Congressional Record, Volume 156 Issue 41 (Friday, March 19, 2010)

[Congressional Record Volume 156, Number 41 (Friday, March 19, 2010)]
[Senate]
[Pages S1760-S1774]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

TAX ON BONUSES RECEIVED FROM CERTAIN TARP RECIPIENTS

The ACTING PRESIDENT pro tempore. The Senate will resume
consideration of H.R. 1586, which the clerk will report.
The assistant legislative clerk read as follows:

A bill (H.R. 1586) to impose an additional tax on bonuses
received on certain TARP recipients.

Pending:

Rockefeller amendment No. 3452, in the nature of a
substitute.
McCain amendment No. 3527 (to amendment No. 3452), to
require the Administrator of the Federal Aviation
Administration to develop a financing proposal for fully
funding the development and implementation of technology for
the Next Generation Air Transportation System.
McCain amendment No. 3528 (to amendment No. 3452), to
provide standards for determining whether the substantial
restoration of the natural quiet and experience of the Grand
Canyon National Park has been achieved and to clarify
regulatory authority with respect to commercial air tours
operating over the park.

Mr. REID. Mr. President, has morning business been announced?
The ACTING PRESIDENT pro tempore. We are on the bill.
Mr. REID. We are on the bill. That is where we should be.
I note the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. DORGAN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. DORGAN. Mr. President, this morning we are awaiting the
opportunity to do a unanimous consent request that would then give us
the road ahead to complete the FAA reauthorization bill on Monday. We
have spent 5 days on the floor of the Senate, entertained a fairly
large number of amendments and had votes on amendments. We have one
large group of amendments that has been cleared by both sides. We will
include that in the unanimous consent request as well.
We made a lot of progress last night in reaching some understandings
about a couple of the complicated and controversial issues. It appears
now, when we get the unanimous consent request, which I think we have
agreed to--we are just getting it prepared--we will be able to get that
done this morning. That will give us the road forward, and we will
complete this bill Monday evening.
This is a very big achievement because the FAA reauthorization bill
has been extended 11 times rather than completed and reauthorized. It
has been extended 11 times without what we needed to do, such as
authorize the activities to modernize our air traffic control system,
update some of the safety issues that are included in this legislation,
update the essential air service program, including the passengers'
bill of rights--a series of provisions that are very important to make
certain we have a modern aviation system that is as safe as it can be
and that is as protective of passengers as is possible, giving the
airlines and those in general aviation, as well, the opportunity to
have a modern air traffic control system, the most modern in the world.
This is a big achievement. I appreciate the cooperation of all of our
colleagues, Republicans and Democrats, who joined last evening in
wanting to finish this bill. We were able to reach some understandings
to do that.
While we are waiting for the opportunity to do the unanimous consent
request--it is not yet completely written--I am going to give a
presentation this morning on the subject of energy.
I will withhold on that. I know our colleague from Arizona is on the
floor. Let me at this point yield the floor, and at some appropriate
point I will spend some time talking about energy.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Arizona.
Mr. McCAIN. Mr. President, I ask my friend from North Dakota, I
intended to speak in morning business as well, if he has no objection.
I ask unanimous consent to address the Senate as in morning business.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.

Health Care

Mr. McCAIN. Mr. President, there is a lot of excitement and interest,
obviously, around the country about the impending, possibly, vote in
the other body, perhaps as early as Sunday. I think it is time we
talked a little bit about reality as well. I would like to mention one
item.
I read from an article from the Dow Jones Newswires:

Caterpillar, Inc., said the health care overhaul
legislation being considered by the U.S. House would increase
the company's health care costs by more than $100 million in
the first year alone.
In a letter Thursday to [House] Speaker Nancy Pelosi and
House Republican leader John Boehner of Ohio, Caterpillar
urged lawmakers to vote against the plan ``because of the
substantial cost burdens it would place on our shareholders,
employees and retirees.''
Caterpillar, the world's largest construction machinery
manufacturer by sales, said it's particularly opposed to
provisions in the bill that would expand Medicare taxes and
mandate insurance coverage. The legislation would require
nearly all companies to provide health insurance for their
employees.

I would point out to my colleagues that this is one of the largest
exporters the United States of America has.
Continuing to quote:

Caterpillar noted that the company supports efforts to
increase the quality and value of health care for patients .
. . unfortunately, neither the current legislation in the
House and Senate, nor the President's proposal, meets these
goals.

Most telling, perhaps, is the comment of the vice president, who said
this:

We can ill-afford cost increases that place us at a
disadvantage versus our global competitors.

So here we are with a huge trade deficit of almost unprecedented
proportions. We owe the Chinese $850 billion, or some huge amount, and
more every day, so Caterpillar is going to have their expenses
increased in 1 year by $100 million or more. How in the world are they
going to be competitive?
I probably should have begun with this. Yesterday, in my home State
of Arizona, almost an unprecedented event took place. The Governor of
the State of Arizona, Governor Jan Brewer, the majority leader of the
senate, and the speaker of the house, held a press conference in which
they talked about a letter they sent to the President of the United
States. I want to quote from the letter:

Dear Mr. President: We share common ground in that we both
have been called to lead during some of the most difficult
times our Nation has faced. Like you, I hear painful stories
on a regular basis from people who are struggling to survive.
Yet in their time of need, our State government is on the
brink of insolvency.
During this downturn, Arizona has lost the largest
percentage of jobs in the United States. The flagging economy
has resulted in a loss of State revenues in excess of 30
percent, placing tremendous pressures on our State budget.
Today, Arizona faces one of the largest deficits of any
State.
There is no doubt that this fiscal calamity has been
compounded by the enormous spending increases we are facing
as a result of our Medicaid, which has seen population growth
of almost 20 percent in the past 12 months. It is for that
reason I write to you today.
You have repeated on several occasions that the debate on
health care reform has consumed the past year and you most
recently called on Congress to vote the measure ``up or
down.'' As the governor of a State that is bleeding red ink,
I am imploring our congressional delegation to vote against
your proposal to expand government health care and to help
vote it down.
The reason for my position is simple: We cannot afford it.
And based on our State's own experience with government
health care expansion, we doubt the rest of America can
either.

Then the Governor of the State of Arizona, Jan Brewer, along with the

[[Page S1761]]

other legislative leaders, goes on to explain why this would cause such
devastating harm to the State of Arizona, which is already suffering
under unprecedented fiscal difficulties.
As the Governor pointed out in her letter, Medicaid has seen
population growth of almost 20 percent in the last 12 months. All over
America, Governors are saying: Don't do this to us. They are saying:
Don't mandate this dramatic increase in our Medicaid expenses.
Governors and legislatures and citizens all over the country are
enacting laws and proposing constitutional amendments that say: You
cannot force us to buy health insurance.
I want to congratulate the Governor of the State of Arizona and our
legislative leaders for their courage in standing up and telling the
American people and the President of the United States the reality of
what they are facing.
I guess a lot of this may be coming to a head in some respects,
although there still seems to be some speculation as to what
``reconciliation'' will take place over here, exactly what form that
will take, and exactly what the rulings of the Parliamentarians and
others will be to what sounds like arcane procedures and how they will
unfold. But I think it is very clear that we are facing, possibly for
the first time in our history, a major reform in the face of
overwhelming opposition to it on the part of the American people.
This morning's Wall Street Journal has an interesting lead editorial
entitled: ``March Madness.'' ``Scenes from a devolution as Democrats
writhe towards 216 votes.'' I want to quote from the editorial of this
morning:

Has there ever been a political spectacle like the final
throes of Obama care? We can't recall one outside of a banana
republic, or, more accurately, Woody Allen's 1971 classic
``Bananas.'' Capitol Hill resembles nothing so much as that
movie's farcical coup d'etat in San Marcos, as Democrats try
to assemble a partisan minimum of 216 votes--if only for an
hour or so at some point on Sunday--and no bribe is too
costly, no deal too cynical, no last-minute rewrite too
blatant.

That pretty much sums it up. One of the issues is, what are the tax
increases in this? When do they kick in? How is it that the
Congressional Budget Office can come up with such estimates, as they
have? Well, the first principle, my friends, is: Garbage in, garbage
out. If you give the Congressional Budget Office certain assumptions,
they will have to give estimates based on those assumptions, even if
those assumptions are totally out of the realm of possibility, such as
cuts of $\1/2\ trillion in Medicare, such as saying that we will have a
so-called ``doc fix''--a reduction in doctors' payments of some $217
billion. We know that is not going to happen. We know that is not going
to happen.
Let me quote again from the Wall Street Journal article:

Also yesterday the white smoke rose up from the
Congressional Budget Office, which released its cost
estimates for the ``reconciliation bill'' and the sundry
fixes without which Ms. Pelosi can't deem the Senate bill
passed. Democrats preemptively released the topline numbers,
which by themselves took weeks of tweaking to game the CBO's
accounting conventions and officially stay under $1 trillion
in spending for 10 years. The real cost over a decade, once
all the spending kicks in, is $2.4 trillion.

Why is that? It is obvious that the first 4 years the taxes are
raised and the benefits are cut, and it is only after 4 years that you
begin to see benefits. That is a classic example of budget gimmickry.
Once again quoting from the article:

CBO Director Doug Elmendorf was thus obliged to release a
``preliminary estimate,'' having ``not thoroughly examined
the legislative language.'' Mr. Elmendorf said at a hearing
that his health-care staff members were close to burning out
under ``the almost round-the-clock schedule'' of unrelenting
Democratic demands about the budgetary effects of this or
that provision. And all for a bill whose subsidies don't
begin until 2014.
By the way, to make the deficit numbers ``work,'' Democrats
decided at the 11th hour to increase their new tax on
investment income to 3.8 percent from 2.9 percent.
Congratulations. White House budget director Peter Orszag
quickly declared that ``the CBO score today should leave no
doubt that we are operating in a new fiscal era.''

We certainly are.

One thing the score also made clear, however, is that Mrs.
Pelosi's reconciliation fixes could easily be blown to pieces
in the Senate. While the Democratic strategy is already a
wholesale abuse of the traditional reconciliation process, it
now bids to violate the actual rules of the reconciliation as
well.
In a carom shot if there ever was one, excise tax on gold-
plated health coverage has received one last tweak. It is
expected to fund ObamaCare as employees take more of their
compensation in wages rather than health insurance, thus
exposing more income to ordinary taxes. The House demand
to delay that tax until 2018--

And does anybody believe we are going to impose taxes in 2018?

--from 2013 in the Senate bill--to appease the likes of AFL-
CIO president Richard Trumka, who met one-on-one with Mr.
Obama on Wednesday--therefore reduces Social Security payroll
tax revenues. But reconciliation expressly forbids such
changes.

The reconciliation rules forbid changes to Social Security.

And CBO says this change will drain some $53 billion from
the program's trust fund.
Senate Republicans will therefore be entitled to raise a
budget ``point of order'' against the entire reconciliation
bill if it does arrive in the upper chamber.
North Dakota Senator Kent Conrad admitted the risks
yesterday, asking rhetorically if he expected that some GOP
``challenges will be upheld? Yeah, I do.'' By the way, Mr.
Conrad and his House North Dakota colleague Earl Pomeroy are
getting a special provision that exempts a state-owned North
Dakota bank from the unrelated private student loan takeover
that Democrats have included as part of ObamaCare. That
multibillion-dollar baby was added to further rig the budget
numbers and win over conflicted Members.

I understand that my colleague Senator Conrad has now said he does
not wish for that exemption to be in legislation.
I want to point out that there are new taxes--even more tax increases
in this bill--more than $560 billion in taxes on Medicare patients,
private health insurance plans, medical device manufacturers, small
businesses, and much more, including Caterpillar's estimate, as I
mentioned, of $100 million more in cost. There is more than $200
billion in taxes on individuals and small businesses; Medicare hospital
insurance tax, $210 billion; penalty payments by employers--these are
penalty payments in taxes on employers that will be enacted between
2010 and 2019.
In other words, the assumption in this legislation is that we will
plan on penalizing employers some $52 billion over 10 years. I think
employers might be interested in hearing that. Then, more than $30
billion in taxes on private health insurance plans--$32 billion--nearly
$20 billion in taxes on uninsured Americans, and $20 billion in taxes
on medical device manufacturers.
I want spend a minute on that--$20 billion in taxes on medical device
manufacturers. The excise tax on manufacturers and importers of certain
medical devices, $20 billion. Impose a 2.9-percent excise tax on
manufacturers and importers of certain medical devices from 2010 to
2019, which will then count as $20 billion in revenue.
Who pays? Who then pays when we raise taxes on the manufacturers of
medical devices? Who at the end of the day is going to pay for that? We
know who is going to pay for it. We know it will be the person who
purchases these medical devices because the companies, obviously,
cannot stay in business at a loss.
I note the presence of my colleague and friend from Arizona. I would
bring this to his attention.
Mr. President, I ask unanimous consent to engage in a colloquy with
my colleague from Arizona.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. McCAIN. I mentioned earlier, I say to my friend, Senator Kyl, the
letter and press conference of our, I think very courageous, Governor
and a speaker of our Arizona House and Senate. They held a press
conference yesterday and announced the letter they were sending to the
President of the United States. I think she graphically demonstrates
not only the incredible burden this lays on our home State of Arizona
but on States all over America.
Isn't it true, I ask my colleague from Arizona, that not only has the
State of Arizona warned of the consequences of this legislation, in the
State of Arizona we may have on our ballot a statement included in our
State constitution that no one should be forced to buy health
insurance. Isn't it true that other States both have enacted
legislation and are working on their own State constitutions to prevent
this mandatory health insurance purchase and the included tax increases
and costs on their States?
Mr. KYL. Mr. President, I appreciate my colleague bringing that to
light.

[[Page S1762]]

The answer, of course, is absolutely yes. I think at last count there
were some 38 States that had expressed either through their attorneys
general, Governor, or State legislature the intention to file
litigation, and some of those States, such as Arizona, will have either
ballot propositions or some have already passed legislation, such as
Idaho, that has the effect of law to exempt their citizens from having
to participate in this Federal mandate.
I ask my colleague, has this letter been printed in the Record yet?
Mr. McCAIN. I had it printed in the Record, and also I highlighted
the comments the Governor said, ``imploring our Congressional
delegation to vote against your proposal. . . .'' Therefore, ``the
reason for my position is simple: we cannot afford it.''
Mr. KYL. Mr. President, if I could, the Governor had sent a previous
letter, which is also in the Congressional Record, in which she
specified the amount of money, $4 billion of extra costs, for the State
of Arizona after our State has already slashed billions from the
budget. In fact, our State is in such financial doldrums that they
literally had to sell some of the buildings at the State capital in
order to generate revenue, and then they are leasing those back.
Our State is in terrible financial condition. As my colleague pointed
out before, with the number of homes in foreclosure and underwater, it
is a terrible situation. Now to impose an additional $4 billion expense
on the people of the State of Arizona with this legislation, as the
Governor said, is very objectionable. She has urged our colleagues in
the House of Representatives, therefore, to oppose the legislation.
Mr. McCAIN. I would like to bring to my colleague's attention--one of
the major health care providers in our home State of Arizona and across
the country is Banner Health, as my colleague knows. There is a letter.
Mr. President, I ask unanimous consent the letter from Peter Fine,
CEO of Banner Health in Phoenix be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

March 15, 2010.
Hon. John McCain,
U.S. Senate, Senate Russell Building, Washington, DC.
Dear Senator McCain: The President has called on Congress
to pass H.R. 3590, the Senate's Patient Protection and
Affordable Care Act, before Easter, along with some changes
that the Administration recently outlined. This legislation
would greatly expand Medicaid at a tremendous cost to
Arizona. Our state cannot afford its current Medicaid program
and your support for H.R. 3590 would be fiscally
irresponsible.
The Arizona Legislature adopted an $8.5 billion spending
plan this past week for SFY 11, addressing one of the largest
deficits of any state. This budget drastically reduces
spending for the Arizona Health Care Cost Containment System
(AHCCCS)--Arizona's version of Medicaid. Specifically, this
budget cuts $2.7 billion in state and federal dollars as
follows:
Eliminates funding for the AHCCCS expansion population,
known as Prop. 204, as of Jan. 1, 2011. As a result, nearly
310,000 adults at or below 100 percent of the federal poverty
level will lose health care coverage under AHCCCS.
Repeals the KidsCare program, Arizona's version of SCHIP,
as of June 30, 2010. KidsCare provides health care coverage
for 47,000 children from low-income families.
Eliminates all Medicaid funding for Graduate Medical
Education, which supports physician residence training
programs.
Cuts $14 million in Medicaid Disproportionate Share
Hospitals (DSH) payments and reduces the number of hospitals
eligible to receive DSH.
Cuts provider payments up to 5 percent beginning October
2010. If Prop. 100 (the one-cent sales tax referendum) fails
to pass on May 18th, the AHCCCS Administration is authorized
to cut provider rates up to 10 percent.
Eliminates behavioral and mental health services for 36,000
individuals, including 14,600 adults who have a serious
mental illness.
Despite these and other drastic program cuts, Arizona's
budget still has $2.5 billion structural deficit--the
difference between on-going expenditures and on-going
revenues. And if Prop. 100 (the one-cent sales tax
referendum) fails, the structural deficit will be a
staggering 43.4 billion.
Arizona has run a budget deficit in eight of the last ten
years. The state's reliance on long-term borrowing to finance
operations has grown significantly and serves only to further
exacerbate the on-going structural deficit. To put a finer
point on it, our state's budget has become a house of cards.
Banner Health, Arizona's largest provider of health care
services, supports expanding access to health care services
for the uninsured but not as an unfunded mandate. According
to the AHCCCS Administration, the Medicaid expansion in H.R.
3590 will cost Arizona $3.9 billion from 2014 thru 2020. The
state simply cannot afford this expansion. This state cannot
financially support the first dollar to gain the federal
match and if the legislation calls for expanded Medicaid
coverage, the federal government will have to financially
support it in total. While the legislation has many good
things that could still be put in place by going after them
individually rather than in a large complex bill, the
negative impact of the unfunded mandates associated with the
expansion of Medicaid will devastate Arizona. Therefore, I
strongly urge you to oppose H.R. 3590 unless the unfunded
Medicaid expansion is removed or fully funded by the federal
government. If not, the effect on the state and its financial
condition will be devastating and will reach unprecedented
levels. Thank you.

Mr. McCAIN. His letter states:

The President has called on Congress to pass H.R. 3590. . .
.
This legislation would greatly expand Medicaid at a
tremendous cost to Arizona. Our state cannot afford its
current Medicaid program and your support for H.R. 3590 would
be fiscally irresponsible. . . .
Despite these and other drastic program cuts, Arizona's
budget still has a $2.5 billion structural deficit--the
difference between on-going expenditures and on-going
revenues. . . .
Arizona has run a budget deficit in eight of the last ten
years.
Banner Health, Arizona's largest provider of health care
services, supports expanded access to health care services
for the uninsured but not as an unfunded mandate. According
to the AHCCS Administration--

That is our State's version of Medicaid--

the Medicaid expansion in H.R. 3590 will cost Arizona $3.9
billion, from 2014 through 2020. The state simply cannot
afford this expansion. The State cannot financially support
the first dollar to gain the federal match and if the
legislation calls for expanded Medicare coverage, the Federal
Government will have to financially support it in total.
While the legislation has many good things that could still
be put in place by going after them individually rather than
in a large complex bill, the negative impact of the unfunded
mandate associated with the expansion of Medicaid will
devastate Arizona.

Mr. KYL. Mr. President, I say to my colleague, Mr. Fine, a leader of
one of the very large health systems in the State of Arizona, had been,
I would say, very forward leaning, maybe even supportive of the health
care reforms that had been proposed by the President initially. This
comes from someone who wanted reform and who notes in this letter that
there are some good things there, but he has finally concluded that the
imposition of the unfunded mandates and other features of the
legislation simply make it--unsustainable.
I ask my colleague for the exact word. I am not sure if it was
``unsustainable.'' But he said: So this legislation should not be
supported. Instead, he suggested the approach that we have taken, which
is we should take the good features that address specific problems and
try to deal with them one by one rather than in this comprehensive
form.
This is from someone who initially was pretty supportive of trying to
move forward with this and now has concluded it is just too much and
the State cannot afford it.
Mr. McCAIN. Also, I am very interested. I said earlier, before my
colleague came to the floor, that the announcement this morning that
Caterpillar has announced the health care bill would cost the company
$100 million more in the first year--$100 million more, just
Caterpillar, in the first year alone.
The hour is late. But what I think maybe my colleague and I should do
is ask people from Raytheon and Boeing and other major manufacturing
companies--by the way, many of them are export driven, Intel and
others, that are located in our State--what the cost to them would be.
If Caterpillar says it is $100 million more in 1 year, I can imagine
what the costs are going to be to the major manufacturers that are
located in the State of Arizona as well.
Again, I want to repeat--I know Senator Kyl agrees with me--I would
like to congratulate our Governor for standing up for the people of
Arizona, for the courage she has shown more than once in her press
conference. The statement she, joined by the members of the
legislature, made is an important aspect of this debate. We should know
in Washington what our actions will do to the people of the States we
represent.

[[Page S1763]]

As Senator Kyl mentioned, 38 States are taking some kind of action or
another to prevent this piece of legislation from--however it comes
out, certainly in its present form, which we know will not change very
much if it is passed--wanting us to stop and start over.
I hope our colleagues will recognize if this legislation passes
through this weekend, through the House of Representatives, that the
fight will then come back to the floor of the Senate. If in the worst
case scenario this legislation is passed by the Senate and signed into
law by the President of the United States, there will be a movement
throughout the country that will be entitled ``Repeal Now'' or
something like that, which will argue strenuously through
demonstrations, at the ballot booth, and at tea parties and gatherings
all over America that we will repeal this legislation.
Back in the 1990s there was a piece of legislation called
catastrophic health care. We passed it through the Congress. The
President signed it. The American people said no.
This fight goes on. All of us want to fix the health care system. All
of us want to bring health care costs down. This is not the way to do
it. It is certainly not the way to do it, which would be done strictly
on a partisan basis for the first time in history that legislation of
this magnitude is passed without a broad, bipartisan basis for it.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Arizona.
Mr. KYL. Mr. President, I am going to be speaking on the legislation
pending before us. Perhaps Senator Dorgan would like to lock in
speaking time after I am done?
Mr. DORGAN. Let me ask unanimous consent to be recognized following
the presentation by Senator Kyl.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. KYL. Mr. President, I am going to speak in more detail later,
following up on comments that my colleague from Arizona, Senator
McCain, has made. He has rightly pointed out that the Governor of the
State of Arizona and our legislative leaders discussed in press
conference in Arizona the impact of this legislation in Arizona. They
are very worried. They have urged our congressional delegation to
oppose the legislation. I will make some comments about that.
But I do want to address this question of the so-called perimeter
rule, which is relevant to the FAA bill that is before us, and an
amendment that has been filed by Senator Ensign that will be modified
and refiled sometime today, either by Senator Ensign or by Senator
Hutchison. It is an amendment which I support.
I am going to discuss the perimeter rule and the way that the
amendment would change it, briefly, today, and then after it is filed
we will have a little bit more to say about it. The Ensign amendment
would have the effect of modifying an archaic regulation that has had
the effect of limiting competition and travel options for those who fly
in and out of Ronald Reagan Washington National Airport.
Many years ago, Congress restricted the departure or arrival of
nonstop flights from airports that are more than 1,250 miles from
Reagan National Airport. It is called DCA, in the terminology--1,250
miles. That established a perimeter beyond which planes could not fly
into or out of Reagan National Airport. That is referred to, therefore,
as the perimeter rule. Effectively, it forced passengers in the Western
United States either to use Dulles Airport or to use some other hub
partway through the country, change planes, and then fly into Reagan
from that shorter distance.
Obviously, this is inconvenient and discriminatory against citizens
in the western portions of the United States who, I submit, should have
equal access to their Nation's Capital as citizens who are closer to
the Capital.
The original purpose of it was a valid one, and it was to ensure the
new Dulles Airport--I think now over 50 years old, but I still think of
it as a new airport--would become successful. It did take a few years
for Dulles to establish itself as a major national and international
airport, now serving, I think--just 2 years ago, the last year for
which I have statistics--over 24 million passengers, which is millions
more than Reagan Airport.
So it is clearly both an international hub in the United States, as
well as the long-haul airport serving the Washington, DC, area. It is
thriving, as I said. It has something over 24 million passengers, and
that was as of over 2 years ago.
Over the years because of not only the success of Dulles Airport but
also improvements in technology and handling more airplanes and
handling more planes on the ground and, importantly, in reducing the
noise of jet engines, the desire of more people to be able to travel
directly into Reagan Airport has obviously increased, and there has
been pressure to grant at least a limited number of exceptions for the
traveling public which is eager for options in getting in and out of
the Washington, DC, area.
So a very few limited exceptions to this perimeter rule were created.
Yet today there are only a dozen nonstop flights--12--between
Washington National and the entire Western United States; specifically,
4 flights to Denver, 3 to Phoenix, 2 to Seattle; 1 to Las Vegas, 1 to
Los Angeles, and 1 to Salt Lake City. And that is out of approximately
400 flights from Washington Reagan Airport. That is the only number--
12--out of more than 400 flights traveling to those important cities in
the United States--Los Angeles and Phoenix, 2 of the top 5 populated
cities in the entire country.
In 1999, now more than a decade ago, the Transportation Research
Board found that the perimeter rules ``no longer serve their original
purpose and have produced too many adverse side effects, including
barriers to competition.'' Of course, barriers to competition not only
make it more costly for flyers but also reduce the ability of airlines
to compete and create stress on them even to remain in business. With
all of the other stresses that have impacted airlines recently, this is
just one more.
The same Transportation Research Board found that these perimeter
rules ``arbitrarily prevent some airlines from extending their networks
to these airports; they discourage competition among the airports in
the region and among the airlines that use these airports; and they are
subject to chronic attempts by special interest groups to obtain
exemptions.'' We all are aware of that latter point because we hear
about it. Every month, it seems, there are people who are putting
pressure on to try to get more exemptions.
There is also legislative precedent that supports this argument that
this DC perimeter rule should be repealed. This was done just 4 years
ago in 2006 in the Wright amendment reform of 2006.
In 1979, there was a Federal law passed, headed by Speaker Jim
Wright, of the House, that restricted flights at Dallas's Love Field
Airport. Love Field was the first airport in the Dallas region, and
this legislation originally limited most nonstop flights from Love
Field to destinations within Texas and neighboring States of Texas.
But, as I said, in 2006 we passed the Wright Amendment Reform Act,
which issued a full repeal of this Love Field perimeter rule. There
were certain conditions to it, but the bottom line was that lifting the
restrictions at Love Field gave the public a lot more flight options,
it cut prices, and it made traveling for the traveling public much more
efficient.
The Ensign amendment would have much the same effect with respect to
the Washington, DC, area. Here is the key thing it does: It would amend
the DC perimeter rule by allowing any carrier that currently has slots
at Reagan Airport--not saying new air carriers would come in; only
those that currently have slots--they could simply convert slots they
currently have that serve large hub airports inside the perimeter to an
airport outside the perimeter.
The first concern is, well, what about the cities that are served
inside the perimeter? The amendment is limited to large hub cities, so
there isn't an argument that some smaller city is going to be cut out.
The only flights that could be transferred would be flights that
already go into large hub cities, cities that are already served with
plenty of flights and can be. So an airline, in order to take advantage
of this amendment, would have to remove a

[[Page S1764]]

flight from one of its large hubs and transfer it to a city outside the
perimeter, a city such as Phoenix or Las Vegas or Los Angeles or Salt
Lake City, for example. This is referred to as the ``slot conversion
provision,'' and this is the guts of the amendment. It does not add
flights; it does not take flights away from small communities; it
simply allows the airlines to move up to 15 flights per carrier from a
hub that they already have to some city outside of the perimeter, the
1,250-mile perimeter.
It ensures that service to small and medium hub airports is not
affected, and it would not alter the slot regulations at DCA--no new
flights in or out of DCA. The only difference is that when a plane
takes off from Reagan National Airport, its destination may be Los
Angeles rather than--pick a city--Omaha--well, Omaha may be a smaller
city--perhaps Dallas or Chicago. So there are no new allowable flight
operations. The airplanes are the same, no additional concentration at
the airport, and obviously very little impact on Dulles because of the
fact that there would be so few flights and they would be going to
cities that presumably are already being served.
As I mentioned, it is capped at 15 round trips per carrier. It is
expected that only five carriers could take advantage of the provision
and that not all of them would be able to take full advantage of it. So
the maximum number of flights would be 75, and it is likely that it
would be far fewer than that. But even if you take the maximum of 75
flights, you are talking about well over 100 flights in and out of
Dulles as it is right now. According to the Metropolitan Washington
Airports Authority, Dulles has 333 daily flights to 83 U.S. cities and
59 daily flights to 43 international cities. Obviously, 75 beyond the
perimeter would have a negligible impact on the operations or demand
for Dulles Airport.
The key, as I said, is we will be able to create greater options for
passengers, thus reducing their cost of travel, providing greater
flexibility, access to the Nation's Capital at a somewhat more
convenient location, and help for airlines that need to do everything
they can to stay in business to serve the traveling public. Airlines
are under a great deal of economic pressure these days, and what these
airlines have said is this will help them continue to serve the
traveling public if they are able to change this perimeter rule.
So we are going to be able to debate further the Ensign amendment,
which is scheduled to be considered by the Senate at 5:30 on Monday.
Because of the fact that it would simply increase the ability of--the
airlines' flexibility to move from large hub cities today to similar
cities outside the perimeter, it is our hope that our colleagues in
Virginia, who naturally have been very concerned over the years about
ensuring the continued success of Dulles Airport, concerned about the
environment for their citizens both in the Dulles area and in the area
of Reagan National Airport, that their concerns would be assuaged by
the fact that this is very limited and it, as far as I can see, has no
adverse impacts of any kind for the citizens of Virginia.
So we would hope eventually to be able to work something out here
where we could modify the perimeter rule. It is anachronistic; it is
decades old. As I said, a lot has changed since it was put into effect,
and we are hoping this is the time to do it. There will be no better
opportunity than on this FAA reauthorization bill. In fact, it is
probably the only opportunity. Given that fact and given the fact that
we have been trying to accomplish this for many years, I think it is
safe to say that those of us who support this are going to insist this
legislation be the vehicle for finally making a change.
I very much appreciate the ability of probably the key person on the
Democratic side, Chairman Rockefeller, but also the chairman of the
subcommittee, Chairman Dorgan, to discuss this matter seriously, and
the Senator from Virginia, Mr. Warner, to discuss this, recognizing
that the conference committee is presumably where all of these issues
are going to be hashed out given the fact that the House of
Representatives adopted an amendment relating generally to the subject
matter but not the Ensign amendment at all.
So it would be my hope, with the kind of constructive conversation we
have had in discussing this, that that kind of constructive
conversation can continue and we can get this matter resolved as part
of the FAA reauthorization legislation.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from North Dakota.
Mr. DORGAN. Mr. President, I thank the Senator from Arizona for his
comments, and I think his comments describe, No. 1, the rather
complicated set of issues--slot rules, perimeter rules for Washington
National, which are rather complicated, somewhat controversial. Yet I
think he knows and I know and everyone understands that when there is a
conference on the FAA reauthorization bill, the House brings to that
conference some provisions the House has completed on slot rules.
So it is going to be an open discussion, and it seems to me all of us
understand that things change, and the slot and perimeter rules will
always be a subject of change. My expectation is there will be a change
coming out of that conference.
I think the discussion we had last evening, as all of us work
together trying to understand what is the optimum solution that relates
to the needs of all of the interests concerned, is something we can and
should strive to achieve, and I think we will do that.
So I appreciate the cooperation of the Senator from Arizona and
certainly the strong feelings of the Senator from Virginia. My guess is
that this will get resolved in the right way because I think all of us
understand the good will here to do it, and that will allow us--in
order to unlock this bill and get it finished Monday night, we needed
to try to find a way to reach a common ending here. And if we can--and
we will, I believe--on Monday evening finalize this bill, that will be
a significant achievement at long, long last.

Energy

I want to talk about energy policy. I wanted to spend a little time
speaking about another important subject. Right now, this Congress is
very focused on health care, all the time these days, and for good
reason because I think the health care debate is reaching a conclusion.
It will get finished perhaps Sunday or Monday in the House and then
taken up next week here in the Senate. But there is another issue out
there that has had a lot of discussion, and it is very big, important,
controversial, and urgent, in my judgment, and that is the subject of
energy and climate change. There is a great deal of discussion about
the intersection of energy and climate change; that is, energy security
for our country and trying to protect our planet from climate change.
Typically, most of us do not think much about energy. We just use it,
and we assume it comes from somewhere. But we use it, and we are
pleased to be able to have access to it. Starting in the very early
hours of the morning, when an electric alarm goes off, a sleepy hand
reaches over and shuts off the alarm and then turns on a light and then
perhaps even turns on a television or a radio. Then in many households,
probably uses an electric toothbrush, a toaster, a coffee pot, and
more. For those who shower in the morning, a hot water heater keeps
that water nice and hot. For those who work really hard, of course,
they shower after work, but all in all, it is the same hot water
heater. And we do this all day long. We just take advantage of flipping
a switch and a light goes on and putting a key in an ignition and the
engine starts, but not realizing that all of this is made possible by
energy, and we use a lot of it.
We had a circumstance in the Washington, DC, area a few years ago
when a lot of homes were out of electricity, I should say, for upwards
of a week. You know, only then did people understand what role it plays
in their lives. All of a sudden, there was no television, no lights at
night, or no hot water. So then people understood the importance and
the role of energy.
So here is this issue of energy security. We import a lot of our oil
from outside of our country. A substantial amount of the oil reserves
in the world is produced in countries that don't like us very well. So
is that a security issue? I think it is, and we ought to worry about
that--being less dependent on others for our energy. Particularly in a
day and age of terrorism, we

[[Page S1765]]

should be more concerned about the issue of national energy security.
Even as we do that and work on the issue of energy security, we are
faced with questions about how we protect our planet. We now understand
from the wide consensus of scientists is there is something happening
to the global climate. Much of it is related to the amount of
CO2 and other greenhouse gases that are emitted into the
atmosphere from man-made sources. So how do we have a future that
addresses our energy production and use and that reduces the
CO2 to bring about a lower carbon future in order to protect
our planet?
These two pieces must fit together and relate to each other: How do
you promote greater energy security and how do you protect the planet
with respect to global climate change?
Well, with energy security, there are about three major ways: one,
you produce more energy; two, you conserve more energy and use it more
efficiently in all kinds of ways; and three, you maximize renewable
energy, even as you produce more from traditional sources. With respect
to climate change, you take a look at what are the carbon emissions
from fossil energy sources and then find ways to lower those emissions.

I want to talk a little about the dilemma we have, and I have spoken
about it before. We wrote a bill in the Senate Energy Committee last
June. We passed it out on a bipartisan vote, and it has been
languishing on the Senate calendar ever since. The reason it has
languished and not been brought to the floor of the Senate is because
there is another group in this Chamber who says: We will not accept
working on an energy bill--even though the bill, by the way, lowers
carbon emissions and is taking steps to do exactly what you would do to
actually reduce carbon. Even though that is the case, we have a group
of other folks in this Chamber who say: We do not intend to allow an
energy bill to come to the floor unless it is part of a cap-and-trade
climate change bill. Well, I want to talk about that a bit.
My colleague, this past week--I probably will not name him--but,
according to this article, ``came out swinging . . . against the idea
of passing just an energy bill.''

``It's the `kick the can down the road' approach,'' said
[one of our colleagues]. ``It's putting off to another
Congress what really needs to be done comprehensively. I
don't think you'll ever have energy independence the way I
want until you start dealing with carbon pollution and
pricing carbon. The two are interconnected.''

He pledged to fight against bringing the Energy and Natural Resources
bill to the floor of the Senate. Then he said it is a ``half-[blank]''
approach bill, and so on.
He is wrong. Everybody has a right to be wrong, of course, but he is
wrong. The bill the Energy Committee passed actually reduces carbon
emissions. If you want to reduce carbon emissions, you can have a
debate in here about targets and timetables. But it is the actual
energy policies that reduce carbon. That is exactly what we did in the
Energy bill.
That Energy bill will maximize the production of energy where the
wind blows and the Sun shines. If you can maximize renewable energy
from the wind and the Sun, then you dramatically reduce carbon. The
only way you can do that is to decide as a country: Here is where we
want to go.
It is interesting to me that if you ask someone about Social Security
or Medicare or a number of other things 50 years from now, they will
give you their estimates of this or that. Then you ask them this: What
kind of an energy future do you want America to have? What do we aspire
to achieve? How will we use energy 50 years from now? They do not have
the foggiest idea. They have not thought much about it. Well, they
should, and we should.
But here is the situation. I feel we ought to produce more here at
home. We ought to conserve more. We ought to promote much greater
efficiency. We ought to maximize the use of renewable energy. We ought
to do all those things. But I feel we ought to find ways to put caps on
carbon. I also am willing to price carbon. I think a price signal on
carbon is important.
What I do not support, and have never supported, is offering a
trillion dollar carbon securities market to Wall Street so they can
trade carbon securities on Monday and Tuesday--with their inevitable
bubble of speculation--and then tell us on Thursday and Friday how much
our energy is going to cost, as a result of the trades they made early
in the week. I have no interest in doing this, given the history of
what has happened on Wall Street, with the bubbles; and there have been
plenty of them. The last bubble threw us right into the ditch as a
result of the most unbelievable avarice and greed and speculative
behavior we have seen in this country in about six or eight decades. I
have no interest in saying to them: Here is a new trillion dollar
carbon security market. You all grab it and trade it. By the way, they
are already prepared to trade carbon derivatives--and probably very
quickly synthetic derivatives. I have no interest in helping them do
that.
But that is not the only way to address this issue. We could consider
other options. We can do a carbon fee. We can do some sort of hybrid
approach in which there are auctions by the government, just as we
auction T-bills. There are other ways to do that. I support a cap on
carbon, and I support finding a way to price carbon. I just do not, and
will not, support a new carbon securities market for Wall Street to
decide what the price of carbon is going to be.
Having said all that, my hope is that perhaps we all could get
together and bring the Energy bill to the floor that actually takes
steps to reduce carbon. By the way, if you are opposed to that, you are
apparently opposed to reducing carbon. Bring that bill to the floor--
and if somebody here wants to do cap and trade, have them offer an
amendment and try to bolt that amendment onto the bill. If they have
the votes, good for them. I am willing to vote for an amendment that
puts a price on carbon when a bill comes to the floor. I will consider
voting for something that caps carbon and puts a price on carbon. Yet,
I will not vote for cap and trade with Wall Street manipulation. I will
vote for the underlying Energy bill, which should be done because that
is the way you begin to lower carbon.
There are many important aspects of the Senate Energy bill. We build
an interstate highway of transmission capability so you can gather the
energy from the wind where the wind blows and then send it on
transmission lines to the load centers that need it. The same is true
with solar energy. We would have the first ever national renewable
energy standard in the history of this country--the first ever--saying
15 percent of electricity must be produced from renewable sources. I
would offer an amendment on the floor that would take that to 20
percent. I believe it should be at least 20 percent.
We have provisions to support building retrofits and greater
efficiency. We do all of the things: maximize renewable with a national
RES, support the development of an interstate transmission capability
and more. Why on Earth, then, would they oppose bringing that bill to
the floor, to do exactly what they suggest has to be done ultimately to
meet the targets they want to propose? I want to mention, as we deal
with this issue--the very fact there is an urgency with respect to
energy and also climate change--the very fact that urgency exists means
there are a lot of things going on.
I want to describe some of them that I think are very positive. I
want to do that because in this Chamber on health care and virtually
every other subject, most of what is discussed is negative. I
understand that problem. That is what we work on. We work on the things
that do not work. We find out what is wrong and debate that. And the
old saying that I have described often: Bad news travels half way
around the world before good news gets its shoes on--is true in this
Chamber as well. It is what sells. But there is a lot of good news.
Let me describe some good news with respect to energy and climate
change. First, in terms of the production of oil, we have had some
important successes. In North Dakota, my home State, the U.S.
Geological Survey has identified the largest reserve of oil that is
recoverable using today's technology that they have ever surveyed in
the history of the lower 48 States--4.3 billion barrels of technically
recoverable oil. Here is how they get it. It is a 100-foot seam called
the Bakken Shale which is about

[[Page S1766]]

10,000 feet below the Earth. They punch a hole in the planet with a
little drilling rig. They go down 2 miles, make a big curve, and go out
2 miles. So they have one drilling rig. They are drilling a well down 2
miles, take a big curve out 2 miles, and then hydrofracture with high-
pressure solution. With that, the oil begins to seep, and they pump the
oil out. In North Dakota, they drill a new well about every 30 days.
We have 100 drilling rigs in North Dakota right now. Last year, for
the first time in a long, long, long time, we actually produced more
oil than we did in previous years. Over decades, we have been on a slow
decline in production. But not last year because we are discovering
more oil and more natural gas. So there is good news in those areas.
With respect to wind, take a look at wind turbines that are going up
all across this country. We are seeing the same with solar. There is so
much good news about the production of energy.
Let me tell you about the inventiveness because I think inventiveness
is going to solve some of these problems. We have people coming in all
the time wanting to get through what is called the valley of death, if
they have a new idea. A new idea needs to get sustained funding and
support in order to demonstrate at scale. Often it is hard to get the
money. That is part of the problem in terms of the valley of death that
they have to go through. Some of them never make it through.

There is a person who is developing synthetic microbes that can be
used to consume, or in layman's terms, eat the coal and leave methane
in its wake. Wouldn't that be interesting: synthetic microbes that
would turn a coal seam into methane.
There is a person who has what he described as a lollipop-shaped
microbe they discovered that breaks cellulose more efficiently than any
other known microbe that would then make cellulosic ethanol that you
would put in your car that is one-third less expensive. That would be a
big deal. I do not know whether it works, but they claim it does.
I have had a presentation by a guy who says he has a diesel engine
that gets 100 miles to the gallon that is being tested. We have had
presentations from a guy who has invented a process for taking the flue
gas from a coal plant, mineralizing it, and turning it into a product
that is harder than concrete which also contains CO2. So you
get rid of the CO2, which is the problem, by creating a
product that has value that is harder than concrete.
We have projects around the country now of taking the CO2
from a power plant and using the CO2 to produce algae--that
single-cell pond scum that you see in wastewater, the green stuff--
producing algae with CO2 and then harvesting the algae for
diesel fuel. Isn't that something? You take a problem and you turn it
into a fuel.
We have another group working on algae that excretes the lipids, and
with very little treatment it becomes the fuel. There are so many
people doing so many things. I had a group come in to tell me about
their new patent that will make a different kind of wind tower--blades
and turbines--that they believe will reduce the cost of producing
energy from wind towers by 50 percent. Well, maybe that is the better
mouse trap. Maybe the world will beat a path to their door. I do not
know.
But there are so many breathless new ideas that are being discovered.
Our national laboratories are studying the guts system of a termite.
Why are we studying 200 strains of bacteria in the guts system of a
termite? Because when a termite eats your house, a termite creates
methane gas. Well, that is not so unusual. That happens with a lot of
organisms that eat something. But it also produces hydrogen. This
little bug that eats your home produces hydrogen. If we can figure out
a way to turn wood into fuel, just as a termite does, then we would
have something interesting and important, and those experiments go on.
We can take the CO2 from a coal-fired power plant,
transport it, and invest that into oil wells and pull up much more oil
from wells that were nearly depleted. This is called enhanced oil
recovery and has been used for years. All of these things are happening
around our country, and all of them, it seems to me, have very
interesting potential.
We had testimony at one of our hearings from a Ph.D. from Sandia
National Laboratory who talked about experiments they are doing there
using a sunlight heat engine and putting CO2 into one side,
water into the other side, fracturing the molecules, and then
chemically recombining them and producing a fuel, water, and
CO2. My point is this: There is a race to the finish here in
this country by a lot of inventive people to find new ways to produce
new energy and find new ways to be able to continue to use our abundant
sources of energy while at the same time protecting the atmosphere and
our planet. I am absolutely convinced that some of these ideas are
going to be the ideas that represent the silver bullets.
We appropriated about $37 billion to the Department of Energy through
the Recovery Act funding, which has been described as the largest
venture capital firm in energy in the history of humankind. Through the
leadership of Dr. Chu, Matt Rogers and others at DOE, they are funding
a lot of inventive, interesting new approaches to address these diverse
energy challenges. How do you continue to use current fossil energy
while protecting our planet? How do you continue to use coal through
geologic sequestration or beneficial use of CO2? How do you
create new kinds of fuels? How do you expand the use of renewables? All
of these things are happening now, and all of them, I think, are
exciting, and I think will have a profound impact on what we do 5, 10,
25, and 50 years from now.
We are working very hard to try to electrify the automobile fleet,
and I believe in the years ahead we will see a much greater movement to
a predominantly electric vehicle fleet. So those are the kinds of
changes we will see.
I know this is important for two reasons. We stick holes in the
Earth, and we suck out about 85 million barrels a day. We also know
that of that roughly 85 million barrels a day, one-fourth of it needs
to come to the United States of America because that is our appetite
for that oil. We are a country whose people depend on and whose economy
runs on oil and on energy.
We know the Chinese and Indians look at this, and in India and China,
we know there are people who want to drive vehicles. In the very near
future, I expect that hundreds of millions of additional people will be
driving cars around this planet. They are going to want to find a gas
station to stop at once a week to put fuel in those cars.
What does that mean for us, for our supply of energy that is
necessary to run the American economy? That is why all of these things
are important.
Let me go back to where I started. We are having this debate about
whether the Energy bill that was passed out of the Senate Energy
Committee on a bipartisan basis should come to the floor of the Senate.
My response is, yes, it should come to the floor of the Senate. I am a
little tired of somebody saying it is not a worthwhile bill to debate.
This person isn't on the Energy Committee. This person doesn't know the
specifics of that bill or at least misrepresents it in a press article.
If there are those who wish to have a cap-and-trade debate in the
Chamber, let them come, but let's bring the Energy bill to the floor.
That is the way the Senate works. You work a bill up through the Energy
Committee, doing something you think is good for the country. In this
case, our bill increases energy security and begins to reduce carbon
emissions. We should bring that bill to the floor through the regular
order. Then, if somebody wishes to offer amendments to cap carbon, I
will be supportive of those amendments. If somebody wants to offer
amendments to put a price on carbon, I could be supportive of that.
However, I will not support the aspect of cap and trade which creates a
further abyss by giving Wall Street a $1 trillion carbon security
market with which to trade for our energy future.
I know I have given this speech five or six times, the first five
times to no avail. Perhaps, I hope, now that we are nearing D-day,
wherein if we don't get an energy bill to the floor, we will have
finished last year and this year having done nothing about what I think
is an urgent national need. We will not have taken steps to bring about
greater energy security and doing the kind of things that are necessary
to reduce carbon emissions.
The Senate Energy Bill takes both of those steps. The fact is, we
have now

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lost nearly a year's time because others have wanted to bolt on cap-
and-trade provision, or they won't allow it to come to the floor unless
they bring their cap-and-trade proposal to the floor.
Understand that I am in favor of capping carbon. I am willing to
price carbon. However, I am not willing to agree that we ought to
abandon the work of the committee which actually begins to reduce
carbon. I am also not willing to agree, given Wall Street's recent
history, to dive into a pool of carbon derivatives with carbon
securities so they can determine our energy pricing future.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Arizona.

Health Care

Mr. KYL. Mr. President, I wish to go back to the subject my
colleague, Senator McCain, was discussing earlier today. He had printed
in the Congressional Record a letter sent by the Governor of the State
of Arizona to the Speaker and to the majority leader of the Senate
relating to the health care legislation, imploring them not to impose
the new mandates that would cost the State of Arizona additional funds
for covering Medicaid patients and urging the Members of the
Congressional delegation to reject the legislation that does that.
It is not clear yet, because it has been hard to go through the
entire legislation, what all the changes are in the last bill, but I do
wish to discuss those that have at least been identified by the staff
who have had an opportunity to read the bill since it was put on the
Web site yesterday.
To back up a little bit, let's remember there was a bill that passed
the House of Representatives. Then there was a bill that came out of
the Finance Committee in the Senate. It was combined with the bill that
came out of the HELP Committee in the Senate. This was done behind
closed doors. It was essentially done by the majority leader in the
Senate. That bill was not the subject of the normal committee process,
but it was presented to the Senate floor. The Senate then modified that
legislation and voted on it and sent that back to the House of
Representatives. So the latest bill represents a piece of legislation
drafted by representatives of the White House, the Senate, and
primarily the House of Representatives, behind closed doors, primarily
to add elements to it that the President desired and to ``fix'' parts
of the Senate bill that Members of the House of Representatives did not
want.
There is an editorial in the Wall Street Journal today called ``March
Madness,'' which discusses this a little bit. In the first paragraph
they say:

No bribe is too costly, no deal too cynical, no last-minute
rewrite too blatant.

The first sentence says:

Has there ever been a political spectacle like the final
throes of Obama care?

I admit I have never seen anything in my roughly 24 years in the
Congress such as this, either in terms of substance or in terms of
process.
I note that several days ago the President said several times he
wants an up-or-down vote on this legislation. ``We just ask for an up-
or-down vote,'' he said. But it now turns out the President and his
colleagues in the House of Representatives don't want an up-or-down
vote. In fact, yesterday, on a purely party-line basis, Democrats
defeated, 222 to 200--some Democrats supporting the Republican
resolution--but defeated the resolution offered by Republicans that
would have required them to vote up or down on the Senate bill.
So what the President requested--an up-or-down vote--is, in fact, not
going to occur in the House. Instead, they are going to pretend the
Senate bill has been passed. The word they use is ``deem.'' We are
going to deem it passed. We are not going to vote on it, but it is
going to be passed anyway. One might say: How on Earth could that
happen?
Well, there is a way they have figured out in which they can include
the Senate-passed bill in a rule they will then pass, and by passing
the rule, they will deem the Senate bill passed and send it to the
President and he would then sign it. Then, later, they will amend that
bill through what they call the reconciliation process. But there is a
little problem with that, too, because when the reconciliation bill
comes back over here, as the chairman of the Budget Committee has
acknowledged, it will be changed. There are points of order that lie
against it and those points of order will be upheld and potentially the
bill could be amended as well so it will have to go back to the House
of Representatives. The reality is, what the House Members are hoping
will correct the Senate-passed bill will not, in fact, do all they hope
it will do.
The Speaker of the House, Nancy Pelosi, told reporters last week:
``Nobody wants to vote for the Senate bill.''
I guess this is the way they avoid that vote, by having the deeming.
They will assume it has passed, even though they haven't taken a vote
on it. The reason they don't want to vote on it is because it has a lot
of bad features from their perspective--and I think from mine as well--
but their hope to fix all those bad features is going to fail as well.
This editorial I mentioned in the Journal points out one of them, and
it is the House demand to delay the tax on insurance plans from 2013 to
2018. That is something labor unions have very much wanted, and they
want to respond to labor unions. They note that Richard Trumka, who met
one on one with President Obama Wednesday--he is the head of the AFL-
CIO--has wanted to accomplish this. The effect it would be to reduce
Social Security payroll tax revenues. The reconciliation bill expressly
forbids any impact on Social Security. So that would be subject to a
point of order, and 41 Republicans have said we will vote to uphold the
points of order. So this particular change the labor unions very much
want in the taxation of the so-called Cadillac plans is not going to be
able to be made in reconciliation. It will be subject to a point of
order. The point of order will be sustained. The bill will have to go
back to the House of Representatives. One of the big things they wanted
to fix will not be fixable by reconciliation. That is just one example.

There are several changes we are aware of in the bill, and let me
identify those for my colleagues. I am sure there will be others we
will discover. Those of us who opposed the bill complained about the
roughly $\1/2\ trillion in new taxes. Well, this latest bill increases
the taxes by over $70 billion. The taxes will now be increased by
almost $570 billion; to be precise, $569.2 billion. The Senate bill
increased taxes by $493.6 billion. So we have now about $77 billion
more taxes in this legislation than in the bill the Senate passed--$77
billion in more taxes. The CBO has, of course, said these taxes will be
passed on to the consumers of health care and the buyers of health
insurance through higher rates.
Medicare. Medicare was cut in the Senate bill by $464.6 billion, but
under this new bill, Medicare will be cut by $523.5 billion, obviously
well over $\1/2\ trillion, and much of that will be in the Medicare
Advantage area we have all been complaining about.
The individual mandate is the requirement that individuals will pay a
tax if they don't buy a federally approved insurance policy. This is
going to be raised by a couple billion dollars. The Senate bill had it
at $15 billion. It is now going to be $17 billion. I don't know whether
that is because they assume more people will fail to buy the policy
and, therefore, will simply be collecting more revenue or the amount of
the tax has been increased. Either way, it is an individual tax
increase, all of which, of course, is administered by the Internal
Revenue Service.
The employer mandate. This imposes $52 billion in new taxes on
employers that don't offer government-approved insurance. That is
almost double from the Senate bill, which was at $27 billion. I can
guarantee the small business folks are up in arms about this additional
new tax on employers.
I mentioned the Medicare Advantage plans. They are now cut by $131.9
billion. The Senate bill cut them by $118.1 billion.
The payroll taxes, which is probably the most destructive of all
these tax increases because it goes right to job creation, are
increased. These are now $210 billion. All these figures are over 10
years. The Senate bill was $86.8 billion, and that was enough. But
think about this: From $86 billion in the Senate-passed bill, the
higher payroll taxes

[[Page S1768]]

are now up to $210 billion--so from $86 billion to $210 billion. That
is 2\1/2\ times higher, and that is a direct tax on employment.
We just considered a bill that gives a break to employers, a payroll
tax break to employers that hire people who have been unemployed. We
understand there is a direct relationship between how much an employer
pays in payroll taxes and how many people he can afford to hire or to
retain--and I say ``he''--about half of small businesses are women
owned, so I should obviously say he or she. We understand the
relationship between the amount of payroll tax you have to pay and the
amount of people you can afford to hire. Yet, in this legislation, we
now impose $210 billion worth of new payroll taxes on employers. This
will be a job killer. Whatever minuscule efforts we have been making in
these other stimulus plans to try to increase jobs, with not much
effect, I might say, and at huge cost per job, all that gets wiped out
when you impose this kind of tax directly on hiring or retaining
employees.
Then there is the 40-percent excise tax on the high-premium plans.
This raises $32 billion. As I say, this is a problem because
reconciliation, by its terms--this isn't a matter of interpretation.
Reconciliation precludes an effect on Social Security. That is the way
it is written. You cannot affect Social Security in reconciliation.
Because of the effect that this provision has, this is not going to be
able to remain in the bill.
All these estimates, according to CBO, are preliminary. In fact, I
think their phrase was that there is substantial uncertainty in their
estimates. So these are not final estimates. Never before, I think,
have we passed a bill without having final estimates from the CBO.
It is interesting to me that as much as folks don't like the IRS, we
are now going to have to add about 16,500 additional IRS employees, at
a cost of up to $10 billion, just to administer the IRS-enforced
provisions of this health care legislation. For example, every citizen
is required to buy an insurance policy. There are certain exceptions,
depending upon your wealth, but you have to buy an insurance policy the
government identifies for you. If you do not, then you have to pay a
tax, and that is administered through the Internal Revenue Service.
That is why they are going to need 16,500 more employees. How do you
like that for increasing the size and the power of the Federal
Government?

Let me mention some of the other effects of the legislation. One of
the payroll tax increases is a brand new tax. It is destructive,
especially to senior citizens or others who have investment income
because, for the first time in our history, we would be applying the
Medicare payroll tax to all investment income of people with incomes
over $200,000. That includes, as I said, investment income--dividends,
capital gains, income of that sort. We have never taxed that in the
past.
Moreover, this is going to hit people with far less income very
quickly because it is not indexed for inflation. Just as the
alternative minimum tax, which originally applied to about 218
millionaires, was never intended to apply to the vast majority of
middle-income Americans, now it applies to over 23 million American
taxpayers because we did not index it for inflation. Likewise, this
tax, too, will be applied to more and more Americans as the years go
on.
I mentioned the higher premiums. The Congressional Budget Office has
specifically said these taxes will be passed on to all Americans. The
taxes are imposed in a variety of ways: If you have insurance, you get
taxed. If you do not have insurance, you get taxed. If you are an
employer, you get taxed. If you do not have insurance for your
employees, you get taxed. If you do and one of your employees goes to
an exchange and is subsidized, you get taxed. You get taxed if you need
a new device, such as a heart stent or a diabetes pump, even a
wheelchair, if you need new drugs to take care of you. Why would we
impose taxes? We are trying to help people with their health care. You
need medical devices and you need pharmaceutical products to help you
stay well or get better. Why tax those items? It is just beyond
imagination.
I can imagine why we would tax alcohol or tobacco or some other sin,
but the very things we need to make us healthy we are going to tax.
Amazing.
We are going to tax insurance. Of course, that immediately gets
passed on to you in the form of higher insurance premiums, which is one
of the reasons that CBO says, yes, insurance premiums will go up under
this bill. Why do that? Because insurance companies are bad. This is
brilliant. This is like shooting yourself in the foot. We do not like
insurance companies, so we are going to tax them and then turn right
around and add that tax to your insurance premiums. The politicians
then say: We punished the insurance companies. We are on your side.
Right, they are on your side so they make sure you pay higher insurance
premiums.
What does the Congressional Budget Office say? We are not even
talking about where your employer provides the insurance. Take the
individual insurance market where you have to buy it; the premiums as a
result of the legislation will go up between 10 and 13 percent, and in
some States it is a lot more than that.
Oliver Wyman Group, which is a very respected third party, has
estimated that it is in the neighborhood of 50 percent for most folks,
and in my State of Arizona it is 72 percent in insurance premiums. That
is wrong. When Congress passes legislation that we are warned in
advance is going to increase insurance premiums, whether it is 10
percent or 70 percent because of the legislation, it is wrong to pass
that kind of legislation. Even in the nonprivate markets, CBO says the
cost will go up because of medical inflation. We are not bringing
insurance premiums down.
There will be more lost jobs. This bill nearly triples the penalty on
businesses that cannot afford to provide their workers with health care
coverage. It was $750. Now it is $2,000 for every worker. This applies
to part-time workers as well as full-time workers. This does not make
sense. Businesses are trying to stay in business, keep people on their
payroll or, hopefully, one of these days hire new people. Yet we impose
these kinds of burdens on them. This is wrong.
What about the idea that we are going to affect the deficit? First of
all, as I said, the Congressional Budget Office has said their
estimates are subject to revision. They are offered with substantial
uncertainty and are preliminary estimates only. They make these
estimates based on what Congress gives them. If Congress includes in
the legislation a provision that says we will cut $500 billion from
Medicare, then the Congressional Budget Office has to score that as a
$500 billion cut to Medicare, even though about half of that cut is the
same kind of thing we have tried to do over the years to eliminate
waste, fraud, and abuse. Of course, if it could be done, it would have
been done.
The President, when he talked about this over a year ago in his State
of the Union speech, could have spent this last year cutting out a lot
of waste, fraud, and abuse. If it is there to be cut out, he could have
done it. It is hard to do. But in the law, the way this has been
written, it will be done; therefore, the Congressional Budget Office
must score it as having been accomplished. It is not going to happen.
As a result, this bill will be in deficit. It will not create the
budget surpluses.
Think about it. One of my friends said: This is a pretty neat deal.
We are going to add 30 million people to the insurance rolls and reduce
the size of the deficit. He said: I have a great idea. Let's get rid of
the deficit by insuring everybody in China. Of course, the absurdity of
the argument makes the point. You do not save money by spending money
to insure more Americans. Every American understands that, which is why
when we look at the surveys, they all laugh.
When they are asked the question: Do you think adding more people to
the insurance rolls and paying for that is going to reduce the deficit?
They say: Of course not, and it is ludicrous to suggest that it is.
I feel sorry for CBO that has to, with a straight face, say this will
reduce the deficit. The only reason they have to say that, or can say
it, is Congress gives a bill that says: You must assume it will reduce
the deficit because we

[[Page S1769]]

are going to make all of these savings in waste, fraud, and abuse. It
will not happen.
There are so many different gimmicks in it. Let me mention two: the
physician payment cliff for Medicaid whereby payments for primary care
physicians are increased for 2013 and 2014, and then it goes away. Do
you really think we are going to pay physicians at the same rate we are
paying them today, or slightly increase the payments in 2013 and 2014,
and then they are going to suffer a 22-percent or 23-percent cut every
year thereafter? Of course not. Yet that is how they balance this out.
They assume a 23-percent cut in physician payments. It is not going to
happen. It would be an abomination.
How do you with a straight face ask physicians to take a 23-percent
cut in what they receive in reimbursements from the government? It is
already difficult for them. In fact, the Mayo Clinic in Phoenix says it
has to cut out many of the services and not take any additional
Medicare patients because the reimbursement from the government is not
enough to keep them in business.
By the thousands physicians are leaving the Medicare and Medicaid
Programs. They cannot stay in it right now. Yet we are to assume we are
going to cut them another 23 percent? It will not happen. Yet that is
what the CBO must assume in making the budget projections.
The bill also hides the cost of filling in the so-called doughnut
hole by not phasing it in. There are a whole variety of these gimmicks.
I will mention one more.
This is the so-called CLASS Act, a long-term entitlement. They
generate a bunch of revenue up front to make payments later on.
However, the bill steals that money, reduces the cost of this new
entitlement program, and never tells us how it is going to make it up
later when it has to pay for the CLASS Act. It is a Ponzi scheme. The
first dollar in they use to take care of the last investor, and
eventually there isn't enough money to take care of the last investor,
so that investor loses all the money, just like what happened with
Bernie Madoff. No idea how they are going to pay for the CLASS Act once
they use all the money they collected for it, spend it all on the new
entitlement, and then have nothing in the till when they have to pay
off benefits under the CLASS Act.
Social Security, same thing. They count the money twice. They say: We
are going to extend the Social Security Program for 17 more years; it
will be viable. However, we are going to take the same money we are
applying to that, and we are going to pay for this new entitlement out
of it, $500 billion.
You cannot count the money twice, as the CMS Actuary pointed out.
The bill is rife with these gimmicks that say it is going to be
balanced. It is not going to be balanced. Everybody knows it is going
to cost trillions of dollars. Mr. President, $2.3 trillion is a low
estimate for the first 10 years of operation.
Let me close with a couple other points.
One of the things that has caused people so much angst about this is
the sweetheart deals. The Senate bill was stuffed with them. Our House
colleagues and, I might say, some of our Senate colleagues, too, said:
That is wrong; we are going to fix some of them. I applaud those who
realized, perhaps after the fact, but at least realized this was
totally inappropriate. Things such as the ``Cornhusker kickback'' to
Nebraska, that is being fixed in the bill. My guess is, even though
some of these may be subject to budgetary points of order, some of them
can be fixed through the reconciliation process. But there are still a
bunch of them in the bill.
For those who said we have to take all of these sweetheart deals out
of the Senate bill and fix that with reconciliation, no. Some are still
there, and there are new ones added.
We talked before about the ``Louisiana purchase.'' It is still in the
bill. Medicare coverage for folks in Libby, MT, still in here. Mr.
President, $100 million for a Connecticut hospital, still in here.
There is a new one. Tennessee, it turns out, is an important State in
terms of votes in the House of Representatives. So Tennessee hospitals
get more money for the so-called DSH payments, the disproportionate
share. Tennessee hospitals--is that going to stay in here?
Another one was put in to help North Dakota relating--this is a whole
other story. We have now taken over student loans for college education
in the health care bill. In case you did not realize, it is not just
health care. After taking over GM, Chrysler, and insurance companies,
AIG, and a bunch of other sectors, now we are going to take over
student loans. That is going to be put in the health care bill.
It turns out that hurts banks. Obviously, banks have a lot of
employees who provide students with these loans. North Dakota has some
banks that were going to get hurt. At least one bank in North Dakota
was going to be able to continue to offer the student loans. To his
credit, I am informed the chairman of the Budget Committee, the Senator
from North Dakota, said: Wait a minute, we cannot do that, so I will
try to get that out somehow or another. That is an appropriate thing to
do.
You see how this happens when bills are written behind closed doors
and there is an effort to make sure there are enough votes to pass it?
They need to sweeten the pot, and this is the kind of thing that
happens. These are some of the provisions. I am sure we will discover
others that are in the bill.
One of my colleagues pointed out there are going to be some deals
that have been made that do not show up in this bill. He is going to be
looking for those deals wherever they do show up.
I note the last two items. We did not want to put more people in
Medicaid, but there are another 2 million people in Medicaid. Still 23
million are uninsured after all is said and done. The whole idea was to
get 30 million people more insured and try to reduce costs.
We know it does not reduce costs. It does not get all the people
insured, and those who are covered, the majority are put into the
Medicaid Program that we know is broken.
Finally, the bill does not prohibit Federal funds flowing to
insurance plans that cover elective abortions. This is a matter of
concern to a great many people in both the House of Representatives and
the Senate. They did not try to fix it in the reconciliation bill. But
even if they had, that would be subject to a point of order as well.
The bottom line is that this legislation, crafted behind closed doors
yet again, is replete with special deals, is worse in virtually every
respect that I can see from the Senate bill. It increases the top line
spending, increases taxes by maybe close to $70 billion or a little
more, cuts Medicare now by $523 billion, adds to the individual
mandate, adds to the employer mandate, hurts Medicare Advantage plans
even more, a much higher payroll tax--$210 billion increased payroll
tax, a job killer--increases insurance premiums even more. It is hard
to see how you can say that this is going to help the American people.
As the editorial in the Wall Street Journal that I cited before
concludes:

This is what happens when a willful President and his party
try to govern America from the ideological left, imposing a
reckless expansion of the entitlement state that most
Americans, and even dozens of Democrats in Congress, clearly
despise.

I hope, Mr. President, that colleagues in the House of
Representatives will have the courage to stand up and represent their
constituents rather than the President and the Speaker of the House.
They owe their obligation to respond to the message their constituents
are sending: They want to stop this bill, to start over, and get it
right.
The ACTING PRESIDENT pro tempore. The Senator from Ohio.
Mr. BROWN of Ohio. Mr. President, I have only been in the Senate
about 3 years, but you don't have to be too quick around here to figure
out that it is pretty easy to attack and to oppose and to try to stop
things.
I am fairly amazed at the number of people I see--and I will share
some letters of people from Ohio, from my home State, about this health
care bill and about what this means personally to them. I will do that
in a second, but just putting aside ideological arguments and political
attacks, these attacks that there is nothing good in this bill, it is a
government takeover, it is socialism, it is putting a government
bureaucrat between you and your doctor--the same argument the John

[[Page S1770]]

Birch Society used against Medicare we are hearing again. I hear those
things, but I really never hear anything constructive.
They talk about the deals, forgetting about the deals they made when
they were in the majority, which were huge giveaways to the drug
companies and to the insurance companies and giveaways to the oil
companies and to these big companies that outsource jobs to China.
Whoever had their hand out, whoever the special interests were, they
got what they wanted. Now I see my colleagues just shrink back and say
how horrible all this is. Well, they have nothing to offer.
They say: Let's stop; let's work together; let's start with a blank
sheet of paper and do this over. Well, they have no intention of doing
that. We spent a year answering their objections, and we accepted 160
Republican amendments in the Health, Education, Labor, and Pensions
Committee, amendments from Senator McCain, Senator Alexander, Senator
Enzi, Senator Burr, and Senator Coburn--from one Republican Senator
after another, one hundred sixty Republican amendments. It is never
enough. They continue to oppose. But in the 8 years when President Bush
was here and in the several years when they were in the majority in
both Houses, the only thing consequential they could do for health care
to insure the uninsured, to do anything, was to give hundreds--not tens
of billions but hundreds of billions of dollars of giveaways to the
Nation's largest drug companies and insurance companies.
Then I hear my Senate colleagues talk about we are blowing a hole in
the budget. The fact is, the Congressional Budget Office--and the
Presiding Officer understands this, because we all know the
Congressional Budget Office is not comprised of Democrats or
Republicans; they are not on our side or their side; they are simply
accountants and lawyers and actuarial people who play this straight--
the CBO says this bill more than pays for itself.
I wonder, Mr. President, if this water we drink here causes amnesia
for some of my colleagues because all of a sudden they are for
balancing the budget. But in 2000, when President Bush took office,
there was a budget surplus--a trillion-dollar budget surplus, year
after year, as far as the eye could see--and we had tax cuts for the
rich that they never even tried to pay for, and they never even tried
to pay for the Iraq war. Even Senator Simpson, one of the most
distinguished Senators of the Republican Party, who sat in this Chamber
for 18 years, said in the paper yesterday: Never, to my knowledge, have
we gone to war without paying for it. But they did that in those days,
and I didn't hear my colleagues saying: Let's pay for this Iraq war,
which cost us billions of dollars a month, month after month, year
after year. When they did the Medicare privatization--the giveaway to
the drug and insurance companies--they didn't try to pay for that
either. But now they are saying we have to balance the budget. And I
think we do, and I know the Presiding Officer and his constituents in
Chesapeake and Arlington and Richmond think the same thing because we
do need to balance the budget. But I find it curious, when the CBO says
this actually creates a budget surplus--and they are not willing to
believe them--that they were also not willing to pay for anything when
they were in the majority.
But putting that aside, this bill is too important for that. It is
too important to throw political accusations around. What is
particularly important is what this bill means to individual Americans.
I hear my Republican friends talking about we are cutting Medicare.
Yet this is the party that opposed Medicare, the party that tried to
privatize Medicare. Yet they accuse us of cutting Medicare? I know
nobody really believes that. They probably ought to quit saying it. It
undercuts anything else they say because, as I say, nobody really
believes that.
They say this bill was done behind closed doors. We had hearing after
hearing, negotiation after negotiation, and floor debates. This has
been going on, well, for 75 years, some would say, because Franklin
Roosevelt tried to do it, Harry Truman tried to do it, John Kennedy
tried to do it, Richard Nixon and Lyndon Johnson, who had some success
between Kennedy and Nixon on Medicare.
Instead, my colleagues would rather talk about process and deals. In
Washington, there is a buzz about process and deals, but in the country
there isn't because people in the country know why we are here and why
we are doing this. And as a result, Mr. President, let me take 5 or 10
minutes to read a handful of letters from constituents of mine because
this is really why we are doing this. We are not doing it to score
political points: This may help the Democrats or it may help
Republicans win the election.
That doesn't really matter. It may help or it may hurt a reputation.
None of that matters. What matters is this bill, and this matters to so
many Americans.
I have read letters on the Senate floor for months now as we have
debated this bill, and what is most common in these letters are two
things. One of the most common things I hear from so many people is
that a year or 2 years before they wrote these letters, they would have
said: I am satisfied with my health insurance; it seems to work pretty
well. Then something happened and they lost their job and then lost
their insurance or they got sick and it was so expensive that the
insurance company cut them off or they had a child born with a
preexisting condition and they couldn't get insurance.
The insurance company model is why this is important, because of what
it does individually for people. In a sort of macro way, think about
how insurance companies operate. I have a lot of insurance companies in
my State. I have no malice aimed toward them or their executives. I
think their executives are paid too much. The CEOs in the average
largest 10 insurance companies make $11 million a year. When they are
cutting people off from their insurance, I think that is a bit of an
overreach.

But I also think the insurance companies, because they compete with
each other, in a for-profit model, do things they probably would rather
they didn't have to do. Let me explain that for a moment. Insurance
companies hire a whole bunch of bureaucrats to decide they do not want
to insure potential customers. They look at all the new applicants, do
tests, find out things about them, and these bureaucrats make the
decision: We don't want to insure that person because that person has a
preexisting condition and will get sick and it will be expensive. So
they hire a bunch of bureaucrats to keep customers away. Then, on the
other end, they hire a bunch of bureaucrats to deny claims of their
customers when they get really sick sometimes.
So their business model is to keep customers away who are too
expensive, too costly, and to deny payments for those who actually get
expensive. That is their business model. That business model serves
their profitability, to be sure, but that business model doesn't serve
the American people.
So while we will continue to use private insurance in this country
for health care--many countries in the world do, although no country
uses private for-profit insurance. Many countries use private insurance
to run their health care systems, in whole or in part, but they are
nonprofit insurance companies. We will continue to use for-profit
insurance companies, but we are going to have a whole set of rules
around what they do. No more denying care for a preexisting condition;
no more putting a cap on coverage so that once you get sick and get
expensive, you could lose your insurance; people will be allowed to
stay on their parents' insurance until they are 26--a whole host of
things. Eighty-five percent of the insurance premium dollar must go to
health care, not to executive salaries and marketing and to hire all
those bureaucrats that the insurance companies do.
So that is the one thing mentioned by people in most of these
letters, people who were satisfied with their insurance a year or 2
years earlier but then found out it wasn't such good insurance.
The second thing in these letters--and a lot of this comes from
people in their early sixties--is many of them say they simply just
need to hang on until they reach 65 and become Medicare eligible
because then they will have the security and stability of something
they trust.
As Senator Cardin of Maryland knows, government really can provide

[[Page S1771]]

health care, as it does with Medicare, as it does with Medicaid, as it
does with TRICARE for all the Active military people in Maryland and
Virginia and Ohio. Government knows how to do this and can do it very
well. But this bill is not a government takeover. It uses the parts of
government that run the insurance, that do the insurance now, but it is
certainly not a government takeover.
Let me now share these three letters from constituents, and then I
will turn it over to Senator Cardin.
This first letter is from Melanie, Erie County in northern Ohio, the
county next to mine, along Lake Erie.

I have a health condition that requires me to be on thyroid
hormone replacement the rest of my life. But before my
condition was diagnosed, I had to undergo all kinds of tests.
And instead of being able to afford a 6 month and 1 year
prescription, I have to buy my pills monthly, depending if I
can afford them or not. We need a health care system that
doesn't let insurance companies decide whether I can afford
the medicine I need.

When someone is sick, they want to put their efforts into, how do I
get well, not into, how can I afford this? Do I have to cut the pills
in half? Do I have to take the pill every other day and hope that works
out right? How am I going to pay for it this month?
There is a mind-boggling statistic that a woman in this country with
breast cancer, without insurance, is 40 percent more likely to die than
a woman with breast cancer who has insurance. Part of the reason for
that is the anxiety and the fear people have when they are sick and
trying to get well but who have to worry about so many other things in
their lives and, most importantly, how are they going to pay for their
medical treatment and how is their family going to deal with this. This
bill will obviously help with that.
Here is a letter from John from Hancock County, Findlay, OH, not too
far south of Toledo.

I am a 44-year-old diabetic who has had this condition for
43 years. Most people who know me thought I would never make
it past 25.

He was diagnosed with diabetes at the age of 1, which is pretty
astounding.

What my insurance company has done to me may make
bankruptcy my only option. In 2008, I needed a new insulin
pump. I filled out all the paperwork that was required by my
insurance company. I received my insulin pump via mail and
thought everything was all right. I received a bill from my
pump supply company for $8,500, along with the supplies to
use the pump for an additional $5,500. That is a $14,000 bill
that my insurance company said they would not pay because of
preexisting condition.

What is the point of health insurance? What is the point of a system
where a man diagnosed as an infant with diabetes is faced with charges
such as this, when diabetes is a terrible affliction that an increasing
number of Americans have? We know how to manage it pretty well so that
people such as John can live a pretty long, productive life. Yet the
insurance company puts him through that. What will that do to his
diabetes and health generally, to have to worry about how he is
possibly going to come up with the $14,000?
Here is the last letter. It comes from Hayden, a young woman who is a
Peace Corps volunteer from Delaware County, outside Columbus. She e-
mailed us from Thailand, but she is an Ohioan.

I am thousands of miles away from you. I am far away from
family, friends, and my hometown of Sunbury, OH. I am a
member of the U.S. Peace Corps in Thailand. I believe I help
to provide for the common good. I am creative, courageous and
compassionate, and I believe my abilities can make a
difference. In 15 months I will return to the United States,
and I would like nothing more than to continue to work in
community development. But I might not be able to.
Unfortunately, my life depends on two pills, each no bigger
than your smallest fingernail. Without insurance, the cost of
these two small pills is often more than my rent. And I am
unlikely to get insurance unless I go to work with a large
company.
Too many of my friends are in the same situation. We are
young and bright, products of an American school system that
has taught us to think independently and pursue our dreams.
We want to be entrepreneurs, researchers, and community
activists.
We need the opportunity to start our own ventures, to take
responsible risks, and to go out into our communities--

Work to start businesses such as the Presiding Officer has.

I work everyday to give voice to those who have none [in
the Peace Corps]. But today I need you to be my voice. I need
you to speak for my generation.
So please let me come home--

She writes, to Delaware, OH, now working in the Peace Corps in
Thailand; she e-mails:

. . . please let me come home to a system that is better
than the one we have now. My future depends on it.

She is serving this great country, the United States, in the Peace
Corps is doing the right thing with her life. When she comes back to
the United States, I hope this bill is passed. I hope the President of
the United States has signed this bill, and we can be a better country
as a result.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Maryland is
recognized.
Mr. CARDIN. Mr. President, I understand the Republican leader will be
coming to the floor and I will yield the floor as soon as the
Republican leader is here and then, after that, I ask that I will have
the opportunity to speak. But until the Republican leader comes to the
floor, let me compliment my colleague from Ohio, Senator Brown. He
points out this debate is about allowing every American to be able to
tell their children that when they get sick, they will have an
opportunity to see a doctor. It is about a small business owner who
should not have to chose between insuring his employees or maintaining
his workforce or expanding his workforce. It is about our seniors
having to decide whether they can take a pill or have to split that
pill because they fall within the doughnut hole and cannot afford
prescription medicines.
This debate is about whether we are, as a nation, going to be able to
bring down the growth rate of health care costs and guarantee that
every American has access to affordable health care and also bring down
our budget deficit in health care, which clearly we have to do in this
Nation.
I look forward to engaging in that debate. I came to the floor to
talk about the FAA bill, and I will do that after the Republican leader
has his opportunity on the floor, but I wished to thank Senator Brown
for pointing out how critically important this debate on health care is
to the American people.
I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. CARDIN. Mr. President, I ask unanimous consent the order for the
quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
The Republican leader is recognized.

Health Care

Mr. McCONNELL. Mr. President, well, it has come down to a few
wavering votes.
That is what this year-long debate has come to: a handful of
Democrats had been holding out to see the final bill.
Now we have it.
Anyone who was waiting to see what the final bill meant for
government spending should vote no, because this bill spends even more.
Anyone waiting to see what the final bill meant for Medicare should
vote no, because the Medicare cuts in this bill are even deeper than
the Senate bill that Speaker Pelosi said Democrats didn't want to vote
on.
Anyone waiting to see what the final bill meant for taxes should vote
no, because the tax increases in this bill are even higher than the
Senate bill.
Anyone waiting to see what the final bill did to the cost curve
should vote against this bill, because this bill is likely to bend the
cost curve up even further than the Senate bill, not down.
If you were waiting for a bill without the CLASS Act in it--a
provision that even top Democrats describe as a Ponzi scheme, then you
will vote against this bill, because it is still in there.
If you were waiting to see if they had cut out the sweetheart deals
that have outraged the Nation and soured the public on the entire
legislative process, then you have to vote against this bill, because
there are even more of them in there now.
If you were waiting for a bill that costs less, then you will vote
against this bill, because it costs even more than the last one.
And if you were waiting for a bill that wouldn't compel taxpayers to

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cover the cost of abortions, then you will vote against this bill
because this is, the National Right to Life Committee says, the most
abortion-expansive piece of legislation ever to reach the floor of the
House of Representatives.
Americans are outraged at what is going on here: a bill that aims to
shift a major segment of our economy into the hands of the government,
and which accomplishes that goal by imposing crushing burdens on
already-struggling seniors, middle class families, and small
businesses, is being rammed through Congress against the clear will of
the public. No amount of spin will change the fact that Medicare will
be deeply cut, insurance premiums and taxes will go up, the Federal
bureaucracy will grow, and as demand increases, the quality of care in
this country will get worse and worse.
Taking a bill that House Democrats are too embarrassed to vote on,
adding more than $50 billion in new taxes and slashing $60 billion more
from our seniors' Medicare and keeping sweetheart deals may make some
Washington Democrats ``giddy,'' but it is not reform.
This bill isn't an excuse to vote in favor of the Democrat plan for
health care. It is a reason to vote against it.
Anyone who votes for this bill is clearly less concerned about
responding to their constituents than responding to the pressure
tactics of Democrat leaders in Congress.
Some may have concluded that there is more merit in following the
cajoling voices in Washington than the clear voices of their
constituents back home, more merit in choosing to side with Democrat
leaders in their quest to ram this bill through over the wishes of the
American people.
Some may argue that the details we have seen since yesterday are
reason to support it. But if anything is clear in this debate, it is
that yesterday's CBO score is conclusive proof that this health care
bill is unsalvageable.
This is something the American people realized a long time ago, and
now they are counting on the final holdouts to vote on their behalf
this weekend. Now that they have seen the final bill, they can't
understand why anyone would do otherwise.
I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. CARDIN. Mr. President, I ask unanimous consent the order for the
quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. CARDIN. Mr. President, first, let me respond very briefly to the
Republican leader and say that, looking at what the Congressional
Budget Office has said, the objective scorekeeper, it says this bill
will accomplish bringing down the growth rate of health care costs, it
will substantially increase the number of Americans who have access to
affordable health care, and it will bring down our budget deficit. It
will bring down our budget deficit by over $130 billion during the
first 10 years but $1.3 trillion during the second 10 years.
That is making progress on dealing with health care costs and
bringing down the Federal budget deficit. The overwhelming majority of
Americans will see their health insurance premiums under this bill go
up at a slower growth rate than they would otherwise go up, and it will
cover another 31 million Americans who currently do not have health
insurance. They will be covered.
The appropriate question that should be asked is how will this
legislation affect health care versus what will happen if we do not get
health care reform passed, and I think it is clear this bill will
improve health care for Americans and bring down the cost of health
care for Americans.
Mr. President, I take this time to talk about the modernization of
the Federal Aviation Administration bill, and I wish to first thank
Senators Rockefeller, Hutchison, Dorgan, and so many others who have
worked on the FAA Modernization Act. Our aviation system clearly needs
modernization. Air traffic control needs to get into modern technology.
What I like most about this bill is what it does under facilities and
equipment, the NextGen flight guidance system using GPS satellite-based
guidance in order to control air traffic in America. That will
substantially cut down travel time for air passengers.
It will save us energy, which we all are talking about. Let me give
one example that will demonstrate how dramatic it is to go to a GPS
system. I think most Americans will be surprised to learn they are
using more high-tech technology in their cell phones than they are on
airplanes in America. I think they would be surprised to learn that.
But this bill will allow us to put that type of satellite technology
into the way that we control air traffic in America.
As I said, it will save time for the passenger, save energy for our
Nation. To give an example, today a flight from Washington, DC, Reagan
National Airport to Boston takes about 537 miles of air travel and
consumes over 7,000 pounds of fuel. Using GPS, using NextGen, we can
save over 20 percent of the mileage traveled and the fuel consumed. We
actually save over 1,000 pounds of fuel. That is just one flight.
Multiply that times the hundreds of thousands of flights throughout our
Nation. We can make a substantial improvement on productivity,
efficiency, and on energy consumption. We can significantly reduce the
number of delays. The delay not only inconveniences that one passenger
but, as you know, the whole system gets thrown into a morass when we
have delays. We will have much better on-time arrival rates because it
will be a more predictable flight using NextGen GPS technology.
The legislation also provides for new technology training
requirements for pilots and air traffic controllers. That is the safety
issue. We know air travel is safe, but we want to make it safer. This
legislation will give us the tools in order to do that.
It provides for grants for improvements to our airports around the
Nation. Let me talk for one moment about BWI, Thurgood Marshall
Airport, the largest airport in the State of Maryland. We have over
$400 million in projects ready to go to improve the efficiency of that
airport. I know Senator Warner is aware, at Washington Dulles Airport,
they have projects ready to go that will help in regard to not just
convenience for the people who use that airport, which is important,
but also safety issues, providing for the types of improvements
necessary to deal with the newer aircraft that are coming on board. All
this will reduce noise in the community, which is also another issue
that is important and I am sure Senator Warner has heard about.
We had 21 million passengers in 2009 use BWI Thurgood Marshall
Airport--21 million passengers. We have to keep up with that, and these
grant programs will allow us to do it. But let me tell you something
else. We have 35 other airports in Maryland. These are commercial,
municipal, regional, and general aviation airports. These airports are
in need of improvement. I have visited many of them.
That will not only be important for air traffic to our rural areas,
but it is also about economic development. This FAA modernization bill
is about jobs. It is about creating new jobs. But it is also about
communities being able to have the type of improvements to their
regional airports that will allow businesses to come in and take
advantage of that regional airport, bringing jobs to parts of Maryland
and our Nation that are, at times, difficult to find. Of course, today,
we need to find more jobs for America. This bill will help us in our
goal to increase the number of jobs.
I have talked about rural air service. I wish to talk particularly
about the essential air service, EAS, issue. I offered an amendment--
and I wish to thank the managers for accepting that amendment--that
would extend the expiration date on the mileage determination for those
rural airports that can qualify for essential air service.
That is important to the people of Hagerstown and that region because
that is the difference between the Hagerstown airport being eligible
for EAS help.
I have visited that airport in Hagerstown. I can tell you how
critically important it is to have passenger service. As a result of
that amendment, we have Cape Air service at Hagerstown. If we did not
have EAS, we would not

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have that passenger service. That means that airport is much more
viable. That is the reason for the EAS program, the viability of
airports in rural areas.
That is important for passenger service, but it is equally important
to have a viable airport so it can bring in the type of economic
activities that are associated by having an airport close by.
Hagerstown, that area, has been able to attract industry relating to
the aircraft industry because it has an airport there.
I must tell you, I do not think they would have the type of airport
if they did not have passenger service. So all of this comes together
and helps us create jobs in a part of Maryland that otherwise could
find it difficult to bring in new economic opportunities.
This bill is very important. I thank the managers again for including
that amendment in the managers' package. It includes the passengers'
bill of rights. Many of my colleagues have talked about the passengers'
bill of rights. We all know about passengers being stranded on the
tarmac for hours, strapped to their seats in a very uncomfortable
position. Well, that is inexcusable. Congress needs to speak to that.
I am pleased the passengers' bill of rights is included in this
legislation that will provide passengers with certain basic rights that
airlines will need to adhere to.
I also am pleased it includes workers, pilots, flight attendants.
This bill is about helping not just the passengers but helping all
those who work in the industry. It will help all the workers. That is
an important issue.
Before I yield the floor, I wish to talk about one other issue that I
understand the distinguished Senator from Arizona, Mr. Kyl, talked
about a little bit earlier; that is, amendments that are being
considered and several have been filed, I understand negotiations are
taking place as to the modification of the perimeter and slot rules as
it relates to Reagan National Airport.
Let me tell you, before we start fooling around with this, let's make
it clear that my colleagues understand how important this issue is to
the people of the District, Virginia, and Maryland. In 1987, a peace
agreement was entered into between the three jurisdictions and the
three airports that are located here: Washington Dulles International,
BWI Thurgood Marshall Airport, and Reagan National Airport.
All were involved in that agreement because, quite frankly, having an
airport located in a residential community is an issue of concern of
safety and noise and economic activities. So we have to be very mindful
what is done at Reagan National.
For that reason, we entered into these restrictions in regard to the
number of slots and the perimeters in which the flights originating
from Reagan National can travel. They were carefully negotiated, and I
urge us to be very careful about any modifications in those slots and
perimeter rules.
We also created the Metropolitan Washington Airport Authority to deal
with Reagan National and Washington Dulles International. But then the
slot issue and the perimeter issue were very important for the
development of BWI Thurgood Marshall Airport in Maryland. These are
very delicate balances.
The growth airports are clearly Washington Dulles and BWI Thurgood
Marshall. They have the capacity for growth; Reagan National does not.
It has a serious issue in regard to noise and safety to the community.
We know that. I would urge my colleagues to be very cautious on
modifying either the slot rule or the perimeter rule.
If we modify the slot rule, obviously, we are putting more traffic
into Reagan National that it cannot handle. The aviation experts have
told us that, that Reagan National is at capacity. It cannot handle
more slots. If you change the perimeter rule, then you are talking
about flights that currently go to cities such as Atlanta, Charlotte,
Philadelphia, Providence, Minneapolis, Miami, Boston, Detroit,
Cincinnati. All those flights are going to be affected.
So this is not about giving the airplanes more flexibility, it is
about affecting a delicate balance that currently exists when you have
three major airports located within a very short distance. I would urge
my colleague to be very cautious as we consider these amendments.
The ones I have seen so far are ones that I would oppose. I would
urge my colleagues to respect the three jurisdictions in which these
airports are located. We are not coming to you suggesting changes in
the slots and perimeter rules. We are not the ones coming to you asking
for it. It is our communities that are affected by the decisions. I
would hope my colleagues would respect the judgment of the Senators
from Maryland and Virginia.
This is a very important bill. It is a very good bill. It modernizes
our FAA. It provides for safety, convenience, and, as I said earlier,
will save time, save energy, and make our air traffic meet the growing
needs of those of who use our airports and Nation.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from North Dakota.
Mr. DORGAN. Mr. President, we have reached a unanimous consent
agreement, which I will read momentarily, with the minority and the
majority agreeing to the request. It is the way forward to a final vote
on the FAA reauthorization bill on Monday afternoon.
It is an important moment because it has taken a long while to get an
FAA reauthorization bill through the Senate. Finally, on Monday that
will be achieved. It will accomplish many objectives that are so
important for our country, air safety, and investment in
infrastructure, the passengers' bill of rights.
It is bipartisan. It represents all the best of what we should be
doing around here. It came out of the Commerce Committee on a
bipartisan basis. We have had this long discussion.
There are a couple discussions prior to the completion of the bill,
and one of them deals with the subject my colleague from Maryland was
just describing. But let me read the unanimous consent request. It has
been agreed to by the minority and the majority.
Mr. President, I ask unanimous consent that no further amendments,
other than those covered in this agreement, be in order to H.R. 1586;
and that when the Senate resumes consideration of the bill on Monday,
March 22, the time until 4:30 p.m. be for debate only, equally divided
and controlled between Senators Rockefeller and Hutchison or their
designees; further, that at 4:30 p.m., the Ensign amendment No. 3476 be
reported for consideration and that it be modified with the changes at
the desk; with the time until 5:30 p.m. for debate with respect to that
amendment, and that the time be equally divided and controlled between
Senators Warner and Kyl or their designees; that at 5:30 p.m., the
Senate proceed to vote in relation to amendment No. 3476, as modified,
that adoption of the amendment require an affirmative 60-vote
threshold, and that if the amendment achieves that threshold, it be
agreed to and the motion to reconsider be made and laid upon the table;
that if it does not achieve the threshold, then it be withdrawn;
further, that it also be in order for the amendment to be withdrawn
prior to the vote; that upon disposition of amendment No. 3476, as
modified, the pending McCain amendment No. 3527 be withdrawn; the
pending McCain amendment No. 3528, if not disposed of, the Senate then
proceed to vote in relation to the amendment; that upon disposition of
the McCain amendment No. 3528, the managers' amendment, which is at the
desk and cleared by the managers and leaders, be considered and agreed
to, and the motion to reconsider be laid upon the table; that the
substitute amendment, as amended, be agreed to and the motion to
reconsider be laid upon the table; that the bill, as amended, be read a
third time, and the Senate then proceed to vote on passage of the bill;
that upon passage, the title amendment, which is at the desk, be
considered and agreed to, and the motion to reconsider be laid upon the
table.

The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. DORGAN. Mr. President, that is a long unanimous consent request.
The potential would be only one vote on Monday or the potential might
be three votes or somewhere in that neighborhood. But it does, upon its
execution on Monday, allow us as a Senate to finish the FAA
reauthorization bill. It has so much to commend

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for our country. I am pleased to have negotiated with so many people--
Senator Hutchison, Senator Kyl on that side, Senator Warner and
others--that we were able to reach agreements so we will have a way
forward dealing with only a couple controversial issues that will
remain and then we will have final passage.
I know the Senator from Florida wishes to speak.

____________________