[Congressional Record Volume 160, Number 31 (Tuesday, February 25, 2014)]
[Senate]
[Pages S1020-S1039]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




COMPREHENSIVE VETERANS HEALTH AND BENEFITS AND MILITARY RETIREMENT PAY 
         RESTORATION ACT OF 2014--MOTION TO PROCEED--Continued

  The PRESIDING OFFICER. Under the previous order, the time until 3:30 
p.m. will be equally divided between the two leaders or their 
designees.
  If no one yields time, the time will be equally divided between both 
sides.
  The Senator from Vermont.
  Mr. SANDERS. Madam President, every Veterans Day and every Memorial 
Day many of us, regardless of our political views, go out into our 
communities and we speak about our respect and admiration for the 
veterans of this country. As chairman of the Senate Committee on 
Veterans' Affairs for the last year, I have learned that regardless of 
political ideology, virtually all Members of the Congress in fact mean 
what they say and do understand and do appreciate the enormous 
sacrifices veterans and their families--and their families--have made 
for our Nation.
  Sadly, everybody in this country knows we are living at a time when 
the Congress is virtually dysfunctional and partisanship runs rampant. 
But I have found on my committee and in the Congress as a whole that 
Members do understand the sacrifices made by the men and women who put 
their lives on the line and do, although we have differences of 
opinion, want to do the right thing to defend those who have defended 
us.
  The good news is that President Obama and the Congress, in a 
bipartisan way, have made significant

[[Page S1021]]

progress in addressing a number of the problems facing veterans in this 
country. The President's budgets have been generous and I think 
Congress has acted in a responsible way.
  That is the good news. But the bad news is that we still have a very 
long way to go if we are to keep faith with those who have put their 
lives on the line to defend us. We have made progress, but we still 
have a long way to go. I hope very much that we will go down that road 
together and we will tell the American people that in the midst of all 
of the partisanship, all of the politics, at least on this one issue we 
can stand together and protect the interests of those people who have 
sacrificed so much for our country.
  Congress cannot bring back to their families those who died in 
battle. As the Presiding Officer knows, just in the recent wars in Iraq 
and Afghanistan, we have lost over 6,700 troops. Congress cannot 
restore the legs and the arms and the eyesight that roadside explosions 
have taken away from brave men and women. Congress cannot simply snap 
its fingers and magically cure the hundreds of thousands who returned 
from Iraq and Afghanistan with post-traumatic stress disorder or 
traumatic brain injury or those who suffer from the pain and 
humiliation of sexual assault. As a nation, however, while we cannot 
magically solve those problems, we can in fact--and it is our 
responsibility, in fact--do everything we can to help ease and 
ameliorate the problems facing our veterans and their families. We 
can't solve it all--we know that--but we can go further in ameliorating 
some of the problems facing veterans and their families.
  I will give my colleagues a few examples. Congress can help the 2,300 
men and women who were looking forward to having families but who 
suffered reproductive injuries in Iraq and Afghanistan. I believe 
Senator Murray will come to the floor. She has long been a champion of 
this issue, as have been others. Let me give my colleagues one case out 
of 2,300: Army veteran Matt Keil of Colorado was wounded by sniper fire 
in Iraq in 2007. The sniper's round struck Matt's neck, causing severe 
damage to a vital artery and his spinal cord. Through sheer 
determination and with the love and resolve of his wife Tracy, Matt's 
condition improved. He and Tracy began to consider having children. 
Doctors assured them that having children could be possible with the 
help of in vitro fertilization. The Keil family paid more than $30,000 
for reproductive treatments. Congress can help the Keil family and 
others to ease that financial burden. That is a cost of war. We should 
be there for that family and for the other families who want the 
opportunity to have children.
  Congress can help the tens of thousands of family members who every 
single day provide loving care for those who were severely injured in 
World War II, in Korea, in Vietnam, and in other wars. Let me give my 
colleagues another example.
  In March of 1969, Miles Epling was on patrol in Vietnam when a booby 
trap detonated, killing some of his fellow marines and leaving him 
without legs. He returned home to West Virginia in a wheelchair. From 
that point on, he has required around-the-clock help from those around 
him. His family provided that help without receiving any training, any 
assistance or any financial support.
  Here is the very good news--and we should be very proud of this, in a 
bipartisan way, as a Congress: In 2010, 4 years ago, Congress passed a 
very strong and excellent caregivers program for post-9/11 veterans. It 
is a program that is working well in providing significant help to 
caregivers of those post-9/11 veterans. I want everybody to put 
themselves in the place of a wife or sister or mother or brother who 
around the clock--around the clock, 24/7, 365 days a year--is providing 
care to folks who have suffered serious injuries in one war or another. 
We provided support for those caregivers post-9/11, for Iraq and 
Afghanistan, but we did not do that for the other wars. Now is the time 
for us to expand the caregivers program for the families of all 
disabled veterans who are in the same position that Miles is in. That 
is the fair thing to do, that is the right thing to do, and that is 
included in this comprehensive piece of legislation.
  Because we have the moral obligation to do the very best we can for 
veterans, the Senate Veterans' Affairs Committee has brought forth 
comprehensive legislation that is strongly supported by virtually every 
veteran and military organization in the country. Today I thank the 
American Legion, the Veterans of Foreign Wars, the Disabled American 
Veterans, the Vietnam Veterans of America, the Military Officers 
Association of America, the Iraq and Afghanistan Veterans of America, 
the Paralyzed Veterans of America, the Gold Star Wives of America, and 
the dozens of other veterans organizations that are strongly supporting 
this comprehensive piece of legislation.
  In their statement of support, the DAV writes:

       This massive omnibus bill--

  That is the bill that is going to be on the floor in a short period 
of time. The DAV writes:

       This massive omnibus bill, unprecedented in our modern 
     experience, would create, expand, advance, and extend a 
     number of VA benefits, services and programs that are 
     important to DAV and to our members. For example, responding 
     to a call from DAV as a leading veterans organization, it 
     would create a comprehensive family caregiver support 
     program for all generations of severely wounded, injured 
     and ill veterans. Also, the bill would authorize advance 
     appropriations for VA's mandatory funding accounts to 
     ensure that in any government shutdown environment in the 
     future, veterans benefits payments would not be delayed or 
     put in jeopardy. This measure also would provide 
     additional financial support to survivors of 
     servicemembers who die in the line of duty, as well as 
     expanded access for them to GI Bill educational benefits. 
     A two-plus year stalemate in VA's authority to lease 
     facilities for health care treatment and other purposes 
     would be solved by this bill. These are but a few--

  ``A few''--

     of the myriad provisions of this bill that would improve the 
     lives, health, and prospects of veterans--especially the 
     wounded, injured and ill--and their loved ones.

  That is from the Disabled American Veterans. I thank them very much 
for their support. The truth is that we have letters of support that 
are similar in nature from dozens of other veterans organizations, and 
we thank them again for their support.
  Madam President, may I ask the time situation--how much time each 
side has and how much time is remaining?
  The PRESIDING OFFICER. The majority has 24 minutes remaining of the 
35 minutes originally granted, and the minority has 35 minutes.
  Mr. SANDERS. Very good.
  What I would like to do now is yield to the former chairperson of the 
Veterans' Affairs Committee, somebody who has done an outstanding job 
for veterans. She has focused on one issue that I feel very strongly 
about; that is, the need to help those veterans who would like to have 
children but as a result of war wounds are unable to do so.
  Mr. CORNYN. Madam President, would the Senator yield for a unanimous 
consent request?
  The PRESIDING OFFICER. Is there objection?
  Mr. CORNYN. Madam President, I ask unanimous consent to be recognized 
following the remarks of the Senator from Washington.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Washington.
  Mrs. MURRAY. I thank you, Madam President. And I thank the chair of 
the Veterans' Affairs Committee for putting together this very good 
piece of legislation we are about to consider.
  It is no secret that in our Nation's Capital we are sharply divided 
on any number of economic and political issues that are facing average 
Americans right now. But I have come to the floor today to talk about 
one issue on which we are rarely divided; that is, our duty to keep the 
promise we have made to provide not only care but opportunity to all 
those who have honorably served in our Nation's Armed Forces. It unites 
even the most unlikely partners because we realize we have all made a 
promise to those who have signed up to serve, and we all need to keep 
it because there is so much on the line.
  When our brave men and women volunteered to protect our Nation, we 
promised them we would take care of them and their families when they 
returned home. We need to ask ourselves, are we doing enough for our 
Nation's veterans? So this comprehensive legislation before us today 
really is the test

[[Page S1022]]

for a lot of Members of Congress. Can we put politics aside now for the 
good of our Nation's veterans? Can we show these heroes, despite our 
differences, that we will work as diligently toward getting them the 
benefits and care they have earned as they have worked for our Nation. 
I hope we can. And I say that because the investments in this bill are 
a lot more than numbers on a page. They are life-changing programs for 
veterans who are looking to take the skills they have learned from the 
battlefield to the boardroom. It is support for the countless victims 
of military sexual assault, who are desperate to come out of the 
shadows. It is providing the dream of having a family to those who are 
suffering from some of the most devastating wounds of war. It is timely 
investment in the very biggest priorities of our Nation's heroes. So I 
would like to use the remainder of my time to highlight just a few of 
the investments that are included in this bill and how they translate 
to the lives of our veterans and their families.
  For those who have worn our Nation's uniform, particularly for those 
young veterans who have spent the last decade being shuttled back and 
forth to war zones half a world away, the road home is not always 
smooth, the redtape is often long, and the transition from the 
battlefield to the workplace is never easy. This should not be the 
case. We should not let the skills and training our Nation's veterans 
have already attained go to waste. We cannot afford to have our 
Nation's heroes unable to find a job to support their families, without 
an income that provides stability, or without work that provides the 
pride and sense of purpose that is so critical to the transition home.
  That is why I am proud that in this legislation we are considering 
today we reauthorize and build on many of the provisions that were part 
of my VOW to Hire Heroes Act, which was signed into law by President 
Obama in 2011. Double-digit unemployment rates for veterans used to be 
the norm, but since VOW became law the unemployment rate for post-9/11 
veterans is now on par with nonveterans. And while recent data from the 
Bureau of Labor Statistics proves that these programs work, we still 
have more work to be done, and that is addressed in this legislation.
  I also believe the great strength of our military is in the character 
and dedication of our men and women who wear the uniform. It is the 
courage of these Americans to volunteer to serve that is the Pentagon's 
greatest asset. Our servicemembers volunteer to face danger, to put 
their lives on the line, to protect our country and our people.
  It is no longer a secret that sexual assault continues to plague the 
ranks of our military services, which is another issue this 
comprehensive legislation addresses. I think we all agree it is 
absolutely unconscionable that a fellow servicemember--the person whom 
you rely on to have your back and be there for you--would commit such a 
terrible crime. Even worse is the prevalence of these crimes. It is 
appalling that they commit such a personal violation of their brother 
or sister in uniform.

  The National Defense Authorization Act that we passed last year took 
some historic action to help servicemembers access the resources they 
need to seek justice without fear, including a provision I authored to 
create a new category of legal advocates called special victims' 
counsels who would be responsible for advocating on behalf of the 
interests of the victim. But we still have a long road ahead of us 
before we put an end to these shameful acts and meanwhile provide all 
the necessary resources to those who have, unfortunately, been 
impacted. Thankfully, the chairman's legislation aims to do just that 
with provisions to improve the delivery of care and benefits to 
veterans who experienced sexual trauma while serving in the military.
  When our best and brightest put on a uniform and join the U.S. Armed 
Forces, they do so with the understanding they will sacrifice much in 
the name of defending our country and its people. But that sacrifice 
should not have to come in the form of unwanted sexual contact from 
within the ranks.
  Finally, I wish to talk today about a provision that has been one of 
my top priorities in the Senate for a while now. It is a provision that 
builds upon our effort to improve VA services for women veterans and 
veterans with families.
  As we all know, with the changing nature of our conflicts overseas, 
we have been seeing the brutal impact of improvised explosive devices, 
or IEDs, which means we are now seeing more and more servicemembers--
both male and female--increasingly susceptible to reproductive, spinal, 
and traumatic brain injuries due to the weapons of war.
  Thanks to modern medicine, many of these servicemembers are being 
kept alive, and they are returning home. Like so many of our veterans, 
these men and women come home looking to return to their lives, to find 
employment, and often to start a family. Yet what they find when they 
go to the VA today is that the fertility services that are available do 
not meet their very complex needs. In fact, veterans suffering from 
these injuries find the VA is today specifically barred from providing 
more advanced assisted reproduction techniques, such as IVF. They are 
told that despite the fact that they have made such an extreme 
sacrifice for our country, we cannot today provide them with the 
medical services they need to start a family.
  These are veterans such as SSG Matt Keil and his wife Tracy. Staff 
Sergeant Keil was shot in the neck while on patrol in Iraq in 2007--6 
weeks after he married the love of his life, Tracy. The bullet went 
through the right side of his neck, it hit a major artery, it went 
through his spinal cord, and it exited through his shoulder blade. 
Staff Sergeant Keil instantly became a quadriplegic. Doctors told 
Tracy, his wife, that her husband would be on a ventilator for the rest 
of his life and would never move his arms or his legs. Well, Staff 
Sergeant Keil eventually defied the odds and found himself off that 
ventilator and beginning the long journey of physical rehabilitation.
  In fact, Tracy and her husband started talking and exploring the 
possibilities of having a family together. Having children was all they 
could talk about once they started to adjust to their new normal. With 
Staff Sergeant Keil's injuries preventing him from having children 
naturally, Tracy turned to the VA and began to explore her options for 
fertility treatments, but because of that VA ban she was turned down. 
So Tracy and Staff Sergeant Keil decided instead to pursue IVF through 
the private sector. Out of options, they decided this was important 
enough to them that they were willing to pay out of pocket to the tune 
of almost $32,000 per round of treatment.
  Well, thankfully, on November 9, 2010, just after their first round 
of IVF, Staff Sergeant Keil and Tracy welcomed their twins, Matthew and 
Faith, into the world. Tracy told me--and I want to quote her:

       The day we had our children something changed in both of 
     us. This is exactly what we had always wanted, our dreams had 
     arrived.
       The VA, Congress and the American People have said 
     countless times [to us] that they want to do everything they 
     can to support my husband [and] make him feel whole again and 
     this is your chance.
       Having a family is exactly what we needed to feel whole 
     again. Please help us make these changes [to the law] so that 
     other families can share in this experience.

  Well, Tracy and Matt are not alone. There are many men and women out 
there who share this common thread of a desperate desire to fulfill 
their dream of starting a family, only to find that catastrophic wounds 
they sustained while defending our country are now preventing them from 
seeing that dream through.
  As we all know, it should not be that way. Our Nation's heroes should 
not have to spend tens of thousands of dollars in the private sector to 
get the advanced reproductive treatments they need to start a family. 
They should not have to watch their marriages dissolve because of the 
stress of infertility in combination with the stresses of readjusting 
to a new life after severe injury, driving relationships to a breaking 
point. Any servicemember who sustains this type of serious injury 
deserves a lot more.
  We came very close to making this bill a reality last Congress. In 
fact, with Tracy Keil sitting up in the gallery--like so many of our 
heroes who have joined us today--with Tracy watching, the Senate 
unanimously

[[Page S1023]]

passed this legislation. Unfortunately, what happened was that some 
Republicans in the House of Representatives refused to take up this 
bill and pass it. So time ran out last year and we were not able to get 
it to the President's desk.
  But this effort is not over. This provision was the very first piece 
of legislation I introduced in this Congress, and there is excellent 
momentum to get it done. This is about giving our veterans, who 
sacrificed everything, every option we have to help them fulfill the 
simple dream of having a family. It says we are not turning our backs 
on the catastrophic reproductive wounds that have become a signature of 
these wars.
  It says to all those brave men and women who did not ask questions 
when they were put in harm's way that we will not let politics get in 
the way of our commitment to you. This provision in the bill will 
reverse this troubling barrier to care and will bring the VA in line, 
finally, with the military which does provide these services under 
TRICARE.
  Our women veterans deserve this. Our male veterans deserve this. Our 
military families deserve this. I am here today to urge my colleagues 
to support this bill, the Comprehensive Veterans Health and Benefits 
and Military Retirement Pay Restoration Act of 2014. Our veterans do 
not ask for a lot. They should not have to. They have done everything 
that has been asked of them. They have been separated from their 
families through repeated deployments. They have sacrificed life and 
limb in combat. They have done all of this selflessly and with honor to 
our country.
  We cannot allow our commitment to them to lapse or to get caught up 
in any kind of unrelated amendments or political grandstanding. So I 
thank the Senator from Vermont and his staff for their tireless work to 
bring this legislation to the floor. I hope we do the right thing now 
and get this legislation passed and get this legislation to the desk of 
the President.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Manchin). The Republican whip.


                               ObamaCare

  Mr. CORNYN. Mr. President, I see the Senator from North Carolina is 
here on the floor. I know he is likely here to respond to the Senator 
from Vermont and the Senator from Washington on the veterans bill that 
is on the floor, and what I believe is a much better alternative for us 
in dealing with the needs of our veterans in a way that is fiscally 
responsible.
  But what I would like to do is to turn to another story that 
continues to unfold worse and worse news over time, that unfortunately 
we tend to get distracted from because there are so many other things 
that are happening. But when the President's signature health care 
bill, the Affordable Care Act, was signed into law 4 years ago, we knew 
that it did not just create a brand new health care entitlement. It 
actually weakened existing programs like Medicare and Medicaid.
  For people who do not deal with these programs on a day-in and day-
out basis, of course, Medicare is for seniors, for health care for 
seniors; Medicaid is a separate program which is shared by the States 
and the Federal Government to provide the safety net health care 
program for low-income Texans in my State.
  But because of the massive new burdens that ObamaCare is placing on 
the health care safety net, which is already failing the neediest 
members of society, the share of physicians accepting new Medicaid 
patients in Texas has fallen from 67 percent in 2000 to only 32 percent 
in 2012. So in 2000, 67 percent of physicians would accept a new 
Medicaid patient. Today it is roughly one-third, one out of every 
three.
  Of course, the reason for that is the Federal Government continues to 
pay less and less. Now I think it is roughly 50 cents on the dollar 
compared to private insurance to a physician who treats a Medicaid 
patient. So we know that many Texas physicians, including a majority of 
established primary care physicians, are not accepting new Medicaid 
patients at all because they are being asked essentially to work for 50 
cents on the dollar, something they cannot afford to do.
  Yet the architects of ObamaCare thought that it was a good idea to 
add millions more people to a broken program, one that already was not 
providing access to quality health care. This, of course, will further 
reduce the quality of Medicaid, which is one reason why many State 
Governors refused the Federal Government's request to actually expand 
the coverage of Medicaid absent reforms to fix it and make sure that it 
would work more fairly and better and more cost effectively. Of course, 
the consequence of that is it will make it even harder on the poorest 
and most vulnerable Americans to gain access to quality health care.
  As for the Medicare program, of course that is for seniors, ObamaCare 
created a new panel of unelected bureaucrats known as the Independent 
Payment Advisory Board. What an innocuous bureaucratic-sounding name. 
Some people call it the IPAB. These are unelected bureaucrats who will 
decide whether your health care is worth a cost-benefit analysis.
  What they will end up doing is slashing Medicare payments to doctors 
so that many physicians can no longer afford to see new Medicare 
patients and provide the treatment that those patients and their 
doctors believe they need and that they want. So it has become 
abundantly clear that the goal of ObamaCare is to make Medicare more 
like Medicaid. We know what that means. We know it is not hard to 
predict, that fewer and fewer doctors will treat Medicare patients and 
some will leave the program all together.
  Why do we know that? Well, we have seen the experience with these new 
major cuts to Medicare Advantage. Not to confuse things too much, but 
Medicare Advantage is actually a private insurance alternative to 
traditional Medicare which pays doctors based on the services they 
provide. Medicare Advantage is a remarkably successful program that 
covers roughly 30 percent of all Medicare beneficiaries, close to 16 
million people.
  The funds to those programs, to those 30 million, to that program 
that benefits 30 million beneficiaries, are being slashed by 
approximately $308 billion as a result of ObamaCare. This is another 
one of these hidden problems with ObamaCare that is now just coming to 
light, even though we talked about it a lot back in 2009 and 2010. Now 
it is coming to fruition.
  The truth is, these cuts in Medicare Advantage will force many 
seniors to pay higher premiums and further undermine their existing 
health care arrangements. You remember the President said: If you like 
what you have, you can keep it. If you like your doctor, you can keep 
your doctor.
  We are now learning that is absolutely not true in many cases. Just 
to give you a sense, though, of Medicare Advantage's popularity, 
according to the Wall Street Journal, about one of two people newly 
eligible for Medicare chose Medicare Advantage and enrollment is 
growing at a rate of roughly 10 percent per year.
  Why is Medicare Advantage so popular compared to traditional Medicare 
fee for service? Well, for all the reasons you might expect. The 
program offers a lot more flexibility and much more patient choice than 
traditional Medicare based on a number of different performance 
measures that also deliver better results than traditional Medicare. It 
has become the primary driver of innovation within the Medicare system.

  Yet we know, and we have known now for 4 years, and we are now seeing 
that the reality is the administration is trying to undermine Medicare 
Advantage to help pay for ObamaCare. Neither one is working the way the 
beneficiaries of those programs expected and were promised they would 
work.
  Earlier this month I joined with 39 of my colleagues here in the 
Senate to send a letter to CMS Administrator Marilyn Tavenner urging 
her to ``maintain payment levels that will allow Medicare Advantage 
beneficiaries to be protected from disruptive changes in 2015.'' Our 
letter described Medicare Advantage as ``a great success,'' noting that 
one study published in the American Journal of Managed Care found that 
``the hospital readmission rates for [Medicare Advantage] enrollees are 
13-20 percent lower than for Medicare [fee-for-service] enrollees.''
  In other words, it is more effective delivering quality care, keeping 
seniors healthy and reducing dramatically the need to have them 
readmitted to hospitals once they are discharged.

[[Page S1024]]

  The Members who signed this letter were not just folks who work on 
this side of the aisle. They included several prominent Democrats, such 
as my two colleagues from New York, the senior Senator from Minnesota, 
the junior Senator from Massachusetts, the junior Senator from Oregon, 
and from Washington State, and from Colorado, who also happens to be 
the Chairman of the Democratic Senatorial Campaign Committee.
  They signed this letter--39 Senators--saying: Please do not cut 
Medicare Advantage in a way that disadvantages current seniors. It is 
bad enough that ObamaCare is effectively taking money out of a 
successful program, Medicare Advantage, to fund a new entitlement. It 
is bad enough that seniors are being forced to pay higher premiums and 
deal with enormous uncertainty in order to facilitate a government 
takeover of the health care system.
  What makes it even worse is that ObamaCare continues to be an 
unmitigated disaster. Every day you pick up the newspaper, every day 
you watch television: Millions of Americans have lost their preferred 
health insurance, and millions more are paying higher premiums for 
coverage. Many families have discovered that their new ObamaCare-
mandated coverage does not give their children access to their 
preferred doctors and hospitals.
  As one physician from Washington State recently told CBS News:

       We're seeing denials of care, disruptions in care; we're 
     seeing a great deal of confusion and, at times, anger and 
     frustration on the part of these families who bought 
     insurance thinking that their children were going to be 
     covered. And they've in fact found that it's a false promise.

  A false promise--that is ObamaCare in a nutshell, if you think about 
it. A program that was sold as a way to help the uninsured and the 
economy has instead hurt the economy and forced millions of Americans 
to lose their existing coverage--a false promise.
  The Congressional Budget Office--the latest bit of bad news--now 
estimates that ObamaCare will reduce the size of the American labor 
force by 2.5 million full-time workers over the next decade. Here is 
the latest news. In addition, CMS has projected the law could lead to 
higher insurance premiums for about 11 million employees at small 
businesses.
  As for the promise of ``universal coverage''--do you remember, this 
was the whole basis for government-mandated health care: Everybody is 
going to be covered. Well, when all is said and done, ObamaCare will, 
according to the Congressional Budget Office, leave upwards of 30 
million people without health care coverage in 2023.
  After witnessing a tidal wave of disruptions and hardships caused by 
his signature legislative accomplishments, what is President Obama's 
response? His response is to either minimize the political damage, to 
kick the news past the November election, to delay the employer 
mandates, to refuse to enforce other provisions of the law, and to 
waive the law which has no clear means for waiver. So basically, it is 
to refuse to enforce the law, to get it past the election. Let's cut 
the bleeding, politically speaking.
  Earlier this month, for the second time since July, the 
administration announced they would unilaterally delay enforcement of 
the employer mandate. Of course, the President--like so much of what he 
does these days--has no clear legal authority to do that, but our 
colleagues across the aisle do not seem to care as long as they kick it 
past the election because they are worried about the accountability 
that comes with this false promise made to sell ObamaCare.
  Americans want the same type of health care reforms that they wanted 
back in 2009. There are plenty of alternatives, sensible patient-
centered reforms that will actually bring down the cost. You know, if 
you want people to buy more of something, you reduce the cost. You do 
not raise the cost. That creates just the opposite problem. We also 
know there are alternatives to expand quality insurance coverage and 
improve access to quality care.
  I might just add--since I know the Senator from North Carolina has 
been patiently sitting there to speak on a different topic--that he and 
Senator Hatch and Senator Coburn have offered what has widely been 
heralded as a very sensible alternative approach to ObamaCare that 
avoids the problems and reduces the costs, and it does not interfere 
with patient choice.
  We know ObamaCare promised these results, but it failed to deliver. 
In response, we have many different alternative ideas that increase 
patient choice, increase transparency, and increase provider 
competition, all of which is designed to produce for consumers lower 
cost, wider coverage, and better quality care.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mr. BURR. Mr. President, may I inquire how much time exists on both 
the majority and minority sides?
  The PRESIDING OFFICER. There is 21 minutes remaining on the 
Republican side, 9\1/2\ minutes remaining on the Democratic side.
  Mr. BURR. I thank the Chair, and I thank my colleague for his 
comments on the Affordable Care Act.
  I am actually excited to be here having a debate about veterans and 
about the promises we have made to those who are reliant on not only 
the VA but on this institution to actually look at the programs and the 
services provided, and when we, as a body, see deficiencies, reforming 
them, fixing them, so our customer--who is that person who made that 
ultimate sacrifice, who put on that uniform and, in many cases, now has 
a lifetime disability because of it--can count on that health care 
system to be there.
  I would have expected we would be on the floor debating in a 
bipartisan way those fixes that were needed to make sure that veterans 
with disability claims didn't have to wait hundreds of days to 
determine whether they were going to have a disability that was signed 
off on and, if so, what the percentage was and that percentage then 
provided them income.
  I thought we would focus on the challenges the Senate has to reform 
how the appeals process works. Because when a veteran is denied a 
disability claim or he gets less than he thinks he should have been 
awarded, then he has the opportunity to appeal that to the court of 
appeals. The time now for the appeals decision has grown to years. It 
shouldn't be like this. It is absurd that the Congress of the United 
States, much less the Veterans' Administration, is content with the 
deficiencies we have in this broken system.
  Instead of being here to look at fixes provided under the Sanders 
bill, we are here looking at how to expand the population of coverage. 
We are here on programs that have had little to no hearings. We are 
here without understanding the intended or the unintended consequences.
  Let me share the knowledge I have of North Carolina where we have the 
largest growing veterans population in America. I don't have the 
facilities today to handle that veterans population in the timeframe 
Americans are used to being delivered health care. I could go out and 
start construction tomorrow, if my good friend the Presiding Officer 
would allocate me the money, since he sits on the Appropriations 
Committee, and build facilities, and I still couldn't meet the 
facilities requirement needed to provide that level of care. As a 
matter of fact, we have about $14 billion worth of construction 
currently underway in the country, and on an annual basis, this body--
the Congress of the United States--allocates about $1 billion in 
facilities construction and maintenance money.
  We have 14 years of backlog right now and we are not even 
anticipating what the effects are going to be of our current warriors 
who have come out of Iraq, who will leave Afghanistan, who might enter 
Syria or who might be in a conflict down the road. No, we are here 
debating in the Sanders bill a massive expansion in who is provided 
benefits in the VA.
  So who is that? It is veterans who have no service-connected 
disability. It is veterans who are above the means-testing threshold. 
Let me put that in layman's terms. These are not people who are low 
income and these are not people who have a service-connected 
disability.
  We are going to have days to debate this bill, and I will introduce 
an alternative. I will openly confess, upfront, that I don't get into 
fixes, because to do fixes there has to be bipartisanship. To reform 
programs in the Federal

[[Page S1025]]

agencies, Republicans and Democrats have to come together.
  We are here today because there was no outreach to attempt to put 
together a compromise bill. If the conversation we had about a day 
before we left a week ago, where my colleague said, this is what I am 
going to do, why don't you sign on, but he wasn't willing to talk about 
changes--if that was compromise, then he did that. But I don't consider 
that to be compromise. I don't consider it to be good-faith 
negotiation.
  But that is behind us. We now have this bill to consider, and it is a 
massive expansion. And what does it do? It basically says to those 
warriors who have service-connected disabilities, those individuals who 
are low income--and this is where they get their service, their health 
care--you are going to have to wait in a bigger line. You are going to 
have to get behind more people. So what veterans expect, which is that 
the most needy will receive the services they need, is not what this 
bill does. It is not at all what it does.
  As a matter of fact, section 301 of the Sanders bill would expand 
eligibility of the VA health care system. It would qualify to enroll in 
the VA health care as priority 8 veterans if they do not have access to 
health insurance except through a health exchange and do not qualify 
for higher priority.
  Before getting into my concerns about this affected section and what 
impact it would have on VA, I wish to comment on how this section has 
been drafted. The section says:

       If a veteran qualifies as a priority 8 veteran and has no 
     other option but the health exchange under the Affordable 
     Care Act, they could enroll in the VA.

  Let me read that again:

       If a veteran qualifies as a priority 8 veteran and has no 
     other option but the health exchange under the Affordable 
     Care Act, they can enroll in the VA.

  We have just mandated that everybody in this country--except when the 
President delays the mandate--has to be under the Affordable Care 
Act and they are part of the health exchange. Here we are saying to 
priority 8 veterans, if your only option is the health exchange, we 
will let you opt into the VA. Well, if the health exchange is that 
good, why would we dare risk all other veterans who have service-
connected disabilities or low incomes having to wait behind people who 
were provided health care out of the health exchange?

  Some priority 8 veterans may even qualify for a subsidy under the 
exchange, something they would not receive if they were to enroll in VA 
health care. I don't know, are they concerned these veterans will be 
unable to find a plan that meets their needs? Everybody else in America 
was shoved into it. Why should we be concerned about them?
  My intention today isn't to open a health care debate. I do have 
serious concerns about this expansion. Expanding eligibility could 
stress an already overburdened system. There is a reason why the 
priority 8 veterans program was halted. The VA found they could not 
provide timely access to services while sustaining a high level of 
care. And judging by the well over 30 health care inspectors reports 
issued by the Office of Inspector General in this Congress alone, the 
VA is having trouble with the limited group they currently serve.
  Here are some examples of the IG's health care inspections report 
released since January 2013: 1. Three deaths in Atlanta because of 
delays in mental health care; 2. Two reports regarding delays in GI 
consults and issues with facilities operating services in Columbia, SC; 
3. Emergency department patient death at the Memphis VA center; 4. Two 
reports on the inappropriate use of insulin pens at both the VA Western 
New York Healthcare System and the Salisbury VA Medical Center; and 5. 
Two reports on Legionnaires' disease at VA Pittsburgh and a review of 
Legionnaires' disease prevention at VHA facilities.
  If we expand enrollment, if we expand the coverage, it would surely 
require an increase in funding at the VA. When we increase the number 
of patients entering the system, we certainly need to hire additional 
staff and to provide more space to treat the new veterans. I have 
already talked about the 14-year backlog we have on facilities now. 
Without followthrough on secondary cost, we only frustrate veterans 
when their expectations aren't met, not satisfy them.
  I truly believe if we expand government programs we need to do it 
responsibly. We need to understand the intended consequences and plan 
for the unintended consequences. We should explore whether the VA can 
manage the implementation of this expansion. We should explore what 
impact this will have on the VA's ability to treat combat veterans and 
veterans with limited incomes and find out what new needs, both in 
staffing and space, would be created by this expansion.
  Unfortunately, we don't know the answers to these questions, because 
in preparation for this section the majority didn't hold an oversight 
hearing looking specifically at the consequences--intended or 
unintended--to expand enrollment of priority 8 veterans. In fact, the 
only hearing on this subject was a hearing on legislation pending 
before the committee on October 30, 2013. At that hearing we heard 
testimony on three dozen bills--clearly, not enough time to examine the 
details of any of the 30 bills.
  From their testimony at the hearing, the VA obviously agrees with me. 
Dr. Robert Jessie, Principal Deputy Under Secretary for Health, 
indicated that expanding enrollment of priority 8 veterans ``presents 
many potential complications and uncertain effects on VA's enrollment 
system.'' That comes from a guy pretty high up within the Veterans' 
Administration. They are not necessarily for this.
  Finally, I want to address a comment my colleague from Vermont made 
at a press conference a few weeks ago. He said:

       We're not going to bring one new person in without making 
     absolutely certain that the VA has the resources to 
     accommodate those people.

  As I read the bill, there is nothing in this provision or in the bill 
itself that would restrict implementation in that way. However, I would 
gladly support an amendment which would delay this provision until GAO 
reports that the VA could manage this additional population of 
veterans.
  Mr. President, you might be thinking, as others who are listening 
might, what does all this cost? How is it paid for? Is the funding 
recurring or is it one-time funding? Is it permanent expansion?
  Let me try to answer some of that for you. The way the Sanders bill 
is paid for is with money out of the overseas contingency operations. 
That is more money we were going to spend that we haven't spent, that 
we never had because we were borrowing it, and now we are going to use 
it to expand this. It is one-time funding for a permanent program. Let 
me say that again. It is one-time funding for a permanent program.
  It is not as though we are going to fund this expansion of priority 
8s, and all of a sudden, when OCO money is gone, we say: Oops, we 
didn't mean it; we are going to pull it back. No, these are going to be 
in the system regardless of the impact, regardless of the consequences.
  So who is adversely affected? Today's warriors. The same warriors who 
are waiting in line to get health care services are now going to 
compete for a limited number of slots to be seen by people who might 
have had private insurance, by people who might have been in the health 
care exchange, by individuals who are not low income and who have no 
service-connected disability. Who else? Those veterans with disability 
claims who are waiting for a determination. I mean these veterans are 
going to be impacted by this because we will have such an influx of 
people within the system. Veterans are waiting for disposition of their 
disability claims, their appeals. Those who have gone back and have 
waited, they have finally gone through hundreds of days for a claim to 
be determined only to find out they have to appeal it. Now they are 
going to go through hundreds of days of appeal, and we are saying we 
are going to have to start using some of these people to administer new 
services which far exceed and are outside of priority 8 which I focused 
on. But we will talk about the entirety of this bill as the next 
several days go on.

  The last one, and I will stop for this afternoon: Who is adversely 
affected? Our kids, our grandchildren, the ones who sit at home today 
hoping the decisions we make about future obligations

[[Page S1026]]

take into account that they are paying the tab. They are the ones who 
will be here years from now keeping the promises we make, and they are 
hoping we only make the ones we can keep.
  Mr. President, how much time is remaining on our side?
  The PRESIDING OFFICER. Five minutes.
  Mr. BURR. I will tell a personal story about a trip to one of our 
military cemeteries abroad.
  We were in the country of Belgium. I was there for a Memorial Day 
service. Much to my amazement, there were probably 4,000 to 5,000 
individuals.
  We got through with the formalities of a very well-constructed 
Memorial Day celebration. As I wandered through the graves, I found a 
Belgium couple with their two young children at the headstone of an 
American soldier from World War II. I asked them one simple question: 
Why are you here?
  The Belgium father, younger than I, looked at me and he said: Sir, I 
inherited this grave from my father. My father took the responsibility 
for this grave to always make sure it was just like it was the day he 
got it. I have now inherited that from my father, and my children will 
inherit that responsibility from me.
  I know there are a lot of veterans organizations who hope Senator 
Sanders' bill becomes law, but I think there are a lot of veterans who 
are hoping it doesn't: the veterans who need the VA system and count on 
it for their mental health treatment, for their substance abuse 
treatment, for their primary care. They count on it for diabetes 
maintenance, they count on it to stay alive, and we promised it to 
them.
  I am sure future generations will look at the decisions we make this 
week and will belly up to the bar for whatever it costs, but I think it 
is important for us to remember our obligations stretch long past our 
service here. Although it seems somewhat easy to spend somebody else's 
money, our kids want us to reform this, our veterans want us to reform 
this, the VA wants us to reform this.
  Once we reform it, we can talk about expansion. Until then, it is 
irresponsible for the Congress of the United States--for the Senate of 
the United States--to talk about dumping more people into a broken 
system, to ask those who have already waited so long to wait longer 
because of our actions.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. I thank my colleague from North Carolina, the ranking 
member of the Veterans' Committee, for his remarks. I look forward to 
debating some of the issues the Senator raised because I think it is 
important for not just the veterans of this country but the tens of 
millions of people who support our veterans to understand what we are 
trying to do to improve lives for those people who have put their lives 
on the line to defend this country.
  I did find it interesting that the ranking member from North Carolina 
suggested in so many words, yes, this bill does have the support of the 
American Legion, the Veterans of Foreign Wars, Disabled American 
Veterans, the Vietnam Veterans of America, the Military Officers 
Association of America, the Iraq and Afghanistan Veterans of America, 
Paralyzed Veterans of America, Gold Star Wives of America, and dozens 
of other veterans organizations, but the implication was they may be 
supporting this bill but veterans back home do not. I doubt that very 
much. In fact, I happen to believe these organizations do a very good 
job in representing the interests of their veterans and that they 
listen to the veterans.
  As the ranking member understands, this bill was put together not 
from my head, not from his head or any Member of the Senate's head. We 
listened to the veterans community which came forward before the 
Congress. In fact, today there was a joint session--which I had to miss 
because I was here--with the DAV, and then we are going to hear from 
the American Legion, from the VFW--we are going to hear from all the 
veterans organizations.
  This bill represents what those veterans organizations said the 
veterans community needs. I strongly disagree with the Senator from 
North Carolina in suggesting the veterans organizations do not do an 
effective job in representing their membership.
  The other point I will make is that I look forward to this debate. 
Every now and then it is a good idea to have a debate on real issues on 
the floor of the Senate, so I look forward to this debate. But in terms 
of the suggestion that this is not a bipartisan bill--I do understand 
absolutely not every word in here nor every source of funding is 
supported by our Republican colleagues, but as chairman of the 
Veterans' Committee, I have worked as hard as I could--and I believe 
the ranking member knows this--to develop as best I could a bipartisan 
piece of legislation. I remind all the Members of the Senate and the 
American people this legislation contains a significant number of 
provisions authored and supported by Republican members of the 
Veterans' Committee, including my friend from North Carolina. In fact, 
to the best of my knowledge, there are some 26 separate provisions 
which Republican Members have authored or cosponsored. That is not an 
insignificant number.
  Further, perhaps two of the most prominent provisions are the omnibus 
bills. That is when we collect the number of different bills and we put 
them into one pot. We did that on two occasions. As the ranking member 
knows, the vote on each of those omnibus bills was unanimous. Every 
Democrat, every Republican, and the Independent chairman of the 
committee voted for them. In truth, other important provisions were 
passed--not unanimously, of course, but they did pass in many cases 
with bipartisan support.
  Furthermore, this bill contains two key bipartisan provisions passed 
overwhelmingly by the Republican-controlled House of Representatives.
  So let me acknowledge that not every provision in this bill was 
brought before the committee. That is true. But the two major 
provisions which were not brought before this committee are bipartisan 
and in fact have been passed overwhelmingly by the Republican-
controlled House.

  With almost unanimous votes, the House passed the same provision 
included in the Senate bill which would solve a longstanding problem to 
authorize the VA to enter into 27 major medical facility leases in 18 
States and Puerto Rico.
  My friend talks about the fact that we need more infrastructure for 
our veterans. He is right. This bill provides 27 major medical facility 
leases in 18 States and Puerto Rico, and in an absolutely 
overwhelmingly bipartisan vote that language was passed in the House.
  The second bill--not included in our discussions in the Senate 
committee--also passed with very broad support in the House--deals with 
ensuring that veterans can take full advantage of the post-9/11 GI bill 
and get instate tuition in the State in which they currently live. If I 
am not mistaken, I believe my friend supports that provision.
  It is fair to say not every provision was debated in the committee. 
He is right. But the two major provisions that were not, were passed 
with overwhelming support in the House and I believe will pass with 
overwhelming support in this body and are included in this legislation.
  I believe virtually every Member of the Senate, regardless of his or 
her ideology, cares about veterans--and I know the Senator from North 
Carolina does--and all of us want to do the very best we can. That is 
why I have worked so hard with Members of my committee, with 
Republicans and Democrats, to make this bill as bipartisan as it 
possibly could be. I am not here to say it is 100 percent bipartisan. 
It is not. But we worked hard, and there are significant and major 
provisions in this bill which come from my Republican colleagues 
because they were good ideas. As chairman of the committee, my view is 
we don't reject an idea because somebody has an ``R'' next to their 
name. If they have a good idea, it is in the bill.
  May I ask the President how much time remains.
  The PRESIDING OFFICER. There is 2\1/2\ minutes.
  Mr. SANDERS. I will very briefly touch on some of the other 
provisions in the bill.
  We restore full COLA for military retirees. As we all know, the House 
and the Senate passed and the President signed the bill to undo the 
provision in the Budget Act, but they did not include those members of 
the military

[[Page S1027]]

who signed up after January 2014. They are still suffering from a cut 
in the COLA. We address that.
  This bill does expand VA health care and among other ways it provides 
dental care. I don't know about other States, but in my State--and I 
suspect all over this country--in talking to veterans, they think 
dental care is part of health care. Right now, except for service-
connected situations, dental care is not provided. We have a major 
pilot project to say to veterans: Yes, dental care is part of VA health 
care and you can get that.
  As to advanced appropriations for the VA, not everybody knows this, 
but we were 7 to 10 days away from disabled veterans not getting their 
checks when the government was shut down. This legislation ensures 
veterans receive consistent access to the benefits they have earned by 
establishing advanced appropriations for the mandatory accounts at VA.
  We move forward in a bipartisan way to end the benefits backlog. My 
colleague from North Carolina pointed out it is a serious issue. 
Everybody agrees it is a serious issue. I think the VA is making some 
progress. This legislation has significant language to help the VA move 
forward in that area.
  This legislation would extend from 5 years to 10 years unfettered 
access to VA health care for recently separated veterans to address 
their health care needs early.
  This legislation renews our vow to hire veterans, making sure 
veterans get the employment opportunities many are now lacking when 
they come back from Iraq and Afghanistan.
  This legislation deals in a significant way with the horrendous issue 
of sexual assault, making sure victims of sexual assault--women and 
men--get the care they need at the VA.
  I will conclude by saying this is a serious bill which deals with a 
very serious issue. My hope is every Member treats the needs of 
veterans with the respect they deserve. I look forward to the debate 
which I am confident we will have.
  Clearly, this is not a perfect bill, and I know there are Members who 
have ideas as to how they can improve it. This is what the legislative 
process is about. My sincere hope, however, is amendments which are 
brought forth deal with veterans issues and not amendments which are 
not relevant and not germane to this discussion.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. SANDERS. I ask unanimous consent for an additional 30 seconds.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SANDERS. The ranking member and I have disagreements, and that is 
what the legislative process is about. Let's debate the issues on the 
floor.
  I hope we show our respect to the veterans by not getting into issues 
that have nothing to do with veterans' needs. I hope we are not off 
debating Iran or ObamaCare or gay marriage or whatever it may be. I 
guess those are good political issues for some people. I hope people 
understand how significant and important the issue itself is--the needs 
of our veterans--and we stay focused on that issue as we bring forth 
amendments.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mr. BURR. Mr. President, I thank my colleague, the chairman of the 
committee. He is right when he said we have a lot of agreements. As a 
matter of fact, about 80 percent of the policies in his bill are in my 
alternative bill, but I have a big problem with the other 20 percent. I 
have a problem with the cost. I have a problem with the unintended 
consequences. I wish we could figure out the intended consequences, but 
we cannot because there has not been much time to do it.
  I look forward to the next several days. I believe the chairman made 
a plea that the amendments be limited to VA issues. That might be 
possible if the minority had the opportunity to amend legislation in 
this institution. I think we have had four votes on Republican 
amendments since July. To suggest that Iran is not important is, in 
fact, turning a blind eye on the world.
  In my bill I have a piece of legislation that is cosponsored by 59 
Senators, and it is bipartisan. My legislation is the Iran sanctions 
bill. Why? Because it is the only way we can get this to the floor. We 
have been denied the opportunity to deal with this issue in any other 
way. This is important to the American people, and it is important to 
our friends and allies around the world. I am sure it will dominate 
part of the debate.
  Make no mistake about it, the one matter the chairman didn't point to 
was what we are fixing. We are adding a lot of stuff, but we are not 
fixing anything. Ask any veteran.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. BURR. Mr. President, I ask for an additional 30 seconds.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BURR. If you ask any veteran about the areas that need reform, I 
believe they would tell Chairman Sanders, just like they would tell me: 
Yes, there are a lot of places that need reform. To suggest that should 
not be part of this debate is ludicrous.
  I look forward to the next several days, and I urge my colleagues to 
support getting on this bill and to vote yea when they come to the 
floor for this next vote.
  I thank the Chair and yield the floor.


                             Cloture Motion

  The PRESIDING OFFICER. Pursuant to rule XXII, the Chair lays before 
the Senate the pending cloture motion, which the clerk will report.
  The legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     hereby move to bring to a close debate on the motion to 
     proceed to Calendar No. 301, S. 1982, the Comprehensive 
     Veterans Health Benefits and Military Retirement Pay 
     Restoration Act.
         Harry Reid, Bernard Sanders, Tom Harkin, Brian Schatz, 
           Mary L. Landrieu, Jack Reed, Jeanne Shaheen, Tim Kaine, 
           Christopher A. Coons, Patrick J. Leahy, Robert P. 
           Casey, Jr., Joe Donnelly, Jon Tester, Barbara Boxer, 
           Richard Blumenthal, Sherrod Brown, Barbara Mikulski.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call has been waived. The question is, Is it the sense of the Senate 
that debate on the motion to proceed to S. 1982, a bill to improve the 
provision of medical services and benefits to veterans, and for other 
purposes, shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  Mr. DURBIN. I announce that the Senator from Florida (Mr. Nelson) is 
necessarily absent.
  The yeas and nays resulted--yeas 99, nays 0, as follows:

                      [Rollcall Vote No. 44 Leg.]

                                YEAS--99

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Begich
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coats
     Coburn
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Crapo
     Cruz
     Donnelly
     Durbin
     Enzi
     Feinstein
     Fischer
     Flake
     Franken
     Gillibrand
     Graham
     Grassley
     Hagan
     Harkin
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johanns
     Johnson (SD)
     Johnson (WI)
     Kaine
     King
     Kirk
     Klobuchar
     Landrieu
     Leahy
     Lee
     Levin
     Manchin
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Paul
     Portman
     Pryor
     Reed
     Reid
     Risch
     Roberts
     Rockefeller
     Rubio
     Sanders
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Tester
     Thune
     Toomey
     Udall (CO)
     Udall (NM)
     Vitter
     Walsh
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--1

       
     Nelson
       
  The PRESIDING OFFICER. On this vote, the yeas are 99, the nays are 0. 
Three-fifths of the Senators duly chosen and sworn having voted in the 
affirmative, the motion is agreed to.
  The Senator from Oklahoma.
  Mr. COBURN. Mr. President, I would like to spend a little bit of time 
offering a viewpoint different from the viewpoint of the chairman of 
the committee on this bill.
  First of all, I want to say by context that my father and his two 
brothers all served in World War II. My two brothers served during the 
Vietnam era.

[[Page S1028]]

There is no question we have an obligation to meet our commitments to 
those who have put their lives and futures on the line for this 
country.
  But it pains me that, although we have increased spending 58 percent 
in the VA programs since 2009, which was fiscal year 2010, what we have 
seen is a complete lack of oversight of what is happening. Let my give 
an example. The VA Committee in the Senate last year held 30 hearings, 
4 of which were oversight. If you read the transcripts of those 
hearings, you cannot call them oversight hearings even though they were 
billed as oversight hearings.
  Why is that important? It is important because there are a multitude 
of significant, serious problems in the Veterans' Administration. Just 
2 days ago it was discovered that in an L.A. VA clinic, the staff of 
the clinic destroyed the medical records of thousands of people so that 
when they do the metric on how far behind they are, we cannot measure 
it; or the fact that 82 veterans last year died of carcinomas through 
delayed diagnosis because they could not get a diagnostic procedure, 
such as a colonoscopy; or the fact that we have all these veterans who 
cannot access mental health care, and we see the suicide rate--
unacceptable, to say the least.
  So we have a bill on the floor that massively--and that is a small 
word for what this bill does--massively expands the authority and the 
ability of the VA to offer care to another 14 million veterans--from 6 
million to 20 million.
  On a system today that cannot keep up, we have 600,000 people waiting 
for a disability determination. We are not having oversight hearings on 
that. We are not having oversight hearings on a South Carolina VA 
hospital where people are dying from malpractice like crazy. We are not 
having the oversight hearings to hold the VA accountable. What we are 
doing is putting a bill to expand their responsibilities instead of 
holding them accountable for the responsibilities they have today. That 
is what we should be doing. Instead, we are going to add $60 billion. 
And that is a conservative number. That is my number.
  But all you have to do is look at what the cost and the efficiency 
and the outcomes are through the VA system to see that we are going to 
diminish the veterans caregiver program by expanding it to everybody. 
We are going to create all sorts of new programs and no resources to 
actually provide them. And we are going to create more advanced 
funding, advanced appropriations, which will limit our ability to hold 
them capable and culpable in the future.
  There are a lot of things we ought to be doing for our veterans right 
now that are already in law that we are not doing, and we come to the 
floor with a massive expansion at a time when we cannot even care for 
what we are doing. As a physician who trained in VA hospitals, I know 
the difference in the level of care. I can assure you it has not gotten 
any better. From my colleagues I speak to in the medical profession and 
from the veterans whom I talk to who contact me, it has gotten far 
worse. It does not have to be that way, but it will always be that way 
if, in fact, we continue to not hold those in leadership positions 
accountable for not stepping to the bar for performance, quality, and 
outcome.
  From Congress to the Pentagon, we must reassess what laws, 
regulations, and rules can be changed to ensure that benefits and other 
decisions the Veterans' Administration makes are beyond reproach and 
based on the best facts available. Let's ensure that the Department's 
limited resources are focused on its core mission rather than disbursed 
in an effort to remedy every possible problem for every veteran. 
Remember, when everyone is first priority, no one is. That is what this 
bill is. We diminish the priority of the commitments we have made to 
the veterans who are out there today.
  Our veterans are looking to us for help. We are about to enact 
legislation that is going to further strain the ability of the VA to do 
its most basic charge: help with the health care, mental health, and 
capability of those who have put it all on the line for this country.
  It is shameful that Congress now is trying to claim credit for 
providing new benefits while our old promises are forgotten. Our 
heroes--our heroes--are literally dying at the hands of malpractice, 
incompetency, and delay.
  If we really wanted to care for our veterans--those with service-
connected disabilities--what we would say is, go wherever you want to 
go to get whatever you need because you served this country. And it 
actually would cost less. But because we pile them into a broken system 
now--and that is not all VA organizations. Let me clarify that. There 
are some excellent VA hospitals that do great work. Their specialists 
are far ahead of the private sector. But on general grounds, to put a 
veteran at a place with less than the best possible care dishonors 
their service to this country--dishonors their service to our country.
  Veterans are our heroes. They are the symbol of our country of 
sacrifice, of giving for others. Yet we have four oversight hearings in 
a year? With the multitude of problems that are going on in the VA 
hospitals and the Veterans' Administration in terms of disability 
determination, we have four? The House had 34 oversight hearings, and 
they were rigorous. When you ask members of the committee: Have you 
read the House oversight hearings? No. They had 26 regular hearings and 
34 oversight hearings trying to hold the VA accountable.
  We are not going to hold the VA accountable with this bill. We are 
going to make them less accountable. And that is a disservice to the 
very people who have honored us by serving in the military of this 
country.
  As of February 15, 2014, the VA has 677,000 claims pending for 
disability compensation. Why should it take a year for somebody who put 
their butt on the line for this country and received an injury and is 
disabled? Why should it take a year for us to determine that we owe 
them an extra bit of compensation and availability?
  What is being done to fix that? We have a VA regional center in my 
home town, with good employees, hard-working employees. They are not 
destroying files so they can say they met a metric. Veterans seeking 
mental health treatment still experience weeks-long delays scheduling 
appointments. The epidemic of overprescription of opiates--let me say 
that again--there is an epidemic of overprescription of opiates for 
those people who served our country, making them dependent addicts 
because we give them the wrong treatments.
  There are avoidable veterans deaths at the VA. In a recent story by 
CNN on misdiagnosis and improper care for gastrointestinal conditions, 
there were 2-year consultation delays--2 years to get in to see a 
specialist at the VA when you are losing blood. How do we explain that? 
Who is accountable? We are, because we are not holding them 
accountable.
  There were 82 deaths last year alone--I am sure that is a far 
understatement--because of delayed diagnosis for just investigative 
endoscopies. That is just what is documented. How do we accept that? 
Had they been in the private sector, they would not have had a delay. 
They would not be dead.
  So here is the proposal that I would put out. Do our veterans deserve 
the best of care in this country? I think they do. Should they be able 
to get that care where they know the quality, they know the outcomes 
and the transparency as to what their future might be or must they be 
forced into a system that is going to give them something less? That is 
where we are today.
  The chairman in his bill increases VA medical care for everybody who 
served without a disability. What will that do to the VA system? We 
cannot handle what we have in front of us now in terms of those who 
have a percentage medical disability that allows them access to the VA 
health care system.
  So when you triple that or more than triple it, where are the 
resources? If we really mean what we say in this bill, you are talking 
hundreds of billions of dollars over 10 years. You are not talking the 
$30 billion that the chairman says is what the cost is. You are talking 
hundreds of billions. But the point I would make is we have an 
infrastructure out there that can care for our veterans. It is the 
hospitals all around the country. It is the doctors all around the 
country. Does a veteran not have the right to get the best care? Should 
we not give him a card and say: You served this country. Here is your

[[Page S1029]]

service connection. Here is your disability. You can get care at a VA 
hospital, if you want, or you can get care wherever you want.
  But I will guarantee you what will happen is, if we give what was 
promised to the veterans--not what we are giving today--real care, real 
opportunity with real transparency as the outcome, what you will see is 
marked improvement in care, marked improvement in outcomes, no change 
in additional cost--no change in additional cost--and access that is 
promised but not denied and delayed.
  In one South Carolina VA facility alone, 20 veterans are either dead 
or dying of cancer because of delayed diagnoses. They had the symptoms 
and presented them to the hospital, but because of delay and 
incompetency--just that one hospital.
  The other thing we know is veterans' malpractice claims are markedly 
increasing--markedly. All you have to do is look at the OIG report on 
the claims of deficiencies at the VA in New Haven, CT. Contamination, 
cross-contamination, inadequate procedures for infection precautions, 
absence of employees that are supposed to be on duty when they are not, 
failure to clean operating rooms properly, failure to have the proper 
ventilation system in an operating room for a contaminated case. That 
is just one hospital.
  What does that mean in real life? What that means in real life is the 
risk for iatrogenic or facility or physician-caused infection goes 
through the roof--not the fault of the physician but the fault of the 
VA for not managing the system properly.
  Former VA epidemiologist, Dr. Steven Coughlin, testified before the 
House Veterans' Affairs Committee that the VA failed to follow up on 
over 2,000 veterans who indicated in VA surveys that they were 
experiencing suicidal thoughts. When the HVAC followed up on Dr. 
Coughlin's claims, they found that they were validated. Unfortunately, 
too many of those who had suggested their problems committed suicide. 
It is a little late.
  Because Dr. Coughlin brought this up, he was admonished, bullied, and 
intimidated for speaking about the ethical lapses at the VA. Where is 
the oversight hearing? You see, if we are not going to hold the VA 
accountable, the quality of care is not going to rise to the level that 
our veterans deserve.
  Another area is this. The VA wasted $3 billion over the past 10 years 
because they failed to secure competitive market prices for surgical 
implants. That is $3 billion. That is documented. That is a GAO study. 
GAO did that. We did not do it. We did not find it. Oh, by the way, at 
the end of the year when they had some money to spend, about $600,000 
worth of artwork was purchased, instead of putting it into additional 
doctors, cleaning operating rooms, additional people to secure 
clearances on disability.
  By expanding VA care and the potential of 22 million more veterans, 
you can guarantee that the veterans who are getting care now are going 
to get poorer quality and less access to care. You can guarantee that. 
That is what this bill is really about. This bill is really about a 
decrease in the requirements for care for our veterans. It is not about 
an increase. It is about a decrease because when you flood that system 
with people who do not have a service-connected disability, what will 
happen is this. Easy goes first and hard goes last. I have seen that in 
the VA my whole life.
  There is also an expansion in the caregivers program. I am not sure I 
disagree with it. But certainly, for those after 9/11 a commitment 
ought to not be diminished if we expand this program. The minimum cost 
for that is $9.5 billion. The VA has not yet met its full obligation 
under the VA caregivers law that we have today. Yet we are not holding 
them accountable.
  There is another area in this bill that I think is tragic. It is well 
intended, but it mandates that the University of West Virginia or the 
University of Oklahoma must give in-State tuition to anybody from 
anywhere that has ever served or they lose their benefits under the GI 
bill. That totally ignores the Constitution in this country.
  Now, 20 States have already said they are doing that. Ten others have 
bills in the process. Eight others have a partial. So we are at 38 of 
the 50 States right now. But in our vision, we are going to mandate 
that the Tenth Amendment does not mean anything, that the 80 percent of 
funding on higher education in Oklahoma that comes from people in the 
State of Oklahoma, that we can co-opt that and coerce them and tell 
them what they are going to do.
  It is well intended. But it is certainly not constitutional. It 
certainly does not respect the Tenth Amendment of the United States. 
Does Oklahoma or West Virginia have the right to make a decision on who 
they give in-State tuition to? Why not just pass a law that says: Every 
State will give in-State tuition to everybody.
  The reason it was connected with States is because of State funding. 
We totally trample that. Again, the advanced appropriations will limit 
our ability to hold those people accountable for the very things that I 
have described to you. But we are going to do it anyway.

       A proposal to expand VA advanced appropriations needs to be 
     considered by the administration as a part of an across-the-
     government review of the advantages and disadvantages of such 
     progress, not only for the VA but potentially other programs 
     and agencies. Only in the context of such a broad review 
     could the administration offer an opinion on making such a 
     change for the VA. Therefore, we cannot offer a position.

  That is from the VA. The real answer is: Give us advanced 
appropriations, and then it is only after the fact that you can hold us 
accountable, not during the fact.
  Here is another GAO study that we should be highly concerned about. 
The VA--this is the GAO--has no idea how long most patients wait to 
receive care. They do not even know their own metrics.

       It is unclear how long veterans are waiting to receive care 
     in VA's medical facilities because the reported data are 
     unreliable, because VA hospitals have tried to cover up wait 
     times, fudge numbers, and backdate delayed appointments in 
     an effort to make things better than they are.

  That is directly from a GAO report. Where is the oversight hearing on 
that; or the L.A. facility that just destroyed medical records so 
nobody could know how long people had been waiting for appointments?
  Based on GAO recommendations to improve reliability of reported wait 
times for new medical appointments in 2013, the VA changed the way it 
tracks and calculates its performances. Using the new tracking method 
in 2013, the VA reported only 41 percent of veterans were scheduled for 
a new primary care appointment and only 40 percent of veterans were 
scheduled for a new specialty appointment within the 14-day standard.
  So 40 percent of the time, with the 6 million veterans we have now, 
they are getting adequate timely care, and 60 percent are not. Yet we 
are going to expand that to 22 million, and we don't have the resource 
base or the facility base or the employee base or the professional base 
or the caregiver base to do that?
  In contrast, in 2012 the VA reported that 90 percent of new primary 
appointments and 95 percent of specialty appointments had met the 14-
day standard.
  The VA exam requests backlog purge. VA employees destroyed veterans' 
medical records to cancel backlog exam requests.
  That is from Patrick Howley, again.
  Oliver Mitchell, a marine veteran and former patient services 
assistant at the Los Angeles VA system, told the Daily Caller: We just 
didn't have the resources to conduct all those exams. Basically we 
would get 3,000 requests a month for medical exams, but in a 30-day 
period we only had the resources to do about 800. That is 25 a day. 
That rolls over to the next month and creates a backlog. It is a 
numbers thing. The waiting list counts against the hospital's 
efficiency. The longer a veteran waits for an exam, it counts against 
the hospital as far as productivity is concerned. Some patients were 
waiting 6 to 9 months for an exam, and the VA didn't know how to 
address the issue.
  Is the answer to open this to another 16 million veterans or is the 
answer to improve the efficiency, transparency, quality, and outcomes 
of the present VA system before we go about expanding this system to 
people who are otherwise covered?
  Mr. Mitchell, when he tried to sound the alarm on the VA's deliberate 
attempt to fraudulently reduce the backlog, was transferred out of his 
department and eventually terminated from

[[Page S1030]]

his job. After he contacted Congress in 2011--2 months later when the 
VA found out about it--he was fired.
  So do we really want transparency in what we are doing? Do we really 
want to know what is going on? Do we really want to fix the system? Do 
we really want to offer health care to veterans and make it equal to 
what they can get in the private sector or do we want to say we want to 
offer all these new benefits at the same time we are not meeting our 
commitment on the benefits we have already promised? That is the game 
that is being played.
  Earlier I said the VA said the Committee on Veterans Affairs held 30 
hearings. They only held 16--16 hearings; 1 every 3 weeks.
  The annual budget of the Department of Veterans Affairs exceeded $134 
billion a year. Delay in vet care is not for the lack of money. The 
delay in vet care is not for the lack of money, it is for the lack of 
accountability in management. Case in point: More than 20 veterans have 
died or are dying due to late diagnosis and treatment of cancer at the 
William Jennings Bryan Dorn Veterans Medical Center in Columbia, SC. 
Documents show only one-third of that $1 million appropriated by 
Congress to fix the problem was used for its intended purpose at that 
VA facility. Only one-third of the money we appropriated to fix this 
problem was actually used to pay for care for veterans on waiting 
lists. At the same time, the documents show the waiting list at Dorn 
kept growing to 3,800 patients in December of 2011.
  I will be back to speak on the floor and offer amendments. I have 
pages and pages of examples of veterans who served this country 
honorably, proudly, and sacrificed to a great extent, who are getting 
substandard care in the system we are offering them today. Before we 
expand that system, what is needed is a rigorous oversight and debate 
about how we are doing what we are doing now.
  The promise of access to care for our veterans, as shown by VA 
centers and clinics all across this country, hospitals all across this 
country, diagnostic procedures all across this country, reflects that 
when access is delayed, that care is denied. And that is what is 
happening right now far too often to the people who have served this 
country. We ought to be about fixing that and holding accountable those 
in the responsible positions, and holding ourselves accountable to do 
what is necessary to give at least the standard of care they could get 
anywhere else in the country. That is the direction in which we should 
go.
  I thank the Presiding Officer for the time, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, I look forward to discussing in the next 
several days the issues Senator Coburn raised, but I did want to make 
one clarification, and I hope the Senator is listening. He repeatedly 
indicated this legislation opens the door to every one of the 22 
million veterans in America, and then proceeded to say that once you 
open the door, you are going to have inadequate care because we don't 
have the resources to take care of 22 million veterans. That simply is 
inaccurate and that is not in the legislation.
  There is nothing in the legislation that says we open the door to 
every veteran in America regardless of income. So when people talk 
about the VA suddenly being flooded by veterans and care being 
diminished because of the huge increase into the system, that is just 
not true.
  What is true? What is true right now is we have an absurd and 
complicated income eligibility system throughout this country. What 
happens in the State of Vermont or the State of California--one's 
eligibility for the VA, if you are a priority 8--is different and 
dependent upon the county in which you live. So in Vermont, you can be 
living in a county where if your income level is $45,000 a year you are 
eligible for VA health care, but in a county where the line is drawn 
just across the street, you may not be eligible. In States such as 
California or Georgia, which have many, many, many counties, you have 
the absurd situation where a person living on one side of the street is 
eligible for VA health care, but the person living on the other side of 
the street is not eligible for VA health care.
  This is totally absurd, and we end up having hundreds and hundreds 
and hundreds of different income eligibility standards. So what this 
legislation does is not open the door--and I hope my Republican 
colleagues will not continue to say it because it is not true--but it 
does say that in a State where you have different income eligibility 
standards based on counties, what we will do is have one income 
eligibility standard per State, that being the highest level. So we 
will have 50 different standards--50 different standards for 50 
different States--not have hundreds and hundreds and hundreds of 
different standards. In every State there will be an income eligibility 
level, but it will not open the door for health care to 22 million 
veterans.
  Second of all, we were very careful in this legislation to say, if a 
veteran who, under this bill, would be eligible for VA health care, a 
veteran who can newly access VA health care, we absolutely have to have 
the medical infrastructure available so that all veterans will get the 
quality care they need; so that new veterans coming in will not 
diminish service for other veterans. In this bill we make clear--and we 
made this clear in our long discussion with the Disabled American 
Veterans--the priority for the VA remains those veterans who are 
injured in action, those veterans who need that care. That is the 
highest priority that we establish.
  So when people say we are opening the door to all veterans, care is 
going to be diminished, that simply is not true. That is not what the 
bill says.
  Thirdly, let me reiterate some of the provisions in this bill, 
because before we vote on final passage--and, by the way, I want to 
take this opportunity to thank every Member of the Senate for voting to 
proceed. I think it is time we had some very serious debate about VA 
health care, and now is the time to do it. But let me reiterate a point 
I made earlier. Senator Coburn raised important issues, Senator Burr 
before him raised important issues, and we should debate those issues. 
But in all due respect for the veterans of this country, who have 
sacrificed so much, let us not politicize this debate on veterans 
issues by bringing in sanctions against Iran or let us not bring in 
ObamaCare, let us not bring in the dozens of other issues that are out 
there. Let us debate this issue on its merits. Let us bring forth 
amendments which deal with veterans issues.
  Senator Coburn and Senator Burr have amendments which deal with 
veterans issues. I welcome those amendments. Let us have those debates. 
Nobody ever suggested this bill is perfect. There are a lot of Senators 
out there, Democrats and Republicans, who have ideas about how we can 
improve the services and the programs we provide to veterans. I welcome 
those ideas. But do not destroy this legislation by politicizing it, by 
doing what we have done month after month, year after year, which is 
why the American people have so much contempt for what goes on in 
Congress. Let us focus on veterans issues.
  We have differences of opinion. Let us debate those issues. Let us 
not bring in extraneous matters, poison pills, which will give people a 
reason to vote against this bill. Let us debate veterans issues.
  Let me talk about some of the issues in this bill that my Republican 
colleagues did not talk about. No. 1, I am proud--I hope we are all 
proud--that recently we made sure the promises made to military 
retirees were kept, that we rescinded the 1-percent COLA decrease that 
was in the bipartisan budget agreement. But we did not go far enough. 
Men and women who are joining the military after January 2014 are still 
subject to that decrease in COLA.
  Are we in favor of keeping promises to all veterans, including the 
new members of the Armed Forces or are we not? Let us debate that 
issue. I believe that we keep our promises to all veterans. That is in 
the bill. If people want to oppose that, they have the right to oppose 
that.
  We have heard in several instances that the VA does not have the 
medical infrastructure to take care of the needs of veterans, and that 
is true. That is why in this bill we authorize the VA to enter into 27 
major medical facility leases in 18 States and in Puerto Rico--18 
States and Puerto Rico.
  So don't come forward and say ``gee, VA does not have the 
infrastructure to

[[Page S1031]]

take care of veterans needs'' but then vote against a provision that 
significantly expands VA health care capabilities. I talked a moment 
ago about what we mean by expanding VA health care. We do away with the 
absurdly complicated bureaucratic situation that now exists in which 
there are hundreds of different income eligibility standards in the 50 
States of the country. We reduce it to 50. In California or Vermont, 
you will know whether you are eligible for health care as a Priority 8 
veteran.
  Does it open the opportunity for more veterans to come into VA health 
care? It does. The reason is because VA provides good-quality health 
care to our veterans, which is why the veterans throughout this country 
whom I have talked to and in patient satisfaction surveys approve and 
are supportive of VA health care. More want to come into the system.
  We heard just how terrible and awful VA health care is, and then we 
heard: We don't want to open the doors because it is going to be 
flooded with new people coming into VA health care. You can't have it 
both ways. If VA health care is so terrible, why are you afraid of new 
people coming into VA health care? The answer is that if you go out to 
the veterans community, they will tell you: Yeah, there are problems in 
VA. But there are problems in every health care institution in this 
country. Over 30,000 Americans die every single year because they don't 
get to the doctor when they should because they don't have health care. 
I don't want any veterans to be part of that number.
  Hospitals all over this country are struggling with an epidemic of 
infections. The VA has done better than many other medical institutions 
in addressing that.
  In terms of telehealth--which is so important to veterans in my rural 
State and in rural States all over the country--guess which medical 
institution is leading the country in terms of telehealth. It is the 
Veterans' Administration. That means a veteran can walk into a VA 
community-based outreach clinic in rural West Virginia and have a 
teleconference with a specialist in any other part of the country. VA 
has been cutting-edge in terms of telehealth.
  We talk about medical technology and medical health care records. 
Guess which health care institution in America has led the effort in 
terms of medical and health care technology. It has been the VA.
  So I find it interesting that on one hand some of my colleagues tell 
us how terrible VA health care is, and on the other hand they are 
nervous that hundreds of thousands of veterans may want to access VA 
health care because, in fact, it is one of the best health care 
institutions in the country.
  Does VA have problems? Of course it has problems. I am not aware of 
any health care institution in America that does not have its share of 
problems. The difference between the VA and many private or nonprofit 
hospitals is--and it should be this way--by law, every problem at the 
VA makes it to the front pages. My guess is that if a hospital in West 
Virginia or Vermont screws up, they don't necessarily make it to the 
front pages. Because VA is public and by law they have to be 
transparent, they are on the front pages.
  In terms of advanced appropriations for VA, my friends on the other 
side have a bit of a problem with that. I don't. I find it interesting 
that when our Republican colleagues in the House shut down the U.S. 
Government because they don't like and wanted to defund ObamaCare, we 
were 7 days to 10 days away from preventing disabled veterans from 
getting the checks they need in order to survive. So I believe advanced 
funding for the VA to make sure that they are never put in that 
position again, that there is money in the bank to pay the benefits we 
owe to our veterans in the event of another government shutdown, is 
good public policy.
  As I mentioned earlier, when we talk about health care, in my view, 
we have to talk about dental care as well. If people do not have 
adequate dental care, it impacts their employability, say if they are 
missing front teeth. People get sick from infections if they don't have 
adequate dental care. I think we owe it to our veterans to make sure 
they do.
  This legislation provides a pilot project for 30,000 veterans to 
begin to access dental care within the VA. We will see how that pilot 
goes. I suspect we are going to see a huge need out there. And if some 
of my colleagues think veterans are not entitled to dental care, then 
we have a difference of opinion. That is fine. Let's debate it. But I 
think dental care is an intrinsic part of health care in general. I 
think we have a dental care crisis in the United States of America and 
within the dental community. Right now dental care is available to 
those veterans who have suffered service-connected dental problems but 
not available to veterans in general. I want to change that.
  I have heard the discussion about the backlog. Every Member of the 
Senate is concerned about the backlog. We have had hearings in the 
Senate about the backlog. I am really glad that today people are 
concerned about the backlog. I just wonder where they were 5 years ago 
when--before Obama became President--the VA was probably the largest 
institution in this Nation, if not the world, that still did all of its 
benefits processing work on paper, not digitally.
  When Secretary Shinseki became Secretary of the VA, he said: We are 
going to bring the VA into the 21st century. We are going to go from 
paper to digital, to an electronic system.
  That is what they have been doing, and what we have seen is real 
progress. Is it fast enough for me? No, it is not. But Secretary 
Shinseki has told me personally and our committee that they are on 
track, so by the end of 2014 all VA claims will be processed within 120 
days with 98 percent accuracy. That is pretty good. Just think for a 
moment what a huge task that is. Individual veteran files wider than 
this, with years and years of records, have to be put into a digital 
system. That is what they are doing, and they are making progress. In 
this legislation, we have brought forth Republican and Democrat ideas 
to make sure that they are, in fact, on target and that they reach the 
very ambitious goals Secretary Shinseki brought forth.
  So if you are interested in the claims backlog, vote for this 
legislation because we have bipartisan language in it to make sure 
veterans do not have to wait years to get their claims processed.
  My friend from Oklahoma said he is not sympathetic to the idea that 
veterans should pay instate tuition, which is essentially what we meant 
when we passed the post-9/11 GI educational bill. Every time we bring 
forth legislation, we hear all of the reasons why we should not go 
forward in providing services and benefits to our veterans.
  I would argue--and many economists would agree with me--that one of 
the most significant pieces of legislation passed in the modern history 
of the United States of America was the GI bill of World War II. That 
bill said to the millions of people who fought in World War II, in that 
terrible war: When you come home, no matter what your income is, you 
will be eligible to get a higher education. As a result of that 
legislation, millions of soldiers who returned were able to go to 
college. They became businessmen, they became doctors, they became 
lawyers. And one of the reasons the economy of the United States of 
America expanded significantly for the middle class was a direct result 
of that very important GI bill.
  What we said several years ago was that we should take that premise 
and apply it to the men and women who served post-9/11 in Iraq and 
Afghanistan. It was quite a political debate here. Some of my 
Republican friends had their doubts. We passed it, and today over 1 
million veterans and their family members are now getting a college 
education. In my view, that was exactly the right thing to do.
  One of the problems is that veterans move about. So if they go from 
the State where they have lived their whole life--for example, they 
lived in Vermont and go to California--and the GI bill promises them 
instate tuition, it turns out the tuition in the State they are in now 
may be a lot higher than in their home State and sometimes makes it 
impossible for them to go to college.
  We agree with virtually all the veterans organizations that the 
intent of the post-9/11 GI education bill was to

[[Page S1032]]

make sure they get instate tuition. So if somebody from California 
comes to Vermont, they get our instate tuition. If somebody from 
Vermont goes to California, they get their instate tuition. Not doing 
so denies many people a higher education.
  Previously, this Congress passed language which says that if you 
served in Iraq and Afghanistan, you are going to get 5 years of free 
health care, which was the right thing to do. It turns out not 
everybody learned about the benefit. Four or five years have come and 
gone. What we say to those veterans is, we are going to give you 
another 5 years to take advantage of that provision.
  Senator Murray from Washington--the former chair of the Veterans' 
Affairs Committee who preceded me--and Senator Reid earlier today 
talked about the employment situation for veterans. I think we all know 
we are in a tough economy. Real unemployment is close to 13 percent. 
Youth unemployment is higher. So when somebody who gets out of the 
service and comes home to look for a job--it is hard to do.
  I believe we have to do what we can to make sure that when people 
leave the service they can find a job. That is what this legislation 
does. We also want to make sure the skills acquired by the men and 
women of our Armed Forces while on Active Duty or in the National Guard 
become applicable to civilian life as well, and we have language in 
this bill that does that.
  There is another issue which I didn't hear my Republican colleagues 
talking about but which is a very important part of the bill. We have a 
situation where some 2,300 veterans who served in Iraq and Afghanistan 
have come back with a variety of wounds that make it impossible for 
them to have children. I will give one example.
  Army veteran Matt Keil of Colorado was wounded by sniper fire in Iraq 
in 2007. The sniper's round struck Matt's neck, causing severe damage 
to a vital artery and his spinal cord. Through sheer determination and 
with the love and resolve of his wife Tracy, Matt's condition improved. 
He and Tracy began to consider having children. Doctors assured them 
that having children could be possible with the help of in vitro 
fertilization. The Keil family paid more than $30,000 for reproductive 
treatments.
  In the legislation on the floor now, we say that is wrong. If a 
servicemember who was injured in war wants to have a family and is 
unable to have a family, we should make it possible for them to do so. 
If some of my colleagues on the other side disagree, that is fine. 
Let's have that debate. I think we owe it to the 2,300 men and women 
who were wounded in battle. They should have the opportunity to raise a 
family.

  We all know that one of the uglier aspects of military service in 
recent years has been the epidemic of sexual assault. When we send 
people into the military, we do not want to see men and women being 
sexually assaulted. I know the Department of Defense is working hard to 
address this issue, but the fact is that many veterans who came home 
from war were sexually assaulted. This legislation contains important 
provisions that would improve the delivery of care and benefits to 
veterans who experienced sexual trauma while serving in the military.
  This provision was inspired by Ruth Moore. She struggled for 23 years 
to receive VA disability compensation. This is a woman who was sexually 
assaulted and had a very difficult time proving that and getting the 
care she needed. We address that issue in this legislation.
  In 2010, the Congress took a very significant step forward in saying 
to family members who were caring for disabled vets that we understood 
how terribly difficult it is for them. There are wives, sisters, 
brothers, and other family members who, 7 days a week, 24 hours a day, 
are on call for veterans who have suffered serious injuries, and that 
is tough. That is very tough and stressful. There are wives and sisters 
and brothers out there who don't get any time off. They are on call 7 
days a week.
  We passed a caregivers act that provides a modest stipend. It 
provides training and time off for people who are caring for veterans 7 
days a week. It says, you can have a day off. We will send in a nurse. 
We did that for post-9/11 veterans. The truth is there are tens of 
thousands of families who are experiencing and going through the same 
issues and have been doing so for decades. I believe it is appropriate 
that we expand the caregivers act to every generation of veterans and 
make sure that those families get the help they need.
  I have heard some of my Republican colleagues say this legislation 
simply opens the door to every veteran in America to come in, and that 
when they come in, the quality of care is going to be diminished. That 
is simply an inaccurate statement, and I hope my colleagues read the 
legislation before they repeat that. It is not true. What we do is end 
the absurd and complicated situation of having hundreds and hundreds of 
different income eligibility standards. Instead of many hundreds of 
standards, there will be one in each State, and it will be the highest 
standard, which will mean that more veterans are able to come into VA 
health care. It does not open the door. We have been clear in saying we 
will not bring more veterans in until we make sure we have the 
infrastructure to deal with those veterans.
  Some people have said: Well, why do you want to bring more veterans 
into the VA? The answer is pretty simple. I talked to many veterans in 
Vermont who would like to get into VA health care because of the 
respect and the knowledge about the needs of veterans and the high 
quality of care they get, and the fact that there is a strong network 
of primary health care facilities all over the country which they can 
access.
  I will conclude for the moment by saying I very much appreciate the 
fact that every single Member of the Senate--I believe there were 99 
votes--voted to proceed on this debate. I look forward to this debate. 
It is an important debate. I look forward to serious amendments which 
address the needs of veterans. I think it would be very disrespectful 
to the veterans community if we started injecting into this debate 
totally extraneous and highly political and partisan issues.
  The issue of sanctions in Iran is a very important issue. People have 
honest differences of opinion. That is not an issue regarding VA health 
care. It is not an issue regarding the caregivers program. It is not an 
issue regarding dental care for our veterans.
  Let's respect veterans and have this debate on veterans issues and 
not on extraneous political issues which will divide us. Let's try to 
come together and not be divided.
  With that, I yield the floor and note the absence of a quorum.
  The PRESIDING OFFICER (Ms. Warren). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. RISCH. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                    Remembering Mayor Marsha Ogilvie

  Mr. RISCH. Madam President, I rise today to pay tribute to a 
distinguished Idahoan, Marcia H. Ogilvie, a loyal and steadfast mayor 
of Sandpoint, ID.
  On January 8 of this year Mayor Ogilvie lost a valiant battle with 
cancer, and my State lost a good friend, a champion for women and 
children, and a tireless public servant.
  Mayor Ogilvie was born at March Air Force Base in southern California 
and moved to the great State of Idaho in 1994. In the 20 years she made 
Idaho her home, she distinguished herself in service to others. As she 
once said--and many in Sandpoint now say--she won the hearts and minds 
of the people in Sandpoint.
  Elected mayor just 2 years ago, and having served the previous 2 
years on the city council, Mayor Ogilvie leaves a giant hole in those 
hearts and in the broader community. The business and professional 
experience Mayor Ogilvie brought was wide and varied and earned her the 
respect of many.
  Early in her career, she served in restaurant and retail management. 
When she and her husband Francis arrived in Sandpoint, they opened a 
couple of small businesses--the Candy Cottage and All Smiles, a gift 
shop. But Marsha Ogilvie was not just about business. She cared deeply 
about the health, welfare, and success of women and children.
  Soon after moving to Idaho, and well before entering public service, 
she established Kinderhaven, a nonprofit

[[Page S1033]]

community organization which is dedicated to supporting children in 
crisis. Founded in 1996, and under the vision and compassionate care of 
Marsha Ogilvie, more than 1,300 children have found the all-important 
help they needed in times of their great distress. So important to the 
Sandpoint community, Kinderhaven was named the grand prize winner in 
the 2002 Governor's Brightest Stars Awards.
  In addition, Mrs. Ogilvie, who crossed paths with many women serving 
as volunteers in the Sandpoint community, started Women Honoring Women. 
It was designed to be a one-time event, but it has evolved since 1999 
into an annual event to recognize and honor women in Bonner County, ID. 
It recognizes women 65 or older who are working to make a difference in 
the lives of others, who love to learn, and who exhibit qualities of 
leadership.
  Marsha Ogilvie recognized these qualities in others because she too 
possessed them--well, all but one. She was only 64 when she passed 
away.
  If these achievements were not enough, Marsha Ogilvie joined with 
three friends to co-author a children's book which was just recently 
published. ``Gigi's Enchanted Forest'' was a way to honor the life of a 
mutual friend of theirs who shared their hope for and love of children 
and a dedication to community service.
  Mayor Marsha H. Ogilvie personified a life of giving and caring. Her 
unparalleled legacy of hard work, reaching out to her community, and 
recognizing those who help others in volunteer service is indelibly 
etched on the hearts and minds of those she served in Sandpoint, ID, 
and far beyond the city limits.
  May God bless her husband, her family, and the hundreds of Idahoans 
who will miss her passion, exuberance, and spirit of joy.
  I thank the Presiding Officer and 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. BARRASSO. 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. BARRASSO. Madam President, I ask unanimous consent to speak for 
up to 15 minutes as if in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Health Care

  Mr. BARRASSO. Madam President, late in the day on Friday--after 
reporters had gone home for the weekend--the Obama administration 
quietly released its new Medicare Advantage payment rates. The cuts the 
President wants to make to this program are potentially devastating to 
millions of Americans.
  The next morning the New York Times' headline read: ``U.S. Proposes 
Cuts to Rates in Payments for Medicare.''
  Politico wrote about it too. They said:

       The Obama Administration is proposing a major cut in 2015 
     payments to Medicare Advantage.

  Fifteen million Americans depend on these health insurance plans the 
President wants to cut.
  Instead of listening to seniors and investing in a program that works 
well, the Obama administration is doing everything conceivable to make 
sure Medicare Advantage fails.
  Back in December the press gave President Obama the Lie of the Year 
Award for his statement that if you like your health care plan, you can 
keep it. Millions of people across America have now gotten letters 
saying their insurance plans are being canceled because of the 
Democrats' health care law. By cutting Medicare Advantage, I tell my 
colleagues, the Obama administration is now ensuring that even more 
Americans can't keep the health care plan they like.
  Twenty-nine percent of all Medicare patients have chosen to enroll in 
Medicare Advantage. There is a reason for that. The Medicare Advantage 
Program lives up to its name by delivering clear advantages. The plans 
give extra benefits such as dental coverage, vision coverage, hearing 
benefits, wellness programs, and other benefits that are important to 
our seniors. Sometimes they offer smaller copayments, lower 
deductibles, and less out-of-pocket costs than the traditional Medicare 
Program does. Sometimes seniors even pay a higher monthly premium for 
these extra benefits, but often the benefits are financed through plan 
savings due to the programs and the way they work.
  For many seniors Medicare Advantage is a good option. It is the right 
option for them. These are people who don't have a lot of money but who 
still want the peace of mind that comes with good health insurance. 
Those seniors are now facing much higher costs or lower benefits 
because of the Obama administration's decisions rolled out last Friday 
night. Because of this proposal and the administration's way to try to 
sneak it out on Friday, seniors are concerned and anxious about what 
the administration is also hiding.
  Ever since the President and Democrats in Congress passed their 
health care law, they have been going after seniors who rely on 
Medicare. They raided a total of over $700 billion from Medicare--and 
we discussed that during the debate over the health care law. The money 
was taken from seniors on Medicare not to strengthen Medicare, not to 
secure the future of Medicare but to start a whole new government 
program for other people. There is a whole new bureaucracy, and it has 
been created by Washington Democrats in the health care law.
  ObamaCare specifically targeted the Medicare Advantage Program, 
significant amounts of direct and indirect payment cuts totaling over 
$300 billion. That is 43 percent of the total Medicare cuts, just for 
this one program. So 29 percent of America's seniors rely on Medicare 
Advantage. Because about 29 percent of seniors on Medicare are in 
Medicare Advantage, they are responsible for 43 percent of the cuts.
  Because of these cuts and other changes in the law, fewer private 
health care plans are going to be able to participate in Medicare 
Advantage in the future. That means a number of things. It means some 
people who rely on these plans are going to find out their plan is 
being canceled entirely. Some people in Iowa--thousands of people in 
Iowa--have already gotten letters canceling their Medicare Advantage 
plan.
  The Kaiser Family Foundation looked at what the President's health 
care law does to seniors and they said that about a one-half million 
patients will lose their existing coverage--seniors on Medicare 
Advantage. These seniors are going to have fewer options to get the 
care they need from the doctor they choose at a lower cost. More of 
these people are going to be forced into a one-size-fits-all government 
plan. They are going to lose the insurance they had, insurance they 
liked and that worked for them.
  Some people may find their new insurance network doesn't include the 
doctors they had before. We have seen this happening all across the 
country. As the major provider of Medicare Advantage had to try to make 
it all work, they had to eliminate many doctors from their plans, so 
that those doctors are not going to be able to keep their patients and 
those patients are not going to be able to keep their doctors, in spite 
of what the President told the American people when he looked into the 
camera and said: If you like your doctor, you can keep your doctor.
  A lot of these people are going to see their costs increase. The 
Kaiser Family Foundation says the average out-of-pocket limit for 
Medicare Advantage plans is going to increase by $464 this year. The 
President and Washington Democrats said their health care plan was 
going to save people money. That is what the President told the 
country. That is why he said he did this whole health care law. He said 
it was going to save people money. That is what people wanted. The 
President told people what they wanted to hear, but he failed to give 
them what he promised. That is why his credibility ratings are down. 
That is why people believe he misled them intentionally, and that is 
why this administration is viewed to be incompetent by a majority of 
Americans. It turns out costs continue to go up because of the law.
  This new round of cuts to Medicare Advantage is just another example 
of how the health care law is wrecking our health care system, not 
fixing it. America's health care system wasn't working before, but the 
President and the law Democrats voted for has made it worse.

[[Page S1034]]

  Medicare is headed toward bankruptcy, but the Obama administration 
has rejected bipartisan solutions to reform and to strengthen the 
program. Through cuts such as the ones announced last Friday, the 
President's health care law takes money from Medicare and uses it to 
pay for something else.
  There was actually a double data dump that occurred on Friday: the 
Medicare Advantage cuts that were announced late in the day, and then 
later than that the CMS--the Medicare/Medicaid services for the 
country--came out with their report and it reported that two-thirds of 
small businesses that provide health insurance for their employees 
would see their prices go up because of the health care law--two-thirds 
of small businesses. These are ones that by law don't have to provide 
health insurance--with employees of less than 50, they don't have to, 
by law, supply it, but they often do supply it. They do supply that 
insurance. I think about 17 million people get insurance that way, 
through work--businesses that are not mandated to supply the insurance, 
but they do it to get good workers. As a result, what they are seeing 
is that their rates are going up.
  So that was part of the double data dump that occurred on Friday.
  It was interesting to see a note that came out of the Democrats' 
lunch meeting today. It was just reported in Roll Call magazine. It 
said: ``A group of Senate Democrats is expected to launch a 
counteroffensive in favor of ObamaCare on Wednesday, a response to 
persistent attacks on the law from their Republican counterparts.''
  First, I will point out the attacks on the law are coming from 
American citizens all around the country. It is what we hear at 
townhall meetings and it is what we hear as we travel around the 
country, people whose families are noting that they are paying more and 
getting less, losing their doctors and losing their insurance. But the 
report in Roll Call says:

       Democrats discussed the new endeavor touting benefits of 
     the Affordable Care Act during Tuesday's weekly caucus lunch 
     to a warm reception, according to Connecticut's Christopher 
     S. Murphy, who is one of the senators leading the effort. A 
     Senate Democrat aide said the formal rollout will come 
     Wednesday.

  I welcome the opportunity to hear what the Democrats have to say 
because the damage being done by this health care law to people all 
across the country is significant.
  It is interesting because all we need to do is turn to Friday's New 
York Times, Robert Pear, an excellent writer for the Times, who had, I 
thought, a fascinating story. He took two pages of the paper: ``Public 
Sector Capping Part-Time Hours . . . '' Public sector capping part-time 
hours. Why? Right here in the headline: ``to Skirt Health Care Law.''
  Let me start: ``Cities, counties, public schools and community 
colleges around the country''--we are not talking about businesses or 
fast food chains; we are talking about cities, counties, public schools 
and community colleges around the country--``have limited or reduced 
the work hours of part-time employees . . .'' Why? ``to avoid having to 
provide them with health insurance under the Affordable Care Act, state 
and local officials say. The cuts to public sector employment, which 
has failed to rebound since the recession''--it says right here--
``could serve as a powerful political weapon for Republican critics of 
the health care law, who claim it is creating a drain on the economy.''
  It is creating a drain on the economy. We have two folks in the 
picture in Medina, OH, working on a trash truck. One of the gentlemen 
talks about his hours being limited to 29 hours. He called it ``a hit 
to his wallet.''
  The President is fighting to talk about raising the minimum wage, 
when people are actually losing take-home pay. It is impacting their 
wages, the health care law is. It is impacting how much money they take 
home at the end of the week.
  The next page talks about somebody who works as a clerk in the parks 
department saw her hours drop from 38 a week to 35 and then to 29. Why? 
Because of the health care law and the 30-hour limit.
  It is interesting to go through the list of the different jobs of 
people who are losing hours, who want to work. These are hard-working 
Americans who are having their hours cut--public sector workers, people 
who work for cities, counties, public schools, community colleges. The 
list goes on: police dispatchers, prison guards, substitute teachers, 
bus drivers, athletic coaches, school custodians, cafeteria workers, 
and part-time professors; office clerks, sanitation workers, park 
inspectors--all in all, people who are being hurt because of the 
President's health care law and the mandates and the way it is put 
together by this President and the Democrats who voted for it.
  It is interesting to see the Senator from Connecticut mentioned here 
as leading the effort, and I would recommend to him this article by 
Robert Pear in Friday's New York Times, who goes specifically to the 
core of what is happening in Connecticut, in that Senator's home State. 
It says:

       Mark Benigni, the superintendent of schools in Meriden, 
     CT--a public school, public sector--and a board member of the 
     American Association of School Administrators said in an 
     interview that the new health care law is having ``unintended 
     consequences for school systems across the Nation.''

  This health care law is full of unintended consequences. Now we have 
someone who is a board member for the American Association of School 
Administrators saying that the health care law is having unintended 
consequences for school systems across the Nation. He specifically 
says, in Connecticut, as in many States--this is the article now:

       In Connecticut, as in many States, significant numbers of 
     part-time school employees work more than 30 hours a week and 
     do not receive health benefits.

  Quoting the superintendent in schools in Meriden, CT:

       Are we supposed to lay off full-time teachers? Are we 
     supposed to lay off full-time teachers so that we can provide 
     insurance coverage to part-time employees?

  The superintendent goes on to say:

       If I had to cut five reading teachers to pay for health 
     benefits for substitute teachers, I am not sure that would be 
     best for our students.

  So I would ask the President of the United States: What do you want? 
These are the choices that because of your health care law, crammed 
down the throats of the American people, you are asking the public 
sector of our country to make. Get rid of five reading teachers in 
Meriden, CT, to pay for expensive health insurance policies for 
substitute teachers. That superintendent is trying to say, I am not 
sure that what the law requires would be best for our students.
  I think this law was not well-thought-out, was not well planned. So I 
will be interested tomorrow to see Senate Democrats come to the floor 
with their ObamaCare PR counteroffensive and explain to the American 
people why they are being faced with a disastrous Web site rollout 4 
days after the President told the American people it will be easier to 
use than Amazon and cheaper than your cell phone bill and you can keep 
your doctor if you like your doctor. Let them explain why 5 million 
people then got letters from insurance companies saying their insurance 
policies have been canceled; why the Web site failure is just the tip 
of the iceberg that the American people are seeing right now in terms 
of premiums going up, canceled policies, can't keep their doctor, 
higher out-of-pocket costs, higher copays, higher deductibles, all in 
spite of the President's glowing promises which, in my opinion, were 
made to deceive the American people in an effort to pass a health care 
law which many people see as bad for patients, bad for providers, and 
bad for the taxpayers.
  I will continue to come to the floor and talk about what I hear as I 
go home to Wyoming each week in terms of a health care law which is not 
providing the patients what they asked for, what they need, and what 
they were promised.
  Thank you. I yield the floor.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Madam President, I wish to thank my colleague Senator 
Barrasso for coming to the floor, and now I would like to give a second 
opinion to what he has just said.
  He said he wants to wait until tomorrow to hear some success stories 
about the Affordable Care Act. I am going to give him a preview 
tonight.

[[Page S1035]]

  Ray Romanowski--62 years old, city of Chicago, musician, part-time 
employee, barrel-chested Polish guy who belongs in the city of 
Chicago--sat next to me at a clinic, patted his wallet and said: Guess 
what, Senator. I have health insurance for the first time in my life, 
and it feels good.
  Judy takes care of hotel rooms down in southern Illinois, a place 
that I stay. She is over there in the hospitality room. Same story: 62 
years old, worked every day she could and never had health insurance 
one day in her life. She was diagnosed with diabetes and, thank God, 
she now has, because of the Affordable Care Act, health insurance.
  Those are just a couple of stories.
  What the Senator from Wyoming did not tell you is that there are 
aspects of this Affordable Care Act which American families value. Do 
you have a child in your family who is sick with maybe asthma, 
diabetes? Is your wife a cancer survivor? In the old days before the 
Affordable Care Act, that meant it would be hard to get health 
insurance and, if you could, it would be very expensive.
  So we changed it. We said: You cannot discriminate against families 
because somebody happens to be sick. Those of us who have raised 
families know that happens pretty regularly. So that protection is in 
the law, and it is a protection which some of the absolutists want to 
repeal. Get rid of it. Let's get back to the good old days when a sick 
child would basically disqualify a family from health insurance.
  It used to be that insurance companies had odd ways of basically 
rating people when it came to premiums. One of the disabilities they 
identified was if the person seeking health insurance was a woman. They 
would discriminate against women seeking health insurance because it is 
possible they would become pregnant and more expensive. We did away 
with that discrimination as well.
  Then there were lifetime limits. Madam President, $100,000 in health 
insurance coverage may sound great, but if you go into the hospital or 
see the doctor the next day and you are told you have cancer and have 
to face radiation, chemotherapy, and more, $100,000 will not last very 
long, and pretty soon you are into life savings and pretty soon after 
that you are into bankruptcy, something the Presiding Officer knows 
very well.
  So we eliminated the lifetime limits on health insurance policies as 
part of the Affordable Care Act. I do not hear the Senator from Wyoming 
and others suggesting they want to go back to those days. Do they?
  The bottom line is this: The Affordable Care Act is a good law. We 
wrote it and passed it without the help of any Republicans. Not a 
single one of them would step up and join us in this effort. Now they 
have done nothing for the last 4 years but criticize it.
  I will say this. It is not perfect. It can be improved. I will invite 
the Senator from Wyoming, who is a medical doctor and a man I respect, 
to join us in improving it. Let's find a way to make it better. Let's 
fix it. There are things that can be fixed into law. That is what 
people sent us here to do. We can give speeches about how good or bad 
it is, but most Americans want it to work. They want health insurance 
that is affordable and available and accessible, and they want to make 
sure they are going to be treated fairly once they buy it.
  I think the marketplaces we will tell you about are working for a lot 
of families, and we are going to come to the floor to tell those 
stories. I know the other side spent a long time talking about what 
they consider to be shortcomings, and there are some obvious 
shortcomings with the Affordable Care Act. The rollout was a disaster. 
Anybody who says otherwise was not paying attention. For 60 days we 
worked to get our Web sites up and running, and some of them still 
leave room to be desired, leave room for improvement.
  But I talked to a businessman in Chicago last week, and he said: It 
is a good thing my business failures are not on the front page of the 
paper every day because I have made a lot of mistakes, but I keep going 
until I get it right. That is what we ought to do, keep going until we 
get it absolutely right.
  We have a good start, trying to bring 60 million uninsured Americans 
under protection of health insurance, to allow people to shop for the 
best policy for their family. That is realistic.
  I also want to add one thing. The critics of the Affordable Care Act 
assume that before we passed it, health insurance premiums did not 
increase. We know better. Particularly for those who had small 
businesses and individuals, their policies were canceled on average 
once every 24 months, and their health insurance premiums went up 12 to 
20 percent.
  A friend of mine has a small trucking company. He tried to cover his 
employees who worked for him and their families until one of the 
employees had a sick baby, and then the health insurance premiums went 
through the roof and they all were out on their own. With the help from 
the employer--what he used to pay each month--they had a helping hand 
looking for health insurance.
  He went to buy health insurance for himself--himself, the owner of 
the company--and his wife. It turned out that if you turned in a claim 
this year for a problem you had with your foot, next year that company 
health insurance plan--the one he bought--would not cover anything 
related to your feet. So you slowly exclude all the possible claims 
that can be made for profitability. Then, in the end, you have a 
worthless health insurance policy.
  Those were the old days. I would say to the Senator from Wyoming and 
his friends, we are not going back to the old days. We can improve this 
law. Let's work together to do it. But we are not going back to the 
days of discrimination based on preexisting conditions, lifetime limits 
on policies, discrimination against women, excluding children from the 
health insurance of their families--the things that really were wrong 
with the system.
  Help us make it better, but do not just come here and complain. I 
think people expect us to be more positive and constructive.
  Madam President, I rise in strong support of the Comprehensive 
Veterans Health and Benefits Act of 2014. Chairman Bernie Sanders of 
Vermont has put together a comprehensive improvement, which I support. 
He is new as chairman, but he is off to a flying start.
  The bill reminds us of our obligations to veterans. I especially 
appreciate that he worked with me on a few priorities. It authorizes a 
new $10 million initiative in prosthetics and orthotics. Limb loss is 
one of the signature wounds of Iraq and Afghanistan. There are not 
enough medical professionals with the expertise needed to fit veterans 
with the best orthotic or prosthetic for their injuries.
  Now the Department of Veterans Affairs can partner with universities 
to expand the number of master's degree programs so our wounded 
warriors continue to receive the best care.
  This veterans package also addresses a problem I have been working to 
fix that allows veterans to consolidate student loans or participate in 
student loan forgiveness without penalty.
  Congress capped the interest rate for servicemembers at 6 percent 
several years ago, but a loophole has prevented servicemembers from 
keeping that protection if they consolidate their student debt or 
enroll in the Public Service Loan Forgiveness Program. This bill closes 
that loophole.
  The bill makes sure veterans using their GI bill education benefits 
will pay instate tuition rates. Senator Sanders has a good bill when it 
comes to student loans.
  There is one provision in it of special interest and importance to 
me. Several years ago one of our colleagues, a Senator from New York by 
the name of Hillary Clinton, came up with a great idea. Senator Clinton 
said: We ought to help the caregivers for disabled vets. I liked the 
idea a lot and was kind of envious that she came up with it first. Then 
she moved on to be Secretary of State. So I called her at the State 
Department and asked: Hillary, is it OK if I take up your bill on 
caregivers? She said: Be my guest. And I did. I introduced the Hillary 
Clinton caregivers bill, and ultimately, with the help of Senator Akaka 
and others, we passed it.
  Here is what it says. If you had someone who was injured after 9/11 
and disabled and you were prepared to give them care, we are going to 
help you. For that wife who stands by her husband, a husband who stands 
by his wife, a mother or father helping the disabled

[[Page S1036]]

vet, here is what we will offer to you: first, the very best in skilled 
nursing training so you know how to take care of your veteran and do it 
the right way; secondly, a respite. Two weeks out of the year you get a 
vacation. We are going to send in some skilled nurses so you can go off 
and relax. You deserve it after spending 50 weeks caring for this 
veteran. Third, if you are in a bind economically, financially, we want 
to make sure you are going to have enough money to survive. So we 
offered a monthly stipend to those caregivers who are helping.
  Let me tell you some stories that I think illustrate this so well, 
why it is important and why it is working.
  In 2005, Eric Edmundson was a 26-year-old Army sergeant when he 
survived a roadside blast in Iraq. He went into cardiac arrest while 
waiting for a transport to a military hospital. His brain was deprived 
of oxygen for almost 30 minutes. He became a quadriplegic as a result 
of the injuries.
  The VA basically told Eric's parents Ed and Beth that there was no 
hope and no place to turn. The doctors said Eric would spend the rest 
of his life in a vegetative state and he should be sent to a nursing 
home. His dad said not only no, but hell no, this is my 26-year-old 
son, and I am not giving up on him.
  So Eric was transferred to the Rehabilitation Institute of Chicago, 
which is where I first met him. His recovery was incredible. His mom 
and dad stayed by their son's side until the day when we proudly 
watched Eric, with a helping hand, literally walk out of the hospital 
in his dress uniform--a sign of dramatic progress in just a few months.
  Today, he is living in North Carolina with his wife and two 
children--beautiful kids. His parents are his full-time caregivers, and 
they share their home with Eric and his wife.
  But even these family caregivers like Ed and Beth need a helping 
hand. They told me about Hillary Clinton's bill, and they got me 
started. I am glad they did. Because now that it has become the law, 
12,000 families just like theirs across America are getting the helping 
hand of the caregiver program. It helps the veterans from Iraq and 
Afghanistan, with their families, be where they want to be: at home 
with their families. If you want to get down to the bottom line, it 
saves the government money. It costs a lot more money to put people in 
VA facilities than to help these families keep the veterans at home 
where they want to be.
  Let me show you one other one, which I think is a great story. This 
is the story of Yuriy Zmysly, who was a marine serving in Afghanistan 
and Iraq. He returned to the United States for what was going to be a 
routine surgery at a military hospital, but because of complications 
from the surgery, from an appendix procedure, he was left with a severe 
brain injury.
  Aimee--who is shown right here in this picture--was his fiance at the 
time. When Yuriy reached the point where he came out in a state where 
he was in a wheelchair and struggling, Aimee said: I promised you I 
loved you and I was going to marry you and we are going through with 
it. And she did. She married Yuriy and stood by his side. They have a 
beautiful daughter Adelina, whom I met just a couple weeks ago in 
Chicago. She is 4 months old. It is for caregivers such as Aimee, who 
dropped everything and even dropped out of school to help care for this 
disabled vet Yuriy that this program is designed.
  I am proud of this program. I think the 256--I think that is the 
right number--caregiver families in Illinois have a special helping 
hand as they help our disabled vets. We need to expand it. Bernie 
Sanders does just that. He expands this program beyond those veterans 
who were afflicted after 9/11 to those who were afflicted before, from 
previous conflicts, from previous service to our country.
  This caregivers program is the right thing to do. These men and women 
who care for our disabled vets are truly saints and angels, and we 
ought to stand by them. Giving them a helping hand through this 
expansion of the caregivers program is right for America, it is right 
for our vets, and it is right for us to do for the men and women who 
risked their lives for our country.
  I yield the floor and suggest the absence of a quorum.
  Mr. BURR addressed the Chair.
  The PRESIDING OFFICER. Will the Senator withhold?
  Mr. DURBIN. I withhold.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mr. BURR. Madam President, I thank my colleague from Illinois, and I 
should have told him I was going to come out to be recognized. Let me 
thank him because he has raised a very important issue on caregivers.
  I also want to thank him for the interest he took in Eric Edmundson, 
who is from North Carolina. I might add to the story, for my 
colleagues, there was not a caregiver program when Eric Edmundson's dad 
took over his care. He did what I think parents have a tendency to do. 
He said: It can be better for my son if I take control of it--and he 
ended up in Illinois at his dad's request. Although he has not made a 
full recovery, he has made a spectacular recovery from the prognosis. I 
know my good friend from Illinois has to go, but I appreciate him 
highlighting that.
  Let me just say that I think all Members of the Senate would like to 
expand the caregivers program. I wrote the caregivers program. Senator 
Akaka, who was then the chairman, came to the floor and it was passed. 
As written, section 303 would expand the caregivers program to veterans 
of all eras. Let me say that again: Veterans of all eras we would 
extend the caregivers program to if the Sanders bill was passed.
  I have the alternative bill, which is in the process of being filed. 
It does not expand the caregivers program--a program I am passionate 
about. I wrote it. It does not do it for a reason, and I want to turn 
to Senator Akaka's comments on the Senate floor when we passed this 
bill, where Senator Akaka, the chair of the Senate Veterans' Affairs 
Committee, said this:

       [O]ne, the needs and circumstances of the newest veterans 
     in terms of the injuries are different--different--from those 
     of veterans from earlier eras; two, the family situation of 
     the younger veterans is different from that of older 
     veterans; and three, by targeting this initiative on a 
     specific group of veterans, the likelihood of a successful 
     undertaking is enhanced.

  To me, the most important of these reasons mentioned by Senator Akaka 
was the belief that the VA would not be able to implement a program of 
that magnitude. That is why caregivers was crafted to be a program that 
we ramped up over time. It was targeted at a very specific population, 
and we envisioned that as the VA got more proficient at actual training 
and implementation of this program, it would be ramped up.
  The VA has proven us right. They have had trouble in implementing 
this program in what is a very limited program. Their rollout and 
management of the program has been flawed in several areas and has been 
a disservice to those veterans in need of these critical services. 
Since the start of the program 2\1/2\ years ago, several problems have 
been brought to my attention. These problems include decisions 
regarding eligibility for the program which are inconsistent across the 
country--no quality assurance program to monitor the quality, 
consistency and timeliness of those decisions, and no formal process to 
appeal the decisions of eligibility for caregiver assistance.
  Let me highlight the issues with this program. I want to share some 
stories of veterans' experiences. A veteran applied to the program at 
the VA in Colorado. His application was denied. Yet, after moving from 
Colorado to Florida, he applied again using the exact same information 
he had previously submitted in Colorado. The VA in Florida granted his 
application. How can this happen? It is because we have an agency that 
has yet to draw on the consistency needed to apply equally to our 
veterans.
  Another veteran in Florida suffered from multiple gunshot wounds 
resulting in paraplegia. VA denied him entry into the program because 
he did not require assistance with at least one activity of daily 
living or ADL. He was being compensated through an aid and assistance 
or A & A program. I find it interesting that this veteran did not 
qualify for caregivers. He was actually compensated under the aid and 
assistance program because what he needs is ADL services, not just the 
one required under the caregiver program.
  In addition, I have also heard many veterans and their caregivers 
were

[[Page S1037]]

treated rudely by the VA staff when applying to these programs for a 
PTSD diagnosis. VA staff have told them that PTSD--get this--that PTSD 
is not a disability that requires assistance with ADLs or activities of 
daily living.
  Assistance with the activities of daily living is only one of the 
four criteria needed as having a serious injury. Under the law, a 
veteran needs to meet one of the four. Even the appeals process does 
not seem to be well thought through. You see, we can write the laws, 
but it is the agency's regulations that they write that dictate how 
these programs are run.
  VA says that they have an appeals process. However, it is vastly 
different from the appeals process at VBA, the Veterans Benefit 
Administration. It leaves Veterans Service Officers or VSOs at a 
disadvantage to help veterans and their caregivers. VSOs have been told 
that VA considers it a medical decision and they cannot question the 
denial. The only recourse veterans and their caregivers have is to 
appeal to the medical center director. The problem with this is that it 
was the medical center director who denied the appeal in the first 
place.
  I am going to go on as the days go on, describing the things in this 
program that we would all like to embrace, things that I think every 
Member of the Senate says: Yes, we ought to do this for veterans. Here 
is the problem. If we have a broken system, jamming more people into it 
is actually the worst thing we can do.
  As I said earlier, there is nothing in the Sanders bill to fix the 
things that are broken at VA. There is nothing in the alternative bill 
to fix things in the VA. But the one thing that I do not do in the 
alternative bill is I do not jam millions more veterans into the 
system. Caregivers should be expanded as VA perfects how to implement 
it, to educate the caregivers, to be able to address the concerns, and, 
more importantly, the intent of why we wrote the program.
  Enrollment or access to VA should only open if we have the health 
care professionals or the facilities to handle them, but not to crowd 
out those current veterans who leave the battlefield today and need the 
services that only the VA can provide. So, even though in everybody's 
wish list we would like to expand to every veteran, in the caregiver 
program we would like to expand to everybody who wants to care for a 
loved one, the truth is, we do the ones who are in the system an 
injustice if we are not prepared to be able to implement it, to handle 
it. That is the difference between the Sanders bill and my alternative. 
We simply look at the things that have bipartisan support, but do not 
necessarily grow the problem worse than it is today.
  I said earlier, my regret--and I see my colleague from South Carolina 
is here. My regret in this debate is that we are not on the Senate 
floor debating reforms to the Veterans' Administration. I think the 
presiding officer would agree that there are areas--these are areas 
that do not have a partisan leaning. When we look at our Nation's 
veterans, we do not see one side of the aisle or the other. We see a 
promise we made to them and a commitment we have got to fulfill.
  To ignore the things that need reform really is a mistake. To talk 
about expanding the population without reforming these areas, quite 
frankly, is disingenuous to the veterans to whom we owe so much.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from South Carolina.
  Mr. GRAHAM. Madam President, I ask unanimous consent to speak for 15 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRAHAM. Madam President, one, I would like to compliment Senator 
Burr for trying to find a way to improve veterans health care. I think 
the comment he made is pretty accurate. Before you expand a system that 
is clearly broken, it looks to me like you would want to fix it.
  There is a bipartisan view that it is broken. A lot of solutions have 
bipartisan support. But we are where we are. I know Senator Sanders is 
very genuine about wanting to expand veterans' benefits. I certainly 
understand where Senator Burr is coming from. We want to, one, pay for 
whatever we do, because we are $17 trillion in debt. But, two, we have 
to look at the broken system. If you include another 14 million 
veterans, people who are not service connected and make them overnight 
eligible for VA health care that is in short supply, you will frustrate 
the ones who need it the most and take a weak system and completely 
break it. It seems to me that is not helping veterans at all.
  But part of the package that Senator Burr has authored also deals 
with another problem of great and immediate concern: imposing sanctions 
on the Iranian nuclear program if the negotiations fail to deliver the 
desired result.
  This is an unfortunate moment for me. Senators Menendez and Kirk have 
been a team for a long time working to impose sanctions on the Iranian 
government as they march toward a nuclear weapon. We have imposed 16 
rounds of sanctions since 1987; 9 U.N. Security Council resolutions 
since 2006, demanding the full and sustained suspension of all uranium 
enrichment related and reprocessing activities and its full cooperation 
with the IAEA.
  This body has been bipartisan when it comes to the Iranian nuclear 
program and our support for Israel. Senator Menendez has been one of 
the leading voices in the entire Congress. He deserves lots of credit. 
He is my friend. We have a new round of sanctions that are bipartisan. 
We have 17 Democratic cosponsors. We have all but two Republicans. So 
we have 59 cosponsors that would allow sanctions to be available and in 
place if we do not reach a final deal in this round of negotiations in 
the P5+1.
  Why is it important that the Congress reimpose sanctions through new 
legislation if there is failure? No. 1, the sanctions are designed to 
get the end game right. I believe that the only successful outcome 
through negotiations would be to dismantle the plutonium-producing 
reactor. The Iranians do not need a plutonium-producing reactor for a 
civilian nuclear power program to comply with the U.N. resolution that 
requires the removal of all highly enriched uranium. A lot of highly 
enriched uranium is now in the hands of the Iranian government. The 
U.N., of all bodies, has asked for it to be removed and turned over to 
the international community.
  I worry that if you leave this highly enriched uranium in place in 
Iran, we will live to regret it. A dirty bomb becomes a real 
possibility. The other aspect of a final deal that has to be 
accomplished, in my view, is that the Iranian regime should be out of 
the enrichment business.
  There are 15 nations that have nuclear power programs that do not 
enrich uranium. Mexico and Canada are two of those nations. We are 
objecting to the South Koreans who want to go into the enrichment 
business. I do not mind South Korea having a nuclear power program, but 
we really have to watch the spread of nuclear proliferation through the 
enrichment of uranium.
  It is imminently possible to have a nuclear power program and have 
the fuel cycle controlled. You do not need to enrich to have commercial 
nuclear power. If you were going to make a list of countries that are 
unreliable and dangerous, and you would not want to give the right to 
enrich, I think Iran would be at the top. Just look at how this regime 
has behaved over the last 30 years. I do not have to time to go into 
all of the ``list of horribles,'' but our resolutions regarding the 
Iranian nuclear program list them very well.
  So we are at an impasse now. The Republican position is that we 
should have a new sanctions vote on the bipartisan sanctions bill now 
while the negotiations are going on to reinforce to the international 
community that we are very serious about pressure being applied to the 
Iranians until we get the deal that we all can live with. I think it is 
fair to say that the Iranians would not be in negotiations without 
crippling sanctions.
  I want to give credit to the Obama administration for implementing a 
sanctions regime that really did cripple the Iranian economy, and it 
has gotten them to the table. Unfortunately, the interim deal has 
absolutely undercut all of our gains. I will give you some details as 
to why all we have accomplished has been undercut and the sanctions 
regime that got the Iranians to the table is crumbling before our eyes.

[[Page S1038]]

  Here is what our allies in Israel say. The prime minister of Israel 
said: ``Iran got the deal of the century, the international community 
got a bad deal.'' I think he is absolutely right. Under the interim 
deal, not 1 ounce of highly enriched uranium is required to be taken 
out of Iran. Some of it would be chemically altered, and you can 
reverse that chemical process so that it could be processed for weapons 
use later down the road.
  Not one centrifuge has been destroyed. Of the 16,000 to 18,000 
centrifuges, not one has been destroyed. The plutonium-producing 
reactor is not being dismantled. It has been mothballed, for lack of a 
better word. I am not so sure it is even in a mothball status.
  So the prime minister of Israel says: ``Iran got the deal of the 
century, the international community got a bad deal.'' Again, I would 
agree. Nothing has been accomplished in the interim deal. The interim 
deal is so far away from a final deal, I do not see how you get there.
  We have to dismantle the plutonium reactor completely, not just stop 
its construction or delay its construction. We should remove all of the 
highly enriched uranium out of the hands of the ayatollahs because it 
is too dangerous to leave it there. The U.N. agrees with that. That is 
the end position. They should not be allowed to enrich. If the Iranians 
want a peaceful nuclear power program, I will be the first to say: That 
is fine. Build a reactor in Iran. Build a couple of reactors if you 
like. Have the Russians help the Iranians construct their reactor, as 
long as the international community can control the fuel cycle.
  There is no need to enrich in Iran for a peaceful nuclear power 
program. We would be crazy as a nation and a world to give this regime 
the right to enrich uranium and have a breakout, to go from low-level 
enrichment to 90 percent, to make a nuclear weapon. I think that is 
what they are trying to do. I would like every Senator to be able to 
answer a question from their constituents about this issue. Do you 
believe the Iranians have been trying to build a nuclear bomb rather 
than a nuclear power program?
  It is clear to me they have been trying to build a nuclear bomb for a 
very long time. They get right up to the edge. They have one of the 
most sophisticated enrichment programs in the world. I do not think it 
is designed to produce peaceful nuclear power.
  Here is what the head of Iran's nuclear agency said last night:

       The iceberg of sanctions is melting while our centrifuges 
     are also still working. This is our greatest achievement.

  He is right. I mean, what more can I say? The head of the Iranian 
nuclear agency, said on Iranian state television:

       The iceberg of sanctions is melting while our centrifuges 
     are also still working. This is our greatest achievement.

  This is what the foreign minister said:

       The White House tries to portray it as basically a 
     dismantling of Iranian's nuclear program.

  The interim deal--

       We are not dismantling any centrifuges, we're not 
     dismantling any equipment, we're simply not producing, not 
     enriching over 5 percent.

  They are telling us and the world, with this interim deal, they are 
not dismantling a damn thing.
  President Rouhani, the new moderate--if you believe that, I have some 
property I want to sell you--said on CNN: ``So there will be no 
destruction of centrifuges--of existing centrifuges?'' President 
Rouhani said: ``No. No, not at all.''
  Well, if you believe, as I do, they should be out of the enrichment 
business, then all the centrifuges should be dismantled and destroyed. 
Because to allow this regime to continue to enrich is dangerous and, 
quite frankly, will lead to a military conflict between Israel and Iran 
and maybe others.
  President Rouhani tweeted:

       Our relationship with the world is based on Iranian 
     nation's interest. In Geneva agreement, world powers 
     surrendered to Iran's national will.

  Well, maybe that is bluster. When you look at the evidence, it's not 
so much bluster. The Deputy Foreign Minister said of the 
interconnections between networks of centrifuges that have been used to 
enrich uranium to 20 percent, so that they can enrich only to 5 
percent:

       These interconnections can be removed in a day and 
     connected again in a day.

  So he is basically saying all we have done is basically pull the plug 
and we will just put it back in if we need to.
  Here is what has happened since the interim deal with the sanctions 
regime. President Rouhani declared:

       We have struck the first blow to the illegal sanctions, in 
     the fields of insurance, shipping, the banking system, 
     foodstuffs and medicine and exports of petrochemical 
     materials.

  He tweeted:

       You are witness to how foreign firms are visiting our 
     country; 117 political delegations have come here.

  France, Turkey, Georgia, Ireland, Tunisia, Kazakhstan, China, Italy, 
India, Austria, and Sweden. The French chamber of commerce led a 
delegation to Iran not long ago with the head of Michelin Tire Company. 
I have been talking to the Michelin Company. They are not going to 
violate the sanctions, but they do believe that after this interim deal 
the smart money is that the sanctions are behind us.
  The International Monetary Fund predicted Iran's economy could turn 
around due to the interim agreement. Listen to this:

       The economy in Iran that was crippled because of the 
     sanctions could turn around based on the interim agreement 
     that doesn't dismantle or remove anything. Prospects for 2014 
     and 2015 have improved with an interim P5+1 agreement. Real 
     GDP growing by 1 to 2 percent in 2014-2015. Inflation would 
     potentially climb 15 to 20 percent. India's oil imports from 
     Iran more than doubled in January from a month earlier. China 
     has emerged as Iran's top trading partner, with nonoil trade 
     hitting $13 billion over the last 10 months. U.S. aerospace 
     companies are seeking permission to sell airline parts to 
     Iran for the first time in three decades. Iran has signed a 
     deal to sell Iraq arms and ammunition worth $195 million, 
     according to documents seen by Reuters. At least 13 major 
     international companies have said in recent weeks they aim to 
     reenter the Iranian marketplace over the next several months.

  These sanctions, my friends on the other side, are crumbling. If we 
do not reset what is going on, the leverage we have gained is being 
lost. We are marching toward a disaster. Having a new round of 
sanctions passed by Congress would tell the international community 
from our point of view this is not behind us, we are not going to take 
the pressure off until we get a result that makes our country and our 
allies in the region safe, particularly Israel. If we do not act now, 
it will be too late.
  To our friends at the White House: When you threaten to veto 
legislation and you accuse people who want to impose sanctions if the 
deal fails as wanting to going to war, I am afraid you completely 
misunderstand the situation as it really exists. I am willing to give 
you credit for imposing the sanctions in a forceful way, but you are 
naive and dangerous in your thought process if you think we can now 
negotiate with the sanctions crumbling and get the right answer.
  The Iranian monetary unit, the rial, has appreciated by over 25 
percent. The Iranian economy is rebounding after the interim deal. They 
are back in business. Inflation is down, the value of their currency is 
up, people are lining up to do business in Iran, the sanctions are 
crumbling, and the U.S. Senate sits quiet.
  All I can say is that we have a chance to turn this around before it 
is too late. I believe the best thing we could do as a body is for 
Republicans and Democrats to pass a new round of sanctions that would 
only take place at the end of the 6-month period if a final deal is not 
achieved that results in the things I have outlined.
  The bipartisan sanction bill reinforces the end game of basically 
dismantling the ability of the Iranians to develop a nuclear weapon. We 
have specific language in the sanctions bill that would get us to a 
good outcome. I am afraid by the time the 6 months is up, the economy 
in Iran will have rebounded and the will of the international community 
to go through this process again will have been lost.
  Right now the smart money is that Iran is a place you can soon do 
business, the sanctions are history, and our European allies, I am 
afraid, will accept a deal with the Iranians that is not in our 
national interest and will certainly not be good for our allies.
  I am very worried the P5+1 has already conceded in their own mind 
some

[[Page S1039]]

enrichment capability in the hands of the Iranian regime for the 
purpose of face saving, supposedly. We should not worry about allowing 
the Iranians to save face, given what they have done to our soldiers in 
Iraq, the amount of terrorism they have spread throughout the world, 
and the way they have behaved. I am not in the face-saving business 
when it comes to Iran. I am in protecting America's national security 
interest business.
  I do not mind the Iranians having a nuclear power program for 
peaceful purposes, as long as you control the fuel cycle. But if they 
want more than that, that tells you all you need to know about what 
their ambitions are.
  I say to my colleagues on the other side: If you allow any enrichment 
capability left in the hands of the Shia Persians in Iran, the Sunni 
Arabs are going to insist on a like capability. And I am here to tell 
you if you want to turn the Mideast into the ultimate powder keg, allow 
the Iranians to have an enrichment program. Because every Sunni Arab 
nation that can afford one will want a like program. If you think you 
can allow the Iranians to enrich uranium and the Sunni Arabs will sit 
on the sidelines and do nothing, you don't understand the Mideast. If 
you want to set the world on the road to Armageddon, that will be the 
end of nonproliferation in the Mideast. The interim deal is a bad deal 
for the world, according to the Prime Minister, and a great deal for 
Iran. The Prime Minister of Israel is right.
  If this administration is contemplating a final agreement that does 
not remove all the highly enriched uranium in Iran, consistent with the 
U.N. resolution, it is making a mistake for the ages. If this 
administration is going to sign on to a deal that allows enrichment to 
continue in Iran, where they now have a class of centrifuges that can 
take less than 5 percent uranium and spin it up to 90 percent, that 
will be a mistake for the ages.

  This is North Korea in the making. But unlike North Korea, where they 
eventually went nuclear after the international community, through 
inspections and sanctions, tried to stop their program, Japan and South 
Korea have yet to feel the need to obtain a nuclear weapon to counter 
the North Koreans. I can assure you the Sunni Arab nations in the 
Mideast will not put themselves in that position. All you have to do is 
ask them.
  I challenge every Member of this body to get on the phone and call 
the major Sunni Arab states and ask them a simple question: If the 
Iranians are allowed to enrich, will you insist on the same right? See 
what they tell you.
  We have a chance here, if we are smart, to reset the table before 
these sanctions completely crumble, and they are. If you think you can 
wait 6 months, have them completely crumble and reimpose sanctions, you 
are kidding yourself, because the world is not going to go down that 
road.
  What will happen if this negotiation with Iran fails to deliver what 
I think is the right outcome--a peaceful nuclear power program without 
any capability to make a nuclear weapon--I think the people throughout 
the region are going to respond forcefully and in kind and our friends 
in Israel and the world are hurt.
  Can Israel tolerate the ayatollahs in Iran having the ability to 
develop a nuclear weapon and the only thing between the State of 
Israel's security is a bunch of U.N. inspectors? Now think about that. 
Would you put America's national security at risk, and the only thing 
between a hostile nation having a nuclear weapon and threatening to 
wipe us off the map and success is a bunch of U.N. inspectors? How well 
did that work in North Korea? That is not a viable outcome.
  We have to stop this program completely. It must be dismantled, not 
mothballed. It has to be dismantled. If the Iranians want a nuclear 
powerplant for peaceful purposes, they can have one as long as somebody 
responsible controls the fuel cycle.
  We are headed toward a disaster if we don't act pretty quickly. I 
don't mean to be so dire, but look at the Mideast. Look at the Syrian 
effort to contain the Syrian chemical weapons program. These thuggish 
regimes are not going to turn over the advantages they have until the 
regime itself is threatened. I believe the Iranians, after Syria, do 
not believe anymore that our country has the will to use military force 
as a last resort to stop their nuclear program. No matter what 
President Obama says, his actions speak far louder than his words. We 
could change things if the Congress would impose new sanctions, 
bipartisan in nature. It would actually allow the administration some 
leverage they do not have today.
  The reason for the bipartisan bill, as in the Burr alternative to the 
Sanders bill, is that many of us believe now that time is not on our 
side. And to my friends on the other side, I hate the fact we have now 
split on what to do about Iran and how to impose sanctions. I have 
enjoyed, as much as anything in my entire time in the Senate, working 
with my Democratic and Republican colleagues to craft policies designed 
to get the right answer when it comes to the Iranian nuclear threat. 
But we are now in a different spot.
  As much as I hate it, I feel compelled, from my point of view, to use 
every opportunity this body presents to bring up the issue. If you do 
not believe the sanctions are crumbling, I would love to hear your 
explanation as to why they are still working, given the information 
that is overwhelming.
  So I hope in the coming days we can regain that bipartisanship. The 
majority leader, several months ago, promised a vote on Iran sanctions 
if we could find a bipartisan bill. He made that promise, and I will 
quote that later in the week. What has happened between then and now is 
the President has weighed in. He has tried to lock his party down and 
he has threatened to veto this sanctions bill.
  Now is not the time to turn the Senate over to the Obama 
administration, which does not have a very good track record when it 
comes to policing the Mideast. Actually, we are helping them, whether 
they believe it or not. The last thing I want is a conflict anywhere in 
the world that can be avoided, but here are our choices: If the 
negotiations fail, Israel will not stand for a nuclear-capable Iran. If 
you attack Iran, you open Pandora's box and many bad things can happen.
  I can tell you this, if there is a war between us and Iran, they 
lose, we win. This is not much of a debate militarily. But it is always 
a terrible thing to go to war unless you absolutely have to. So if the 
Iranians believe we are serious about sanctions and we are serious 
about using military force as a last resort, we may actually still get 
the right answer.
  If they don't believe that, we are putting Israel and our allies in a 
terrible spot. If the Iranian program survives these negotiations and 
they march toward a nuclear weapon as the North Koreans did, if the 
U.N. inspections fail and they achieve their goal of a nuclear weapon, 
then we have emptied Pandora's box, because every Sunni Arab state will 
follow in kind. Then only God knows what happens next. We have a chance 
to avoid that.
  But Israel will never stand for the proposition that the only thing 
between the ayatollahs having a nuclear weapon and the State of 
Israel's survival is a bunch of U.N. inspectors trying to control a 
program with a live capability; and Sunni Arab states will not allow 
the Iranians to enrich without them claiming an equal right. All this 
can be avoided if we act decisively. But if we continue to wait and 
allow the sanctions to crumble, God help us all.
  I yield the floor, and 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. SCHUMER. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________