[Congressional Record (Bound Edition), Volume 153 (2007), Part 16]
[Senate]
[Pages 22593-22632]
[From the U.S. Government Publishing Office, www.gpo.gov]




            SMALL BUSINESS TAX RELIEF ACT OF 2007--Continued

  Mr. BAUCUS. Mr. President, I ask unanimous consent that the Senator 
from Virginia, Senator Webb, be recognized for 1 minute; and then 
following him, the Senator from Oregon would like 3 minutes on the 
bill, and then Senator Vitter would be No. 3, with no time for Senator 
Vitter.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Virginia.


                           Amendment No. 2618

  Mr. WEBB. Mr. President, I ask for regular order with respect to my 
amendment No. 2618, which is a pending amendment to the Children's 
Health Insurance Program bill.
  The PRESIDING OFFICER. The amendment is pending.


                    Amendment No. 2618, As Modified

  Mr. WEBB. Mr. President, I ask unanimous consent to modify my 
amendment, and I now send the modification to the desk.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment, as modified, is as follows:

       Strike Section 701 and insert the following:

     SEC. __. ELIMINATION OF DEFERRAL OF TAXATION OF CERTAIN 
                   INCOME OF CONTROLLED FOREIGN CORPORATIONS.

       (a) In General.--Section 952 (relating to subpart F income 
     defined) is amended by adding at the end the following new 
     subsection:
       ``(e) Special Application of Subpart.--
       ``(1) In general.--For taxable years beginning after 
     December 31, 2007, notwithstanding any other provision of 
     this subpart, the term `subpart F income' means, in the case 
     of any controlled foreign corporation, the income of such 
     corporation derived from any foreign country.
       ``(2) Applicable rules.--Rules similar to the rules under 
     the last sentence of subsection (a) and subsection (d) shall 
     apply to this subsection.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years of controlled foreign 
     corporations beginning after December 31, 2007, and to 
     taxable years of United States shareholders with or within 
     which such taxable years of such corporations end.

  Mr. WEBB. Mr. President, the technical modification to my amendment 
simply makes clear that the amendment strikes section 701 of the bill, 
which is the tobacco tax revenue-raising section, and replaces section 
701 with a section eliminating the current law on tax deferral of 
foreign corporate income.
  I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from North Dakota.


                      Amendment No. 2934 Withdrawn

  Mr. DORGAN. Mr. President, early in the consideration of the 
children's health insurance bill we are now considering, I offered an 
amendment, No. 2534. The amendment was to reauthorize the Indian Health 
Care Improvement Act, a piece of legislation we have moved through the 
Indian Affairs Committee, an authorization for Indian health care 
matters that has been proposed 11 times before in the last 8 years but 
has not passed the Congress.
  We have a full-scale emergency and crisis with respect to Indian 
health care. I will not go on at great length except to say this: This 
Government has a responsibility for health care for Federal prisoners, 
and we also have a trust responsibility for health care for American 
Indians. We spend twice as much per person on health care for Federal 
prisoners as we do to meet our trust responsibility to provide health 
care for American Indians. I believe I can say without hesitation that 
there will be people who will die today and tomorrow in this country 
because we do not have adequate health care and have not kept our 
promise to the American Indians with respect to the trust 
responsibility for health care on Indian reservations.
  I have determined we are going to pass this legislation this year. 
With the cooperation of my colleague from Montana, Senator Baucus, who 
indicated yesterday the Finance Committee will mark up this bill on 
September 12--it is a very important commitment from someone who shares 
my passion on this and who is a very strong supporter of American 
Indians and Indian health care--and with a commitment from Senator 
Reid, who similarly is a very strong supporter of these issues, that he 
will bring that bill to the floor of the Senate in this session of the 
Congress--with those commitments, I believe we will now, finally, in 
the Senate, pass the Indian Health Care Improvement Act, at long last.
  With those commitments, I am confident we are on the road to getting 
done what we need to get done to meet our responsibility. Because of 
that, I will withdraw my amendment to reauthorize the Indian Health 
Care Improvement Act on this Children's Health Insurance Program bill, 
and I ask unanimous consent to withdraw amendment No. 2534.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Montana is recognized.
  Mr. BAUCUS. Mr. President, I very much compliment the Senator from 
North Dakota. He is absolutely correct. This legislation is on a must-
pass list. I have given my commitment to mark the bill up on September 
12 in the Finance Committee. The leader has indicated he will give 
every assurance to try to get the legislation up on the Senate floor 
and go on to pass it. It has passed before, but it got hung up in the 
last Congress. It is high time we get

[[Page 22594]]

this legislation passed, and I thank the Senator for, first, pushing 
the issue so hard and, second, working with the Senate to find an 
expeditious way to get this legislation passed.
  Mr. President, I ask unanimous consent that after Senator Vitter is 
recognized, Senator Kohl be recognized for 5 minutes and Senator Allard 
be recognized for 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Louisiana is recognized.


         Amendment No. 2596, as Modified, to Amendment No. 2530

  Mr. VITTER. Mr. President, I ask unanimous consent to set aside any 
pending business so that amendment No. 2596 may be called up.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. VITTER. Now I send a technical modification to the desk.
  The PRESIDING OFFICER. The Senator will suspend. The clerk will 
report.

       The Senator from Louisiana [Mr. Vitter], for himself and 
     Mr. DeMint, proposes an amendment No. 2596, as modified, to 
     amendment No. 2530.

  Mr. VITTER. I ask unanimous consent that the reading of the amendment 
be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 2596), as modified, is as follows:

       At the end of title I, insert the following:

     SEC. ___. REQUIREMENT THAT INDIVIDUALS WHO ARE ELIGIBLE FOR 
                   CHIP AND EMPLOYER-SPONSORED COVERAGE USE THE 
                   EMPLOYER-SPONSORED COVERAGE INSTEAD OF CHIP.

       (a) In General.--Section 2105(c) (42 U.S.C. 1397ee(c)), as 
     amended by section 401(a), is amended by adding at the end 
     the following new paragraph:
       ``(12) Requirement regarding employer-sponsored coverage.--
       ``(A) In general.--No payment may be made under this title 
     with respect to an individual who is eligible for coverage 
     under qualified employer-sponsored coverage, either as an 
     individual or as part of family coverage, except with respect 
     to expenditures for providing a premium assistance subsidy 
     for such coverage in accordance with the requirements of this 
     paragraph.
       ``(B) Qualified employer sponsored coverage.--
       ``(i) In general.--In this paragraph, the term `qualified 
     employer sponsored coverage' means a group health plan or 
     health insurance coverage offered through an employer that 
     is--

       ``(I) substantially equivalent to the benefits coverage in 
     a benchmark benefit package described in section 2103(b) or 
     benchmark-equivalent coverage that meets the requirements of 
     section 2103(a)(2);
       ``(II) made similarly available to all of the employer's 
     employees and for which the employer makes a contribution to 
     the premium that is not less for employees receiving a 
     premium assistance subsidy under any option available under 
     the State child health plan under this title or the State 
     plan under title XIX to provide such assistance than the 
     employer contribution provided for all other employees; and
       ``(III) cost-effective, as determined under clause (ii).

       ``(ii) Cost-effectiveness.--A group health plan or health 
     insurance coverage offered through an employer shall be 
     considered to be cost-effective if--

       ``(I) the marginal premium cost to purchase family coverage 
     through the employer is less than the State cost of providing 
     child health assistance through the State child health plan 
     for all the children in the family who are targeted low-
     income children; or
       ``(II) the marginal premium cost between individual 
     coverage and purchasing family coverage through the employer 
     is not greater than 175 percent of the cost to the State to 
     provide child health assistance through the State child 
     health plan for a targeted low-income child.

       ``(iii) High deductible health plans included.--The term 
     `qualified employer sponsored coverage' includes a high 
     deductible health plan (as defined in section 223(c)(2) of 
     the Internal Revenue Code of 1986) purchased through a health 
     savings account (as defined under section 223(d) of such 
     Code).
       ``(C) Premium assistance subsidy.--
       ``(i) In general.--In this paragraph, the term `premium 
     assistance subsidy' means, with respect to a targeted low-
     income child, the amount equal to the difference between the 
     employee contribution required for enrollment only of the 
     employee under qualified employer sponsored coverage and the 
     employee contribution required for enrollment of the employee 
     and the child in such coverage, less any applicable premium 
     cost-sharing applied under the State child health plan, 
     subject to the annual aggregate cost-sharing limit applied 
     under section 2103(e)(3)(B).
       ``(ii) State payment option.--Subject to clause (iii), a 
     State may provide a premium assistance subsidy directly to an 
     employer or as reimbursement to an employee for out-of-pocket 
     expenditures.
       ``(iii) Requirement for direct payment to employee.--A 
     State shall not pay a premium assistance subsidy directly to 
     the employee, unless the State has established procedures to 
     ensure that the targeted low-income child on whose behalf 
     such payments are made are actually enrolled in the qualified 
     employer sponsored coverage.
       ``(iv) Treatment as child health assistance.--Expenditures 
     for the provision of premium assistance subsidies shall be 
     considered child health assistance described in paragraph 
     (1)(C) of subsection (a) for purposes of making payments 
     under that subsection.
       ``(v) State option to require acceptance of subsidy.--A 
     State may condition the provision of child health assistance 
     under the State child health plan for a targeted low-income 
     child on the receipt of a premium assistance subsidy for 
     enrollment in qualified employer sponsored coverage if the 
     State determines the provision of such a subsidy to be more 
     cost-effective in accordance with subparagraph (B)(ii).
       ``(vi) Not treated as income.--Notwithstanding any other 
     provision of law, a premium assistance subsidy provided in 
     accordance with this paragraph shall not be treated as income 
     to the child or the parent of the child for whom such subsidy 
     is provided.
       ``(D) No requirement to provide supplemental coverage for 
     benefits and additional cost-sharing protection provided 
     under the state child health plan.--
       ``(i) In general.--A State that elects the option to 
     provide a premium assistance subsidy under this paragraph 
     shall not be required to provide a targeted low-income child 
     enrolled in qualified employer sponsored coverage with 
     supplemental coverage for items or services that are not 
     covered, or are only partially covered, under the qualified 
     employer sponsored coverage or cost-sharing protection other 
     than the protection required under section 2103(e)(3)(B).
       ``(ii) Notice of cost-sharing requirements.--A State shall 
     provide a targeted low-income child or the parent of such a 
     child (as appropriate) who is provided with a premium 
     assistance subsidy in accordance with this paragraph with 
     notice of the cost-sharing requirements and limitations 
     imposed under the qualified employer sponsored coverage in 
     which the child is enrolled upon the enrollment of the child 
     in such coverage and annually thereafter.
       ``(iii) Record keeping requirements.--A State may require a 
     parent of a targeted low-income child that is enrolled in 
     qualified employer-sponsored coverage to bear the 
     responsibility for keeping track of out-of-pocket 
     expenditures incurred for cost-sharing imposed under such 
     coverage and to notify the State when the limit on such 
     expenditures imposed under section 2103(e)(3)(B) has been 
     reached for a year from the effective date of enrollment for 
     such year.
       ``(iv) State option for reimbursement.--A State may 
     retroactively reimburse a parent of a targeted low-income 
     child for out-of-pocket expenditures incurred after reaching 
     the 5 percent cost-sharing limitation imposed under section 
     2103(e)(3)(B) for a year.
       ``(E) 6-month waiting period required.--A State shall 
     impose at least a 6-month waiting period from the time an 
     individual is enrolled in private health insurance prior to 
     the provision of a premium assistance subsidy for a targeted 
     low-income child in accordance with this paragraph.
       ``(F) Non application of waiting period for enrollment in 
     the state medicaid plan or the state child health plan.--A 
     targeted low-income child provided a premium assistance 
     subsidy in accordance with this paragraph who loses 
     eligibility for such subsidy shall not be treated as having 
     been enrolled in private health insurance coverage for 
     purposes of applying any waiting period imposed under the 
     State child health plan or the State plan under title XIX for 
     the enrollment of the child under such plan.
       ``(G) Assurance of special enrollment period under group 
     health plans in case of eligibility for premium subsidy 
     assistance.--No payment shall be made under subsection (a) 
     for amounts expended for the provision of premium assistance 
     subsidies under this paragraph unless a State provides 
     assurances to the Secretary that the State has in effect laws 
     requiring a group health plan, a health insurance issuer 
     offering group health insurance coverage in connection with a 
     group health plan, and a self-funded health plan, to permit 
     an employee who is eligible, but not enrolled, for coverage 
     under the terms of the plan (or a child of such an employee 
     if the child is eligible, but not enrolled, for coverage 
     under such terms) to enroll for coverage under the terms of 
     the plan if the employee's child becomes eligible for a 
     premium assistance subsidy under this paragraph.
       ``(H) No effect on previously approved premium assistance 
     programs.--Nothing in this paragraph shall be construed as 
     limiting the authority of a State to offer premium assistance 
     under section 1906, a waiver described in paragraph (2)(B) or 
     (3), a waiver approved under section 1115, or other authority 
     in effect on June 28, 2007.

[[Page 22595]]

       ``(I) Notice of availability.--A State shall--
       ``(i) include on any application or enrollment form for 
     child health assistance a notice of the availability of 
     premium assistance subsidies for the enrollment of targeted 
     low-income children in qualified employer sponsored coverage;
       ``(ii) provide, as part of the application and enrollment 
     process under the State child health plan, information 
     describing the availability of such subsidies and how to 
     elect to obtain such a subsidy; and
       ``(iii) establish such other procedures as the State 
     determines necessary to ensure that parents are informed of 
     the availability of such subsidies under the State child 
     health plan.''.
       (b) Application to Medicaid.--Section 1906(d) (42 U.S.C. 
     1396e(d)), as added by section 401(b) is amended by adding at 
     the end the following: ``The provisions of section 
     2105(c)(12) shall apply to a child who is eligible for 
     medical assistance under the State plan in the same manner as 
     such provisions apply to a targeted low-income child under a 
     State child health plan under title XXI. Section 1902(a)(34) 
     shall not apply to a child who is provided a premium 
     assistance subsidy under the State plan in accordance with 
     the preceding sentence.''.

  Mr. VITTER. Mr. President, I also ask unanimous consent to add 
Senator DeMint as a cosponsor of the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. VITTER. Mr. President, this is an important amendment in the 
context of what we are doing with regard to the SCHIP program. It will 
ensure that families who are now covered by health insurance stay 
covered and are not, in fact--perhaps unintentionally but are 
nonetheless--kicked off or encouraged to leave their current health 
insurance for the SCHIP program. It is an issue called crowding out.
  The goal of the amendment is very clear. We want to encourage 
children who are eligible for SCHIP but currently have access to 
employer coverage to use that employer coverage. If they have 
difficulty maintaining that because of costs, we want to give States 
the flexibility so they can maintain that coverage. What we do not want 
to do--certainly what I do not want to do, what Senator DeMint does not 
want to do, and I hope what the huge majority of Members of this body 
do not want to do--is create a mechanism to push people off good 
private insurance or to encourage them to drop good private insurance 
or to encourage employers to drop that coverage simply because we are 
reauthorizing and perhaps expanding SCHIP. No child and no family 
should be forced onto any Government health insurance program if they 
are currently insured otherwise through the private sector, through the 
employer, et cetera.
  CBO's own numbers show that 40 percent to 50 percent of the kids 
covered under SCHIP and 40 percent to 50 percent of those who would 
become eligible under this SCHIP expansion are, in fact, kids who are 
shifted out of private coverage into SCHIP. The CBO analysis on this 
issue is very clear on this point. In my mind, there is no reason the 
taxpayers should be paying for that insurance for folks already on good 
private sector insurance. We should not be encouraging this very 
significant shift, this very significant crowding out.
  As I suggested, opponents of this amendment might say: We are not for 
that because it may be too costly for some of these families to pay 
premiums in private plans even if they are currently on them. We 
recognize that argument and that reality. Our amendment--this is very 
significant--our amendment allows premium subsidies for these 
individuals who need that to keep them on their current private 
coverage and to ensure that coverage is affordable. We maintain State 
flexibility in implementing those subsidies. We give the States enough 
leeway, enough flexibility to create and maintain those subsidies to 
keep folks on good private insurance. The Vitter-DeMint amendment 
requires individuals who are eligible for SCHIP but currently have 
employer coverage to continue to use that coverage. If they truly need 
help, truly need premium subsidies, States have the flexibility to do 
that.
  I believe the clear majority of the public and the majority of those 
in Congress support Government help to those who need it. But just as 
true, a clear majority of the public, a clear majority of us do not 
want to create an incentive to kick people out of insurance they have. 
We do not want to create an incentive for employers to end or limit 
insurance they have. That would be a very negative consequence of these 
good intentions. Our amendment prevents that to a great extent. In 
doing so, I have to say I think it draws a clear philosophical divide: 
Do we give people the resources, the ability to continue with their 
current quality care in the private sector or are we, in fact, all for 
pushing people into a one-size-fits-all Government-run program rather 
than allowing them that choice and that quality care in the private 
sector? My amendment says absolutely, if they are covered in the 
private sector, we want to encourage that to continue. We want to make 
sure that can work. We don't want to kick them out. We don't want to 
encourage employers to kick them out. But part of that is assisting 
families who really do need help to maintain that. That is a very 
important part of the Vitter-DeMint amendment also.
  I think this is an idea which should have broad consensus and 
bipartisan support. I look forward to that on the floor of the Senate 
and invite my colleagues to look at this and then support the Vitter-
DeMint amendment, No. 2596.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.
  Mr. KOHL. Mr. President, I rise to talk about putting our country on 
a path to insuring all of its children. For the past decade, the 
Children's Health Insurance Program--CHIP--has given kids in working 
families the doctor's visits and medicines they need when they are 
sick, and the checkups they need to stay well.
  Skyrocketing health care costs combined with a decline in employer-
sponsored health insurance means that thousands of kids and families 
would go without basic medical care if CHIP did not fill the need. 
There are now more than 46 million uninsured Americans--9 million are 
children. This is simply unacceptable--every child needs health 
insurance.
  Without health insurance, many families must forgo routine checkups, 
crossing their fingers that their children will stay healthy. If their 
son or daughter becomes ill, they wait to see if the symptoms go away. 
But delay can be tragic. If those symptoms linger or get worse, parents 
are forced to take their kids to the emergency room for help. When a 
common cold turns into pneumonia, what would have been a simple, cheap 
fix if caught early, mushrooms into a complicated, lengthy and 
expensive treatment.
  Wisconsin's CHIP program, called BadgerCare, serves 67,000 working 
families and makes all the difference in a child's future. BadgerCare 
kids are healthier and more likely to succeed in school--including 
increased school attendance and a greater ability to pay attention in 
class.
  However, there are over 100,000 kids in Wisconsin who are eligible 
for BadgerCare, but are left out--in danger of having a small health 
problem becoming a life threatening illness. In order to reach these 
kids, Wisconsin received a waiver from this administration to cover 
their parents. Secretary Leavitt recognized that when the family is 
insured, children have better access to health care and get the 
preventative health services they need saving expensive trips to the 
emergency room. BadgerCare provides seamless coverage for families and 
works to reduce the number of uninsured children. Strengthening 
BadgerCare will ensure that this successful program can continue to 
cover working families in Wisconsin. It is a good investment of our 
scarce Federal dollars.
  The bipartisan Senate Finance Committee agreement to renew CHIP is 
the right approach. It provides an investment of $35 billion over 5 
years to strengthen CHIP and it is completely paid for. No one loses 
health coverage as a result of this reauthorization. It keeps coverage 
for the 6.6 million low-income children currently enrolled in CHIP and 
gives States the resources necessary to reach an additional 3.2

[[Page 22596]]

million uninsured children eligible but not enrolled in CHIP.
  The initial price tag may seem steep, but, in the long run, it will 
save money. By catching and treating childhood illnesses early, we will 
save money that would be spent on emergency care. I want to thank 
Senators Baucus and Grassley for their tireless work on this 
compromise. It is my hope that the Senate will act to put kids first 
and support this bill.
  The PRESIDING OFFICER. The Senator from Colorado.


                    Amendment No. 2535, as Modified

  Mr. ALLARD. I ask unanimous consent to modify amendment No. 2535.
  The PRESIDING OFFICER. The amendment has not yet been called up.
  Mr. ALLARD. I call up amendment No. 2535 and then ask unanimous 
consent that it be modified, and the modified version is at the desk.
  The PRESIDING OFFICER. Without objection, the clerk will report the 
amendment.
  The assistant legislative clerk read as follows:

       The Senator from Colorado [Mr. Allard] proposes an 
     amendment No. 2535, as modified, to amendment No. 2530.

  Mr. ALLARD. I ask unanimous consent that the reading of the amendment 
be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment, as modified, is as follows:

       At the appropriate place, insert the following:

     SEC. __. TREATMENT OF UNBORN CHILDREN.

       (a) Codification of Current Regulations.--Section 
     2110(c)(1) (42 U.S.C. 1397jj(c)(1)) is amended by striking 
     the period at the end and inserting the following: ``, and 
     includes, at the option of a State, an unborn child. For 
     purposes of the previous sentence, the term `unborn child' 
     means a member of the species Homo sapiens, at any stage of 
     development, who is carried in the womb.''.
       (b) Clarifications Regarding Coverage of Mothers.--Section 
     2103 (42 U.S.C. 1397cc) is amended by adding at the end the 
     following new subsection:
       ``(g) Clarifications Regarding Authority to Provide 
     Postpartum Services and Maternal Health Care.--Any State that 
     provides child health assistance to an unborn child under the 
     option described in section 2110(c)(1) may continue to 
     provide such assistance to the mother, as well as postpartum 
     services, through the end of the month in which the 60-day 
     period (beginning on the last day of pregnancy) ends, in the 
     same manner as such assistance and postpartum services would 
     be provided if provided under the State plan under title XIX, 
     but only if the mother would otherwise satisfy the 
     eligibility requirements that apply under the State child 
     health plan (other than with respect to age) during such 
     period.''.

  Mr. ALLARD. Mr. President, I ask Senator McConnell be added as a 
cosponsor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALLARD. Mr. President, I come to the floor today to discuss my 
amendment to codify the unborn child rule in the pending SCHIP 
legislation. This needs to be done, and it needs to be done in this 
reauthorization. The unborn child rule is a regulation that since 2002 
has allowed States to provide prenatal care to unborn children and 
their mothers. It recognizes the basic fact that the child is in the 
womb--the child in the womb is a child.
  When a pregnancy is involved, there are at least two patients; there 
is the mother and there is the baby. It only makes sense to cover the 
unborn child under a children's health program. The bill before us 
modifies the SCHIP statute to allow States to cover pregnant women of 
any age. It also contains language that asserts that the bill does not 
affirm either the legality or illegality of the 2002 ``unborn child'' 
rule. My amendment would codify the principle of the rule by amending 
the SCHIP law to clarify that a covered child:

       includes, at the option of a State, an unborn child.

  The amendment further defines ``unborn child'' with a definition 
drawn verbatim from Public Law 108-212, the Unborn Victims of Violence 
Act. So it is not new language in our statute.
  My amendment would also clarify that the coverage for the unborn 
child may include services to benefit either the mother or unborn child 
consistent with the health of both. In addition, the amendment 
clarifies that the States may provide mothers with postpartum services 
for 60 days after they give birth.
  Many States' definition of coverage for pregnant women leads to the 
strange legal fiction that the adult pregnant woman is a child. Surely 
it was not the intent of anyone to develop a State Children's Health 
Insurance Program to allow a loophole for States to define a woman as a 
child. Surely we can agree that the child in the womb who receives 
health care is a child receiving care along with his or her mother.
  My amendment will also allow for coverage of the mother, whereas the 
pending legislation only allows for pregnancy-related services. There 
are many conditions that can affect the mother's health during 
pregnancy that are not related to her pregnancy. Under the pending 
legislation, a pregnant mother could not get coverage for any condition 
that is not related to her pregnancy. We should be allowing mothers to 
stay healthy so they will have healthy babies.
  This also leads to reduced costs associated with premature or low 
birth-weight babies. Eleven States are already using this option to 
provide such care through the State Children's Health Insurance 
Program. If the intent of the sponsors is to provide coverage for the 
pregnant woman and her unborn child, then they should have no problem 
supporting my amendment.
  We should ensure that pregnant women and their unborn children are 
both treated as patients. This is a matter of common sense. Every 
obstetrician knows that in treating a pregnant woman, he is treating 
two patients, the mother and her unborn child.
  Keeping this coverage in the name of the adult pregnant woman alone 
is bad for the integrity of a children's health program, bad for the 
child, and even bad for some of the neediest of pregnant women.
  I am urging my colleagues to support my amendment.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. McCaskill.) The Senator from Montana.
  Mr. BAUCUS. Madam President, as I have said many times in this 
debate, the Children's Health Insurance Program Reauthorization Act is 
good for America. I wish to take a few minutes to talk about why this 
children's health bill is good for my home State of Montana.
  Montana ranks fifth highest in the Nation for the percentage of 
children without health insurance. In 2006, 37,000 Montana children did 
not have health insurance. That is one in every six children. More than 
half of those uninsured children, that is 19,000, were either eligible 
for Medicaid or for CHIP, the Children's Health Insurance Program, but 
not enrolled.
  One of the reasons for our higher rate of uninsured kids is because 
the percentage of employers offering health care to Montana's working 
families is quite low. Less than half of all employers in the State of 
Montana offered health coverage in 2005. This means many working 
families do not have access to health coverage. Although families who 
do not have access to coverage through work could buy it on their own, 
health coverage is often priced out of reach for lower income families. 
The average cost of a family health plan on the open market in Montana 
is about $8,000 a year. That is nearly one-fifth of the family's income 
for a family of four earning $41,300, which is twice the poverty level. 
Again, the average cost is about $8,000, which is about one-fifth of a 
family's income for a family of four earning $40,000, and most families 
simply obviously cannot afford that cost.
  CHIP, the legislation before us, offers affordable, comprehensive 
health coverage for working families. CHIP works, and it has helped 
thousands of Montana families.
  Abigail Tuhy's family is one of those families. Abigail's mom, Fawn, 
is a mother of four, and Fawn's story tells volumes about why we need 
CHIP. She writes:

       I don't know what our family of 6 would do without [CHIP]. 
     . . . In one year, my 2\1/2\-year-old had nine stitches 
     because she split her head open and my 6 year old broke his

[[Page 22597]]

     arm two times. CHIP paid for the surgery, hospital stay and 
     all of the care provided. CHIP has also paid for all of my 
     children to receive all of their shots and their check-ups. 
     Without CHIP, I would not have insurance for my children.

  Abigail is only 1 of the more than 38,000 children helped by CHIP 
over the past decade. Today more than 14,000 Montana children are 
covered by it and the number is growing.
  This year, the Montana legislature, for example, took a positive step 
forward, changing the CHIP eligibility level from 150 percent to 175 
percent of the Federal poverty line. That is just over $36,000 for a 
family of 4. Montana started implementing this expansion in July, which 
will bring an additional 2,000 children next year.
       This is clearly good news, but we cannot rest on our 
     laurels. There are more uninsured children who need our help. 
     The CHIP Reauthorization Act will provide Montana with the 
     funding it needs to maintain current CHIP enrollment, fund 
     its expansion, and make significant strides toward covering 
     more of the uninsured children.
  Under this legislation, Montana would receive about $28 million next 
year. That is $12 million more than its allotment for last year. New 
CHIP allotments, combined with new funds in the State to expand 
coverage to low-income children, could allow the State to cover as many 
as 12,000 children who are uninsured today.
  The legislation before us also includes new funding to help Montana 
improve access to health care, including $200 million in new Federal 
grant money for States to improve the availability and 
comprehensiveness of dental health for children, and $100 million in 
Federal grants to improve outreach and enrollment, especially in rural 
areas.
  This bill also includes provisions that specifically target Indian 
Country. Although Indian children are eligible for coverage through the 
Indian Health Service and tribal facilities, the IHS, the Indian Health 
Service, is only funded at 60 percent of need today, leading to tragic 
denials of care when funds run out. I mean it is abominable. This bill 
makes important changes to improve the health of Indian children. It 
provides new funds for outreach and enrollment in Medicaid and in CHIP. 
It also allows those Indians to use tribal documents to prove 
citizenship for Medicaid. It gives States a higher Federal match for 
translation and interpretation services in the program. And it requires 
the Secretary to monitor racial and ethnic disparities in care. All 
move us to a healthier future for Indian children in Montana.
  As we debate CHIP today, let us remember the uninsured children in 
our home States, those kids who need help. In Montana, there are 
mothers whose daughters have cystic fibrosis. There are Native American 
children without health care coverage because they do not have a birth 
certificate. So let's keep in mind the children of Montana and every 
other State who need and deserve our help. Let's reauthorize this 
Children's Health Insurance Program today and improve the health of all 
American children.
  Madam President, I ask unanimous consent the following Senators be 
recognized for the following amounts of time: first, Senator Dodd for 5 
minutes; Senator Clinton for 5 minutes; and Senator Coburn for 15 
minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Madam President, reserving the right to object, and I will 
not object, I wish to inquire, have we gotten an agreement in place for 
when the next block of votes could come?
  Mr. BAUCUS. Madam President, it is being written up right now.
  Mr. LOTT. I do not object.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BAUCUS. We do have a block of votes. It has been agreed to.
  Madam President, I yield the floor and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DODD. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                Amendment No. 2631 to Amendment No. 2530

      (Purpose: To expand family and medical leave in support of 
              servicemembers with combat-related injuries)

  Mr. DODD. Madam President, on behalf of myself and Senator Clinton, 
Senator Dole, Senator Graham, Senator Mikulski, Senator Chambliss, 
Senator Brown, Senator Cardin, Senator Menendez, Senator Salazar, 
Senator Kennedy, Senator Reed and Senator Boxer, I send an amendment to 
the desk and ask for its immediate consideration.
  The PRESIDING OFFICER. Without objection, the pending amendment is 
set aside and the clerk will report.
  The assistant legislative clerk read as follows:

       The Senator from Connecticut [Mr. Dodd], for himself, Mrs. 
     Clinton, Mrs. Dole, Mr. Graham, Ms. Mikulski, Mr. Chambliss, 
     Mr. Brown, Mr. Cardin, Mr. Menendez, Mr. Salazar, Mr. 
     Kennedy, Mr. Reed, and Mrs. Boxer, proposes an amendment 
     numbered 2631 to amendment No. 2530.

  Mr. DODD. Madam President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  Mr. DODD. Madam President, on behalf of myself and Senator Clinton 
and the others I have mentioned here, I seek to, as soon as possible, 
meet the suggestions that have been recommended by the President's 
Commission on Care for America's Returning Wounded Warriors. I want to 
express my gratitude to my colleague from New York as well as to others 
who have joined with us on this effort. This report was submitted to 
the President by our former colleague, Senator Dole, former Secretary 
of Health Donna Shalala, and this report is rather extensive on their 
recommendations on how we might better serve our returning soldiers 
from the theaters of conflict in Iraq and Afghanistan.
  The President's Commission on Care for the Returning Wounded 
recommended:

       That Congress should amend the Family and Medical Leave Act 
     to allow up to 6 months of leave for a family member of a 
     servicemember who has a combat-related injury and meets the 
     other eligibility requirements in the law.
  I am very proud of many things I have done over the last 25 years in 
the Senate. None exceeds my sense of pride more than passage of the 
Family and Medical Leave Act. Along with Senator Bond, Senator Dan 
Coats, Senator Specter, Senator Kennedy, and many others, after 7 
years, three American Presidents, and two vetoes, we were able to adopt 
the Family and Medical Leave Act which, since its passage, has assisted 
more than 60 million Americans in being away from their jobs to be with 
family members during critical times in their lives without losing that 
job. These important life situations include the joyous occasion of a 
birth or adoption and the difficult circumstance of an illness of a 
child or another family member for up to 12 weeks of unpaid leave. It 
has been a remarkable asset to many people.
  I suspect there is not a single American family who would not relate 
to the importance of being able to be with a family member during a 
time of significant crisis. Obviously, as our wounded warriors coming 
back from Afghanistan and Iraq are recovering from their injuries, 
having their families and others with them could be of immeasurable 
help. Senator Dole and Donna Shalala and other members of the 
Commission rightly made the recommendation that we should amend the 
Family and Medical Leave Act to provide for up to 6 months' leave for a 
family member to be with these individuals without losing their job. 
That is what we have done with the amendment we are offering to this 
bill.
  Clearly, this bill has nothing to do with family medical leave. My 
colleagues from Montana and Iowa, have a tremendous responsibility in 
adopting the legislation before us, of which I am a strong supporter. 
But, knowing that we only have a short time before we adjourn for more 
than a month, there is a sense of urgency about providing for these 
families. I would hope all of us would support this amendment. This is

[[Page 22598]]

a bipartisan suggestion that will make a difference in the lives of 
families who are assisting in the recovery of a wounded warrior.
  I commend former Senator Dole, former Secretary of Health and Human 
Services Donna Shalala, and the distinguished members of the Commission 
for their thoughtfulness and thorough work on this matter. As the 
author of the underlying law, I have worked to maintain its protections 
and extend its protections to assist more employees. I agree with the 
Commission that FMLA is the best method for providing critical support 
for our returning heroes who are recovering from their war wounds. I am 
pleased to be joined, as a principal cosponsor, by Senator Clinton of 
New York. After more than 7 years of work, as I mentioned earlier, this 
proposal I made more than 20 years ago became law. It became law within 
days after January 20, 1993, when President William Jefferson Clinton, 
as his very first act, signed into law the Family and Medical Leave 
Act.
  I remember with great clarity that bright day overlooking the rose 
garden at the White House, President Clinton signing that bill into 
law. Pat Schroeder of the other body was the principal author in the 
House of Representatives and too often gets neglected in talking about 
the history of the Family and Medical Leave Act. I will be eternally 
grateful to Pat Schroeder for the tremendous job she did in the other 
body in seeing to it that this proposal became the law of the land.
  The Commission's findings indicate the critical role that family 
members play in the recovery of our wounded servicemembers:

       In their survey, 33 percent of active duty, 22 percent of 
     reserve component, and 37 percent of retired/separated 
     servicemembers report that a family member or close friend 
     relocated for extended periods of time to be with them while 
     they are in the hospital.
       Twenty-one percent of active duty, 15 percent of reserve 
     component and 24 percent of retired/separated servicemembers 
     say friends or family gave up a job to be with them or act as 
     their caregiver.
       More than 3,000 servicemembers have been seriously injured 
     during operations in Iraq and Afghanistan. In virtually every 
     case, a wife, husband, parent, brother, or sister has 
     received the heart stopping telephone call telling them that 
     their loved one is sick, or injured, halfway around the 
     world.
       Family or close friends stayed to assist recovery of almost 
     66 percent of active duty and 54 percent of reserve component 
     servicemembers.

  The Support for Injured Servicemembers Act provides up to 6 months of 
family and medical leave for spouses, children, parents and next of kin 
of servicemembers who suffer from a combat-related injury or illness. 
FMLA currently provides for 3 months of unpaid leave to a spouse, 
parent or child providing care for a person with a serious illness. Our 
servicemembers need more. These are extraordinary circumstances. The 
point of the Commission and the Dignified Treatment of Wounded Warriors 
Act that the Senate recently passed is to take care of our wounded 
soldiers, sailors, airmen, and marines returning from Iraq and 
Afghanistan with combat-related injuries. We should support their 
families in caring for these heroes.
  It is essential we do everything possible to support our troops, to 
allow their loved ones to be with them as they recover from combat-
related injuries or illnesses. That is why we should expand and improve 
benefits for those caring for our servicemembers.
  Let me emphasize the major points: You have to have been injured in 
the theater of combat, Afghanistan or Iraq or in preparation for 
deployment. Our amendment allows for a parent, spouse, child or next of 
kin to provide that care-giving role. It would allow them to be with 
them for up to 6 months without losing their jobs. The leave is without 
pay. What is the universe we are talking about? It is not the entire 
Nation, obviously, or anyone who is wearing a uniform who happens to 
have been injured. You have to have been injured or acquired the 
illness as a result of being in the combat theater or when preparing to 
be deployed.
  The amendment is specific as to who could be the caregiver. It is 
very specific about the amount of time an employee acting as a 
caregiver would be covered. We have tried to narrow this down in a way. 
I am grateful to Bob Dole. He called me last Thursday early on and 
remembered that I had spent such an inordinate amount of time, with the 
help of Senator Kennedy and others, to adopt the Family and Medical 
Leave Act so many years ago. Most would agree today it has made a 
difference in the lives of people. I can't think of any better 
constituency to serve with expanded family medical leave than our 
service men and women.
  I see my colleague from Georgia. I thank him as well for being a 
cosponsor of this proposal. Those preparing for deployment obviously 
would be covered, if they end up being affected as a result of their 
injuries or illness suffered while in the theater of combat.
  Again, as someone who has been a floor manager of many bills over the 
years, I understand that is not easy to get a particularly difficult 
bill like this done. I applaud the commitment my colleague from Montana 
has brought to this legislation. It is my hope that we can achieve the 
kind of unanimity around this idea of supporting military families, 
given the fact that the President's Commission is calling for this, our 
former colleagues calling for it. We have a strong bipartisan group of 
Senators who believe this is worthwhile to do for this limited group of 
our fellow citizens who have suffered immeasurably as a result of their 
contribution. I would hope before we leave here in these next 24 or 48 
hours that the very least we could do would be to provide this kind of 
benefit for them and their families.
  I truly appreciate the work of our cosponsors. In particular, their 
willingness to adopt a provision that would expand the pool of typical 
caregivers under current law for this specific purpose. Those 
caregivers are limited to spouses, children, and parents. Our amendment 
extends the caregiver role to next of kin, a brother, sister or other 
relative, perhaps.
  I gather my colleague from New York, who was very helpful in pulling 
this together, is on her way to the floor. She might want to be heard 
on this as well. I was drawing this out while we wait for her arrival.
  Mr. BAUCUS. I might say to my good friend, we have noticed.
  I don't see the Senator from New York here yet, but she is on her 
way. In the meantime, I ask unanimous consent that the Senator from 
Georgia be recognized and, following the Senator from Georgia, Senator 
Clinton be recognized.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Georgia is recognized.
  Mr. CHAMBLISS. I thank the Chair.
  Since the Senator is running for President, we are glad to 
accommodate him for what time he needs. He is serious and very 
emotional about this issue, and he should be. We all should be. I 
commend the Senator from Connecticut for spending a good bit of time on 
talking about this issue. I commend the Senator from New York for 
bringing this issue to the forefront. We are in a war unlike any war we 
have ever been in before. We are in different times today with respect 
to military conflicts, and the inclusion of our wounded warriors in the 
Family and Medical Leave Act is certainly well deserved and something 
that I hope we get passed before we leave.
  I rise to commend the President's Commission on Care for America's 
Returning Wounded Warriors for their hard, high-quality work in 
analyzing and recommending improvements for our Nation's treatment of 
wounded warriors. The Dole-Shalala Commission has boldly addressed one 
of the most important issues facing our military today and has created 
a simple roadmap that will help make monumental improvements to the 
military health care system. I am pleased the Commission's 
recommendations span agencies, cross services, and take into 
consideration the needs of both veterans as well as their families.
  During their review, they visited 23 health care facilities, 
including military and VA hospitals and treatment centers nationwide, 
held 7 public meetings, heard testimony from military health care 
experts, and communicated

[[Page 22599]]

directly with servicemembers, their families, and health care 
professionals. This dialog is greatly needed and must continue. I 
provided my own input directly to the Commission regarding one of 
Georgia's own success stories in providing care to wounded warriors 
through a partnership between the Eisenhower Army Medical Center at 
Fort Gordon, GA, and the Augusta VA hospital. This Commission untangled 
a web of complex issues and provided six recommendations based on their 
findings. Former Senator Dole and Secretary Shalala did what others 
have been trying to do since World War II. Their joint statement 
succinctly describes the culmination of these efforts.
  The face of our military has changed, as have their needs. Some 
returning servicemembers, injured in the line of duty, have complex and 
often multiple injuries placing greater challenges on the DOD and VA as 
well as family members. Well-meaning attempts over the years to reform 
health care in the military and VA have produced many positive results 
that have also made the system more complex and confusing in some 
areas. In these cases, it is difficult for servicemembers, their 
families, and caregivers to understand how to navigate the system. The 
events that brought us to this point were inexcusable and could have 
been prevented. However, I would be remiss if I did not mention a 
letter I received from a constituent whose son was a patient at Walter 
Reed Medical Center, after being evacuated from Iraq due to injuries he 
sustained in an IED attack. The letter said to the commander and staff 
at Walter Reed:

       You and your staff are a remarkable team that has the 
     welfare of our soldiers and families foremost in mind as you 
     execute your critically important duties. My family and I owe 
     you and your team our heartfelt thanks and debt of gratitude 
     we can never repay.

  This kind of feedback tells me the Army's improvements are taking 
hold. Through the Commission and recent legislation, these improvements 
will continue. I applaud the Commission's work and am equally pleased 
that much of it parallels the initiatives set forth by the Senate's 
Dignified Treatment of Wounded Warriors Act. The President's Commission 
recommended that seriously wounded servicemembers receive a patient-
centered recovery plan developed by a cadre of highly skilled recovery 
coordinators. Such a plan can only increase the level of support given 
to our wounded warriors.
  Along these same lines, the Wounded Warrior bill requires development 
of a unified and comprehensive policy between the VA and the Department 
of Defense that addresses personnel strength, training, access, 
standards, family counseling, and creation of a DOD-wide ombudsman. Of 
central importance, the Commission recommends a complete restructure of 
the disability and compensation systems. We have all heard case after 
case of lost paperwork, endless waste, bureaucratic delays, and 
confusing redundant processes. Both the Commission and the Wounded 
Warrior bill provide guidance to consolidate systems and streamline 
this process.
  One of the most important recommendations made by the Commission, 
also addressed in the Wounded Warrior bill, concerns increased support 
to the families of our Wounded Warriors. Although the Commission did 
not visit Georgia, I have spent time at Fort Stewart and Fort Benning 
with family members of deployed troops, and I have spent as much time 
with the troops themselves in my five visits to Iraq. I can tell you 
that when it comes to taking care of our servicemembers, the well-being 
of their families is of paramount, if not greater, importance to them 
than their own well-being. These troops can count on their families. 
The more we support the families, the better we are taking care of our 
troops.
  Among other things, the Dole-Shalala report recommends extending 
privileges under the Family and Medical Leave Act from 12 weeks to 6 
months, which will allow family members to take up to 6 months of leave 
to care for a wounded servicemember. I am proud to be a cosponsor of 
this bill that introduces legislation that enacts this recommendation.
  The bill Senator Pryor and I cosponsored on this subject, the Wounded 
Warrior Assistance Act, S. 1283, also contains provisions along these 
lines, such as advocating counseling and job placement services for 
family members, as well as the creation of an ombudsman's office which 
will provide support to members and their families.
  So, once again, I commend Senator Clinton for her initiative in 
getting this bill on the Family Medical Leave Act introduced and I 
concur again with the Senator from Connecticut. I hope this legislation 
is completed before we leave here in the next couple of days.
  The global war on terror has brought recognition of the enormous 
impact of two previously silent and little-noticed conditions to the 
forefront: post-traumatic stress disorder and traumatic brain injury. 
Accordingly, both the Commission and the Wounded Warrior bill address 
these issues. The Dole-Shalala report advocates the most aggressive 
treatment for both conditions by the DOD and the VA, and also 
recommends private-sector involvement to capitalize on the most recent 
and valuable findings and treatments.
  Similarly, the Wounded Warrior bill provides comprehensive and 
coordinated policies between DOD and the VA on PTSD and TBI. The 
Wounded Warrior bill creates a level of accountability for the DOD and 
VA by requiring an annual report on PTSD and TBI expenditures and 
reports assessing progress in the overall treatment of these 
conditions.
  The bill also includes a provision I proposed that builds upon a 
study at Emory University for TBI treatment and the use of progesterone 
and directs collaboration between DOD and other Federal agencies in 
TBI-related research and clinical trials.
  The approach taken by the Commission and in the Wounded Warrior Act 
capitalizes on cooperation among Federal agencies, as well as between 
the Federal Government and private sector. As part of the fiscal year 
2008 National Defense Authorization Act, I proposed a sense-of-the-
Senate amendment that DOD continue to encourage collaboration between 
the Army and the VA in the treatment of wounded warriors.
  A prime example of this type of collaboration is in Augusta, GA, 
between the only Active-Duty rehabilitation unit, located at the 
Augusta Department of Veterans Affairs Medical Center, and the 
behavioral health care services program at the Eisenhower Army Medical 
Center at Fort Gordon, GA. This unique, unprecedented collaboration 
between the Augusta VA and the Eisenhower Army Medical Center has been 
growing since its inception in 2004, assisted by GEN Eric Schoomaker, 
now the head of Walter Reed and former commander of the Eisenhower Army 
Medical Center. Our wounded warriors deserve the best possible care. 
The recommendations of the President's Commission and the requirements 
set forth in the Dignity for Treatment of Wounded Warriors Act pave a 
clear path for the type of medical treatment and support the people 
defending our Nation deserve.
  I am proud to be a cosponsor of the Wounded Warrior Act, unanimously 
approved by the Senate. I am pleased with the comprehensive 
recommendations provided by Senator Dole and Secretary Shalala. I 
especially thank the servicemembers and their families who have shared 
openly and bravely about their experiences to this body as well as to 
the Commission. Their stories made the need for this reform real to all 
of us, and their experiences can help us transform the quality of 
military health care. Doing so will be one small way of saying thank 
you to the men and women in the U.S. military for their service and 
their sacrifice.
  Mr. President, I ask unanimous consent that I have 2 additional 
minutes to address the bill before the Senator from New York is 
recognized.
  The PRESIDING OFFICER (Mr. Casey). Is there objection?
  Without objection, it is so ordered.
  Mr. CHAMBLISS. Thank you, Mr. President.
  Mr. President, I would like to address the State Children's Health 
Insurance

[[Page 22600]]

Program, the bill that currently is before the Senate. I have been a 
strong advocate of this particular program. We, in Georgia, I think, 
have one of the model SCHIP programs in the country. We call it 
PeachCare. It provides health insurance to 290,000 uninsured poor 
children in my State. We cover no adults in Georgia. Every single dime 
that is spent on this program in Georgia is spent on children, and that 
is the way it should be.
  That is one of the problems I have with the reauthorization of this 
bill as it came out of committee. It does three things that really 
bother me.
  First of all, the bill that came out of committee does not take all 
parents off of coverage under the SCHIP program on a national basis. It 
does remove, over a 2-year period, all adults who are not parents of 
some of the children who are eligible for this particular subsidy, and 
that is good. The problem is, it still covers any number of adults. 
This is a children's program, and that is where the money ought to be 
spent. Every single dollar we spend on an adult takes money away from 
children.
  Secondly, under this bill, States are authorized to go up to 300 
percent of the Federal poverty level for coverage. The previous bill 
authorized up to 200 percent of the Federal poverty level. In Georgia, 
we are at 235 percent of the Federal poverty level, which means that a 
family of four making $48,000 is eligible for coverage under our 
PeachCare program.
  Unfortunately, once you reach the level of 300 percent of the Federal 
poverty level, you are at almost $62,000 for a family of four in 
income, and you are still eligible under this program.
  Lastly, I would simply say the bill out of the Finance Committee is 
financed by the creation of new and additional taxes. I think the 
American taxpayers--I do not care in what form the taxes are--are 
already an overburdened group of citizens.
  From the standpoint of trying to find funding for this program, the 
Lott amendment did exactly what we needed to do in Georgia to cover all 
290,000 of our existing children who are covered, plus all who will be 
coming on within the next 5 years, which is the term of this bill.
  Senator Lott found offsets in his amendment that would not have 
required the raising of any taxes to cover those children. That is the 
type of sensible approach that should have been taken. I regret that it 
did not pass.
  Unfortunately, I am not going to be able to support this bill in its 
current form.
  With that, Mr. President, I thank the chairman for being generous, 
and thank the Senator from New York for allowing me to extend my time, 
and I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that the time 
until 4:30 p.m. today be for debate with respect to the amendments 
listed below, and that they be debated concurrently; that all time be 
between the managers; that no amendments be in order to any of the 
amendments covered in this agreement prior to the votes; that the votes 
with respect to the amendments occur in the order in which the 
amendments are listed here; further that after the first vote, the time 
for votes be limited to 10 minutes, and there be 2 minutes of debate 
prior to each vote; and that at 4:30, the Senate proceed to vote in 
relation to the amendments; that the Graham amendment No. 2558 be 
modified with the changes at the desk; that Senators Kyl and Graham be 
recognized respectively at 3:45 and 4 p.m. The amendments are Specter 
amendment No. 2557, Graham amendment No. 2558, Ensign amendment No. 
2540, Thune amendment No. 2579, and Kyl amendment No. 2537.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Mr. President, reserving the right to object, it sounds as 
if maybe what I understood--what I have here that was going to be in 
the agreement--was altered a little bit when the Senator read the UC. 
For instance, on the third line, beginning after the semicolon: ``that 
all time be between Senator Baucus and amendment sponsor; that no 
amendments be in order to any of the amendments''--is that the way you 
read it?
  Mr. BAUCUS. Yes--well, I struck some of those words you read and 
inserted ``the managers.'' The thought was, it gives more flexibility 
so the two managers of the bill could then work with the sponsors of 
the amendments to allocate time. Some may want to speak longer than 
others. I felt that was just a way to better organize the time.
  Mr. LOTT. I just want to make sure the manager on this side really 
wants to work with the sponsors of these various amendments.
  Mr. BAUCUS. I am sure he does.
  Mr. LOTT. Well, I am not sure he does. That was the point. But I just 
wanted to get that clarification.
  With that clarification, I have no objection.
  The PRESIDING OFFICER. Without objection, it is so ordered.

  The amendment (No. 2558), as modified, is as follows:
       Beginning on page 218, strike line 5 and all that follows 
     through page 220, line 2, and insert the following:
       (a) Cigars.--Section 5701(a) of the Internal Revenue Code 
     of 1986 is amended--
       (1) by striking ``($1.594 cents per thousand on cigars 
     removed during 2000 or 2001)'' in paragraph (1) and inserting 
     ``($50.00 per thousand on cigars removed after December 31, 
     2007, and before October 1, 2012)'',
       (2) by striking ``(18.063 percent on cigars removed during 
     2000 or 2001)'' in paragraph (2) and inserting ``(53.13 
     percent on cigars removed after December 31, 2007, and before 
     October 1, 2012)'', and
       (3) by striking ``($42.50 per thousand on cigars removed 
     during 2000 or 2001)'' in paragraph (2) and inserting 
     ``($10.00 per cigar removed after December 31, 2007, and 
     before October 1, 2012)''.
       (b) Cigarettes.--Section 5701(b) of such Code is amended--
       (1) by striking ``($17 per thousand on cigarettes removed 
     during 2000 or 2001)'' in paragraph (1) and inserting 
     ``($50.00 per thousand on cigarettes removed after December 
     31, 2007, and before October 1, 2012)'', and
       (2) by striking ``($35.70 per thousand on cigarettes 
     removed during 2000 or 2001)'' in paragraph (2) and inserting 
     ``($104.9999 per thousand on cigarettes removed after 
     December 31, 2007, and before October 1, 2012)''.
       (c) Cigarette Papers.--Section 5701(c) of such Code is 
     amended by striking ``(1.06 cents on cigarette papers removed 
     during 2000 or 2001)'' and inserting ``(3.13 cents on 
     cigarette papers removed after December 31, 2007, and before 
     October 1, 2012)''.
       (d) Cigarette Tubes.--Section 5701(d) of such Code is 
     amended by striking ``(2.13 cents on cigarette tubes removed 
     during 2000 or 2001)'' and inserting ``(6.26 cents on 
     cigarette tubes removed after December 31, 2007, and before 
     October 1, 2012)''.
       (e) Smokeless Tobacco.--Section 5701(e) of such Code is 
     amended--
       (1) by striking ``(51 cents on snuff removed during 2000 or 
     2001)'' in paragraph (1) and inserting ``($1.50 on snuff 
     removed after December 31, 2007, and before October 1, 
     2012)'', and
       (2) by striking ``(17 cents on chewing tobacco removed 
     during 2000 or 2001)'' in paragraph (2) and inserting ``(50 
     cents on chewing tobacco removed after December 31, 2007, and 
     before October 1, 2012)''.
       (f) Pipe Tobacco.--Section 5701(f) of such Code is amended 
     by striking ``(95.67 cents on pipe tobacco removed during 
     2000 or 2001)'' and inserting ``($2.8126 on pipe tobacco 
     removed after December 31, 2007, and before October 1, 
     2012)''.
       (g) Roll-Your-Own Tobacco.--Section 5701(g) of such Code is 
     amended by striking ``(95.67 cents on roll-your-own tobacco 
     removed during 2000 or 2001)'' and inserting ``($8.8889 on 
     roll-your-own tobacco removed after December 31, 2007, and 
     before October 1, 2012)''.

  Mr. BAUCUS. Mr. President, it is my understanding under the previous 
order Senator Clinton is the next to be recognized.
  The PRESIDING OFFICER. The Senator from New York.
  Mrs. CLINTON. Mr. President, I thank Chairman Baucus, and I thank 
both Senators Dodd and Senator Chambliss for their vigorous explanation 
and advocacy of the bill which we have introduced that we are proposing 
to have as an amendment to the current legislation pending before the 
Senate because we think the duty to honor our veterans, our 
servicemembers, and their families is urgent. This is a duty we take 
very seriously.
  Clearly, based on the recently released report by the Commission on 
Care for America's Returning Wounded Warriors, chaired by former 
Senator Bob Dole and former Secretary of Health and Human Services 
Donna Shalala, it is a matter of grave urgency

[[Page 22601]]

for our Nation to do everything we can to improve support for our 
servicemembers and veterans.
  The Commission found that one of the most important ways to improve 
that care is to improve support for families. That is why Senator Dodd 
and I have offered an amendment to the CHIP legislation, the Support 
for Injured Servicemembers Act.
  We are proud to have the bipartisan support of Senators Dole, Graham, 
Mikulski, Chambliss, Brown, Salazar, Cardin, Menendez, Kennedy, Boxer, 
and Jack Reed because this is a matter that goes way beyond politics as 
usual. It is certainly way beyond partisanship.
  During the course of the Dole-Shalala Commission work, they showed 
what many families across the country already knew, that the Family and 
Medical Leave Act--which Senator Dodd worked so hard on for so many 
years, and which was the first piece of legislation signed by my 
husband--has been a godsend to 60 million Americans over the course of 
the last years--people taking care of newborn babies, a family member 
with an accident or illness, caring for an aging relative. It has made 
it possible for so many Americans to balance the difficult 
responsibilities of family and work.
  But what has been abundantly clear--with all of our wounded warriors 
returning from Iraq and Afghanistan--is it has not been sufficient for 
family members to care for those young servicemembers who have 
sustained a combat-related injury.
  Currently, spouses, parents, and children can receive only 12 weeks 
of leave under the Family and Medical Leave Act. All too often, as we 
have now learned, that is insufficient, as injured servicemembers 
grapple with traumatic brain injuries, severe physical wounds, learning 
how to use a prosthetic, trying to understand what post-traumatic 
stress disorder means to them and to their futures. Indeed, family 
members have dropped everything. They have tried to be at the bedside, 
stayed in the area to help their loved one, given up jobs even. That 
seems to us to be more than the sacrifice their loved one has already 
made demands.
  Imagine if your husband or your wife or your son or your daughter had 
been injured. You would want to be with them. You would want to take 
care of them. But you would not want to lose your job in the process. 
It is not a choice that military families should have to make. 
Therefore, that is why we are asking our colleagues to join with us to 
pass the Support for Injured Servicemembers Act, and to allow us to 
fulfill this duty we all feel to our military families.
  I appreciate very much Senator Dodd's leadership on this issue for 
many years, and on this particular piece of legislation. We invite even 
more cosponsors from both sides of the aisle to join us, and we hope we 
will have a vote on this legislation before we leave, before we finish 
the CHIP legislation, so we can go home and tell military families that 
help is on the way.
  Thank you very much, Mr. President.
  The PRESIDING OFFICER. Who yields time?
  The Senator from Montana is recognized.
  Mr. BAUCUS. Mr. President, I see the Senator from Texas is seeking 
recognition. I ask unanimous consent that she be allowed to speak next 
for--10 minutes?
  Mrs. HUTCHISON. Mr. President, 10 minutes would be fine. I ask to 
bring my amendment up, set aside the pending, and continue to speak.
  Mr. BAUCUS. Certainly.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                Amendment No. 2620 to Amendment No. 2530

  Mrs. HUTCHISON. Mr. President, I ask unanimous consent to set aside 
the pending amendment and call up amendment No. 2620 and ask for its 
immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The bill clerk read as follows:

       The Senator from Texas [Mrs. Hutchison] proposes an 
     amendment numbered 2620 to amendment No. 2530.

  Mrs. HUTCHISON. Mr. President, I ask unanimous consent that the 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:


                           amendment no. 2620

    (Purpose: To increase access to health insurance for low-income 
     children based on actual need, as adjusted for cost-of-living)

       Strike section 110 and insert the following:

     SEC. 110. COVERAGE FOR INDIVIDUALS RESIDING IN HIGH COST 
                   AREAS WITH FAMILY INCOME ABOVE 200 PERCENT OF 
                   THE FEDERAL POVERTY LINE.

       (a) In General.--Section 2105(c) (42 U.S.C. 1397ee(c)) is 
     amended by adding at the end the following new paragraph:
       ``(8) Coverage of individuals residing in high-cost 
     areas.--
       ``(A) In general.--For fiscal years beginning with fiscal 
     year 2008, a State shall receive payments under subsection 
     (a)(1) with respect to child health assistance provided to an 
     individual who resides in a high cost county or metropolitan 
     statistical area (as defined by the Secretary, taking into 
     account the national average cost-of-living) and whose 
     effective family income exceeds 200 percent of the poverty 
     line (as determined under the State child health plan), only 
     if such family income does not exceed 200 percent of the 
     poverty line as adjusted for the cost-of-living in the State 
     under subparagraph (B)).
       ``(B) Adjusted poverty line.--The Secretary shall adjust 
     the poverty line applicable to a family of the size involved 
     with respect to each State to take into account the cost-of-
     living for each county or metropolitan statistical area in 
     the State, based on the most recent index data from the 
     Council for Community and Economic Research (previously known 
     as the American Chamber of Commerce Research Association),the 
     2004 Consumer Expenditure Survey of the Bureau of Labor 
     Statistics, and the Bureau of Economic Analysis of the 
     Department of Commerce.''.
       (b) Conforming Amendment.--Section 2105(a)(1) ( 42 U.S.C. 
     1397dd(a)(1)) is amended, in the matter preceding 
     subparagraph (A), by inserting ``or subsection (c)(8)'' after 
     ``subparagraph (B)''.
       (c) Regulations.--Not later than 90 days after the date of 
     enactment of this subparagraph, the Secretary shall 
     promulgate interim final regulations to carry out the 
     amendments made by subsections (a) and (b).

  Mrs. HUTCHISON. Mr. President, I rise today to offer an amendment 
that would help address what some view as a serious problem in the 
underlying legislation, and what others might view as a matter of 
fairness in the underlying legislation.
  The purpose of the SCHIP program is to provide health insurance 
benefits to children in families who make too much to qualify for 
Medicaid but not enough to afford private insurance. We define that 
criteria as families up to 200 percent above the Federal poverty line. 
The current Federal poverty line for a family of four is $20,650. The 
Federal poverty line for Hawaii and Alaska is a little higher. Two 
hundred percent, then, would be $41,300.
  My State of Texas maintains its SCHIP program consistent with the 
original purpose and therefore allows a family of four making $41,300 
to qualify for SCHIP coverage. When my constituents see the bill before 
us allowing families of four making up to 300 percent of the Federal 
poverty line, which is $61,950, to qualify for Government-supported 
health care, many believe this is going too far. They certainly take 
issue with families making up to 400 percent of the poverty line, which 
would be $82,600, receiving Government-funded health insurance.
  I have heard the supporters say that allowing coverage above 200 
percent of the Federal poverty line argue that the cost of living in 
certain areas necessitates higher Federal poverty level coverage. One 
only has to utilize the various cost-of-living calculators on the 
Internet such as those found on bankrate.com or CNN/Money to see that a 
salary in one area of the country can be worth a very different amount 
than in another. The cost-of-living calculators adjust income by 
comparing the cost of housing, utilities, and transportation, all of 
which have a significant impact on the actual need of the family.
  For example, in this chart, you see that the cost of living in 
Austin, TX, would be $40,000, whereas after you add housing, utilities, 
and transportation, if you compare that to the cost in Washington, DC, 
it would be $58,697, or rather the salaries would be commensurate after 
you add the cost-of-living indicators in it.

[[Page 22602]]

  The bill before us does not make a direct connection between the 
cost-of-living standards and approvals of SCHIP plans beyond the 200 
percent Federal poverty line restrictions. It doesn't seem right to 
arbitrarily allow coverage of families beyond 200 percent of the 
Federal line if there is no relationship to the cost of living. If 
$41,300 of family income in one State is equal to a higher amount in 
another due to a cost of living that exceeds the national average, my 
proposal would accommodate that. Why don't we say in this legislation 
that similarly situated families will be treated similarly. That is 
what my amendment would do.
  Under my amendment, the Secretary of Health and Human Services will 
be required to factor in the cost of living in States that are seeking 
to cover families above 200 percent of the poverty line. Utilizing the 
most recent index data from the Council for Community and Economic 
Research, the Bureau of Labor Statistics and the Bureau of Economic 
Analysis, the Secretary shall adjust the Federal poverty line 
throughout specific areas in those States that reflect the actual cost 
of living in those specific areas. The Secretary could then approve 
families up to twice the new adjusted Federal poverty line, accounting 
for a higher cost of living in that area.
  The Secretary would break down the analysis by county or metropolitan 
statistical area to ensure that States with high-cost areas in some 
parts of the State and low-cost areas in other parts of the State would 
not receive the same amount. This does what I think everybody has said 
we need to do, and that is adjust if there is a cost-of-living 
increase, but not lump it State by State.
  In my State of Texas, there will be metropolitan areas with a higher 
cost of living. So if my State wanted to go above the 200 percent, the 
Secretary could factor in where there needed to be an adjustment. If it 
were over the 200 percent in a metropolitan area such as Dallas, it 
might be a different calculation than if it is in a rural area, say 
Lubbock. This seems to me to equalize the unfairness of a whole State 
getting the higher rate through a waiver which the bill before us is 
trying to mitigate by putting a limitation on the percent above the 
poverty line that a State may go, but why not do it by SMSA--the 
Statistical Metropolitan Area--or by county, where you can get the 
adjustment that is right and fair.
  My amendment is very simple. The 200 percent of the poverty line, 
when adjusted for the cost of living in a specific area, could equal 
$45,000, it could equal $50,000, or it could be right at the poverty 
line. If you needed to go above it, the Secretary would be able to say 
in New York City, for instance, there should be an adjustment, but in 
upstate New York, perhaps not.
  So this is the amendment. I think this brings reasonableness, 
rationality, and equity to approvals beyond the nonadjusted Federal 
poverty limits. If you do not go above the 200 percent which is in the 
law, you would never have to make these adjustments. There are 
certainly metropolitan areas that have a legitimate claim to a higher 
cost of living, but it does not necessarily mean the whole State should 
be given that kind of adjustment, and it would be more reasonable for 
the taxpayers throughout America to know that the people were getting 
the adjustment if they needed it, but not if they didn't.
  Mr. President, I ask for the yeas and nays on my amendment.
  The PRESIDING OFFICER. Is there a sufficient second.
  There is a sufficient second.
  The yeas and nays were ordered.
  Mrs. HUTCHISON. Thank you, Mr. President.
  I thank the Senator from Connecticut also for the process, and I 
certainly would urge my colleagues to support this amendment, which I 
think is what should end up in the final bill. It is simple, it is 
clear, and it is fair.
  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. BAUCUS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Tester). Without objection, it is so 
ordered.
  Mr. BAUCUS. Mr. President, I ask that the time consumed by the 
Senator from Texas be charged against the time controlled by the 
minority, and further, that the time for the quorum call be equally 
divided.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BAUCUS. Mr. President, 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. ENSIGN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Who yields time?
  Mr. LOTT. Mr. President, I yield 5 minutes from our side. Is that 
sufficient time, I ask the Senator?
  Mr. ENSIGN. If I need more time, I will ask for it.
  The PRESIDING OFFICER. The Senator from Nevada.


                           Amendment No. 2540

  Mr. ENSIGN. Mr. President, I wish to talk about my amendment. My 
amendment says that the Children's Health Insurance Program, which is 
designed to cover low-income children, should first cover low-income 
children. Many of the States today are covering nonpregnant adults and 
I believe this is at the expense of low-income children. This program 
is called the State Children's Health Insurance Program and it is 
called that for a reason. It is supposed to be for low-income kids. It 
was not intended for nonpregnant adults.
  My amendment says that you cannot cover nonpregnant adults until you 
cover 95 percent of the targeted low-income children's population. Some 
States have extended their SCHIP coverage to nonpregnant adults. 
According to the Government Accountability Office, SCHIP covered 6 
million individuals, including more than 600,000 adults in the year 
2005. This means that 1 out of every 10 people covered by SCHIP was an 
adult. GAO indicated that in Wisconsin, two-thirds of the total SCHIP 
enrollees in 2005 were adults. Almost half of the enrollees in Rhode 
Island were adults. It also found that shortfall States are likely to 
cover a high proportion of adults.
  The GAO wrote:

       Adults accounted for an average of 55 percent of enrollees 
     in shortfall States, compared with 24 percent in nonshortfall 
     States.

  Covering adults is not the primary purpose of SCHIP. I am seriously 
concerned that nonpregnant adults may be benefitting from SCHIP funds 
at the expense of low-income children. We need to refocus the SCHIP 
program to its original intent--to make low-income children the 
priority. My amendment today will ensure that SCHIP funds are used to 
provide health insurance coverage to low-income children. In my 
opinion, that is the intent of the original law and the way in which 
SCHIP dollars should be allocated.
  This proposal does not deprive States of Federal dollars. What it 
does say is that a State can't use its SCHIP money to provide health 
benefits to nonpregnant adults until it has enrolled 95 percent of its 
targeted low-income children.
  We have heard a lot about the need to cover low-income kids, about 
keeping them healthy, and giving them a chance in life. If the States 
aren't forced to cover 95 percent of the low-income kids first, they 
will continue the current policies and many low-income kids won't be 
reached out to and brought into the SCHIP program. If we require the 
States to cover 95 percent of low-income kids, we will be amazed at how 
many of these kids the States will find.
  I believe it is important for us to adopt this amendment. If we are 
going to expand SCHIP, let us make sure low-income children are the 
priority.
  Mr. President, I yield the floor.
  Mr. BAUCUS. Mr. President, a couple of words with respect to the 
amendment offered by the Senator from Nevada. I might as well finish 
them now,

[[Page 22603]]

since he spoke. Basically, his amendment means that no State, after the 
date of enactment, could provide for adults--childless adults or 
parents, parents of kids. No State. That is what this is.
  I also point out that the standard of 95 percent is an impossible 
standard. No State can meet that standard. There is no State in the 
Nation that could meet 95 percent. We have mandatory driver's license 
requirements in States, and even those mandatory requirements average, 
nationwide, about 85 percent. That is mandatory, and we are talking 
about something voluntary here.
  So no State can possibly reach 95 percent compliance, which would 
mean, at the beginning of the date of enactment, all adults would be 
off--right now, immediately; all parents off--right now, immediately. 
And I don't think that is what we want to do. Why? Because the 
administration has granted lots of waivers to a lot of States for a lot 
of adults, and States are reliant on them.
  In this legislation, over a 2-year period, we are stopping that, but 
we give States 2 years to stop providing coverage for childless adults 
and for parents. States can provide for parents with those waivers, but 
it is written in a way to discourage the use of CHIP money for parents 
unless States go the extra mile and seek out more low-income kids to 
provide coverage for them.
  The legislation before us is a good compromise, but the amendment 
offered by the Senator from Nevada is way too Draconian. I might also 
add that all experts say if you cover parents, you will cover more 
kids. If you don't cover more parents, you are going to cover fewer 
kids. There is a very strong correlation between health insurance 
coverage for parents and parents getting good health care for their 
children. Put in reverse, there is a strong correlation of parents who 
do not have health insurance--we are talking low-income families here--
who will not provide good health care, on average, for their kids.
  On the basis of policy, I don't think it is a good idea. It totally 
disrupts the compromise worked out on both sides of the aisle on this 
legislation. Senator Grassley, Senator Hatch, myself, and Senator 
Rockefeller worked very hard to get a compromise here. This legislation 
starts to squeeze down on adults, but it doesn't cold turkey say no. 
That would be unfair, especially with respect to parents, because 
parents who have health insurance themselves will tend to provide 
better health care for their kids.
  When the appropriate time comes to vote on this amendment, I think 
the right thing to do would be not to support this amendment because of 
the reasons I indicated.
  I yield the floor.
  Mr. LOTT. Mr. President, I don't believe there is any other Senator 
wishing to speak right now, so I will rise in support of the amendment 
by the Senator from Nevada, Mr. Ensign.
  I believe that Senator Baucus, Senator Grassley, Senator Hatch, and 
those who put together this compromise did want to try to begin to get 
some control on the explosion of this program. But there are a lot of 
others who don't want to do that. They want it to go the other way.
  Yes, the administration is to blame for a lot of the problems here. 
They granted the waivers for these States, and they shouldn't have. 
They started granting waivers for higher and higher and higher income 
children to be covered, for adults to be covered--and not just pregnant 
mothers but parents and, in some States, even beyond that.
  As I have said before, there is no ``A'' in SCHIP. It is the State 
Children's Health Insurance Program--for children, SCHIP as we refer to 
it here in this Chamber. But I do have every reason to believe there 
are many who fully intend for this program, the CHIP program, to be the 
program that covers not only low-income children, middle-income 
children, but all-income children and adults. That is the goal here.
  I voted for this program 10 years ago because I thought there was a 
need to make sure that truly low-income children had access to health 
care. A lot of them were not covered, obviously, by private insurance 
or Medicaid, and I thought there was a need to address this particular 
area. But it is like so many Washington programs; once they get 
started, they never end. And once they get started, they grow and grow 
and grow.
  Who is going to help get a grip on this program? Who is going to pay 
for this program? This is a $60 billion, 5-year program this bill would 
provide for--the underlying bill. The House just passed a bill that I 
think is close to at least $80 billion over the next 5 years. They pay 
for it in the House partially by taxes but also by cutting Medicare. So 
we are taking elderly off of the Medicare Program so we can put more 
money into the SCHIP program not just for low-income children but for 
middle-income children and for adults.
  I think the Senator is absolutely right. Let us make sure these 
States provide at least 95 percent of what they are supposed to supply 
to the low-income children before any adults can get in it. Yes, they 
will have to take adults off. Exactly. They should have to. They should 
have never put them on there.
  Now, again, I acknowledge we are hopeful this bill will begin to get 
this under control. It does take away the waiver that is being used, 
and has been abused by this administration. But I cannot believe that 
Senators are ignoring the fact that this program is being exploded, 
covering people who were never intended to be covered, and paying for 
it by damaging low-income people or elderly people.
  I am glad we have this amendment. If we could at least get the adults 
off this program, even if it does cover some increased level of 
children below the 200 percent of poverty, I could see that it would be 
more acceptable. But that is not what this does.
  I fear what is going to happen in conference. I don't know, maybe the 
Senator from Montana and Senator Grassley can sit there and say, oh, 
no, no, no, we are not going above what we passed in the Senate. But I 
think the reverse is going to be true. This is the base. The $60 
billion is the beginning. It is obvious, if you have a classic 
conference, which we are not going to have, and we are at $60 billion 
and the House is at $80 billion, what is it going to be? Oh, $70 
billion. That is the way it works around here. That is the way it used 
to work, although we don't have conferences anymore now. We dished up a 
product such as we had on this lobbying and ethics fiasco a while ago.
  I don't know how we get through this and help the people we want to 
help, intend to help, and keep it from covering more and more children 
and more and more adults. If we want to go to Washington bureaucratic-
controlled and managed health care, if we want to go ahead and go to 
Government-run socialistic medicine, fine, this is it. This is the way 
it is going to happen.
  A few years ago, there was an attempt to come in the front door and 
say, oh, no, we are only going to provide free health care to 
everybody. It failed miserably, right here. And by the way, it failed 
in August of that year, I believe it was 1993. Well, here we are coming 
through the back door this time. And incredibly, even my colleagues on 
the Republican side of the aisle are buying this deal.
  I will be back. I don't know whether I will be on the floor of the 
Senate, but I will be back in years to come and say, I warned you. This 
thing is going to continue to grow. It won't be $60 billion, $70 
billion, or $80 billion, it will be $140 billion over 10, or more.
  I appreciate the amendment Senator Ensign came up with. I support it, 
and I hope we can pass it. And I wish the managers good luck in trying 
to keep control of this thing. If you pull it off, even though I still 
think you have way too big a program here, I will be first in line to 
congratulate you if you can hold it to where it is now.
  I yield the floor.
  Mr. BAUCUS. Mr. President, the Senator is always interesting, 
sometimes entertaining, but the Senator from Mississippi raised a 
couple of good questions. The real question is what are the answers to 
the questions.
  One question is, what about adults? This is a children's program, and 
I

[[Page 22604]]

think most Senators react a little adversely to covering adults. This 
Senator does too. It is a children's program, not an adult program. The 
Senator acknowledged graciously that most of the adult coverage problem 
is due to waivers this administration has given the States. The States 
want to cover adults. Why do they want to cover adults? Well, 
basically, because of the match rate, the money the States get under 
the Children's Health Insurance Program is higher, so they want to 
cover adults. What we are trying to do is figure how are we going to 
put the lid back on this. That is what we are trying to do here. It 
probably gets to the question of what is a fair transition period. What 
is the fair way to wean the States off of covering adults?
  I guess it is important to remember there are a lot of people, adults 
out in the country who are getting health insurance, and they do not 
know what we are debating here in Washington, DC. They do not know the 
difference between CHIP, Medicaid, and match rates. All they know is 
they are getting some health insurance. And I don't know if it is right 
to just willy-nilly, automatically, cold turkey cut them off entirely, 
because they are depending on it.
  I do think it is right, however, to wean States off this, and the 
States can, when their legislatures meet, figure out ways to cover 
adults they wish to but not on this program. That is what we are doing. 
That is what this legislation does. It says in the first year you can 
get a free ride, but in the second year your match rate is way down to 
the Medicaid match rate, which is basically about 30 percent less than 
the match rate under the Children's Health Insurance Program. A 30-
percent cut will have a real effect on a lot of these States and 
discourage them from proceeding further.
  In addition, legislation not too long ago repealed waivers so the 
States could no longer apply for waivers to get childless adult 
coverage. So question No. 1 is, what is the right thing to do about 
some States adding adults? Let us not forget, 91 percent of 
beneficiaries under the Children's Health Insurance Program today, 91 
percent, are kids under 200 percent of poverty. Today. The vast bulk 
are kids. So when we talk about adults, we are talking about less than 
9 percent, because some States have up to 200 percent of poverty. We 
are talking not too many people when we are talking about adults. This 
is kind of a philosophical question as much as anything else.
  What is the best way to put the lid back on the can, to keep States 
from providing it for too many adults? We think we have a fair way to 
do it, as I just described, a fair transition period, and that is why 
we negotiated out this position.
  Point No. 2 is, what is going to happen in conference. I have no 
idea. Senators know there are lots of ways to skin a cat around here. 
On the surface it looks like maybe if the Senate and House go to 
conference on these two bills--the Senate bill is much less, the House 
bill is much larger. They contain the Medicare provisions, physicians 
update provisions, and they are two different animals. When that 
happens, generally some other solution presents itself. That is why I 
say to my good friend from Mississippi, I hear what he is saying about 
the views of many Senators who do not want the conference report to 
come back with a number that is too difficult for many Senators to 
swallow, especially on the Republican side of the aisle. But I also say 
to my good friend, there are ways to do this. We may not go to 
conference exactly; the House may send back something else, maybe just 
a CHIP bill, and we will do the physicians update at a later date. 
There are many kinds of ways to do things around here.
  Our goal is to help low-income kids who do not have insurance today 
so a few more get it. This is not a huge, massive expansion. This has 
nothing to do with national health insurance, none of that.
  We are saying: Here is a program passed in 1997, it is bipartisan, 
Senators on both sides of the aisle like this program, there have never 
been any problems with it, it has worked real well, it just came up 
with reauthorization. The only slight problem is waivers for adults, 
but we are managing that. That is not a big deal. We can take care of 
that. So let's just reauthorize it, give it a little bump up to help a 
few more--not a lot, a few more kids get health insurance, and it costs 
a few dollars because health care costs are going up so much in this 
country.
  While we are helping a few kids get health insurance, at a later 
date, next year, the following couple of years--clearly, Congress has 
to address the rising cost of health insurance in this country. But as 
a bottom line, this is a good thing to do, to help low-income kids get 
some health insurance.
  Let's remember, in the United States of America there are about 48 
million people without health insurance. We are the only industrialized 
country with that many people without health insurance. It is an 
outrage. The very least we can do is help our kids get some health 
insurance, particularly those who are low-income kids. That is what we 
are trying to do in a fair and reasonable way.
  Mr. DORGAN. I wonder if the Senator from Montana will yield for a 
question?
  Mr. BAUCUS. I am honored to yield to my friend from North Dakota.
  Mr. DORGAN. As I understand it, this legislation is paid for. The 
Finance Committee reported out a piece of legislation to provide health 
care coverage for about 3 million more children, and it is fully paid 
for; is that correct?
  Mr. BAUCUS. That is correct.
  Mr. DORGAN. I don't know what is in second place with respect to what 
is important in people's lives, but if your children are not in the 
first place, something is wrong. Everybody who is a parent ought to 
understand the priority is your child--the children of this country.
  I ask the Senator from Montana, the circumstances are that we have a 
lot of people in this country who do not have health insurance 
coverage. We have substantial problems with respect to dramatically 
increasing costs of health care. The fact is, we have sick kids in this 
country who do not get health care. They ought to get health care, but 
they do not because their parents do not have enough money in their 
pocketbook or their checkbook, and they are worried what it is going to 
cost if they take their kid to the doctor.
  One of my colleagues and I held a hearing a couple of years ago, and 
a mother held up a poster with a colored picture of her son. He was 
dead. He died because he didn't get the health care he needed when he 
needed it. The fact is, that is happening in our country and, I say to 
my colleague from Montana, this is not a giant leap forward, but it is 
a significant step, to say we can do this. We can help children. We can 
provide health insurance for children who do not have it. We can fully 
pay for that bill, as the Senator from Montana has done, and his 
colleagues in the Finance Committee.
  I ask my colleague, this is not a health insurance bill that is going 
to cover all Americans, that is going to dramatically expand, is it? 
Isn't this just a piece of legislation that takes a step forward in 
saying to 3 million kids that the days they are sick, no longer will 
their parents have to make a decision about whether they can afford to 
take them to a doctor? Isn't that what this is about?
  Mr. BAUCUS. The Senator is correct. But not only is it 3 million, it 
is 3 million low-income kids.
  Mr. DORGAN. If I might further inquire, that answer means these are 
kids who come from families who do not have the resources?
  Mr. BAUCUS. And they usually do not have health insurance because 
they can't afford it, even if their employer provides it.
  Mr. DORGAN. Further inquiring, in circumstances where they might 
believe they have no choice, they don't have any money, and they have a 
desperately sick child, they are going to show up in an emergency room. 
If that emergency room doesn't turn them away--and some will--that 
child will get the most expensive or the costliest

[[Page 22605]]

health care because that is where it costs the most to provide health 
care--in the hospital emergency room. That is why this approach is so 
important.
  I hear people say, what a radical thing to do, what an awful thing to 
do. This ought to be considered a baby step forward, but an important 
baby step, nonetheless, in doing what we are required to do in this 
country. Again, that is putting our children first, especially putting 
sick children first, sick children who come from families that do not 
have the money to find a way to get them to the doctor. That is what 
this is about. This ought to be a no brainer.
  One final question, if I might. We have been on this for a while, and 
it has been a wide open discussion, and there have been a lot of 
amendments. I believe we have four or five additional votes scheduled 
at 4:30 today. I would like to inquire, what next? What do we 
anticipate? How many additional amendments might exist?
  I hope we can work through this. It is a bipartisan bill. It makes so 
much sense. What does the Senator from Montana anticipate after the 
next batch of votes?
  Mr. BAUCUS. Mr. President, I expect, frankly, the Senate will finish 
tonight, late tonight, and get this legislation passed--as well it 
should. In addition to the five amendments pending beginning at 4:30, 
there could be at least about 10 more later today--maybe a package 
about 8:00, another about 10 o'clock, something like that. My hope is 
some of those will not all be offered.
  Mr. DORGAN. It is important to finish the bill tonight. It is a 
bipartisan bill with strong support. It is a matter of giving everybody 
an opportunity to offer their amendments, which we have done. At that 
point I think it will be a significant achievement for all Americans, 
what we have done for poor, sick children in this country. I thank my 
colleague from Montana for the leadership he and Senator Grassley and 
so many others have shown on this bill. This is a very important step 
for this Congress.
  Mr. BAUCUS. Mr. President, I don't know if we have much time left. I 
am trying to figure out how much time we have.
  The PRESIDING OFFICER (Mr. Webb). Each Senator has 3 minutes 
remaining.
  Mr. CONRAD. Will the Senator yield?
  Mr. BAUCUS. Sure. How about 3 minutes?
  Mr. CONRAD. If I could ask the Senator a question or two?
  Mr. BAUCUS. Sure.
  Mr. CONRAD. I was listening to the floor earlier today. I heard 
colleagues say this SCHIP program is a first step toward socialized 
medicine. Is this Children's Health Insurance Program a new program?
  Mr. BAUCUS. I say to my good friend, this is not a new program. We 
are just reauthorizing a current program. It is not new.
  Mr. CONRAD. How many children are covered under this program?
  Mr. BAUCUS. Currently, there are about 6.6 million children covered.
  Mr. CONRAD. As I understand it, this would add several million 
children?
  Mr. BAUCUS. About 3.3 million, roughly.
  Mr. CONRAD. About 3.3 million, and there are already 6 million. I am 
wondering if they are suggesting this program should be eliminated, 
which would mean 6 million children currently covered would no longer 
be covered?
  Mr. BAUCUS. Actually, the Senator is making another point, which is 
about 6 million kids are eligible today under the current law but just 
are not covered. So we are saying we are not increasing the 
eligibility, we just want to help give a little stimulus so those who 
are currently eligible but not covered--a few more of them will be 
covered by health insurance.
  Mr. CONRAD. Is it my understanding the American Medical Association 
has endorsed this legislation?
  Mr. BAUCUS. The Senator is correct. There are many medical 
associations that support this bill.
  Mr. CONRAD. Does the Senator know of anytime in the history of this 
country where the American Medical Association has endorsed socialized 
medicine?
  Mr. BAUCUS. I don't know if I want to answer that question, because I 
can think of one major bill that many thought was socialized medicine 
but they now strongly support.
  Mr. CONRAD. I just say the argument being made out here is one of the 
most far-fetched arguments I have seen on this floor; No. 1, that this 
is somehow socialized medicine. Isn't this care provided by private 
doctors?
  Mr. BAUCUS. That is a very good point. I might say, this legislation 
received endorsements from over 50 different organizations, major 
organizations--AARP, pharmaceutical companies, the American Medical 
Association. This bill has wide endorsements.
  As the Senator has just implied--yes, this program says: OK, States, 
you figure out how you want to administer it. It is up to you, the 
States, not Uncle Sam.
  Most States say we are going to utilize health insurance companies, 
private health insurance companies to administer this, with copays and 
deductibles, and so forth.
  Mr. CONRAD. The fact is, this care is provided by private physicians 
using private insurance companies, endorsed by the American Medical 
Association and many other national organizations, including many 
business organizations; is it not?
  Mr. BAUCUS. That is correct. This legislation also provides 
assistance for States to provide--the fancy term is ``premium 
assistance''; that is, to help families pay the insurance companies.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mr. LOTT. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Under the previous order, there are now 2 minutes of debate equally 
divided prior to a vote in relation to amendment No. 2557 offered by 
the Senator from Pennsylvania, Mr. Specter.
  Who yields time?
  Mr. BAUCUS. Mr. President, we have five votes now. Senator Specter is 
detained. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BAUCUS. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that the first 
amendment we vote on in the package would be the Kyl amendment. I see 
Senator Kyl on the floor. I make that request that we proceed 
immediately to the Kyl amendment, with 2 minutes equally divided prior 
to the vote, and subsequent to the Kyl amendment, that we go back in 
the same order; that 10 minutes be allotted between votes.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Reserving the right to object. Were you making a unanimous-
consent request?
  Mr. BAUCUS. Yes.
  Mr. LOTT. Senator Kyl would like to defer to Senator Specter, who 
should be here momentarily. They are all on the Judiciary Committee. He 
would like to let Senator Specter go first, if he could.
  Mr. KYL. Mr. President, I appreciate the courtesy. Because we have 
been held in the Judiciary Committee until now, I was not able to 
debate my amendment. Given the fact there are not many people on the 
floor, I would want my 2 minutes when there are people on the floor. 
For that reason, if we could set it at one of the later votes, I would 
appreciate it.
  Mr. BAUCUS. I appreciate that. I am trying to move this along. The 
Judiciary Committee did break up some time ago.
  Mr. KYL. Thirty seconds ago.
  Mr. BAUCUS. No, longer than that.
  Mr. KYL. Well, I was there.

[[Page 22606]]


  Mr. BAUCUS. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BAUCUS. I ask for the regular order.


                           Amendment No. 2557

  The PRESIDING OFFICER. There are now 2 minutes of debate equally 
divided prior to the vote in relation to amendment 2557 offered by the 
Senator from Pennsylvania, Mr. Specter.
  Mr. SPECTER. Mr. President, the core issue is the repeal of the 1993 
alternative minimum tax rate increase. The alternative minimum tax was 
put into effect in 1969 in order to catch people who paid little or no 
taxes; people in high brackets who had sufficient loopholes to avoid 
taxation.
  Regrettably, it has grown by bracket creep to be very expansive. In 
2006, it covered 3\1/2\ million people. If it is not changed, it will 
cover 23 million people this year. The tax was increased in 1993 from 
24 to 26 percent for people making under $175,000, to 2 percent more 
for people in the upper bracket.
  This is a matter that can be explained in a minute. It is a tax which 
never should have occurred, and now we can correct it for the people in 
the lower brackets.
  The PRESIDING OFFICER. The Senator's time has expired.
  The Senator from Montana.
  Mr. BAUCUS. Mr. President, I very much share the concerns of the 
Senator from Pennsylvania, I think every Member of this body does. That 
is, no one wants the Americans who currently do not pay the alternative 
minimum tax to have to pay it next year. They will have to unless this 
body, this Congress, makes the appropriate change in the adjustment.
  I am fully committed to finding a solution so anybody who has not 
paid alternative minimum tax in 2006, when he or she files their tax 
returns next April, does not have to pay it for 2007.
  This is not a good solution. Frankly, with this solution by the 
Senator from Pennsylvania, many more Americans are going to have to pay 
the AMT; it is not paid for, it is at a cost of about $420 billion.
  Therefore, I raise a point of order that the pending amendment 
violates section 201 of the Senate Concurrent Resolution 21, the 
Concurrent Resolution on the Budget for fiscal year 2008.
  Mr. SPECTER. Mr. President, I move to waive the applicable points of 
order under the Congressional Budget Act with respect to the amendment 
and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The result was announced--yeas 47, nays 52, as follows:

                      [Rollcall Vote No. 295 Leg.]

                                YEAS--47

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Cochran
     Coleman
     Collins
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchison
     Inhofe
     Isakson
     Kyl
     Leahy
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Murkowski
     Roberts
     Sessions
     Shelby
     Smith
     Snowe
     Specter
     Stevens
     Sununu
     Thune
     Vitter
     Warner

                                NAYS--52

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coburn
     Conrad
     Corker
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Harkin
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez
     Mikulski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Rockefeller
     Salazar
     Sanders
     Schumer
     Stabenow
     Tester
     Voinovich
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The PRESIDING OFFICER (Mr. Tester). On this vote, the yeas are 47, 
the nays are 52. Three-fifths of the Senators duly chosen and sworn not 
having voted in the affirmative, the motion is rejected. The point of 
order is sustained, and the amendment falls.


                    Amendment No. 2558, as Modified

  Under the previous order, there is now 2 minutes of debate prior to a 
vote in relation to amendment No. 2558 offered by the Senator from 
South Carolina, Mr. Graham.
  The Senator from South Carolina.
  Mr. GRAHAM. Mr. President, the Finance Committee's proposal 
reauthorizing the SCHIP program for 5 years is funded by a permanent 
tobacco tax increase. That is a $35.2 billion expansion of SCHIP, which 
is above the $25 billion in the baseline budget. The money for this 
comes from a cigarette tax increase of 61 cents to $1 per pack. There 
will be a tax increase on cigars by 53 percent, with the sales price up 
to $10 per cigar.
  Despite being a 5-year reauthorization, the tax part of it goes in 
perpetuity. So it is a very simple amendment. When the program itself 
is sunset to be reviewed, let's sunset the tax part of it to be 
reviewed. That is all it is. If you are going to sunset the program, 
sunset the tax increases and make an intelligent decision at that 
point.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, the Senator clearly described his 
amendment. There is a slight problem that the cost of about $36 billion 
over 10 years is not paid for. I think we should adhere to the Budget 
Act and pay for provisions we enact.
  So, Mr. President, I raise a point of order that the pending 
amendment violates section 201 of Senate Concurrent Resolution 21, the 
concurrent resolution on the budget for fiscal year 2008.
  Mr. GRAHAM. Mr. President, I move to waive the applicable points of 
order under the Congressional Budget Act with respect to the amendment, 
and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 39, nays 60, as follows:

                      [Rollcall Vote No. 296 Leg.]

                                YEAS--39

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     McCain
     McConnell
     Murkowski
     Nelson (NE)
     Sessions
     Shelby
     Stevens
     Sununu
     Thune
     Vitter
     Warner
     Webb

                                NAYS--60

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     Martinez
     McCaskill
     Menendez
     Mikulski
     Murray
     Nelson (FL)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Tester
     Voinovich
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The PRESIDING OFFICER. On this vote, the yeas are 39, the nays are 
60.

[[Page 22607]]

Three-fifths of the Senators duly chosen and sworn not having voted in 
the affirmative, the motion is rejected. The point of order is 
sustained, and the amendment falls.


                           Amendment No. 2540

  The PRESIDING OFFICER. Under the previous order, there is 2 minutes 
of debate equally divided prior to the vote in relation to amendment 
No. 2540 offered by the Senator from Nevada, Mr. Ensign.
  The Senator from Nevada is recognized.
  Mr. ENSIGN. Mr. President, this amendment is very simple. It says we 
should focus on low-income kids before adults. The original intention 
of the program was the Children's Health Insurance Program. This says 
95 percent of all of those targeted--whether they are 200 or 300 
percent of poverty; whatever your State is--they have to be covered 
before you can cover nonpregnant adults.
  The chairman of the Finance Committee is going to say no State can 
meet this. Well, if we don't set the goal for them and don't make them 
meet it, they won't meet it, of course. So if we are going to have a 
Children's Health Insurance Program, the money should be focused on the 
children. This says you cannot spend money on the adults unless they 
are pregnant adults until 95 percent of those targeted kids are 
enrolled in the program, and that is where the money is spent. I urge 
the adoption of the amendment.
  Mr. BAUCUS. Mr. President, this is a poison pill. The effect of it is 
to kill this legislation.
  The Senator is correct, no State can meet 95 percent. No state 
currently meets 95 percent. Driver's license participation, which is 
mandatory and not voluntary, is 85 percent. Participation in Medicare 
Part D, which is voluntary and not mandatory, is only 56 percent. There 
is no way in the world any State can meet a voluntary compliance rate 
of 95 percent, so this is a killer amendment. It kills the bill. It 
ostensibly applies to adults, but it kills the bill. I urge Senators 
not to kill the SCHIP program and vote against the amendment.
  Mr. ENSIGN. Mr. President, have the yeas and nays been ordered?
  The PRESIDING OFFICER. They have not.
  Mr. ENSIGN. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The question is on agreeing to the amendment.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from Connecticut (Mr. Dodd) 
and the Senator from South Dakota (Mr. Johnson) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 43, nays 55, as follows:

                      [Rollcall Vote No. 297 Leg.]

                                YEAS--43

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Conrad
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Dorgan
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Murkowski
     Nelson (FL)
     Nelson (NE)
     Sessions
     Shelby
     Sununu
     Thune
     Vitter
     Voinovich
     Warner

                                NAYS--55

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Domenici
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez
     Mikulski
     Murray
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Tester
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--2

     Dodd
     Johnson
       
  The amendment (No. 2540) was rejected.


                           Amendment No. 2579

  The PRESIDING OFFICER. There will now be 2 minutes of debate equally 
divided prior to a vote in relation to amendment No. 2579, offered by 
the Senator from South Dakota, Mr. Thune.
  The Senator from South Dakota is recognized
  Mr. THUNE. Mr. President, let me start by saying this amendment is 
not a poison pill. By voting for this amendment, it doesn't impact any 
other part of the legislation, except to limit the expansion of SCHIP 
in the following ways:
  To show you how expansive in nature this bill is, this bill would not 
prevent a State, such as New York, from going to the 400 percent of 
Federal poverty level, which in New York is about $82,000, which, 
interestingly enough, would subject over 12,000 people in New York--
taxpayers--to the alternative minimum tax.
  So, essentially, what we are saying is you are poor enough to qualify 
for SCHIP, but you are wealthy enough to be subject to the AMT.
  My amendment says that for children or adults from families with 
incomes so high they are going to be subject to the AMT, they cannot 
also be eligible for SCHIP. Families should not be considered low-
income for the purpose of receiving taxpayer-funded health insurance 
and, at the same time, wealthy enough to have to pay the alternative 
minimum tax.
  The Congressional Budget Office scores this amendment as achieving 
savings because there will be fewer people qualifying for SCHIP than 
otherwise under this bill.
  This helps us get back to the original intent of the bill, which is 
to cover low-income children, which I strongly support. I hope Members 
will support the amendment.
  Mr. BAUCUS. Mr. President, the Senator raises two issues, the AMT and 
this legislation. They are two entirely separate, independent issues. 
We will deal with the AMT at the appropriate time, not on this bill. 
The AMT is a huge problem. This Congress and the committee are going 
to, as sure as I am standing here, make sure we have some kind of AMT 
patch so taxpayers who did not pay the AMT tax in 2006 will not have to 
pay it for 2007.
  We should not try to solve the AMT problem on the backs of the low-
income kids. It is wrong, dead wrong. I strongly urge Senators to keep 
first things first. This is a kids bill, not an AMT bill. We deal with 
kids today and help low-income kids and we will deal with the AMT at a 
later date. Believe me, we will find a solution to that.
  I urge Senators to keep their eye on the ball with kids and not to 
support the amendment.
  The PRESIDING OFFICER. All time has expired.
  Mr. THUNE. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The question is on agreeing to the amendment.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 42, nays 57, as follows:

                      [Rollcall Vote No. 298 Leg.]

                                YEAS--42

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Murkowski
     Roberts
     Sessions
     Shelby
     Stevens
     Sununu
     Thune
     Vitter
     Voinovich
     Warner

                                NAYS--57

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey

[[Page 22608]]


     Clinton
     Coleman
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez
     Mikulski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Tester
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2579) was rejected.


                           Amendment No. 2537

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes for debate prior to a vote in relation to amendment No. 2537 
offered by the Senator from Arizona, Mr. Kyl.
  The Senator from Arizona is recognized.
  Mr. KYL. Mr. President, my amendment says that the program is 
implemented as long as no more than 20 percent of the beneficiaries are 
crowded out of private insurance; in other words, no more than 20 
percent of the beneficiaries already have private insurance.
  Here is the problem: The Congressional Budget Office says that 
between 25 and 50 percent of the people who are going to be covered 
under this program already have private insurance. What is worse, every 
one of the newly eligible is already insured. In other words, CBO says 
100 percent of the newly eligible, the people we are adding to this 
program, already have insurance. Now why should the American taxpayer 
have to pay for people who already have insurance?
  Surely, in response to the argument of the other side that it is as 
efficient as we can get, we can be more efficient than 100 percent 
inefficient. My amendment says that when we get it down to only 20 
percent inefficiency, then the program takes effect; in other words, 
when only 20 percent of the people we are paying for already have 
insurance.
  The PRESIDING OFFICER. The Senator's time has expired.
  The Senator from Montana.
  Mr. BAUCUS. Mr. President, this is plainly, simply, clearly a killer 
amendment. There is no way in the world that CBO can certify 20 percent 
crowd-out. They cannot do it.
  There are many organizations trying to figure out what is the so-
called crowd-out rate. They are all over the lot. It is almost 
impossible to tell what it is. That is the reason for the big range to 
which the Senator referred. The one to one is not accurate. If you read 
the CBO table closely and go down to the next line, you will see it is 
much less, about one-third under the table. There is no way CBO can 
certify this. It cannot happen.
  If this amendment is adopted, you are basically saying no State can 
have a Children's Health Insurance Program. This is clearly a killer 
amendment. We should not kill the Children's Health Insurance Program. 
We should help more kids get health insurance, kids who are not now 
getting it.
  I urge refusal of this amendment.
  Mr. President, before we vote, I wish to set up a series of 
colloquies among several Senators after this vote. I ask unanimous 
consent that the following Senators be recognized for the following 
amounts of time on the Lincoln amendment No. 2621: Senator Lincoln, 5 
minutes; Senator Nelson of Nebraska, 3 minutes; and Senator Snowe, 3 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The question is on agreeing to the amendment.
  Mr. KYL. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. (Mr. Nelson of Florida). Are there any other 
Senators in the Chamber desiring to vote?
  The result was announced--yeas 37, nays 62, as follows:

                      [Rollcall Vote No. 299 Leg.]

                                YEAS--37

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McCain
     McConnell
     Sessions
     Shelby
     Sununu
     Thune
     Vitter
     Voinovich
     Warner

                                NAYS--62

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Tester
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2537) was rejected.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. OBAMA. Mr. President, I believe under the current agreement, the 
Senator from Arkansas, Senator Lincoln, is next. I ask unanimous 
consent simply to call up an amendment, if there are no objections.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Reserving the right to object.
  The PRESIDING OFFICER. The assistant Republican leader.
  Mr. LOTT. Mr. President, I reserved the right to object to make sure 
I understand what the request is.
  Mr. OBAMA. My only request was to call up the amendment so it would 
be pending. I will not speak any further.
  Mr. DeMINT. I ask the Senator to modify his request to allow me to 
bring up my amendment No. 2755 and allow me 10 minutes to speak.
  Mr. OBAMA. I want to make sure I do not leave the Senator from 
Arkansas waiting. I was not going to speak on this but simply get my 
amendment pending.
  Mr. DeMINT. I will speak afterwards.
  Mr. OBAMA. After the existing order? I have no objection to that.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Further reserving the right to object.
  The PRESIDING OFFICER. The Senator from Mississippi.
  Mr. LOTT. I will yield to the Senator from Idaho.
  Mr. CRAIG. Senator Lincoln is already under an operative unanimous 
consent agreement, as I understand it. There is simply a unanimous 
consent agreement to bring it up. I have been waiting to speak to an 
issue I think is critical, and I am happy to accommodate, but I wish to 
be in that mix, if at all possible, for 15 minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. LOTT. Mr. President, if I could, I object. I think we can work 
this out.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. Objection is heard. The regular order is 
before the Senate.
  Mr. LOTT. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The regular order is the recognition of the 
Senator from Arkansas.
  Mr. LOTT. Mr. President, as soon as she completes her statement, we 
can go back and get this worked out.
  The PRESIDING OFFICER. The Senator from Arkansas is recognized.


                Amendment No. 2621 to Amendment No. 2530

  Mrs. LINCOLN. Mr. President, I remind colleagues under the unanimous 
consent agreement there was also time for my colleague Senator Nelson.
  I ask unanimous consent the pending amendment be set aside and my 
amendment No. 2621 be called up for consideration.
  The PRESIDING OFFICER. Is there objection?

[[Page 22609]]

  Without objection, it is so ordered.
  The clerk will report.
  The legislative clerk read as follows:

       The Senator from Arkansas [Mrs. Lincoln], for herself, Ms. 
     Snowe, Mr. Nelson of Nebraska, Mr. Baucus, Mr. Grassley, Mr. 
     Kennedy, Mr. Enzi, Mr. Durbin, Mr. Crapo, Mr. Smith, and Mr. 
     Hatch, proposes an amendment numbered 2621 to amendment No. 
     2530.

  Mrs. LINCOLN. I ask unanimous consent the reading of the amendment be 
dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

(Purpose: To express the sense of the Senate that Congress should enact 
 legislation that improves access to affordable and meaningful health 
  insurance coverage, especially for Americans in the small group and 
                  individual health insurance markets)

       At the end of title VI, insert the following:

     SEC. __. SENSE OF SENATE REGARDING ACCESS TO AFFORDABLE AND 
                   MEANINGFUL HEALTH INSURANCE COVERAGE.

       (a) Findings.--The Senate finds the following:
       (1) There are approximately 45 million Americans currently 
     without health insurance.
       (2) More than half of uninsured workers are employed by 
     businesses with less than 25 employees or are self-employed.
       (3) Health insurance premiums continue to rise at more than 
     twice the rate of inflation for all consumer goods.
       (4) Individuals in the small group and individual health 
     insurance markets usually pay more for similar coverage than 
     those in the large group market.
       (5) The rapid growth in health insurance costs over the 
     last few years has forced many employers, particularly small 
     employers, to increase deductibles and co-pays or to drop 
     coverage completely.
       (b) Sense of the Senate.--The Senate--
       (1) recognizes the necessity to improve affordability and 
     access to health insurance for all Americans;
       (2) acknowledges the value of building upon the existing 
     private health insurance market; and
       (3) affirms its intent to enact legislation this year that, 
     with appropriate protection for consumers, improves access to 
     affordable and meaningful health insurance coverage for 
     employees of small businesses and individuals by--
       (A) facilitating pooling mechanisms, including pooling 
     across State lines, and
       (B) providing assistance to small businesses and 
     individuals, including financial assistance and tax 
     incentives, for the purchase of private insurance coverage.

  Mrs. LINCOLN. Mr. President, I ask one more unanimous consent request 
and that is to add Senator Hatch as an original cosponsor to our 
amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. LINCOLN. Mr. President, I am so pleased to be here today, 
offering this amendment to affirm this body's commitment to move 
forward with health care reform in the small group and individual 
markets this year. We certainly know our focus here is on children. We 
want it to be. We know that is a priority. We know if we take things 
one step at a time, we do a much better job at it, so we are glad to be 
here working on children's health care and the availability and 
accessibility to that.
  But we are also excited with the group of Members who have expressed 
their concern about the small group market, those of our small 
businesses and our self-employed, and the real concerns and needs they 
have in terms of access to health insurance. As is evident from this 
distinguished list of cosponsors joining me in offering this amendment, 
it is an extremely important issue, one that Members across the 
political spectrum in this body are committed to addressing in the 
coming months.
  I know this week has been about children's health care, and rightly 
so. But we must not get ourselves into believing we are nearly done, 
because we are not. Much more work is required of us to ensure all 
Americans have access to affordable and quality health care.
  There are now approximately 45 million Americans without health 
insurance. In my home State of Arkansas, 20 percent of working age 
adults are uninsured. Additionally, more than half of our uninsured 
workers are employed by businesses with less than 25 employees or are 
self-employed. These small business employees are almost always in a 
small group and individual health insurance market, where similar 
coverage usually costs more than it would in a large group market. 
Actually, they end up without anything, in terms of health insurance, 
because it becomes so costly.
  Addressing this problem must be a national priority. That is why we 
have come together as a group. Those who lack health insurance do not 
get access to timely and appropriate health care. They have less access 
to important screenings and state-of-the-art technology and 
prescription drugs.
  This is not a new problem and none of us see it as that, but it is a 
growing problem and it is one that we must address and we must begin to 
start to find the solution, the solution using new and innovative ideas 
to this age-old problem. I, along with each of these distinguished 
cosponsors on this amendment, have been working for a long time, trying 
desperately to make progress on this issue. We have not all approached 
it in the very same way, and, no, we have not necessarily seen the same 
path to a solution, but that is all right because what is important is 
that through this amendment we are recognizing and affirming our 
responsibility to come together in a bipartisan way, to use our 
individual expertise and perspectives, and to find a workable solution 
that is going to move the ball down the field and start providing real 
relief for our working families in this great country this year.
  I take a moment to thank my partners on this amendment. I thank them 
for their determination to move forward in a bipartisan fashion, to 
make real progress on health insurance reform, specifically for small 
businesses and the self-employed. I thank them for all their tireless 
efforts, because each person in this cosponsorship list has taken a 
tremendous amount of their time over the past several years to devote 
attention to this critical issue: Senator Snowe, who is on the Senate 
Finance Committee and also on the Small Business Committee; Chairman 
Baucus and Ranking Member Grassley have been wonderful, in the midst of 
all the things they have been facing, to work with us as a group to 
talk about what we can and cannot do in the Finance Committee; Senator 
Ben Nelson, who has a tremendous history in dealing with this issue, 
from the perspective of his State but also here on the HELP Committee; 
HELP Committee Chairman Kennedy; and Ranking Member Enzi, who comes 
with tremendous background; and Senator Durbin and Senator Crapo, with 
whom I have worked on so many different issues, as well as Senator 
Smith and Senator Hatch.
  We have a lot of work to do. I look forward to rolling up my sleeves, 
along with each of these cosponsors and each of our colleagues, to make 
the small businesses and the self-employed working families of this 
country a priority, as we have the children of this Nation.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mrs. LINCOLN. I wish to recognize my good friend from Nebraska, 
Senator Nelson.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Nebraska has 3 minutes.
  The Senator from Illinois is recognized.


                Amendment No. 2588 to Amendment No. 2530

  Mr. OBAMA. I ask unanimous consent the pending amendment be set aside 
so I may call up amendment No. 2588.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from Illinois [Mr. Obama], for himself, Mrs. 
     McCaskill, Mr. Harkin, Mr. Kerry, and Ms. Landrieu, proposes 
     an amendment numbered 2588 to amendment No. 2530.

  Mr. OBAMA. I ask unanimous consent the reading of the amendment be 
dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

(Purpose: To provide certain employment protections for family members 
    who are caring for members of the Armed Forces recovering from 
            illnesses and injuries incurred on active duty)

       At the end of title VI, insert the following:

[[Page 22610]]



     SEC. ___. MILITARY FAMILY JOB PROTECTION.

       (a) Short Title.--This section may be cited as the 
     ``Military Family Job Protection Act''.
       (b) Prohibition on Discrimination in Employment Against 
     Certain Family Members Caring for Recovering Members of the 
     Armed Forces.--A family member of a recovering servicemember 
     described in subsection (c) shall not be denied retention in 
     employment, promotion, or any benefit of employment by an 
     employer on the basis of the family member's absence from 
     employment as described in that subsection, for a period of 
     not more than 52 workweeks.
       (c) Covered Family Members.--A family member described in 
     this subsection is a family member of a recovering 
     servicemember who is--
       (1) on invitational orders while caring for the recovering 
     servicemember;
       (2) a non-medical attendee caring for the recovering 
     servicemember; or
       (3) receiving per diem payments from the Department of 
     Defense while caring for the recovering servicemember.
       (d) Treatment of Actions.--An employer shall be considered 
     to have engaged in an action prohibited by subsection (b) 
     with respect to a person described in that subsection if the 
     absence from employment of the person as described in that 
     subsection is a motivating factor in the employer's action, 
     unless the employer can prove that the action would have been 
     taken in the absence of the absence of employment of the 
     person.
       (e) Definitions.--In this section:
       (1) Benefit of employment.--The term ``benefit of 
     employment'' has the meaning given such term in section 4303 
     of title 38, United States Code.
       (2) Caring for.--The term ``caring for'', used with respect 
     to a recovering servicemember, means providing personal, 
     medical, or convalescent care to the recovering 
     servicemember, under circumstances that substantially 
     interfere with an employee's ability to work.
       (3) Employer.--The term ``employer'' has the meaning given 
     such term in section 4303 of title 38, United States Code, 
     except that the term does not include any person who is not 
     considered to be an employer under title I of the Family and 
     Medical Leave Act of 1993 (29 U.S.C. 2611 et seq.) because 
     the person does not meet the requirements of section 
     101(4)(A)(i) of such Act (29 U.S.C. 2611(4)(A)(i)).
       (4) Family member.--The term ``family member'', with 
     respect to a recovering servicemember, has the meaning given 
     that term in section 411h(b) of title 37, United States Code.
       (5) Recovering servicemember.--The term ``recovering 
     servicemember'' means a member of the Armed Forces, including 
     a member of the National Guard or a Reserve, who is 
     undergoing medical treatment, recuperation, or therapy, or is 
     otherwise in medical hold or medical holdover status, for an 
     injury, illness, or disease incurred or aggravated while on 
     active duty in the Armed Forces.

  The PRESIDING OFFICER. The Senator from Nebraska.


                           Amendment No. 2621

  Mr. NELSON of Nebraska. Mr. President, I rise today, along with my 
colleague from Arkansas, my friend Senator Lincoln, to speak on a 
separate but overlapping issue related to the challenge of providing 
health care coverage for the 9 million uninsured American children. Our 
colleagues Senators Baucus, Grassley, Rockefeller, and Hatch have 
forged a bold agreement to cover millions of children through the SCHIP 
program, the health program for our kids.
  However, another problem remains. These children, by definition, live 
in households that have not been adequately covered by the private 
market. In fact, of the 45 to 46 million Americans who are currently 
uninsured, over 80 percent are employed. These people get up every day 
and work hard to support their families and keep our economy moving 
forward but are left praying their family doesn't face a bankrupting 
health crisis. Fifty percent of these Americans work for small 
businesses with fewer than 24 employees. The small business workforce 
is especially important in my State, and I know it is critical for many 
of my colleagues from other States as well.
  I applaud the hard work which has gone into SCHIP, and I intend to 
vote for this important package. But I am also glad we have the 
opportunity to show our commitment toward providing market-based 
relief, which will afford additional coverage for the remaining 
uninsured Americans.
  This is indeed one of our country's greatest challenges. I look 
forward to turning our focus to solutions for small business, alongside 
the leaders of the Finance and HELP Committees who have joined us 
today. I thank the floor managers for affording us this time. I am 
encouraged by the progress made today.
  The PRESIDING OFFICER. The Senator from South Carolina.


                Amendment No. 2577 to Amendment No. 2530

    (Purpose: To amend the Public Health Service Act to provide for 
 cooperative governing of individual health insurance coverage offered 
                        in interstate commerce)

  Mr. DeMINT. Mr. President, I ask unanimous consent that the pending 
amendment be set aside, and amendment No. 2577 be called up for 
immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from South Carolina [Mr. DeMint] proposes an 
     amendment numbered 2577.

  Mr. DeMINT. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')
  Mr. DeMINT. Mr. President, one of the best ways we can help millions 
of American children access quality health coverage is to lower the 
cost of insurance for their families. Two-thirds of the uninsured have 
income at or below 200 percent of the Federal poverty level, and they 
cite a lack of affordability as a top reason for why they do not have 
coverage.
  Our Tax Code already discriminates against Americans whose employers 
do not offer health benefits. I applaud a number of my colleagues, 
Senator Wyden, Senator Burr, and many others, who have talked on the 
floor extensively about how we can equalize the Tax Code and make 
health insurance available to everyone.
  Another driver of rising health insurance prices is excessive State 
regulation. These State mandates raise the cost of insurance, which, in 
turn, increases the number of Americans who are priced out of the 
health insurance market.
  Current law traps Americans by only allowing them to buy health 
insurance in the State where they live. This is not fair, and it makes 
very little sense in a time when we are trying to lower the cost of 
health insurance. My amendment, which we call the Health Care Choice 
Act, will help millions of American children by allowing their parents 
to shop for health insurance the same way they shop for many other 
products: online, by mail, over the phone or in consultation with an 
insurance agent in their hometown.
  This amendment will empower consumers by giving them the ability to 
purchase an affordable health insurance policy with a full range of 
options. This amendment would reform the individual health insurance 
market by allowing individuals and families who reside in one State to 
buy a more affordable health insurance plan that is offered and 
licensed in another State. That is an important point.
  We are not talking about insurance that is not licensed. Every State 
has regulatory processes, and insurance products would have to be sold 
under one of those regulatory regimes in one of our 50 States. Health 
insurance plans would be able to sell their policies to individuals and 
families in every State, as other companies do in the sale of a wide 
variety of goods and services in other sectors of our economy.
  Under this amendment, consumers would no longer be limited to picking 
only those policies that meet their States' regulations and mandated 
benefits. Instead, they could examine the wide array of insurance 
policies qualified in States across the country.
  Consumers could finally choose the policy that best suited their 
needs and their budget without being tripped up by State boundaries. 
This approach would provide more choices and more freedom to all 
Americans. If they want to purchase a basic, low-cost policy without 
hundreds of benefit mandates that they do not need, they will be 
allowed to do it.
  Likewise, those Americans who are interested in a particular benefit 
would be allowed to do that as well. The Health Care Choice amendment 
will help the uninsured find affordable

[[Page 22611]]

health insurance while also providing every American with better 
insurance choices. This amendment harnesses the power of the 
marketplace to allow Americans to tailor their insurance choices to 
their individual needs. That is something we should all be able to 
support.
  According to the Heritage Foundation, a nonpartisan think tank, this 
amendment will broaden and intensify competition across health care 
plans and medical providers, encourage a serious review of existing 
health care regulations in every State, and expand the choice of 
millions of Americans of more affordable health insurance policies.
  Mr. LOTT. Will the distinguished Senator yield for a question?
  Mr. DeMINT. Yes, I will yield.
  Mr. LOTT. Mr. President, I am very interested in what the Senator has 
to say.
  Are you telling me that if I am in Mississippi and I want to buy a 
health insurance policy in South Carolina, I cannot do that?
  Mr. DeMINT. You can't. Your State limits you. The way we have this 
set up federally, there is really no national market for health 
insurance.
  Mr. LOTT. What is the possible explanation for that, or 
justification?
  Mr. DeMINT. I wish I knew. I think many years ago we didn't have a 
good regulatory structure for insurance. It was provided to the States. 
But clearly health insurance is an interstate commerce issue.
  Mr. LOTT. Absolutely.
  Mr. DeMINT. People move all over the place. Companies have offices 
all over the place. For us to continue to limit the purchase of health 
insurance to the State one lives in makes no sense.
  Mr. LOTT. I certainly agree. I thank the Senator for bringing this to 
the attention of the Senate.
  Mr. DeMINT. I appreciate the question. I appreciate the support of 
the Senator.
  In New Jersey, the average cost for a single person to buy health 
insurance is over $4,000 a year. Right across the river in 
Pennsylvania, the average is less than $1,500 a year. This amendment 
will give consumers the option of buying the health insurance that 
meets their needs and is right for them, even if it is right across the 
border. This amendment will result in significant cost savings.
  A recent study found that consumers would save an estimated 77 
percent in New Jersey, 22 percent in Washington, 21 percent in Oregon, 
and 16 percent in Maryland, if those States eliminated some of their 
mandates.
  There will also be cost savings from cutting redtape because 
insurance plans won't have to go through 50 different certification 
processes.
  By mandating benefits, State legislators have swelled the number of 
Americans without health insurance, making each health policy's 
coverage very different. They have added things such as acupuncture and 
marriage therapists and in vitro fertilization, things that may be 
important to some people but not to everyone. They should not be 
mandated to everyone.
  Finally, this amendment is widely supported by Americans across the 
political spectrum. A poll conducted by Zogby International in 
September of 2004 found that 72 percent of respondents support allowing 
an individual in one State to buy health insurance from another State, 
if the insurance is State regulated and approved, as it would be under 
this amendment. The poll showed that only 12 percent of Democrats 
opposed it.
  People understand intuitively that it doesn't matter. As the Senator 
from Mississippi just said, it doesn't make sense that we limit people 
to buying health insurance in only one State.
  I encourage my colleagues to support the amendment, and I ask for the 
yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. Is there further debate?
  The Senator from Montana.
  Mr. BAUCUS. Mr. President, this amendment is one that certainly 
cannot be accepted. Essentially, it allows insurance companies to race 
to the bottom, race to the State with the lowest level of standards of 
insurance regulation, to market and sell in any State, irrespective of 
what the standards would be in the other States. I don't think that is 
good policy. I understand what the Senator is driving at but certainly 
not tonight. Without a closer examination of what our State insurance 
regulation policies should be, this is not the time to get into this 
issue.
  Mr. DeMINT. Will the Senator yield for a question?
  Mr. BAUCUS. Certainly.
  Mr. DeMINT. Are there particular States that you think the 
regulations are unacceptable for the people who live there?
  Mr. BAUCUS. That is up to people in those States and their insurance 
commissioners, the decisions they make with respect to how their State 
sets up insurance regulation and sets up insurance commissioners.
  Mr. DeMINT. My amendment does not change any of the State 
regulations. States continue to control their own regulations. It would 
allow the residents of the State, if they did not feel that the 
mandates were appropriate for their family needs, to look at another 
State for a policy where it was also regulated.
  Mr. BAUCUS. That is correct. And that is the problem with the 
amendment. It would encourage companies to race to the bottom. I don't 
think we want that encouragement. We want a national program.
  Mr. DeMINT. I believe we have had a second on a rollcall vote.
  Mr. BAUCUS. At the appropriate time, if the Senator wishes to spend 
more time--I don't know where we are right now, frankly.
  Mr. DeMINT. Parliamentary inquiry: I believe we had a second on the 
rollcall vote.
  The PRESIDING OFFICER. The Senator from Montana has the floor. Does 
he yield?
  Mr. BAUCUS. Mr. President, if the Senator would like to have a vote 
on his amendment, we will at the appropriate time.
  The PRESIDING OFFICER. The yeas and nays have already been ordered.
  Who yields time? Is there further debate?
  Mr. BAUCUS. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BAUCUS. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                Amendment No. 2619 to Amendment No. 2530

  Mr. BAUCUS. Mr. President, I ask unanimous consent that the pending 
amendments be temporarily laid aside, and I call up amendment No. 2619 
on behalf of Senators Nelson of Florida and Alexander; that the 
amendment be agreed to and the motion to reconsider be laid on the 
table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 2619) was agreed to, as follows:

     (Purpose: To reduce the cap on the tax on large cigars to $3)

       On page 218, line 16, strike ``$10.00'' and insert 
     ``$3.00''.


                 Amendments Nos. 2631 and 2588 En Bloc

  Mr. BAUCUS. I ask unanimous consent that the following amendments be 
agreed to: No. 2631 on behalf of Senators Dodd and Clinton, and No. 
2588 on behalf of Senator Obama en bloc, and that the motion to 
reconsider be laid upon the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendments (Nos. 2631 and 2588) were agreed to.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that at 7:45 this 
evening, the Senate proceed to vote in relation to the following 
amendments; that no amendment be in order to any of the amendments 
listed here prior to the vote; that there be 2 minutes of debate 
equally divided prior to each vote; that after the first vote, the vote 
time be limited to 10 minutes; that the

[[Page 22612]]

amendments be voted in the order listed: Coburn No. 2627, Vitter No. 
2596, Allard No. 2535, Hutchison No. 2620, Kyl No. 2562, and Sanders 
No. 2600.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Mississippi.
  Mr. LOTT. Mr. President, reserving the right to object, I ask only 
that the Senator include in his request that Senator Coburn have 5 
minutes before his vote, which is the first in the group.
  Mr. BAUCUS. I amend that to be equally divided.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


        Unanimous Consent Agreement--Executive Calendar No. 240

  Mr. BAUCUS. Mr. President, I ask unanimous consent that at the 
conclusion of the next group of votes, the Senate proceed to executive 
session to consider Calendar No. 240, Timothy DeGiusti, of Oklahoma, to 
be a U.S. district judge; that there be 2 minutes for debate equally 
divided between the chairman and ranking member; that the Senate then 
vote on the nomination, the motion to reconsider be laid on the table, 
the President be immediately notified of the Senate's action, and the 
Senate return to legislative session.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BAUCUS. Mr. President, I ask that at this time Senators Klobuchar 
and Coleman be granted 10 minutes for a colloquy.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The Senator from Minnesota.


                         Tragedy In Minneapolis

  Mr. COLEMAN. Mr. President, my colleague, Senator Klobuchar, and I 
wish to thank our colleagues in the Senate for their thoughts and 
prayers for the victims in the almost unconscionable tragedy that 
struck our State yesterday.
  We just returned from the scene of an unprecedented disaster in our 
State's history. As my colleagues have watched on the news over the 
last 24 hours, one of the busiest bridges in Minnesota--the I-35W 
bridge near the University of Minnesota in Minneapolis--collapsed into 
the Mississippi River yesterday evening.
  The Mississippi is not just a river in Minnesota; it is our identity. 
Right near where the bridge went down, in 1680, Father Louis Hennepin, 
the first European in the region, first spotted the Falls of St. 
Anthony. A few years earlier, he ``discovered'' Niagara Falls as well. 
As the head of navigation of one of the world's great rivers, the Falls 
of St. Anthony became the focal point for Minnesota's lumber, textile, 
and flour-milling businesses that put us on the map.
  Many Minnesotans have visited the spot far upstream in northwestern 
Minnesota, where the ``Mighty Mississippi'' is a little stream, flowing 
out of Lake Itasca, that you can walk across. It is why we call 
ourselves the Headwaters State and pride ourselves of being a place of 
invention and innovation.
  So when the bridge came down 24 hours ago, part of Minnesota's soul 
fell with it as well. Having visited the site firsthand today, there 
are three things I would like to join Senator Klobuchar in asking of 
our colleagues, our fellow Minnesotans, and all Americans this 
afternoon.
  First, and most importantly, please keep the victims of this tragedy 
and their families in your thoughts and prayers. The courage of the 
first responders and other citizens who joined together last night in 
the noblest of rescue efforts will receive our unending respect. 
Unfortunately, our mission is no longer rescue but recovery.
  The days ahead will be incredibly difficult for the families of the 
victims of those who we know have already left us and the many more who 
remain missing. For comfort in this time of unspeakable tragedy, we 
implore each and every one of you to honor their loss by keeping them 
near to your heart and in your prayers.
  Secondly, let us acknowledge the skill, coordination, and courage of 
those responding to the scene of this horrific event. I was the mayor 
of St. Paul, Minneapolis's twin city and proud neighbor, when we 
experienced the tragedy that will define our era--the attacks of 9/11. 
I remember the challenges we had with communication, with logistics, 
and with overall preparedness.
  Minneapolis, St. Paul, and the State of Minnesota learned the lessons 
of preparation that day and set out to ensure that if any major 
emergency should happen again, we would be ready. Mr. President, you 
hope that day never comes, but yesterday it came for the ``Mill City.''
  Our Governor, Mayor Rybak, Hennepin County Sheriff Rich Stanek's 
office, other local first responders--police and fire--and hundreds of 
Twin City residents responded in a manner which those of us who 
witnessed will carry with us forever.
  Mr. President, Senator Klobuchar and I saw the living definition of 
heroism and leadership today.
  We saw and heard stories of bystanders linking arms to pull victims 
from submerged automobiles, rescue divers braving the dangerous current 
of the Mississippi to reach vehicles beneath shredded concrete and 
jagged steel, and the faces of moms and dads reunited with their 
children after their miraculous escape from a trapped schoolbus. These 
images will reverberate across our State for years to come, and we owe 
all those who contributed to those stories of survival our eternal 
gratitude.
  Finally, as we move forward in the coming days and weeks, let us 
commit ourselves to rebuilding this critical artery in our heartland 
and to protect against another tragedy such as this from ever occurring 
in our great Nation. This process will take time, energy, and 
dedication.
  Next, it is absolutely critical we begin a comprehensive evaluation 
of our Nation's infrastructure immediately. The one thought many of my 
colleagues have conveyed to me over the last 24 hours is the fear this 
could have happened to any bridge in their home State or hometown. We 
need to make sure it never will.
  We also need to rebuild. Our Federal Highway Administration operates 
a program to assist in this type of disaster, providing emergency 
relief for Federal highways in the wake of tragedy.
  Our Governor made a request today to the Secretary of Transportation. 
Senator Klobuchar and I will join the entire Minnesota delegation in 
working with the Department of Transportation to transfer this funding 
as quickly as possible. My colleague will talk a little bit about some 
of the details of what we are asking. We need, in sum, to make the 
funding as expeditious as possible. We have some legislative hurdles we 
believe we can correct.
  Senator Klobuchar and I have introduced a bill to waive the cap on 
emergency highway funds that can be transferred in such a scenario and 
to allow those funds to be used to help transit routes and facilities 
in the meantime, as an interim measure.
  We do not have much time to rebuild in Minnesota. The construction 
window is extremely small because of our difficult winters. We need to 
pass this waiver before we recess, hopefully, tomorrow.
  As Minnesota has come to the aid of other States in their time of 
disaster, we are going to need a lot of help in our home State. I am 
happy to hear from around this Capitol and throughout the 
administration that help will be coming very soon.
  We must wrap our arms around those who have lost and grieve.
  There will be the temptation to turn pain and agony and suffering 
into anger and blame. Unfortunately, blame will come--responsibility 
for this tragedy may lie in many places--but I ask all of us today, let 
prayers and support be the order of the day.
  Our obligation and commitment to the victims of the horror of 
yesterday's tragedy must be to recognize that we can no longer put off 
our commitment and obligation to our Nation's infrastructure.
  I am committed to that cause on behalf of Minnesota and reach out to 
my colleagues to ask you to join with me

[[Page 22613]]

in making that commitment to all of America.
  At one of the darkest moments of the American Revolution, George 
Washington wrote these words in a letter:

       Perseverance and spirit have done wonders in all ages.

  The people of Minnesota are writing a new chapter in that American 
story in the aftermath of one of the worst disasters my State has ever 
seen.
  I am honored to be a Minnesotan today, and I look forward to what I 
trust we will accomplish together tomorrow.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Ms. KLOBUCHAR. Mr. President, I thank my colleague, Senator Coleman, 
for those fine words and for his description of the history of the 
Mississippi River, which is such an important part, as he noted, of our 
State's history. But for me it is personal. I live only 8 blocks from 
where this bridge buckled under. This is a place where every day I 
drive with my husband and our 12-year-old daughter.
  As I looked down at that bridge, when I stood on the side and saw 
that schoolbus barely hanging to the side of that fallen concrete, I 
thought of those drivers, I thought of those other moms with their kids 
in the backseat--that on an August day, maybe they were going to a 
Twins game or maybe they were driving home from work--and never did 
they expect that a massive eight-lane interstate highway bridge would 
suddenly buckle to the ground. That is what we saw when we went there 
this morning.
  But the other thing I saw that I come back to tell the Nation is 
there are little miracles every day--the miracle of that schoolbus, 
where kids from a very poor neighborhood in Minneapolis were sitting 
and somehow saved, and acts of heroism. People saw on the news the 
woman diver who went in and back in and back in, without any safety 
equipment on, among the concrete and the shards looking for survivors.
  This was a disaster that no one expected, but it was something our 
city and our State had planned for. We learned the lessons from 9/11, 
and we had many practices for these kinds of disasters. I was the 
former prosecutor for this area. I remember meeting with the sheriff 
and the police chief and we planned these drills and we went through 
them. You could see the results today. You could see the lives that 
were saved.
  When we got in today and drove on this highway, there were actually 
billboards--actual billboards--already up telling people how to get 
around the scene. There were actually 24 buses added to the transit 
service, already, at 6 a.m. in the morning and advertised in the 
newspaper so people could get to work. This is going to be a model as 
we go forward for how to handle national disasters.
  The Mississippi River starts in Minnesota. In fact, you can walk 
across it by Lake Itasca, as Senator Coleman noted. But then you go 
down and it gets bigger and bigger and pretty soon it ends in New 
Orleans.
  When I think about what happened today, I think of a much bigger and 
more massive disaster with Katrina and how that was handled and how 
people in Washington responded. In some ways, I always think of those 
people stranded on those roofs. I think the mirror of those people was 
a reflection of leadership and a lack of leadership. We are not going 
to let that happen in Minnesota.
  We know this is not the massive disaster of Katrina. But it is a huge 
mess, and it involved a loss of life. So we are coming together, 
bipartisan, with our colleagues on the other side of the aisle. Senator 
Reid is fully behind this. Senator Durbin, Senator Schumer, Senator 
Murray--they all talked to me already this morning, and they pledged 
their support.
  So what we have proposed, working with Senator Coleman--we are 
working together on this--and working with the Republican leadership, 
is we get a bill passed tonight to at least authorize a lifting of the 
cap so we can move forward for emergency disaster relief.
  But I think this is also a reminder, as we go forward, that we have 
to invest in our Nation's infrastructure. We do not know what the cause 
of this disaster was. One thing I learned as a prosecutor is, you do 
not come to conclusions unless you know the cause. But this is a 
reminder that we need to invest in our long-term infrastructure, and we 
need to have those emergency funds in place, because a bridge such as 
this in the middle of America should not fall into a river on an August 
day.
  We need to get to the bottom of this and we will rebuild this bridge 
and we will rebuild this country.
  Our prayers are with the families, our thoughts are with the rescue 
workers. We thank them for working throughout the night. We thank our 
hospital personnel and our firefighters and our police officers and the 
ordinary citizens who were walking by--it is right in the middle of the 
University of Minnesota campus--and dove into that river to help.
  This was the true spirit of Minnesota, and the world watched last 
night.
  Thank you, and I thank my colleagues for their support and all the 
help they have given us as we move forward. This is going to be a long 
process. It is not going to end tonight. Our goal is to get this bridge 
rebuilt and to get our city moving again.
  Thank you very much.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas.


                           Amendment No. 2621

  Mrs. LINCOLN. Mr. President, having visited with certainly the 
managing Senators for this bill, I would like to call up my amendment 
No. 2621. I believe it is appropriate at this time to ask unanimous 
consent for its acceptance.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, I thank the Senator for her efforts on 
this amendment. She has worked very hard on it, and I urge the adoption 
of the amendment.
  The PRESIDING OFFICER. Without objection, the amendment is agreed to.
  The amendment (No. 2621) was agreed to.
  Mr. GRASSLEY. Mr. President, I ask unanimous consent for possibly 10 
minutes to have Senator Burr, Senator Bennett, and myself engage in a 
colloquy.
  The PRESIDING OFFICER (Mr. Sanders). Without objection, it is so 
ordered.
  Mr. GRASSLEY. Mr. President, as my colleagues have stated, we have to 
make health insurance more affordable. One thing Democrats and 
Republicans can agree on is that there are inequities in the tax 
treatment of health insurance. We all agree that Congress should level 
the playing field and expand access to health insurance; the question 
gets down to how.
  Proposals which have been introduced so far include the President's 
proposal, which includes a standard deduction for health insurance. 
Senator Burr, Senator Coburn, Senator Martinez, Senator Corker, and 
Senator Dole have formally introduced a tax credit proposal. Each 
proposal contemplates eliminating the exclusion for employer-provided 
coverage to meet this end. Currently, a taxpayer who receives health 
insurance through his or her employer is not taxed on the cost of the 
health coverage. Individuals who do not receive health coverage through 
their employer and are not employed and purchase health insurance on 
the individual market generally do not receive a tax benefit. As we 
just discussed, this problem is most acute in the small business 
context.
  Senator Wyden and Senator Bennett are also interested in fixing the 
health care system and making health insurance more affordable. Their 
proposal also contemplates amending the Tax Code for that purpose. I 
commend Senators Wyden and Bennett for their work in this area.
  I wish to ask Senator Burr if he would take an opportunity at this 
time to comment on this and explain where he is coming from, and then I 
will call on Senator Bennett.
  Mr. BURR. Mr. President, I thank Senator Grassley for, as a key 
member of the Finance Committee, acknowledging the fact that it is time 
we

[[Page 22614]]

treat all Americans the same; that if you give a tax break on one side, 
you should give a tax break on the other side; that you should treat 
everybody alike. I think we approach this in a bipartisan way with 
Senator Wyden and Senator Bennett, and though we disagree about exactly 
how to implement it, this is tremendous progress.
  As the chairman described the difficulty we have today and the 
challenge in front of us, I think all of us say: When are we going to 
fix it? Today, we are on the floor talking about an expansion for 
uninsured children. What we are attempting to do is to take care of the 
whole uninsured population. Through refundable tax credits, which I 
believe reach all Americans--not some and not just those with incomes 
that have tax deductibility at the end of a calendar year but all 
Americans--I think we accomplish that commitment to say we want to go 
out and make sure every American has coverage. We want to make sure 
they have the resources to go in the private marketplace and negotiate 
coverage that reflects their age, their income, their health condition. 
We want health care to be portable so you are no longer locked to an 
employer because of health care. We want individuals to have the 
capacity to take it with them, regardless of where they work.
  We propose that once we reach tax equity, every individual in this 
country would receive annually a $2,160 refundable flat tax credit, and 
every family would receive a $5,400 annual refundable flat tax credit, 
more than enough money to cover the tax consequences of a benefit that 
is not treated as wages, and for any extra money that is left over if 
you are on employer plans, it would be deposited in a health savings 
account where those additional funds could only be used for health 
care.
  For individuals in the market today who don't have coverage, all of a 
sudden we have provided the money for them to go into the marketplace 
and to negotiate coverage for themselves or for their families. That 
check would go directly from the U.S. Treasury to the insurer that is 
providing that coverage. If there is something left over from their tax 
credit after they have negotiated for coverage, it would go into their 
health savings account.
  We are maximizing the amount of dollars just by treating Americans 
the same--not by giving one special favors and others being deprived of 
that but saying we are going to treat all Americans the same. Then, an 
amazing thing happens: We no longer have a debate on uninsured 
Americans because every American has the opportunity through that--it 
is not under the Government plan--to receive that refundable flat tax 
credit.
  Some may be at home saying: This really doesn't apply to me. But it 
does because when you eliminate the uninsured in this country, you 
eliminate the cost shift each one of us who has health insurance today 
pays for. I tell my colleagues that the cost of every American's health 
insurance will come down if, in fact, we solve this problem once and 
for all.
  I think the commitment from the ranking member of the Finance 
Committee is an important first step for us treating the tax side of 
this in an equitable fashion, and I look forward to working with our 
other colleagues on exactly what the solution is.
  I yield the floor.
  Mr. BENNETT. Mr. President, I apologize for my voice. Some people may 
say I need a little health care, but, in fact, I am in good shape.
  I wish to thank the ranking member of the Finance Committee for his 
diligence in this situation as well as his attention to this issue over 
more than a decade. As a very freshman Senator in 1994, I participated 
in the debate we had on comprehensive health care that ended up in a 
situation President Clinton described in his State of the Union Message 
the following year. He said: Last year, we almost came to blows over 
health care, and he wanted to know why we couldn't get together on 
bipartisan lines.
  Well, the ranking member of the Finance Committee has signaled his 
willingness to get together along bipartisan lines. Senator Wyden, a 
member of the committee, has talked to me about this, and I have been 
more than happy to join with Senator Wyden, and I thank him for his 
statesmanship and his willingness to deal with this question in a 
bipartisan way.
  Senator Burr has talked about how universal coverage--the term 
Republicans always used to hate to use--is now a legitimate concept. 
Universal coverage used to be code word for a single-payer, government-
run system, which Republicans opposed. We now understand that everyone 
in the country should have access to health care so that the cost 
shifting Senator Burr talked about can stop and the debates over what 
can be done for the uninsured can stop, and it can be done if we change 
the tax laws in an intelligent way.
  Our tax laws for the coverage of health insurance go back to the 
Second World War. I think the economy has changed sufficiently since 
the Second World War that we can recognize that the tax laws need to be 
changed. Senator Wyden's leadership on this issue, opening up the 
question of how we can use tax credits now to achieve what Democrats 
have wanted to achieve for a long time, which is universal access to 
health care, and at the same time provide what Republicans have wanted 
for a long time, which is real market forces in health care, to me is 
an idea whose time has come.
  So I am looking forward to the opening the ranking member of the 
Finance Committee has suggested, where the Finance Committee can have 
hearings on this issue when we come back after August. I know that will 
require the cooperation of the chairman of the committee, and I am not 
being presumptuous to try to suggest what the schedule should be. But I 
am grateful that the conversation is taking place, that the recognition 
that hands must be joined across the aisle to deal with this question 
that has been raised, and I look forward to participating in the debate 
in any way that I can be helpful.
  Mr. GRASSLEY. Mr. President, how much time remains?
  The PRESIDING OFFICER. One minute.
  Mr. GRASSLEY. I am going to not say any more, but I ask unanimous 
consent for 3 additional minutes, and then I will be done because there 
are three other Members whom I forgot to mention whom I promised a 
minute to.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRASSLEY. I yield 1 minute to Senator Corker and then 1 minute to 
Senator Martinez and then 1 minute to the Senator from Oklahoma, or 
whoever wants to use the last minute.
  Mr. CORKER. Mr. President, I appreciate the opportunity to speak to 
this issue. Certainly, Senator Bennett and Senator Wyden, Senator 
Coburn, Senator Burr, and Senator Martinez and a number of people have 
joined in this debate, and we have spent a great deal of time talking 
about the important health care bill, the one we are voting on right 
now tonight. But the fact is, we all know we need to reform health care 
so that we have equal tax treatment, so that people have the 
opportunity to actually buy private health insurance and choose the 
physicians of their choosing.
  We can continue to have these short-term fixes--we now have a fix 
that takes us through 2012 on this program--or we can have reform that 
really works. I appreciate the chairman and the ranking member having 
hearings for us to be able to talk about this in a real way. I hope 
what has happened with Senators Wyden, Bennett, and Burr, and Senators 
Coburn and Martinez and others, including myself, is that hopefully we 
will have an opportunity to have a real debate on health care reform so 
that we can really move toward what this country ought to do, and that 
is to make sure Americans have the opportunity for affordable, quality 
health care, and we can move beyond these short-term solutions we are 
faced with today.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida is recognized.
  Mr. MARTINEZ. Mr. President, I wish to rise also to speak on this 
issue. It is very important that we talk about children's health care, 
as we have been

[[Page 22615]]

doing over the last several days, but it is equally important that we 
talk about all Americans. In the State of Florida, 17 percent to 20 
percent of the people are uninsured on any given day. That is 
unacceptable. We as a country have to deal with this issue. I want to 
deal with it in a way that allows for there to be tax equity, for one 
thing, for those who purchase health insurance through their employer 
and have tax equity for those who choose to buy a single individual 
policy of their own. We need to find a way through the tax credit 
program we have introduced with this bill so that we then make it 
possible for people to buy health insurance.
  So the goal is not to create a single-payer system, to create a 
government-run system--which we know is not ideal and which we know has 
not been the way to provide the greatest and best care--but to provide 
a way for people to become insured and for those who cannot afford it 
to have an opportunity through the Tax Code to get the help they need 
so they can purchase it.
  I believe there are a lot of good ideas we need to discuss, a lot of 
debate that needs to take place. At the end of the day, I don't think 
we should fear a discussion, and we should not fear the possibility 
that we all are coming to a consensus on the idea that all Americans 
have to have a place where they can go for their health care. A lot of 
health care dollars can be saved if people have that kind of 
maintenance and care all along so that they are not only going to a 
health care facility in a crisis, in a medical crisis. We would save a 
lot of dollars in the end, and the quality of life of the American 
people would increase as well.
  I thank the ranking member for his courtesy and yield the remainder 
of my time to him.
  The PRESIDING OFFICER. The Senator from Oklahoma is recognized.
  Mr. COBURN. Mr. President, I just want to make two points on the 
Every American Insured Act, and that is that every American ought to 
have access to health care, and if we do that, the average American's 
health care policy right now would go down $1,000 a year. There is over 
$250 billion in cost shifting that is in the system today that will go 
away. We ought to be thinking about that. We ought to be looking at it.
  What we do know from around the world is that a true competitive 
market will yield the best quality and the best results and the best 
outcomes for every American.
  Mr. GRASSLEY. Mr. President, the underlying intent of any of these 
proposals is to put downward pressure on insurance costs, thereby 
reducing the cost of health care.
  If Congress goes in the direction of a tax credit, the tax credit 
must be structured so that low-income individuals have a meaningful tax 
subsidy to purchase health insurance.
  If Congress goes in the direction of a standard tax deduction, any 
deduction must be structured to ensure that taxpayers who continue to 
receive health care coverage through their employer do not see a 
significant increase in their taxes.
  Congress should also contemplate a combination of a tax credit and a 
deduction.
  A combination effectively marries these tax concepts and may serve as 
a viable compromise.
  I believe that the Senate Finance Committee should hold hearings on 
the various ways we can reform the health care system. We may even be 
able to mark up a proposal that could be acted upon by this body before 
the end of the year.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arizona is recognized.
  Mr. KYL. Mr. President, there is only about 17 minutes before voting 
starts. I have an amendment I would like to speak to for 4 or 5 
minutes. If there is not somebody else who needs that time right now, 
let me do that.
  This relates to an amendment that will be, I believe, the last one we 
vote on in this next tranche that simply reinserts into the code the 
very minimum wage tax provisions the Senate voted on and approved. It 
was--if not unanimous, it was a very strong vote in favor of those 
provisions.
  Recall that when the minimum wage bill was dealt with in the House, 
they originally had a bill, but they ended up putting it in the Iraq 
supplemental appropriation because that was a must-pass bill. So the 
minimum wage provisions were attached to that bill, and they passed but 
without all of the Senate-passed tax provisions.
  The bill we are literally debating tonight came from the House of 
Representatives and is that tax bill. Now, we have amended it to 
include the SCHIP provisions, but what we need to do is to use that 
House shell bill for its original purpose, also, and that is to add 
back the exact provisions we passed in this body to help small 
businesses offset the costs of the minimum wage requirements we imposed 
upon them. They have to do with depreciation for leaseholds, 
restaurants, and for some retail construction. I will explain what each 
of them is.
  Under the leasehold restaurant renovation provision, under current 
law, leasehold and restaurant improvements and renovations are 
depreciated over a 15-year period, but that only applies through the 
end of this year. What we did here in the Senate was to extend that 
treatment through the end of 2008--very reasonable.
  New restaurant construction. Current law requires that components of 
a new restaurant be depreciated over as long as 39 years, if you can 
believe it. It doesn't make sense to depreciate restaurant renovations 
over 15 years but new construction over 39. So what the Senate did was 
to fix this inconsistency and provide for the same appreciation, a 15-
year period, and to extend that again through the end of the year 2008. 
This applies to things such as convenience stores. A direct competitor 
of a quick-service restaurant can use the 15-year depreciation schedule 
for all construction, and it is permanent in our Tax Code. If you have 
a different kind of restaurant, you don't have that same tax treatment. 
The Senate recognized that inconsistency and put that into the law and 
extended it until 2008.
  Finally, an owner-occupied retail. Improvements made to that were 
depreciated for as long as 39 years. The Senate recognized that owner-
occupied retail space is not renovated and maintained as often as 
leased space. So our minimum wage bill provided a 15-year recovery 
period for improvements made to owner-occupied retail spaces. We 
extended that same treatment through the end of the year 2008.
  My point is those three provisions, which we passed in this body--I 
think they are all supported by members of the Finance Committee--are 
not law only because they got dropped in the very bill we are debating 
today that came over from the House. It is, therefore, the perfect 
opportunity for us to put them back in.
  I am sure my friend, the chairman of the committee, will say this is 
the wrong bill to do it; this is the SCHIP bill. Well, I say we should 
not have put the SCHIP bill on the tax bill. We should use that tax 
bill for its original purpose--to have the House have to pass the same 
tax provisions we passed. We have to deal with these expiring 
provisions sometime this year. Right now, they expire at the end of 
this year. We have to do it. We might as well do it in the very bill it 
was intended to be done on right now.
  There may be a commitment to do all of these so-called extender 
provisions sometime before the end of the year. When we come back in 
September, things are going to get pretty dicey with the issues 
relating to foreign policy and, ultimately, probably tax bills such as 
AMT relief. We have the FAA reauthorization and all these other things, 
with time running out.
  There is no reason we cannot do it now. I suggest that we do it. All 
this amendment does is extend the current law provisions for 
restaurants and leaseholds through the end of 2008--the same thing we 
would be doing with the usual extender package--and adding the new 
restaurants construction and owner-occupied retail space to the 15-year 
depreciation category, as we already did when we passed the minimum 
wage bill in the Senate.

[[Page 22616]]

  Remember, we have now imposed the minimum wage burden on small 
businesses, and they are going to expect some relief so they don't have 
to bear all of the expense of it. They expected that relief. They are 
not going to get it if we are not able to extend it before the end of 
this year. This is the place to do it. I hope my colleagues, when they 
get to this last amendment, No. 2562, relating to depreciation for 
retail and restaurants and construction, will recall that they have 
already supported this once before. We have this commitment to our 
small business constituency, and I think this is the perfect vehicle 
for us to ensure that that relief actually gets to them and that they, 
therefore, can take advantage of it beyond the end of this current 
year.
  Mr. COBURN. Mr. President, under the previous order, at 7:45, I had 5 
minutes reserved. I wish to start on that amendment now, and that would 
give me a total of 10 minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. BAUCUS. Mr. President, I understand we have worked on another 
amendment, a Senator Wyden amendment, on juvenile diabetes. I 
understand it has been worked out all the way around. I urge the 
Senator to offer it now so we can get that out of the way, and the 
Senator from Oklahoma can then speak.
  Mr. COBURN. I withdraw my request.


         Amendment No. 2570, As Modified, to Amendment No. 2530

  Mr. WYDEN. I thank the chairman from the Senate Finance Committee.
  I ask unanimous consent to call up my amendment No. 2570, and I send 
it to the desk with a modification.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Oregon (Mr. Wyden) proposes an amendment 
     numbered 2570, as modified.

  The amendment is as follows:

       On page 217, after line 25 insert the following:

     SEC. _. DEMONSTRATION PROJECTS RELATING TO DIABETES 
                   PREVENTION.

       There is authorized to be appropriated $15 million during 
     the period of fiscal years 2008 through 2012 to fund 
     demonstration projects in up to 10 states over 3 years for 
     voluntary incentive programs to promote children's receipt of 
     relevant screenings and improvements in healthy eating and 
     physical activity with the aim of reducing the incidence of 
     type 2 diabetes. Such programs may involve reductions in 
     cost-sharing or premiums when children receive regular 
     screening and reach certain benchmarks in healthy eating and 
     physical activity. Under such programs, a State may also 
     provide financial bonuses for partnerships with entities, 
     such as schools, which increase their education and efforts 
     with respect to reducing the incidence of type 2 diabetes and 
     may also devise incentives for providers serving children 
     covered under this title and title XIX to perform relevant 
     screening and counseling regarding healthy eating and 
     physical activity. Upon completion of these demonstrations 
     the Secretary shall provide a report to Congress on the 
     results of the State demonstration projects and the degree to 
     which they helped improve health outcomes related to type 2 
     diabetes in children in those States.

  Mr. WYDEN. Mr. President, I will be very brief. The amendment has 
been accepted by the leadership on the Senate Finance Committee. We 
have been talking a lot about health care. We have a lot of health care 
in our country, but, unfortunately, not enough prevention or wellness.
  This amendment is designed to deal with epidemic juvenile diabetes. 
We can effect it by encouraging people to change behavior through 
personal responsibility with a bipartisan agreement to promote that.
  I urge its adoption.
  Mr. BAUCUS. Mr. President, as the Senator indicated, it has been 
agreed to by both sides.
  The PRESIDING OFFICER. Without objection, the amendment is agreed to.
  The amendment (No. 2570), as modified, was agreed to.


                      Amendment No. 2618 Withdrawn

  Mr. BAUCUS. Mr. President, before the Senate proceeds, I ask 
unanimous consent that amendment No. 2618 be withdrawn.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Oklahoma is recognized.


                           Amendment No. 2627

  Mr. COBURN. Mr. President, I ask unanimous consent to call up 
amendment No. 2627, and I ask unanimous consent that Senator Vitter be 
added as a cosponsor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is pending.
  Mr. COBURN. Mr. President, this is a fairly straightforward 
amendment. I am not sure what the chairman thinks about it. One of the 
things we know--even from the chairman's words earlier--he rejected the 
CBO evaluation of the new enrollees in this system. What we do know is 
that a large number of children who now have insurance with their 
parents are going to be moved out of that insurance to somewhere else.
  In the old SCHIP program, we had a concept of premium assistance. In 
the two States that have gotten through the very tough parameters of 
that assistance and have met it to meet the requirements of SCHIP, we 
found fewer kids go away from their parents' insurance and stay unified 
in the same clinic, with the same doctors, with continuity of care. And 
77 percent of the children between 200 and 300 percent, which is what 
we are addressing with the new bill, are already covered. For the fully 
eligible kids up to 200 percent, CBO tells us for every one we add, we 
will take one off.
  This amendment says let's not take them off. Let's use the money for 
premium assistance to help those parents keep the insurance with them. 
In Oregon--and the Senator from Oregon might know this--those families 
who chose the premium assistance option were more likely to receive 
care in a doctor's office or HMO, rather than a public health clinic or 
a hospital clinic. Families using the premium assistance option also 
reported fewer unmet primary and specialty care needs than those in 
traditional SCHIP. The premium assistance option works. We need to 
remove the difficulties and barriers so that more individuals eligible 
for SCHIP have the freedom to access it.
  Ensuring that newly eligible populations under the Baucus-Grassley 
proposal are covered with a premium assistance model will ensure the 
preservation of market-based health care, rather than decline that 
system.
  Many lower income families already participate in the private health 
insurance market. Seventy-seven percent, as I said, of those in the 200 
to 300 percent of the Federal poverty level are already covered in a 
private insurance market. So if the purpose of SCHIP is to get kids 
covered and we are worried that some in this group--those at 200 to 300 
percent--why not use premium assistance to help them stay in a 
contiguous family policy and help the parents maintain them within that 
policy?
  We accomplish the same goal and we do a couple other things. No. 1, 
we let parents make a decision on who their doctor is going to be for 
their child, rather than a Government bureaucrat. In many SCHIP 
programs, there is a limited number of providers, and the child may not 
be seen now. What this does is use the funds to allow them to stay with 
their parents, still reaching the goal of covering more kids; but, 
also, CBO has scored this amendment as saving money because we will 
cover more children at a lower cost.
  It is a fairly commonsense amendment. There are problems with the 
requirements on the premium assistance model in the old SCHIP program. 
As a matter of fact, four other States had gone to it and then left 
because of the complications of getting the waivers and meeting the 
requirements of the SCHIP, which forced children away from the primary 
care doctor they and their parents wanted to have.
  There is one other thing that I think is important. Whether we like 
to admit it or not, 60 percent of the primary care doctors in this 
country don't take SCHIP or Medicaid. So we have limited it down to 40 
percent. If we want to have equal access for these children under the 
SCHIP program, we need to take the Medicaid SCHIP stamp off their 
forehead. We need to give to them the market so they can go where they 
want to go. By doing premium assistance, you allow that freedom of 
choice by the parents of the children. When

[[Page 22617]]

we don't allow premium assistance, we take choice away--here is what I 
had and now I don't have the choice. I submit to the body that this 
will discourage a large number of children from going into the SCHIP 
program. So if our goal is to increase it from 200 to 300 percent, and 
over 77 percent of those are already insured, why would we not want to 
keep those already insured and do a premium assistance model and help 
the other 23 percent with the SCHIP program?
  It is a straightforward amendment. The Massachusetts Institute of 
Technology economist Amy Finkelstein recently released research about 
the unintended effect of what happens when the Government controls 
health care. The summary of that is we pay more, but we don't get 
better results.
  I showed a chart here the other day, actually, of the fully absorbed 
cost of us buying insurance through the SCHIP program versus what you 
can buy in the private market. The difference is astounding. It is 
about $1,800 more to buy a $1,352 policy versus the other.
  The PRESIDING OFFICER. The Senator's 5 minutes has expired.
  Mr. COBURN. I ask unanimous consent for an additional 5 minutes, as I 
did when I requested it from the chairman.
  The PRESIDING OFFICER. Is there objection?
  Mr. BAUCUS. What did the Senator request?
  Mr. COBURN. I requested to start 5 minutes early so I could still 
have the 7:45 to 7:50 time slot. I will finish up faster than that. I 
need 2 or 3 minutes.
  Mr. BAUCUS. No objection.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. COBURN. Mr. President, America spends 16 percent of its gross 
domestic product on health care, and that doesn't take into account any 
research and development. It is important to know that, through the 
private sector, M.D. Anderson, in Texas, spends more on research than 
the entire country of Canada. We don't want to disrupt that.
  So keeping these children in a private program with their parents, 
with the continuity of care, I can tell you that as a practicing 
physician, when you have one child go one place and one child going 
somewhere else, and a parent going somewhere else, the ability to 
access health care declines. So I hope the chairman will consider 
accepting this and look on it favorably. We will actually make the 
Baucus-Grassley bill much more effective, much like we are seeing in 
Oregon, which has been effective with children staying on the same 
health care with their parents.
  With that, I yield the floor.
  Mr. BAUCUS. Mr. President, we are close to 7:45. I suggest that the 
voting begin now.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  Mr. COBURN. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The yeas and nays were ordered.
  Mr. BAUCUS. Mr. President, I understand there is 2 minutes allowed 
equally divided prior to the vote; is that correct?
  The PRESIDING OFFICER. Yes, it is.
  Mr. BAUCUS. Does the Senator wish to speak for 1 more minute?
  Mr. COBURN. I just spoke.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, this is not wise. I do not think we should 
adopt this amendment. What does the amendment do? Basically it would 
require at least 34 States would have to resign their successful 
Children's Health Insurance Programs in ways that force children into 
potentially inferior coverage; that is, their health insurance coverage 
would be worse than under SCHIP. Why? Because sometimes private health 
insurance requires deductibles or limits hospital stays, may prevent 
insulin from being available for diabetes. It forces premium 
assistance. It forces people into coverage they may not want. I don't 
think we want to do that.
  Second, it would force children to take the premium assistance to 
purchase HSAs. That is not a good idea. HSAs work better for wealthier 
Americans, healthier Americans. We are talking about low-income kids, 
and they have to spend a lot of money on high-deductible HSAs. I don't 
think it is a good thing to do.
  We are here to help kids. We are not here to force kids into private 
coverage plans and use their premium assistance to buy HSAs.
  I urge the amendment not be agreed to.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. COBURN. Mr. President, I note a couple points. This does not 
force any kid, 200 percent or under, to go into the premium assistance 
program. A family making $62,000 a year--that is not a low-income kid. 
As a matter of fact, 21 States in this country have less income than 
that. It is working well where it is being utilized, and it does not 
force anyone into inferior care.
  I understand the chairman's objection. I take that, but the record 
should show that of those who are on premium assistance today, they 
have adequate or greater care than the SCHIP program.
  Mr. BAUCUS. Mr. President, since the Senator took an extra minute, I 
ask to respond and then get to the vote.
  Essentially, this amendment forces kids to use premium assistance in 
two negative ways. One, it forces them into private coverage. They may 
not want it because the private coverage might be worse. Second, this 
amendment has the effect of forcing premium assistance to buy HSAs.
  I don't want to encourage it at this point because HSAs are better 
for the healthier and wealthier and not low-income kids. I urge the 
amendment not be agreed to.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  The yeas and nays have been ordered.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER (Mr. Pryor). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 37, nays 62, as follows:

                      [Rollcall Vote No. 300 Leg.]

                                YEAS--37

     Alexander
     Allard
     Barrasso
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Coleman
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McCain
     McCaskill
     McConnell
     Sessions
     Shelby
     Sununu
     Thune
     Vitter
     Voinovich

                                NAYS--62

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Collins
     Conrad
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2627) was rejected.


                           Amendment No. 2596

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes of debate equally divided on amendment No. 2596, as modified, 
offered by the Senator from Louisiana, Mr. Vitter.
  Mr. VITTER. Mr. President, this is also a crowding-out issue, which I 
think is a very important and central issue in this debate. I am for a 
safety net. I am for insuring children who

[[Page 22618]]

aren't insured, who can't get health insurance otherwise. What I am not 
for is pushing kids who are on perfectly solid ground off that solid 
ground and into the safety net. That is what, in part, this very large 
SCHIP expansion would do, perhaps 50 percent of the new SCHIP enrollees 
being folks--kids--who have private insurance. Now, that is wrong and 
it is also very expensive to the taxpayer.
  What this amendment does is simple: It says we are for a safety net, 
but we are not for pushing people who are on solid ground into the 
safety net. And if they have difficulty staying on that solid ground in 
terms of affording their premiums, we are going to allow States to have 
premium subsidization, premium support to be able to keep those folks 
on good private insurance. That is what we should do, rather than push 
people off solid ground into the safety net at great taxpayer expense.
  I yield back my time.
  Mr. BAUCUS. Mr. President, I don't think we want to do this. This 
requires--it mandates--that States deny kids coverage under the program 
if their employer offers health insurance. It requires it. I don't know 
where we have those kinds of requirements today in the health care 
area. Senior citizens are not required to sign up for Medicare Part B. 
There is no requirement. Why should we require States to prevent 
children's health insurance coverage if by chance the child's family is 
offered private health insurance? The private health insurance may be 
inferior to what the child would otherwise get in the program. The 
benefits might be much less. Who knows what doctors are available. Who 
knows?
  I don't think we want to require States to prevent families and low-
income kids from getting CHIP coverage simply because an employer 
offers health insurance. That is not a fair choice. I think we should, 
therefore, reject the amendment.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  Mr. VITTER. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER (Mr. Sanders). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 35, nays 64, as follows:

                      [Rollcall Vote No. 301 Leg.]

                                YEAS--35

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McConnell
     Sessions
     Shelby
     Sununu
     Thune
     Vitter
     Voinovich

                                NAYS--64

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Bunning
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCain
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2596), as modified, was rejected.


                           Amendment No. 2535

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes of debate equally divided on amendment No. 2535, as modified, 
offered by the Senator from Colorado, Mr. Allard.
  Mr. ALLARD. Mr. President, this amendment codifies the ``unborn 
child'' rule. The purpose of this amendment is to provide health care 
services to benefit either the mother or unborn child, consistent with 
the health of both.
  It has been reported that some States denied health care to the 
mother for disorders not directly affecting the unborn child. This is 
just a commonsense amendment. Obstetricians recognize that you are 
dealing with two separate individuals, that you have to deal with the 
unborn child as well as the mother. Obviously, you need to have a 
healthy mother in order to have a healthy unborn child.
  I ask for an ``aye'' vote.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. BINGAMAN. Mr. President, I urge a ``no'' vote on the amendment. 
This amendment is an effort to inject a very highly contentious 
abortion rights issue into this children's health insurance 
legislation. I think it is a mistake for us to do that.
  The underlying bill which came out of the Finance Committee protects 
the right of any State in the country to provide health care to 
pregnant women. It protects the rights specifically of the 11 States 
that are currently providing coverage under this unborn fetus 
regulation to continue to do that. So there is no need for this 
amendment. I urge my colleagues to oppose it.
  Mr. ALLARD. Mr. President, how much time do I have remaining?
  The PRESIDING OFFICER. Twenty-three seconds.
  Mr. ALLARD. Mr. President, this is not unprecedented action. We have 
passed the Unborn Victims of Violence Act, and so this is basically 
what we are trying to do, to make sure the mothers have the health care 
they need.
  I yield the remainder of my time and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the amendment.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 49, nays 50, as follows:

                      [Rollcall Vote No. 302 Leg.]

                                YEAS--49

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Casey
     Chambliss
     Coburn
     Cochran
     Coleman
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchison
     Inhofe
     Isakson
     Kennedy
     Kerry
     Kyl
     Landrieu
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Nelson (NE)
     Roberts
     Sessions
     Shelby
     Smith
     Sununu
     Thune
     Vitter
     Voinovich
     Warner

                                NAYS--50

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Clinton
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Harkin
     Inouye
     Klobuchar
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Obama
     Pryor
     Reed
     Reid
     Rockefeller
     Salazar
     Sanders
     Schumer
     Snowe
     Specter
     Stabenow
     Stevens
     Tester
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2535), as modified, was rejected.
  Mrs. MURRAY. Mr. President, I move to reconsider the vote.
  Ms. STABENOW. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 2620

  The PRESIDING OFFICER. Under the previous order, there will now be 2

[[Page 22619]]

minutes of debate equally divided on amendment No. 2620 offered by the 
Senator from Texas, Mrs. Hutchison.
  Mrs. HUTCHISON. Mr. President, we have been talking about having one 
State or another State have a different cost of living, and therefore 
having to have a waiver for the whole State. My amendment says the 
Secretary will look at the cost of living in an area of the State, a 
county, or a statistical metropolitan area, so you don't have to have a 
waiver for a whole State, if it is only one city or one area in that 
State that needs the extra help. That is my amendment. I hope my 
colleagues will support it.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, just assume that you are a person who is 
maybe in one city and move to another town or have relatives in one 
city or town in the same State. You don't know what the match is going 
to be. You don't know whether you qualify or don't qualify. I don't 
understand this amendment at all. I am really quite astounded that we 
would want to even countenance doing something like this. Essentially 
it says: OK, MSA, State, you don't get the 300 percent match rate in 
Medicaid. You get 200 percent. You get Medicaid which is adjusted by 
cost of living, and MSA with a county or a State. I don't get it. I 
think we have to get some simplicity, some continuity, allow some 
people to have some idea of what the law is. I urge Senators to not 
support the amendment.
  Mrs. HUTCHISON. Mr. President, it just makes common sense that you 
would want to help the areas that have a clear cost-of-living 
adjustment need, but you don't have to do it for a whole State if it 
isn't needed in the whole State. It would save taxpayer dollars. It is 
equitable. It is fair, and it is responsible. I hope we can adopt it.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  The yeas and nays have been ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER (Mr. Pryor). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 21, nays 78, as follows:

                      [Rollcall Vote No. 303 Leg.]

                                YEAS--21

     Allard
     Barrasso
     Bennett
     Chambliss
     Cochran
     Cornyn
     Craig
     Crapo
     Dole
     Domenici
     Enzi
     Graham
     Hagel
     Hutchison
     Inhofe
     Isakson
     Lugar
     McCain
     Sessions
     Shelby
     Vitter

                                NAYS--78

     Akaka
     Alexander
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Brownback
     Bunning
     Burr
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coburn
     Coleman
     Collins
     Conrad
     Corker
     DeMint
     Dodd
     Dorgan
     Durbin
     Ensign
     Feingold
     Feinstein
     Grassley
     Gregg
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lott
     Martinez
     McCaskill
     McConnell
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Thune
     Voinovich
     Warner
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2620) was rejected.
  Mr. REID. Mr. President, I move to reconsider the vote.
  Mr. BAUCUS. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. REID. Mr. President, I have had a conversation with the two 
managers of the bill, and we have two or three amendments left, and one 
of those could go away, which means we will have a couple of votes, 
maybe three votes before final passage.
  The managers, I think we would all acknowledge, have done a very 
outstanding job on a difficult piece of legislation.
  I would also say, Mr. President, we are going to have to be in 
session tomorrow. At 9:30 in the morning--I told Senator Byrd it would 
be a 9:45 vote--there will be a 9:30 vote in the morning. We will vote 
on a judge at 9:30. Then we will proceed on some other matters. We are 
going to try to complete the WRDA conference. We are going to have a 
real yeoman's try at completing the competitive matter. I understand 
there is a hold on that now. We would hope we could complete that by 
unanimous consent; if not, a short timeframe within which to debate 
that and vote. It is something that is bipartisan and Members have 
worked on for well more than a year.
  We also have, of course, good news tonight. The mental health parity 
is being hot-lined tonight. I hope we can complete that tonight. That 
is legislation Senator Domenici and others have been pushing for a long 
time. I am not going to mention all the people who have been pushing 
it, but Senator Domenici has been talking about it a lot in recent 
days, and I appreciate his advocacy for that.
  The big issue tomorrow is to see what we can do to complete the 
problems that everyone has read about dealing with the surveillance 
program that is going on to listen to these bad people who are trying 
to create problems in our country and around the world. We do not have 
that worked out yet. I have had a conversation with the distinguished 
Republican leader. Hopefully, we can have that set up so there is some 
way of disposing of that issue tomorrow.
  Now, that is what we have left before we leave here. It is not an 
easy agenda, but it is one we can complete with a little cooperation 
from both sides.
  The PRESIDING OFFICER. The Senator from Montana.


                      Amendment No. 2600 Withdrawn

  Mr. BAUCUS. Mr. President, I ask unanimous consent that Sanders 
amendment No. 2600 be withdrawn.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 2562

  Under the previous order, there will now be 2 minutes of debate 
equally divided on amendment No. 2562, offered by the Senator from 
Arizona, Mr. Kyl.
  The Senator from Arizona.
  Mr. KYL. Mr. President, this amendment simply has us do something we 
have already done. We passed, I believe, unanimously some provisions to 
help small businesses pay for the minimum wage increase. We all did 
that. The bill went over to the House of Representatives. You will 
recall they attached the minimum wage bill to the Iraq supplemental, 
and they dropped out these tax provisions.
  This amendment simply reinstates the same tax provisions for small 
businesses in three areas: leasehold and restaurant depreciation, 
extending them from the end of this year through 2008; new restaurant 
construction, a 15-year depreciation period; owner-occupied retail, a 
15-year depreciation period--all just through the end of the year 2008.
  As to the first one, it has to be done this year because it expires 
at the end of this year. As I said, we adopted this. We checked the 
record. I think it was by unanimous consent. In any event, I believe it 
was unanimous. We already passed it.
  Here is the irony. The underlying bill that the SCHIP bill has been 
attached to is that minimum wage bill. So to the argument that this is 
not the right bill, I would say, actually, this is not the right bill 
for SCHIP, but it is the right bill for this amendment. So I hope we 
can repeat what we have already done and adopt this small business 
relief.
  The PRESIDING OFFICER. The Senator's time has expired.
  The Senator from Montana.
  Mr. BAUCUS. Mr. President, this world is filled with irony. It is 
ironic, frankly, that we are here in this situation. But, essentially, 
first, I support what the Senator is trying to do. We

[[Page 22620]]

reported this same provision out of the Finance Committee, as the 
Senator stated, at an earlier time as part of that small business-
minimum wage package. It was then paid for.
  I say to my friends and my colleagues that we will find a time to do 
this provision. It is part of the extenders package. Extenders are 
taken up at the end of the year. That is when we put them all together 
and find out what we want to do, not here on this legislation. It is 
not paid for. This costs $5 billion. I do not think it belongs on this 
bill. I, frankly, have to now raise a point of order.
  Mr. President, I raise a point of order that the pending amendment 
violates section 201 of S. Con. Res. 21, the concurrent resolution on 
the budget for fiscal year 2008.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. KYL. Mr. President, I move to waive the applicable provisions 
under the Congressional Budget Act with respect to the amendment, and I 
ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 49, nays 50, as follows:

                      [Rollcall Vote No. 304 Leg.]

                                YEAS--49

     Alexander
     Allard
     Barrasso
     Bayh
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Coleman
     Collins
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Murkowski
     Roberts
     Sessions
     Shelby
     Smith
     Snowe
     Specter
     Stevens
     Sununu
     Thune
     Vitter
     Warner

                                NAYS--50

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Conrad
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Harkin
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez
     Mikulski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Rockefeller
     Salazar
     Sanders
     Schumer
     Stabenow
     Tester
     Voinovich
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The PRESIDING OFFICER. On this vote, the yeas are 49, the nays are 
50. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected. The point of order is 
sustained, and the amendment falls.


                           Amendment No. 2552

  Mr. SMITH. Mr. President, I ask unanimous consent that the pending 
business be set aside, and I further ask to call up amendment No. 2552 
and dispense with its reading.
  The PRESIDING OFFICER. Is there objection?
  Mr. DeMINT. Mr. President, I object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. SMITH. Mr. President, may I read this before he objects? I wonder 
if my colleagues would indulge me.
  Mr. President, this amendment is the outgrowth of a bill I introduced 
with Senator Kohl this year. As many of my colleagues know, Congress 
modified the Supplemental Security Income Program to include a 7-year 
time limit on receipt of benefits for disabled refugees and asylees. 
This policy was intended to balance a desire to have people who 
immigrate to the United States to become citizens, with an 
understanding that the naturalization process also takes time to 
complete.
  Unfortunately, the naturalization process often takes longer than 7 
years. Applicants are required to live in the United States for a 
minimum of 5 years prior to applying for citizenship. In addition to 
that time period, their application process often can take 3 or more 
years before resolution. Because of this time delay, many individuals 
are trapped in the system and faced with the loss of their SSI 
benefits. In fact, we know that to date, more than 7,000 elderly and 
disabled refugees have lost their SSI benefits and another 16,000 are 
threatened to lose their benefits as well in the coming years.
  Many of these individuals are elderly refugees who fled persecution 
or torture in their home countries. They include Jews fleeing religious 
persecution from the former Soviet Union, Iraqi Kurds fleeing from 
Saddam Hussein's regime, Cubans, and Hmong people from the highlands of 
Laos who served on the side of the U.S. military during the Vietnam 
war. They are elderly and unable to work and have become reliant on 
their SSI benefits as their primary income. To penalize them because of 
delays encountered through the bureaucratic process is unjust and 
inappropriate.
  The Bush administration in its fiscal year 2008 budget acknowledged 
the necessity to correct this problem, this injustice, by dedicating 
funding to extend refugee eligibility for SSI beyond the 7-year limit.
  This legislation builds upon those efforts by allowing an additional 
2 years of benefits for elderly and disabled refugees, asylees, and 
other qualified humanitarian immigrants, including those whose benefits 
have expired in the recent past.
  Additionally, benefits could be extended for a third year for those 
same refugees who are awaiting a decision on a pending naturalization 
application.
  These policies are limited to 2010 and are completely offset in cost 
by a provision that will work to recapture Federal Government funds due 
to unemployment insurance fraud.
  The offset that is provided was also taken from the President's own 
budget.
  By reducing fraud in the unemployment insurance system, the provision 
would effectively reduce taxes on employers by $326 million over the 
next 10 years, according to the CBO estimate.
  I thank my colleagues for listening. I hope for your support and ask 
that this amendment be accepted by unanimous consent.
  The PRESIDING OFFICER. Is there objection?
  Mr. DeMINT. Mr. President, I object.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that Senator Kerry 
be recognized now to offer a sense of the Senate, which will be agreed 
to.
  The PRESIDING OFFICER. The Senator from Massachusetts is recognized.


                Amendment No. 2529 to Amendment No. 2530

  Mr. KERRY. Mr. President, this will be very brief. Senator Snowe and 
I have joined together, as the chair and ranking member of the Small 
Business Committee, to put together a task force effort between the 
Secretary of Health and Human Services, Secretary of Labor, Secretary 
of the Treasury, and the Small Business Administrator to coordinate and 
assist in trying to effectively reach out to small businesses to help 
them be aware of how they can take advantage of the Children's Health 
Insurance Program.
  This has been cleared on both sides. It doesn't cost any additional 
funds whatsoever. It simply is an effort to try to coordinate and 
implement this as effectively as possible. I ask for its adoption.
  I send the amendment to the desk.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Massachusetts [Mr. Kerry], for himself and 
     Ms. Snowe, proposes an amendment numbered 2529.

  The amendment is as follows:

  (Purpose: To establish a multiagency nationwide campaign to educate 
  small business concerns about health insurance options available to 
                               children)

       At the appropriate place, insert the following:

     SEC. __. OUTREACH REGARDING HEALTH INSURANCE OPTIONS 
                   AVAILABLE TO CHILDREN.

       (a) Definitions.--In this section--

[[Page 22621]]

       (1) the terms ``Administration'' and ``Administrator'' 
     means the Small Business Administration and the Administrator 
     thereof, respectively;
       (2) the term ``certified development company'' means a 
     development company participating in the program under title 
     V of the Small Business Investment Act of 1958 (15 U.S.C. 695 
     et seq.);
       (3) the term ``Medicaid program'' means the program 
     established under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.);
       (4) the term ``Service Corps of Retired Executives'' means 
     the Service Corps of Retired Executives authorized by section 
     8(b)(1) of the Small Business Act (15 U.S.C. 637(b)(1));
       (5) the term ``small business concern'' has the meaning 
     given that term in section 3 of the Small Business Act (15 
     U.S.C. 632);
       (6) the term ``small business development center'' means a 
     small business development center described in section 21 of 
     the Small Business Act (15 U.S.C. 648);
       (7) the term ``State'' has the meaning given that term for 
     purposes of title XXI of the Social Security Act (42 U.S.C. 
     1397aa et seq.);
       (8) the term ``State Children's Health Insurance Program'' 
     means the State Children's Health Insurance Program 
     established under title XXI of the Social Security Act (42 
     U.S.C. 1397aa et seq.);
       (9) the term ``task force'' means the task force 
     established under subsection (b)(1); and
       (10) the term ``women's business center'' means a women's 
     business center described in section 29 of the Small Business 
     Act (15 U.S.C. 656).
       (b) Establishment of Task Force.--
       (1) Establishment.--There is established a task force to 
     conduct a nationwide campaign of education and outreach for 
     small business concerns regarding the availability of 
     coverage for children through private insurance options, the 
     Medicaid program, and the State Children's Health Insurance 
     Program.
       (2) Membership.--The task force shall consist of the 
     Administrator, the Secretary of Health and Human Services, 
     the Secretary of Labor, and the Secretary of the Treasury.
       (3) Responsibilities.--The campaign conducted under this 
     subsection shall include--
       (A) efforts to educate the owners of small business 
     concerns about the value of health coverage for children;
       (B) information regarding options available to the owners 
     and employees of small business concerns to make insurance 
     more affordable, including Federal and State tax deductions 
     and credits for health care-related expenses and health 
     insurance expenses and Federal tax exclusion for health 
     insurance options available under employer-sponsored 
     cafeteria plans under section 125 of the Internal Revenue 
     Code of 1986;
       (C) efforts to educate the owners of small business 
     concerns about assistance available through public programs; 
     and
       (D) efforts to educate the owners and employees of small 
     business concerns regarding the availability of the hotline 
     operated as part of the Insure Kids Now program of the 
     Department of Health and Human Services.
       (4) Implementation.--In carrying out this subsection, the 
     task force may--
       (A) use any business partner of the Administration, 
     including--
       (i) a small business development center;
       (ii) a certified development company;
       (iii) a women's business center; and
       (iv) the Service Corps of Retired Executives;
       (B) enter into--
       (i) a memorandum of understanding with a chamber of 
     commerce; and
       (ii) a partnership with any appropriate small business 
     concern or health advocacy group; and
       (C) designate outreach programs at regional offices of the 
     Department of Health and Human Services to work with district 
     offices of the Administration.
       (5) Website.--The Administrator shall ensure that links to 
     information on the eligibility and enrollment requirements 
     for the Medicaid program and State Children's Health 
     Insurance Program of each State are prominently displayed on 
     the website of the Administration.
       (6) Report.--
       (A) In general.--Not later than 2 years after the date of 
     enactment of this Act, and every 2 years thereafter, the 
     Administrator shall submit to the Committee on Small Business 
     and Entrepreneurship of the Senate and the Committee on Small 
     Business of the House of Representatives a report on the 
     status of the nationwide campaign conducted under paragraph 
     (1).
       (B) Contents.--Each report submitted under subparagraph (A) 
     shall include a status update on all efforts made to educate 
     owners and employees of small business concerns on options 
     for providing health insurance for children through public 
     and private alternatives.

  The PRESIDING OFFICER. If there is no further debate, the question is 
on agreeing to the amendment.
  The amendment (No. 2529) was agreed to.
  Mr. KERRY. Mr. President, I move to reconsider the vote.
  Mr. BAUCUS. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that Senator 
Cardin be recognized for the purpose of offering an amendment that also 
has been cleared on both sides.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Maryland is recognized.


         Amendment No. 2567, as Modified, to amendment No. 2530

  Mr. CARDIN. Mr. President, I send to the desk the modification of 
amendment 2567.
  The PRESIDING OFFICER. The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from Maryland [Mr. Cardin], for himself, Ms. 
     Mikulski, Mr. Bingaman, and Ms. Collins, proposes an 
     amendment numbered 2567, as modified.

  Mr. CARDIN. Mr. President, I ask unanimous consent that reading of 
the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

     (Purpose: To improve the provisions relating to dental health)

       Strike section 608 and insert the following:

     SEC. 608. DENTAL HEALTH GRANTS.

       (a) In General.--Title XXI (42 U.S.C. 1397aa et seq.), as 
     amended by section 201, is amended by adding at the end the 
     following:

     ``SEC. 2114. DENTAL HEALTH GRANTS.

       ``(a) Authority To Award Grants.--
       ``(1) In general.--From the amount appropriated under 
     subsection (f), the Secretary shall award grants from amounts 
     to eligible States for the purpose of carrying out programs 
     and activities that are designed to improve the availability 
     of dental services and strengthen dental coverage for 
     targeted low-income children enrolled in State child health 
     plans.
       ``(2) Eligible state.--In this section, the term `eligible 
     State' means a State with an approved State child health plan 
     under this title that submits an application under subsection 
     (b) that is approved by Secretary.
       ``(b) Application.--An eligible State that desires to 
     receive a grant under this paragraph shall submit an 
     application to the Secretary in such form and manner, and 
     containing such information, as the Secretary may require. 
     Such application shall include--
       ``(1) a detailed description of--
       ``(A) the dental services (if any) covered under the State 
     child health plan; and
       ``(B) how the State intends to improve dental coverage and 
     services during fiscal years 2008 through 2012;
       ``(2) a detailed description of the programs and activities 
     proposed to be conducted with funds awarded under the grant;
       ``(3) quality and outcomes performance measures to evaluate 
     the effectiveness of such activities; and
       ``(4) an assurance that the State shall--
       ``(A) conduct an assessment of the effectiveness of such 
     activities against such performance measures; and
       ``(B) cooperate with the collection and reporting of data 
     and other information determined as a result of conducting 
     such assessments to the Secretary, in such form and manner as 
     the Secretary shall require.
       ``(c) Use of Funds.--The programs and activities described 
     in subsection (a)(1) may include the provision of enhanced 
     dental coverage under the State child health plan.
       ``(d) Maintenance of Effort for States Awarded Grants; No 
     State Match Required.--In the case of a State that is awarded 
     a grant under this section--
       ``(1) the State share of funds expended for dental services 
     under the State child health plan shall not be less than the 
     State share of such funds expended in the fiscal year 
     preceding the first fiscal year for which the grant is 
     awarded; and
       ``(2) no State matching funds shall be required for the 
     State to receive a grant under this section.
       ``(e) Annual Report.--The Secretary shall submit an annual 
     report to the appropriate committees of Congress regarding 
     the grants awarded under this section that includes--
       ``(1) State specific descriptions of the programs and 
     activities conducted with funds awarded under such grants; 
     and
       ``(2) information regarding the assessments required of 
     States under subsection (b)(4).
       ``(f) Appropriation.--Out of any funds in the Treasury not 
     otherwise appropriated, there is appropriated, $200,000,000 
     for the period of fiscal years 2008 through 2012, to remain 
     available until expended, for the purpose of awarding grants 
     to States under this section. Amounts appropriated and paid 
     under the authority of this section shall be in addition to 
     amounts appropriated under section 2104 and paid to States in 
     accordance with section 2105.''.
       (b) Improved Accessibility of Dental Provider Information 
     More Accessible to Enrollees Under Medicaid and CHIP.--The 
     Secretary shall--
       (1) work with States, pediatric dentists, and other dental 
     providers to include on the

[[Page 22622]]

     Insure Kids Now website (http://www.insurekidsnow.gov/) and 
     hotline (1-877-KIDS-NOW) a current and accurate list of all 
     dentists and other dental providers within each State that 
     provide dental services to children enrolled in the State 
     plan (or waiver) under Medicaid or the State child health 
     plan (or waiver) under CHIP, and shall ensure that such list 
     is updated at least quarterly; and
       (2) work with States to include a description of the dental 
     services provided under each State plan (or waiver) under 
     Medicaid and each State child health plan (or waiver) under 
     CHIP on such Insure Kids Now website.
       (c) GAO Study and Report on Access to Oral Health Care, 
     Including Preventive and Restorative Services.--
       (1) In general.--The Comptroller General of the United 
     States shall conduct a study of children's access to oral 
     health care, including preventive and restorative services, 
     under Medicaid and CHIP, including--
       (A) the extent to which providers are willing to treat 
     children eligible for such programs;
       (B) information on such children's access to networks of 
     care;
       (C) geographic availability of oral health care, including 
     preventive and restorative services, under such programs; and
       (D) as appropriate, information on the degree of 
     availability of oral health care, including preventive and 
     restorative services, for children under such programs.
       (2) Report.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General shall submit a 
     report to the appropriate committees of Congress on the study 
     conducted under paragraph (1) that includes recommendations 
     for such Federal and State legislative and administrative 
     changes as the Comptroller General determines are necessary 
     to address any barriers to access to oral health care, 
     including preventive and restorative services, under Medicaid 
     and CHIP that may exist.
       (d) Inclusion of Status of Efforts to Improve Dental Care 
     in Reports on the Quality of Children's Health Care Under 
     Medicaid and CHIP.--Section 1139A(a)(6)(ii), as added by 
     section 501(a), is amended by inserting ``dental care,'' 
     after ``preventive health services,''.

  Mr. CARDIN. Mr. President, I thank Senator Baucus and Senator 
Grassley who helped on this amendment. It has been cleared. It deals 
with the dental, or oral, health care in the underlying bill. The bill 
provides for $200 million to help States expand dental care within the 
Children's Health Insurance Program.
  This amendment adds additional provisions that would require the 
States to describe these benefits as they do other benefits and how 
they would improve the benefits to our children. It expands Web 
information so individuals will have a better understanding as to what 
providers are available for dental care in their community. It has 
certain studies as to the status of dental health care and oral health 
care for our children.
  Again, I thank the leadership of the committee for their help. I also 
offer this amendment on behalf of Senators Mikulski, Bingaman, and 
Collins. I thank them for their help in putting this amendment 
together.
  Mr. BAUCUS. Mr. President, I urge adoption of the amendment.
  The PRESIDING OFFICER. If there is no further debate, the question is 
on agreeing to the amendment of the Senator from Maryland.
  The amendment (No. 2567) was agreed to.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that all pending 
amendments be withdrawn, with the exception of the DeMint amendment No. 
2577; that no further amendments be in order, except a managers' 
amendment which has been cleared by the managers and the leaders; that 
upon disposition of the DeMint amendment and the managers' package, 
Senator Dole be recognized for 5 minutes to make a budget point of 
order against the substitute amendment; that once the point of order 
has been raised, Senator Baucus be recognized to move to waive the 
applicable point of order; that upon disposition of waiver, if waived, 
then the substitute amendment, as amended, be agreed to, the bill, as 
amended, be read the third time, and without further intervening action 
or debate, the Senate proceed to vote on passage of the bill.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BAUCUS. Mr. President, it is pretty clear we have one more vote 
that I am aware of before final passage. There will be a little bit of 
intervening business that should not take much time. So we are about 
done.
  The PRESIDING OFFICER. The Senator from South Carolina.


                           Amendment No. 2577

  Mr. DeMINT. Mr. President, as I have talked about this amendment 
today, I have been surprised that several colleagues were not aware 
that Americans are not allowed to buy health insurance, except in the 
State where they live. Americans can buy anything from all over our 
country. Yet they are limited to where they can buy health insurance.
  One way we can lower the cost of health insurance and create more 
choices for all Americans is to allow each and every American the 
opportunity to buy a health insurance policy in any State where those 
policies are certified. Some will say this is a race to the bottom. But 
I ask those critics, which State does not have the regulations that you 
approve of? Every State legislature has a set of regulations they have 
approved. So these products would be safe, but they create more choice.
  I encourage my colleagues to support this amendment that would allow 
Americans to buy health insurance all over the country, to help create 
a national market and make health insurance more affordable for every 
American.
  Mr. BAUCUS. Mr. President, this amendment effectively eliminates 
State insurance protections. The States with the least regulation would 
become the home of private health insurers who sit back and watch a 
race to the bottom. States would be inclined to--and encouraged to--
pass regulations that are very weak, and that would mean the insurer 
could qualify in that State and then market anyplace else in the 
country. It is totally opposed to the current system, where each State 
has its own insurance regulations. One can argue whether that is a good 
system, but that is what it is.
  We should not, at this point, adopt this amendment, which has the 
effect of appealing the current structure and allowing a race to the 
bottom in health insurance coverage.
  Mr. DeMINT. Will the Senator yield?
  Mr. BAUCUS. Yes.
  Mr. DeMINT. We don't change any of the State regulations. We only 
allow the people not to be regulated anymore. They get to buy insurance 
wherever they want to buy it. But regulations in the States don't 
change.
  Mr. BAUCUS. Mr. President, the Senator made my point. It is a race to 
the bottom. I urge rejection of the amendment.
  The PRESIDING OFFICER. Is there further debate on the amendment?
  Mr. DeMINT. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The question is on agreeing to the amendment. The clerk will call the 
roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 37, nays 62, as follows:

                      [Rollcall Vote No. 305 Leg.]

                                YEAS--37

     Alexander
     Allard
     Barrasso
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Coleman
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Domenici
     Ensign
     Enzi
     Graham
     Hagel
     Hutchison
     Isakson
     Kyl
     Lott
     Lugar
     Martinez
     McCain
     McConnell
     Sessions
     Shelby
     Stevens
     Sununu
     Thune
     Vitter
     Voinovich

                                NAYS--62

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Collins
     Conrad
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Gregg
     Harkin
     Hatch
     Inhofe
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     McCaskill
     Menendez

[[Page 22623]]


     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                             NOT VOTING--1

       
     Johnson
       
  The amendment (No. 2577) was rejected.
  Mr. BAUCUS. I move to reconsider the vote, and I move to lay that 
motion on the table.
  The motion to lay on the table was agreed to.


                Amendment No. 2645 to Amendment No. 2530

  Mr. BAUCUS. Mr. President, I send a managers' technical amendment to 
the desk and ask for its immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Montana [Mr. Baucus] proposes an amendment 
     numbered 2645 to amendment No. 2530.

  Mr. BAUCUS. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:
       On page 22, lines 3 and 4, strike ``paragraph'' and insert 
     ``subsection''.
       Beginning on page 53, strike line 15 and all that follows 
     through page 54, line 4 and insert the following:
       ``(iv) Amount of federal matching payment in 2011 or 
     2012.--For purposes of clause (ii), the applicable percentage 
     for any quarter of fiscal year 2011 or 2012 is equal to--

       ``(I) the REMAP percentage if--

       ``(aa) the applicable percentage for the State under clause 
     (iii) was the enhanced FMAP for fiscal year 2009; and
       ``(bb) the State met either of the coverage benchmarks 
     described in subparagraph (B) or (C) of paragraph (3) for the 
     preceding fiscal year; or

       ``(II) the Federal medical assistance percentage (as so 
     determined) in the case of any State to which subclause (I) 
     does not apply.

       On page 56, line 5, insert ``clause (ii) or (iii) of'' 
     after ``under''.
       On page 74, lines 15 and 16, strike ``13-consecutive week 
     period'' and insert ``3-month period''.
       On page 118, strike lines 17 through 21.
       Page 120, line 5, strike ``section 1902(a)(46)(B)(ii)'' and 
     insert ``subsection (a)(46)(B)(ii)''.
       Beginning on page 120, strike line 22 and all that follows 
     through page 121, line 4, and insert the following:
       (ii) provides the individual with a period of 90 days from 
     the date on which the notice required under clause (i) is 
     received by the individual to either present satisfactory 
     documentary evidence of citizenship or nationality (as 
     defined in section 1903(x)(3)) or cure the invalid 
     determination with the Commissioner of Social Security; and
       On page 130, strike lines 9 and 10, and insert the 
     following:
       (1) In general.--
       (A) In general.--Except as provided in subparagraph (B), 
     the amendments made by this section shall take effect on 
     October 1, 2008.
       (B) Technical amendments.--The amendments made by--
       (i) paragraphs (1), (2), and (3) of subsection (b) shall 
     take effect as if included in the enactment of section 6036 
     of the Deficit Reduction Act of 2005 (Public Law 109-171; 120 
     Stat. 80); and
       (ii) paragraph (4) of subsection (b) shall take effect as 
     if included in the enactment of section 405 of division B of 
     the Tax Relief and Health Care Act of 2006 (Public Law 109-
     432; 120 Stat. 2996).
       On page 142, lines 14 and 15, strike ``previously approved 
     premium assistance'' and insert ``premium assistance 
     waiver''.
       On page 150, beginning on line 3, strike ``issued'' and all 
     that follows through line 9 and insert ``developed in 
     accordance with section 701(f)(3)(B)(i)(II) of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 
     1181(f)(3)(B)(i)(II)).''.
       On page 151, line 14, strike ``411(b)(2)(C)'' and insert 
     ``411(b)(1)(C)''.
       On page 157, line 1, strike ``411(b)(2)(C)'' and insert 
     ``411(b)(1)(C)''.
       On page 161, between lines 14 and 15, insert the following:

       (VII) health insurance issuers;

       On page 165, between lines 2 and 3, insert the following:
       (2) Amendments to public health service act.--Section 
     2701(f) of the Public Health Service Act (42 U.S.C. 300gg(f)) 
     is amended by adding at the end the following new paragraph:
       ``(3) Special rules for application in case of medicaid and 
     chip.--
       ``(A) In general.--A group health plan, and a health 
     insurance issuer offering group health insurance coverage in 
     connection with a group health plan, shall permit an employee 
     who is eligible, but not enrolled, for coverage under the 
     terms of the plan (or a dependent of such an employee if the 
     dependent is eligible, but not enrolled, for coverage under 
     such terms) to enroll for coverage under the terms of the 
     plan if either of the following conditions is met:
       ``(i) Termination of medicaid or chip coverage.--The 
     employee or dependent is covered under a Medicaid plan under 
     title XIX of the Social Security Act or under a State child 
     health plan under title XXI of such Act and coverage of the 
     employee or dependent under such a plan is terminated as a 
     result of loss of eligibility for such coverage and the 
     employee requests coverage under the group health plan (or 
     health insurance coverage) not later than 60 days after the 
     date of termination of such coverage.
       ``(ii) Eligibility for employment assistance under medicaid 
     or chip.--The employee or dependent becomes eligible for 
     assistance, with respect to coverage under the group health 
     plan or health insurance coverage, under such Medicaid plan 
     or State child health plan (including under any waiver or 
     demonstration project conducted under or in relation to such 
     a plan), if the employee requests coverage under the group 
     health plan or health insurance coverage not later than 60 
     days after the date the employee or dependent is determined 
     to be eligible for such assistance.
       ``(B) Coordination with medicaid and chip.--
       ``(i) Outreach to employees regarding availability of 
     medicaid and chip coverage.--

       ``(I) In general.--Each employer that maintains a group 
     health plan in a State that provides medical assistance under 
     a State Medicaid plan under title XIX of the Social Security 
     Act, or child health assistance under a State child health 
     plan under title XXI of such Act, in the form of premium 
     assistance for the purchase of coverage under a group health 
     plan, shall provide to each employee a written notice 
     informing the employee of potential opportunities then 
     currently available in the State in which the employee 
     resides for premium assistance under such plans for health 
     coverage of the employee or the employee's dependents. For 
     purposes of compliance with this subclause, the employer may 
     use any State-specific model notice developed in accordance 
     with section 701(f)(3)(B)(i)(II) of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1181(f)(3)(B)(i)(II)).
       ``(II) Option to provide concurrent with provision of 
     summary plan description.--An employer may provide the model 
     notice applicable to the State in which an employee resides 
     concurrent with the furnishing of the summary plan 
     description as provided in section 104(b) of the Employee 
     Retirement Income Security Act of 1974.

       ``(ii) Disclosure about group health plan benefits to 
     states for medicaid and chip eligible individuals.--In the 
     case of an enrollee in a group health plan who is covered 
     under a Medicaid plan of a State under title XIX of the 
     Social Security Act or under a State child health plan under 
     title XXI of such Act, the plan administrator of the group 
     health plan shall disclose to the State, upon request, 
     information about the benefits available under the group 
     health plan in sufficient specificity, as determined under 
     regulations of the Secretary of Health and Human Services in 
     consultation with the Secretary that require use of the model 
     coverage coordination disclosure form developed under section 
     411(b)(1)(C) of the Children's Health Insurance 
     Reauthorization Act of 2007, so as to permit the State to 
     make a determination (under paragraph (2)(B), (3), or (10) of 
     section 2105(c) of the Social Security Act or otherwise) 
     concerning the cost-effectiveness of the State providing 
     medical or child health assistance through premium assistance 
     for the purchase of coverage under such group health plan and 
     in order for the State to provide supplemental benefits 
     required under paragraph (10)(E) of such section or other 
     authority.''.
       On page 205, line 11, strike ``2112(b)(2)(A)(i)'' and 
     insert ``2111(b)(2)(B)(i)''.

  Mr. BAUCUS. Mr. President, I ask that the amendment be agreed to.
  The PRESIDING OFFICER. If there is no further debate, the question is 
on agreeing to the amendment.
  The amendment (No. 2645) was agreed to.
  The PRESIDING OFFICER. The Senator from North Carolina.
  Mrs. DOLE. Mr. President, this bill seeks revenues for the very 
laudable State Children's Health Insurance Program by unfairly taxing 
tobacco products. I urge my colleagues to acknowledge the reality that 
this tax increase is an irresponsible and fiscally unsound policy.
  Tobacco sales have been declining 2 to 3 percent per year and are 
expected to be slashed by another 6 percent if the Federal excise tax 
is increased. But in order for this tax increase trick to work, more 
than 22 million additional Americans will need to take up smoking to 
keep the SCHIP program running over the next decade.

[[Page 22624]]

  In addition, according to the Tax Foundation, no other Federal tax 
hurts the poor more than the cigarette tax. Of the 20 percent of the 
adult population who smoke, around half are in families earning less 
than 200 percent of the Federal poverty level. In other words, many of 
the families SCHIP is meant to help will be disproportionately hit by 
the Senate's proposed tax hike.
  I oppose this tax hike plan not only because it is fiscally unsound 
but also because it unfairly hurts the economy of my home State of 
North Carolina. A massive and highly regressive tax increase on an 
already unstable product is an irresponsible way to fund such an 
important program.
  Mr. President, section 203 of the fiscal year 2008 budget resolution 
makes it out of order for the Senate to consider legislation that 
increases the deficit by more than $5 billion in any of the four 10-
year periods starting in fiscal year 2018 through 2057. The pending 
substitute amendment would increase the long-term net deficit in excess 
of $5 billion. I, therefore, raise a point of order under section 203 
of S. Con. Res. 21 against the pending substitute amendment. This 
legislation clearly violates the Budget Act.
  I yield the floor.
  Mr. BAUCUS. Mr. President, I very much appreciate the words of the 
Senator from North Carolina. I know she means well, and is fighting 
very hard for her State. But pursuant to section 904 of the 
Congressional Budget Act of 1974, I move to waive the applicable 
sections of that act for the purpose of the consideration of this 
amendment, and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The assistant 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 South Dakota (Mr. 
Johnson) is necessarily absent.
  The yeas and nays resulted--yeas 67, nays 32, as follows:

                      [Rollcall Vote No. 306 Leg.]

                                YEAS--67

     Akaka
     Alexander
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Corker
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                                NAYS--32

     Allard
     Barrasso
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McCain
     McConnell
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich

                             NOT VOTING--1

       
     Johnson
       
  The PRESIDING OFFICER. On this vote the yeas are 67, the nays are 32. 
Three-fifths of the Senators duly chosen and sworn having voted in the 
affirmative, the motion is agreed to.


                      School-Based Health Centers

  Ms. STABENOW. Mr. President, I rise to engage the distinguished 
Finance Committee chairman in a colloquy.
  Mr. BAUCUS. I would be happy to have a colloquy with the 
distinguished Senator.
  Ms. STABENOW. I want to express my appreciation for the chairman's 
efforts, and those of Ranking Member Grassley, in working to ensure the 
health and well-being of our Nation's children.
  As the chairman knows, more than 1,700 schools offer on-site, 
comprehensive well care, illness-related care, and dental care to 
nearly 2 million students from rural, suburban, urban, and Native 
American communities where access to such care is limited or 
nonexistent. A recent article in the March issue of Health Affairs 
discusses the role of school-based health centers as an effective means 
of helping children get the care they need.
  I was prepared to offer an amendment to the pending Children's Health 
Insurance Program bill that would ensure that school-based health 
centers are recognized as a provider under both Medicaid and the 
Children's Health Insurance Program. While the vast majority of these 
centers receive Medicaid reimbursement, only one in four receives 
reimbursement under the Children's Health Insurance Program for the 
providing the exact same quality services that a child might receive at 
another provider.
  After discussing this with the chairman, we noted that my amendment 
is included in section 121 of the House version of the Children's 
Health Insurance Program reauthorization bill. Therefore, to finish the 
Senate reauthorization as quickly as possible, I am prepared to not 
offer my amendment. But before I do that, I wanted to ask the chairman 
if he would support the House provision recognizing school-based health 
centers in conference?
  Mr. BAUCUS. I first thank the Senator from Michigan for her 
leadership on the Healthy Schools Act and school-based health centers. 
I, too, recognize the importance of school-based health centers. 
Clearly, efforts must be made to ensure that not only children have 
coverage but also access to health care providers. I support this 
amendment and will work with my colleague to address this issue in 
conference.
  Ms. STABENOW. I thank the chairman for his support and assurance. I 
will not offer my amendment.


                                diabetes

  Mr. DOMENICI. Mr. President, I want to begin by complimenting the 
chairman, the Senator from Montana, Mr. Baucus, and the ranking member, 
the Senator from Iowa, Mr. Grassley, for all their work on this 
Children's Health Insurance Program. You have taken a very difficult 
and contentious issue and produced legislation that will help many 
families. You should be congratulated.
  I would like to raise the issue of diabetes as part of the 
reauthorization of the State Children's Health Insurance Program. I 
have offered an amendment along with my colleague Senator Dorgan, which 
would reauthorize the Special Diabetes Program for Indians and the 
Special Funding Program for type 1 diabetes research. This amendment is 
identical to the language in S. 1494, which I also introduced with 
Senator Dorgan.
  Diabetes is one of the most serious and devastating health problems 
of our time. Although diabetes occurs in people of all ethnicities, the 
diabetes epidemic is particularly acute in our Native American 
populations. That is why during the negotiations on the 1997 Balanced 
Budget Act, the same bill that created this SCHIP program, I helped 
craft an agreement to finance diabetes programs of the Indian Health 
Service and help raise the profile of tribal health programs. The 
Special Diabetes Program for Indians began with funding of $30 million 
annually for 5 years and was later expanded to $150 million a year. 
This funding has been used widely in Indian country, including among 
the Navajo Nation and the 19 Pueblos in New Mexico.
  These programs are set to expire in 2008, and I believe they need to 
be a priority in this Congress.
  Mr. BAUCUS. I want to thank the Senators from New Mexico and North 
Dakota for their leadership on this important issue. I have worked hard 
in previous Congresses to support this program and helped shepherd its 
last reauthorization as part of the 107th Congress. It is important 
that we work together to make sure our Native American and rural 
communities have the resources they need to provide treatment and 
prevention programs. It

[[Page 22625]]

is important to support research to work to find a cure for this 
disease. Although we were not able to include this provision in the 
bill that is before us on the floor, I am aware that these critical 
programs expire in 2008; and that the reauthorization of these programs 
is a priority for the Finance Committee.
  Mr. GRASSLEY. I would also like to thank my colleagues for their 
leadership on this issue. I share your concern with the diabetes 
epidemic in the United States and especially the effect it is having on 
our Native American communities. I support the reauthorization of the 
Special Diabetes Program for Indians and also the reauthorization of 
the Special Funding Program for type I diabetes research. The 
prevention and treatment of diabetes has improved greatly over the past 
decade. These programs have clearly played a major role in these 
improvements. I also look forward to working with my colleagues to 
reauthorize these programs during this Congress.
  Mr. HATCH. I would also like to speak in support of the 
reauthorization of the Special Diabetes Program for Indians and the 
Special Funding Program for type I diabetes research. My record as an 
advocate for diabetes research and treatment programs is well 
documented. I have helped to lead the efforts in past years to 
reauthorize these programs and I look forward to working with my 
colleagues to make the reauthorization of these programs a priority for 
the Finance Committee this Congress.
  Mr. DOMENICI. I want to thank the Senators for their time. With that 
I will withdraw my amendment and I ask the chair that my amendment No. 
2629 be withdrawn.


                           amendment no. 2535

  Mr. SPECTER. Mr. President. I voted against the Allard Amendment for 
the following reasons.
  This amendment sought to codify in law the treatment of unborn 
children, therefore establishing the fetus as protected separately from 
the mother. Under the current bill, SCHIP States may treat pregnant 
mothers. In 2002, the Bush administration issued a regulation that gave 
States the option of extending SCHIP coverage to unborn children 
without a waiver.
  While I support the waiver policy in the pending legislation, this 
amendment is an effort to advance a political cause rather than provide 
a medical necessity because pregnant women are now covered. Under 
current law, there is ample ground for coverage during pregnancy. In 
fact, the Senate bill allows States to provide coverage for pregnant 
women without denominating them as unborn children to advance a 
political cause.
  While the amendment failed by a vote of 49 to 50, there is no 
practical effect in terms of health care coverage for pregnant women.


                           amendment no. 2557

  Mr. BYRD. Mr. President, while I opposed the Specter amendment, I do 
believe that the alternative minimum tax needs to be reformed. In the 
coming months, I hope to support efforts to do away with the inequities 
of the alternative minimum tax that unfairly burden West Virginians.


                           Amendment No. 2621

  Mr. DURBIN. Mr. President, today the Senate adopted a resolution 
expressing the sense of the Senate that small business owners should 
have some help when it comes to providing health insurance for their 
employees. I am an original cosponsor of the resolution adopted by 
amendment and strongly support its goals.
  The current health insurance system is simply not working for small 
employers and the self-employed. Employees of small businesses are much 
more likely to be uninsured than employees of large businesses. They 
are charged higher premiums for similar coverage. Their premiums can 
increase dramatically from year to year when a fellow employee gets 
sick. And employees rarely have a choice when it comes to their health 
plan.
  Over the past several months, I have sought out the opinions of 
people with a variety of viewpoints, which has resulted in constructive 
dialogue on how Congress can respond to these challenges. We are making 
progress. I think a workable compromise can be found.
  There is general agreement on what we want to accomplish. We need to 
create opportunities for small businesses to group together in a large 
pool. We need to ensure there are choices in private health plans that 
employees can choose from. And some form of subsidies will be needed to 
make health coverage more affordable.
  We know what we need to put in place, and we are working on how to 
reach these goals. The resolution demonstrates the Senate's commitment 
to finding a consensus this year. We won't end up with a Democratic 
bill, and we won't end up with a Republican bill. It will have to be a 
bipartisan bill.
  We need to work together, take the best ideas that are offered, and 
develop a proposal that has bipartisan support. That is the only way 
this Congress can address the need to help small business manage rising 
health care costs, while making health care coverage available for 
their employees.
  Mr. McCAIN. Mr. President, I am pleased that the Senate is debating 
the reauthorization of the State Children's Health Insurance Program, 
SCHIP. This is a vital safety net program that offers health care 
coverage to one of our most vulnerable populations, low-income 
children. I support a timely, fiscally responsible reauthorization of 
this program.
  The SCHIP program has served a critical purpose for many years. In 
1997, Congress created SCHIP to come to the aid of the millions of 
children who were going without health insurance because their families 
were stuck between earning too much money to qualify for Medicaid and 
not having enough money to purchase private health care coverage. I was 
pleased to join many of my colleagues in supporting its establishment. 
Thanks to this program, low-income children have been able to count on 
a safety net program that can provide them with health care coverage 
that they might otherwise go without.
  I strongly support the central purpose of SCHIP and believe that 
children of low-income families should have health insurance coverage. 
In some ways, this program has been a great success, as we have been 
able to drop the rate of uninsured children by nearly 25 percent from 
1996 to 2005 and SCHIP covered about 6.6 million children last year. At 
the same time, however, I am greatly concerned that the program has 
expanded beyond what Congress first intended. In some cases, SCHIP 
coverage has been extended to middle-income children and to certain 
adult populations. I don't believe that was the intention of Congress 
when we created this program. This has complicated SCHIP 
reauthorization, and I believe that if we allow SCHIP to grow beyond 
its original purpose, SCHIP spending will grow exponentially and 
jeopardize its future success.
  Several options have been proposed to reauthorize the SCHIP program. 
One, the CHIP Reauthorization Act, which was reported by the Finance 
Committee, would greatly expand SCHIP beyond its original framework, 
lead to an explosion in new spending, and reduce private health 
coverage in our country. The other, the Kids First Act, which I 
support, would keep SCHIP's focus on providing low-income children with 
health insurance in a fiscally responsible manner.
  I am concerned over the direction that the CHIP Reauthorization Act 
would take SCHIP and the precedent it would set for future 
authorization bills. The current SCHIP baseline is currently $25 
billion; however, under the Finance Committee's proposal, spending 
would explode by an additional $35 billion and will end up costing $60 
billion over 5 years. Not only that, according to CBO, at the end of 5 
years, in order to comply with pay-go rules, this bill reduces the 
SCHIP allotment in the fifth year 2013 from $8.4 billion to $600 
million. If there is anyone who seriously believes Congress will cut 
SCHIP funding by $8 billion in 1 year and cause millions who would then 
rely on SCHIP to lose coverage, I have got some beachfront property in 
Yuma, AZ, that I am willing to sell.
  The CBO report also points out that if the costs of the program 
continue to grow according to enrollment projections, the total cost of 
the program

[[Page 22626]]

over the fiscal year 2008-2017 period would be $112 billion. Even the 
massive tobacco tax increase included in the bill, which would raise 
about $71 billion from fiscal year 2008-2017, can't cover that cost. I 
am not sure where the extra money will come from to cover the cost of 
the bill, and it is unfair that we leave this for a future Congress to 
figure out how to cover our overspending. In other words, let's put a 
halt to business as usual.
  The CHIP bill also represents a change in the mission of SCHIP by 
further eroding private health coverage of children. With expanded 
eligibility for SCHIP, we are likely to see families who already have 
private coverage drop that coverage and opt for a Government-run, 
Government-subsidized program. CBO estimates that, among newly eligible 
populations covered under this bill, each additionally enrolled 
individual in SCHIP will be matched by one individual leaving private 
coverage. We will be spending billions and billions of dollars 
providing coverage for children who already have coverage, and I 
believe this is a dangerous step toward Government-run health care 
insurance.
  Instead, Congress should remember the central mission of SCHIP and 
focus the program reauthorization on providing low-income children with 
health insurance coverage if they don't otherwise have it. Several of 
my colleagues offered the Kids First Act as a substitute amendment to 
the CHIP bill. It would reauthorize SCHIP, provide an increase in 
funding, and avoid a costly regressive tax increase. This bill would 
ensure that SCHIP mission remains covering low-income children and will 
focus efforts on enrolling children who are already eligible for SCHIP 
and Medicaid but are not currently enrolled. It also recognizes that 
millions of children receive private health coverage and would improve 
current laws that allow States to offer premium assistance for coverage 
through private plans. Additionally, the Kids First Act also includes 
small business health plan reforms. Unfortunately, the Kids First Act 
failed after it was offered as an amendment during debate earlier this 
week.
  At this time, I cannot support the CHIP Reauthorization Act. While I 
applaud the sponsors efforts to reauthorize SCHIP, I believe that bill 
differs drastically from the original intention of the SCHIP law and is 
fiscally irresponsible. I support the ideas contained in the 
alternative bill, the Kids First Act, which I believe would keep SCHIP 
focused on providing health insurance coverage to low-income children 
and would do so without dramatic increases in Federal spending or 
higher taxes on Americans.
  Mr. AKAKA. Mr. President, I support the Children's Health Insurance 
Program Reauthorization Act.
  According to the Center on Budget and Policy Priorities, the 
Children's Health Insurance Program has reduced the number of uninsured 
children by one-third since its enactment in 1997. The administration's 
opposition to this legislation is a vital mistake that threatens the 
health and well being of our Nation's children. This program is not 
partisan and debate on this issue should not be ideological. We simply 
want children to have access to health care. Making investments in the 
health care of children will help ensure that they grow up into healthy 
adults. In order to learn and lead active and healthy lives, children 
must have access to health care.
  As of June 2007, 17,512 children were enrolled in Hawaii's Children's 
Health Insurance Program. An estimated 5 percent of children in Hawaii 
do not have health insurance. This is approximately 16,000 children who 
do not have health insurance. I am proud that my home State, Hawaii, 
has continued to develop innovative solutions to help increase access 
to health care. This year, Hawaii enacted legislation establishing the 
Keiki Care Program. The Keiki Care Program is a public-private 
partnership intended to make sure that every child in Hawaii has access 
to health care.
  Now is not the time to cut Federal resources provided to States to 
provide health care for children. The legislation currently before the 
Senate will preserve the access of health care for the 6.6 million 
children currently enrolled in the Children's Health Insurance Program. 
It will also expand health care access to an estimated 3.2 million 
children.
  The Children's Health Insurance Program Reauthorization Act must be 
enacted. This administration's opposition to this program is 
shortsighted and threatens the well-being of our Nation's children.
  Mr. LIEBERMAN. Mr. President, I rise today to offer my support to not 
only the reauthorization of the Children's Health Insurance Program, or 
CHIP, but also to the expansion of this successful program.
  CHIP was created a decade ago on a bipartisan basis with the support 
of a Democratic President and a Republican Congress. Members of both 
sides of the aisle came together to address the problem of uninsured 
children across this country. In 1997, over 22 percent uninsured low-
income children were uninsured. In 2005, that percentage had decreased 
to less than 15 percent. It is clear that CHIP has significantly 
lowered the percentage of low-income children that are uninsured. 
Overall, CHIP has led to a one-third reduction in the percentage of 
low-income uninsured children in America.
  CHIP covers a total of 6 million children today, and research shows 
us that these children are doing better than those without insurance. 
CHIP kids are more likely to have seen a physician, and to have had a 
well-child visit than uninsured children. They are more likely to 
receive hospital care and prescription medications for their health 
conditions. Most importantly, CHIP kids have better health and academic 
outcomes, such as improved care for asthma; declines in infant 
mortality, childhood deaths, and low-birth weight; and improved 
academic performance. These facts make it clear that our bottom line 
should not be dollar amounts, but the health and success of our 
children, and it is clear that children enrolled in CHIP are healthier 
and doing better in the classroom. I see no greater reason than that to 
expand this successful program.
  CHIP is a national success story that we should all take pride in. 
Unfortunately, it is one the few success stories that we have to report 
in health care over the last decade. Health care costs are rising at 
ever increasing rates, employer sponsored coverage is decreasing, the 
numbers of uninsured is rising, health care quality is not where it 
should be given the amount we spend on health care, and patients are 
not involved enough in their own care.
  As families, businesses, and providers confront these realities, 
Washington is in a deadlock about how to solve one of our most daunting 
domestic challenges. CHIP, however, offers this Congress another 
opportunity to reduce the number of uninsured children in this country 
now. Just as importantly, we have an opportunity to also make an 
investment in our future by improving the health status of our Nation's 
children. It is imperative to our Nation's future health security to 
provide these children with the coverage they need to be healthy and 
productive for years to come.
  I know that members of both parties want to cover uninsured children 
in their States and across the country. Members of both parties want 
CHIP to function as efficiently as possible and to reach those most in 
need. Members of both parties want to provide States with flexibility 
to address their States' unique concerns. Now, we are all faced with a 
new challenge--to cover the 9 million children that remain uninsured 
across America, 6 million of whom are eligible for Medicaid or CHIP. 
This challenge brought a core group of Senators from the Finance 
Committee together around these common goals, which they used as a 
foundation for reauthorizing and expanding this successful program to 
move towards covering all of the 9 million uninsured children that 
remain in this Nation.
  Both sides worked tirelessly together and compromised so that the 
legislation we are now considering could be brought to the Senate floor 
and so that we could move towards bringing health

[[Page 22627]]

security to more of America's uninsured children. If enacted, this 
legislation would provide coverage to over 3 million more children, 
again reducing the number of uninsured children by one-third. States 
would receive new funding for reaching out to eligible children and 
enrolling them. States will also receive funding based on their 
spending projections, thereby reducing the likelihood of budget 
shortfalls as we have seen increasingly in recent years. States will 
receive incentives to lower the rates of uninsured children in their 
State. Lastly, States will continue to have the flexibility to design 
programs that meet their unique needs. In Connecticut, children up to 
300 percent of the Federal poverty level are eligible for CHIP and this 
legislation would allow my State to continue to build on its success 
and enroll even more children into this successful program. This 
legislation also establishes a new framework for improving quality, 
which should be a priority as we consider ways of containing health 
care costs, by creating a quality initiative to develop, implement, 
collect measurement data on quality of care.
  I know there are some in the Senate that are opposed to this 
legislation and to the expansion of this program. This week they have 
spoken extensively on their proposals for health care reform and their 
willingness to move forward on that larger issue. However, while we 
wait to reform the health care system in this partisan environment, 
children in this country are living without access to health care. We 
have a moral obligation to care for these children and give them the 
best chance to succeed in school, and at life, by keeping them healthy. 
There are others that say the program should be expanded even more 
significantly. While I agree with this latter sentiment, the nature of 
the work of this body is bipartisan. To progress, we each may have to 
give something up to our colleagues. I urge them to continue on this 
course and support this legislation.
  The legislation before this Senate body is the product of months of 
bipartisan negotiation, compromise, and a shared vision and goal across 
both parties. CHIP reauthorization should be an example to all in this 
Chamber of what can be accomplished when we put partisanship aside and 
focus on what we have in common.
  Most of all, I urge the President to not veto CHIP reauthorization if 
a bill were to reach his desk. It would signal a colossal missed 
opportunity to provide health security to those that are most 
vulnerable in our Nation.
  Mr. ENZI. Mr. President, I rise today to speak about the State 
Children's Health Insurance Program, or what folks on Capitol Hill are 
calling S-CHIP.
  SCHIP was created by a Republican Congress in 1997 to help low income 
kids get health insurance. The goal of the program is to help kids that 
don't qualify for Medicaid, but also can't afford to get health 
insurance on their own, receive the care they need. This program 
expires on September 30, 2007, and I am here today to speak about how 
important it is to reauthorize this critical program in a way that 
protects private health insurance and keeps kids healthy.
  I would like to speak for a few minutes about the how the program 
works today and how the proposals the Senate is discussing will change 
what currently happens.
  Currently States have three options: they can enroll kids in 
Medicaid, create a new separate program, or devise a combination of 
both approaches. SCHIP is financed jointly by the Federal Government 
and the States, and States receive a higher percentage of Federal money 
for their SCHIP beneficiaries than they do for their Medicaid 
beneficiaries. This was originally designed to encourage States to 
create SCHIP programs. States have 3 years to spend their SCHIP 
allotments. Funds that aren't spent within 3 years are usually 
redistributed to States that have spent their allotment and need 
additional money.
  When the Republican-led Congress enacted SCHIP in 1997, the program 
authorized $40 billion for 10 years. I will come back to this point in 
a bit, but the underlying bill before us today authorizes $60 billion 
over 5 years--the baseline spending is $25 billion over 5 years and 
this bill authorizes an additional $35 billion over 5 years. The budget 
resolution contained a deficit neutral reserve fund to spend $50 
billion over 5 years in addition to the $25 billion in the baseline, so 
a total in the budget resolution is $75 billion over 5 years. This is a 
lot of money and Congress needs to ensure the money is being used to 
pay for health insurance for kids that don't currently have health 
insurance.
  The nonpartisan Congressional Budget Office estimates that Senator 
Baucus' bill will reduce private coverage--that is kids will move from 
private health insurance to taxpayer-funded public health insurance. 
This is a highly inefficient policy--especially given how bureaucratic 
some State programs are structured. This is not an efficient use of the 
taxpayer's money.
  Part of the reason why the crowd out effect is so great under the 
Finance bill is because the bill allows States to expand coverage to 
kids up to 400 percent of the Federal poverty level--which by the way 
translates to an annual income of $82,000 for a family of four. The 
higher the income expansion, the greater the crowd out effect. This is 
simple economics.
  Now I would be remiss if I didn't mention what a great job my home 
state of Wyoming is doing in administering SCHIP. Wyoming first 
implemented its SCHIP program, Kid Care CHIP, in 1999 and in 2003, 
Wyoming formed a public-private partnership with Blue Cross Blue Shield 
of Wyoming and Delta Dental of Wyoming to provide the health, vision, 
and dental benefits to nearly 6,000 kids in Wyoming. These partnerships 
have made Kid Care CHIP a very successful program in Wyoming. All 
children enrolled in the program receive a wide range of benefits 
including inpatient and outpatient hospital services, lab and x-ray 
services, prescription drugs, mental health and substance abuse 
services, durable medical equipment, physical therapy, and dental and 
vision services. Families share in the cost of their children's health 
care by paying copayments for a portion of the care provided. These 
copays are capped at $200 a year per family.
  Wyoming is also engaged in an outreach campaign targeted at finding 
and enrolling the additional 6,000 kids that are eligible for Kid Care 
CHIP but aren't enrolled.
  As Congress works to finalize a bill to reauthorize this program, it 
is essential that we focus on the kids first. Some states SCHIP 
programs cover parents of kids that are on SCHIP and some States even 
cover childless adults. Adults without health insurance are a problem 
in this country, but not a problem this program was originally intended 
to address. I think there are responsible, market-based things Congress 
can do to help more American adults get health insurance, but this 
bill, the State Children's Health Insurance Program, should focus on 
the C for Children.
  Not only does this bill need to focus on kids, we need to focus on 
low income kids. In July 2005, Wyoming's Kid Care CHIP began covering 
kids up to 200 percent of the Federal poverty level--those with family 
incomes below $42,000. The median family income in the United States is 
about $46,000, so the Wyoming benefit is very generous. Some of my 
colleagues are advocating for expanding SCHIP to cover kids and adults 
at 400 percent of the Federal poverty level. That means families making 
as much as $82,000 a year would have their kid's health insurance paid 
for by the government. Again, this is an inefficient use of taxpayer 
dollars. Why should the government provide health care for kids that 
come from families making $82,000 a year? I'll tell you why my 
colleagues are advocating for it--they see this as the first step 
toward government-run health care. They want the U.S. to be more like 
Canada and Great Britain. They want to take the private sector out of 
health care. They want to put the government in the exam room and tell 
you what doctors you can see and when you can see them and what drugs 
they can prescribe for you. I don't believe in this.

[[Page 22628]]

Not only do I not believe in this, I think this goes against all the 
principles upon which this country was founded.
  Now I do agree that our health care system is breaking down, and in 
fact I don't think we have a health care system, I think we have a sick 
care system. That is why, earlier this month, I introduced ``Ten Steps 
to Transform Health Care in America,'' a bold and comprehensive 
solution that addresses our health care crisis by building on market 
based ideas to expand access to health insurance for all Americans. I 
would like to take just a little bit of time to discuss each of Ten 
Steps.
  The first of the Ten Steps is eliminating unfair tax treatment of 
health insurance, expanding choices and coverage and giving all 
Americans more control over their own health care. The Joint Committee 
on Taxation estimated that removing this tax bias and a few related 
health care tax policies will save the Federal Government $3.6 trillion 
over the next ten years. That is a lot of money that can and should be 
used to expand choices and access and give individuals more control 
over their health care. Ten Steps ensures every American can benefit 
from this savings--whether they get their health care from their 
employer, from the individual insurance market, or they decide they 
want to get off Medicaid and switch to private insurance. Everyone 
should be treated equally.
  The second step of Ten Steps would increase affordable options for 
working families to purchase health insurance through a standard tax 
deduction. The national, above-the-line standard deduction for health 
insurance will equal $15,000 for a family and $7,500 for an individual.
  The third step of Ten Steps is what makes this a hybrid approach--I 
couple the standard deduction with a refundable, advanceable, 
assignable tax-based subsidy. The tax subsidy is equal to $5,000 for a 
family, $2,500 for an individual. The full subsidy amount is available 
to individuals at or below 100 percent of the Federal poverty level, 
FPL, which is $20,650 for a family of four. The subsidy is phased out 
as an individual's salary increases, with individuals at 200 percent 
receiving half of the subsidy and individuals at 301 percent receiving 
the standard deduction instead of the subsidy.
  The fourth key step for health care reform is to provide market-based 
pooling to reduce growing health care costs and increase access for 
small businesses, unions, other kinds of organizations, and their 
workers, members, and families. Those of you who know me well recognize 
how central this would be to any health care reform proposal of mine.
  The fifth step blends the individual and group market to extend 
important HIPAA portability protections to the individual market so 
that insurance security can better move with you from job to job.
  The sixth step emphasizes preventive benefits and helps individuals 
with chronic diseases better manage their health. America should have 
health care, not sick care. Prevention. Prevention. Prevention. This 
step is modeled after a very successful program in Wyoming. In 2005, 
Wyoming EqualityCare, our Medicaid Program, began providing one-on-one 
case management for Medicaid participants with a chronic illness, such 
as diabetes, asthma, depression, and heart disease, to encourage better 
self-management of these conditions. The program provides educational 
information on self-management as well as a nurse health coach that 
follows up with each patient to ensure they have what they need to take 
care of themselves.
  The seventh step gives individuals the choice to convert the value of 
their Medicaid and SCHIP program benefits into private health 
insurance, putting them in control of their health care, not the 
Federal Government. This is very pertinent to the underlying bill we 
are discussing today. The rationale for this step is simple. If the 
market can provide better coverage at a lower price, then why not allow 
Americans to access that care? This gives low-income individuals more 
options about where they receive their care and what care is available 
to them. It is time for people to start making decisions about their 
care--let's get the government out of the doctor's office.
  The eighth step in Ten Steps is a bipartisan proposal which the HELP 
Committee approved last month--the Wired for Health Care Quality Act. 
This bill will encourage the adoption of cutting-edge-information 
technologies in health care to improve patient care, reduce medical 
errors and cut health care costs. Some of the most serious challenges 
facing healthcare today--medical errors, inconsistent quality, and 
rising costs--can be addressed through the effective application of 
available health information technology linking all elements of the 
health care system.
  The ninth step of Ten Steps helps future providers and nurses pay for 
their education while encouraging them to serve in areas with great 
need. The ninth step also ensures appropriate development of rural 
health systems and access to care for residents of rural areas and 
gives seniors more options to receive care in their homes and 
communities.
  The final step decreases the sky-rocketing costs of health care by 
restoring reliability in our medical justice system through State-based 
solutions.
  I realize that I have talked for quite a bit about Ten Steps to 
Transform Health Care in America and that, the underlying legislation 
is the reauthorization of the State Children's Health Insurance 
Program. I believe it is important to think bigger than just one 
program and think about the health care system as a whole. I have 
spoken a few times on the Senate floor about what I call the 80/20 
rule. I always believe that we can agree on 80 percent of the issues 
and on 80 percent of each issue, and that if we focus on that 80 
percent we can do great things for the American people. I believe that 
if we work together on these proposals we can find that 80 percent. I 
would like to work with my colleagues on that 80 percent. I want 
action--real action to provide real coverage for Americans. I support 
reauthorizing this program in a way that protects private health 
insurance and keeps kids healthy. I also support looking beyond this 
single program at reforming the entire health care system.
  Mr. LEVIN. Mr. President, I am proud that we have produced a 
bipartisan bill to continue to provide health care insurance to 
children of low-income parents. The Children's Health Insurance 
Program, which we created 10 years ago, has been a great success, but 
it is set to expire on September 30. This bill to reauthorize and 
expand the program deserves our strong support.
  I urge the President to approve the bipartisan compromise my 
colleagues worked so hard to achieve and not to carry out his threat to 
veto a bill, a veto which could result in denying health care coverage 
to many uninsured children from working families.
  The Balanced Budget Act of 1997 created a children's health insurance 
program under title XXI of the Social Security Act. This program allows 
states to insure children whose families are above Medicaid eligibility 
levels through block grants, and it allowed states flexibility in 
designing how CHIP would be implemented.
  Since 1997, CHIP has received about $40 billion in appropriations and 
has been widely successful. Currently, 6.6 million children are 
enrolled in CHIP. Seventy percent of those children came from families 
with incomes below 150 percent of the poverty level, and more than 90 
percent were from families with incomes below 200 percent of the 
poverty level.
  CHIP coverage leads to better access to preventative and primary care 
services, better quality of care, better health outcomes and improved 
performance in school. Some experts estimate that families with insured 
children are five times less likely to delay health care because of 
costs than families with uninsured children. Michigan has had 
particularly impressive results from CHIP and currently has the second 
lowest rate of uninsured children in the nation.
  Although CHIP has been successful, it still fails to address the 
problem

[[Page 22629]]

fully. Too many children qualify for the program but are unable to 
receive insurance because of inadequate funding. There are still 9 
million uninsured children nationwide, 6 million of which are eligible 
for either Medicaid or CHIP. In Michigan, while 55,000 children are 
covered under CHIP, 90,000 Michigan children are currently eligible for 
Medicaid or MIChild, Michigan's CHIP program, but are not receiving 
services. In addition, according to the Robert Wood Johnson Foundation, 
the recent decline in employer-sponsored health care coverage is 
threatening the access to private health care coverage for many more 
children.
  With CHIP set to expire this year, the path we need to take is clear 
we need to reauthorize and to also expand CHIP.
  This bill before us was reported by the Senate Finance Committee with 
a bipartisan majority of 17-4. It will reauthorize CHIP and increase 
funding for the program by $35 billion over 5 years. The Children's 
Health Insurance Program Reauthorization Act of 2007 would ensure that 
there is sufficient funding to cover the children currently enrolled 
and to expand the program to additional children in need. This plan 
would increase outreach and enrollment for uninsured low-income 
children of the working poor, enhance premium assistance options for 
low-income families, and improve the quality of health care for our 
Nation's children.
  This reauthorization would also provide $200 million in grants for 
states to improve access to dental coverage; require that states 
providing mental health services provide those services on par with 
medical and surgical benefits under CHIP; and allow states to use 
information from food stamp programs to find and enroll eligible 
children. This bill would also help to reduce racial and ethnic health 
care disparities by improving outreach to minority populations and 
provide new funding for state translation and interpretation services.
  The additional $35 billion in funding is expected to reach an 
estimated 3.2 million additional uninsured American children from low-
income families. Up to 50,000 more Michigan children would be covered 
over the next 5 years.
  There are two aspects of the bill that are disappointing. The current 
CHIP program allows for flexibility at the State-level in how the 
program is implemented. The administration has encouraged this 
flexibility by approving waivers to some States that would allow them 
to cover services to other needy populations after ensuring that it is 
not at the expense of enrolling eligible children into CHIP.
  Michigan has had a waiver that allows it to cover adults who make 
less than $3,500 a year--adults who are the ``poorest of the poor.'' 
But under the bill we passed today, some of these waivers will be 
phased out
  The second disappointment is that this bill does not go as far as we 
could have to fund and expand CHIP. In the fiscal year 2008 budget 
resolution, the Senate included an increase of $50 billion for CHIP. 
However, the bill, as a result of compromises made, provides $35 
billion.
  I voted for an amendment offered by Senator Kerry that would have 
provided the additional $15 billion that would have taken us back to 
$50 billion. With this additional funding, the Kerry amendment would 
have provided more incentives to increase the enrollment of uninsured 
children. Unfortunately, this amendment was not agreed to.
  On balance, however, this is a strong bill. President Bush's approach 
would be far worse. The President wants to add only $5 billion over 5 
years, which many believe will not even sustain the current levels of 
coverage and certainly would not help the millions of children still 
living without health insurance.
  President Bush has threatened to veto the Senate's CHIP 
reauthorization bill, but I hope the Senate's action today will send a 
strong message to the President that this program has broad bipartisan 
support.
  Here are just a few examples of the way in which CHIP fills a need. A 
courageous and hardworking mother from Royal Oak, MI, wrote:

       As a single working mother, I could not afford the family 
     insurance that my employer offered, and definitely could not 
     afford private pay. Without this insurance I do not know what 
     I would have done. [SCHIP] offered us options, doctors 
     instead of emergency rooms, less time missed at work and 
     school. Please continue and increase funding for this 
     valuable program. Thank you.

  A registered nurse from Berkley, MI wrote:

       I work in Detroit with impoverished, uninsured and 
     underinsured adolescents and the SCHIP program has helped 
     tremendously in getting them the health care they so 
     desperately need.

  And a registered nurse from Pleasant Ridge, MI, wrote:

       It is an imperative to continue to support, and expand, 
     health care services to children. These services are the 
     building blocks of personal health leading to healthy, active 
     adults. Health promotion and disease prevention programs have 
     been shown to save significant healthcare dollars later in 
     life by assuring that each individual grows and develops to 
     their fullest potential. Healthy children become healthy 
     adults who then support the growth of communities and the 
     economy.

  We have a moral obligation to provide Americans access to affordable 
and high quality health care. No person, young or old, should be denied 
access to adequate health care, and the expanded and improved 
Children's Health Insurance Program is an important step toward 
achieving that goal.
  Ms. COLLINS. Mr. President, one of the first bills that I sponsored 
when I came to the Senate 10 years ago was the legislation that 
established the State Child Health Insurance Program--or SCHIP--which 
provides health care coverage for children of low-income working 
parents who cannot afford health insurance yet make too much money to 
qualify for Medicaid.
  Since 1997, SCHIP has contributed to a one-third decline in the 
uninsured rate of low-income children. Today, over 6 million children--
including 14,500 in Maine--receive health care coverage from this 
remarkably effective health care program.
  According to a recent assessment by the nonpartisan Center for 
Children and Families at Georgetown University, ``While the coverage 
news for the nation is generally bleak, the story for children's health 
coverage stands apart. Of all the health reform efforts, covering 
children has been resoundingly successful. Since its creation, SCHIP 
has partnered with Medicaid to help ensure that children have the 
health care that they need.''
  Still, there is more that we can do. While Maine ranks among the top 
4 States in the Nation in reducing the number of uninsured children, we 
still have more than 20,000 children who don't have coverage. 
Nationally, about 9 million children remain uninsured.
  Unfortunately, the authorization for SCHIP, which has done so much to 
help low-income American families to obtain the health care that they 
need, is about to expire. As the cochair with Senator Rockefeller of 
the nonpartisan Alliance for Health Reform, I have long been concerned 
about the need to extend the SCHIP program in order to renew our 
commitment to meeting the health care needs of children in our Nation's 
low-income working families.
  That is why I am pleased to support this legislation to extend and 
strengthen this important program. This bipartisan bill increases 
funding for SCHIP by $35 billion over the next 5 years, a level which 
is sufficient to maintain coverage for all 6.6 million children 
currently enrolled, and also allows the program to expand to cover an 
additional 3.3 million low-income children.
  The legislation the Senate is currently debating also improves SCHIP 
in a number of important ways. I am particularly pleased that the bill 
includes a requirement for States that offer mental health services 
through their SCHIP program to provide coverage that is equivalent in 
scope to benefits for other physician and health services. Treating 
behavioral and emotional problems and mental illness while children are 
young is critical to preventing more serious problems later on.
  Despite the demonstrated need, children's dental coverage offered by

[[Page 22630]]

States isn't always all that it should be. Low-income and rural 
children suffer disproportionately from oral health problems. In fact, 
80 percent of all tooth decay is found in just 25 percent of children. 
I am, therefore, cosponsoring amendments with Senators Snowe, Bingaman, 
Cardin, and Mikulski to strengthen the dental coverage offered through 
SCHIP to ensure that more low-income children have access to the dental 
services that they need to prevent disease and promote oral health. I 
am hopeful that these amendments will be included in the final package.
  In recognition of the fact that good health begins before birth, the 
Senate bill also gives States the option of covering low-income 
pregnant women under SCHIP. Current regulations do permit States to 
cover unborn children, making reimbursements available for prenatal, 
labor, and delivery services. Medically necessary postpartum care, 
however, is not covered. The Senate bill will change that.
  The Senate bill will also eliminate the State shortfall problems that 
have plagued the SCHIP program, and it also provides additional 
incentives to encourage States to increase outreach and enrollment, 
particularly of the lowest income children.
  In short, Mr. President, the bill before the Senate is a prescription 
for good health for millions of our Nation's working families, and I 
urge all of my colleagues to join me in supporting it.
  Ms. SNOWE. Mr. President, I want to congratulate Chairman Baucus and 
Ranking Member Grassley, as well as Senators Rockefeller and Hatch, for 
their visionary leadership and tireless perseverance in crafting an 
SCHIP package that has received so much bipartisan support. I also want 
to thank them for never losing sight of the single over-arching goal--
obtaining health insurance for uninsured children.
  I rise today to strongly support a Senate resolution I have filed 
with Senator Lincoln and a host of my colleagues on both sides of the 
aisle which contains a resounding and inescapable message: Congress 
must unite to address the small business health insurance crisis--this 
year.
  I am encouraged by the unprecedented level of constructive, 
bipartisan dialogue currently taking place on the issue of small 
business health insurance reform. The roster of support on our Small 
Business Resolution speaks volumes about its viability: Senators Baucus 
and Grassley, Kennedy and Enzi and Senators Ben Nelson, Durbin, Smith, 
and Crapo. This diverse, bipartisan group tells me that the will is 
there. We can get this done--if we don't retreat to partisan corners 
and if we work together and make tough compromises just as we have done 
on the SCHIP bill--which this body will soon likely pass--where we sat 
down, rolled up our sleeves, and worked together to fashion a consensus 
package.
  As past chair and now ranking member of the Small Business Committee, 
if there is one concern I have heard time and again, it is the 
exorbitant cost to small businesses of providing health insurance to 
their employees. Health insurance premiums have increased at double-
digit percentage levels in 4 of the past 6 years--far outpacing 
inflation and wage gains. Is there any question that the small business 
health insurance crisis is real?
  We could not be at a more pivotal juncture on this threshold issue. 
According to the Kaiser Family Foundation, last year the average group-
sponsored health insurance policy for an individual was $4,242--the 
average family plan cost $11,480. And the figures are dramatically 
worse for those purchasing health insurance in the individual market. 
For example, in my home State of Maine, a health insurance plan on the 
individual market can cost a family of 4 in excess of $24,000 per year. 
Funds which could be used for other expenses such as saving for college 
tuition or retirement security or a down payment on a home--not for one 
year of health care.
  This phenomenon perpetuates a cycle of spiraling costs and declining 
access as fewer and fewer small businesses offer health insurance to 
their employees. Only 48 percent of our smallest businesses are able to 
provide this workplace benefit--a 10 percent drop from 5 years ago. 
Clearly, it is time we started heading in the opposite direction.
  Of course, this is easier said than done as small group markets such 
as those in Maine have no real competition and represent major 
impediments. No competition means higher costs, and higher costs mean 
no health insurance.
  Making matters more challenging is the fact that across the country, 
the largest insurers now control 43 percent of the small group markets. 
In Maine, a sum total of four large insurers now control 98 percent of 
the small group market.
  So the issue isn't whether the United States has the greatest health 
care system in the world--we do. But with nearly 45 million uninsured 
in this country, our goal should be nothing less than providing health 
care access for all. It is all the more incumbent upon this Congress to 
consider every possible viable avenue and reach across the partisan 
divide to solve this crisis, an approach that reflects the undeniable 
will of the American people on this matter.
  That is why I have advocated for and championed Small Business Health 
Plan legislation which would allow small businesses to ``pool'' 
together across state lines to provide their employees with health 
insurance at significantly lower costs. It is an idea which is gaining 
growing support. A recent study published by the National Association 
of Realtors concluded that an overwhelming majority of voters--89 
percent, including 93 percent of Republicans and 86 percent of 
Democrats--favor legislation that would allow small businesses to pool 
together to negotiate lower health insurance costs.
  I continue to believe that Small Business Health Plans are a logical 
solution to the small business health insurance crisis, and I thank 
Senator Enzi for all of his tremendous efforts in getting legislation 
passed through the HELP Committee last year, and for having them 
considered on the Senate floor for the first time ever.
  As we move forward in this debate, we must leave no stone unturned in 
our search for consensus solutions to this crisis as we seek to reform 
the small group and individual health insurance markets.
  We must address how to allow health insurers to provide lower-cost 
products to small businesses across state lines while maintaining the 
most widely accepted and necessary benefits and services.
  We must figure out how to ``rate,'' or price, these products--and 
also how and whether this can be done in a uniform manner, without 
jeopardizing consumer protections.
  Finally, we should examine ways to use the tax code as a mechanism 
for increasing access to health care and injecting competition into the 
state small group markets.
  In conclusion, Congress must consider small business health insurance 
reform legislation this year, in a bipartisan, comprehensive way that 
can secure significant consensus support. In the coming months, I look 
forward to a robust and productive debate on this issue in the Finance 
Committee.
  I yield the floor.
  Mr. LEAHY. Mr. President, I wish to express my support for the 
passage of the Children's Health Insurance Program reauthorization. 
This is a vitally important program that ensures some of the most 
vulnerable among us, our children, have access to the health care they 
deserve. There is no question that we are a country with a health care 
crisis. In the richest, most powerful country in the world, it is a 
disgrace that we have 47 million people with no health coverage. 
Addressing this national priority is long overdue, so I am especially 
pleased that this new Congress will take action by extending health 
care coverage to millions of children.
  Congress created this program 10 years ago to provide coverage to 
children whose families earned too much to qualify for Medicaid, but 
lacked health care coverage through their employer or the private 
market. At that

[[Page 22631]]

time, there were more than ten million children who were uninsured. In 
the last decade, we have seen the success of the Children's Health 
Insurance Program; it has covered over 6 million low-income children, 
providing consistent quality health care.
  With the success of this program, it is appropriate that we renew it 
for 5 more years, but also extend it so that millions of additional 
low-income, uninsured children will now have health coverage. This 
expansion is critically important because through CHIP children have 
far better access to preventive and primary care services than they 
would if they were uninsured. With more routine health care, we know 
that kids have better health outcomes and perform better in schools.
  Studies have also shown that approximately 6 million children are 
eligible for public coverage but are not enrolled in CHIP. I am pleased 
that the Finance Committee has been able to craft a bill that would 
cover 3.2 million children, but I do hope that we can go even further 
and expand this coverage to additional children. Because uninsured 
children are nine times less likely to receive needed health care on 
time and are more likely to go without a visit to a doctor's office, we 
need to cover as many of them as possible.
  My State of Vermont has been a leader when it comes to covering kids. 
We are referred to an early expansion State because prior to the 
creation of this program, Vermont extended Medicaid coverage to low-
income children through a program known as Dr. Dynasaur. The bill 
before the Senate would allow Vermont to maintain coverage for the kids 
currently covered, but also reach out to the remaining children that 
are eligible but not enrolled in the program.
  The Finance Committee proposal would also have a positive impact on 
health care by increasing the tobacco tax. This action will have a 
significant affect on our country's health, reducing the rate of 
cancer, strokes and heart attacks. Further, an increase in the tobacco 
tax will also reduce the prevalence of smoking, especially among 
adolescents. We know that when cigarettes become more expensive, both 
kids and adults will change how much they smoke. This is a positive 
outcome and one that I support.
  I appreciate the hard work that has gone into crafting this 
bipartisan legislation. I believe it puts the country on the right 
track towards ensuring all children have health insurance and I 
strongly support it.
  Mr. ROCKEFELLER. Mr. President, this is a monumental day for all 
Americans but especially children and their families. I am proud of the 
work we have accomplished over the past few days in the Senate on the 
Children's Health Insurance Program--or CHIP--Reauthorization Act of 
2007. Renewing this program for another 10 years is a fitting way to 
mark this Sunday, August 5th's 10-year anniversary of the day the first 
CHIP bill was signed into law.
  As you know, this legislation was the result of countless hours of 
negotiations between Senators Baucus, Grassley, and Hatch and I. CHIP 
legislation has a history of bipartisanship, I am quite proud of it.
  Many Members of this Chamber had hoped for something different in 
this bill.
  There were some on the other side of the aisle who wanted to place 
further restrictions on those covered by this bill and decrease the 
funding to $15 million. I know that there were others on this side of 
the aisle who wanted to add benefits and increase the funding to $50 
billion. Individually, we were each tempted by some of the suggested 
changes in the more than 86 amendments to this bill.
  But the fundamental goal has been sustained throughout our debates 
and votes--expanding access to health care for millions of children, 
including those eligible children who are not yet enrolled.
  Each of us knows the statistics in our own State. I am proud that 
nearly 39,000 West Virginians were enrolled in the program last year.
  These kids can see a doctor when they get sick, receive necessary 
immunizations, and get the preventative screenings they need for a 
healthy start in life, because of this important program. The passage 
of this bill means 4,000 more West Virginia children will have 
affordable and stable health insurance coverage including access to 
basic preventative care and immunizations.
  Bipartisan passage in the Finance Committee was our first ``win.'' 
Senate passage is the next bold step. Our conference, like all of the 
CHIP negotiations, will be intense. But if we keep our focus on 
covering children and bipartisanship, I am confident that we will 
achieve our vital goal of continuing this successful program for 
children.
  Many individuals have worked long and very hard on this legislation 
for months. I truly appreciate the efforts of Chairman Baucus and 
Ranking Member Grassley and their professional staff. Senators Hatch 
and Snowe and their staff played an essential role in our negotiating 
team.
  But I also want to take a moment to mention the extraordinary work of 
my health care legislative assistant, Jocelyn Moore. She is enormously 
dedicated and she has a deep commitment to health care policy, 
especially the needs of children. Jocelyn is a talented professional 
who have been working around-the-clock for many months. My legislative 
director, Ellen Doneski, has also been involved throughout the process 
and is a real leader. I am grateful for their dedication and commitment 
and inspired by the intellect and mastery of the issue of children's 
health policy.
  I thank my staff, and my colleagues. Let's get ready for conference 
negotiations and stay focused on what matters most--covering children.
  Mr. McCONNELL. Mr. President, when this debate first began, I came to 
this floor to say that SCHIP has proved to be, in many ways, a 
remarkable success for this Nation.
  Thanks to a program passed by a Republican-led Congress 10 years ago, 
the rate of uninsured children in America has dropped by 25 percent 
from 1996 to 2005. Last year, 6.6 million children had health care 
because of SCHIP--and over 50,000 of them were in my home State of 
Kentucky.
  SCHIP has accomplished what it was designed to do: protect children 
in low-income families, families too well off to qualify for Medicaid 
but still needy enough to have difficulty affording private insurance.
  When the program came up for reauthorization, this Senate's goal 
should have been to retain what works, and to strengthen the law in 
areas where it has been misused.
  Unfortunately, that is not what happened. SCHIP was originally 
created to help the needy. But it is clear the authors of this new 
proposal have overreached.
  Some have seized the reauthorization of SCHIP as a license to raise 
taxes, increase spending, and take a giant leap forward into the land 
of government-run health care.
  The problems with this bill are numerous, and I have spelled them out 
on this floor before. Because of a budgeting gimmick, the current bill, 
H.R. 976, will end up costing $41 billion more than advertised.
  It will raise taxes at a time when the American people are already 
taxed too much by more than doubling the Federal tax on tobacco.
  It will leave open loopholes allowing some States to raid their kids' 
health funds and use the money for adults. The ``C'' in ``SCHIP'' 
stands for children.
  It will allow families in certain States who make as much as four 
times the Federal poverty level to still qualify for SCHIP insurance. A 
family of four in New York City making as much as $82,600 could 
qualify.
  That means thousands of families in New York alone will be poor 
enough to receive SCHIP--yet also rich enough to pay the alternative 
minimum tax, a tax designed specifically to target the so-called 
``wealthy.''
  By luring people away from the private market, H.R. 976 will 
eventually remove 2 million people from private health coverage.
  Senators Lott, Kyl, Gregg, Bunning and I saw the problems with this 
bill,

[[Page 22632]]

and proposed an alternative. The Kids First Act would have reauthorized 
SCHIP and ensured that states had sufficient resources to cover all of 
the kids already enrolled.
  It would have added an additional 1.3 million children to the program 
by 2012. And it would have done all of this without raising taxes or 
increasing the deficit.
  The Kids First Act kept the focus on SCHIP's true goal: Protecting 
low-income children.
  Many States, including Kentucky, would actually have had more SCHIP 
funds to spend on kids under the Kids First Act than under the bill on 
the floor. I am sorry the Senate did not see fit to adopt our proposal.
  I know many Senators worked their hardest during this debate to craft 
comprehensive solutions for the uninsured in America. I appreciate 
their efforts. I look forward to continuing that work.
  Unfortunately, so much effort has not produced an answer. This bill 
is unlikely to receive a Presidential signature. Nothing will have been 
accomplished. We will have to pass a temporary extension of SCHIP, and 
then go back to the drawing board for a long-term reauthorization.
  When we do, I hope the Senate can stay focused like a laser beam on 
what SCHIP is truly all about: Providing a safety net for kids in low-
income families.
  I look forward to working with all of my colleagues to craft 
legislation that can meet that goal, pass this Senate, and be signed 
into law.
  But for now, the bill on the floor will not accomplish that. I intend 
to vote ``no.'' And I urge my colleagues to do the same.
  Mr. BAUCUS. Mr. President, we are about to vote final passage 
tonight. I am not going to take the time of Senators for all the 
customary thank-yous. I will do that at a later date. But I do very 
much want to thank Senators Grassley, Hatch, and Rockefeller and all 
the great team who helped make this possible.
  I also thank the parents across the country who love their children 
and are determined to provide the best possible health care for them. I 
say to the parents, to all Americans, I hope this bill helps you 
provide that health care, and I think it will. I thank all Senators for 
their cooperation in helping make this happen tonight.
  The PRESIDING OFFICER. Under the previous order, the substitute 
amendment, No. 3520, as amended, is agreed to.
  The question is on the engrossment of the amendment and third reading 
of the bill.
  The amendment was ordered to be engrossed, and the bill to be read a 
third time.
  The bill was read the third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass?
  Mr. BAUCUS. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from South Dakota (Mr. 
Johnson) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 68, nays 31, as follows:

                      [Rollcall Vote No. 307 Leg.]

                                YEAS--68

     Akaka
     Alexander
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Corker
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Hutchison
     Inouye
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                                NAYS--31

     Allard
     Barrasso
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McCain
     McConnell
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich

                             NOT VOTING--1

       
     Johnson
       
  The bill (H.R. 976), as amended, was passed.
  (The bill will be printed in a future edition of the Record.)
  Mr. REID. Mr. President, I move to reconsider the vote.
  Mr. BAUCUS. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 2646

  Mr. BAUCUS. Mr. President, I ask unanimous consent that the title 
amendment at the desk be considered and agreed to and the motion to 
reconsider be laid on the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 2646) was agreed to, as follows:

       Amend the title to read:
       A bill to amend title XXI of the Social Security Act to 
     reauthorize the State Children's Health Insurance Program, 
     and for other purposes.

                          ____________________