listen to the will of the American people. It is not too late 
for us to push the reset button and work on health care reform in a 
truly bipartisan manner. We are eager and willing, as we have been all 
year, to work on a responsible solution that every American can be 
proud of. There are all kinds of things we could agree on, that 
Republicans would work hand in glove with Democrats to solve, if they 
were willing to do it.
  But keep in mind the HELP Committee bill was totally Democratic. Not 
one Republican was asked to help write it. The House bill, totally 
Democratic. Not one Republican was asked to help write it. I admit my 
friend, the Senator from Montana, Max Baucus, worked hard to try to get 
a bipartisan bill. But in the end, he did not have enough flexibility 
to reach a deal. All of a sudden, he finds his bill being put 
together--between the House bill and the HELP Committee bill--behind 
closed doors, with very few people involved--all Democrats and the 
White House and probably two or three or four or five from the Senate 
but no more than that.
  Throughout this debate, I have heard a lot of rhetoric from the other 
side of the aisle how Republicans are opposed to this $2.5 trillion 
tax-and-spend bill because, as the Democrats incorrectly suggest, we 
want the status quo. Oh, give me a break. We all know this is 
completely false. We on this side of the aisle have asked the Democrats 
over and over again to step back and write a new bill with us. But they 
are so consumed with their arrogance of power that they simply want to 
push what they have always wanted; that is, more government and more 
government controls over all our lives. America is a

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free nation, the greatest Nation in the history of mankind. What makes 
us great is not our reliance on the Federal Government but our 
individual resolve and strength. Americans want the Federal Government 
to help them, not support them.
  Well, let me tell you the other side of this. In a recent Gallup 
Poll, Independents around this country opposed this bill 53 to 37. 
These are Independents. So it would be wise for my Democratic friends 
to realize America is not behind them; not behind this bill. It is time 
for them to listen to what the majority of Americans want and that is 
not this bill.
  I cannot tell you the kind of opposition I have seen in my State to 
this bill. It is almost unprecedented. I read it in the letters, hear 
it in the calls. At airports and grocery store aisles and on the 
streets people stop me and say: Don't let that thing pass.
  Absolute power corrupts, and that is what we are seeing in Washington 
today. Democrats control the White House, the House, they have a 
filibuster-proof Senate and they have used this absolute power to 
rubberstamp this administration's big-government agenda and have 
tripled our deficit within 1 year--1 year. We will run deficits of at 
least $1 trillion a year for the foreseeable future, while our national 
debt will triple. We are literally mortgaging the future of this 
country to foreign countries as we speak. Enough is enough. Let us step 
back and start over on a plan we can all be proud of and all work on.
  We hear a lot about how the Republicans are simply standing for big 
and evil insurance companies and how the Democrats are the defenders of 
American families. Well, these days, nowhere is this Democratic 
hypocrisy more clear than the individual, mandated policy that is part 
of this tax-and-spend legislation.
  Let's be very clear about who would benefit the most from this 
provision, which would, for the first time in our Nation's history, 
give the Federal Government the power to force Americans to either buy 
health insurance or face a tax penalty enforced by our friends at the 
Internal Revenue Service. There are only two clear winners under this 
policy, and it is not the American families. First, it is the Federal 
Government, that will now use this authority as a blank checkbook to 
increase the penalty in the future as a new revenue stream for its out-
of-control spending habits; and, second, are the insurance companies, 
that will now reap the benefits of having Americans being forced to buy 
coverage at the decree of the Federal Government.
  Right now, States are responsible for determining policies that best 
meet their unique demographic needs and challenges. Massachusetts, for 
example, has decided to implement an individual mandate, while Utah has 
decided not to. Under this bill, we are explicitly taking away this 
State flexibility and authority to give the Federal Government the 
authority to make this one-size-fits-all decision for all 50 States and 
every American. This is an unprecedented grab of State power by 
Washington--a fundamental threat to the very Federalist vision our 
Founding Fathers used more than 200 years ago to create the greatest 
Nation in the history of the world, in the history of mankind.
  I am gravely concerned about the precedent this policy will set for 
us as a nation going forward. If the Federal Government can force us to 
buy health insurance, what else can it force us to do? The 
possibilities are endless, just like my concerns, which I share with 
millions of Americans, on Washington's growing role in our private 
lives and personal decisions. Think about it. Washington has become an 
unwanted houseguest in our homes and lives who will not leave. If it 
does not start listening to the families, it will get kicked out, 
sooner rather than later. Think about it.
  A couple of our friends have even said: Well, it is similar to car 
insurance. The States require you to buy insurance for your car, and it 
is in the best interest of the community that you do so. Well, the 
reason they do is because you want to drive. It is an activity you want 
to participate in, and so they get away with it. Here, if they have an 
individual mandate, they are forcing you to buy policies that are 
defined by Washington. If you don't, you are going to be penalized.
  This has never happened before in our lives. If they can get away 
with this, I have to tell you, they can get away with anything. The 
liberties of all Americans are going to be affected by it. This is not 
an activity. This is not something we choose to do necessarily. If we 
choose to do it on our own, that is great. But to have the government 
come in and say you have to buy this policy--for the first time in 
history--you have to do this, even though you don't want to buy it, is 
unprecedented.
  Well, let me say, I think it is fair to see I am not very enthused 
about the health care ideas of our colleagues. But I do wish to end on 
a positive note. There are some good things we can all do, some of 
which are in the bill. It is not totally bad. It is only about 90 
percent bad, but there is at least 10 percent we could build on; that 
we could work together on.

  I am not just saying that. Look, I have been around here a long time. 
I can name all kinds of bills I have worked on with some of the most 
liberal people in the whole Congress to pass. Hatch-Waxman is a perfect 
illustration. That created the modern generic drug industry. Henry 
Waxman is as liberal as it gets but he was willing to face up to these 
realities with me, and we did Hatch-Waxman. I call it Waxman-Hatch when 
I am around him.
  I might add the orphan drug bill. We found there were only maybe two 
or three orphan drugs being developed. These are drugs to benefit 
population groups of less than 200,000. Well, it is clear the drug 
companies can't afford to do it for 200,000 people because it costs 
upward of $1 billion. Biological drugs cost even more than that, and 
they are not truly drugs. But the fact is, they cost even more than 
that. We came up with some very small incentives--but they were 
incentives with prestige--and some tax breaks and all of a sudden it 
was about a $14 million or $15 million bill, as I recall, in the early 
1980s, when I was chairman of the Labor and Human Resources Committee. 
Today, we have well over 300 orphan drugs being developed, many of 
which have been developed, and from some of them blockbuster drugs have 
evolved.
  Let's take the CHIP bill. That was the Hatch-Kennedy bill. Ted 
Kennedy, very liberal. He would have preferred to have the Federal 
Government do it all--just like our colleagues do today with this 
enormous number of 60 votes on their side--but he was willing to work 
with me. I went to him and said: Look, I had two families from Provo, 
UT, come to visit me--husbands and wives. In each family's case, both 
the husband and the wife work. Neither family's combined joint income 
is over $20,000 a year. At that time, it was too much to have their 
kids qualify for Medicaid and too little for them to be able to buy 
health insurance. I said: The only kids left out of the health care 
equation are children of the working poor. Teddy, we have to do 
something about that. He saw it, and he said yes.
  He wasn't happy with the bill, in the end, because it was exactly 
what I told him it would be. It would basically be block-grants to 
states, where the States would handle it in accordance with their own 
demographics. It has worked amazingly well, until now. They are shoving 
more and more people into CHIP, other than the children of the working 
poor whom we originally decided to help.
  Well, I could go on and on and on, on so many pieces of legislation, 
but I will just mention those few. I am very concerned because I 
actually believe that if we get what they are talking about on the 
other side, it will not only bankrupt the country, it will make more 
and more people dependent upon the Federal Government. Like I say, a 
natural constituency for the Democratic Party, but it is a matter of 
great concern to me.
  Are our colleagues bad people? No. They simply believe the Federal 
Government can do it better. There are some things the Federal 
Government can do better, such as defending our national security 
interests, which is what the Constitution expects the Federal 
Government to do.
  But even there, under this administration, we are not doing as well 
as we should. Although I commend the President for deciding to send the 
people to

[[Page S13093]]

Afghanistan and for standing on these issues. Once he saw the 
intelligence and the other information, it infused reality into his 
decision-making process. I give him credit. I am one who believes he 
deserves great credit for the decision he made. But even in that 
decision, he had to be very careful how he characterized when we are 
going to leave. He did leave it flexible. In that alone, he deserves a 
lot of credit because he knows there may not be enough time to do all 
we have to do to create the well-trained police and security forces 
that are necessary to keep Afghanistan free and to keep the world from 
allowing the Taliban and al-Qaida to obtain nuclear weapons.
  Well, that is another subject for another day. I wish to end by 
saying I don't believe anybody on the other side is an evil person or a 
person who doesn't believe they are acting in the best interest of the 
country, but I do not see how--I do not see how they can continue to 
push what they are trying to push, I think to the detriment of this 
country.

  I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas is recognized.
  Mr. BROWNBACK. Before my colleague leaves the floor, I wish to ask 
him a question or two if he wouldn't mind. He has been involved in most 
of the major health issues that have passed this body in the last 15 
years. What was the vote margin in the Senate on some of those bills, 
on the Hatch-Kennedy, Hatch-Waxman bills? How many votes, roughly? I am 
not asking you to pull that up from memory, and it may not be fair to 
do. As I recall, a number of people on both sides of the aisle ended up 
supporting those bills.
  Mr. HATCH. On the CHIP bill I can't remember what the exact number 
was but I think it was between 70 or 80 votes. It was a bipartisan 
bill. In fact, on the Finance Committee when I brought it up only two 
Senators voted against it. It was like 19 to 2.
  Mr. BROWNBACK. In the Finance Committee?
  Mr. HATCH. Every Republican except two, and every Democrat voted for 
it.
  Mr. BROWNBACK. And Hatch-Waxman? It is longer back.
  Mr. HATCH. That was unanimous. If I recall correctly, I think it was 
done through a unanimous consent.
  Mr. BROWNBACK. I believe you did a major health care bill with 
Senator Dodd from Connecticut.
  Mr. HATCH. Yes.
  Mr. BROWNBACK. Do you recall the split?
  Mr. HATCH. They were all bipartisan. That is what gets me, because 
people know--people such as myself, such as the senior Senator from 
Kansas--we are willing to work on it with them. We know we can't get 
everything we want. Our colleagues have different viewpoints than we 
do. But tell me that I am wrong--I know you can't--that the HELP 
Committee bill was done solely between a few people at the White House 
and the Kennedy staff, and basically a few Democrats. That was it. No 
Republicans.
  The House bill, I wish to ask the Senator, does he know of any 
Republican who was asked to participate in helping to develop that 
monstrosity they call the House bill?
  Mr. BROWNBACK. If I could respond to my colleague, I do not know of 
any. I don't know of any who were even asked. I know of some who were 
told you can join this bill, or asked that--OK, can you join our bill 
but you don't have any input.
  Mr. HATCH. After they came up with it, but how about the Reid bill? 
Does the Senator know if any Republicans were involved, able to 
participate in that bill, after the discussion between the White House 
and Senator Reid and a few Democrats?
  Mr. BROWNBACK. None. I know of none.
  Mr. HATCH. None were involved. After they get it they say we want to 
work with you. After they get it done in the ways that I don't think 
any Republican can support, then they will say, yes, we would like it 
to be bipartisan. Has the Senator seen any acceptance of amendments 
here on the floor?
  Mr. BROWNBACK. I haven't seen any at all, and particularly when we 
tried to work in a bipartisan fashion to add Hyde language into the 
bill that was defeated, not accepted.
  My point is something I have seen the Senator say in a quote, that a 
good health care bill should have 70 votes because it is major 
legislation that affects everybody in the United States. It has huge 
costs associated with it. So it is not something you do on a single-
party basis, it is something you work extensively on over a long period 
of time.
  I ask my colleague again, over how many years he worked with Senator 
Kennedy on getting the Hatch-Kennedy bill, or Waxman--my guess is those 
are lengthy pieces of negotiations that take a period of time to get 
something that has bipartisan support.
  Mr. HATCH. That is right. One thing I appreciated very much about 
Senator Kennedy, as liberal as he was--he was the leading liberal lion 
in the Senate, in the whole Congress, in my opinion--he knew unless we 
could get together in a bipartisan way we could not get the job done. 
This involves one-sixth of the American economy; one-sixth. We are 
being told take it or leave it. That is what I call an arrogance of 
power.
  I don't want to be mean to my colleagues, I think many of them are 
very sincere, but it is an arrogance of power to not deal with the 
other side and to not even talk to us about it until after you have 
done what you want to do. I have to say, this is the worst I have seen 
it in the whole 33 years I have been in the Senate.
  Mr. BROWNBACK. If I could ask one more question before my colleague 
leaves--and also a comment that I like the Senator's tie, nice bright 
colors on a Saturday session.
  Mr. HATCH. It is a western tie. I thought I would wear it out of 
loudness today.
  Mr. BROWNBACK. What does the Senator think of getting--how many total 
votes could you get for a bipartisan health care bill along the lines 
of which a number of people on our side have discussed, where you 
expand access, you try to bend the cost curve down, you try to get more 
access to low-income individuals? Does the Senator think he could craft 
a bipartisan bill that could get well over 60 votes on health care 
reform?
  Mr. HATCH. I believe we could craft a bill that would get almost 100 
votes. I think we would at least get between 70 and 80 votes and 
probably more if we worked together to do it. I don't think there is 
any question we could do that.
  Look, we all want prevention, we want maintenance, we all want to 
cover as many people as we possibly can, we all want to correct some of 
the deficiencies that are in these bills, we all want to take care of 
people with preexisting illnesses. I could go on and on. Those are 
things we could build upon in ways that would work.
  This bill is not going to work very well. But we could build upon 
that, bipartisan-wise, and build a complete bill We Republicans would 
not get everything we want. But I think there are Democrats who believe 
we ought to use the principles of federalism, have 50 State 
laboratories out there, let them work on their own problems in 
accordance with their own demographics. I know Kansas is not New 
Jersey. Neither is Utah. And New Jersey is not Kansas or Utah, to pick 
three States. You can do that with any three States. But we know one 
thing, if we follow the principles of federalism--that is what we did 
in CHIP, and CHIP worked well by anybody's measure--if we follow the 
principles of federalism we would be able to look and pick and choose 
from the various States what works and what does not.
  You would have the usually big Democratic States that probably 
wouldn't function no matter what you do. But even they would benefit. 
Even they would benefit from looking at the other States and saying 
will that work in our State. Frankly, that is what made this country 
great.
  There are friends on the other side who do not agree with me on that 
but there are friends over there who do agree with me on that, as you 
can see, getting 70 or 80 votes on the CHIP bill. There were other 
bills we put through by unanimous consent, because people recognized 
they were well intentioned, well written, had bipartisan support and 
nobody wanted to vote against them.
  Mr. BROWNBACK. I said I would only ask the Senator one more question, 
but I have one more. My question is you didn't do those bills on the 
fly where you were amending them, saying

[[Page S13094]]

OK, we can't quite find 60, let's go back to a closed room and let's 
rebuild the bill. You built them over a long period of time. You did a 
good job of working the problems out together, and then you built it as 
it went along. You didn't say OK, let's do it on the fly, let's change 
this, let's change that. You build a solid piece of legislation and 
move it forward, not changing it at the 11th hour as we are seeing take 
place now.
  Mr. HATCH. That is right. When Senator Kennedy and I did the CHIP 
bill, as an illustration, we had to go up and down this country giving 
speeches everywhere, building constituencies, working very hard 
together. It is no secret, in the end it was not everything he wanted. 
It wasn't everything I wanted either. He wanted the Federal Government 
in control of it. I wanted the States to be in control of it. But in 
the end I happen to know, as one of the dearest friends of Senator 
Kennedy, with all the differences we had--and we had plenty, we fought 
each other most of the time, but in the end he was as proud of that 
bill as any bill he passed or he worked on--even though it was put 
together in a way that brought a great number of Republicans on board.

  Frankly, that can be done here. I have no doubt it could be done 
here. I look at the distinguished Senator in the chair. He is one of 
the brightest guys in the Senate. He has a lot of experience in this 
area. I personally believe the people such as the Senator from Rhode 
Island, the Senator from Kansas, myself--if we got together we could do 
things that our respective States would be proud of and would be 
pleased to work on--even though there would be some give and take, and 
that is what we need to do.
  Look, I point out one more time, the HELP bill is totally Democratic, 
not one Republican, until they brought the bill to the committee. The 
House bill--totally Democratic, not one Republican was even asked to 
give input. And this bill, not one Republican. In fact, not many 
Democrats.
  I made the point here a few minutes ago, most of the Democrats do not 
know what is in the bill that was submitted to the Congressional Budget 
Office. You heard the very competent minority--majority whip, the 
Senator from Illinois, say he did not know what was in the bill either. 
When the minority--excuse me, the majority; I have that in my mind, I 
think. If the majority whip didn't know, how in the world are we 
Republicans going to know? And how in the world are the rest of the 
Democrats going to know? These are things that worry me and bother me.
  I believe they believed with President Obama's aura, with his 
strength in politics, with all of us wanting to help him and with their 
distinctive 60-person majority, that they could put over whatever they 
wanted to. This was their opportunity to go to a single-payer system--
or at least to move the whole system much farther toward a single-payer 
system than it even is today.
  These things bother me a great deal. Frankly, I hope we can get our 
colleagues to sit down and work with us. I think both sides would have 
to give. Both sides would have to get together. But at least one-sixth 
of the American economy would be treated with respect rather than one 
side saying take it or leave it.
  Mr. BROWNBACK. I thank my colleague from Utah for that explanation 
and also for the years of service he has given, and particularly a lot 
of focus on health care issues. I haven't always agreed with my 
colleague from Utah. I have always found him, though, very sound in his 
thinking, very knowledgeable in his ways, in knowing how you do this, 
and particularly when you are talking about health care these are 
bipartisan issues in and of themselves and they need to be in this 
body.
  He also talked about the principles of federalism, which I think we 
have deviated from in what we see from this bill. I wish to read from 
the Constitution, article I, section 8. That is the piece I wish to 
focus on here for a minute about the constitutional question involved 
in this health care bill. Article I, section 8 reads simply this way, 
that the Congress shall have--and then it lists a series of enumerated 
powers: power to ``regulate Commerce with foreign Nations, and among 
the several States, and with the Indian tribes.''
  That is our ability to regulate commerce, with the foreign nations, 
among the several States, and with the Indian tribes. There are a 
number of people raising the question about whether you can 
constitutionally require everybody in the United States, by virtue of 
their citizenship or status in the United States, to have health 
insurance. I think it is highly questionable.
  It appears to me from several legal scholars that this is 
unconstitutional for us to do. It is a major plank in the health care 
legislation that has been brought forward by the Democratic majority 
and I do not believe it is going to stand constitutional challenge. I 
want to develop that for my colleagues here today.
  The Congressional Budget Office said this about the constitutional 
question here. They said forcing individuals to buy insurance would be 
`` . . . an unprecedented form of federal action.'' Those are big words 
in a time when we are seeing a lot of what I think are unprecedented 
Federal actions. Then going on to say, ``The Government has never 
required people to buy any good or service as a condition of lawful 
residence in the United States.''
  You would be requiring, as a condition for lawful residence in the 
United States, the purchasing of a good or a service--in this case 
health insurance. As laudable as some people may look at that or say 
that is, that would be what is being required. The Congressional Budget 
Office does not know of any time where a person in the United States 
has been required to buy any good or service as a condition simply of 
lawful residence in the United States. I think it raises significant 
constitutional questions.
  You have to remember, as everybody does, but I think we have to 
remind ourselves because too often we act as if we don't remember that 
the Federal Government is a constitutional government of limited 
powers.
  From James Madison in the Federalist Papers, quoted often but it 
bears repeating because it is a foundational issue:

       [I]n the first place it is to be remembered that the 
     general government is not to be charged with the whole power 
     of making and administering laws. Its jurisdiction is limited 
     to certain enumerated objects.

  Which is what I just read from in article I, section 8.
  Chief Justice John Marshall, in the famous Marbury v. Madison case, 
stated:

       The powers of the legislature are defined and limited; and 
     that those limits may not be mistaken or forgotten, the 
     Constitution is written.

  We can't violate that. The Federal Government is limited to 
enumerated powers granted by the Constitution. The Founding Fathers who 
drafted and ratified the Constitution were unwavering in their desire 
to restrict the powers of States and limit the powers of Congress. To 
achieve their goal they created a system that splits State and Federal 
authority so that one government, Federal or State, does not maintain 
too much power over the liberty of the American people. Therefore, the 
Framers created a system with a legislature of limited and enumerated 
powers, the Congress, to enact laws which shall be necessary and proper 
for the execution of powers. One of those is the commerce clause I just 
read which grants Congress the authority to regulate commerce with 
foreign nations, among the several States, interstate commerce, and 
with Indian tribes.
  Many have used the commerce clause to justify the implementation of 
this unconstitutional mandate. Those individuals often cite the case of 
Wicker v. Filburn, a 1942 case. The U.S. Supreme Court decision found 
that a law prohibiting a commercial farmer growing an additional acre 
of wheat to feed chickens beyond the limits imposed on wheat production 
mandated by the Federal Government was constitutional and fell under 
the enumerated powers granted by the commerce clause. Filburn was 
ordered to destroy his crops and pay a fine to the government for being 
too productive.
  The Supreme Court, interpreting the Constitution's commerce clause, 
decided that Filburn's wheat growing activities reduced the amount of 
wheat he would buy for chicken feed on the open market and affected 
interstate commerce and, thus, could be regulated by the Federal 
Government. However, that Supreme Court decision, agree with it or not, 
still does not expand the

[[Page S13095]]

powers of this body under the commerce clause to impose a monetary fine 
or penalty upon a citizen who fails to purchase or enter into a private 
contract for health insurance. That doesn't expand our authority under 
the commerce clause. It doesn't change the commerce clause. For us to 
require somebody to do something simply as a status of citizenship, the 
Congressional Research Service says:

       Despite the breadth of powers exercised under the Commerce 
     Clause, it is unclear whether the clause would provide a 
     solid constitutional foundation for legislation containing a 
     requirement to have health insurance. Whether such a 
     requirement would be constitutional under the Commerce Clause 
     is perhaps the most challenging question posed by such a 
     proposal, as it is a novel issue whether Congress may use 
     this clause to require an individual to purchase a good or a 
     service.

  To think that the Federal Government can compel any individual to 
purchase a commodity because that individual is alive and breathing is 
unconstitutional and is at least a novel issue that this $2.5 trillion 
proposal is built around. Should we be doing this major change in 
health care, $2.5 trillion in spending, \1/2\ trillion in reduction in 
Medicare, \1/2\ trillion raising in taxes off of a novel constitutional 
question involved in the inherent piece of it, that being the 
requirement for everybody to have health insurance? I think not. Along 
with all the other problems with it, I think it has an enormous 
constitutional question right in the middle of it. And what if you pull 
that out and the Supreme Court says, ultimately, you can't require 
that. Then you have done $2.5 trillion, $\1/2\ trillion in Medicare 
cuts, $\1/2\ trillion in tax increases, and your core piece is pulled 
out; it is unconstitutional. Then the whole house of cards falls apart.
  Another popular argument for forcing citizens to purchase health 
insurance under penalty of law is that States require people to buy car 
insurance. This argument is not only constitutionally flawed but also 
an underwhelming argument that in many respects hardly deserves comment 
and adds little to the debate. It is recognized that States maintain 
inherent police powers to regulate behavior and enforce order within 
their borders to promote public welfare, security, health, and safety. 
This is a fundamental difference between the power of States and the 
enumerated powers of the national government, such as commerce between 
States and Indian tribes. This is a much broader granting of 
jurisdiction to the States.
  State vehicle insurance laws are exactly that, laws implemented by 
States, and are generally derived from State constitutions and not the 
Federal Constitution under which this body operates. Furthermore, these 
laws require an individual who voluntarily participates in the use of 
an automobile to insure that vehicle. It is not a right of citizenship 
as a Kansan that you have to buy auto insurance. But if you want to 
operate a car on our roads, you have to have auto insurance. It isn't a 
requirement of citizenship.
  We are requiring this as an article of citizenship. You have to have 
health insurance, a novel and enormously expansive role of the Federal 
Government.
  The Federal mandate for the purchase of health insurance forces 
individuals to purchase a commodity not because they choose to 
participate in an economic or commercial activity such as what one 
would think would be covered under the commerce clause but forces an 
individual to purchase a product simply because that person exists. 
This mandate is an abuse of the power granted to this Congress by the 
Constitution.
  Last night I spent some time developing another thought that I think 
is an important one for us to consider. It is one this body has spent 
some time over the last decade dealing with; that is, the removal of 
the marriage penalty from our Tax Code, which we haven't gotten very 
far in doing, but getting the marriage penalty out, the thought being 
that marriage is a good institution. It is a fabulous institution for 
the formation of family. It is something that has an enormous role in 
our culture and society and should be rewarded and should not be taxed.
  The fundamental principle exists, if you want less of something, tax 
it; if you want more of something, subsidize it. In the Democratic 
health care bill there are marriage penalties on both low-income and 
upper income individuals that will reduce the incidence of marriage in 
this society, under the principle that if you are going to tax 
something, you will get less of it.
  This bill has marriage penalty taxes in it. I want to go through a 
series of these, starting with the high cost plan tax, the Cadillac 
insurance plan. Married couples under this bill are hit hardest by the 
high cost plans tax. The number of single and married tax filers is 
equal, but married taxpayers pay more than twice as much as singles as 
a percent of new tax revenue in this bill.
  So if you are married filing jointly, you will pay 62 percent--single 
filers, 25 percent--in this bill. Is that something we want to do? Do 
we want to say, if you are married, you will pay more of the tax? Most 
people would say: We want to encourage marriage and the formation of 
family around marriage. We should have these at least equal or maybe do 
a higher tax on the other end. But most would say let's have these be 
equal.
  Instead, in this we have a huge increase in the amount of money 
married filers will have to pay as compared to taxes paid by single 
filers. Consequently, you encourage people to say: Let's not get 
married because we don't want to pay the increase in taxes.
  The high cost plans tax, the Cadillac plans tax, will hit married 
couples' households far more severely than single filers. Even though 
the number of married filers and single filers is roughly equal, the 
high cost plans tax will impact the total tax bill of married couples 
much more severely: 25 percent of the revenue will be from single 
filers, 62 percent of the bill will go to married filers. One thing is 
certain, 62 percent of married couples' households don't make more than 
$250,000. So not only is this unfair to married households, it is a 
direct contradiction of the President's promise that you wouldn't pay 
more taxes if you were making below $250,000. In this case you do under 
the Cadillac insurance plan proposal or piece in this proposal.

  I want to look at another chart on this subject. If we wanted to talk 
about factors that impact an individual's decision to enter the 
workforce or to invest in a business, an important factor is the 
marginal tax rate they will face on the next dollar they earn. 
Basically, it is a question of whether it is worth the effort and risk 
to work. What is my marginal tax? If I work longer and make another 
$100, how much do I get to keep? The marginal tax rate.
  This is an especially important factor for low-income households, 
people who don't have much marginal income to work off of. They need 
every dollar they can get. So if you are going to tax their marginal 
rate, they are looking at this saying: I don't want to get in that 
category. I need to hold back from getting in that category.
  We have tried to help the less economically fortunate with various 
types of support programs: TANF, food stamps, the earned-income tax 
credit, the additional child tax credit, to name a few. Low-income 
families already face high marginal tax rates as a result of the 
phaseout of their benefits and tax rates that mean the loss of benefits 
they get under TANF, food stamps, the earned-income tax credit, housing 
assistance, the welfare package we put together for low-income 
individuals. Low-income families already face high marginal tax rates 
as a result of the phaseout of their benefits. These phaseouts already 
impose significant barriers to marriage.
  In other words, whenever you get a combined income of a low-income 
couple, you lose more benefits. Consequently, people don't get married 
because they look and say: I will lose my health benefits if I get 
married. I will lose my medical benefits, my housing benefits. I may 
lose food stamps. I will not get married.
  Yet you look at the chances for children in that situation to get out 
of poverty, their best chance is to have a stable mom and dad and a 
stable marriage environment, providing for the comfort and support of 
those children. Our incentives are disincentives toward marriage in 
this way, and they are built even more significantly into this health 
care bill.
  As an example, let's take two individuals at 150 percent of the 
poverty level. After the new subsidies proposed

[[Page S13096]]

in this legislation are taken into account, these two individuals would 
pay $1,478 for their health insurance. But if they get married, their 
bill will increase to $2,308, a marriage penalty of $830, if you are at 
the 150 percent of poverty level or below. If you are at 150 percent of 
poverty or below, you don't have marginal income to mess around with. 
You need everything you have just to provide the basics. So if you are 
looking at this increase in the marriage penalty of $830, you are 
saying: We can't afford to get married.
  Is that the signal we want to send from the Federal Government? No. 
Everybody in this body would say that.
  Let's take a pair of individuals earning 250 percent of the poverty 
level. One has no children; the other has two children. Unmarried they 
will, after subsidies, pay $5,865 for their health coverage. If they 
decide to marry, they will face a penalty of $2,050.
  Let's turn to the new Medicare tax that will go into effect in 2013. 
The tax will apply to wage and salary income as well as certain 
business income for individuals. The tax will apply to income of that 
type for above $200,000 for individuals and $250,000 for joint filers.
  The penalty is obvious on its face. Let's take an example. Two 
unmarried individuals earn $200,000 each, and their total Medicare 
taxes would be $11,600. But if they get married, the penalty is $750. 
Or take two individuals, one making $150,000 and the other $200,000. 
Single, their Medicare taxes total $10,150; if they get married, they 
will pay an additional $500. This is on top of the marriage penalties 
that two earners face under current law. The marriage penalty is there. 
I don't think it is as significant as for the low-income individuals, 
but it is here as well.
  My point is, why on Earth would that even be built into the base of 
the bill, particularly on the low-income couples? Why on Earth would 
you build in a marriage penalty on people who can't afford it? If 
combined income is over $250,000, you can afford another $500. I am 
willing to agree with that. But not this couple that is making at 150 
percent of poverty or 250 percent of poverty, one with two kids. They 
can't afford that. Why on Earth would you build it into this? This is 
ridiculous that it be placed in the proposal. It makes no sense.
  Creating and expanding on the penalties for marriage makes zero 
sense. Families are a critical determinant of the well-being of our 
society. Family structure also has a significant impact on economic 
well-being, on education, and the effect on the social fabric of this 
Nation is positive.
  It is a fundamental law of economics that when you tax something, you 
get less of it. Why would we tax marriage, particularly for low-income 
individuals, when it is the best chance for those children involved 
with this couple to have a stable environment, if they will form a 
solid marriage unit? And we are going to tax it and discourage it. That 
is wrong. That is wrong as a policy matter.
  There is a number of other problems I have had with this overall 
bill. This piece of it absolutely makes no sense to me, why we would do 
something like this. I urge my colleagues to vote against this bill, to 
take these sorts of things out, to take them out of the base law. 
Unfortunately, in the United States today, this is kind of repeating 
what already takes place in food stamps, what takes place in health 
benefits for low-income individuals right now. They cannot afford to 
get married or they lose their benefits. It is ridiculous. We ought to 
give people bonuses for getting married, not penalties for getting 
married. Now we are going to add to it by putting it in this health 
insurance bill. It is wrong and it is bad policy.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Alaska.

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