[Congressional Record Volume 158, Number 99 (Thursday, June 28, 2012)]
[Senate]
[Pages S4689-S4717]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                SCHEDULE

  Mr. REID. Mr. President, the next hour will be divided between the 
Republicans and Democrats. The Republicans will control the first half 
and the majority will control the final half.
  It was last night, but just barely, when we finally worked out some 
agreement on a piece of legislation we are dealing with. The House 
posted that last night just before midnight to meet their rules. It 
includes the transportation conference and flood insurance and student 
loans in one package. I say to all of my Senators that we are going to 
finish this before we leave. I hope we can do it today. We certainly 
can if the will is there. Otherwise, if it takes tomorrow or whenever, 
we have to finish the bill. I know everyone has a lot of work to do, 
but we have to finish this legislation. The student loan program 
expires at the end of the month. The highway program has to be 
completed by the end of the month. The work that has been done has been 
hard.
  I met with the Democratic chairs yesterday at noon. I explained to 
everyone that we were trying to work our way through this. These are 
veteran legislators, the chairmen of all of the committees here in the 
Senate. We talked a lot about compromise being what legislation is all 
about. Legislation is the art of compromise, consensus building, but 
when it comes right down to doing that, it is hard for Senators to give 
up what they want. But this is a bill that affects almost 3 million 
people. That is just the transportation part of it--the flood part, 7 
million people, and the student loan, 7 million people. So everyone had 
to give a little bit or we could not have gotten this done.
  I am terribly disappointed on a part of what did not get done. I have 
always been a big fan of the Land and Water Conservation Fund. I do not 
have a better friend in the world than Ken Salazar. This is something 
he wanted so very much, but we could not get it done. So there is a lot 
of disappointment in many different areas.
  But this is legislation at its best. I say that purposefully. It is 
hard to get these pieces of legislation done, but we got it done. And 
as I said, we are going to work through the process. With the Senate 
being such that it is, people can hold measures up, but they cannot 
hold them up forever. So we are going to work through this. It is for 
the betterment of our country if we complete this legislation as 
quickly as possible.


                Measure Placed on the Calendar--S. 3342

  Mr. REID. Mr. President, S. 3342 is at the desk and due for its 
second reading.
  The ACTING PRESIDENT pro tempore. The clerk will read the title of 
the bill for the second time.

[[Page S4690]]

  The assistant legislative clerk read as follows:

       A bill (S. 3342) to improve information security, and for 
     other purposes.

  Mr. REID. Mr. President, I would object to any further proceedings 
with respect to this matter at this time.
  The ACTING PRESIDENT pro tempore. Objection is heard. The bill will 
be placed on the calendar.


                              Health Care

  Mr. REID. Mr. President, there is a lot going on in Washington today. 
I so admire the Supreme Court's ability to keep everything quiet. I 
mean, it is really incredible that we are going to have two major 
decisions this week--one dealing with immigration, one dealing with 
health care--and there has not been a single word that has come out of 
the Supreme Court. I am so impressed. That is the way it has always 
been, and I hope it stays that way.
  Today the Supreme Court will rule on the constitutionality of the 
landmark health reform that made affordable, quality care a right for 
every American. Millions of Americans are already seeing the benefits 
of this law--I repeat, millions of Americans. The Democrats are very 
proud that we stood for the right of every man, woman, and child to 
lifesaving medical care instead of standing for insurance companies 
that worry more about making money than making people better.
  The Supreme Court's decision, being a lawyer myself--I know the 
Presiding Officer was the chief legal officer for the State of New 
Mexico, the attorney general--when you are in the area of law and are a 
lawyer, whatever the Court does, you accept that. That is our form of 
government. We are a nation of laws, not a nation of men. So whatever 
the Court does, we will work through that. If they uphold it, that is 
great. If they do not uphold it, whatever it is, we stand ready, 
willing, and able to work to make sure Americans have the ability to 
get health care when they are sick.
  I look forward to the opinion coming out in the next half hour or so, 
and we will see what that holds. I know that will cause a lot of 
interest here in the Senate, but we cannot take our eyes off what we 
have to do today; that is, figure a way forward on these other matters 
with which we have to deal--flood insurance, student loans, and the big 
Transportation bill.


                       Reservation of Leader Time

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
leadership time is reserved.
  The ACTING PRESIDENT pro tempore. Under the previous order, the 
following hour will be equally divided and controlled between the two 
leaders or their designees, with the Republicans controlling the first 
half and the majority controlling the final half.
  The Senator from Wyoming is recognized.


                            Debt and Deficit

  Mr. ENZI. Mr. President, I come to floor to talk about a bit of a 
crisis the United States is in right now. We are out of money, but we 
are not recognizing that we are out of money. We must make that 
realization soon. We are going to have to do some work for this country 
to keep it operating so that the next generation has the same hope as 
the present generation.
  I think the best example of where we are is probably this highway 
bill. Highways are important to this country. We need them to get from 
one place to another. We need them to move the goods across this 
country to keep the economy going--highways are extremely important. 
Highways have always been funded from a gas tax, until now. Using 
different funding is a prime example of what is about to happen in all 
of the bills that we do because we have run out of money and we haven't 
taken the necessary steps to solve that crisis.
  When the highway bill came to the Finance Committee, I suggested that 
we ought to change the gas tax so that there was an inflationary rate 
added each year for the following year. That was the least that I could 
think of to do for highways. It would have added half a cent a gallon. 
The price fluctuates at the pump more than half a cent a day.
  I have to tell you, though, that I really thought there would be 
strong support for doing something like that, taking a minimal step. I 
had the amendment devised so that it could be changed easily to 
increase that amount. The Simpson-Bowles deficit commission said--and 
this was over a year and a half ago--that for the next 3 years, we 
needed to raise the gas tax 5 cents per year for 3 years. So we really 
ought to be at 7\1/2\ cents or 10 cents in increase already. Now, if we 
did that, the highway bill could be funded from highway funds. And that 
is a user fee. If you drive, you buy gas. If you buy gas, you pay for 
the highways on which you drive.
  I have been talking about this ever since we started on the highway 
bill, and I have not had anybody say to me: You are wrong, we should 
not raise the gas tax. I was really surprised. I thought there would be 
a huge outcry and that I would be in a lot of trouble for suggesting a 
raise in the gas tax. But America understands we are broke better than 
Congress understands.
  Both parties told me we would not vote on my amendment. And we didn't 
vote on that amendment in committee, and we didn't vote on that 
amendment on the floor. Of course, by my count, I think I had two 
Democrats supporting me and two Republicans supporting me, but we 
didn't even really get to debate it. We should debate it. We should go 
to the logical spot for highway money, the spot that through the 
history of highways has been used to fund highways.
  So where are we getting the money? Well, we did raise the tax on 
people who have pensions, and that is very important. There is a trust 
fund--the Pension Benefit Guaranty Corporation has a trust fund to see 
that if a company goes out of business and it had promised pensions, 
then the Pension Benefit Guaranty Corporation's trust fund makes up 
part of that. They do not make up all of it, but they make it part of 
it. So it is an insurance policy for people across America who have 
pensions. And we said: That needs a little bit more of a jolt. So we 
did a couple of things. One of the things was to do some smoothing so 
companies would not have to put quite as much money into the fund, and 
therefore they would have maybe more profit, and on the profit they 
would pay taxes, and we can steal those taxes to put in the highway 
trust fund so that we can build the highways. We have never stolen 
money to pay for highways before. Never use the Pension Benefit 
Guaranty trust before. But this bill does that. And then there is 
another little bit of money that comes right out of the Pension Benefit 
Guarantee trust fund that goes into the highway bill. That is the wrong 
way to do business. We should not violate trust funds.

  Wait until the seniors who said ``don't touch my Social Security'' 
realize that Social Security is a trust fund and that we are stealing 
from trust funds. I think we will hear a furor across this country that 
will be unmatched if Social Security is touched. So we are not touching 
that one--yet.
  We have maxed out our credit cards. You know what a maxed-out credit 
card is. That is when you buy something and the clerk says: I am sorry, 
but there is a hold on your card. When you check on it, you find out 
that you have so much debt with that credit card company that they are 
not going to let you charge any more. Well, we have maxed out a lot of 
our credit cards. We are relying on foreign countries to help us out 
with our debt. There is a problem in Europe right now. The euro is 
having a real tough strain. Eight of the banks that have a lot of euros 
have invested that in U.S. bonds because we are the safest place in the 
world. But if those banks collapse, they will need their money. Between 
those eight euro banks and the four Japanese banks, that is 40 percent 
of the money, almost 40 percent of the money we borrow from other 
countries in order to keep our government going. We are at $16 trillion 
worth of debt. What is worse, we have quadrupled the bottom line on the 
Federal Reserve. We have made money--we have printed money to four 
times the amount of money we had 3 years ago.
  We are facing some really difficult times, and we are going to have 
to deed up to those. One of those ways would be to raise the gas tax 
and to do the highway bill the way the highway bill ought to be done.
  Now, I mention these trust funds, and I mention them for a very 
specific reason; that is, they found a trust fund

[[Page S4691]]

they could violate. They did it very cleverly. They did not mention it 
to anybody who is going to be affected by the trust fund. Fortunately, 
there were some diligent people who took a look at that highway trust 
fund bill, and they said: Wow, they are going after abandoned mine land 
money in this bill.
  That is an abandoned mine land trust fund. The money comes from coal 
that is mined, and the money, the tax on that coal, is supposed to go 
to fix abandoned mines across the country. The conference report's 
drafters found $700 million in that trust fund. That trust fund hasn't 
maxed out its credit cards because, so far, we are still mining coal in 
this country, and so far there is money going into it.
  But there are uses for that money that need to be achieved. It helps 
fix abandoned mine lands. Another use is taking care of orphan miners. 
I mentioned the pension folks before; when their company goes out of 
business, they get a little help. Under the abandoned mine land trust 
fund, if a coal company goes out of business and the miners don't have 
any health insurance then part of this abandoned mine land money goes 
to make them whole in the health insurance area.
  This system was part of a grand coalition that came together to solve 
some problems that are involved with mining in America. The companies 
and the employees and the States that were involved said this probably 
isn't the perfect solution, but it helps a lot of people, so we were 
going to do it, and we did it. We were able to override a point of 
order on the budget in order to maintain that trust fund and move the 
money from the trust fund to where it was supposed to be used.
  For more than a decade, the money wasn't even taken out of the trust 
fund, and do you know why? Anytime I asked about it and said we needed 
some of the money, the government said: Oh, I am sorry. You will have 
to put some money in there so we can take the money out. I said: What 
kind of a trust fund do you have to put money into twice before you can 
get money out? The money already went in there once before. Here is how 
it works. The money goes into bonds and the bonds go into the drawer 
and the money gets spent. Think about that. Seniors have been 
complaining about the Social Security trust fund and how we have been 
spending money from the Social Security trust fund. They were more 
clever than most people who are involved in trust funds because they 
figured it out.
  The Social Security trust fund has a whole bunch of bonds in the 
drawer. It doesn't have money in the drawer. But don't worry, those 
bonds are backed by the full faith and credit of the United States of 
America, and Europe is about to have a huge problem.
  It is kind of interesting. In America, every single man, woman, and 
child owes more than $49,000 in national debt--and it is growing daily. 
In one meeting I attended, I mentioned that figure and somebody said: 
Can I pay my $49,000 and not be responsible for the rest of it? I said 
that is not the way it works. Even if we could do that, that is not the 
way it works. So it is $49,000 for every man, woman, and child in the 
United States. If a child is born today, we can tag him or her with a 
$49,000 debt immediately.
  Why is that significant? You have probably watched Greece and Italy. 
Greece and Italy had to do 19 percent cuts. They cut pension plans 19 
percent. They cut employees 19 percent. They cut the number of 
employees 19 percent. They cut the services they provide by 19 percent. 
They cut everything by 19 percent. You probably saw there were some 
riots in their countries. If we cut 19 percent, there would be riots in 
this country. Here is an interesting fact. In Italy, they only owe 
$40,000 per person. In Greece, they only owe $39,000 per person. We owe 
$49,000 per person. We are considered to be the safest place in the 
world to put your money, and I think that is right--at the moment--and 
it will change if we don't act soon.
  If we keep doing what we are doing in the highway trust fund--and it 
shows better there than any other place I can think of--we won't be a 
secure place to invest. The way we are fiddling with funds and 
shuffling credit cards so we are not using the maxed-out ones, has to 
stop, my friends.
  With the highway bill before us, the conferees did construct a bill 
so they could get quite a few votes on it. They put a limit on the 
amount of money certified states could get from the abandoned mine land 
trust fund. It doesn't discriminate against very many States. It does 
discriminate against Wyoming, and so I make a plea that they not do 
that and remove the section of the bill. Trust fund money needs to go 
for what the trust fund said the money would go for.
  Even if they decide to steal from Wyoming--and I hope they don't--but 
even if they do, the money ought to go into the other States that are a 
part of the trust fund that need to do mine clean up. Over the 10 years 
of the bill, it takes about $715 million worth of money from the 
abandoned mine land trust fun--10 years. I did mention 10 years.
  There is a reason I mentioned 10 years. This highway bill we are 
talking about doesn't get all the money from all the places we are 
stealing from in a short enough period to pay for the highways we are 
going to build over the life of that bill. After the bill expires and 
all those things have been built, we will still be trying to collect 
the money from the sources it has been stolen from in order to pay for 
what has already been built. OK. What happens when we get to the end of 
this highway bill, and we are still waiting for all the places we stole 
the money from to get the money in? Where do we steal the next money 
from? We better raise the gas tax. We better take a look at what we are 
doing, and make changes. If there is a user fee--and that is what the 
gas tax is--if we use the highways, we buy gas; if we buy gas, we pay 
into the trust fund. We should use the user fee to pay for highways. We 
have an additional problem that is the user fee is probably diminishing 
because there are cars that run on electricity now, and that will 
probably be increasing. Alternative fuels will be increasing, and that 
will affect how much money goes into the trust fund.
  But just to meet the immediate needs, there needs to be something 
done, and stealing from other trust funds is not the way to do it. If 
we get in the habit of stealing from trust funds, Social Security will 
have to watch out. Of course, that will be the end of the road for a 
lot of people in this body if they start stealing from Social Security. 
But it ought to be the end of the road for people if they are stealing 
from other trust funds because it starts the habit, and we can't afford 
that habit.
  Mr. REID. 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 majority leader is recognized.


                          Affordable Care Act

  Mr. REID. Mr. President, I am happy, I am pleased to see the Supreme 
Court put the rule of law ahead of partisanship and ruled that the 
affordable care act is constitutional.
  This is a long opinion. We know when we come back here after the 
elections there may be some work we need to do to improve the law, and 
we will do it together. But today millions of Americans are already 
seeing the benefits of the law we passed. Seniors are saving money on 
their prescriptions and checkups, children can no longer be denied 
insurance because they have a preexisting condition--protection that 
will soon extend to every American. No longer will American families be 
a car accident or heart attack away from bankruptcy.
  Every Thursday I have a ``Welcome to Washington.'' Today we had a 
group of people from Nevada who have or have relatives who have cystic 
fibrosis.
  It has been so hard for these young people to get insurance. It is 
not going to be that way anymore. No longer will Americans live in fear 
of losing their health insurance because they lose a job. No longer 
will tens of millions of Americans rely on emergency room care or go 
without care entirely because they have no insurance at all. Soon, 
virtually every man, woman, and child in America will have access to 
health insurance they can afford and the vital care they need.
  Passing the Affordable Care Act was the single greatest step in 
generations toward ensuring access to affordable, quality health care 
for every person in America, regardless of where they live or how much 
money they make.

[[Page S4692]]

  Unfortunately, Republicans in Congress continue to target the rights 
and benefits guaranteed under this law. They would like to give the 
power of life and death back to the insurance companies. Our Supreme 
Court has spoken. This matter is settled.
  No one thinks this law is perfect. The Presiding Officer doesn't and 
neither do I. Democrats have proven we are willing to work with 
Republicans to improve whatever problems exist in this law or, in fact, 
any other law.
  Millions of Americans are struggling to find work today, and we know 
that. Our first priority must be to improve the economy. It is time for 
Republicans to stop refighting yesterday's battles. Now that this 
matter is settled, let's move on to other issues such as jobs.
  I note the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. McCONNELL. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Recognition of the Minority Leader

  The ACTING PRESIDENT pro tempore. The Republican leader is 
recognized.


                           Health Care Ruling

  Mr. McCONNELL. Mr. President, 2\1/2\ years ago a Democratic President 
teamed up with a Democratically led Congress to force a piece of 
legislation on the American people they never asked for and that has 
turned out to be just as disastrous as many of us predicted. Amid 
economic recession, a spiraling Federal debt, and accelerated increases 
in government health spending, they proposed a bill that made all those 
problems worse.
  Americans were promised lower health care costs, and they are going 
up. Americans were promised lower premiums, and they are going up. Most 
Americans were promised their taxes wouldn't change, and they are going 
up. Seniors were promised Medicare would be protected. It was raided to 
pay for a new entitlement instead. Americans were promised it would 
create jobs. The CBO predicts it will lead to nearly 1 million fewer 
jobs. Americans were promised they could keep their health plans if 
they liked it. Yet millions have learned they can't.
  The President of the United States promised up and down that this 
bill was not a tax. This was one of the Democrats' top selling points 
because they knew it would never have passed if they said it was a tax. 
The Supreme Court has spoken. This law is a tax. The bill was sold to 
the American people on a deception. It is not just that the promises 
about this law weren't kept; it is that it made the problems it was 
meant to solve even worse. The supposed cure has proven to be worse 
than the disease.
  So the pundits will talk a lot about what they think today's ruling 
means and what it doesn't mean, but I can assure you this: Republicans 
will not let up whatsoever in our determination to repeal this terrible 
law and replace it with the kind of reforms that will truly address the 
problems it was meant to solve.
  Look, we have passed plenty of terrible laws around here that the 
Court finds constitutional. Constitutionality was never an argument to 
keep this law in place, and it is certainly not one we will hear from 
Republicans in Congress. There is only one way to truly fix ObamaCare--
and only one way--and that is a full repeal that clears the way for 
commonsense, step-by-step reforms that protect Americans' access to the 
care they need from the doctor they choose at a lower cost. That is 
precisely what Republicans are committed to doing.
  The American people weren't waiting on the Supreme Court to tell them 
whether they supported this law. That question was settled 2\1/2\ years 
ago. The more the American people have learned about this law, the less 
they have liked it.
  Now that the Court has ruled, it is time to move beyond the 
constitutional debate and focus on the primary reason this law should 
be fully repealed and replaced--because of the colossal damage it has 
already done to our health care system, to the economy, and to the job 
market.
  The Democrat's health care law has made things worse. Americans 
wanted repeal, and that is precisely what we intend to do. Americans 
want us to start over, and today's decision does nothing to change 
that. The Court's ruling doesn't mark the end of the debate. It marks a 
fresh start on the road to repeal. That has been our goal from the 
start. That is our goal now, and we plan to achieve it. The President 
has done nothing to address the problems of cost, care, and access. We 
will.
  I yield the floor. I suggest the absence a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. UDALL of New Mexico. Mr. President, I ask unanimous consent that 
the order for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Whitehouse). Without objection, it is so 
ordered.


                       Honoring Our Armed Forces

                   Army Staff Sergeant Israel Nuanes

  Mr. UDALL of New Mexico. Mr. President, just last month we 
commemorated Memorial Day. Memorial Day is a day of remembrance, a day 
of mourning, and a day of gratitude. It is a day when Americans from 
all walks of life gather to thank and honor the people we have lost, to 
honor the men and women who gave their lives in service to our country, 
and to acknowledge a debt that can never truly be paid.
  I rise today to honor Army SSG Israel Nuanes. Staff Sergeant Nuanes 
died on Saturday, May 12, while serving in Kandahar Province in 
Afghanistan. He was fatally injured by the detonation of an improvised 
explosive device. He was 38 years old.
  In the decade that our Nation has been at war in Afghanistan, 
thousands of men and women have volunteered to serve our country. In 
order to protect others, they put their own lives at risk. They leave 
their homes and their loved ones to defend the freedoms we hold dear. 
Nearly 2,000 of them, thus far, will not come home.
  Staff Sergeant Nuanes was from Las Cruces, NM. He lived most of his 
adult life as a soldier. He was assigned to the 741st Ordnance Company, 
84th Explosive Ordnance Disposal Battalion, 71st Ordnance Group. He 
served two tours of duty in Iraq. After returning from Iraq in 2010, he 
enlisted for 6 more years. His unit deployed to Afghanistan earlier 
this year.
  Time and again he answered the call of his country. President Kennedy 
said:

       Stories of past courage . . . can teach, they can offer 
     hope, they can provide inspiration. But, they cannot supply 
     courage itself. For this, each man must look into his own 
     soul.

  In Iraq, in Afghanistan, wherever his country needed him, Staff 
Sergeant Nuanes had that courage. Despite the danger, despite the risk, 
he went where his country sent him with commitment, with determination, 
and with an unflinching sense of duty. He was awarded the Bronze Star 
and the Purple Heart. There is sorrow in his death, but also 
inspiration in his life.
  This courageous soldier loved his family. He loved his country. He 
made the ultimate sacrifice defending it. He leaves behind two 
children, Israel and Laurissa. He has left them far too soon.
  Abraham Lincoln said it best almost 150 years ago. There is little 
our words can do to add or detract on these solemn occasions. But I 
offer my deepest sympathies to the family of SSG Israel Nuanes. We 
honor his courage, we honor his sacrifice, and we mourn your loss.


                              Health Care

  Mr. President, we have all heard the historic ruling on the 
Affordable Care Act today. I know the Presiding Officer has been 
following this closely. We all have been following this closely. The 
Supreme Court has upheld the Affordable Care Act.
  The Affordable Care Act has moved us forward, but now the call on the 
Republican side is for full repeal of the law. So it seems their 
legislative objective is going to be to introduce a piece of 
legislation--and we will have a vote on the Senate floor--for full 
repeal. I wish to remind New Mexicans in particular what is at stake 
when we talk about full repeal.
  First of all, insurance companies today, with the Affordable Care Act 
in place, cannot deny coverage if a person has a preexisting condition. 
That is something that is tremendously important to New Mexicans. If 
someone has a young child who has cancer and they

[[Page S4693]]

have to get insurance, they can't deny them because of a preexisting 
condition.
  There is no doubt that we can improve upon the law, but New Mexico 
has already received more than $200 million in grants and loans to 
establish an insurance exchange, strengthen community health centers, 
train new health professionals, and so much more.
  Since passing the law, more than 26,000 young adults under 26 years 
old have been allowed to stay on their parents' insurance plans. Almost 
20,000 New Mexico seniors on Medicare received a rebate to help cover 
prescription costs when they hit the doughnut hole in 2010. And 285,000 
New Mexicans with private health insurance no longer have to pay a 
deductible or copay for preventive health care such as physicals, 
cancer screenings, and vaccinations. More is yet to come under the 
Affordable Care Act.
  So this is the contrast: There are some who are calling for full 
repeal; there are others of us who recognize that there are significant 
accomplishments, and we want to work further with the other side in a 
bipartisan way to put aside partisanship and move forward with 
improving our health care system.
  I note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                          Health Care Decision

  Mr. CORNYN. Mr. President, this morning's decision by the Supreme 
Court has clarified some things and has made other things more muddled. 
One, it has clarified the importance of the upcoming election on 
November 6, 2012. The only way to stop the overreaching by the Federal 
Government, including the President's flawed health care bill, is to 
elect a new President and a Congress that will repeal and replace this 
fundamentally flawed law.
  Before the health care bill became law, the President repeatedly 
assured the American people he would not raise taxes on the middle 
class. He declared emphatically that the individual mandate was 
``absolutely not a tax increase.'' But the Supreme Court has made 
absolutely clear the only way ObamaCare can be upheld as within the 
constitutional power of Congress is for it to be considered a tax 
increase, and a tax increase on every single American, regardless of 
income.
  The President told us his health care law would reduce premiums by 
$2,500 for the average family. That was another broken promise. Last 
year, the average American family, with employer-sponsored insurance, 
saw their premiums rise by $1,200.
  The case against this health care legislation is very simple: It 
relies on massive tax increases, job-killing regulations, and 
government coercion. It will place Washington bureaucrats between 
patients and their doctors and it will cause millions of Americans to 
lose their current insurance coverage. So much for ``if you like it, 
you can keep it.'' And as we now know, ObamaCare has made the problem 
of rising health care costs worse, not better.
  For these reasons and more, we need to repeal this entire piece of 
legislation and start over. We all share the goal of expanding health 
care coverage, but there are good ways and bad ways to do it. The 
authors of ObamaCare chose a fundamentally flawed way: Yet another 
government takeover.
  Perhaps one of the most telling things Congress has done in the last 
2 years is pass a bill under Medicare for prescription drug coverage 
for seniors. Rather than a government-run program, we created a 
marketplace for competition, where prescription providers can compete 
for consumers' favor by improved or lower cost and better service. 
Indeed, by using the cost discipline of a consumer-oriented approach to 
health care, that government program came in 40 percent under projected 
cost. That is the only time I know of in the health care field where 
the government has actually created a program that people like and that 
has come in significantly under cost.
  We cannot continue to cut health care payments to providers because, 
quite simply, fewer and fewer providers are going to provide that 
service. We know that is true in Medicare, where many seniors can't 
find a doctor to take them as a patient because providers won't accept 
Medicare's low reimbursement rates. We know it is even worse for 
Medicaid patients, because that government program pays providers a 
fraction of what they would be paid if they were simply covered by 
private insurance.
  All Americans should have access to high-quality coverage and high-
quality care. The best way to make quality coverage and care more 
accessible is to reduce the cost. ObamaCare increases the cost. We need 
to reduce the cost and make it more affordable, and the best way to 
reduce cost is through patient-driven reforms that increase 
transparency, eliminate government distortions, and boost private 
competition. Those are the reforms Americans want, and those are the 
reforms they deserve.
  Unfortunately, President Obama has made clear he views health care 
reform as a vehicle for expanding the size of government and its 
intrusion into the decisions that should be reserved for patients in 
consultation with their private doctors.
  Time and time again the President has put ideology ahead of basic 
logic and sound economics. Therefore, to ensure future health care 
reforms empower patients and reduce cost and make it more affordable, 
we need to put a new President in the White House.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mrs. Hagan). The Senator from Iowa.
  Mr. HARKIN. Madam President, as chair of the Health, Education, 
Labor, and Pensions Committee in the Senate--the committee that drafted 
large portions of the Affordable Care Act--in looking back at all of 
the hearings we had, the long markup sessions, working across the aisle 
with Republicans, working with the administration, finally getting it 
passed and signed into law, this is a great day.
  There has been a cloud hanging over this because of those who didn't 
want to reform the health care system. They wanted to keep insurance 
companies in charge. Well, we said, no, we are going to change this; we 
are going to reform the system and make it work for people, not just 
for insurance companies.
  There are those out there who didn't want to change, who didn't want 
to reform the system, and so they brought cases to court. And as we 
know, this issue has wound its way through the courts--some deciding 
yes and some deciding no--and then went to the Supreme Court.
  I remember being in the Court this spring for the arguments on this 
law, and we have been waiting since for the Supreme Court to make its 
decision. Well, this morning, the Supreme Court gave a resounding 
confirmation that the Affordable Care Act is indeed constitutional.
  Some have been saying President Obama wins this or the Democrats win 
or the Republicans lose--that kind of thing. I don't see it that way. 
What I see is that this is a great victory for the American people, for 
the businesses of America, and for our economy. That is what this is 
all about. It moves us forward so that every American--every single 
American--will have quality, affordable health care coverage--something 
we have never done in this country. That is why this is such a landmark 
bill and such a landmark decision by the Supreme Court.
  The Supreme Court's decision allows us to move ahead and replaces 
what I have often called a sick-care system--a system that will maybe 
get to you, if you are lucky, in the emergency room if you are sick, 
but not one that gets to you before that to keep you healthy. That is 
what the Affordable Care Act is moving toward--a system of more 
preventive health care, more promoting of wellness and keeping people 
healthy in the first place by giving them the coverage they can use to 
access affordable wellness and preventive health care.
  The Supreme Court has made it clear what we have known all along, 
that those who want to block this law and who are now clamoring to 
repeal it are on the wrong side of this issue. They are on the wrong 
side of history. We can go all the way back to those who didn't want to 
have a Social Security System. They were on the wrong side

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of history. There were those who didn't want to have a Medicare system. 
They were on the wrong side of history. And those who want to repeal 
this law can stand with them. They can stand with them in history.
  But I think history has shown that every time we expand the rights of 
people to certain basic needs in people's lives, we become a stronger 
country, a more unified country, a better country, with more 
opportunity for all.
  For those of us who believe that quality, affordable health care is a 
right and not a privilege, this is a great victory.
  I see that some in the House have scheduled a vote to repeal it after 
we get back from the Fourth of July break. They have already voted to 
repeal it; I guess they are going to vote to repeal it again. They are 
on the wrong side of history. I call upon my Republican friends in the 
House and the Senate: It is over. This is constitutional. Now let's 
work together to make it so that it is implemented and that it works 
for everyone.
  I say to my Republican friends that I have never said the Affordable 
Care Act is like the Ten Commandments, chiseled in stone for all 
eternity. I have often likened it to a starter home to which we could 
make some additions and some improvements as we go along. But at least 
that starter home has put a roof over our heads--a roof that will give 
quality affordable health care insurance to every American. So I say to 
my Republican friends, bring your toolkits if you want to make it 
better and improve it. Bring your toolkits, don't bring a sledgehammer. 
Don't bring a sledgehammer to break it down and try to repeal it. So 
let's work together, put politics behind us, and make this bill work 
for everyone, make it work for every American. The Justices have 
spoken. Now it is time for us to get back to work to build a reformed 
health care system that works not just for the healthy and the wealthy 
but for all Americans.
  This is a victory. It is not a victory for President Obama. It is not 
a victory for my committee or anyone else around here. This is a 
victory to make sure that no one--no one in the future is ever denied 
health care coverage because he or she got cancer, to make sure that no 
one in the future will be denied quality affordable health care 
coverage because they have diabetes.
  It is a victory for families who have had a child who needed 
intensive, very expensive health care coverage to make sure that child 
would live and grow and be able to take full part in our society, 
although sometimes those costs are extremely high. In the past, there 
have been annual limits, and if you went above that, you had to pay out 
of pocket. There were lifetime caps. How many women have I met in the 
past who have had breast cancer and had to have intensive treatments 
for a period of time but they bumped up against a lifetime cap. They 
had to pay out of their pocket. So this is a victory for them. It is a 
victory for families so that they don't face lifetime caps and annual 
caps. It is a victory for every family in America to ensure that their 
child can stay on their family's policy until age 26. That is who wins 
here--ordinary hard-working families in America. It is a victory for 
hard-working families to make sure that insurance companies have to 
provide--have to provide--cost-effective, lifesaving preventive care at 
no cost to get to people early on to keep them healthy in the first 
place. It is a victory for working families so no longer do they have 
to choose between paying for health insurance or other critical family 
needs such as food, shelter, transportation, education. That is what 
this is about. That is what this victory is all about. It is a victory 
for American families.
  I say to those who now want to repeal it, who are going to start to 
make a political issue out of this, you are on the wrong side of 
history. The American people will now begin to take a look at this bill 
in a new light: that it is constitutional, it will be implemented, and 
what is in it for us? And I just went through what is in it for every 
American family. The American people will not want to go back. They 
will not want to repeal this law. There may be improvements we can make 
as we go along. That is fine. But I say woe to those who vote to repeal 
this bill. The American people will hold you accountable for being on 
the wrong side of history, the wrong side of progress, the wrong side 
of ensuring that every American family has quality affordable health 
care in America.
  Madam President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. VITTER. Madam President, I ask unanimous consent the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. VITTER. Madam President, I come to the floor, as many of our 
colleagues have done, to talk about this very significant and, for me 
at least, stunning U.S. Supreme Court decision on ObamaCare. First of 
all, I use the word ``stunning,'' not particularly because of the 
outcome. I would not have been shocked at either outcome--upholding the 
law or striking down the law. I considered both of those clear 
possibilities. I am stunned and shocked, somewhat confused, by the 
decision--by the nature of the decision, by the nature of the majority, 
and by the reasoning.
  I am not going to dwell on that. It is not my role or the role of 
other Senators to second-guess it or to claim we have some authority to 
rewrite it. But I do find that doing backflips beyond the significant 
power of the Court to completely recharacterize the individual mandate 
and parts of the law associated with it as a tax--it was never proposed 
as a tax. It was never debated as a tax. It was never written as a tax. 
It was never meant as a tax in any part of the ObamaCare debate or 
legislative action. So I certainly agree with Justice Kennedy who said 
out loud from the bench, which I think is significant, that to read it 
``as a tax'' is not just reading the law a certain way, it is rewriting 
the law. Judicial rewriting of tax policy, judicial writing of the law 
to create a tax, is particularly worrisome. I absolutely agree with 
that.
  I do think the majority, led tragically by Chief Justice Roberts, did 
backflips to rewrite the law in order to uphold it. I think that is 
very unfortunate.
  What it also means for the country and for the policy debate and for 
us in the Congress is at least two things, which I think are also very 
important. No. 1, it means that if this is a tax, this is a massive tax 
increase on the middle class, which stands full square against the 
clear and repeated campaign promises of President Obama. So this is a 
huge tax increase, now that it is a tax, completely against everything 
he ran on and what he said over and over, campaigning for office.
  It also means something separate that is very significant. If this is 
all about taxes and spending, it means a different Congress next year--
hopefully, led by a different President--can repeal all of that with a 
simple majority of votes in the Senate through reconciliation. If this 
is all about taxes and spending, then it can all be undone through the 
reconciliation process. Of course, that is significant for one reason 
and one reason only: In the Senate, it means that lowers the 
requirement from 60 votes to a simple majority. If there is a 
Republican President, that would be 50 votes, plus the Vice President 
as the tiebreaker.
  So my bottom line is simple. It was my bottom line yesterday before 
the opinion, it was my bottom line over the last several months, and it 
was my bottom line the day after Congress passed ObamaCare and the 
President signed it into law. It may be ruled constitutional, but it is 
still a bad idea that is making things worse. It is putting an all-
powerful Federal Government between the patient and his or her doctor, 
and it is costing us an enormous amount of money as individuals, as 
citizens, as a society, and as a government that we clearly cannot 
afford.
  Many of us made those arguments during the original debate. But I 
think all of those arguments have been validated and are even more 
clearly true and compelling in the months since ObamaCare was passed, 
in particular, because costs have been going through the roof. The 
suggestion that this was going to save us money and not cost us extra 
money--even the suggestion of that argument--has gone out the window. 
It is clear the opposite is true. Individual premiums have gone up as a

[[Page S4695]]

result, family premiums have gone up as a result, and costs to the 
government and to society have gone up as a result. It has made the 
already staggering problem of health care costs worse and worse. It has 
made health care for everyday Americans less and less affordable. 
Because of that, I certainly renew my commitment to work with others to 
fully repeal ObamaCare lock, stock, and barrel.
  Under the Supreme Court's decision today, I restate again that I 
think it is very significant since it is all about a tax and all about 
taxes and spending that can be addressed early next year with a simple 
majority in the Senate if there is a President Romney and a Republican 
Congress to do it.
  I thank the Chair.
  I yield the floor.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. WHITEHOUSE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WHITEHOUSE. Madam President, in light of the Supreme Court's 
decision on the Affordable Care Act, I wanted to come to the floor 
today to bring just a few Rhode Island voices into the discussion that 
is taking place.
  One such person is a man from Providence, RI, named Greg, who has a 
16-year-old son named Will. Will has cystic fibrosis, which requires 
Will to spend several hours every day undergoing the treatment that 
dreadful disease requires. He sees a specialist four times a year to 
monitor the disease. He has daily prescriptions and treatments.
  Without this bill, Will and his father were looking at two problems: 
One, denial of coverage because Will's cystic fibrosis was a 
preexisting condition; and, two, lifetime caps.
  For people like Will all around the country, this has been a real 
blessing because lifetime caps are forbidden and kids with preexisting 
conditions must be covered notwithstanding the preexisting condition. 
So for Greg, the father in Providence, and his son Will, I want their 
voices to be heard today in not so much celebration but relief that 
what they have been provided by the health care law is still in place.
  Another voice to bring to the Senate floor is Olive. Olive is a 
senior citizen. She lives in Woonsocket, RI. Her husband has fairly 
serious Alzheimer's and requires several medications to treat it. Until 
the Affordable Care Act came along, Olive and her husband fell in the 
doughnut hole and had to pay 100 cents on the dollar for the husband's 
Alzheimer's medications while they were in the doughnut hole.
  When I ran for this office, one of the things I pledged to do was to 
work my heart out to close the doughnut hole. In the Affordable Care 
Act, it does close. Right now there is a 50-percent discount for Olive 
on her husband's Alzheimer's drugs when they are in the doughnut hole. 
For them that 50-percent discount means $2,400, which, for senior 
citizens who count on Social Security in Woonsocket, makes a difference 
in the quality of their lives. Overall, it is up to $13.9 billion in 
doughnut hole discounts for seniors and people with disabilities as a 
result of this bill. That makes a big difference in every single one of 
those lives, just like Olive and her husband.

  A third voice I wish to bring to the Senate is Brianne, who is a 22-
year-old graduate of the University of Rhode Island, out and working 
part time as a physical therapist, but her job does not provide health 
insurance. She would be going without entirely, hanging her fortunes on 
chance, as the President recently said, if it were not for the 
Affordable Care Act. She and 9,000 young adults in Rhode Island have 
achieved coverage as a result of this bill by being able to get on 
their parents' policies.
  Danny is also a recent college graduate living in Providence, having 
graduated from Brown University. He is passionate about renewable 
energy planning but couldn't make the health insurance work. Because of 
the Affordable Care Act, like Brianne, he is able to be on his parents' 
health insurance coverage and have that peace of mind.
  The last story I will tell is about a small business owner named 
Geoff in Providence who provides health care insurance for his 
employees because he believes it is the right thing to do. He qualified 
for the law's small business health care tax credit, so he has seen a 
significant advantage to his small business from this provision.
  I think it is a relief to put this quarrel behind us, to be able to 
move on and deal with the economic issues we face. As we do, I wish to 
make sure that Greg and Olive and Brianne and Geoff and Danny were all 
heard here on the floor today, because they are Rhode Islanders in 
whose lives this bill has made a real and practical difference.
  I thank the Presiding Officer.
  I yield the floor. I see the distinguished Senator from Wyoming ready 
to speak.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Madam President, it is disappointing that the Supreme Court 
has upheld the constitutionality of the new health care law. Just 
because it is constitutional doesn't mean it is the best policy, the 
perfect policy, or even good policy. And just because the Court upheld 
the law does not change the fact that the American people have 
overwhelming concerns about it--not all of it but a lot of it.
  In fact, the Court affirmed that the new health care law is a massive 
tax increase on the American people. Congress must get serious about 
fixing our broken health care system. We can start by changing this 
misguided health care law that has divided the American people and 
failed to address rising health care costs. Congress should work 
together to make commonsense, step-by-step health reforms that can 
truly lower the cost of health care. I was pleased to see that the 
Supreme Court narrowed the Medicaid expansion because States can't 
afford them. Hard-working Americans are still struggling in this anemic 
economy and need real action to make health care more affordable.
  Reforms do not have to start here in Washington. Our Nation's States 
are laboratories of democracy and can play a significant role in 
addressing the health care crisis in America. Governors are in a 
special position to understand the unique problems facing their States, 
and fixing health care, like most problems facing our Nation, cannot be 
a one-size-fits-all solution. Efforts underway by Indiana Governor 
Mitch Daniels provide a great example of what different States are 
working on. He is moving forward with the Healthy Indiana initiative, 
which is an affordable insurance program for uninsured State adults 
aged 19 to 64.
  Outside Washington, some health insurance companies have already 
stated they will adopt several reasonable provisions to lower health 
care costs. These include allowing young adults to be covered until age 
26 while on their parent's plan, not charging patients copays for 
certain care, not imposing lifetime limits, and not implementing 
retroactive cancellation of health care coverage. They said they would 
do that regardless of how the Supreme Court case came out.
  One of the most effective ways Congress can address the rising costs 
of health care is to focus on the way it is delivered as part of the 
Nation's current cost-driven and ineffective patient care system. 
America's broken fee-for-service structure is driving our Nation's 
health care system further downward, and tackling this issue is a good 
start to reining in rising health care costs. What is fee for service? 
This method of payment encourages providers to see as many patients and 
prescribe as many treatments as possible but does nothing to reward 
providers who help keep patients healthy. These misaligned incentives 
drive up costs and hurt patient care.
  The new health care law championed by President Obama and 
congressional Democrats did very little to address these problems. The 
legislation instead relied on a massive expansion of unsustainable 
government price controls found in fee-for-service Medicare. If we want 
to address the threat posed by out-of-control entitlement spending, we 
need to restructure Medicare to better align incentives for providers 
and beneficiaries. This will not only lower health care costs, it will 
also improve the quality of care for millions of Americans. In the 
health care bill, we took $500 billion out of Medicare and put it into 
new programs. Then we appointed an unelected board to suggest

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cuts that can be made, and the only place left for cuts are providers, 
hospitals, home health care, nursing homes, and hospice care. I don't 
think that is where we want to be cutting Medicare.
  Shifting the health care delivery system from one that pays and 
delivers services based on volume to one that pays and delivers 
services based on value is an idea that unites both Republicans and 
Democrats. We have been mentioning a number of simple steps that can be 
taken while Congress weighs the larger fixes needed for preventive 
care. We can encourage insurers to offer plans that focus on delivering 
health care services by reducing copays for high-value services and 
increasing copays for low-value or excessive services. Consumer-
directed health plans provide another avenue for linking financial and 
delivery system incentives and have the potential to reduce health care 
spending by $57 billion a year. Bundled payments will support more 
efficient and integrated care. All of these options have already been 
utilized by a number of private sector firms with great success. The 
Federal Government should be willing to support viable reforms where it 
is needed, but also refrain from handcuffing innovative private sector 
designs with excessive regulations or narrow political interests.
  Our Nation has made great strides in improving the quality of life 
for all Americans, and we need to remember that every major legislative 
issue that has helped transform our country was forged in the spirit of 
compromise and cooperation. These qualities are essential to the 
success and longevity of crucial programs such as Medicare and 
Medicaid. But when it comes to health care decisions being made in 
Washington lately, the only thing the government is doing is increasing 
partisanship and legislative gridlock. I wish to leave the Senate with 
some words of wisdom from one of our departed Members, and that is 
Senator Daniel Patrick Moynihan, a Democrat from New York, who served 
in this body. He said in 2001, shortly before he retired:

       Never pass major legislation that affects most Americans 
     without real bipartisan support. It opens the door to all 
     kinds of political trouble.

  Senator Moynihan correctly noted that the party that didn't vote for 
it will criticize the resulting program whenever things go wrong. More 
importantly, he predicted the measure's very legitimacy will be 
constantly questioned by a large segment of the population who will 
never accept it unless it is shown to be a huge success.
  That is a quote from Daniel Patrick Moynihan, former Senator.
  Truer words were never spoken. We have seen each of these scenarios 
play out over the past 2 years as the new health care law polarized the 
Nation. I hope this distinguished body has the courage to learn from 
our mistakes, because our Nation needs health care reform, but it has 
to be done the right way. Providing Americans with access to high-
quality affordable health care is something I am confident Democrats 
and Republicans should be able to agree on.
  Two-and-a-half years ago, a Democratic President teamed up with a 
Democratic-led Congress with only Democratic votes to force a piece of 
legislation on the American people that they never asked for and that 
has turned out to be as disastrous as predicted. How so? Amid an 
economic recession, a spiraling Federal debt, and accelerating 
increases in government health spending, they proposed a bill that has 
made the problems worse.
  Americans were promised lower health care costs. They are going up. 
Americans were promised lower premiums. They are going up. Most 
Americans were promised their taxes wouldn't change. They are going up. 
Seniors were promised Medicare would be protected. It was raided to pay 
for a new entitlement instead. Americans were promised it would create 
jobs. The CBO predicts it will lead to nearly 1 million fewer jobs. 
Americans were promised they can keep their plan if they liked it, yet 
millions have learned that they can't. And the President of the United 
States himself promised up and down that this bill was not a tax. That 
was one of the Democrats' top selling points, because they knew it 
would never get passed if they said it was a tax. The Supreme Court 
spoke today. It said it is a tax.
  This law was sold to the American people under deception. But it is 
not just that the promises about this law were not kept, it is that it 
has made the problems it was meant to solve even worse. The supposed 
cure has proved to be worse than the disease.
  We pass plenty of terrible laws around here that the Court finds 
constitutional. We need to do some commonsense, step-by-step reforms 
that protect Americans' access to the care they need, from the doctor 
they choose, and at a lower cost. That is precisely what I am committed 
to doing.
  The American people weren't waiting on the Supreme Court to tell them 
whether they supported this law. That question was settled 2\1/2\ years 
ago. The more the American people have learned about this law, the less 
they have liked it.
  Now that the Court has ruled, it is time to move beyond the 
constitutional debate and focus on the primary flaws of this law 
because of the colossal damage it is doing and has already done to the 
health care system and to the economy and to the job market, which 
needs to be turned around. There are things that need to be done and 
can be done.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DURBIN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mrs. McCaskill). Without objection, it is so 
ordered.
  Mr. DURBIN. Madam President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. Madam President, I cannot remember another day when so 
many Americans were waiting for the Supreme Court to rule, but today 
was one of those days all across America. Everyone understood that a 
decision just across the street this morning by the nine members of the 
Supreme Court was historic and politically significant.
  The Supreme Court handed down a decision, consisting of 193 pages, 
with all of the major opinions--dissenting and concurring opinions 
included--in the case of National Federation of Independent Business v. 
Sebelius. We knew this was a case to decide the constitutionality of 
the Affordable Care Act. That, of course, was one of President Obama's 
first major legislative undertakings when he was elected President. 
Many of us who were part of the Senate and the House during this debate 
will never forget it. I have been lucky enough to represent my great 
State of Illinois for quite some time, in both the House and Senate, 
but there has never been a more historic and exhausting debate than the 
one that preceded the final vote on the Affordable Care Act. The last 
vote in the Senate actually occurred on Christmas Eve, and then we 
hurried away from here to be with our families, knowing we had done 
something of great historic import.
  Behind this decision was my human experience that most every one of 
us has had at one time or another. I can recall in my own family 
experience that moment when I was a brandnew dad and a law student--not 
exactly a great combination in planning, but that was my life. Our 
daughter was born with a serious problem. We were here in Washington, 
DC, and we were uninsured--no health insurance, a brandnew baby, and I 
was a law student. I can remember leaving Georgetown Law School a few 
blocks from here to go over to Children's Memorial Hospital to sit in a 
room with all of the other parents who had no health insurance. It was 
a humbling experience, waiting for your number to be called for a 
brandnew doctor whom you had never seen before to sit down and ask you 
again for the 100th time the history of your child. You never feel more 
helpless as a parent in that circumstance--to have no health insurance 
and to hope and pray you are still doing the best for your child. That 
experience is one that literally millions of Americans have every 
single day,

[[Page S4697]]

with no health insurance, praying that they will get through the day 
without an accident, a diagnosis, or something that is going to require 
medical care. What we tried to do with the Affordable Care Act was 
twofold: first, to expand the reach of health insurance coverage to 
more families; second, to make health insurance itself more affordable 
and more reasonable.

  Let me start with this question of affordable and reasonable health 
insurance. Similar to my family, many families had children born with a 
problem--asthma, diabetes, cancer, heart issues. These are children who 
need special care, and many times families, when they turned to ask for 
health insurance, were turned away. That is not fair and it is not what 
we need in America. We need health insurance to protect those families, 
and that is one of the major provisions in the Affordable Care Act.
  Secondly, many people don't realize until it is too late that their 
old health insurance policies had lifetime limits. There was only so 
much money the insurance company would pay. People who got into 
challenging medical situations, with expensive health care needs, 
learned in the midst of their chemotherapy their health insurance was 
all in--finished, walked away. We change that in the Affordable Care 
Act. We eliminated the lifetime limits in health insurance policies for 
that very reason.
  We also said health insurance companies should be entitled to a 
profit and, of course, should charge a premium to cover the cost of 
their administration of health care. But we started drawing limits on 
what they could ask. We said 85 percent of the money collected in 
premiums needed to be paid into actual health care, with the other 15 
percent available for marketing, for administration, and for executive 
compensation. Eighty-five percent had to go into the actual cost of 
health care, hoping to keep premiums from rising too fast. That was in 
the Affordable Care Act.
  When it came to coverage, we detected a problem: too many families 
had their sons and daughters graduating from college, looking for jobs, 
and not finding full-time jobs with health insurance. So we expanded 
family health care coverage to include children--young men and women--
through the age of 25. We thought parents should be able to keep them 
under the family health care plan while they are getting their lives 
together and looking for work. That was one of the basics that was 
included in the Affordable Care Act.
  All of those make health insurance more affordable and more 
reasonable for the families who need it.
  Then came the question of what to do about those people who have no 
health insurance. Some people don't have health insurance because they 
work at a job that doesn't provide it and they can't afford it. Others 
have an opportunity to pay for it but decide they are going to wait or 
that they don't need it. We hear that particularly from younger people 
who think they are invincible and will never ever need health insurance 
coverage. So the question was how do we expand the reach of health 
insurance coverage. We did it in this bill.
  We set a standard and said people should not have to pay any more 
than 8 percent of their income for health insurance premiums. If they 
are in lower income categories, we will help them with tax credits and 
treatment in the Tax Code to pay for their health insurance. For 
employers--the businesses people work for--they will be given 
additional tax credits to offer health insurance, hoping to continue to 
expand that pool of insured people in America. For the poorest of the 
poor, we said, ultimately, they would be covered by Medicaid--the 
government health insurance plan--and for at least the first several 
years, the Federal Government will pay the entire cost, the expanded 
cost of that coverage.
  The notion is to get more and more people under the tent--under the 
umbrella of coverage. That not only gives them peace of mind, but it 
also means for many hospitals and providers across America there will 
be fewer charity patients.
  Let's be honest about it. Even people without health insurance get 
sick. When they do, they come to a hospital and they are treated. When 
they can't pay their bills, those bills are passed on to all the rest 
of us.
  In my hometown of Springfield, IL, at the Memorial Medical Center, 
the CEO there said: If we have everybody walking through our front door 
at least paying Medicaid, we will be fine. Do that, Senator. That is 
what this bill sets out to do.
  There were some people who objected to the part which said, if 
someone can afford to buy health insurance and doesn't, they are going 
to pay a penalty. Some people called it a mandate. Others--myself 
included--called it personal responsibility. If someone can afford to 
buy health insurance, they should buy it because 60 percent of the 
folks who don't buy it end up getting sick and the rest of us pay for 
it. That is not fair to the system. It is estimated to cost those with 
private health insurance $1,000 a year just to pay for those who don't 
buy it when they can. That was one of the issues being debated before 
the Supreme Court. So this bill, which ultimately passed, was signed by 
President Obama, has been debated back and forth ever since. It became 
a major topic in this year's Presidential campaign. I don't believe 
there was a single Republican Presidential candidate who didn't get up 
and say: I will get rid of it on the first day I am in office. Governor 
Romney has said that. Yet when you look at all the provisions--the 
expansion of coverage--even expanding Medicare's prescription drug Part 
D for seniors--to think we would eliminate that, think about the 
hardship that would create across our country.
  We all waited expectantly for this day, this day at the end of the 
October term of 2011 for the U.S. Supreme Court, and the decision today 
was that the Affordable Care Act President Obama signed into law is 
constitutional. Now we can move forward.
  Some people have said: Is it perfect? The answer, of course, is no. I 
say half jokingly, the only perfect law was carried down the side of a 
mountain on clay tablets by ``Senator Moses.'' All the other efforts 
are our best human efforts and always subject to improvement. The same 
thing is true for this. I am sure the President would say exactly the 
same. The good news is that today, the Supreme Court found the 
President's Affordable Care Act is constitutional.
  There was, of course, some question of one provision or another, but 
the bottom line is Chief Justice Roberts--not considered a liberal by 
any standards--led the Court in a decision that found this law 
constitutional. The important part of that is it means, for a lot of 
families, there is going to be help through this law.

  In Illinois last year, 1.3 million people on Medicare and 2.4 million 
people with private health insurance received preventive care at no 
cost. That is a provision in this law that was found constitutional 
today. That means that mammograms, cholesterol screenings, and other 
efforts ahead of time for preventive care will help people prevent 
illness and save lives.
  Speaking of prevention, the law provides help for States with their 
prevention programs--programs to help our children stay strong with 
immunizations, programs that detect and prevent diabetes, heart 
disease, and arthritis.
  Another reason this law is so important is because of lifetime 
limits, as I mentioned. Before this law, insurance companies would 
literally say: Sorry, you hit your limit. We can't pay for any more 
chemotherapy. But because the Affordable Care Act was found 
constitutional today by the Court, 4.6 million people in my State of 
Illinois alone received the care they needed last year without having 
to worry about an insurance company's lifetime limits. It is prohibited 
by the Affordable Care Act.
  In these tough economic times, as I mentioned, when young people are 
looking for work, the fact they can now have health insurance through 
their family's plan up to the age of 26 is a sensible policy. Two-and-
one-half million young Americans received protection under the 
Affordable Care Act because of this single provision, and 102,000 of 
them live in my State of Illinois.
  Of course, the law, as I said, requires the insurance companies to 
spend more money of their premiums on actual medical care--85 percent, 
in fact. Over $61 million has been returned to those

[[Page S4698]]

with health insurance policies, and 300,000 people in Illinois are 
included, in the form of a rebate, because of the medical loss ratio.
  For seniors, it will be a helping hand to pay for prescription drugs. 
They are going to be able to help fill the so-called doughnut hole and 
have less money come out of their lifetime savings to pay for the drugs 
they need to keep them strong and even alive. It also means preventive 
care for a lot of these seniors, so they are able to get the annual 
checkup in order to detect some problem before it gets serious.
  From the business side, the Affordable Care Act--found constitutional 
today by the Supreme Court--is going to help small businesses pay for 
health insurance. The new tax provisions help them do the right thing 
and buy health insurance for their employees. So far, more than 228,000 
businesses across America have taken advantage of this new tax credit 
and have saved $278 million.
  When this is all implemented--the Affordable Care Act--30 million 
more people will have health insurance across America. By 2019, 15 
million of these will be in Medicaid and the rest will be in exchanges 
and in private health insurance.
  Another provision in here was important and that was the expansion of 
community health care clinics. Senator Bernie Sanders of Vermont, a 
good friend and a great leader on these issues, pushed hard for it. I 
have been to these community health care clinics across my State. They 
are wonderful primary care in the neighborhoods, in the small towns, in 
Springfield, and in Chicago, that truly help people along the way.
  Today, the President of the United States went to the cameras after 
the Supreme Court decision and talked about this decision by the Court 
and this law. He said for those who believe the Affordable Care Act was 
just politics as usual, it was a political risk and he knew it. There 
were close friends and advisers of the President who basically 
counseled him not to try and take this on. This issue has stopped 
President after President.
  I tried to help President Clinton and then-First Lady Clinton when 
they were attempting to get health care reform passed. Try as they 
might, they couldn't get it done. But President Obama stuck with it. 
Even though there was precious little help from the other side of the 
aisle, he stuck with it and got the bill passed. They then challenged 
him in court at every level they could, and today--at the highest Court 
of our land--it was found constitutional.
  The President said--and I think we all should pay attention to this--
it is not only good in its substance--and I have described that--but it 
is also a new challenge for us, Democrats and Republicans, to make it 
work. The American people want us to come together to make health 
insurance affordable and available, to incentivize quality care, and to 
make certain America, the richest Nation on Earth, has the best and 
most affordable health care on Earth.
  It took the Supreme Court 193 pages to say it today, and now it is up 
to us, both Democrats and Republicans, to work together, maybe put the 
swords aside and sit down at a table and make this law even better 
across America. I think the American people are counting on us. The 
Supreme Court, in finding President Obama's Affordable Care Act 
constitutional, made it clear that now it is up to us to put the 
policies in place that will make it successful and help families, 
businesses, and individuals all across America.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas.
  Mrs. HUTCHISON. Madam President, we have had a monumental decision 
from the Supreme Court of the United States, and I have to say I am 
disappointed, because while the opinion is not very clear, in many 
respects, the result is clear, and that is we are getting ready to see 
one of the largest tax increases in the history of our country.
  We are all talking about the fact the Supreme Court has declared the 
Obama health care plan constitutional, but let's look at how it was 
declared constitutional. It was not based on the commerce powers of the 
Congress in the Constitution. It was based, instead, on taxing 
capabilities--the taxing power--of the Congress.
  I wish to read excerpts from an interview George Stephanopoulos did 
with President Obama.

       Under this mandate--

  Stephanopoulos says--

     the government is forcing people to spend money, fining you 
     if you don't. How is that not a tax?

  President Obama replies:

       No. That's not true, George. For us to say that you've got 
     to take a responsibility to get health insurance is 
     absolutely not a tax increase.

  Stephanopoulos goes on later to say:

       But you reject that it's a tax increase?

  President Obama replies:

       I absolutely reject that notion.

  Yet the Court today said this is constitutional because of Congress's 
power to tax. So we are going to see the tax increase go forward, and 
the small businesses and businesses that are looking at this, the 
individuals, are going to have a whopping increase in the cost of doing 
business at a time when--I certainly don't have to point out--we are in 
an economic downturn, when the private sector is not hiring, when we 
have an over 8-percent unemployment rate. Yet now we see more costs on 
top of what we already have in this country.
  I don't think that is the recipe for getting this country going again 
and hiring people to work.
  I would like to read a few quotes from employers on the impact of the 
Obama health care plan on their businesses.
  Scott Womack, the president and owner of Womack Restaurants, is an 
IHOP franchisee. He said:

       Let me state bluntly. This law will cost my company more 
     than we make.

  Grady Payne, who is the CEO of Connor Industries, said--it is very 
interesting because Conner Industries is headquartered in my home State 
of Texas:

       Conner Industries is headquartered in Fort Worth, Texas 
     with plants in 8 different states. Conner Industries started 
     in 1981 with five people and one location. Today they have 
     grown to 450 employees and eleven plant locations. They offer 
     health coverage to their employees and the company pays over 
     half of the total premium cost. In 2014, the company will 
     have to choose how to comply with the law, either buy a more 
     expensive, government-approved healthcare benefit or drop 
     health coverage completely and pay the $2,000 fine for each 
     of their employees. Thus, Mr. Payne has stated that the 
     impact of this law will cost them over $1,000,000 no matter 
     what option they choose.

  The chairman and CEO of NuVasive, a medical device company in San 
Diego, in an op-ed said:

       Provisions of the Affordable Health Care Act are destroying 
     jobs, hindering innovation and slowing the economic recovery. 
     To offset the medical device tax increase, we will be forced 
     to reduce investments in research and development and cut up 
     to 200 planned new jobs next year.

  So what we have seen today is a validation of what many of us were 
concerned about when this law was going through Congress; that is, the 
enormous increase in the tax, the fine, and the overall burden to the 
businesses of this country which would do several things that are not 
good for the people of our country: It will increase costs to American 
consumers; it will inject the government into doctor-patient 
relationships; it will most certainly add new burdens on business in an 
environment in which we have over 8 percent unemployment. I also think 
it is very clear that though the President promised that people will be 
able to keep their health care coverage as they know it, that health 
care coverage is not going to be there because so many companies are 
going to drop the health care coverage they have been offering because 
it is too expensive to comply with the government conscription of the 
plan that is required in order to avoid the $2,000 fine.
  I think what the Court said is insightful in this respect; and that 
is, while they said this law is constitutional based on the taxing 
power of Congress, they are not ruling on the wisdom nor the fairness 
of the policy. I think it is going to come down to the people of our 
country because the election this year is going to determine the 
ultimate fate of this bill. The Republican nominee, Gov. Mitt Romney, 
has said very clearly, on the first day he is sworn into office he will 
ask for the repeal of this health care law.
  I think it will become an issue in every contested congressional race 
and

[[Page S4699]]

every Senate race: Are you going to vote to keep this law that has been 
ruled constitutional based on the fact that it is a taxing power of 
Congress? The people will be able to decide if they want this jolt on 
their health care, if they want the extra cost, if they want the 
intrusion on the patient-doctor relationship, and if they want to 
possibly lose the coverage they have and be taxed to go into another 
plan--a government plan.
  We are going to see the erosion of the quality of health care in this 
country if we are not able to repeal this law and start all over.
  Now, I will say the purpose of passing health care reform is to 
provide more options for people to get affordable health care coverage. 
I think that is a worthy goal. I think we should go for that goal in a 
way that does not burden the economy of our country, stop employers 
from employing people; in a way that preserves the doctor-patient 
relationship and doesn't intrude on the people who do have coverage 
they want to keep. That should be our goal.
  There are several months before the election. I hope we will be able 
to do something in this Congress to start a new process of providing 
affordable health care options for the people of our country and not 
continue on this path of enormous tax increases--which have been 
validated by the Court--as well as an intrusion on the quality of our 
health care, and not something that in the bigger picture is going to 
keep our businesses from hiring more people to get the economy jump-
started, which should be every one of our goals.
  I hope we can work on this in a productive way before the election, 
but I also hope the people will make the final decision in the election 
if Congress has not acted before; that we will have a decisive election 
that will say we can do better. We, the people of the strongest country 
on Earth, can do better than a health care system that will be 
eventually turned over to the government if we go down this path.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER (Mr. Sanders). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Ms. LANDRIEU. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                            Flood Insurance

  Ms. LANDRIEU. Mr. President, there are so many important issues in 
Washington today, it is hard to know what to speak on first. But I am 
going to take this opportunity to talk about flood insurance. One of 
the reasons is because there are three States in the Union that carry 
the most policies relative to our population, and it may be the most 
policies regardless of our population. That would be Florida, No. 1; 
Texas, No. 2; Louisiana, No. 3; and, of course, California, No. 4.
  So while this bill affects everyone in the country, the four States 
that it affects the most and by far are the four States that I 
mentioned, and Louisiana happens to be one. So the people of my State 
pay a lot of attention to flood insurance. We always have, and we 
always will have to.
  I am sorry to say that just within the last few hours, with so much 
changing around here at the last minute, I was just given the 
information that the flood insurance bill--which we have not even 
debated on the floor of the Senate--is now going to be put into an 
omnibus package which includes many other important bills: the 
Transportation bill, the RESTORE Act--which is also important for the 
gulf coast, parts of it that were accepted by the House, and there were 
a few important parts that were, unfortunately, left on the cutting 
room floor over in the House--and now the flood insurance bill.
  I want to make it clear that if I were called on to vote on the flood 
insurance bill that is now going to be a part of this package, I would 
vote no because there are some very important provisions that I was 
going to offer as amendments to the bill that I think are crucial to 
not just my State but to the State of Florida, potentially to the State 
of California, and potentially to Texas as well. I am not sure their 
Senators are in complete agreement or understand some of the 
challenges, but I want to point out a few of them. Unfortunately, I am 
not going to get a chance to vote no because I am going to have to vote 
for the whole package, which I intend to do, although this flood 
insurance bill is not in the position I would support. Let me give 
three reasons.

  No. 1, there is a provision of the bill that talks about V-Zones; 
that is, velocity zones. Right now, with FEMA, FEMA basically says if 
you are in a velocity zone, you cannot rebuild.
  I have St. Bernard Parish, Plaquemines Parish, Lafourche Parish, 
Terrebonne Parish, Cameron Parish, and large sections of St. Tammany 
and St. John the Baptist and Orleans Parish that you can see are 
designated V-Zones. This means likely to be flooded, not just based on 
their elevation but the way that the historical patterns of storms 
coming out of the gulf affect them.
  I understand that we have to be very careful in these areas so I had 
an amendment to say: No, you can rebuild but you have to rebuild up to 
the right elevation or you have to rebuild according to the highest 
standards. If we do not fix this, and this bill passes--which it looks 
as though it will--there will be great concerns or questions, if not a 
downright prohibition, on building in these areas regardless of whether 
you pay for insurance. This is not right.
  The other amendment I was prepared to offer is an affordability 
amendment. People may not realize this--I hope Members will be 
listening. Again, this bill affects all the States, but in the 
underlying bill there is a provision that allows these rates for 
everyone in the country to be increased by 15 percent a year.
  People are struggling to pay flood insurance now. I think that is 
very steep. People who are arguing for the 15-percent a year increase 
say it is important to get this program actuarially sound, it is 
currently running a $20 billion deficit. I am well aware of the need to 
get this program in line. But I was going to offer an amendment that 
simply created and expanded a short, small, but important affordability 
provision of $10 million that the Department would have to help people 
on fixed incomes or lower or middle-income families who of course are 
working along the gulf coast and in some of these coastal areas. They 
are not sunbathing, not vacationing. This is not about second homes. 
This is about primary homes. They have a right to live and have been 
living for generations near the coast. These are fisherman, et cetera. 
That was an affordability amendment that I cannot offer or file for the 
Record.
  This is a very important issue. Flood insurance is not just about 
business and commerce; it is about culture; it is about a way of life; 
it is about preserving coastal communities; it is about being resilient 
in storms. Yes, Louisiana wants to pay its fair share. Florida must pay 
its fair share. Texas must pay its fair share. We have no problem with 
that. We have been for years.
  Some Members are now waking up and saying: Oh, my goodness, now you 
are telling us, people in other parts of the country, we have to buy 
flood insurance? But we have a levee. You are telling us we have to buy 
flood insurance?
  Yes. We had levees in Louisiana for 200 years. Unfortunately, they 
break. Sometimes when the Federal Government doesn't build them 
correctly, they disintegrate and our people get flooded. Yes, we have 
levees, we pay to build the levees, and we pay for insurance, and we 
are still not as protected as we could be. Again, we are not sunbathing 
down here on this coast. We are producing oil and gas for the Nation. 
We are running the largest port system in North America, and we drain 
40 percent of the continent.
  Florida has a little different situation. They do a great deal of 
tourism and they do a great deal of sunbathing and other things. I am 
happy for Florida and their economy. But the people I represent are not 
running huge vacation operations. This is not an optional place for us 
to live. It is not optional for us, it is not optional for the Nation, 
and it is not optional for the world. We have to find an affordable and 
safe way to live here.
  I had an amendment to try to make this more affordable. That 
amendment is not going to be offered. The only positive thing I can say 
about the bill--

[[Page S4700]]

and there are some positive things, and this is important, I know, to 
the realtors. I support them almost 100 percent--and the homebuilders. 
I have a very good record with the realtors and homebuilders. I believe 
in what they do and they are right when they say: We have to have a 
permanent extension because we cannot close deals. People cannot sell 
their homes. We have to have this insurance program. And they are 
correct.
  Like a lot of things up here, it is a balance. With the amendments I 
was going to put on the bill and actually had worked out to do so, on 
balance the bill would have been better. I was prepared to vote for it 
on the floor. Now that it is being stuck into this package without the 
debate on the floor and without the amendments, I must go on record to 
say that I would vote against the bill in its current form, even though 
I know we need long-term flood insurance. Because of the increased 
rates, the lack of the affordability, and the lack of a fix to the V-
Zones, I think it tips the balance against the bill generally.
  There is nothing I can do about it. That is the way it is going to 
happen. But I wanted to submit my comments for the Record. I can 
promise the Members of this Senate after this bill goes into effect you 
are going to hear a lot of complaints from your constituents. I am 
certain we will be back here within the year, after the elections--
regardless of who wins and who loses--fixing some provisions that 
should have been fixed, but because there is not going to be a debate 
on the Senate floor will not be.
  I know this bill came out of the Banking Committee in the Senate with 
bipartisan support. I am well aware of that. But I think there were 
some corrections or some perfections that could have been done on the 
Senate floor. We are not going to have that opportunity.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. RUBIO. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded and that I be recognized to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. RUBIO. Mr. President, as we know, the Supreme Court ruled on the 
health care law, and we have had a lot of phone calls and e-mails. 
People want to know what this means above the politics. Sometimes I 
think that in Washington everything is analyzed over what this means 
for the elections and what this means to the Republicans or the 
Democrats. What I hope to do today by coming to the floor of the Senate 
is to respond to some of my constituents from Florida, and folks around 
the country who have called as well, to show what this means in real 
life and what my position is toward this moving forward. So that is 
what I hope to do here today in the few minutes I have while the Senate 
waits on the pending matter.
  Let's begin by understanding what has happened today. The Supreme 
Court doesn't decide whether something is a good idea or a bad idea; 
the Supreme Court's job is to decide whether something is 
constitutional. Today, by a vote of 5 to 4--four of the Justices 
disagreed, but five of the Justices, including the Chief Justice, 
decided that a key component of the health care law that passed the 
year before I was elected was constitutional. They said it was 
constitutional because it was under the taxing powers of the Congress. 
In essence, they said that this mandate, this requirement is 
constitutional because it is a tax.
  That is curious, of course, because the President denied that it was 
a tax. I looked it up. I remember a specific interview the President 
gave while this was debated where he was asked by George Stephanopoulos 
on ABC: Is this a tax? He denied it. He denied it and said there was no 
way this was a tax. If I could find the right quote in here just to 
make sure I am not misquoting anybody in this day and age of fact-
checking, the President specifically said that the notion that it was a 
tax was wrong. However, months later, when this appeared before the 
Supreme Court of the United States, his lawyers argued that, no, this 
is constitutional because this falls within the power of the government 
to tax. So that is important because that is the reason this law still 
stands on the books today.
  Let's remind ourselves of what a mandate is. This is not a mandate 
that the government provide an individual with insurance, this is a 
mandate that a person find insurance for himself or herself. For a 
mandate to work--and anyone who has been for a mandate will admit this 
to you--the penalty for not buying insurance has to be severe enough so 
that the person will decide to buy the insurance; otherwise, people 
will just pay the fine and not get the insurance.
  So what does this mean in the real world? I found a blog post from 
2009. The numbers may have changed a little bit, I am not 100 percent 
sure, but this is from when the House was deliberating at the time. An 
economist took this up on July 14, 2009, and he actually used a couple 
of real-world examples. This may be very similar to you, so listen 
carefully.
  The first example he used is of a gentleman who is single and earns 
about $50,000 a year, which is four times the Federal poverty level, so 
he wouldn't qualify for the subsidies under the bill. Now, he is a 
single 50-year-old nonsmoker, small business employee. That means he 
works for a small business that doesn't provide health insurance and 
isn't required to because the law requires businesses that have more 
than 50 employees to provide insurance. If he works at a place that has 
five employees, they are not required to offer health insurance. So to 
reiterate, he is 50 years old, works at a small business that is not 
required to offer insurance, and makes $50,000 before taxes. He doesn't 
have insurance. Now, he cannot afford a bare-bones policy. This 
economist went through ehealthinsurance.com and found that the cheapest 
policy he could find was $1,600 a year. Depending on where you live in 
the country, when they start taking out taxes, $50,000 doesn't add up 
to a lot of money. This is middle class. He can't afford a $1,600-a-
year policy, so instead he would have to pay a $1,150 fine, which is a 
tax. That is what he would have to pay. Guess what. Even after paying 
the $1,150, he still doesn't have insurance. This is the real-world 
impact of the mandate.
  Here is another example. This one actually uses my home State, so I 
picked this one. A married couple with two kids has a small business. 
They run a small tourist shop in Orlando, FL. I am not sure if these 
are real people or if it is hypothetical, but I like the fact that they 
picked Orlando, FL. The husband and wife make $90,000 a year at their 
small business. That is what the business makes, again, before taxes. 
They have a small business making $90,000. Between all the expenses 
they have and all the other tax components that come up, it is middle 
class. This is middle class, OK? These are two employees, but their 
wages exceed the amount to qualify for the small business tax credit. 
Because their business is so small, there will be no financial penalty 
for a business that only has two employees, but as individuals they 
still have to buy health insurance for themselves and for their 
children.
  So here they are, husband and wife, 40 years old, two kids, they own 
a small tourist shop, and they are the only employees, making $90,000 a 
year together. The cheapest insurance they can get is a high-deductible 
plan with about a $6,000-a-year annual deductible. It costs them about 
$3,800 a year. The fine is $2,000 a year. So that is probably what they 
end up having to do now. This is a $2,000 increase in their taxes 
through a fine, and they still don't have insurance to show for it.
  This is the third example I want to give, and this is not part of the 
analysis. I pointed out that the law now requires any business with 
more than 50 full-time employees to offer health insurance. Now, 
offering health insurance is a good thing. We should try to encourage 
that and provide opportunities for businesses to do it. Imagine you are 
one of these businesses and you are asking yourself if you should hire 
the 51st or 55th employee. Should I grow my business? Well, as a result 
of this new mandate, maybe you decide not to now. How much will this 
cost us? It is $2,000 per employee if they don't comply. How much will 
this cost us? Maybe this is not the year to add a few jobs. Even worse, 
maybe they should become a part-time business.

[[Page S4701]]

  I heard a lot about this in my campaign from franchises. Taco Bell 
and McDonald's are not owned by Taco Bell or McDonald's, they are owned 
by a small business owner. They are going to decide to make everyone 
part time because they can't afford to pay the fine. They can't afford 
to pay for the insurance. This would be a bad idea no matter what the 
economy is because now we are discouraging them from growing their 
businesses. No matter what the economy looked like, this would be a bad 
idea.
  Let me explain why it is worse. No. 1, guess who gets to enforce all 
of this stuff. Guess whom they have to answer to. Guess who they have 
to prove they have insurance. Your neighborhood, friendly IRS. That is 
who is in charge of enforcing this. Millions of Americans now have an 
IRS problem because they don't have health insurance.
  This idea that they don't have health insurance--because if we read 
some of these statements and interviews that the President gave when he 
said it wasn't a tax, it made it sound as though they don't want to buy 
insurance and they want to use the money for something else because 
they are irresponsible. They are not irresponsible. They can't afford 
it. There is not a private market for them to buy insurance because 
they can only buy insurance from their States. If they live in Florida 
and there is some company in California that wants to sell them 
insurance, too bad, they can't buy it. That is ridiculous. That is what 
we should be changing here. These people are not doing it because they 
don't want to be responsible. They can't afford it. Their house is 
upside down. They are making half as much and working twice as long. 
Their kids want to go to college. Everything has gotten more expensive, 
including gas, milk, their water bill, and electricity bill. On top of 
that, we are going to hit them with this?
  We just got a report today that shows that the economy barely grew in 
the first 3 months of this year. It was less than 2 percent. Our 
economy is not growing. When it is not growing, the debt gets worse, 
the unemployment gets worse, everything gets worse. We should not be 
doing anything in Washington that makes it harder for people to grow 
this economy. Why would we do something such as this to people? Why 
would we hit the owner of a tourist shop with a $2,000-a-year tax or 
else the IRS is going to chase him around? Why would we hit this guy 
who is 50 years old, trying to make a living in the world working for a 
small business, with a $1,000-a-year tax when we are trying to grow our 
economy?

  Health insurance is a real problem. It is. I wish more Americans 
could get their health insurance the way Congress gets it. We get it 
very simply. We get to choose, depending on which State we are from, 
between 8 to 10 companies, and we can decide. If we want a higher 
copayment, we pay less premium and vice versa. We get to choose. Most 
Americans don't have that choice. They get their insurance from their 
job and their job tells them: This is your insurance plan. Pick a plan 
out of this book. Those are the kinds of things we should be working 
on.
  So apart from everything else, this is a terrible idea because it 
hurts our ability to grow our economy. This is the real-life impact of 
this bill. This is the impact it is going to have, and we are going to 
see it. We are going to see it in a further downturn in our economy and 
in slower economic growth. This is going to have a real impact. This is 
a big deal. People across this country and across Florida have every 
right and every reason to be worried about the impact this is going to 
have on them. This is a middle-class tax increase, and millions of 
Americans now have an IRS problem. People will now have to, for the 
first time in American history, prove they have health insurance or 
they are going to have to deal with the IRS. I guarantee that is not 
good for small business. I guarantee that is not good for the middle 
class. I guarantee that is not good for economic growth.
  That is where we are today. If there is anything I hope we can do--I 
wasn't here when the health care bill passed, but I hope some of my 
colleagues who voted for this will think to themselves: This is not 
what we intended. We want to help people who are uninsured but not like 
this. This is never what we wanted to do. I hope enough reasonable 
minds will come together to either suspend or repeal this, and let's 
start from scratch. Let's come up with a real plan to help deal with 
the health insurance crisis in America.
  I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Nebraska.
  Mr. JOHANNS. Mr. President, today marks one of the most historic and 
certainly highly anticipated Supreme Court decisions in a long time.
  I would be less than candid if I didn't say I am enormously 
disappointed that the Court upheld the law in its individual mandate 
which requires all Americans to purchase government-approved insurance 
whether they choose to or don't choose to. I believe it is 
fundamentally wrong for the U.S. Government to intervene in the lives 
of Americans in this very direct way. However, the Supreme Court's role 
within our system of government is to interpret the Constitution, and 
they have spoken. So with the ruling now officially out, what is 
important is where we go from here.
  The Court did not decide that this law is good policy. In fact, Chief 
Justice Roberts went out of his way to clarify this point. It is clear 
in my mind that we must do everything we can to repeal this flawed law 
because it is enormously bad policy.
  While we have waited over 2 years for the final decision about this 
law's constitutionality, we haven't had to wait that long to learn why 
the law is bad for America. The law was a train wreck from the very 
beginning: backroom deals, empty promises, political tactics that 
epitomize what disgusts Americans about their government. Some of the 
law's leading supporters even admitted they hadn't read the 2,700-page 
bill. The Speaker acknowledged we are going to have to pass the law to 
see what is in it. My colleagues across the aisle hastily passed the 
bill on the notion that there were some gold nuggets in there, tucked 
inside the law, and that maybe Americans would think they were lucky 
enough to cash in. We have come to know nothing could be further from 
the truth.
  After more than 2 years, there has been a lot of rain but not a 
single rainbow and certainly no pot of gold when it comes to this 
legislation. Instead, what we have seen is one broken promise after 
another.
  Just last week, the administration's own Medicare Actuary reported 
national health care spending will increase at an average of more than 
50 percent over the next decade. The same study estimated, in 2014, the 
increase in private health insurance premiums is expected to accelerate 
to 7.9 percent. But the startling fact is that is more than twice the 
increase Americans would have faced in the absence of the health care 
law.
  This is just one of many studies that indicate the law does not bend 
the cost curve down as the President promised. It begs the basic 
question: Why would Congress pass a massive overhaul of our country's 
health care system that actually increases the cost of care? It is so 
ironic that the majority decided to call this health care law the 
Affordable Care Act. One can hardly argue that more people will receive 
better care under a plan that drives costs upward as well as puts 
Medicare on an unsustainable path.
  The Medicare Actuary asserted in the most recent trustees report that 
the law could lead to significant access issues for beneficiaries under 
Medicare, and Medicare itself is estimated to be insolvent by 2024. Due 
to the cuts to Medicare and the health care law, he said: ``The prices 
paid by Medicare for health services are very likely to fall 
increasingly short of the cost of providing those services.''
  He goes on to say: ``Severe problems with beneficiary access to 
care'' will occur.
  That is just another way of saying, to put it very directly and 
simply, our seniors are going to find it harder and harder to find a 
doctor or a hospital that will accept them as patients. To put it 
simply, our seniors are going to have difficulty accessing medical care 
under this law.
  The health care law perpetuates the problems within this very 
difficult system. It is clear that heavy-handed government solutions 
are not the answer, but that is exactly what this law creates. In this 
law, there are 159 new

[[Page S4702]]

boards, over 13,000 pages of new regulations, and it gives the 
Secretary of Health and Human Services more than 1,700 new or expanded 
powers. No one will convince me this act isn't a seizure of our 
government, of our health care system, and putting it under the power 
of government.
  Americans don't want government bureaucrats diagnosing and 
prescribing their care. They want the freedom to choose an insurance 
plan that covers their needs and to simply see the doctor of their 
choice.
  It seems the President even manipulated this sentiment, which is why 
he said no fewer than 47 different times: ``If you like your plan, you 
can keep it.'' He knew that pledge would help him gain support for his 
law, but, sadly, the American public was misled and his promise can't 
be kept.
  The nonpartisan Congressional Budget Office estimates up to 20 
million Americans could lose the insurance they get through work--the 
insurance they like and want to keep--because of this health care law. 
Families in 17 States, including my own State of Nebraska, no longer 
have access to child-only health insurance because of the mandates in 
this misguided legislation. That is not the only way the law will hurt 
hard-working American families. The Director of the CBO testified that 
the new law will mean 800,000 fewer jobs over the next decade.

  The American people deserve more than a laundry list of flawed 
policies and empty pledges. Americans deserve step-by-step reform 
instead of rushed policy; transparent reforms, not a 2,700-page 
entangled mess; and an open debate, not a closed-door discussion and 
the backroom deals that were so necessary to get this flawed piece of 
legislation passed. More than anything, they deserve sound policy that 
delivers on the promises.
  I will do everything I can to continue to push to repeal this 
misguided law and to push for policies that set us on the right course 
because the path we pave will define our future as a nation. There is 
no disputing that Medicare and Medicaid are two of the biggest drivers 
of our Nation's $15 trillion debt. So if we want to secure a sound 
future for our children and our grandchildren, we have to fundamentally 
reform these government programs, not double down on policies that will 
bankrupt them. In that same vein, we can't ignore our struggling 
economy. Instead, we need policies that promote business growth and job 
creation. I believe we can pass step-by-step reforms that confront 
these tough issues and policies that depart from a top-down, one-size-
fits-all approach.
  The issue of health care touches all of us at the deepest level. 
Whether it is a new life entering into our world, a tough diagnosis, a 
lifesaving surgery or care for a loved one in their final days, health 
care decisions should not be dictated by Washington. Families and the 
physician they trust need to be at the heart of the decisions that 
impact their health. The Supreme Court has spoken definitively about 
the constitutionality of this law, but Americans have spoken loudly and 
clearly when it comes to the sensibility of this process and of this 
policy. It is time to repeal it and put in place sensible reforms that 
truly do bring down costs.
  I yield the floor and I note the absence of a quorum.
  The PRESIDING OFFICER (Mrs. Shaheen). The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. LEE. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. LEE. Madam President, I rise today to speak about the Supreme 
Court's ruling this morning in the case involving the constitutionality 
of the Affordable Care Act's individual mandate. In that case, the 
Supreme Court rendered a decision that may be spun by many, perceived 
by many, as a victory for the proponents of the controversial 
individual mandate contained within the Affordable Care Act.
  I would submit today, however, that this victory, if it is being 
called that, will prove to be not only hollow but also short lived. I 
say that because, significantly, the Supreme Court was able to uphold 
the constitutionality of the mandate only by a series of gymnastics 
that allowed the Court to find this was a tax.
  First, the Court addressed the issue and concluded, for only the 
third time in the last 75 years--only the third time since 1937--that 
Congress had, in fact, exceeded its power as asserted under the 
commerce clause of the U.S. Constitution.
  Having concluded that Congress lacks the authority to compel 
commerce, the creation of commerce so that it could then regulate 
commerce, the Supreme Court went on to shoehorn this individual mandate 
provision into the Supreme Court's conception of Congress's taxing 
power. This awkward construction is one that exposes many of the true 
flaws of the individual mandate.
  The mandate itself, we must remember, was not wildly popular among 
the American people at the time it was enacted. It has become even less 
popular as the American people have come to understand it. A recent 
poll revealed that roughly 74 percent of Americans do not like the 
individual mandate. This is easy for us to understand when we think 
about the fact that we as Americans--we are born as a free people. We 
were intended to live as a free people. It offends our most basic sense 
of freedom to have one of the most personal decisions made for us by 
government--particularly by the impersonal, distant government that is 
based in Washington, DC.
  These kinds of decisions should be made by the individuals and 
families in consultation with their doctors, not by government 
bureaucrats in Washington, DC. So the fact that it is unpopular does 
not surprise us, and given the fact that the Supreme Court was able to 
uphold the individual mandate only by calling it a tax is very 
significant. It is especially significant given the fact that it was 
pitched to the American people as something other than a tax.
  The President promised us he would not raise our taxes. He promised 
us the individual mandate did not amount to a tax increase. He promised 
us all along that he would never raise the taxes of any American 
earning less than $250,000 a year. Well, those who participated in 
Congress who voted for this provision also promised us this would not 
amount to a tax increase. They did so for one simple reason: They knew 
it could not pass. They knew it would not be able to get the number of 
votes necessary to make it become law if they called it a tax. So they 
did not. They went to great lengths to make sure it was not described 
or characterized or structured as a tax within the text of the statute 
itself.
  Now, after the fact, the Supreme Court has taken the step of 
shoehorning this regulation into Congress's taxing authority, and it is 
calling it a tax, effectively insulating those Members of Congress who 
voted for it from the political liability attached to having voted for 
a tax increase--not just any tax increase but a tax increase that the 
Joint Committee on Taxation has concluded will be borne overwhelmingly 
by hard-working, middle-income earners.
  In fact, they have concluded that over 75 percent of the burden 
associated with this mandate that has now been deemed a tax will be 
paid by those earning less than $250,000 a year. It was unpopular 
before we were told it would be deemed a tax. Now that it is a tax, we 
cannot expect that its status as a tax will enhance its popularity. If 
anything, we can expect that it will become even less popular with the 
American people.
  For that reason, I am absolutely convinced that for those who call 
this a victory for the individual mandate, it will prove to be anything 
but a victory. It will prove to be something that will result in a 
groundswell of people contacting their Members of Congress, telling 
them they do not want their taxes raised, telling them that Members of 
Congress who voted for this promised them it would not be a tax 
increase, asking them, for instance, to vote on it, to decide once and 
for all whether they are willing now to call it a tax, given that was 
the only way in which it could be affirmed, upheld, as a valid 
constitutional exercise of Congress's power.
  As we move forward to the November elections, we are going to hear a 
lot about what people do not want out of their national government. We 
will

[[Page S4703]]

continue to hear a lot from those people who are offended by this 
notion that the government can tell them where to go to the doctor and 
how to pay for it, who are offended by the notion that government would 
step in and tell Americans: You have to buy health insurance, not just 
any health insurance but that health insurance which Congress, in its 
infinite wisdom, has deemed necessary for every American to purchase. 
And if you do not, you are going to be penalized. If you do not, you 
are going to be taxed.
  People are going to be upset about this. They are going to complain 
to Congress and to candidates for Congress. They are going to complain 
to the President and to other candidates for the Presidency that this 
is not the kind of government they want. After they do that, they will 
proceed, and they will start talking about what kind of government they 
do want. That is where we have to move, away from the kind of 
government we do not want toward the kind of government we do want.
  The kind of government we do want today is, in so many respects, the 
same kind of government we as Americans have always wanted ever since 
our founding; that is, a government that at the national level 
recognizes limits to its power, recognizes that whenever government 
acts it does so at the expense of our individual liberty.
  When the Federal Government acts, to a significant degree it does so 
at the expense of our State governments, governments which are closer 
to the people and often more responsive to the needs and to the 
evolving demands of the people. This is not simply a technicality upon 
which we are involved in a discussion. This is a very important part of 
the political process. It is essential that any time we raise taxes, we 
do so in a way that is clear to the people and that we stand 
accountable to the people for raising taxes. The courts do not have the 
expertise to do that, and yet they exercised that power today.

  As the majority opinion today reminded:

       The Supreme Court of the United States possesses neither 
     the expertise nor the prerogative to make policy judgments. 
     Those decisions are entrusted to our Nation's elected leaders 
     who can be thrown out of office if the people disagree with 
     them.

  This reminds me of one of my favorite quotes from our country's 
greatest Founding Father, George Washington, who said something very 
similar way back in 1789, when he explained:

       The power under the Constitution will always be in the 
     people. It is entrusted for certain defined purposes and for 
     a limited period to the representatives of their own 
     choosing. And whenever it is executed contrary to their 
     interests or not agreeable to their wishes, their servants 
     can and undoubtedly will be recalled.

  This reminds us of the fact that we as Americans are in control of 
our own destiny as a nation. We as Americans are here and have the 
prerogative to explain what we want and what we do not want out of our 
government. The government exists to serve the people and not the other 
way around. The decision rendered by the Supreme Court today, while I 
disagree with it in many respects, is one that I predict will usher in 
a new era of robust debate and discussion over issues of federalism and 
individual freedom. That debate, I am convinced, will lead inexorably 
to the result that we as Americans will become more free, less captive 
to a government that tells us where to go to the doctor and how to pay 
for it, and that we as a people will again prosper as we regain our 
God-given right to constitutionally limited government.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Ms. MIKULSKI. Madam President, I rise to speak on the Affordable Care 
Act. Today I am so relieved that the Supreme Court has upheld the 
Affordable Care Act as constitutional. With this ruling, our Nation's 
highest Court has made it clear that no matter who you are--a man or a 
woman, a senior facing cancer, a child with juvenile diabetes--you will 
have health care that is available, reliable, and undeniable.
  Health care reform has achieved many goals that the American people 
wanted us to do: One, expanding universal access. Now 32 million people 
will have health care they did not have before. Second, it breaks the 
stranglehold of insurance companies, ending their punitive practices, 
particularly in those areas of preexisting conditions where they denied 
health care because a child might have autism or asthma or for women 
where they had a particular approach where they charged us more than 
for men of comparable health status--30 percent more. Then they treated 
simply being a woman as a preexisting condition, or a pregnancy, 
sometimes the need for a C section. In some States being a victim of 
domestic violence was considered a preexisting condition. We ended that 
practice.
  We also saved and strengthened Medicare, and we emphasized 
prevention, early detection, and screening. That will save lives, 
improve lives, and also save money.
  I am proud of what we did in Congress with the universal coverage. 
For the first time in our history we are committed to covering every 
single American with health care. It helps young families to be able to 
look out for their children. It helps young adults recently graduated 
from college, some looking for a job, some working in startups where 
there is no health insurance.
  Because of health care reform, 52,000 young adults in Maryland will 
have coverage on their parents' policies while they go back to school, 
look for a job, or get that entrepreneurial spirit going.
  Then there are these punitive practices of the insurance companies. 
Much has been said about how we interfere with people's right to see 
the doctor of their choice or get health care.
  That is what insurance companies have been doing for years. People in 
pinstripes sitting in boardrooms made decisions on who could get health 
care and who couldn't. We stopped them from denying families health 
insurance. We stopped insurance companies from denying children's 
coverage. Congress ended, as I said, discrimination against women.
  I remember when they tried to take our mammograms away, and I said no 
and organized the preventive health care amendment. We women fought to 
have access to mammograms and other things related to our particular 
life needs. The fact is we wanted it for the men too. We organized for 
the prevention amendment so we could limit the need of copays for this, 
so we women could have access to mammograms, so men could have access 
to screening for prostate cancer, so all Americans could get that 
screening for the dread ``C'' word, such as colon cancer, and how about 
diabetes and heart disease. These are the kinds of things that, if we 
can have early detection and early screening, will save lives, stop the 
spread of the disease or keep it from getting worse.
  Diabetes, undetected, uncontrolled, and unmanaged, can result in the 
loss of an eye, a kidney or a leg, all because one has lost their 
health insurance. Because of what we have done in the Affordable Care 
Act, not only will people have health care, but they will have the 
preventive services where, early on, they will be able to examine 
exactly where they are and have access to a diabetic educator and have 
the monitoring and coaching they need and, hopefully, the diabetes 
comes under control and the health care costs come under control. That 
is what we did in this bill, and I am very proud of it.
  I travel my State a lot. As I went from diner to diner out there in 
the communities, where I could talk to the people unfettered, 
unchoreographed, they said to me: Barb, I not only worry about losing 
my job, but I worry about losing my health insurance. I don't know what 
will happen to my family. I fear that I am one health care catastrophe 
away from family bankruptcy. I want to make sure my family is taken 
care of.
  I talk to small businesses. How can they afford that? They need 
predictability and understanding and they need access to something 
called the health care exchange, where it will be akin to an economic 
mall, where they will be able to go to the health exchange and see the 
whole lineup of private health insurance companies and the benefits 
they offer. Small businesses will be able to navigate that and see what 
they need and what they can afford for the benefit of their workers.
  This is the American way. This does use market techniques, but at the 
same time we don't use the free market to endanger the people in terms 
of universal access and some of these others.

[[Page S4704]]

  There are many things in this bill. One of the other things I like so 
much was that we insist that 80 percent of the premium we pay goes into 
health care, not into the executives' pockets for perks, privileges or 
profits.
  I believe in the free enterprise system, and I believe in profit, but 
I don't believe in profiteering. So we said 20 percent goes into 
administrative costs, and if they can control those, they will make a 
bigger profit. But 80 percent has to actually go to rewarding providers 
for the health care they do, for their education and training. I think 
it is terrific.
  Part of the bill has already kicked in. My constituents in Maryland 
will see over $5 million returned to them because we insisted on this 
provision. We are for providers getting what they need in terms of 
reimbursement but at the same time looking at and making sure it goes 
into the health care they need.
  Today we have had the ruling of the Supreme Court. I was out there on 
the steps of the Supreme Court, and I loved every minute of it. As you 
know, I got into politics as a neighborhood protester. I fought a 
highway and the downtown establishment and I fought the political 
bosses. When I talk to young people around the world--particularly 
those with aspirations in autocratic or dictatorial environments--I 
tell them that in America when you are a protester, they don't put you 
in jail, they send you to the Senate. I am here because of the first 
amendment of the Constitution--free speech, freedom of assembly.
  When I was out there on the steps today and heard the roar of the 
crowd, whether it was the tea party who had access to a microphone or 
whether it was me who had access to a microphone, I knew the Founders' 
vision of America had worked. They believed in limited government. They 
believed in checks and balances. No President should have unlimited 
power. No Congress should have unbridled power, and the Supreme Court 
would be an independent judiciary to act as referee.
  President Obama proposed a bill. We duked it out in the Congress and 
we passed it and sent it out into the land. There have been legal 
challenges. It went to the Supreme Court, and the Court looked at the 
bill not for utility or even desirability, they looked at it for 
constitutionality. Today, they ruled that the bill was constitutional.
  I am sure somewhere there is Tom Jefferson, John Adams, and his wife 
Abigail, who said they lived the Constitution, and in that health care 
bill, by the way, John, they didn't forget the ladies.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. CARDIN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. I ask unanimous consent to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. Madam President, I take this time to comment on the 
Supreme Court decision on the Affordable Care Act. This was a good day 
for the American people. It allows us to move forward with providing 
universal health care coverage for all Americans--affordable, quality 
health care.
  I wish to quote from a former Member of this body when he said:

       For me, this is a season of hope, new hope for a justice 
     and fair prosperity for the many and not just for a few, new 
     hope. And this is the cause of my life, new hope that will 
     break the old gridlock and guarantee that every American--
     north, south, east, west, young, old--will have decent, 
     quality health care as a fundamental right and not a 
     privilege.

  That was a statement from our former colleague, the late Senator Ted 
Kennedy, on August 26, 2008. This Congress acted and did what was right 
to move this Nation forward to join all the other industrial nations in 
the world to say health care is a right, not a privilege.
  The Supreme Court today recognized it was Congress's responsibility, 
and Congress had the legal authority to move forward. As a result of 
this decision, we are going to find that $10.7 billion has been 
recovered already today by dealing with waste, fraud, and abuse in the 
Medicare system. We will be able to continue with those programs that 
make our health care system more affordable. We will be able to 
continue health care coverage for those between the ages of 19 and 25 
who are now on their parents' health insurance policy; 3.1 million 
young adults have benefited from that provision of the Affordable Care 
Act that was upheld by the Supreme Court today.
  Seventeen million children with preexisting conditions can no longer 
be denied coverage by their insurers. That provision is now safe as a 
result of the Supreme Court decision. And 5.3 million Americans on 
Medicare have saved, on average, $600 on their prescription drugs.
  As you know, we worked in this Affordable Care Act to close the 
coverage gap--the so-called doughnut hole--on prescription drug 
coverage for our seniors. In upholding the Affordable Care Act, the 
Supreme Court allows us to continue to make sure that coverage gap is 
eliminated.
  There are 70,000 Americans with preexisting conditions who now have 
the security to know their coverage is safe. In addition, in 2011, 32.5 
million seniors received one or more free preventive services. So far 
in 2012, 14 million seniors have already received these services.
  The expansion of benefits in Medicare that was under the Affordable 
Care Act, providing the wellness exam and eliminating the copayments on 
preventive health services, will also now be saved and our seniors will 
be able to continue to receive those benefits.
  On the doughnut hole, the coverage gap on prescription drugs will 
save $3.7 billion for 5.2 million seniors, with an average of $651. 
This is real money. This is the difference between some seniors being 
able to take their medicines or having to leave them on the 
pharmacist's desk. That is now also protected.
  Insurance companies will provide almost 13 million Americans with 
over $1 billion in rebates in 2012. We put into the health reform 
proposals protections against excessive premiums by private insurance 
companies. Well, that is going to save consumers in America over $1 
billion. And 105 million Americans will no longer have lifetime limits 
on their coverage.
  Insurance should be there to protect you. Before the Affordable Care 
Act, there were limits that might not have covered extraordinary costs, 
catastrophic costs. We now have that protection as a result of the 
Affordable Care Act and the Supreme Court's upholding that decision 
today.
  It is also important for small businesses. In 2011, 360,000 small 
businesses took advantage of the tax credit that helps small companies 
afford to buy health insurance for their employees. When we fully 
implement this bill in 2014, small companies will enjoy the same larger 
pools and lower premiums that larger companies enjoy today in covering 
around 2 million workers. So we have already made a significant amount 
of progress as a result of the Affordable Care Act and the Supreme 
Court upholding that law today.
  I wish to talk a minute about the Patients Bill of Rights. One of the 
major parts of the bill was to take on the abusive practices of private 
insurance companies. We all know that was at risk if the Supreme Court 
did not uphold the actions of Congress. As a result of upholding the 
actions of Congress, we now find, for example, access to emergency 
care, a provision I worked on, says it is prudent for you to go to an 
emergency room if you are having shortness of breath, if you are having 
chest pains. It is the right thing to do to go to the emergency room 
and that your insurance company has to pay for that visit. It can't go 
by your final diagnosis that it may not be a heart attack. After you 
get your bill, and it is not paid for by your insurance company--you 
might have a heart attack--this bill protects a person and makes sure 
insurance companies do not use abusive practices against you.
  Access to women's health care is guaranteed under the Patients Bill 
of Rights. Access to pediatric care and choice of health care 
professional as your primary care--all that is in what we call the 
Patients Bill of Rights that protects you against abusive practices of 
private insurance companies.
  Clinical trial coverage is also here, and the provision I worked on, 
health

[[Page S4705]]

disparities. We know we pay a heavy cost in America because of health 
disparities in minority populations and in gender issues. We now have a 
National Institute for Minority Health and Health Disparities at the 
National Institutes of Health. That will help us understand why we have 
these disparities in our system and what we can do to reduce those 
disparities, because it is the right policy for America and it will 
also save us money. That law now is protected. That institute is 
protected and is no longer in jeopardy as a result of the Supreme 
Court's upholding of the Affordable Care Act.
  Let me talk about oral health care. We have talked frequently on the 
floor here about Deamonte Driver, the 12-year-old in Maryland who, in 
2007, had no health insurance and could not get access to dental care 
and lost his life. We said that was not going to happen again in our 
State, or anyplace in the Nation, and we are proud that children's 
access to pediatric health care--dental care--is protected under the 
essential benefit provisions in the Affordable Care Act that was upheld 
by the Supreme Court today.
  I also want to comment on the importance of the legal decision beyond 
health care. To me, it shows the Supreme Court was able to find a way 
to advance the rule of law and to follow precedent we have seen in 
upholding programs such as Social Security and Medicare, which are 
mandatory insurance programs. It is the right decision on the rule of 
law. It is the right legacy for this Court to find a way--in a Supreme 
Court that has nine different Justices with different views--to come 
together on an opinion that upheld the authority of Congress to act on 
a major national problem.
  Now it is time for us to move forward. This issue has been litigated. 
The Supreme Court is the final arbiter of this decision. It is 
constitutional. I urge my colleagues, both Democrats and Republicans, 
to work together to implement this bill in the best manner for the 
people of this Nation. We know we are saving money, we know the 
Congressional Budget Office says the implementation of the Affordable 
Care Act will save hundreds of billions of dollars over the first 10 
years and then trillions of dollars beyond that in our health care 
system. Let's work together to make sure it works. Let's work together 
in the interest of the American people. Let's put our partisan fights 
aside, let's accept what the Supreme Court has done, and let's move 
forward to get this law implemented in the most cost-effective way so 
we can indeed achieve the goal Senator Kennedy was talking about--that 
every American should have access to affordable quality care in the 
richest Nation in the world.
  With that, Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. LAUTENBERG. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. LAUTENBERG. Madam President, today, June 28, 2012, 30 million 
American people gave thanks, and it is because the Supreme Court this 
morning upheld the health care law that will provide those 30 million 
people with access to affordable health insurance.
  Today is a proud day for America and for the values we cherish 
because on this day our Nation's highest Court has reaffirmed that 
America is a country that works for everybody, not just a privileged 
few. We fought for these values for many years, and this victory is 
just the latest in America's long struggle for a fairer and more equal 
country. We took the first step 77 years ago when President Franklin 
Roosevelt signed Social Security into law, ensuring that in this 
country no senior would go hungry. Thirty years later President Lyndon 
Johnson helped America take the next step when he created Medicare and 
Medicaid, ensuring that our seniors and the most vulnerable among us 
would always have access to health care. And today our efforts to 
ensure that every American has access to quality health care has been 
given the stamp of approval by our Supreme Court. Today we established 
our belief in America, the wealthiest Nation on Earth, that it is our 
moral duty to make sure everyone can keep themselves and their families 
healthy.
  A little more than 2 years ago, we heard the call of Americans 
struggling to pay for health care--parents who had to choose between 
keeping their children healthy and putting food on the table and 
seniors who couldn't afford lifesaving medication. So we passed and 
President Obama signed into law the Affordable Care Act, and already 
millions of Americans are reaping the benefits of this law.
  Thanks to health reform, insurers can no longer deny people coverage 
for a preexisting condition. If someone has cancer or some other 
longtime sickness, insurers can't deny them coverage if they are 
already sick from these conditions. Up to 17 million children with 
preexisting conditions are already benefiting from this provision. 
Under the Affordable Care Act, insurance companies are prohibited from 
canceling coverage when people are sick. And more than 3 million people 
in my State of New Jersey no longer have a lifetime limit on their 
health insurance coverage.
  Today millions of seniors are already receiving free preventive 
health services and are saving an average of $600 a year on 
prescription drugs. And it is not just seniors who are seeing lower 
costs; almost 2 million New Jerseyans with private insurance now 
receive preventive health service at no additional cost. For women, 
these services include cancer screenings, such as Pap smears and 
mammograms. Since the 1950s, cervical cancer screenings have cut 
mortality rates by more than 70 percent. Think about that--70 percent 
of the people are alive now who otherwise would have died if they 
didn't have the coverage.
  Young people have benefited as well. More than 73,000 young adults in 
New Jersey obtained health coverage last year through their parents' 
insurance plans. This has brought their parents peace of mind, knowing 
that their children, who may have just graduated from school and are 
making their way in the world, will be covered with insurance if they 
need it.
  But even with the Supreme Court's decision, our friends the 
Republicans continue to fight our efforts. They are again showing they 
will stop at nothing to make seniors have to pay more for medications, 
more families going bankrupt, and more parents having to choose between 
feeding their children and taking them to the doctor.
  Our colleagues across the aisle keep telling us that they want to 
repeal and replace health reform, that they simply favor other 
solutions, but they have no proposals and no ideas on how to do that. 
Instead, they just keep giving the American people the same message: 
Give your benefits back; we can't afford it--in this rich Nation of 
ours.
  Well, I have a message for my friends here in this place where care 
is so carefully given: If you don't want Americans, I say to colleagues 
here, to have affordable health coverage, then you ought to give yours 
back. That is what I say. The Republican hypocrisy is stunning. As 
Members of Congress, politicians have access--all of us--to world-class 
health care, but they are determined to take away the lifeline that 
health reform law offers to families who really need it.
  Let's be clear. Without this law, insurers could once again restrict 
benefits, cancel coverage when people get sick, and refuse care to 
people with preexisting conditions. The Republicans want to return to 
the days when it was legal for insurers to turn away sick children, to 
say: Sorry, you are not covered by insurance. No matter how sick you 
are, we can't give you any help.
  And I say to my Republican colleagues, stop attacking the American 
health care plan, not the Obama health care plan. Start working with us 
to ensure a healthy and happy future for all of our children and 
grandchildren.
  Americans don't want to relive the health care debates with the lies 
about death panels and socialized medicine. The American people want us 
to move forward and work together to lower costs and make sure no 
American gets left behind. That is what the American people deserve 
from us. They send us to this place for 6 years at a time. That is the 
America we must believe in. That is the America we fight for. And today 
we are one step closer to making that America a reality.

[[Page S4706]]

  I speak for myself. Some years ago, I was 18 years old and I signed 
up to serve my country in World War II. It was a dark moment in our 
history. The war was at its height. My father was on his deathbed. He 
was just past 42 years of age. He had cancer, acquired--like his 
brother and his father did--from work in the mills of Paterson, NJ. 
That is what they had. My mother was a 37-year-old widow. Things were 
tough. Things were difficult. I had a little sister. My father died, 
and we all grieved. I was already enlisted in the Army, and they 
permitted me to stay home until my father passed on. But what happened 
is not only did my father leave grief, but he left bills--bills for 
hospitals, for pharmacists, for doctors. People shouldn't have to go 
through that. The coverage ought to be there that says: We will take 
care of you. You are an American citizen. Be proud of that. And don't 
let anybody fight to take away your rights to protect their rights. No, 
that is not a balance.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER (Mr. Blumenthal). The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. GRAHAM. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRAHAM. I ask consent to be recognized for 5 minutes to speak 
about the Supreme Court's ruling.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRAHAM. Mr. President, there are a couple observations I would 
like to make about the historic ruling by the Supreme Court today. No. 
1 is about the legislative process. Members of Congress during the 
debate on Obama health care had a very passionate, heated debate which 
is part of democracy. As I recall the debate, when people on our side 
suggested this is a tax increase, that all the fines and costs 
associated with the health care bill would be a massive tax increase, 
our friends on the other side, almost to a person, said: No, this is 
not a tax increase. President Obama assured the American people during 
the debate that the fine is not a tax.
  I think the reason that was so is because if we debated this bill and 
the only way we could pass the bill is using the power of Congress to 
tax under the Constitution, there would not have been 10 votes for the 
legislation. Nobody would have wanted to go home and say I just 
increased your taxes by billions of dollars over the next 10 years to 
fix health care, because I think most Americans believe our health care 
in this country needs to be reformed, and it is in many ways broken and 
needs to be fixed, but there are very few people in this country who 
believe we don't tax enough and that is the problem with health care.
  That is not the problem. The problem with health care is not the lack 
of how much we tax, it is the lack of choices people have and the 
competition when it comes to purchasing health care. Many of us want to 
give people a chance to buy health care outside of the State in which 
they live, which they cannot do today. Many of us believe some form of 
medical malpractice reform will lower costs. Many of us are for 
preventing preexisting illnesses being used to deny health care.
  I would like to give individuals the same tax writeoffs as businesses 
have when it comes to purchasing health care, and I am willing to help 
those who do not have the money to buy health care to be able to 
purchase health care in the private sector.
  I am willing to do a lot of things, but I am not willing to impose a 
massive tax increase to fix health care. Also, I do not think it is 
fair for people in the body, during the debate on a bill, to say: This 
is not a tax increase, vote for the bill, and wind up having to be told 
by the Court the only way this is legal is for it to be a tax increase.
  Here is my challenge to every Member of the Democratic Party who said 
this was not a tax increase when we debated the bill. I am asking now, 
if they did not want to increase taxes to fix health care, repeal this 
bill and work with me and others to find a way to fix health care 
without a massive tax increase. If after the Supreme Court ruling they 
are still OK with the legislation, be honest enough to go back home and 
say: I raised your taxes to fix health care because I thought that was 
the right thing to do.
  Then let's have a debate about whether that is the right thing to do. 
I can promise, it is not the right thing to have a debate where the 
President of the United States and the architects of the bill assure 
everyone they are not having a tax increase when, in fact, that is the 
only way this bill can stand.
  I believe we all owe it to the American people to be on record. If 
after today's ruling Senators are still for this legislation, have the 
courage to tell the American people: I am for it, even though I had to 
raise your taxes to make it happen. Stand behind what they believe. If 
someone believed at the time this should not be considered a tax 
increase and they are upset or they are worried that it is now being 
called a tax increase and they think that is wrong, have the courage to 
say let's start over. Nobody is going to hold it against a political 
leader who is willing to change their mind if it makes sense.
  I cannot think of a better opportunity for Congress to revisit an 
issue than this. If there is ever a bill that needed to be revisited it 
is the Obama health care bill. It needs to be revisited and it needs to 
start over because it was passed on a party-line vote. It was passed 
with statements being made that this is not a tax increase when it 
turned out to be. I hope we have the wisdom and the courage to start 
over and sort of get this thing right.
  The second point I would like to make is that no one in this country 
has suggested that health care needs to be fixed through a massive tax 
increase. Let's find a better model to fix health care than hundreds of 
billions of dollars of new taxes.
  A final thought is, how do we move forward? In November of 2012, 
every person who voted for Obama health care told their constituents 
this is not a tax. They owe it to their constituents to go back and 
say: Listen, the Supreme Court said this can only stand with it being a 
tax. I am either OK with that or I would like a second chance to fix 
it.
  President Obama is a good man and sincerely believes that health care 
needs to be reformed in a certain way. I agree it needs to be reformed 
but not in this way. The President owes it to the American people to 
correct his statement when he assured us all this was not a tax 
increase. Many Americans found comfort in that. I have always believed 
the Court could uphold this law under one theory and one theory only. I 
never believed the commerce clause was so broad that we in Congress 
could compel someone to buy a product they did not want. The Court said 
today that the commerce clause cannot be used in such a fashion.
  The bill was sold as a power within the commerce clause. The Court 
said today the commerce clause will not allow Congress to make the 
public buy a product. That is not commerce. That should make all of us 
feel better that there are some limits on the commerce clause vis-a-vis 
our Congress. But the Court did say when it comes to the power of a tax 
to tax, the Congress's discretion is broad. That is constitutionally 
true, and it has always been so. The Congress has the power to raise 
taxes to pay for a war. Even though we may disagree with the war, we 
have it in our power to say for the public good we are going to raise 
taxes to pay for a war.
  Congress also has the power, in my view, to say: The health care 
system is broken. We are going to raise taxes to fix it. I don't think 
that is the right answer, but I think that is within our power.
  The Court said today the fine is really a tax. Now that we know it is 
really a tax, what are we going to do about it? Are we going to leave 
in place the largest tax increase in modern history to fix health care 
or are we going to be smart enough, wise enough, and courageous enough 
to start over? I hope we are wise enough, courageous enough, and smart 
enough to start over and this time do it in a way that is truly 
bipartisan.
  The worst possible outcome for the American people is for the 
Congress to pass legislation that affects one-fifth or one-sixth of the 
economy and say this is not a tax, and at the end of the day that is 
the only way the law can stand is for it to be a tax.
  So I hope between now and the election we can have another debate 
about

[[Page S4707]]

health care. All those who stand by this product need to tell their 
constituents: I believe in this product, and I am willing to tax you in 
a large way to make it happen. If we had had that debate to begin with, 
this bill would have never passed and we would have worked together. 
Second chances are hard to get in life. Congress now has a second 
chance.
  One final thought about Medicaid expansion. Congress said we are 
going to expand Medicaid dramatically under this proposal to insure 
people not covered by Medicaid today. If you are 133 percent above 
poverty, you would be included in Medicaid. In my State 31 percent of 
South Carolinians would be eligible for Medicaid under the Obama health 
care formula. That would mean an additional $1 billion of a matching 
requirement by the State of South Carolina to get the Federal money. 
That means my State would have to cut education, raise taxes, or cut 
public safety to come up with the money to match Medicaid expansion 
under the Obama health care act.
  The Supreme Court said we cannot do that to the States. We cannot 
expand Medicaid dramatically, which will bankrupt States and tell them 
if they don't agree with the expansion, they lose all the money under 
the program; that is coercive.
  In September of last year, along with Senator Barrasso, I introduced 
legislation called the Graham-Barrasso bill, which would allow States 
to opt-out of Obama Medicaid expansion and still receive the money they 
receive under the current program. That is basically what the Court 
said we should be doing. So I hope the Republican leader will impress 
upon the Democratic leader to bring up the bill we introduced last 
September and legislatively allow States to opt out of Medicaid 
expansion under ObamaCare if they choose to.
  I guarantee there will be a bunch of red and blue States opting out 
of Medicaid expansion under this bill because it will make them 
hopelessly bankrupt, and that is not the way to solve health care for 
the poor. That part of the bill needs to be addressed too.
  This is a historic ruling by the Supreme Court, but for it really to 
be historic in its fullest sense, Congress should take this historic 
opportunity to revisit health care and get this right without a massive 
tax increase.
  I yield the floor. I note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. INHOFE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. INHOFE. Mr. President, first of all, my friend from South 
Carolina articulated very well what happened today with the Supreme 
Court. I think it is going to be a wake-up call for a lot of people in 
America. I think it will, as he suggested, have a profound effect on 
the elections in November when people realize the Court has ruled that 
people who don't have coverage are going to be penalized by $695 per 
individual, and families who do have coverage will have to pay an 
additional about $2,100, and the employers of America are going to be 
dealing with the government exchange. People are going to be concerned 
about it. I think they are going to want to send people to Congress in 
both the House and the Senate and in the White House who are going to 
change this system.
  So I stand on the Senate floor and say that is what I am predicting 
and we will see what happens.


                        Highway Reauthorization

  I want to make one comment because we are going to vote shortly on a 
significant bill. It is the highway reauthorization bill. It makes me 
very proud because we have been trying for a year and a half to do 
this. When we passed the last highway reauthorization bill, it was in 
2005. At that time I was the chairman of the Environment and Public 
Works Committee. It was, as I recall and going from memory, a $286.4 
billion bill. It was for 5 years. Of course, that expired in 2009.
  The problem we have had since 2009 is that we have been operating on 
what they call extensions. Most people are not aware that when we 
operate on extensions, we are operating with the same amount of money 
we are spending out of the highway trust fund, but we are only getting 
two-thirds of what we would get if it were a reauthorization.
  First of all, they can only do it in a short period of time. There is 
no planning, and they have all said we lose about 30 to 33 percent of 
the amount of spending power or money that should be spent on highways, 
bridges, and maintenance.
  It is kind of funny because I have been ranked as the most 
conservative Member of this body at different times, and I am always in 
the top three. Yet I have always said I may be the most conservative, 
but I am a big spender in two areas: One is national defense and the 
other is transportation, and that is what this is all about.
  I have had occasion to talk to a lot of the new members of the 
conference committee over in the House and explained to them the 
conservative position and the conservative vote on this is to vote for 
the highway reauthorization bill that is going to be coming up to us. 
Hopefully, it will be here tonight. It is going back and forth between 
the House and Senate. I believe most of the conferees have already 
signed off on this bill, so it is coming up. It has been a long time in 
the making. I am very excited about it.
  Let me also say that while I take the position that the conservative 
vote is to vote for the highway reauthorization bill, I am not alone in 
this feeling.
  Mr. President, I would like to submit for the Record a statement by 
the chairman of the American Conservative Union. It is an op-ed by Al 
Cardenas, who is the chairman of the American Conservative Union. He 
presents a strong case as to why this is the conservative position that 
should be taken.
  I ask unanimous consent that the statement and op-ed piece by the 
chairman of the American Conservative Union be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                   [From the Examiner, June 21, 2012]

        Conservatives Should Break Transportation Bill Gridlock

                            (By Al Cardenas)

       The spending and debt crises of the past few years in 
     Washington have forced an important debate about the proper 
     role of government, and the need for prioritizing government 
     spending.
       The failed $800 billion stimulus, TARP, countless bailouts 
     and Congress' failure to make a serious attempt at 
     controlling our $16 trillion debt have given many 
     conservatives rightful anger over how Washington spends our 
     money.
       Unfortunately, well-placed mistrust in Congress' ability to 
     spend our tax dollars is now jeopardizing legitimate spending 
     projects, chief among them this year's transportation funding 
     bill. If Congress fails to act by June 30, important 
     transportation projects critical to our national defense and 
     our economy will lose their funding. The effects on our 
     already suffering economy will be far-reaching and profound.
       While there are important disagreements between members of 
     the House and Senate on this bill, enough consensus exists on 
     the broad framework that there's no excuse for not passing it 
     in time.
       First, the current framework does not contain any earmarks. 
     This is a monumental achievement in its own right considering 
     ``Bridge to nowhere'' and ``John Murtha's airport'' served to 
     make transportation earmarks the poster children of wasteful 
     pork spending. Second, the myriad of highway spending 
     categories that used to serve as hiding places for pet 
     projects has been reduced from 87 down to 21.
       Third, thanks to the leadership of Senator Jim Inhofe and 
     conservatives in the House, the cumbersome and unnecessary 
     environmental review process for road construction projects 
     will see significant reform. How much reform is up for 
     debate, but we're going to get something better than what we 
     have now, that much is assured.
       Fourth, not passing a bill will hurt our already suffering 
     economy.
       While big-government Democrats mistakenly place their 
     economic faith in the religion of government spending, 
     conservatives know the economic pump is best primed by a 
     robust private sector. Government cannot do much to stoke job 
     creation on its own, as evidenced by President Obama's 
     repeated failures during the past three years. But government 
     can play a profound role in stalling job creation and hurting 
     economic growth. Failure to pass a transportation bill would 
     have a negative effect on commerce and the businesses that 
     count on safe and reliable roads.
       Perhaps most importantly, those of us who believe in 
     constitutional conservatism understand that unlike all the 
     things the Federal Government wastes our money on,

[[Page S4708]]

     transportation spending is at the core of what constitutes 
     legitimate spending.
       Article One, Section Eight of the Constitution specifically 
     lists interstate road-building as one of the delineated 
     powers and responsibilities vested in the federal government. 
     In Federalist Paper #42, James Madison makes an early case 
     for the federal government's role in maintaining a healthy 
     infrastructure, by stating ``Nothing which tends to 
     facilitate the intercourse between the states, can be deemed 
     unworthy of the public care.''
       Let's be clear--the legislation before Congress is still 
     the product of a Democratically-controlled Senate, and far 
     from conservative perfection. But there can be no denying 
     that it represents a marked improvement over previous 
     transportation funding bills. Enough progress has been made, 
     victories won, and concessions secured from Democrats, that 
     conservatives should feel comfortable dropping their 
     objections and working to ensure passage of a bill before 
     June 30.
       The road to reforming government spending will be long and 
     winding, but conservatives have us headed in the right 
     direction.

  Mr. INHOFE. I am looking forward to having this. Certainly, my State 
of Oklahoma is not the only State that has bridges and road problems.
  Another good thing we are waiting on--and I feel very confident we 
are going to be able to pass this out of the Senate--is the pilots' 
bill of rights, which we are in the process of, hopefully, getting 
done. When that time comes, I would like to be recognized to talk about 
some of the great extensions of justice to people who have been denied 
that justice heretofore just because they happen to be pilots.
  I will yield the floor, and I suggest the absence of a quorum.
  The bill clerk proceeded to call the roll.
  The PRESIDING OFFICER. The clerk will call the roll.
  Mr. COATS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Indiana.


                          Health Care Decision

  Mr. COATS. Mr. President, I come to the floor today to speak about 
the Supreme Court ruling on health care. Obviously, we were all glued 
to the television set this morning and watched this historic and 
momentous decision. I was deeply disappointed with the ruling. I 
respect the Court and its work, but I was disappointed that the Court 
failed to strike down this law as many anticipated they would. I was 
disappointed because I believe the law has been deeply and fatally 
flawed from the very beginning.
  It became a major issue, of course, in the 2010 election as people 
watched this massive bill that impacts every American get passed 
without bipartisan support. The procedures were worked around and 
violated in order to pass--even though it was against the will of the 
majority of the American people. This was a 2,700-page monstrosity so 
infamously described by the then-Speaker of the House as something we 
have to pass first so you can find out what's in it. Well, we found out 
what's in it. We have had 2 years to examine this and we have seen 
parts of it being played out, with more to come.

  I think what we have learned is this bill is fatally flawed and it 
ought to be repealed. It doesn't mean we don't have health care issues 
we should deal with, but we need to deal with it in a bipartisan way 
that can be better explained to the American people and that is 
affordable. It is labeled the Affordable Care Act, but it is anything 
but affordable. In a time of deep recession and over a period of the 
last 2 or 3 years of a stagnant economy, this law adds a burden of 
regulation and taxation that is working against our ability to come out 
of this deep hole of economic distress.
  Americans found out what was in this bill, and I think it reaffirmed 
many of their deep concerns about going forward with a plan that tries 
to wrap up the entire U.S. health care system in one big ball--2,700 
pages worth. It reaffirms the people's concerns with federal rules and 
regulations and taxes and mandates. The American people are saying that 
this is not how we want reform of our health care system. We want to 
make it more affordable and more accessible, but letting Washington 
essentially decide how to go forward without giving flexibility to the 
States and flexibility to the private sector to initiate reforms 
clearly is not what the American people--or at least the majority of 
the American people--were wanting.
  Despite the promises that were made about the impact of this bill by 
those who authored it and by the President, middle-class Americans have 
found that the health care law is a massive tax. The Supreme Court 
reaffirmed that today. This is not just a penalty; this is a massive 
tax on working Americans--and not just the rich. It is a tax on the 
middle class and it is a tax on every American taxpayer, even though 
the President has insisted, now famously, on YouTube and every news 
station, that this was not a tax on the middle class or a tax on any 
Americans.
  Families have found out their insurance premiums are going up, not 
down, as was promised by those who supported this bill and authored 
this bill. Seniors have found out they may not be able to keep the 
insurance plan they have and could lose access to Medicare Advantage. 
Medicare Advantage is a program many seniors have enrolled in and found 
to be successful in addressing their health care needs at a reasonable 
cost.
  Business owners found out they would be fined $2,000 per employee if 
they failed to provide workers with a health care insurance plan 
approved by Uncle Sam. I don't know how many business owners I have 
talked to in Indiana over the past couple of years who have said they 
have sat down with their employees and discussed with them how much 
they are able to provide in health care coverage without cutting jobs 
and without sinking the company. Many companies have worked out 
different types of agreements with employees and various types of plans 
based on their ability to provide that kind of coverage acceptable by 
both the employees and the owners of the business. Now all of these 
agreements are wiped out because it is determined that Washington will 
decide what the minimum level of the plan should be. Several business 
owners have told me they simply can't run their business in this 
economy on the low margins, if any margins they are achieving, and 
provide that kind of increase in insurance or opt out of it and pay a 
fine of $2,000 per employee.
  For those businesses with under 50 employees, there is an exemption. 
Other businesses have said: Guess what. I have 47 employees. Does 
anyone think I am going to hire over 50? No way. No way am I going to 
push myself into a category where I have to pay a fine of $2,000 per 
employee if I don't comply with the health care mandates out of 
Washington, DC. So what we see is a lot of payment of overtime for 
existing workers but we don't see hiring. We don't see the expansion of 
hiring, particularly in small business, because of the so-called 
Affordable Care Act.
  I have spoken to patients and doctors all over the State of Indiana, 
including health care providers, insurance companies, hospital 
administrators, doctors who are part of a group and those individuals 
who are in a private practice, and all of the other entities that are 
engaged in health care. They all have major concerns with this law and 
to a group, they have opposed this Affordable Health Care Act, or so it 
is described.
  We have a dynamic medical device industry in Indiana, as we do in 
several States across this country. It is one of the cutting-edge, 
leading industries in terms of our ability to provide new and 
innovative products to make people's lives healthier and safer and to 
prevent a number of unintended consequences from various medical 
procedures. They learned after reading this act that they were going to 
be subject to a 2.3-percent tax levied on their gross receipts because 
they were a pay-for for this bill. These companies that make 
pacemakers, artificial joints, and surgical tools find that this tax is 
something that drives them to the point where they need to think about 
transferring their business overseas, or part of their business 
overseas, or not hire the workers they wish to hire. This is a tax 
imposed on one of our dynamic and innovative industries that is leading 
in our exports. This industry may no longer be able to compete under 
this tax.
  Just because this ruling that came down today saying the health care 
law is constitutional does not mean it is the right policy for us to go 
forward. The law remains unpopular and

[[Page S4709]]

unaffordable. I wish to state here today that I am committed to working 
with my colleagues to repeal the health care law and give our citizens 
the power and the flexibility to make their own decisions relative to 
their health care and to use those innovative ideas that are out there 
to put a much better package together that addresses the real question 
of rising health care costs and access.
  I have traveled our State and listened to all of these providers and 
I have asked them this question: If the health care law is struck down 
by the Supreme Court, what would you propose? Because we still have a 
problem here. We have rising health care costs that have to be 
contained, we have an access problem, and we have a number of other 
problems in terms of gaining access to coverage and payment for health 
care issues. What would you propose? I have a long list of answers. I 
have talked about it here on the floor. I talked about it during the 
campaign. All across my State I have talked about the things I have 
learned from listening to the people who are on the frontline doing 
this business every day. There are all kinds of innovative solutions 
out there. There are all kinds of things we ought to be looking at. I 
know all of us who support the repeal of the current law are committed 
to bringing forward sensible, affordable, cost-effective, quality-
effective solutions to our health care issues.
  What the Supreme Court essentially has done is say that this issue is 
for Congress. Congress represents the people. We need to be 
representative of the people. So what we need to do now is listen to 
the people. It is the people who will decide the future of health care 
for this country. I believe it is the people who will decide in this 
coming election. It is the people who will decide whether they want 
evermore Washington--evermore taxing and spending, evermore debt, 
evermore Federal mandates and regulations--or whether they want to 
approach this in a different way that can reduce spending, empower 
individuals, give States greater flexibility, and bring forward 
sensible, step-by-step, incremental, affordable, tested, proven ways of 
addressing our rising health care costs.

  So the Supreme Court has turned it back to Congress. It is our 
responsibility now to go forward and represent all those who were not 
listened to when this bill was run through this Congress in a way that 
violated a lot of our procedures and in a way that I believe went 
against the majority will of the American people. Here we are, and now 
it is back on us, and we now need to stand up and take responsibility. 
Those who voted for it will be defending it, of course. Those who voted 
against it--or those of us who were here, partly because it was an 
issue in the 2010 campaign--are here to not just simply say we don't 
like what is there but to offer also positive solutions to the problem.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. REED. Thank you, Mr. President.
  Today's Supreme Court ruling that the Affordable Care Act is 
constitutional and the law of the land is a victory, I believe, for 
Rhode Islanders and for all Americans. Families will no longer fear 
financial ruin if a child becomes seriously ill or face denial of 
health coverage due to a child's preexisting condition, and they will 
no longer have to worry that the terms of their coverage will run out 
as they are being treated after a major medical emergency.
  Indeed, tonight, all Americans can sleep a little easier knowing they 
and their children will have access to quality, affordable health care. 
This is the type of security we want for our children and what this law 
will provide.
  Indeed, for the first time in our history, parents can, with some 
confidence, trust that whatever lies ahead, their child at least will 
have access to affordable health care. We couldn't say that with any 
confidence a few years ago--even 2 years ago--before we took up this 
legislative activity.
  This law has already benefited many people in Rhode Island, including 
individuals, families, and businesses. Children up to age 26 are now 
able to remain on their parents' health insurance plan. In Rhode 
Island, this has benefited an estimated 9,000 young adults and their 
parents. Over 15,000 Rhode Island seniors have saved a total of $14 
million on prescription drugs since the law was enacted, an average of 
close to $600 annually. Seniors will continue to save on their 
prescription drug costs until the existing coverage gap is closed and 
will continue to have access to free preventive care such as annual 
wellness visits and screenings.
  Rhode Islanders can now expect rebates if an insurance company spends 
too much on administrative costs and CEO bonuses instead of on their 
health care.
  For too long, health insurance companies got away with increasing 
premiums and decreasing coverage, which resulted in higher costs and 
unfair practices. Beginning in 2014, Rhode Islanders will be able to 
purchase health insurance on a new exchange, a single point of entry 
where they can evaluate the costs and coverage of health insurance 
options. They will, indeed, for the first time for many Rhode 
Islanders, have a real choice about the health care they receive and 
the insurance they purchase. According to Families USA, 97,000 Rhode 
Islanders will have access to tax credits to make their coverage more 
affordable. Thousands more childless adults will gain coverage through 
the Medicaid Program.
  Now that the Court has spoken, I hope we can work on a bipartisan 
basis to do what we must do, and that is to create jobs and improve our 
economy. This health care decision is a landmark decision, but the work 
now--the work of all of us--should be to reinvigorate our economy so 
that not only can people have confidence in their health care, but they 
can have the further and indeed very primary confidence that they will 
have meaningful work.
  In that respect, I am glad Congress is poised to take action that 
will enable millions of students and families across the country to 
breathe a sigh of relief about the student loans they need to borrow 
for the upcoming academic year. Everyone, from every sector of the 
country, will tell us that the key to our future is higher 
education, that we cannot be competitive in a world economy unless we 
have the best educated students in this country, that we cannot be the 
powerful force we have been in the world unless we have education.

  The key for so many jobs today is going on past high school into 
postsecondary education. Yet we are days away--unless we act--from 
doubling the loan interest rate we are charging our students.
  There has been quite a bit of stalling tactics for months. I hope 
those tactics are over, as the July 1 deadline approaches. I hope we 
are soon to take action to prevent the doubling of the subsidized 
Stafford loan interest rate.
  I would like to thank majority leader Harry Reid for his tireless 
efforts to negotiate a bipartisan solution. I also wish to recognize 
and thank three other individuals who were absolutely critical in this 
effort, who were leaders, without equivocation, with deep conviction; 
that is, Chairman Tom Harkin of the HELP Committee, who led with vigor 
throughout this effort; Senator Sherrod Brown of Ohio, who has been 
committed to this effort; and also our colleague in the House of 
Representatives, Congressman Joe Courtney of Connecticut. They have 
been extraordinary.
  Last January, Congressman Courtney and I introduced legislation to 
permanently extend the law that makes college loans more affordable for 
millions of students across the country.
  President Obama called on Congress to address the student loan 
interest rate hike in his State of the Union Address. Back then, many 
Republicans scoffed at the idea. In fact, they voted for budgets that 
assumed the interest rate would double, and they did that without any 
apparent equivocation.
  But thanks to students and families across the country who raised 
their voices and made themselves heard, my colleagues got the message: 
Fixing the student loan interest rate matters. It matters a great deal. 
It matters to individuals trying to build a better life for themselves. 
It matters to parents whose dream to give their kids a chance at a 
better life depends on being able to afford college. It matters to our 
shared economic future because the single most important investment we 
as a nation can make is to educate our young people.
  So thanks to groups such as Campus Progress, USSA, U.S. PIRG, Young

[[Page S4710]]

Invincibles, and the Rebuild the Dream coalition that pushed this issue 
to the forefront where it belongs. The letters, e-mails, calls, visits, 
bus tours, and campus rallies made a difference.
  We should soon be voting, I hope, to keep this student loan rate low 
for another year. However, it is important to remember this is only a 
temporary, short-term fix. Now we need to develop longer term solutions 
to the growing burden of student loan debt, the rising cost of college, 
and the need to improve higher education outcomes so students complete 
their degrees and get the full benefit of their investment in 
education.
  These are tough issues, but we have to address them head on. Our 
economy and our future depends on addressing these issues.
  It is estimated, for example, that more than 60 percent of the jobs 
will require some postsecondary education by the year 2018. In 2010, 
only 38 percent of working-age adults held a 2-year or 4-year degree. 
We have very few years to go from 40 percent to 60 percent. That gap 
represents the challenge we have in being a competitive economic force 
in the world. Certainly, if we are ever going to close that gap, we 
have to make sure we do not double the interest rate on Stafford loans, 
as a first step.
  But, as I suggest, there are many other steps we must take. We have 
to address the rising cost of college. The cost of attending college 
has increased by 559 percent since 1985--559 percent--rising far faster 
than costs for gasoline, health care, and other consumer items.
  Keeping student loans affordable and interest rates low is one part 
of the solution. Providing more grant aid through Pell grants and other 
programs is another.
  We need to call on institutions to do their part to keep costs in 
check. Yes, the college community has to rally around this and has to 
think of innovative ways to provide excellent education at a lower 
cost, a more affordable cost. States have to play a role too. When 
State support for higher education goes down, tuition goes up. The 
crises of so many States--real crises, difficult crises--have forced 
them to reduce their support for higher education, and the result, as I 
suggest, has been tuitions climb, and that is another burden middle 
America and middle-class, middle-income families are bearing.
  I look forward to working with my colleagues on developing a 
comprehensive approach to addressing these issues.
  Also, I would just like to say, I hope we are on the verge--at least 
for the next year--of avoiding a doubling of interest rates on student 
loans. We have a long way to go to ensure that every American with 
talent and drive and the skills has the means to go to college. This is 
an important first step. There are many more we must take, and I hope 
we do that very quickly.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Franken). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Franken). Without objection, it is so 
ordered.
  Mr. REID. Mr. President, I want to spend a few minutes and bring 
everybody up to date. We have had wonderful cooperation in the last 
several weeks. We have gotten a lot done. Our passing the three bills 
that are left to do--student loans, flood insurance, and the highway 
bill--would be a significant accomplishment. We are going to do it; it 
is only a question of when.
  A lot of the committees and the chairs and ranking members worked 
late last night. I talked to CBO today. They didn't get the information 
that they started scoring until 4 a.m. They are moving forward and 
doing their best. As with all agreements, things come up, and at this 
point everything appears to be just right. The committees of 
jurisdiction have indicated they have worked through all these matters. 
They have completed the drafting of a revised version of the conference 
report. We expect this to be filed momentarily--it could have already 
been filed.
  But what we have done many times is we have voted on what the House 
has filed before they passed it. We have done that many times. It is 
standard procedure. Right now we don't have the consent from all 
Senators to do that, but that could be forthcoming. I will report back 
to the Senate within the next hour, after I find out whether we can 
finish this work tonight or whether we have to come back tomorrow.
  Everyone stay tuned. At this point, I can't express enough 
appreciation to everyone--Democrats and Republicans in the House and 
Senate. As I laid out to my chairmen at the lunch I had yesterday, this 
has been truly an example of what legislation is all about--compromise. 
Compromise really sounds good. Legislation is the art of compromise--
until you are faced, as a Senator, with something you may not get 
because of the overall good of the bill. Sometimes we have to 
understand that we have to give things up for the betterment of this 
country. We cannot let the perfect be the enemy of the good. So 
everyone understands that to this point.
  As I have indicated, we will know within the next hour, and I will 
report back as to whether we can finish tonight or come back tomorrow.
  The PRESIDING OFFICER. The Senator from Illinois.


                         Surface Transportation

  Mr. DURBIN. Mr. President, I thank the majority leader and especially 
Senators Boxer and Inhofe, as well as their counterparts on the 
Commerce Committee and the Banking Committee, who have put so much time 
into this bill, so much effort. We are trying now to get this important 
and complex bill right and then to secure the support of both sides of 
the aisle to move it forward. A lot of work has been going into it. 
Everybody is working hard to try to accomplish what the majority leader 
has spelled out. I am sure he will tell us if there are any 
developments.


                          Political Prisoners

  Mr. DURBIN. Mr. President, off and on and for some time I have come 
to the floor to speak about an issue that doesn't receive a lot of 
attention, which is political prisoners in foreign lands--journalists 
in Cameroon, an AIDS activist in Uzbekistan, and a lot of others. I am 
pleased that over the years, working with many of my colleagues, we 
have been able to see many of these innocent political victims 
released. Former Senator Brownback, as well as Senators Cardin, Casey, 
Kennedy, Lieberman, and Rubio have all been part of a joint effort to 
deal with these political prisoners.

  Sadly, there is no shortage of political prisoners in this world. 
They languish in horrible prisons in places such as Iran and North 
Korea. Today I want to focus on a number of them, and I will preface my 
remarks by apologizing ahead of time for my pronunciation of these 
names. Some of these are extremely difficult to pronounce for those of 
us in the States, particularly from the Midwest.
  I suppose one might start typically with the most outrageous case, 
but, tragically, all of the cases I speak to fit that definition. Let 
me start with the heartbreaking case from 6 years ago--that of Gambian 
journalist Ebrima Manneh.
  Manneh was a reporter for the Daily Observer newspaper. He was 
allegedly detained by plainclothes Gambian security officials. He was 
held incommunicado for years, although he was seen during the initial 
years of his detention by witnesses in at least one detention facility 
and one hospital. No one has seen him for years. It is possible he died 
in custody. But imagine the pain and uncertainty of his family, who 
have no help and no answers.
  The Economic Community of West African States Court of Justice, which 
has jurisdiction over Gambia, and the United Nations Working Group on 
Arbitrary Detention both ruled against the Gambian Government on the 
case and called for his release. After years of waiting, the Gambian 
Government recently requested United Nations help to investigate 
Manneh's case and the death of one other journalist.
  This was a welcome move by the Gambian Government, and I hope ongoing 
discussions with the United Nations will expedite the investigation and 
bring some resolution to the case and answers for Manneh's family.
  Some years ago, there was a change in leadership in Turkmenistan, one

[[Page S4711]]

that many hoped would open that country's closed and repressive 
political system. Unfortunately, President Berdimuhamedov has yet to 
meet those modest expectations. One would think in a country where the 
President wins an election with a 97-percent vote, and where there is 
an annual week of happiness, that Turkmen leadership could be more 
gracious to its political opponents. Unfortunately, the following 
examples demonstrate just the opposite.
  Gulgeldy Annaniyazov is a long-time political dissident who left 
Turkmenistan in 2000 to settle in Norway as a political refugee. He 
reportedly returned to Turkmenistan in June 2008 to visit his family 
and was arrested. After a closed trial on October 7, he was sentenced 
to 11 years in prison.
  Annakurban Amanklychev and Sapardurdy Khadzhiev are members of the 
human rights organization Turkmenistan Helsinki Foundation. They were 
convicted in August 2006 after trials of only 2 hours and sentenced to 
6 and 7 years in jail on charges that were never very clear.
  Unfortunately, we don't have a photograph of Mr. Khadzhiev. 
Turkmenistan Government officials have been quoted as asserting these 
individuals were arrested and convicted for ``gathering slanderous 
information to spread public discontent.''
  The legal bases for their detention are suspect at best and raise 
serious concerns of political intimidation, questionable charges, 
closed trials, and inappropriately punitive punishment.
  In May 2010, more than 20 Senators--and that is not an easy feat in 
the Senate--signed a letter to Secretary of State Clinton urging the 
administration to raise these cases with the Turkmenistan leadership. I 
know the State Department did in fact take those steps, and I thank 
them, but I hope they will continue.
  In November 2010, the United Nations Working Group on Arbitrary 
Detention released its opinion that the arrest and continued detention 
of the Turkmenistan Helsinki Foundation members is arbitrary and in 
violation of the Universal Declaration of Human Rights and the 
International Covenant on Civil and Political Rights. That United 
Nations group called on the Turkmen Government to immediately release 
them.
  Sadly, they continued to languish under harsh sentences that include 
hard labor, torture, and forced psychotropic drug injections.
  To the leaders of Turkmenistan, I say, if you want to change the 
image of your nation in the world, you must release these and other 
political prisoners.
  Some who follow this may wonder what difference it makes if I make a 
speech on the floor of the Senate about someone languishing in a prison 
in Turkmenistan. All I can tell you is that after years of doing this, 
it does make a difference. It turns out, people listen. And when they 
listen, sometimes they react, and often in a positive way. These people 
languishing in prisons do not believe anybody in the outside world 
knows they are alive. Groups are trying to make sure others are aware 
of that fact, and that is why I come to the floor, as many of my 
colleagues do.
  It is hard to believe in Europe there is still one regime like that 
of Alexander Lukashenko. He is often known as the last dictator of 
Europe. I have been to Belarus twice, once with the Helsinki Commission 
group, led by Senator Cardin of Maryland, where we actually met this 
President Lukashenko; and most recently I went there after the highly 
suspect 2010 elections held in December. What was egregious about this 
election was that President Lukashenko, on the night of the election, 
beat up and arrested all the candidates who had the nerve to run 
against him, as well as hundreds of Belarusian citizens who showed up 
in central Minsk to protest his actions.
  Lukashenko's barbaric behavior, and that of his KGB henchmen--and, 
yes, Belarus still has something called a KGB security service--earned 
him sweeping condemnation from Europe and the United States, further 
isolating his nation and hurting his own people.
  Sadly, today, a year and a half after this outrage, Lukashenko is 
still holding the man in this photograph. This Presidential candidate--
Mikalai Statkevich--was sentenced to 6 years in a medium security 
prison for having the nerve to run against Lukashenko. At least 6, and 
as many as 13, other protestors from the election still sit in jail.
  This is outrageous in Europe today or anywhere on the planet, for 
that matter. It is time for President Lukashenko to let this man and 
these people go.
  Next I turn to Vietnam. Although our bilateral relationship continues 
to improve with Vietnam, we cannot ignore the troubling disregard for 
freedom of speech in that country. It is illustrated by the unfounded 
detention of the popular blogger Nguyen Van Hai, better known as Dieu 
Cay.
  Let me show this photograph of him. He is the head of the Free 
Vietnamese Journalists' Club, and as such Cay has been detained almost 
continuously by Vietnamese authorities since 2008, when he was 
convicted and tried for trumped-up tax evasion charges.
  In 2009, the U.N. Working Group on Arbitrary Detention highlighted 
Cay's case, as well as the ``illegal arrests'' and continued 
persecution of a number of other Internet bloggers.
  In October 2010, on the day Cay was due to be released, having 
fulfilled his sentence, he was transferred to a new jail and re-
arrested for violating a security provision that prohibits 
propagandizing against the government. The propaganda in question--3-
year-old blog postings. The subject of his propaganda--freedom of 
speech, and other issues considered by the government to be too 
sensitive, such as labor strikes and the trials of two human rights 
lawyers.
  Cay's arrest is part of a well-documented trend in Vietnam in which 
national security concerns have been cited as a pretext for arrests and 
criminal investigations.
  The State Department's Human Rights report notes the Vietnamese 
Government is increasing suppression of dissent, increasing measures to 
limit freedom of the press, speech, assembly and association, and 
increasing restrictions on Internet freedom. The trend is clear, and it 
is very concerning.
  Secretary Clinton noted in a speech last year on Internet Rights and 
Wrongs, ``In Vietnam, bloggers who criticize the government are 
arrested and abused.''
  It is long overdue that Vietnamese leaders release Cay and stop 
harassing journalists and bloggers.
  Lastly, on Saudi Arabia, our ally on many important issues, but also 
a friend with whom we have vast differences when it comes to basic 
freedoms and women's rights. Let me tell a recent story that is truly 
hard to believe.
  Since early 2012, the Saudi Government has imprisoned 23-year-old 
blogger Hamza Kashgari. His crime? He tweeted an imaginary conversation 
with the Prophet Muhammad. That action sparked a spate of death 
threats, causing him to remove the tweet and flee to New Zealand in 
fear of his life. While stopping in Malaysia for a plane transfer, 
Malaysian authorities detained him until their Saudi counterparts 
swooped in and returned him to Saudi Arabia under arrest.
  Back in the kingdom--facing accusations of blasphemy and calls for 
his execution by top clerics--he repented before the Saudi court and 
showed great remorse, asking for forgiveness. That was 4 months ago, 
yet he remains imprisoned, awaiting his fate, with no sense when a 
decision will be made.
  I can imagine his actions sparking a debate in Saudi Arabia, but 
leading to calls for a death sentence for blasphemy? In today's world, 
that is hard to believe.
  Saudi Arabia has initiated steps toward social, educational, 
judicial, and economic reform, and we encourage them to do more. 
Immediately freeing Mr. Kashgari would be an important move. This man 
has suffered enough and deserves his freedom now.
  These are just a sample of the many political prisoners who still 
suffer in parts of the world. I want them and their families and the 
governments that unjustly imprison them to know they are not forgotten. 
I and my colleagues here in the Senate will continue to do our best to 
draw attention to their plight, work for their release, and stand up 
for the cause of human rights in the United States and around the 
world.

[[Page S4712]]

  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. BOXER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Begich). Without objection, it is so 
ordered.


                         Surface Transportation

  Mrs. BOXER. Mr. President, we are anxiously awaiting work on the 
Transportation bill that came out of the Environment and Public Works 
Committee, of which I am proud to be the chairman.
  Last year we wrote a bill called MAP-21. That stands for Moving Ahead 
for Progress in the 21st Century. I was proud to see this bill become a 
bipartisan bill, with Senator Inhofe working with me and his staff and 
my staff working together as one. When we got it out of the committee, 
I think it was a unanimous, or close to unanimous, vote.
  I know when our young people learn how a bill becomes a law it sounds 
a little easier than it really is. I often think, in my spare time I 
should write a little pamphlet on how a bill really becomes a law 
because I would say to the young people who are here today, as well as 
those who might be listening, it is a little trickier than it sounds 
because when we learn about how a bill becomes a law in school, it is 
very simply put.
  The bill starts in a committee in the House or Senate, and it moves 
to the floor of that body. Then it starts in a committee in the other 
body, it moves to the floor of that body. It passes both Chambers. If 
it is identical, it goes to the President. If there are differences, 
there is a conference committee, and then it goes to the President. The 
President either signs it or vetoes it. If he signs it, it is a done 
deal. If he vetoes it, we need to have a whole lot of votes--two-
thirds--to override.
  So that is how it is taught in schools, and it is absolutely true. 
But getting it to the point where we are now, where we await a 
conference report, is sometimes a very long and winding path. This one 
was a long and winding path. I think we are where we are, at the point 
where we hope to vote soon on it, because people were willing to meet 
each other halfway.
  I have been saying for a long time, we all stand in our respective 
corners and insist that it is our way or the highway and nothing ever 
gets done. We must come together, and the Senate proved it can come 
together around our version of the highway bill. It passed by 74 votes. 
We were hopeful the House would just take it up and pass it. It didn't 
happen that way. They wrote a less comprehensive bill; they sent it 
over; and then we went into a conference committee. There was a lot of 
difficulty because there were issues that were simply not seen in the 
same light between the House and Senate.
  I would have to say, through all of this Senator Inhofe and I, 
Republicans and Democrats, on the EPW Committee were united. But we 
didn't have that unifying factor with the House Republicans. I want to 
thank every member of the conference committee, Democratic and 
Republican, House and Senate, because everyone worked extremely hard. 
They worked hard. They were knowledgeable. Their staffs worked hard. 
They asked a lot of questions. They cared a tremendous amount about the 
policies.
  The great news about the bill that is coming out of the conference 
committee is that it is a jobs bill, first and foremost. It is going to 
save about 1.9 million--almost 2 million--jobs that are currently held 
in the private sector, and it will create up to 1 million new jobs 
through an expanded TIFIA program. TIFIA is a program that fronts the 
funds for local government to have a revenue stream, and the leverage 
on that is about 30 to 1. So if you have an amount of approximately $1 
billion, you will be able to get $30 billion of economic activity. So 
that is a good part that we can all be proud of. That is a fact.
  The bill will be coming soon, we hope. It is not here yet, and it is 
not done yet, but it is close. What we hope we will have before us is a 
bill that creates close to 2 million--I am so tired. I have to say, I 
haven't gotten much sleep in the past 3 days because we have been 
working nonstop.
  I will say it again. We protect almost 2 million jobs that are 
currently held in the private sector, and we will create up to 1 
million; hence, the 3 million jobs that are relying on this bill.
  We have thousands of businesses that care a lot about what we do. 
These are general contractors, these are equipment dealers, these are 
people in the concrete industry. I can tell you these organizations of 
business and labor have been behind us every inch of the way. When I 
was giving up hope because I didn't think we could move forward, they 
were there to say: Keep on going. And they weighed in. I think the work 
product reflects the fact that we would never, ever give up.
  There is a lot of talk about, What did Democrats give up? What did 
Republicans give up? Let's just say this is a negotiation between 
Republicans and Democrats, a negotiation between the House and Senate, 
and not everybody got what he or she wanted. That is for sure.
  But I just want to say to people who might be listening that in a 
negotiation nobody gets everything they want. You have to meet each 
other halfway, and that is what happened in this negotiation.
  We both wanted to see this as a reform bill. The Senate brought a 
package together that took the 90 programs down to 30, and that pretty 
much survived the conference committee. We also did some more reforms, 
certainly, on project delivery because all sides agree it is taking too 
long to get some of these public works projects done. It is taking 
sometimes 15 years, 14 years, 13 years to do a road start to finish or 
to do a bridge. We need to make sure we can move faster because our 
economy needs that, but still, in my view, protect the rights of 
citizens throughout this country to ensure their communities are taken 
care of, that there is no damage to their communities, that the air 
quality is protected, the water quality is protected.
  We were able to keep those environmental laws while we were tough on 
deadlines and milestones and very tough to say: This is it. If you 
can't finish in this time, and we are trying to get this for 15 years 
to 8 years per project--if you don't do that, you have to explain 
why. There has to be a really good reason why these projects would be 
delayed.

  I believe the funding in the bill is fair. Every single State is 
protected. This is a 2-year-3-month bill. Every State will get the 
amount of money they got last year, plus inflation. That is very 
important. It is the current level of funding with the inflation put 
in, and every State can now know, if and when this bill passes, that 
they can count on that funding for 2 years and 3 months. Everything is 
paid for.
  There are a lot of comments about, what did we do about pedestrian 
walkways and bike paths. I want to be clear. That was an intense 
subject of negotiations. There were those who wanted no funds set aside 
for bike paths, pedestrian paths, and it was very clear--safe streets, 
safe roads to school, et cetera--we had to negotiate on this.
  Honestly, I think what has come out is a good thing, and let me 
explain why. We kept the same amount of funding, same set-aside 
percentage for these transportation alternatives, but what we said was, 
for the first time, half of those funds will go directly to locals, 
will go to the metropolitan planning organizations, will go to the 
large cities. That is key because we want the local people, who know 
their area best, making these decisions. We protected those funds. The 
only way anyone in the State can use those funds is if there is a 
nationally declared disaster and there are some unobligated funds 
around--yes, that could be borrowed but must be paid back from any 
supplemental appropriation.
  On the State portion, which is the other 50 percent, we built in more 
flexibility, and there are a lot of people who are calling this a cut. 
It is not a cut. Some States will use it all. I say to the people in 
the States who are worried about it, use your pressure, use your power, 
use your grassroots strength to make sure you lobby your State 
legislatures and your Governors to provide for safe streets to schools, 
for bike paths, for pedestrian walkways. These are very important 
safety issues.

[[Page S4713]]

  I know not everyone is happy, but I wanted to be clear on that. If 
the choice is between doing away with that wonderful program, which I 
think is wonderful, or making a few concessions on flexibility, I think 
we did the right thing. I honestly do.
  This bill is all paid for. I have to thank so much Senator Max Baucus 
and his team, the Republican members of the Finance Committee, and also 
the team in the House headed by Mr. Camp because they came up with a 
pay-for that people on all sides can live with. It gives us that 
security for 2 years and 3 months.
  We don't have any riders on this bill. I know some people very much 
wanted it. We don't have them. It became part of the give-and-take at 
the end of the day.
  Two provisions that I lament are not on there are the oceans trust 
fund, which is part of the RESTORE Act, and the Land and Water 
Conservation Fund that was also part of the RESTORE Act. I lament that 
those provisions are gone. I commit myself to working with Senator 
Whitehouse on the oceans trust fund and Senator Baucus on the Land and 
Water Conservation Fund to get that done. But I have to be completely, 
totally frank with the Senate; we just could not get it done. There was 
nothing we could offer or give that would allow us to move forward with 
those two very critical environmental programs.
  I tell you, our oceans deserve attention and our land deserves 
attention. These issues are certainly not going away. Having said that, 
the rest of the RESTORE Act is in this bill. That means those folks in 
the Gulf States who were so harmed by this horrible BP spill will be 
able to use some of those fines as they come in to restore--that is why 
we called it the RESTORE Act--restore their environments, restore their 
fisheries, restore the damage that was done by that horrific BP spill. 
We don't know how much money will come from those fines. We will watch 
it very carefully. But we know that when they do come--if this bill 
passes, and I am very hopeful it will--our Gulf States will have the 
help they need.
  I want to say to the people, particularly in Louisiana, whom I 
visited many times, your Senators work very hard. I would say Mary 
Landrieu took the lead on this. Senator Vitter was on the conference. I 
want to say that Mary Landrieu--you know her well--is unrelenting, and 
she was very clear with us.
  I want to say to my friend in the chair, from Alaska, how helpful he 
was to us, pointing out some of the great unmet needs he is dealing 
with in his State, a beautiful State, a very interesting State that has 
unique needs. I want him to know how much I appreciated his working 
with us, giving us the facts as we needed them. I also thank Senator 
Murkowski, but I particularly want to say to Senator Begich, thank you. 
You happen to be in the chair, and I believe you were mentally 
effective for your State. Really, you made the case for fairness. I 
hope you are comfortable with how this bill turned out.
  I have never met a team of more dedicated staff--never. Again, they 
are not resting because we are not done. Until we are done, they are 
not resting. But we are talking seriously about this staff getting 3 or 
4 hours of sleep over the last 2 or 3 days. The issues were still 
coming at us in ways we could not believe at noon today. Last night we 
had to work out some issues.
  It has been, in many ways, a very difficult negotiation but 
certainly, if and when this bill comes before us and it is passed, a 
very satisfying one.
  I have to mention Bettina Poirier, who is my chief of staff and chief 
counsel. I have never seen anyone more professional, more energetic, 
more persuasive. I have to thank her counterparts: David, Grant, 
Andrew, Jason, Tyler, Mary, Kate, and Paul, all of whom were just 
amazing. If I left anyone out, forgive me; I will correct it in the 
Record if I did.
  I have to say to the staff of Senator Inhofe that you were amazing--
part of the team. You worked together. If we had disagreements, we 
talked them out, but for the most part we were on the same page. So 
Ruth and James, you know who you are. You also have had a very rough 
few days, working very hard on this.
  Congressman Mica's staff also worked very hard, and they are very 
tough negotiators, but we were able to talk out our differences. It was 
not always pleasant to deal with it because people see things in 
different ways, but we got it done.
  We are not out of the woods yet in the sense that we do not have the 
bill before us. We are awaiting a decision made by the leaders as to 
when we will have this vote. But I would like to say that I believe, as 
I stand tonight, that really the work of the conference is completed, 
and that is very rewarding.

  The last thing I want to say is a huge thank you to the outside 
groups that have stood by my side this entire time. I tell you, I have 
had conference calls with them for months and months, sometimes four 
times a week, sometimes three times a week, sometimes six times a week, 
seriously, sometimes on Saturday, Fridays, Mondays--whenever we needed 
to touch base. This is an amazing coalition of people--workers from 
organized labor, people from the construction trades. The chamber of 
commerce and AFL/CIO worked together. That is a rarity, you know, in 
today's very difficult atmosphere where everyone is arguing over 
everything--the granite people, the cement people.
  I want to say something to a gentleman--I will not identify his 
name--who brought a couple of cement trucks. We had a rally. I think 
Senator Begich was there. After the rally, we were saying: Pass the 
bill, get the bill done. I talked to this gentleman. He identified 
himself as a conservative Republican who is so much for this bill. One 
of the most touching things that happened was that he introduced me to 
two of his drivers who came over to meet me. As I stood there with 
these two gentlemen and the owner of the business, I realized how much 
they were counting on us.
  What we do here matters. What we do here should matter. What we do 
here is literally life and death for the construction industry, for the 
business end and for the workers.
  We know--our President and all of us--we all know this economic 
recovery is too slow. One of the things that is weighing us down is the 
construction industry. One of the things that is weighing it down is 
the transportation sector. We know that if we do not do our job and we 
pass another extension here, that is a signal that the construction 
industry is going to suffer and suffer mightily. We cannot have that. 
We are on the brink of getting this done.
  I know I have left out a lot of people I want to thank. I do not have 
really a written speech here in front of me. I will go back and I will 
correct the record if I left anyone out. But we are close to getting 
this done. Whether it is in the next few hours or more than a few 
hours, I believe we will get it done. All the people who brought us to 
this day--I should mention Senator Reid, our majority leader, who never 
gave up even though I was--at one point, I am sure he was ducking me as 
I walked around because I would always say: Let's keep going, Mr. 
Leader. And he did. He kept on going.
  When we went over to meet with Speaker Boehner was a very important 
moment, with Chairman Mica. It was important. I think it helped us at 
that point to realize that everyone did want to have a bill.
  I have to say that the Democrats in the House--I am sure it has been 
very difficult for them because they had so many priorities as well. 
But they were very clear, day after day, pushing hard for a bill, until 
finally everybody came together and passed some messages to the 
conferees that said: Get the job done. And everybody came together on 
that one--get the job done.
  For me personally, this has been a very important day. This is a day 
when I think we are very close to getting a transportation bill done.
  It is also a day that President Obama will forever remember, where 
the centerpiece of his work was upheld as constitutional by the Supreme 
Court. We all know we cannot go back to the days when people with 
preexisting conditions suffered and could not get insurance. We just 
cannot go back to the days when being a woman was considered a 
preexisting condition. It was impossible for her to get insurance. We 
cannot go back to the days when kids were thrown off their parents' 
health insurance at 18. We can't go back to

[[Page S4714]]

the days that seniors were going broke, having to choose between a drug 
that was lifesaving or having dinner that night.
  In my State, 6 million Californians are getting preventive services. 
They are getting mammograms, cancer screenings, and everything they 
need now because of this health care bill. There are 300,000-plus 
senior citizens who are getting help paying for their prescription 
drugs and 300,000 more students who are now on their parents' 
insurance.
  We are going to hear a lot of outrage about how this was bad for 
America. Let me just say that I thought today was a critical day for 
America. No piece of legislation is perfect. We will have to fix this, 
that, or the other in everything we do whether it is in a 
transportation bill or health care bill, but I think we need to move 
forward. We need to not go backward. We need to make sure that health 
care in America doesn't become such an expensive burden for all of our 
people because it just drags down our families and it doesn't enable 
them to do for their kids and for their moms and dads.
  So I think today was quite a day for the history books, and I look 
forward to working across the aisle in everything we do here, whether 
it is transportation or health care or anything else, to make life 
better for people, not to make it worse. I think if we all do that and 
if we listen to each other, we can get things done.
  I thank the Chair.
  I notice there is no one on the floor at this time, so I would note 
the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. SESSIONS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                          Health Care Decision

  Mr. SESSIONS. Mr. President, I want to share a few thoughts about the 
Supreme Court's ruling today and the status of the health care bill.
  I believe the health care bill cannot be justified as written and 
will have to be changed. It will have to be repealed, and we have to 
start over. It is just that simple.
  As ranking member of the Budget Committee, I began to look at the 
numbers we have had. Our team is going to redouble their effort in the 
weeks to come so we can know precisely how much this legislation will 
cost. As that becomes more and more understood by the American people, 
it will be clear that we do not have the money to pass the bill.
  I know a lot of people are confident that it will undermine the right 
of an individual American to see the doctor of their choice, despite 
the President's protestations. Even I believe today that people will 
not be able to continue to keep their insurance--at least not all 
people will be able to--and there will be other different problems. 
There is a real concern that under the legislation the quality of 
health care will go down. I believe that is accurate for a lot of 
reasons, and people like Dr. Barrasso and Dr. Coburn have explained 
that in great detail.
  As a member of the Budget Committee, I want to share some thoughts 
about the financing of the legislation to raise the issue of why we 
cannot go forward with it.
  The President promised the American people before a joint session of 
Congress, right down the hall in the House Chamber: ``Now, add it all 
up, and the plan that I'm proposing will cost around $900 billion over 
10 years.'' Now, $900 billion is a lot of money, there is no doubt 
about that. He said that is how much it would cost over a 10-year 
period. As we have all learned, that was a gimmicked-up number. It was 
fundamentally gimmicked up as a result of the fact that the cost of the 
bill where it begins to pay out money and will have real cost and the 
implementation of the bill was delayed 4 years. So you take a 10-year 
window, and the bill is going to be out there for 6 of those 10 years, 
and you announce it is only going cost $900 billion.
  That is not the right question, is it. The right question for the 
American people to actually understand the impact of the legislation 
would be to ask how much it would cost over the first 10 years of full 
implementation. That is what you should be asking. We all know that the 
numbers have come in on that. Under the CBO estimate strictly adhering 
only to the insurance portion of the bill, I believe they came in as 
saying not $900 billion but $1,400 billion would be the cost over the 
first 10 years, but the true cost of the health care bill is yet higher 
still. A complete and honest assessment of the cost of the President's 
health care bill would include a full 10 years of spending starting in 
2014. Adding up CBO's estimates for the different provisions in the 
bill, the President's health care bill will amount to at least $2,600 
billion--$2.6 trillion, not $900 billion. It is almost three times the 
estimated costs over the true 10-year period. Now, that is how we go 
broke in this country. That is how this country is going broke. We go 
through a whole debate, and the President insisted that is how much the 
bill was going to cost.
  When the Democrats had a filibuster-proof majority in the Senate, 
they had 60 Democratic Senators, and they insisted it was going to pay 
for itself. They said there was more revenue than needed to pay for the 
cost of the bill, so don't worry about it, be happy. On Christmas Eve, 
without amendments and after much secret debate and a bill plopped on 
the floor, the bill was voted up or down, 60 votes to 40. Every single 
Democrat voted for it, and every single Republican voted against it.
  I just have to say that the first 10 years of the bill is going to 
cost three times what was estimated.
  In addition to delaying the major spending provisions during the 
original window of the legislation, here are some of the other 
accounting gimmicks, tricks, and maneuvers that the drafters used to 
manipulate the score the Congressional Budget Office gave to the bill, 
to manipulate how much they would say the bill cost and to hide its 
impact.
  Well, one of the most significant things is a double-counted $400 
billion. Can you imagine that? The U.S. Government, according to the 
score manipulation and the way it was done by the CBO, utilizing 
complex rules of the CBO to its advantage, the way it was analyzed, 
they double-counted $400 billion. So they cut Medicare expenses, they 
raised Medicare taxes, but they took the money and used it to fund the 
new bill and said they made Medicare more solvent. In some ways, we 
could argue they did make Medicare insolvent because the money that was 
spent on the health care bill was borrowed from Medicare. They are debt 
instruments for Medicare.

  So my analysis of the legislation is that Medicare got a benefit, but 
there was no money for the health care bill. Yet they counted it as 
being $400 billion free to be spent without adding to the debt of the 
United States, but it does add to the debt. Medicare is going broke. 
Medicare is going to call the debt from the United States. It increases 
the debt of the United States $400 billion. It was counted both 
places--as income from Medicare and income available to be spent on the 
health care provision. That is a stunning development.
  I got a letter from the head of the CBO the night before we voted, 
December 23, and he said, in effect--not in effect, I think this is a 
direct quote: It is double-counting the money, although the conventions 
of accounting might indicate otherwise.
  He told us in a letter before we voted that it was double-counting 
the money, but under the unified budget process rule that was utilized 
here, it didn't score.
  In addition, they counted $70 billion of extra income that would come 
from the CLASS Act, which was designed for young people. The net result 
of that was that in the first decade or so of the CLASS Act's 
implementation, healthy young people wouldn't make many claims and 
there would be a surplus of $70 billion. But over 20, 30, 40 years, the 
CLASS Act goes into serious decline. Its actuarially unsound. It was 
referred to as a Ponzi scheme by the Democratic budget chairman, 
Senator Conrad. Finally, the Secretary of HHS could not certify it as a 
sound program, so $70 billion has been wiped off that as income 
available to be spent.
  They included--unrelated to this bill--student loan savings of $19 
billion.

[[Page S4715]]

They relied on off-budget Social Security revenue for $29 billion, not 
scored toward the cost of the bill.
  They ignored the cost of implementing the law. Imagine that. I mean, 
you have a bill. How much is it going to cost? It is going to cost $900 
billion. Well, do you not score the cost of it? What about all these 
IRS agents? There will be 1,000-plus to 2,000 IRS agents who have to be 
hired and paid for, which is $115 billion not counted in the cost of 
the bill. Is this why we are going broke in this country? We score a 
bill, say it only costs $900 billion, and we have $115 billion of 
administrative costs not even counted.
  Then there was no permanent solution to the doctor reimbursement 
figure. To pay the doctors at the rate they needed to be paid--and I 
agree they need to be paid at this rate--would cost $208 billion over 
the current level of expected spending. If we don't have this doc fix, 
as we call it, doctors would receive a 20-plus percent cut in pay for 
doing Medicare work immediately. They are already paid less for 
Medicare work than they are paid for private insurance. Doctors would 
quit doing Medicare work if they took a 20- or 25-percent reduction in 
fee payments. That is $200 billion. That was one of the main reasons we 
were supposed to have comprehensive health care reform, to deal 
permanently with this doctor fix that was being fixed every year, but 
not permanently. The bill didn't do it. The bill never fixed it, 
therefore leaving a $208 billion hole in the plan that we have to find 
money for, and it is an essential part of all of that.

  So I would just say to my colleagues that this cost is unsustainable. 
It will put us on a debt course we cannot continue to be on. We are 
going to continue to look at the numbers, and I am going to ask people, 
if they desire, to come to the Senate floor and show me if I am wrong. 
Let me see where I am wrong. But I don't think they can show that we 
are wrong because I and my staff are working as hard as we can to make 
sure what we say about the cost of this bill is accurate and fair.
  What does this do to the long-term debt of our country? That is a 
matter of great importance. One of the things our government does now 
is analyze the unfunded obligations of the U.S. Government. When we 
pass a law that says when everybody reaches a certain age, they get to 
draw a Social Security check of so much money, and it increases on a 
percentage basis each year, that is an obligation of the United States. 
That is an entitlement program, we call it. People are entitled to that 
whether the government has any money to pay it.
  So the health care bill is an entitlement. It has a guaranteed right 
for an individual American to receive certain subsidized health care 
benefits under this plan, and it is a permanent program, but it doesn't 
have a permanent source of income dedicated to paying for it in any 
significant fashion. So it creates what the Congressional Budget Office 
refers to as an unfunded liability, unfunded obligations. To show 
Americans and Congress the true state of our long-term financial 
health, they do it over 75 years. It is not a perfect estimate, but it 
is a pretty good estimate of whether the programs are actuarially sound 
and what they will do to the debt of America over 75 years.
  Under the numbers we have seen from the CBO and the work of our 
committee, it is pretty clear the health care bill that was passed by 
this Congress will add $17 trillion to the unfunded liabilities of the 
United States of America--$17 trillion--not a little amount of money, a 
huge amount of money. To give perspective on how large it is, the 
Social Security unfunded liability over 75 years is only--only--$7 
trillion. This is 2\1/2\ times as large an unfunded liability addition 
to our government as Social Security, and we are wondering how we are 
going to save Social Security. It is more than half of the unfunded 
liabilities of Medicare or half of the unfunded liabilities of Medicare 
over 75 years.
  At a time when we have a serious demonstrated requirement that we 
reduce the unfunded liabilities of Medicare and Medicaid and Social 
Security, this bill would add $17 trillion to it. This is why every 
expert has told us this Nation is on an unsustainable course.
  The total unfunded liabilities before the passage of the health care 
bill were $65 trillion over 75 years. That trend, experts tell us, is 
unsustainable and threatens the future of our children and 
grandchildren. After the bill passes, it is $82 trillion. We don't have 
the money to do health care reform in this way, with 2,700 pages and 
$17 trillion in additional cost to the Treasury. We don't need to 
affirm and repass legislation that was said to cost $900 billion in the 
first 10 years. In truth, in the first 10 years of its obligation--
beginning the year after next--for the first 10 years it will cost 
almost three times that much--$2,600 billion. So it is a matter of 
great concern to me.
  As to the Court decision today, I am going to look at the Court 
decision and evaluate it. But I think it is additional proof that this 
health care legislation, from the beginning and in its entirety--a 
2,700-page Rube Goldberg contraption--will never work. It is further 
proof of that.
  Even the fundamental justification for the legislation that it was 
not a tax but a mandate has been rejected by the Court. The law was 
only upheld by saying it is not a mandate. In effect, it is a tax that 
the sponsors of the bill directly said it was not. Indeed, the 
President said it was not a tax himself, directly. So certainly this 
opinion that allowed the legislation to stand, by the narrow margin of 
5 to 4, in no way is an affirmation of the wisdom of the bill but is in 
fact demonstration that the people who cobbled it together and who 
rammed it through without full floor debate and amendments, that that 
scheme was flawed from the beginning and it will not work.
  Indeed, there are 1,700 references in that legislation to regulations 
to be issued by the Secretary of HHS. In other words, once the bill is 
passed, we will turn over huge sections of it to unknown bureaucrats 
who will issue regulations to administer this monstrosity. It is just 
not a practical and decent way to do business.
  So I believed the bill clearly violated the interstate commerce power 
granted to the Federal Government. The Federal Government can only act 
and pass legislation if it has been specifically authorized by the 
Constitution. One of the authorized powers was to regulate interstate 
commerce. But if a person is sitting on the creek bank in Alabama, not 
buying insurance, not participating, can he be made to buy a product in 
interstate commerce when he is explicitly not participating in that? I 
didn't believe it could be done, and the Court agreed. The Court 
rejected the Obama administration's argument that it did.
  They said the Federal Government has no power to compel a person to 
participate in a commercial market when a person doesn't participate. 
If a person participates, maybe they can regulate it. But if a person 
doesn't participate, they can't tell a person to participate because 
this is a government of limited power.
  It was a historic and important ruling that the Supreme Court made 
clear: that there are limits to the power of the U.S. Government. I 
felt good about that. But now that Chief Justice Roberts and other 
members of the Court concluded that it may look like a mandate, but we 
call it a tax--and I haven't done the technical analysis they went 
through to reach their opinion, but that doesn't seem correct to me. It 
seems as though it is still a mandate, a mandate to buy something a 
person doesn't want to buy. That doesn't sound like a tax to me. Maybe 
it is. Maybe they can defend it that way, but I don't see how that is a 
tax. It sounds like a mandate and a penalty.
  So scholars will be reading that opinion for some time, and we will 
know whether Chief Justice Roberts announces that this apparent 
mandate, apparent requirement that the President said was not a tax, 
now it is a tax and the law is constitutional because of it. We will 
wrestle with that. But it does deal with the fundamental question: Can 
we afford this legislation. I say we cannot. I believe the facts are 
crystal clear that we cannot. We absolutely have to reform it, start 
over, create a health care system that works at a reasonable cost for 
the American people and does not burden our children with exorbitant 
debt that could throw us into a debt crisis at most any time, and in 
the long term destabilize the health of the Nation we love so much.

[[Page S4716]]

                            Flood Insurance

  Mr. BINGAMAN. Mr. President, on June 20, I introduced a bill to 
authorize the FEMA administrator to waive the 30-day waiting period for 
flood insurance policies purchased for private properties affected by 
wildfire on Federal lands. Senators Tom Udall, Mark Udall, and Michael 
Bennet are cosponsors of this legislation.
  As we speak, wildfires are burning across the Western states and it 
is critical that we take immediate steps to protect communities against 
the tragic consequences of flooding. To this end, I am pleased that the 
Senate included this legislation in the National Flood Insurance 
Program reauthorization bill, which we will be voting on later today or 
tomorrow.
  Flooding is the most common and costly natural disaster in the United 
States. In 1968, Congress created the National Flood Insurance Program 
to help provide a means for property owners to financially protect 
themselves. The Act, however, requires a 30-day waiting period before 
coverage under a new contract for flood insurance can take effect. This 
is to prevent individuals from delaying until the last minute to 
purchase insurance when the risk of flooding is high.
  Unfortunately, today's large catastrophic wildfires in the West can 
alter the watershed conditions on our forested Federal lands so rapidly 
that nearby communities find themselves in flood hazard areas that 
didn't exist the day before. The heat of the fires can make the ground 
impermeable to water, which significantly increases runoff when 
rainfall comes.
  In some cases, the U.S. Forest Service will advise a community to 
purchase flood insurance immediately after a wildfire is put out, only 
to see that community flooded by a few inches of rainfall weeks before 
the 30-day wait period has lapsed. When this happens, homeowners are 
tragically without any flood insurance coverage.
  Every year States throughout the U.S. deal with the devastating 
consequences of wildfires. Firefighters are currently battling several 
major fires in New Mexico, including the largest fire in the State's 
history. Over 340,000 acres in the Gila and Lincoln National Forest 
have been burned and over 100,000 acres have been burned in Colorado 
leaving thousands of residents struggling to cope with the aftermath 
and the risk that flooding presents.
  While our immediate concern is fighting these wildfires, we need to 
take steps to protect communities against the tragic consequences of 
flooding. In fact, in the area of the Whitewater-Baldy Fire, though the 
damage from the fire is extensive, the damage caused to property and 
risk to life is expected to be far greater from the associated flooding 
despite the mitigation and prevention efforts in progress. Recently, I 
joined Secretary Vilsack and Forest Service Chief Tidwell for a 
briefing on the Little Bear Fire, and although progress is being made 
in containing the fire, people are very concerned that the monsoons 
will soon drop rain on soil that can't absorb the moisture.
  It makes little sense to punish homeowners in communities who have 
not faced the kinds of flood risk they are currently presented due to 
the sudden devastation of nearby Federal forest land.
  I should also note that after consultation with the Congressional 
Budget Office, it is my understanding that this legislation does not 
score for budget purposes. I appreciate the Banking Committee's 
willingness to work with us on this issue. This legislation represents 
a critical step forward in providing access to Federal flood insurance. 
The fire-stricken communities need help, and they need it now.


                         surface transportation

  Mr. LEAHY. Mr. President, I am dismayed that the final conference 
report on the surface transportation reauthorization bill did not 
include funding and continued authorization for the Land and Water 
Conservation Fund, LWCF, program, despite the fact that this provision 
was included in the Senate-passed bill. This short-sighted decision is 
counterproductive and ultimately, harmful to America.
  The LWCF program represents a promise that was made to the American 
people almost 50 years ago to invest in conservation and outdoor 
recreation. The LWCF Program has long been a successful bipartisan 
program that has touched all 50 States and nearly every county in 
America. I strongly believe that the LWCF provision, that was included 
in the Senate bill and which was passed in the Senate by a vote of 76 
to 22, should have been included in the final conference report.
  Over the course of half a century, the LWCF program has protected 
natural resource lands, outdoor recreation opportunities, and working 
forests across America. The program is so successful, in fact, that 
every part of the LWCF Program is oversubscribed, with the demand for 
State and local recreational needs, access for sportsmen, and working 
lands opportunities far exceeding the funds that have been available.
  The LWCF Program has been extremely important to Vermont. Two 
successful Vermont examples are the Green Mountain National Forest and 
the Silvio O. Conte National Wildlife Refuge. Among the most visited 
lands in the National Forest System, the Green Mountain National Forest 
has provided accessible and affordable recreation for millions of 
residents in the densely populated Northeast. Likewise, the Silvio O. 
Conte National Wildlife Refuge, which stretches across Vermont, New 
Hampshire, Massachusetts, and Connecticut, is a revolutionary project 
that has helped to conserve prime fish and wildlife habitat across the 
7.2 million-acre Connecticut River watershed.
  By failing to include the LWCF Program in the final conference 
report, I believe that we are squandering a critical opportunity to 
protect America's precious natural resource lands and grow the economy. 
The Outdoor Industry Association estimates that outdoor recreation is 
an overlooked economic giant, generating $646 billion in direct 
consumer spending, supporting 6.1 million direct jobs, and producing 
$80 billion in Federal, State, and local tax revenue each year. This 
amount dwarfs total spending in other sectors such as pharmaceuticals 
and motor vehicles, which respectively account for $331 billion and 
$340 billion in direct spending.
  I am extremely disappointed that the final conference report did not 
include the bipartisan-supported LWCF Program. This will hurt all 
Americans today and for generations to come. I urge my colleagues to 
come together and right this wrong. The benefits of the LWCF Program 
are clear and we owe it to the American people to provide funding for 
this essential and successful program.
  Mr. President, I thank the Chair and yield the floor and note the 
absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Order of Business

  Mr. REID. Mr. President, I am sorry it has taken so long. There are a 
lot of things to do around here. The conference report has been filed. 
As I said earlier today, I appreciate very much the work of everyone, 
including our very hard-working staffs on both sides of the Capitol. 
But there is no need for us to wait anymore. We are not going to finish 
this tonight. We are going to have to come back tomorrow.
  I have talked to a number of people, and I wanted to make sure before 
anything was announced that the papers had been filed. They have been. 
We have a number of issues we are trying to work through procedurally. 
We are not going to be able to do that tonight. I am not passing blame 
on anyone, because we all have a lot to do tomorrow, a lot of things 
that we are going to put on hold. This is a very big work period for us 
the next 10 days. I think it is appropriate to say we will be back at 
10 o'clock in the morning to finish this legislation and do it as 
quickly as we can. We do not know what time the House is going to vote 
on this tomorrow, but we may have to wait now until they pass it. That 
is one of the pieces we are working on. We have done our very best to 
try to complete everything tonight, but we are not going to be able to 
do that.
  I am disappointed. I heard that from many people, how disappointed 
they are that we could not move further

[[Page S4717]]

down the road. But that is the way it is.
  Mr. LEAHY. Mr. President, would the leader yield for a question?
  Mr. REID. I would be happy to yield.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. LEAHY. Mr. President, I know the distinguished majority leader 
has been working very hard to accommodate Senators in a vote. I know he 
has the support of every member of our caucus in doing that. I believe 
I heard the distinguished leader say we will come in at 10.
  Mr. REID. Yes. If I thought it would help to come in earlier, I would 
do that. But it would only be----
  Mr. LEAHY. The Senator anticipated my next question. I appreciate 
that.
  Mr. REID. We likely cannot do anything until the House votes on the 
bill tomorrow. We are trying to work through that. I have to say, the 
House has been extremely cooperative in everything we have done the 
last few days. I see on the floor my friend, the chairman of the 
Environment and Public Works Committee. She knows how hard this has 
been and how cooperative the Republicans have been. No one has been 
more so than the ranking member of the Environment and Public Works 
Committee, Jim Inhofe. I will always admire Jim Inhofe for the manner 
in which he approached this important piece of legislation. We pass out 
accolades on this floor, about everyone, how hard they work, but we 
would not be able to get this bill done except for Jim Inhofe. Fact.
  So I am disappointed we cannot do this tonight. As the chairman of 
the Judiciary Committee just said, we would stay here tonight on our 
side until the wee hours of the morning, because we have some things to 
do. I was scheduled to be in Lake Tahoe tomorrow, but I can't be there. 
Other people have certainly more important trips than that. But it is 
one of the issues we have to face with these jobs we have, which are a 
tremendous privilege, but sometimes we do not have the ability, as a 
Governor does or the President does, a member of the Court does, to 
say: This is the schedule. There are 100 different leaders here, each 
thinking they have the best way of solving the problems of the world, 
and it takes a while sometimes to work through their opinions.

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