[Congressional Record (Bound Edition), Volume 154 (2008), Part 9]
[Senate]
[Pages 12388-12415]
[From the U.S. Government Publishing Office, www.gpo.gov]




MEDICARE IMPROVEMENT FOR PATIENTS AND PROVIDERS ACT OF 2008--MOTION TO 
                                PROCEED

  The ACTING PRESIDENT pro tempore. Under the previous order, the

[[Page 12389]]

Senate will resume consideration of the motion to proceed to S. 3101, 
which the clerk will report.
  The legislative clerk read as follows:

       Motion to proceed to S. 3101, a bill to amend titles XVIII 
     and XIX of the Social Security Act to extend expiring 
     provisions under the Medicare program, to improve beneficiary 
     access to preventive and mental health services, to enhance 
     low-income benefit programs, and to maintain access to care 
     in rural areas, including pharmacy access, and for other 
     purposes.

  The ACTING PRESIDENT pro tempore. The Senator from New York.
  Mr. SCHUMER. Mr. President, I have come to speak on the Medicare 
bill, but I must make a few remarks in relation to the debate between 
the majority and the minority leaders. The bottom line is very simple, 
and that is they haven't said let's fight over what amendments nor have 
they offered amendments. They have said that we will not even proceed 
to the bill.
  So when the majority leader, Senator Reid, says it is Orwellian, of 
course it is. In every instance when the minority has come and said 
they will do amendments related to the specifics of the issue at hand, 
the majority leader has been more than accommodating, rankling even 
some on our side. But they don't want to do that.
  Senator Reid read the memo. They want to slow the bill down with 
extraneous amendments that have nothing to do with energy because they 
do not want to allow a vote, even on ANWR.
  Now, my friend from Kentucky talks about ANWR as the answer. Even the 
most optimistic experts say it will be 7 years before we get a drop of 
that oil. So the minority leader and the minority are saying wait 7 
years and maybe we will get oil prices down. We don't want to wait that 
long. In 7 years, we could have an energy policy that weans us away in 
part from fossil fuels in a serious and significant way, like what is 
being done in Europe and other places. They do not want to do that 
because big oil dominates. They do not want to do that because their 
base says drill in ANWR, and the people say no.
  This idea that we don't want any production, the minority leader is 
just patently incorrect. Democrats, including myself, helped lead the 
charge and voted to increase production in the east gulf. That is the 
place where there is the most available oil and gas near refineries. 
And it wouldn't take 7 years the way starting a whole new venture in 
Alaska would. We voted for it under Republican leadership, when the 
Republicans led. So we are willing to increase production, but we do 
believe we are not going to drill our way out of this problem.
  The majority leader is exactly right. The actions of the minority 
leader say: Don't even debate it. Then he says they want to debate it. 
Well, if you want to debate it, don't block the motion to proceed. And 
I am certain--though I haven't talked to the majority leader about 
this, but I will, and I know from his past actions--if they have a 
series of amendments that are related to energy, they will be 
entertained. But if they want to debate George Bush's tax cuts or the 
estate tax, well, the majority leader has a perfect right to say, don't 
do it.
  So, Mr. President, again, this week in the Senate, Republicans are 
blocking lower energy costs. They are the party of no--no, no, no. They 
are the party of no on global warming, they are the party of no on 
lower energy costs, they are the party of no on tax help for solar and 
wind, and they are the party of no on preventing the oil companies from 
just doing everything they want. And as the majority leader said, the 
status quo is not what America wants, but the status quo is exactly 
what the minority, the Republicans, are standing for.
  I said it yesterday, and I will say it again--I said in the DSCC that 
I care more about the substance. I would much rather we move forward. 
But as head of the DSCC, the minority is filibustering themselves right 
out of their seats. When three-quarters of Americans demand dramatic 
change, and the minority says no change, that is not a formula for 
political success. You don't have to be a political genius to know it.
  So I would say to the rank-and-file members on the other side, I 
don't understand the logic, I don't understand the thinking, but you 
are sure not helping yourself or helping your country.
  Now, Mr. President, I would like to talk about Medicare for a 
minute--that is the bill we are on--and I rise to speak in strong 
support of the Medicare Improvement for Patients and Providers Act of 
2008. I want to congratulate our leader on the Finance Committee, 
Chairman Max Baucus, for introducing this much needed legislation.
  When Lyndon Johnson signed Medicare into law in 1965, he promised it 
would transform the lives of America's senior citizens, and he said 
this:

       No longer will older Americans be denied the healing 
     miracle of modern medicine. No longer will illness crush and 
     destroy the savings that they have so carefully put away over 
     a lifetime so that they might enjoy dignity in their later 
     years.

  No one could have said it better, and yet 40 years later we are at a 
critical moment. Do we make much needed improvements to the program to 
allow it to fulfill its promise to America's seniors or do we ignore 
this challenge?
  We have worked hard in the Finance Committee to put together fair and 
reasonable legislation that is supported by all physicians groups and 
millions of beneficiaries. We have compromised. I don't believe 
Medicare Advantage should come out of medical education. It affects my 
State, the majority of it will, and I am still willing to sort of suck 
it in and say, OK. But some on the other side are saying no, it has to 
be all their way. We know that fee for service in Medicare Advantage is 
far more lucrative and far more spread around the country. Yet we don't 
have very much of that in here to help pay for the other necessary 
increases. But it is a compromise bill. It is a bipartisan bill with 
broad support on the Finance Committee, and I urge all Members to vote 
for cloture today so we can provide help to millions of America's 
seniors and the hard-working health care providers who treat them.
  We have to pass this bill to avoid catastrophic cuts to doctors. We 
know these physicians face a 10-percent cut. To those who say, well, 
they are doctors, they can afford it, the trouble is, if we do this 
cut, lots of doctors don't take Medicare, and our poor senior citizens 
are left in the lurch. When we cut resources to doctors, patients lose, 
in this instance. So we need to put aside politics and do the right 
thing for our seniors and pass this bill.
  Some Members seem to think that doing more for low-income seniors--
those Americans who are trying to make ends meet and are deciding 
between filling their car's tank with $4 gas and paying for a doctor's 
visit--is wrong. Opponents of this measure say now is not the time to 
improve Medicare. Well, I say now is exactly the time. We need to cut 
costs where we can and enhance the program where it is needed.
  Our constituents are waiting for action. In my State of New York, the 
AARP dropped off 20,000 petitions in three wheelbarrows at my office in 
Albany. These 20,000 petitions were from New Yorkers asking Congress to 
pass this bill, to pass S. 3101, because it helps seniors on fixed 
incomes, establishes an e-prescribing requirement, and helps limit 
premium increases.
  We are particularly pleased the bill emphasizes preventive health 
care and expands coverage for key screenings, which can catch problems 
before they become more serious, and many other important measures.
  In addition, the bill stops the cuts to physicians for 18 months and 
provides a 1.1-percent update for 2009.
  The Medical Society of New York and medical societies throughout 
America are in favor. I have spoken to the head of the AMA, who is Dr. 
Nancy Nielsen from Buffalo, NY. She is the incoming President of the 
AMA. She has been tirelessly working, and I want to give her a shout-
out of thanks here on the floor of the Senate.
  I am particularly pleased that this bill provides increased payments 
for our ambulance providers. We put in a bill to do this; it got 25 
bipartisan cosponsors. GAO found that ambulance providers are 
reimbursed on average 6 percent below their costs for providing

[[Page 12390]]

services to Medicare patients. This is unacceptable. It means they cut 
back on the lifesaving equipment needed in the ambulance. We all know, 
for things like stroke and heart attack, having an up-to-date, modern 
ambulance with the most lifesaving equipment is often the difference 
between life and death, so this increase will actually save lives.
  It also, unlike the other alternative, ensures that pharmacists 
dispensing prescriptions are receiving payments on time. Two thousand 
independent pharmacies in New York--and many more thousands around the 
country--are counting on this important change to keep them in the 
black. That is in the bill. You cannot ask pharmacies, small 
businesspeople, to just give a line of credit to the Federal 
Government. That doesn't make much sense.
  This is a good bill. I urge we move forward and get the 60 votes. I 
hope we will not have another filibuster, No. 76. Let's hope and pray 
that doesn't happen so we can help America's seniors and continue to 
modernize Medicare and move this bill forward.
  I yield the floor and suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. SCHUMER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. SCHUMER. I ask unanimous consent that during the times when we 
are in a quorum call, the time be equally divided between the minority 
and the majority.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. SCHUMER. Now I again suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Ms. COLLINS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Ms. COLLINS. Mr. President, I ask unanimous consent that following my 
remarks, the remaining Republican time be allocated to the following 
list for up to 15 minutes each, with Senator Grassley controlling the 
remaining time: Senators Enzi, Chambliss, Stevens, Hatch, Cornyn, and 
Coleman.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  (The remarks of Ms. Collins pertaining to the introduction of S. 3119 
are printed in today's Record under ``Statements on Introduced Bills 
and Joint Resolutions.'')
  Ms. COLLINS. I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Wyoming.


                              Fuel Prices

  Mr. ENZI. Mr. President, over the past few weeks I have had the 
opportunity to come to the Senate floor to speak on a No. 1 issue I am 
hearing about as I travel around Wyoming, and that is the high price of 
gasoline and diesel fuel. I want to continue to address that issue 
today. I listened to the debate on S. 3044, the so-called Consumer-
First Energy Act. It might as well be called the No Energy Act because 
the bill does nothing to improve our Nation's energy situation and will 
actually do damage to it. One of the targets of S. 3044 is energy 
speculators. Their role in the high price of energy has been brought up 
time and time again, and my colleagues in the majority have been 
especially vigilant in their desire to rein in this group as if they 
were the big bad wolf.
  If you listen to their arguments, they are persuasive. Unfortunately, 
they don't tell the whole truth. An editorial I recently read from the 
Wall Street Journal pointed out the flaws in their argument.
  The article stated:

       The first refuge of a politician panicked by rising prices 
     is always to blame ``speculators.'' So right on time for this 
     election season Congress has decided to do something about 
     rising oil prices by shooting the messenger known as the 
     energy futures market. Apparently this is easier than 
     offending the Sierra Club by voting for more domestic energy 
     supply. Futures markets are not some shadowy, dangerous force 
     but are essentially a price discovery mechanism. They allow 
     commodity producers and consumers to lock in the future price 
     of goods, helping to hedge against future price movements. In 
     the case of oil prices, they are about supply and demand and 
     the future rate of inflation. Democrats now argue that these 
     futures markets are generating the wrong prices for oil and 
     other commodities.
       And who are these ``speculators'' driving up the prices? 
     The futures market operator Intercontinental Exchange says 
     that an increasing share of customers are not financial 
     houses but are commercial firms that need to manage oil-price 
     risks--[that means] the refiners, the airlines, and other 
     major energy consumers. Another term for these [energy] 
     ``speculators'' would be ``American business.''

  The article continues:

       If Democrats won't believe futures traders, maybe they'll 
     heed their biggest political funder. When . . . hedge fund 
     billionaire George Soros testified before Congress on this 
     issue, he noted, ``Regulations may have unintended adverse 
     consequences. For instance, they may push investors further 
     into unregulated markets which are less transparent and offer 
     less protection.''

  The article concludes:

       Democrats will find that moving jobs to Dubai from New York 
     and Chicago will not end commodity inflation that they 
     themselves have helped to create.

  I ask unanimous consent that the editorial be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

             [From the Wall Street Journal, June 10, 2008]

                       Dubai's Favorite Senators

       The first refuge of a politician panicked by rising prices 
     is always to blame ``speculators.'' So right on time for this 
     election season, Congress has decided to do something about 
     rising oil prices by shooting the messenger known as the 
     energy futures market. Apparently this is easier than 
     offending the Sierra Club by voting for more domestic energy 
     supply.
       Futures markets aren't some shadowy dangerous force, but 
     are essentially a price discovery mechanism. They allow 
     commodity producers and consumers to lock in the future price 
     of goods, helping to hedge against future price movements. In 
     the case of oil prices, they are a bet about supply and 
     demand and the future rate of inflation. Democrats 
     nonetheless now argue that these futures markets are 
     generating the wrong prices for oil and other commodities.
       And who are these ``speculators'' driving up prices? The 
     futures market operator Intercontinental Exchange says that 
     an increasing share of its customers are not financial houses 
     but commercial firms that need to manage oil-price risks--
     refiners, airlines, and other major energy consumers. Another 
     term for these ``speculators'' would be ``American 
     business.''
       Not ironically, the leaders of Capitol Hill's shoot-the-
     messenger caucus are among those most culpable for the lack 
     of domestic oil supplies. Senator Maria Cantwell (D., Wash.) 
     has been threatening to hold up appointments to the Commodity 
     Futures Trading Commission until the CFTC increases 
     regulation of oil trading. In the best tradition of 
     bureaucratic self-protection, the CFTC's acting chief Walter 
     Lukken has agreed to investigate.
       Ms. Cantwell's recent press release on ``outrageous energy 
     prices'' didn't mention her own contributions to the problem. 
     According to the Almanac of American Politics, she 
     ``successfully worked the phones'' in 2005 to round up enough 
     colleagues to block drilling in the Alaskan wilderness. Ms. 
     Cantwell has also backed a slew of mandates and subsidies 
     that have helped to raise food prices by diverting corn and 
     other crops to a fuel. She even claims to have helped create 
     the biofuels industry in her state.
       Her counterpart in the House is Michigan's Bart Stupak, who 
     claims special credit for a permanent ban on drilling in the 
     Great Lakes and has also cast votes against exploration in 
     Alaska and off the California coast. With $4 gasoline, this 
     is a man in need of political cover as Michiganders head into 
     the summer driving season. A spokesman says Mr. Stupak is 
     hoping to roll out a new bill by the end of this week to 
     require ``additional reporting and oversight' in the oil 
     futures markets.
       Then there's New York Senator Chuck Schumer, another 
     staunch opponent of new domestic oil supplies. Mr. Schumer 
     has egged on the Federal Reserve's rate-cutting binge that 
     has contributed so much to the oil price spike. But, with 
     impeccable political timing, he now suspects ``price 
     manipulation by speculators'' is the real cause of rising gas 
     prices.
       Mr. Schumer's answer is the ``Consumer-First Energy Act,'' 
     due for a cloture vote in the Senate today. Bundled with a 
     windfall profits tax on oil companies, the plan also includes 
     an increase in margin requirements

[[Page 12391]]

     for those who wish to trade oil futures. This would of course 
     make it more expensive to trade in U.S. futures markets, 
     which in a world of computerized, instantaneous trading means 
     that those trades would merely move to markets overseas. As 
     luck would have it, the Dubai Mercantile Exchange celebrated 
     its first birthday last week with the launch of two new oil 
     futures contracts that compete with those offered by American 
     exchanges.
       Leave aside the question of whether Mr. Schumer believes 
     that the Dubai exchange, which is majority-owned by Middle 
     Eastern governments, will offer more consumer protection than 
     America's shareholder-owned exchanges. This is the same Chuck 
     Schumer who warned in 2007 that heavy regulation threatens 
     New York's preeminence in global finance. Along with Mayor 
     Michael Bloomberg and former Governor Eliot Spitzer, Mr. 
     Schumer introduced a long report on the threats facing New 
     York with a short note that specifically mentioned Dubai as 
     an increasingly formidable competitor. That of course was not 
     an election year.
       If Democrats won't believe futures traders, maybe they'll 
     heed their biggest political funder. When Senator Cantwell 
     invited hedge-fund billionaire George Soros to testify last 
     week, she probably didn't expect the backer of left-wing 
     causes to deviate from her market-manipulation narrative. But 
     among other things, Mr. Soros noted that ``Regulations may 
     have unintended, adverse consequences. For instance, they may 
     push investors further into unregulated markets which are 
     less transparent and offer less protection.''
       Democrats will find that moving jobs to Dubai from New York 
     and Chicago will not end the commodity inflation that they 
     themselves have helped to create.

  Mr. ENZI. Do we need an open and transparent market? Yes. Is there 
more that could be done? Probably. Which is why the Commodity Futures 
Trading Commission announced, on June 10, that it was forming an 
interagency task force to evaluate developments in the commodity 
markets. Rather than sitting here in the Senate Chamber spending our 
time criticizing commodities traders, we should be working together to 
pass legislation that we can agree on to improve our Nation's energy 
situation. The problem we face is a problem of supply and demand, less 
American-made energy and more demand for that energy. That is the 
problem that Congress should be addressing. That is what those in 
control of both Houses of Congress don't seem to understand at this 
stage, even though 2 years ago they complained about the price of 
gasoline and promised they would bring the price down.
  The continued rise of gas prices is going to put an end to this dog-
and-pony show eventually. Unfortunately, we are not at that point yet 
where the majority will seriously deal with this issue. The bills we 
are debating will do nothing to improve our Nation's energy situation. 
The substitute to the Lieberman-Warner Climate Security Act would have 
cost us money, at a time when we are paying record energy prices. The 
so-called Consumer-First Energy Act would lead to less investment in 
energy; therefore, less supply and, therefore, higher prices for 
consumers. As bad as these bills are, the process by which they get 
here is even worse. They don't go through committee. They won't be 
signed by President Bush, and yet we still waste the time of the Senate 
talking about them, as if they will be made law and they will improve 
the Nation's energy situation. That is not the case. It is also not how 
we do things around here.
  I have heard complaints that Republicans are stopping progress on 
important legislation. I have heard complaints that the majority is 
unable to legislate. ``Unwilling'' would be a better term. We are 
paying record prices at the pump. Those record prices are connected to 
specific actions or inactions by those in control of Congress in the 
recent past and years ago.
  Recently, on May 13, the Democratic majority defeated the American 
Energy Production Act by a vote of 56 to 42. The measure would have 
expanded domestic oil production as well as opening the potential of 
oil shale and coal-to-fuel technology. In 1996, President Clinton 
vetoed a bill that would have enabled us to get 1 million barrels of 
American oil a day. That is what we are demanding that Saudi Arabia 
give us. I remember in 1973, when we made some demands on Saudi Arabia, 
and they cut us off entirely. Some of us are old enough to remember the 
gas lines and the shortages we had then. But he vetoed a bill that 
would have enabled us to get a million barrels of American oil a day 
from the Arctic National Wildlife Refuge, an area about a sixth the 
size of Dulles Airport. The entire refuge is considerably bigger, but 
we are talking about drilling on a very small portion of it.
  On May 22, House Democrats voted down a measure sponsored by 
Congressman Mike Conaway that would have expanded the use of coal to 
fuel, oil shale, and tar sands, as well as expediting the permitting 
process for new refineries on three closed military bases. In December, 
Democratic members of the Senate Environment and Public Works Committee 
debated a proposal to ensure development of nuclear energy to meet 
emission goals. That is this year.
  The list goes on and on, as does the majority's theatrics of 
inaction. When they got the majority a year and a half ago, the Speaker 
promised lower gasoline prices. How have they delivered? Their answer 
for our need to produce more American energy is to always say no, and 
their solution is always, let's tax the oil industry, a plan we know 
won't work because, under President Carter, we tried that, and we drove 
a lot of business overseas, which is where we have to ship our money 
unless we can get oil production in the United States. A lot of people 
don't realize--maybe they do--that Saudi Arabia is the biggest producer 
and that the Soviet Union is the second largest producer. What they 
don't realize is that the United States is the third largest producer, 
and we could solve a lot of our own problems if we were to do some of 
the things suggested here.
  Like most of my colleagues, I support developing more alternative 
energy. I support the use of wind energy and the development of better 
solar energy technologies. Wyoming is the perfect place for a lot of 
that development to happen. We have, most days, the sunshine, and we do 
get some wind. While we need to develop those technologies for the long 
term, we need all the energy we can get today. We need more American 
oil from American soil, we need more domestic natural gas, we need more 
nuclear energy, and we definitely need more clean coal. More taxes and 
lawsuits are not going to get us there.
  I emphasize again that I have a lot of faith in American ingenuity. 
For the long term, there is some research that could be done that would 
work with coal to make it cleaner, greener, and meet the needs, because 
that is the biggest resource we have. We have more Btus in coal than 
Saudi Arabia has in oil, and we have that in one county in Wyoming. But 
for the shorter term, yes, we do need to conserve, and, yes, we need 
alternative energy sources. We cannot abandon the sources of energy we 
have right now.
  I am going to end with a story. A while ago, I had to go out to 
California for a meeting. I was supposed to speak in the evening, and 
my plane got into California at rush hour. I thought: I am probably not 
going to be able to make this speech. I rented a car. My wife was with 
me. I found out they have these high-occupancy vehicle lanes. Well, 
there was one lane for high-occupancy vehicles. I have never seen so 
many lanes. I am pretty sure there were six more lanes besides the one 
lane for high-occupancy vehicles. I made that speech on time. I zinged 
right through that high-occupancy-vehicle lane because it only required 
two people in the car--only two. Out here, there are a lot that require 
three, but in California it was only two. Now, what about the other six 
lanes of traffic? Stalled out. Six lanes--cars stopped dead, idling 
their motors, putting carbon in the air, one person to a car. Now, that 
is a State with 34 million people and huge concentrations of people. So 
I would like to encourage California to carpool a little bit.
  Now, I would encourage the people in Wyoming to carpool too, but I 
spend a lot of time trying to teach the East and the far West about the 
Midwest, and most of the people we have are driving because they have 
to and because they are going to a single site where they are the only 
worker. And we only have half a million people, to

[[Page 12392]]

begin with. But a lot of trucks come through our State that are 
delivering produce and other things to the rest of the Nation, and that 
is important to have happen.
  But when people talk about gasoline and trying to reduce its use, 
they have to remember that a lot of that is to provide services and 
products that we in the United States have grown very accustomed to. We 
do not rely on everything coming from our own county; we rely on it 
coming from not only the rest of the United States but the rest of the 
word.
  The only way we are going to get out of this dilemma is to work on 
the short term, which is to get people to conserve; work on the medium 
term, which is to do some things with alternative energy but to put 
some research into the future so we can handle the kinds of things we 
need to provide for the energy we need for this country. Increasing the 
supply is the only thing that is going to bring down the price.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Brown). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CHAMBLISS. 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. CHAMBLISS. Mr. President, I rise today to talk about how Congress 
can take action to provide relief to American families who are really 
feeling the pain at the pump due to high gas prices.
  Obviously, this is a very complex issue and requires a multipronged 
strategy to respond. But the base price of gasoline reflects the 
principles of supply and demand. Asian economies continue to boom, 
creating soaring demand for oil. At the same time, many oil-producing 
regions are curbing output. These factors can create a perfect storm 
that leads to historic high prices for the price of crude oil and the 
resulting prices at the pump we see today.
  I believe we must find both short-term and long-term solutions to 
provide energy security for our Nation and give relief to the 
unprecedented gas prices we are experiencing today.
  Republicans and Democrats recently came together and passed a piece 
of legislation, with my vote, to suspend the filling of the Strategic 
Petroleum Reserve until the end of the year. This was an attempt to 
provide a short-term solution to high gas prices at the pump by dealing 
with the supply side of the issue. It is a bill that passed with strong 
bipartisan support.
  The Strategic Petroleum Reserve has the capacity of 727 million 
barrels of oil and currently holds just over 700 million barrels. The 
United States had been filling this Reserve to the tune of about 70,000 
barrels per day.
  This was the right thing to do for several reasons: first, because we 
should not be buying the most expensive oil ever and simply putting it 
in the ground; secondly, because it will leave a little more oil on the 
market, which will hopefully alleviate prices somewhat; and third, 
because it shows that Congress recognizes that increasing the supply of 
oil in the market can have an impact on the price of oil. Finally, it 
sends a message to energy markets that Congress can take action and 
thereby reduce speculation, which certainly has been a participant in 
the rising price of oil.
  Congress also acted in a bipartisan manner to address a component of 
the long-term solution to energy security by enacting the Energy 
Independence and Security Act in December of last year. This 
legislation, again with my support, was an attempt to provide a long-
term solution to high gas prices by dealing with the demand side of the 
issue.
  This legislation contains an aggressive new renewable fuels standard 
that requires fuel producers to include a certain amount of alternative 
fuel in their product. I am excited about the significant opportunity 
this provides for Georgia, which has not been a large producer of 
biofuels in the past, to participate in the development of renewable 
fuel sources. The renewable fuel standard requires 36 billion gallons 
of renewable fuels in American motor fuels by 2022. I think it was the 
right thing to do to require 21 billion of the 36 billion gallons of 
renewable fuels to come from advanced biofuels. This means instead of 
corn-based ethanol, we will be making fuels from cellulose such as wood 
chips, peanut hulls, and switchgrass.
  This emphasis on biofuels is consistent with legislation I introduced 
last year to increase the amount of advanced biofuels and gasoline. 
This is also very consistent with the farm bill that passed this body. 
In the energy title in that farm bill, of which I was particularly 
excited about and remain excited, what we did was to induce the 
manufacture of additional amounts of ethanol in this country. But the 
production of ethanol from corn has had unintended consequences--we 
have seen the price of food products increase. It hasn't just been 
corn-based food products as a result of the high demand for corn. We 
have seen more corn planted, which means the demand for wheat, 
soybeans, peanuts, as well as other commodities, has increased and 
driven up the price because farmers are simply planting more corn due 
to the high price. It looks as if the demand is going to be there for a 
long time to come.
  So in this farm bill, what we did was to incentivize the production 
of ethanol not from corn but from cellulosic-based products, whether it 
is peanut hulls, switchgrass, pine trees, or who knows. In my part of 
the world, we have a vine culled kudzu that grows rampant across 
Georgia, and there is not much use for it. One of these days we may 
even see a biodegradable product, such as kudzu, become available for 
the manufacture of ethanol. It is a serious problem, and in the farm 
bill we sought to address the additional production of ethanol through 
cellulosic-based products.
  I wish to read a couple pieces of correspondence I have received from 
constituents of mine which further emphasizes the intensity of this 
problem, the seriousness of this problem, and the fact that all of a 
sudden families are simply not able to incorporate into their budget 
this huge increase in gasoline prices in such a short period of time.
  Deanna Payne of Winder, GA, writes as follows:

       Senator Chambliss: Due to the high cost of gas, I am having 
     to cut down on groceries and visit local food banks. My 
     husband makes the same amount of money he did in 2007, but we 
     just can't make ends meet. Gas prices have doubled the cost 
     of some of the grocery items I used to purchase. I just can't 
     do it. Please give us some relief! This is ridiculous! 
     Americans are going hungry and losing everything!

  Another constituent from Augusta writes:

       I am very concerned about rising gas prices and what if 
     anything Congress plans to do to help Americans. I cannot 
     afford to fill up my vehicle at these rates which today are 
     approaching $4. My husband is a platoon sergeant training 
     troops at Fort Gordon. I work at the Medical College of 
     Georgia. We have a combined income of over $70,000. It is 
     becoming harder and harder to put any money aside. Not only 
     is the cost of gas rising, but the cost to heat and cool our 
     home and the cost of groceries are all making it difficult to 
     make ends meet. My husband re-enlisted in September 2007. We 
     as a family came to the decision that even during this time 
     of war, the Army was the only guarantee of a paycheck and 
     health care coverage for the next few years. I hope that 
     Congress is putting aside its partisan issues and working 
     together to help all Americans, as I feel our Nation will 
     soon fall apart at the rate it is going now.

  A constituent from Montrose, GA, writes:

       Please work to help us with the prices of gas and its 
     effects on every household's budget. We should be drilling 
     anywhere and everywhere to alleviate this current situation. 
     The brightest in this country need to be assembled and given 
     the resources to come up with alternative energy sources. We 
     need to have the Nation go to a 4-day work week starting with 
     government agencies leading the way by example. These 
     problems have been gradually getting worse all along with 
     nothing getting done. Steps better be taken soon before this 
     country gets into a position that it can't recover from. 
     Thank you.

  From Douglasville, GA:

       I am a single mother of 3. I had to take $20 out of my 
     grocery money to pay for gas just to get to work. That is the 
     only place I drive. The kids and I walk to our local stores 
     if

[[Page 12393]]

     needed. This is not the American Dream, or the way we are 
     supposed to live in the great United States! I can't afford a 
     new car that is better on gas. I already drive a 4 cylinder. 
     SOMETHING'S GOT TO GIVE!

  I am sure the Presiding Officer has dozens and dozens of these same 
types of letters in his office, and it is a further indication of the 
fact that Americans truly are hurting at the gas pump. It is imperative 
we provide the leadership in Washington that reacts from a short-term 
standpoint but, more importantly, looks to the long-term solution to 
this problem. It is going to be very difficult to reduce gas prices in 
this short term, but I think, without question, if we implement today 
long-term policies, we will see an immediate reaction by oil-producing 
countries and we will see an immediate effect on gas prices and I 
think, without question, we will see a lowering of those gas prices, to 
a certain extent.
  But the important matter is we have to address the issue. As I look 
around this body and see the rhetoric going back and forth on both 
sides of the aisle, I don't see solutions coming out. I see blame being 
placed. I see political statements being made. I think it is time we 
put those political statements aside, we put partisan politics aside, 
and we, sure enough, try to reach an accord for some commonsense 
solutions to a problem that is having a direct effect on constituents 
of Republicans and constituents of Democrats alike. It is time we make 
sure we address this problem for the long term, incorporate the 
multifaceted issues that are involved, and that we come together and 
make sure we are doing the work the people sent us to do. I don't see 
that happening today, and that is what I am hearing from my 
constituents back home.
  So I hope, as we move forward over the next several days before we 
adjourn for the Fourth of July week break, when we are all going to be 
back home and we are going to continue to hear these issues raised, we 
can say: Here is what we are prepared to do in a bipartisan way to 
solve this problem and to make sure we don't continue to be dependent 
on foreign petroleum imports, to the tune of 62 percent of our needs; 
that we are taking action to address that imbalance, and we are taking 
action to implement measures to ensure that alternative fuels are 
developed, that the research is put in place to provide those 
alternative fuels at the gas pump, which will help drive the price 
down, and that we are prepared to implement conservation measures and 
implore the American people to also think about that from the 
standpoint of the implementation of conservation measures. If we don't 
do it ourselves, it is difficult for us to ask the American people to 
do it.
  So I do hope the leadership in this body, on both sides of the aisle, 
is listening to the American people and is cognizant of the fact that 
people across America simply don't think we are doing anything and that 
partisan politics is not allowing us to do anything; that we address 
that issue; that we find long-term solutions which will help in the 
short term as well as the long term; and that we seek positive 
legislation coming forward from both sides of the aisle to address this 
problem immediately.
  With that, 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. STEVENS. 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. STEVENS. Mr. President, what is the situation regarding time?
  The PRESIDING OFFICER. The Senator from Alaska has 15 minutes.


                          Development in ANWR

  Mr. STEVENS. Mr. President, Americans are forced to pay more for gas 
every day, every week. The price is going up and up. There have been 
many ideas presented on the floor of the Senate, but I do think some of 
the comments made by the Senator from New York, Mr. Schumer, need a 
response. He has made some comments about the developing of the Arctic 
Plain, known as ANWR. Actually, it is not part of the Arctic Wildlife 
Refuge. It is 1\1/2\ million acres that were set aside in 1980 for oil 
and gas exploration and development. That land has been waiting for 
approval of Congress and the President. The 1980 act required that 
there be an environmental impact statement finding that there would be 
no irreparable harm to the flora and fauna of the Arctic, and that 
finding would have to be approved by the President and Congress; 
namely, it would have to be approved by an act of Congress, signed by 
the President.
  Since 1981, we have tried to proceed as was planned at that time. At 
the time that President Carter had withdrawn over 100 million acres of 
Alaska land, the one success we had in that bill--the 1980 bill--was 
the provision that permitted the exploration and development of the oil 
and gas resources of this area of the Arctic Plain.
  Now, the Senator from New York said opening ANWR's 1 million barrels 
a day of production would reduce the price of gas at the pump by only a 
penny. We found that rather strange because he later said he wanted the 
President to ask the Saudi Arabian people to increase their production 
of oil from 700,000 to 800,000 barrels a day, and if they did, it would 
reduce the price of gas at the pump--at first, he said by 35 to 50 
cents, and then he said it would reduce it by 62 cents a gallon. I find 
it strange that 1 million barrels of oil from Alaska would reduce the 
price at the pump by only one penny but 800,000 barrels a day from 
Saudi Arabia would reduce the price at the pump by 62 cents. Somehow or 
other, that kind of calculation is not the way we add up things in 
Alaska.
  Let me repeat that. He said: One million barrels a day from Alaska 
would reduce the price at the pump by one penny, but 800,000 barrels a 
day from Saudi Arabia would reduce the price up to 62 cents. It is not 
really understandable when a Senator presents arguments that contradict 
each other. I think it is time now for the Senator from New York to 
come back to the Senate floor and restate his position on ANWR. Is it 
an economic position or is it just a philosophical position, where he 
is agreeing with those people who are against exploration and 
development of the Arctic Slope? If it is, I understand it.
  At first, the Senator from New York said he favored drilling in the 
eastern Gulf of Mexico because the oil could come to market more 
quickly than Alaskan oil. That, too, is too much to pass up. Congress 
authorized the eastern gulf development a year and a half ago, in 
December 2006. The lease sale occurred this past March, and it will be 
7 to 10 years before that oil comes to shore. As a matter of fact, it 
is probably going to take longer to develop the gulf oil than it would 
take to develop the Alaskan oil on the Arctic Slope because the 3-D 
seismic has been done in our State. We know where the oil is located. 
We just have to finish exploration and develop that field. And it would 
take less time because there is a pipeline already in place.
  Perhaps the Senator from New York has forgotten that we have a 
pipeline. At the time of the Persian Gulf war, that line carried 2.1 
million barrels a day to American markets. Now it is carrying about 
700,000. It is about two-thirds empty, Mr. President. That is a very 
difficult thing for Alaskans to understand, when we know there is oil 
in the Arctic Plain waiting to be developed. As a matter of fact, if 
President Clinton had not vetoed the ANWR bill in 1995, we would have 
up to 1\1/2\ million barrels a day being delivered today through that 
pipeline. That argument has been the same every year since 1980.
  I have been here every year trying to get approval of the finding 
that there would be no irreparable harm to the Arctic if developed. It 
is supported by the people of Alaska and other people of the United 
States and there is an overwhelming approval now to proceed with 
development of the Arctic Slope. It has to be done.
  We have had development of our Arctic at Prudhoe Bay. At the time we 
argued on the floor of the Senate for approval of the amendment to 
permit the

[[Page 12394]]

oil pipeline to be built back in the 1970s, there were cries on the 
Senate floor, in the press, and throughout the country that it would 
harm the caribou, that the caribou would be put into jeopardy.
  Mr. President, there are three to four times as many caribou in that 
area now than before the pipeline was built. As the pipeline was built, 
in the area where it was restored, we planted grasses there that were 
even better than the natural grasses. If you want to see caribou in 
Alaska now, the place to go is by the pipeline. We have not had any 
spill on shore of any nature. There was some last winter--in terms of a 
gathering pipeline, that leaked a little. But it was during the 
wintertime, and it was totally cleaned up and there has been no 
irreparable harm.
  We have literally billions of barrels of oil available to us. At the 
time we proceeded with the oil pipeline, the estimate was made that 
Prudhoe Bay would develop 1 billion barrels. Well, we have sent over 14 
billion barrels of oil to the south 48, by virtue of the Mondale 
amendment to the Oil Pipeline Act, that all the oil transmitted in the 
Alaska pipeline must go to American markets. I voted for that 
amendment. I think this is American oil, and it should fill American 
needs. As a matter of fact, we are tired of seeing the increase in the 
importation of oil from foreign sources.
  At the time of the 1970s embargo on oil by the Arab nations, we were 
importing about 33 percent of our oil. Today we are importing over 60 
percent of our oil. In about 5 years we will be importing about 40 
percent of our natural gas, LNG. Think about that. This Nation, which 
has been a leader in the world in industrial development and in 
technology, is going to be at the place where almost two-thirds of our 
need for oil or gas is going to be dependent upon foreign sources, when 
we have known areas in this country that can boost out oil and gas.
  It is primarily a situation where this is an opposition that has 
arisen on a political basis. After President Clinton vetoed the ANWR 
bill in 1995, many of my friends on the other side of the aisle decided 
they would not support ANWR anymore, and they have voted that way.
  I think it is unfortunate because we should have access to develop 
American sources of oil to meet American needs. This area of our North 
Slope meets those conditions fairly well. I do think the concept of the 
Senator from New York, in demanding that the President go to Saudi 
Arabia to increase their production when he opposes doing so in this 
country, is unacceptable.
  It is the duty of Congress to keep American dollars in America when 
we can. By developing a very small portion--less than 2,000 acres of 
that million and a half acres, which is all we need to develop for the 
oil and gas resources of the Arctic Plain--we could offset the entire 
oil imports we bring in from Venezuela or Saudi Arabia. I was surprised 
at my friend from New York, when he said the idea of developing the 
ANWR oil is a poorly executed ``magic trick.'' I don't know what is 
magic about it. It is just a matter of simple engineering. We can and 
have developed oil and gas in the Arctic, and we have not seen the harm 
that other people have indicated would come to either our area or to 
the wildlife of our area.
  We need to have Americans realize it is the very fact of starting to 
develop this oil that will bring down the prices from foreign sources. 
Once the foreign sources see we are getting ready to increase our own 
supply, they will start reducing their price in order to take away the 
incentive we have, based on the current prices, to open these areas in 
the United States. So if you want an immediate reaction from anything, 
in terms of this current gas price problem, then have the Congress act 
and have the President sign a bill to start the development of the 
Arctic Plain, known as ANWR. If we do that, that signal to the foreign 
producers of oil will say America is just getting ready to restore its 
own supply. If it restores its own supply, prices will come down in 
foreign oil. They don't want our competition; they want our markets. So 
far they are convinced that we will not provide our own oil, and since 
we will not, there is no limit to what they will charge us for oil.
  We have seen such a dramatic change that I cannot believe it. At the 
time the oil pipeline was approved, oil was $7 and $8 a barrel. It is 
now approaching $150 a barrel. Why? Because of the law of supply and 
demand. We have refused to increase our domestic supply of oil, and 
having done so the price is set at a world price.
  I remember there used to be a posted price in San Diego or Los 
Angeles or Philadelphia or Seattle or even in Alaska--a posted price by 
the refineries on how much they paid for oil. That is no longer the 
case. The case is now that we look to the foreign suppliers to see what 
they are going to charge. We have to pay whatever they charge. With an 
increasing demand all over the world from the developing countries, 
such as China, there is no reason for us not to understand what is 
happening.
  Just a week ago, on the front page of the Wall Street Journal, there 
was a chart that showed the future situation with oil and gas. It 
showed the supply almost steady at the same level for coming years. It 
showed the demand on an ever-increasing curve going up, up, and up. 
When the price of oil started going up, I predicted on the floor of the 
Senate, when we debated the ANWR situation in 2006, that the price of 
oil could reach $100 a barrel. Actually, there was laughter from the 
other side of the aisle. Some of my Democratic colleagues laughed and 
said it was another exaggeration by the Senator from Alaska.
  Mr. President, it reached not only $100 a barrel, it is over that. It 
is going to stay over $100 a barrel, until we wake up and start 
developing our own supply of oil. Once we start developing that supply, 
the foreigners will know we are going to be able to bring that price 
down by our supply, and they will start bringing it down so we will not 
increase it to the point where we present a dangerous challenge to 
their domination of the world market, as far as oil is concerned.
  I think the concept of these imports has just been totally missed. My 
friends talk about exporting jobs. Nothing has exported more jobs than 
purchasing our oil abroad. Every 1 million barrels of oil a day coming 
in has eliminated 20,000 jobs in the United States. That is 20,000 jobs 
for every million, and we are importing over 12 million barrels of oil 
a day. Mr. President, 12 million barrels of oil is the same as 240,000 
jobs.
  When we look at this, I think it is time for the Senate to settle 
down. I do hope my friend from New York will settle down a little bit 
because there is no trickery in ANWR, there is no trickery in exploring 
and developing American sources of oil. The trickery is in terms of the 
prices we are paying, the exaggerated prices caused by those who are 
buying futures and speculating futures on our oil. We are no longer 
buying oil from foreign sources, we are buying them from some of our 
own people who invested in futures, and they are speculating on that 
price and driving up the price.
  It is time for us to get down to the fact that we must find a way to 
authorize exploration and development of the Arctic Plain, known as 
ANWR.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Kansas is recognized.
  Mr. BROWNBACK. Mr. President, I ask unanimous consent to speak on 
Senator Cornyn's time for up to 5 minutes, and I further ask unanimous 
consent that after I speak, the Senator from Illinois be recognized.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BROWNBACK. Mr. President, I appreciate my colleague from Alaska 
raising some of these points. I was thinking particularly about the 
point that the markets react to what actions are taken, and that is a 
key point on driving prices down.
  I used to report on commodity markets a number of years ago when I 
was a broadcaster. The idea of buy on the rumor and sell on the fact is 
something to which markets react. So we could

[[Page 12395]]

help on a near-term basis driving these prices down if we would act. 
Plus, I like the idea of pegging a price of a gallon of gasoline. When 
the average prices across the country hit $4.50 a gallon, let's give 
Governors the option of opening some of these closed-off lands. These 
are ideas we ought to be talking about on getting energy prices down.


                        Tornado Damage In Kansas

  Mr. President, the reason I have come to the floor is not to talk 
about energy prices but to talk about what happened in my State last 
night. We had devastating tornadoes. A series of tornadoes struck parts 
of our State and caused at least two deaths and a huge amount of damage 
in a swath 150 miles long. The counties of Ellsworth, Saline, 
Dickinson, Riley, Clay, Geary, Pottawatomie, and Jackson all suffered 
severe damage last night.
  The town of Chapman in Dickinson County, with a population of 1,400, 
appears to be the hardest hit. Initial estimates are 85 percent of the 
homes and businesses have received some damage, and up to 70 percent of 
the town may be destroyed.
  One person is reported dead in Chapman. Also one person is reported 
dead in Soldier, KS. That is in Jackson County. Certainly, my prayers 
and the prayers of many go to the victims and their families who are 
struggling and suffering.
  Damage was also reported in Salina, KS, and Manhattan, KS. The 
northern part of Kansas State University apparently received extensive 
damage.
  I am hopeful my colleague Pat Roberts and I will be able to travel 
with others this afternoon to look at some of that damage.
  Evidently, the tornado touched down near the old field house on 
Kansas State University campus, the Ahearn Field House, and traveled 
across campus. There was damage sustained on Cardwell Hall, Ward Hall, 
Burt Hall, and the engineering complex. Ward Hall houses a nuclear 
reactor, a teaching facility nuclear reactor, and the building received 
some damage. The reactor is safe.
  The Wind Erosion Laboratory, a federal laboratory on the K State 
campus, apparently was destroyed.
  Damage was also reported in several of the parking lots with cars 
being tossed around. The Sigma Alpha Epsilon house received extensive 
damage. Thankfully all the residents there are safe.
  While it is early, the damage will be well into the millions of 
dollars. My office and the office of my colleague Pat Roberts contacted 
FEMA and State officials this morning, and we continue to work closely 
with both State and Federal officials to help the citizens of Kansas 
rebuild.
  This has been a very difficult, extraordinary tornado season. I was 
in north central Kansas on Monday of this week looking at damage to 
another of our towns, Jewell, KS, and the extensive damage there by a 
tornado within the past 2 weeks. We have had these on a periodic basis. 
We are getting a lot of hail damage and a lot of wind and rain damage 
throughout the State. It seems as if every other night there is some 
system developing and passing through the region.
  Certainly, as well, everybody's thoughts and prayers are with the 
scout troop in Iowa that suffered four deaths, apparently perhaps more, 
due to the tornado that was in much of that same line of thunderstorms 
and tornadoes that swept throughout much of the Midwest last night.
  I say that to this body as a way of recognizing and stating to people 
what is taking place as far as damage, and also the support and help we 
are going to need throughout the Midwest for some of the tornado damage 
that has occurred. It is extensive.
  We are in a very difficult tornado season. It does not appear to be 
abating. We are getting a lot of flood damage, hail damage, and tornado 
damage. We will be reporting back to the body on some of the work that 
is going to need to be done to rebuild, whether it is Kansas State 
University, Chapman, or other places that have been damaged. We can 
only hope we can last the rest of the season with no more loss of life 
and hope there is no more damage to communities. But it has been a very 
difficult season.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The assistant majority leader is recognized.


                           Price of Gasoline

  Mr. DURBIN. Mr. President, in my brief period of time, I wish to 
address two issues. One relates to a topic that is important across 
America. Another relates to the pending legislation.
  The first topic is the issue of the price of gasoline. I don't need 
to show this chart to people to remind them what is happening. 
Beginning with the Bush administration when the President was sworn 
into office, the average price for a gallon of gasoline was $1.47. As 
of June 9, the average price across America was $4.04, the most 
dramatic increase in the price of gasoline in our history. It is a 
situation which has called for analysis and attention because no matter 
where we go--in Illinois, Ohio, in any State--people say: Senator, what 
are you going to do about these gas prices? They are killing us.
  They go to the gasoline stations, the service stations, pull out 
their credit cards and cash, and cannot believe how much it costs. It 
is not just an inconvenience for many people, it is a hardship. For 
some, they have had to make family budget decisions because they cannot 
afford to keep the tank full, and many do not have an option. If they 
are from my part of the world in downstate Illinois, there are not that 
many buses outside the cities. There is no mass transit. What are you 
going to do? You moved out into the country to get a home you can 
afford. You commute to a job spending an hour each way to work. And now 
filling that gas tank takes so much of your paycheck, so you have to 
cut back in other areas or borrow more deeply, finding your credit card 
balance growing and your ability to reckon with it diminishing. That is 
the reality of where we are today.
  Obviously, people across America say: Well, Senators, what are you 
going to do about it? You were elected, weren't you, to do something 
about the issues and challenges facing our country?
  So this week we came to the floor and said: Let's debate it. Let's 
put our best efforts to work. Let's debate a bill that may help and 
amend it and try to come up with some way to deal with the energy 
crisis facing America.
  On Tuesday, we took this vote. We needed 60 out of 100 Senators to 
vote to start the debate--60 out of 100. When the final count was in, 
all the Democrats voted for it, six or seven Republicans joined us, and 
we were still about nine votes short of what we needed. The motion to 
proceed failed.
  At that point, we couldn't even debate the most serious issue facing 
families and businesses across America. That is unfortunate. All we 
needed were nine more Republicans to join us to start the debate. That 
is all we wanted to do--start the debate. Maybe we would have agreed on 
something. Wouldn't that be newsworthy.
  But as it stands, we had two votes on Tuesday, we tried to proceed to 
bills, and in both instances, the Republican minority said: No, we 
don't want to debate anything on the floor of the Senate this week. And 
that is exactly what we have done. We have debated nothing.
  If Members of the Senate were paid for the votes they cast, this 
Senate this week has not earned a minimum wage. I don't know how we can 
continue to do this in what is euphemistically called the world's 
greatest deliberative body. Mr. President, do you know what the problem 
was? One of the provisions in our bill angered the Republicans. We 
suggested that the oil companies, if they are going to charge these 
outrageous amounts for their products, should be subject to a higher 
tax for windfall profits. I support that. I think it is the right thing 
to do, to discourage the profit taking that is going on. Many 
Republicans oppose it, and I don't question their motives on it. Isn't 
it worth debating? Isn't it worth a vote? At the end of the day 
somebody wins and somebody loses. That is what happens on the floor of 
the Senate. But on the

[[Page 12396]]

Republican side, they stopped us from even going to that debate over 
the oil companies.
  Surely, they must hear from their voters at home how bad the 
situation is. I know they hear from the oil company lobbyists who are 
roaming these hallways that they need to be protected.
  Let's take a look and see how the oil companies have been doing. Not 
bad. Starting in 2001 when President Bush arrived on the scene, this is 
an indication of the profits of the oil companies. Profits of the oil 
companies under this administration have gone up 400 percent.
  Some of the numbers are startling. In 2006, profits reported by 
ExxonMobil were $39.5 billion, the largest recorded profit in U.S. 
history. Listen to that. Not the largest recorded profit by an oil 
company; the largest reported profit by any business in the history of 
the United States of America.
  Come 2007, ExxonMobil broke its own record. Profits went up to $40.6 
billion; the annual salary for their CEO, $21.7 million. A retirement 
package for ExxonMobil's previous CEO--job well done--no gold watch for 
this man, a gold mine, $400 million as his farewell gift. What a great 
party that must have been to say thanks for all the good work you have 
done for ExxonMobil. Here is $400 million. Have a nice day.
  People across America are not having a nice day. When they pull into 
an Exxon station, when they fill up their gas tank, it is a bad day, it 
is a tough day for a lot of American families.
  The total combined net profits of the big five oil companies under 
this administration are $556 billion. How much money did they invest 
back into more oil wells, more production? About an 80-percent increase 
in their capital investment, a 300-percent increase in the cash they 
held back to buy back stock and improve their profitability--not 
improve their productivity, their profitability.
  Investments in alternative fuels by these big five oil companies? 
Negligible. That is the reality.
  I think that is worth a debate, don't you? Isn't that what the Senate 
is supposed to be about? We come in and say it is time for this to end, 
it is time for Americans to stop being taken to the cleaners by the oil 
companies, and it is time for them to pay higher taxes to discourage 
them from profit taking. I support that position. Others oppose it.
  On Tuesday, the Republicans said: No, there will be no debate. And 
that is the end of the story, at least for this week. We will go home 
and the voters will ask the same question: What did the Senate do about 
oil prices, gas prices this week? And the honest answer is nothing.
  This is not the first time we faced this filibuster. The Republican 
filibusters so far in this 2-year session, 75 Republican filibusters 
and still counting--75. To put it in perspective, a filibuster is when 
you delay or stop debate on an issue, delay or stop a bill, an 
amendment, a nomination. It is your right in the Senate to do that. But 
people were careful not to abuse it in the past.
  In the history of the Senate, the largest number of filibusters in 
any 2-year period of time was 57. So far in this session, with another 
6 or 7 months to go, the Republicans have initiated 75 filibusters, 75 
attempts to stop progress in the Senate, to stop debate in the Senate, 
to stop us from moving forward on bills related to everything under the 
Sun. They even went so far as to filibuster a technical corrections 
bill. These are the bills that go in and take a hard look and see, oh, 
we forgot the punctuation or there is a reference that needs to be 
changed slightly. It is the kind of housekeeping you do when you have 
huge pieces of legislation, where even though staff works hard and the 
Members work hard, they miss something. So the technical corrections 
bill came up, we thought this would be easy, so let's get this over 
with, but it took a week because we faced a filibuster on it. They 
wanted to filibuster a technical corrections bill. That doesn't take us 
to where we need to go as a nation.
  We at least owe the American people a healthy, spirited, fair, and 
open debate on the issue when it comes to this energy crisis. We can't 
get it in this Senate. We have been stopped. A 51-to-49 Senate does not 
allow us to come up with the 60 votes we need to move the debate 
forward. Well, the final vote will be in the hands of the voters of 
America on November 4. They will decide whether they want change in 
this town and change in this Chamber; whether they want to elect some 
people who will come, roll up their sleeves, and get down to work.
  We have a lot of things to do in this country--an energy crisis, 
global warming, carbon pollution, a health care crisis, two wars, a 
looming recession, and the bankruptcy of Medicare and Social Security. 
We don't need more filibusters. We need more work right here in the 
Senate. I hope we can return to that after the next election, or maybe, 
if there is a miracle, even next week, if the minority party decides 
that is what will happen.


                                Medicare

  Mr. President, we are debating a motion to proceed, once again, to a 
bipartisan bill to help Medicare. It has the support of AARP, the 
American Medical Association, and lots of others. It picks up where we 
left off in December, when we passed a bill that was a short-term fix. 
We bought 6 months then, and we are back again.
  The bill we are considering prevents physicians from facing a 10.6-
percent cut in Medicare payments on July 1, and gives them a 1.1-
percent payment increase for 2009. The physicians who work under 
Medicare will also receive a 2-percent bonus, if they participate in a 
program to reduce the number of errors and improve the quality of their 
service, called the Physician Quality Reporting Initiative. It is a 
responsible way to avoid a severe cut in payments to physicians and to 
ensure payments are adequate for the next 18 months.
  As important as it is to ensure that our physicians are paid 
adequately for the good work they do for millions of Americans--some 40 
million Americans covered by Medicare--we didn't want this bill to just 
be a doctor fix. The bill contains a lot of changes in Medicare that 
will help beneficiaries.
  The Medicare Savings Programs provide financial assistance to low-
income Medicare beneficiaries who can't afford Medicare's premiums, 
copayments, and deductibles. Many low-income beneficiaries are excluded 
from this assistance because they have accumulated modest savings. 
These are retired people, by and large.
  Today, if you have assets of more than $4,000, $6,000 for couples, 
you can't qualify for Medicare Savings Programs. We haven't changed 
that number for almost 20 years--$4,000. Under the bill before us, the 
asset limit will roughly double, providing real assistance to those who 
don't have much money and still need Medicare.
  This bill, which the chairman of the Finance Committee, Chairman 
Baucus, brings to us, also makes an important move toward mental health 
parity. It is hard to imagine it has been more than 5 years, almost 6 
years since Senator Paul Wellstone died in a plane crash. What a great 
guy. What a great Senator. His heart was there for so many issues but 
especially when it came to mental health issues because his family was 
touched by this challenge. Paul Wellstone used to ask: Why don't we 
treat mental illness like an illness, instead of a curse? Why don't we 
treat mental illness like a physical illness when it comes to health 
insurance? He worked on us and worked on the issue and Senator 
Domenici, a Republican from New Mexico, joined him to make it a 
bipartisan effort.
  I am sorry to say that some 6 years later, we haven't passed that 
Wellstone-Domenici bill. Senator Kennedy was working on it before he 
had his problems. I hope we can return to it. This bill takes a modest 
step forward in that debate.
  Over the years, our understanding of mental health and the ways to 
treat it have grown, but Medicare continues to discriminate against 
services for those who are mentally ill by imposing a 50-percent cost-
sharing requirement compared to 20 percent for most other services. 
This bill phases out that higher copayment over 6 years. It is a step 
in the right direction.

[[Page 12397]]

  We have made some progress in recent years, adding preventive health 
services to Medicare, such as screenings for heart disease, diabetes, 
and cancer, but it literally requires an act of Congress to add a new 
preventive benefit. The Baucus bill will make it easier to add 
preventive services to Medicare. It would create a process for the 
Secretary of Health and Human Services to add them, if recommended by 
the U.S. Preventive Services Task Force.
  We also address market abuses in this bill. There is a program called 
Medicare Advantage. Private health insurance companies love it. You 
know why. They make a bundle off these programs. They sell them to 
seniors, and they charge more than 12 percent over basic Medicare 
premiums. Frankly, I happen to believe they do not show the results for 
their effort, and they are involved in some marketing practices which 
we have to try our best to curb.
  Seniors are vulnerable. You know as well as I do that many people who 
reach their elderly years don't have someone at hand to give them good 
advice, and many times, frankly, they sign up for things they 
shouldn't. This bill addresses disturbing reports of abusive and 
fraudulent sales-and-marketing practices by Medicare Advantage plans 
and Medicare drug plans. Medicare beneficiaries have been enrolling in 
private plans they didn't understand, and many of them have faced 
outright fraud and exploitation by these Medicare Advantage companies. 
This bill will rein that in.
  Senator Chuck Grassley of Iowa, a man I respect and like, is going to 
offer an alternative to our bill, which I have described, but it 
doesn't provide assistance to low-income Medicare beneficiaries. It 
doesn't deal with mental health parity, and it doesn't ease the process 
of adding preventive services.
  There are many other provisions in this bill. It has been long 
overdue, and a lot of people have asked us to take up this bill because 
Medicare is so important at a time when people are losing their health 
insurance coverage. For the seniors and disabled who count on Medicare, 
this bill is important. But we need 60 votes. I hope we will get 60 
votes. I hope we don't face another filibuster on this critically 
important bill.
  This is something that should pass. This bill is balanced, it 
provides needed improvements to Medicare, but it is responsible. We 
fully offset any cost to the Treasury, primarily by reducing 
overpayments in the private Medicare Advantage plans, which are paid 13 
percent--I said 12 percent earlier, but it is 13 percent--more than it 
would cost to cover someone in traditional Medicare.
  I think it is responsible. Rather than adding new costs to Medicare 
and to the deficit, we pay for it. Pay as you go. In the old days, that 
used to be called being a fiscal conservative. The other side of the 
aisle used to be very proud to say they were fiscally conservative. 
Now, ironically, the table is turned. In fact, it is turned upside 
down. The Democrats are calling for fiscal conservatism--pay as you go, 
don't add to the deficit, be responsible--and the Republicans--some--
are saying no. I hope they do not prevail. I hope we can prevail with a 
paid-for bill.
  It is a bipartisan bill. Senators Snowe, Rockefeller, and Smith have 
joined Senator Baucus. I am going to support it, and I hope all my 
colleagues do when it comes up for a vote later this afternoon.
  I yield the floor.
  The PRESIDING OFFICER. The senior Senator from Utah is recognized.
  Mr. HATCH. Mr. President, I rise to oppose cloture on the motion to 
proceed to the Baucus Medicare bill, and there is reason to oppose at 
this time.
  I will keep my comments brief, but I wish to make one point perfectly 
clear. I have said, time and time again, I am willing to work with my 
colleagues on the other side of the aisle to get a bipartisan Medicare 
bill through the Senate. I have always prided myself on being someone 
who is fair, honest, and who wants to get the job done. Unfortunately, 
others in this body don't seem to want to get the job done, and that 
disappoints me more than most of you will ever know.
  My biggest frustration is we are not that far apart. Both sides wish 
to restore physician Medicare payments so doctors are not cut by 10 
percent on July 1. We also agree we need to implement the provisions on 
e-prescribing, electronic health records--where my home State of Utah 
is the leader--and value-based purchasing for Medicare providers and 
beneficiaries. We both believe a strong, robust rural health care 
package is necessary and, therefore, should be included in the Medicare 
package. Both the Democratic and Republican Medicare bills include 
marketing reforms for Medicare Advantage plans in order to ensure 
beneficiaries are treated with respect and are given truthful and 
helpful information so they may choose the Medicare Advantage plan that 
best suits their personal needs. Medicare Advantage has worked 
amazingly well. Democrats want to take the ``pay for'' out of the 
Medicare Advantage plans, and 90 percent of the people in this country 
who are on Medicare Advantage want to continue on it because they 
believe they are better treated. They are, as a matter of fact. It is a 
system that works. Why change it?
  We include provisions that would allow both hospital-based renal 
dialysis centers and skilled nursing facilities to be sites for 
telehealth services. As a strong supporter of telehealth services, I am 
very supportive of this provision, and both bills have it in.
  Finally, both bills extend the Special Diabetes Program for 2 more 
years. This program is very important to me. So as you can see, we 
agree on a lot. Unfortunately, the two outstanding issues, in my 
opinion, are Medicare beneficiary protections and offsets.
  The Baucus Medicare provisions include provisions that would increase 
Medicare beneficiary protections in the Medicare Program. It would 
increase the low-income subsidies for beneficiaries, extend the 
availability of the ``Welcome to Medicare'' physical examination from 6 
months to 1 year.
  I wish to make it clear our side could support these beneficiary 
changes, but we are very concerned about the impact these changes would 
have on long-term entitlement spending. The prices are going to 
continue to ramp up all the time, and our friends on the other side 
don't ever seem to worry about that. With 76 million baby boomers 
retiring over the next three decades, the Medicare Program is already 
headed for serious fiscal disaster. So we need to be thoughtful about 
these provisions and not just do what our colleagues on the other side 
want to do.
  Therefore, we believe it makes sense to means test the Medicare Part 
D beneficiary premiums for higher income beneficiaries. Although my 
friends on the other side are constantly arguing that the rich don't 
pay their fair share, unfortunately, when we suggested this, colleagues 
on the other side of the aisle--and, in fairness, some on our side as 
well--objected to means testing Part D premiums. I do not understand 
their objections.
  We already means test Medicare Part B premiums, and that had 
bipartisan support. Making that change would not only have wealthier 
beneficiaries shouldering a greater share of their Part D premiums, it 
could also pay for some of the beneficiary protections included in the 
Baucus Medicare bill.
  It is greatly disappointing to me that our friends on the other side 
of the aisle are not willing to accept this offset. In fact, we have 
been told pointblank that they cannot support increasing Part D 
premiums for rich Medicare beneficiaries in order to provide more 
assistance and benefits to lower income seniors. That is despite the 
fact that they have cut some very serious programs for the poor in 
order to find offsets for some of the things they want to do. I am 
going to say it again. I do not understand it. Especially since both 
sides supported means-tested Medicare Part B premiums.
  Hopefully, we will be able to change their minds when we begin our 
work to improve the Medicare Program so it will be more efficient for 
both beneficiaries and providers. That is the reason why we should vote 
against cloture, so our friends on the other side have to come together 
with us to have a better bill, and I believe we can.
  The second major issue concerns the offset used in the Baucus bill to 
pay for

[[Page 12398]]

its provisions. The White House has told us, time and time again, the 
President will only be able to accept very minimal reductions to the 
Medicare Advantage Program. Time and time again he has said that. 
Otherwise, he is going to veto the bill.
  That is why Senator Grassley and I have insisted the White House be 
included in the Senate Medicare negotiations. We do not want to send a 
Medicare bill to the White House that is going to be vetoed and, 
therefore, put the physicians' Medicare payments in jeopardy. It is 
another reason to vote against cloture, so we don't go through the 
charade we will have to go through if we don't.
  But that is exactly what is going to happen if the Baucus Medicare 
gets cloture today. It will probably pass the Senate and then be 
considered by the House of Representatives. The House will make changes 
to the bill, too, that will probably not be acceptable to the White 
House. Then the Senate will have to consider the Medicare bill with the 
House's changes before it is sent to the White House for a certain 
veto. It is ridiculous. Why do they have to do a partisan bill? Why not 
work with us, since we want to work with them?
  We will not have the votes to override the President's veto of the 
Medicare bill, so we will be back to square one and we will have wasted 
a lot of time and maybe even have done some very bad damage.
  I believe the Grassley Medicare legislation, which I strongly 
support, would not suffer the same fate as the Baucus legislation. That 
is why I believe this bill should be considered by the Senate instead 
of the Baucus Medicare bill. We are so close together on almost all 
these provisions, except for these few I have mentioned. The Grassley 
bill is a better bill. The President will sign it into law.
  I would like to take a moment to highlight the major differences 
between the Grassley Medicare bill and the Baucus Medicare legislation.
  On this chart, first, as you can see the Grassley Medicare bill 
encourages e-prescribing sooner rather than later. The Grassley bill 
requires physicians to e-prescribe by 2010, while the Baucus bill 
delays mandatory e-prescribing until 2011.
  In addition, the Grassley Medicare bill repeals the Deficit Reduction 
Act provision on the transfer of ownership of oxygen equipment to 
Medicare beneficiaries. The Baucus bill cuts Medicare payments for 
oxygen and oxygen equipment. It is somewhat shocking to me, but that is 
what they do.
  On durable medical equipment for competitive bidding, the Grassley 
bill includes a sense of the Senate to delay competitive bidding for 
durable medical equipment for 18 months. The Baucus Medicare proposal 
as filed does not even address competitive bidding.
  Let's go to chart No. 2.
  The Grassley bill also has provisions on hospital value-based 
purchasing. The Baucus Medicare bill does not include a similar 
provision. You would think we would want to go to hospital value-based 
purchasing.
  The Baucus Medicare bill reduces the Medicare reimbursement rates for 
power wheelchairs, of all things. The Grassley Medicare bill does not 
cut Medicare payments for power wheelchairs. You would think we could 
get together on that.
  The Grassley Medicare bill provides continued relief for hospitals 
with high numbers of undocumented individuals. The Baucus bill does not 
include a similar provision. Again, as anybody can plainly see, the 
Grassley bill is a better option.
  I am going to conclude with one very valid and important point. My 
colleagues need to vote against cloture today so we can begin work on a 
bipartisan bill that will be signed by the President. We do not need to 
be wasting our time going back and forth on a bill that does not have a 
chance of becoming law. In fact, we need to roll up our sleeves and get 
to work immediately so we can get this legislation to the White House 
before the July 1 deadline. Otherwise, our Medicare beneficiaries and 
doctors participating in the Medicare Program will lose. But you know 
who the biggest loser will be in this process. That is the Senate, 
because we have failed to do our job, therefore letting down both 
Medicare beneficiaries and Medicare providers.
  I urge my colleagues to vote against cloture to avoid this terrible 
situation and to take the more appropriate, better designed, and more 
compassionate bill. Frankly, that is what our bill is. I just hope our 
colleagues will see this and vote against cloture.
  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. BINGAMAN. 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.


                             Habeas Corpus

  Mr. BINGAMAN. Mr. President, I will speak very briefly here to call 
to the attention of all Senators the very important decision that was 
just handed down this morning by the Supreme Court regarding the 
prisoners who are detained in Guantanamo.
  The Supreme Court has once again rejected the administration's 
approach in disregarding basic due process rights and our Nation's 
longstanding commitment to the rule of law. The Court, in a decision 
written by Justice Kennedy, held that individuals detained at 
Guantanamo have a constitutional right to challenge their prolonged 
detention in civilian courts.
  Furthermore, the Supreme Court found that the Military Commissions 
Act of 2006 amounted to an unconstitutional suspension of the writ of 
habeas corpus. The Court today reiterated that the Great Writ, the writ 
of habeas corpus, remains as a fundamental protector of individual 
liberty and as a safeguard against arbitrary detention by the 
Government. This right, which is enshrined in our Constitution, simply 
allows for an independent and meaningful review of a person's 
confinement by the Government.
  Nothing in today's decision requires that the Government release the 
prisoners held at Guantanamo. Many of those prisoners have been held 
there for over 6 years without access to meaningful judicial review. 
The decision simply allows these individuals to ask a court whether 
their continued confinement is in accordance with our Constitution.
  The President has asserted extraordinary authority to indefinitely 
imprison anyone he designates as a so-called enemy combatant--that 
would include U.S. citizens, according to the administration's legal 
position--and that that detention could continue without any judicial 
review.
  It is time that we change course and recognize that acting in a 
manner consistent with our Constitution and with our core American 
values is not a sign of weakness.
  It is a sign of our strength and a sign of who we are as a people. I 
am very pleased that our highest Court has reaffirmed our Nation's 
respect for the rule of law and sent a clear message that the 
Constitution remains strong.
  I yield the floor and 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. DORGAN. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, I was just visiting with my colleague from 
New Mexico. I was unaware of the Supreme Court decision this morning. 
But the decision by which they have overturned some legislation that 
retracted the right of habeas corpus for those who might be suspected 
of some sort of illegal activity and so on in this country, that 
decision by the Supreme Court is a very important decision.
  I could not believe when the Senate passed a piece of legislation 
saying that someone who is apprehended or detained in this country 
would not have the right of habeas corpus. That is a different kind of 
country than I know. There are countries in this world

[[Page 12399]]

where they can pick you up right off the streets and say: Do you have 
papers? Even if you have papers they can throw you in jail, and you 
have no right to anything, including filing a writ to say: A government 
cannot hold me. A government must prove there is reason to hold me.
  That is unbelievable that this Congress it--not with my vote. But I 
commend the Supreme Court. I haven't had much opportunity to do that 
recently, I must say. But their ruling this morning gives me some hope.
  Mr. President, we have a cloture vote at 3 o'clock this afternoon. I 
wanted to mention the important subject of the cloture vote is dealing 
with some Medicare changes.
  Medicare is an unbelievably important program. Prior to Medicare, not 
many people look back and remember this because most of us have lived 
our lives with Medicare in existence. Before Medicare, one-half of the 
American senior citizens had no health insurance at all. Does anybody 
think that an insurance company says: You know what. We have a new 
business plan. Our plan is we want to find people who are old and 
provide health insurance for them. That is not the way a business plan 
works. If you are selling insurance, you like to find somebody young 
and healthy.
  As a result, if you go back to the 1950s, early 1960s, you will find 
that one-half of senior citizens of this country had no health 
coverage. Now, it is a very small percentage that have no health 
coverage. The vast majority of American senior citizens are covered by 
Medicare. It is a good program.
  I grew up in a little town of 300 people. We had a guy named Doc 
Hill, Dr. Simon W. Hill. He came into town and he stayed until he died. 
He practiced medicine. We did not have a Medicare Program, but he tried 
to give everybody whatever health care they needed. He tried the best 
he could. We had no lawyer in our town, so he was never sued. He pulled 
the tooth of my neighbor. He was not a dentist, but he was a doctor. 
The neighbor had a terrible toothache, we were 50 miles from the 
nearest dentist, so Doc Hill pulled his tooth. It turns out he pulled 
the wrong tooth. But, you know, the fact is, Doc Hill did the best he 
could. He practiced medicine in my hometown. I think he delivered close 
to 2,000 babies decade after decade after decade. He ran his own 
Medicare and Medicaid Program. If you did not have any money, you got 
health care to the best he could give it. If you had money, he would 
charge you an arm and a leg. If you had 24 fryer chickens, he would 
take that; maybe a quarter beef, maybe half of a hog--whatever it was, 
he ran a program in a little town.
  Well, that is all gone. That does not exist anymore. The fact is, we 
now have a Medicare Program that serves America's senior citizens with 
health care and says to them: If you get sick, here is a program that 
is to provide some help to you.
  Now, my colleague, Senator Baucus, and the Finance Committee have 
brought a piece of legislation to the Senate floor, and we have to have 
a cloture vote on it this afternoon because the other side is 
objecting. My hope is that we will have sufficient votes this afternoon 
to advance this bill.
  It makes some changes in Medicare that need to be made because we are 
bumping up against a deadline at the end of this month. Among other 
things, it reauthorizes the special diabetes program. That is something 
in which Senator Domenici from New Mexico and I have been involved. We 
have introduced some reauthorization legislation here.
  The diabetes issue is a scourge in this country. I chair the Indian 
Affairs Committee in the Senate, and the fact is, we have some areas on 
Indian reservations in this country where 40 or 50 percent of the adult 
population are affected by diabetes. Go there and go to their dialysis 
units and see all of them sitting hooked up to dialysis units. Then see 
how many have lost their legs through amputation. See how many of them 
have early heart disease as a result of their diabetes. This piece of 
legislation by Senator Baucus and the Finance Committee begins to 
address some of those issues.
  It also makes reforms to what is called the Medicare Advantage 
Program. Now, some of my colleagues have come to the floor and said, 
well, this bill cuts Medicare. That is total rubbish. This does not cut 
Medicare. It takes one portion of Medicare, called the Medicare 
Advantage Program, which pays more for healthcare as opposed 
traditional Medicare.
  This is one of those little pilot programs that some in this Chamber 
wanted, so they seeded it with extra funding. Well, the extra funding 
has been a waste of money, a tragic waste of money. And this gets some 
of the waste and abuse out of it. If my colleagues are upset about 
getting rid of waste and abuse, I am sorry. Maybe they will not sleep 
very well if we pass this bill. But the fact is, when we see waste and 
abuse, we ought to go after that. That is what the Finance Committee 
and Senator Baucus have done.
  They have used that funding they have achieved by getting rid of some 
waste and abuse in the Medicare Advantage Program. They have used that 
funding to address some other urgent issues.
  If we do not do anything by the end of this month, we will see a 10-
percent cut to physician payments. Well, physicians in my State are 
already at the bottom of the wage index on physician payments. And the 
fact is, a 10-percent cut would be devastating to senior citizens in my 
state who rely on Medicare. It seems to me we should not be doing 
things that will predict a degradation of health care. We should not be 
doing those things.
  The Finance bill and Senator Baucus have brought a piece of 
legislation to the floor that avoids that 10-percent payment cut and 
establishes a 1.1-percent increase instead through fiscal year 2009.
  It is the right thing to do. Now, if you decide you do not want to 
vote for cloture, to even allow this to proceed, then you are saying: 
You know what, just whack these programs. It does not matter what kind 
of health care exists in our States. It does not matter what happens to 
the senior citizens.
  If that is your view, you know, God bless you. But it is sure a far 
cry from my view. I think we have responsibilities to make Medicare 
work, to provide decent funds for the providers so that our senior 
citizens have health care that all of us can be proud of.
  There are many other features in this piece of legislation that are 
important. It talks about prompt payment to Main Street pharmacies. We 
have drugstores and pharmacists on the Main Streets across this country 
that are not getting the kind of prompt payment they should get. And 
some of them are threatened with the closure of their business because 
we have a system that is not reimbursing them as it should.
  It improves access to telehealth, which is very important. This is a 
rather new form of delivery of health care, and Medicare is a part of 
it. It works. I have been in clinics, and I have seen the delivery of 
very sophisticated CAT scans and the delivery of x rays to a 
radiologist 150 miles away to get a reading and to be sent back to that 
rural clinic.
  All of that makes a lot of sense. It gives us access to some of the 
best in the country through telemedicine. Then, in addition, the 
telemental health part of that is an opportunity for psychologists and 
psychiatrists to be engaged in telemental health, particularly on 
Indian reservations and elsewhere, where we have some of the highest 
rates of suicide any place in the country. Accessing telemental health 
services can be very important.
  On the northern Great Plains--I know the Presiding Officer is from 
Montana. In Montana, North Dakota, on the northern Great Plains, the 
rate of suicide among Indian youth--I am talking about Indian teens--is 
not double, triple, or quadruple the rate across the country, it is 10 
times the national rate. That is why telemental health is so important 
for all elements of our population, but also especially in Medicare for 
senior citizens. We are doing it in other areas. Extending it to 
Medicare makes a great deal of sense.
  The improvement of the quality of health care in Medicare, the 
prevention

[[Page 12400]]

of the 10 percent in payment cuts to physicians, the diabetes 
prevention program, the elimination of the wasteful payments to 
Medicare Advantage, are just a few of the examples of why we must 
expect our colleagues will vote for cloture at 3 o'clock this 
afternoon. This is the right vote. It is an important vote.
  Now, we have been through--yesterday it was energy, with gas at $4 a 
gallon, and oil at somewhere around $130, $140 a barrel, the minority 
decided to embrace once again their just-say-no policy on everything. 
It does not matter what it is, just say no.
  It reminds me of an old codger in his eighties who was once asked by 
a news reporter who said: Well, you have been around a long time. You 
must have seen a lot of changes in your life.
  He said: Yeah, I have been against all of them.
  We have people on the floor of the Senate who have decided they are 
against everything--just say no. My hope is after just saying no 
yesterday to energy issues at a time when gas is $4 a gallon, it is 
unbelievable to me they would just say no to begin addressing that, but 
they did.
  My hope is that today, on behalf of health care for senior citizens, 
they would finally decide to just say yes. If they will do that at 3 
o'clock, we will pass this cloture petition and we will take what the 
Finance Committee and Senator Baucus have offered in the spirit of 
improving Medicare and saying to senior citizens and saying to their 
health care providers: We are going to do the right thing.
  There is a time urgency. By the end of June we have to solve this 
matter. And I hope my colleagues will be listening and understand that 
we need this cloture petition to prevail at 3 o'clock this afternoon.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. I so appreciate the Senator from North Dakota and his 
comments about the just-say-no philosophy around here. I have been in 
this institution only 15 months. I have seen his leadership on a whole 
host of issues, and I have also seen the disappointment that it is one 
filibuster after another--74, 75 filibusters, more than anytime in 
Senate history--on such commonsense legislation as the Energy bill 
yesterday and the Medicare bill today.
  I am happy to see that Senator Baucus and Senator Reid have brought 
the Medicare Improvements for Patients and Providers Act to the Senate 
floor today. It is crucial not just immediately for physicians and 
hospitals, not just immediately for patients, most importantly, but it 
is also crucial to the future of Medicare.
  The bill not only prevents a 10.6-percent cut to payments for 
physicians and other health care professionals, it gives these 
providers a small payment increase. The cost of providing health care 
has increased; payments to health care professionals should increase 
too.
  Our history with Medicaid should teach us about the importance of 
preserving Medicare by keeping payment rates viable for providers. 
Inadequate Medicaid payment rates have compromised access to dentists 
and other health professionals. I visited with the dental unit at 
Children's Hospital in Columbus and talked to dentists all over the 
State, talked to hygienists and others. It is pretty clear that we do 
not have enough dental care, we do not have adequate dental care, 
especially for low-income young patients. The reason is we do not have 
adequate reimbursement for dentists to provide Medicaid dental care, 
particularly for those children. We need to fix that Medicaid problem, 
not recreate that same problem in Medicare.
  This bill is about so much more than provider payment, as Senator 
Dorgan said. It contains important measures to improve Medicare for 
beneficiaries. It increases subsidies for low-income patients. It 
invests in preventative health care. It reduces out-of-pocket costs for 
mental health treatment.
  Senator Durbin spoke of Senator Wellstone's work and Senator 
Domenici's work on mental health treatment; to treat it like a disease 
not a stigma, and how important that is. This makes some downpayment on 
that solution.
  This bill eliminates late enrollment penalties for Part D and 
modernizes Medigap policies. It bolsters rural health care, something I 
have discussed in my roundtables around Ohio. I have done some 90-plus 
roundtables in 65 counties and seen how inadequate rural health care is 
in rural areas of my State, as it is in the Presiding officer's State 
of Montana. The bill authorizes a special diabetes program.
  This morning in my every-Thursday-morning coffee, which I have for 
Ohio residents in Washington, I met with Ohioans from Cincinnati, 
Columbus, Toledo, and Cleveland. Ohio's children are suffering from 
type 1 diabetes. They told devastating stories. One man told about his 
teenage daughter going blind. Another told me that by the time a young 
child with diabetes turns 18, she will have endured more than 30,000 
shots.
  Diabetes is one of the most prevalent and pressing health threats we 
face as a nation. The cost to the health care system is more than any 
other single disease. Reauthorizing the cost-effective Medicare 
diabetes program serves patients and taxpayers.
  The bill has other crucial provisions. It exempts the value of life 
insurance from counting against seniors attempting to qualify for the 
low-income subsidy in Part D. Constituents have written to me telling 
me they are afraid of saving for the future, of all things, because 
they might lose their eligibility for subsidized drugs. What kind of 
system is that? This bill will help fix that.
  One of the most common stories I have heard in my 90-plus 
roundtables, where I convene meetings of 15, 20, 25 people and ask them 
questions for an hour and a half, 2 hours, and we talk about their 
hopes, dreams, and problems, and where we, as a Senate, might be able 
to work with them and make their lives better, one of the most common 
stories I hear from Defiance and Gallipolis, from Middletown and 
Ashtabula, whether I am meeting with providers or patients, is about 
Medicare. My office receives thousands of constituent letters about 
Medicare. I recently heard from an infectious disease doctor in Lima, 
who explained how he is squeezed by current Medicare rates. He said:

       As health care costs have escalated and reimbursement has 
     fallen, we have had to make some hard decisions.

  He told me he has had to let go of employees, cut office hours, and 
that the financial stress is at the breaking point. He said:

       Last year, a doctor would call me [about a patient] with an 
     infected abscess. Commonly, I had the patient sent to my 
     office, lance the boil, pack the wound, and give IV 
     antibiotics daily in my office until transitioned to pills. 
     The patient was never admitted to the hospital.

  Since his office is less and less able to provide outpatient 
services--remember, I said he had laid people off--similar patients are 
now admitted to the hospital. What happens?
  ``The admission day alone,'' he says, ``costs more than the entire 
course of therapy in my office.''
  It is obvious how inefficient and expensive this is. We need to fix 
the current payment system, and we will. But we should not grossly 
underpay those professionals while we work on a better system. Until 
that day, we should pass this bill. Medicare is one of the great 
accomplishments of our Government and of our country. Senators Dorgan 
and Durbin both talked about in 1965, half of America's seniors didn't 
have any health insurance. Today that number is less than 1 percent. 
Because Medicare is one of the great accomplishments of our Government 
and our country, we have to preserve it. This bill takes major strides 
to do so.
  In addition to voting yes at 3 o'clock on cloture, there has been 
another piece of related legislation I want to speak on for a moment. 
It is the alternative bill offered by Senator Grassley, who I think is 
one of the single best legislators in this body. The bill he wrote as 
an alternative to our bill, to the Baucus legislation, perpetuates a 
shameful politically motivated subsidy program that overpays private 
insurance health maintenance organizations to the tune of $10 billion a 
year.

[[Page 12401]]

What this does is it overpays private insurance companies, undercutting 
fee-for-service traditional Medicare, causing taxpayers--requiring 
taxpayers--to give huge, frankly, unearned dollars to these insurance 
companies as they try to privatize Medicare. The Baucus bill redirects 
these taxpayer-funded windfall payments from HMOs to concrete 
improvements in the Medicare Program.
  In the beginning of my speech, the first 6 or 7 minutes, I talked 
about improvements we are making in the Medicare Program. We are able 
to do so by taking money away from the private for-profit Medicare HMOs 
that have reaped a windfall in the last 10 years as this Congress, 
particularly the Republican House and Senate for most of the last 
decade, shoveled more and more public dollars into these private 
insurance programs, these private HMOs, and private HMO executives have 
had grossly inflated salaries and benefits and retirements, all of 
that. Ending those gratuitous overpayments to HMOs should not be an 
option for this Congress; it should be an imperative that we finally do 
that.
  Taxpayers can't afford to coddle private, for-profit health 
maintenance organizations, and we can't continue to do it. I encourage 
my colleagues to vote for the very crucial Baucus Medicare legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. CORNYN. Mr. President, you don't have to be an expert in health 
care policy to know that our health care system is in need of reform. 
Today we spend $2 trillion on health care or almost $7,500 per person. 
In 10 years, national health care spending is expected to reach $4.3 
trillion. That is more than double or $13,000 per person, which would 
comprise almost 20 percent of our gross domestic product. Clearly, this 
rate of growth is unsustainable. While we should be enacting 
legislation to address this health care crisis, Congress is once again 
bogged down in debate over how to prevent physician payment cuts from 
going into effect. Meanwhile, the sustainable growth rate, the SGR, 
which is the formula for these Medicare payments to physicians, has 
only increased costs, decreased beneficiary access and quality of care, 
and discouraged future generations of physicians, especially in primary 
care.
  If Congress fails to act, Texas physicians will lose $860 million 
between July 2008 and December 2009. That is $860 million which is a 
cut of $18,000 per Texas physician. That figure balloons to $16.5 
billion by 2016, due to nearly a decade of scheduled cuts. It is great 
that Members of Congress and outside coalitions are presenting health 
care reform plans, but they are ignoring the fundamental problem. You 
can have a great plan. You can have great coverage. But none of that is 
any good unless you have access to that coverage.
  Physicians' reimbursement cuts have been looming over our heads for 
years; in fact, since 1996 and the passage of the Balanced Budget Act. 
Yet Congress continually decides to put off for tomorrow what 
desperately needs to be done today. So every year Congress cuts 
segments of health care services, either rightly or wrongly, to prevent 
these cuts. I firmly believe--and physicians in my State firmly 
believe--that short-term fixes are not the solution. This last one was 
a 6-month fix which will expire shortly. I don't know anyone else in 
the private sector, whether they be a physician or a small business, 
who can continually plan based on the vagaries of a 6-month fix, 
without knowing whether they will simply be put out of business or what 
the Congress will come up with as a solution on a 6-month basis. We 
need a longer term solution, in other words. We can't address greater 
health care costs until we fix the mess caused by the SGR or the 
sustainable growth rate formula for Medicare reimbursements.
  Over 3 months ago, in anticipation of the looming physician payment 
cut set for July 1, I introduced legislation that addressed the issue 
at hand permanently. Even the proposal we will vote on at 3 is only 
good for 18 months. I think we need a permanent solution. My 
legislation is entitled Ensuring the Future Physician Workforce Act of 
2008. It provides positive reimbursement updates for providers. It 
eliminates the ineffectual expenditure cap known as SGR, and it 
increases incentives for physician data reporting. At the same time 
this bill facilitates the adoption of health information technology by 
addressing costs and legislative barriers. It educates and empowers 
physicians and beneficiaries in relation to Medicare spending and 
benefits usage and studies ways to realign the way Medicare pays for 
health care.
  My bill doesn't mandate whether physician payments should be based on 
utilization, performance, care, coordination, or any other particular 
methodology. My bill does start to lay down a new path toward reform, 
innovation, and restoration of the eroded physician-patient 
relationship. It does say that providers and beneficiaries should not 
be the ones to be punished by Congress's inaction.
  Why Congress decided in 1996 to try to balance the budget on the 
backs of health care providers is beyond me. Because beyond the 
challenges that presents to the health care providers, it has 
diminished access to health care. More and more physicians refuse to 
take new Medicare patients, because the reimbursement rates are simply 
so low. In Travis County, where Austin, TX is located, there was a 
story published in the Austin American Statesman that said only 18 
percent of physicians in Travis County are accepting new Medicare 
patients. I would like to say that was an isolated incident, but it is 
not.
  This is a huge issue and deserves serious and thoughtful 
deliberation. The last time the majority party held a hearing on 
physician payment reform was almost 16 months ago, almost exactly a 
year before I introduced Ensuring the Future Physician Workforce Act of 
2008. Yet there has been zero legislative activity, let alone 
introduction of language addressing this critical issue from a long-
term perspective. Again, we have been stuck in the same old rut of 
coming up with temporary fixes, including the 6-month fix that will 
expire on July 1.
  I am disappointed in Congress's inaction in this regard. I do believe 
that Congress needs to do more than simply kick the can down the road 
for another few months and put off a solution that we ought to be 
working toward on a bipartisan basis and embracing today.
  My colleagues on the other side of the aisle have missed a major 
opportunity to take positive steps forward. They presented a bill, 
unfortunately, on which we will vote at 3 o'clock, that bypassed the 
committee, ignored the importance of bipartisan input and contribution, 
and they are determined to have a vote on a bill that they know has no 
chance of becoming law. Because as we all know around here, no bill has 
a chance of becoming law unless it is truly a bipartisan product. The 
rules and traditions of the Senate guarantee that. That is one of the 
things that makes sure that when we vote on things, they have broad 
support, represent a consensus position, and that they are, in the view 
of the vast majority of Senators, in the best interest of the American 
people. But when you try to force a bill that is strictly partisan, 
that has very little bipartisan support, we know what will happen. That 
is what is going to happen this afternoon on this vote: It won't become 
law.
  The American people were promised a different way of legislating by 
the majority when they took power. But we have seen, unfortunately, 
this sort of gamesmanship occur time and time again. I heard Senator 
Schumer, the Senator from New York, chairman of the Democratic 
Senatorial Campaign Committee, rail against obstruction of their 
legislative agenda. But it is almost a sure thing, when all you do is 
take a partisan position on legislation and you refuse, as the majority 
leader has done, to allow an amendment process, as he did last week on 
the climate tax bill, and you deny full and fair debate, it is 
virtually a guaranteed result of failure when you take that sort of 
approach to legislation. That is what is going to happen again this 
afternoon.

[[Page 12402]]

  Because the chairman of the Finance Committee has chosen to take a 
partisan approach on this legislation, we have come up with an 
alternative that offers solutions to physicians, seniors, and 
taxpayers. This alternative will provide doctors with a positive 
increase in their reimbursement rates, extend critical programs, and 
reform payments to Medicare Advantage plans, and also implement many 
other necessary changes to the Medicare Program. This alternative 
legislation includes provisions for e-prescribing, closely mirroring 
legislation I cosponsored earlier this year.
  We need to change our ways in the Senate. Rather than trying to check 
off a box saying, yes, we threw it up, a partisan effort we knew was 
going to fail, and now we can claim we were the champions of reform, 
while the ones who would not allow this partisan process to go forward 
are obstructing it, we need to get together and work in a bipartisan 
way to ensure that Medicare beneficiaries not only have the coverage 
they need and deserve but also the access which is guaranteed by a fair 
rate of compensation for physicians.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.


                             Habeas Corpus

  Mr. LEAHY. Mr. President, while I was chairing a Judiciary Committee 
meeting today, I received notice of the Supreme Court's ruling this 
morning in Boumediene v. Bush. I normally do not come to the floor to 
talk about Supreme Court rulings, whether I agree or disagree with 
them, but this one is of fundamental importance to all Americans, and I 
wish to take just a moment.
  We Americans know there is nothing more fundamental than the right of 
habeas corpus--the right to challenge your detention by the Executive 
as unlawful. It was part of our reason for fighting a revolution. It is 
enshrined in our Constitution. We have preserved it through two world 
wars. We cherish it as something that has set us apart from so many 
other countries around the world.
  This administration has tried repeatedly to push the limits of 
Executive power, including its effort to extinguish the Great Writ for 
certain detainees. In three separate decisions, a conservative U.S. 
Supreme Court in recent years has rejected this administration's 
erosion of fundamental rights. I applaud the Supreme Court for doing 
that because these protections set the United States apart from those 
who wish to harm us.
  Today's decision repudiating the administration's efforts to curb 
judicial review of detainees echoes earlier court decisions that have 
solidified our constitutional system of checks and balances.
  The administration has rolled back essential rights that have long 
guided our Nation's conscience. The administration has acted as though 
the President--and the President alone--can decide the rights of 
Americans.
  But the Great Writ has kept us strong as a nation from the time we 
fought a Revolution. We fought that Revolution to say that we will 
protect our own rights and we will set up three branches of Government 
to do so, including an independent Federal judiciary.
  Today's Supreme Court decision in Boumediene v. Bush is a stinging 
rebuke of the Bush administration's flawed detention policies. It is 
also a vindication for those who have argued from the beginning that it 
was unwise as well as unconstitutional for Congress, at the 
administration's request, to try to override a core constitutional 
protection.
  A majority of the Court has ruled that the constitutional right to 
habeas corpus extends to territories, including Guantanamo Bay, Cuba, 
where the United States exercises de facto control. The Court further 
held that the administration's detention procedures used at Guantanamo 
Bay are a constitutionally inadequate substitute for habeas corpus 
rights. Therefore, the provisions of the Military Commissions Act that 
stripped away the habeas rights of detainees held at Guantanamo Bay are 
unconstitutional.
  As a result, those detainees who have been determined to be 
``unlawful enemy combatants'' are entitled to seek habeas relief in 
Federal courts, just as they had been doing before Congress' ill-
advised decision to endorse the administration's detention policies 
through passage of the Military Commission Act in 2006. No detainee is 
set free as a result of this decision. Rather, detainees will simply be 
able to challenge their detention before a neutral, life-tenured judge.
  The Court's 5-to-4 decision sustains the long held and bipartisan 
belief that I and others have always maintained: Congress made a grave 
error when it voted to strip habeas corpus rights in the run-up to the 
2006 mid-term elections, and leave in place hopelessly flawed 
procedures to determine whether detainees could be held indefinitely 
with no meaningful court review, merely by the President's decree.
  I have said many times on the floor of this Senate that we are the 
conscience of the Nation. Certainly, part of our job is to uphold our 
Constitution. It is easy to uphold our Constitution when we see no 
threats on the horizon. It is more difficult but even more important to 
uphold it when we do see threats on the horizon. So Congress, as I 
said, made a grave error in trying to diminish habeas corpus, and I am 
gratified that today's Supreme Court decision takes a significant step 
in reversing that action.
  Mr. President, the Great Writ--the Great Writ of habeas corpus--
protects you and protects me. It protects all 300 million Americans. It 
protects people who look to the United States to be a beacon of 
freedom. I am grateful that the Supreme Court believes, as I do, that 
this fundamental right must be preserved.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. COLEMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                                 Energy

  Mr. COLEMAN. Mr. President, I rise to speak about the rising cost of 
energy, at a time when Americans are suffering from gas prices that are 
seeing $4 a gallon and diesel fuel is higher than that. The price of 
diesel fuel has gone up 65 percent from where it was a year ago. That 
impacts farmers, it impacts small businesses. The Medicare bill is a 
critical issue, but right now we need to address the impact the cost of 
gas and energy is having. It is having a devastating effect on folks as 
they sit around the dining room table trying to figure out how to make 
ends meet. It is getting tougher and tougher to find money for food and 
fuel. I wish to say up front that the principal culprit right here is 
our addiction and our dependence on foreign oil.
  My folks in Minnesota--families, farmers, and businesses--can't 
afford these rising costs. They are talking about commodity prices 
rising. On the other hand, the cost of commodity prices is rising 
because of the cost of oil. The cost of energy, gas, and diesel on 
those folks who are producing the food is having a devastating impact.
  My State has one of the highest housing foreclosure rates in the 
Nation. The State of Minnesota is always seen as being somehow outside 
the economic woes that affect so many. The unemployment rate is going 
up, not down. Record fuel costs are the final straw for a lot of folks. 
It should be the final straw for partisan bickering on energy that is 
getting us nowhere and is letting the American people down.
  Mr. President, 232 years ago yesterday, Thomas Jefferson, John Adams, 
Benjamin Franklin, and other Founders were set to work by the 
Continental Congress on a document that set America on a new course, 
just as the American Army was retreating from the British to Lake 
Champlain.
  The invasion we have today is the invasion of hundreds of billions of 
dollars of foreign oil. This year nearly a half a trillion dollars will 
be sent overseas for energy we should be capable of producing at home. 
This is America. We

[[Page 12403]]

should have the technological ability, the capacity, and the resources 
to end that addiction. The fact is we are being held hostage by a world 
oil market where much of the supply is controlled by thugs and tyrants 
such as Chavez and Ahmadinejad.
  Just as the Founders, we have a choice. We can focus on our 
differences as Republicans and Democrats or we can work together to 
fight a common foe. Are our differences greater than those of the 
colonists, most of whom had never been outside their home States? We 
know that is not true.
  Now is the time to write our own declaration of independence. Now is 
the time to use every resource at our disposal to address this energy 
crisis.
  Now is the time for us to declare that American freedom, liberty, and 
security are not going to be held hostage over a barrel of oil. That is 
what it is about. It is about being held hostage. We may in the future 
always import foreign oil, but we are being held hostage by our 
dependency.
  Our Nation's future depends on the decisions we make right now. The 
good news is that we possess the resources to take our energy prices 
head on. If we were, in fact, to make that commitment, we could stand 
up and say we are not being held hostage anymore. July 4 is just around 
the corner. If we were to do that, I think it would have a dramatic 
impact on speculation because they would know America is now 
committed--Democrats and Republicans--to doing the right thing. It is 
simple: renewables, increased production, and redoubling of our clean 
energy technologies efforts.
  To make this happen, we not only have to transform how we do energy 
in this country, we have to transform how we do business in the Senate.
  On Tuesday we had a contentious vote on an energy package that wasn't 
a bipartisan product. I voted to go forward on the debate of that 
package because I believe we must get going on a new energy bill. 
However, I think the only thing yesterday's process was set up to 
deliver was finger pointing. We must sit down together, Democrats and 
Republicans, and find out what policies we can agree on and then send 
an energy bill to the President.
  The energy bill proposed by the other side of the aisle includes many 
ideas we have seen before. I am reminded of a quote by H.L. Mencken, 
who wrote:

       There is always a well-known solution to every human 
     problem--neat, plausible, and wrong.

  I believe we need to stop rehashing ideas that don't get to the heart 
of the problem and begin an energy revolution by dramatically 
increasing production of every energy resource at our disposal. I still 
don't support drilling in ANWR. We have the opportunity, though, to do 
deepwater exploration off the Outer Continental Shelf and tap into 
substantial resources. That is increased production. We had the worst 
natural disaster in the history of this country, Hurricane Katrina, and 
there wasn't a drop of oil spilled, so there shouldn't be an 
environmental issue there to increase production. We need to 
dramatically increase investment in renewable fuels. I support that. It 
is critical to my State. Energy efficiency, boost nuclear energy 
production, and take advantage of coal to liquids--coal to jet fuel.
  This week I have been listening to my colleagues speak about energy. 
Some say what we need is more efficiency. The others say we need more 
renewables in nuclear, oil, and gas development. I believe we need all 
of those sources of energy. I don't think our debate should be about 
whether to drill or whether to tax those who drill. You are not going 
to increase production by simply taxing the oil companies. That is not 
going to solve the problem. It may make a political point somewhere, 
but it is not going to solve the problem. Instead, I believe the answer 
to breaking through our energy crisis and our political energy logjam 
is to couple domestic oil and gas development with responsible 
environmental protection--you can do both--to fully utilize the clean 
energy technologies at our disposal, such as nuclear, while we look to 
emerging technologies, to grow more fuel on the farm and save energy at 
home. We need to move forward with at least the potential of cellulosic 
ethanol.
  Today I have introduced an energy bill, the Energy Resource 
Development Act of 2008, that I hope will foster the bipartisan 
discussion we need to have. It is not about holding my idea of the 
perfect energy bill in the air, pointing a finger and saying: This is 
what they won't do. No, this bill is about asking the other side what 
we might be able to do together.
  Here is what I think we can do together: We could open the Outer 
Continental Shelf to oil and gas development outside of Florida in a 
way that protects the economy, the environment, and the economy of 
States in new development areas. There is an estimated 2.8 billion 
barrels of crude oil and 12 trillion cubic feet of natural gas that 
could be produced between now and 2025 in areas currently under 
moratoria. If developed, this could reduce America's trade deficit by 
$145 billion by offsetting oil imports.
  We must open development in a way that recognizes that many States 
are opposed to opening development in the Federal waters off their 
coasts, which is why my bill does not allow the Federal Government to 
allow development unless the State's Governor approves of the plan. 
And, to get the discussion going between the Secretary of the Interior 
and the Secretary of Defense and coastal Governors, this proposal will 
give the Governors an opportunity to make a counterproposal and to 
propose long-term protection of Federal waters off their shores. The 
Federal Government can then accept this proposal and begin negotiation 
with the Governor. The idea is to move past the take-it-or-leave-it 
approach to Outer Continental Shelf development and provide States the 
authority and process they need to make a deal that protects their 
economic and environmental interests.
  My bill would require that an oil company holding an OCS lease 
develop the oil and gas on that tract in a reasonable timeframe or lose 
the right to develop that area. Existing leases that come up for 
renewal will face the same limitation.
  No. 2, this proposal would create an energy independence trust fund 
to be funded with the Federal share of additional royalties that would 
be collected when more of the Outer Continental Shelf is opened for 
development. This trust fund, which could receive tens of billions of 
dollars from new royalties, would go to fully fund all renewable 
energy, energy efficiency, research and development, and technology 
deployment programs from the Energy Policy Act of 2005 and the Energy 
Independence Security Act of 2007. We have made a big commitment to new 
technology in past energy legislation. This is a way to fund it. This 
would make sure programs we already have on the books to develop 
technology such as fuel cells, hybrid vehicles, solar, wind, advanced 
batteries, building efficiency--the list goes on and on--are fully 
funded. We want to make sure they are fully funded.
  Additionally, the fund will provide resources for a new ethanol 
pipeline loan guarantee program and provide new nuclear energy 
production incentives.
  No. 3, the bill would utilize our 250-year supply of coal by creating 
a new standard of production of fuel from clean coal, often called 
coal-to-liquid technology. My bill would take a new approach by 
tightening the environmental standards required of this fuel.
  No. 4, my bill would recognize the fact that nuclear energy is one of 
America's energy solutions as it provides an affordable, zero-emissions 
source of energy. The French are not braver than we are. Close to 90 
percent of their energy is nuclear. This proposal will improve the loan 
guarantee for nuclear production, create a nuclear production tax 
credit, and increased training for the nuclear workforce.
  I believe these measures do a great deal to address our current 
energy crisis. But I promise my colleagues I am open to their ideas and 
initiatives as well. The only thing I am not open to is more political 
gamesmanship and bickering.
  The American people want and need bipartisan energy legislation that 
goes

[[Page 12404]]

to the root causes of our energy problems. I urge my colleagues to 
consider this proposal. I urge my colleagues and leadership on the 
other side of the aisle to sit down with a bipartisan coalition. I urge 
all of us on my side of the aisle to sit down and put together a 
bipartisan coalition that will produce a bill that truly transforms how 
we do energy as we, as Senators, work together for the American people.
  That is what they are looking for right now. They are frustrated. 
They are scared. They are facing economic stress. They are looking to 
us. We have a responsibility to put the gamesmanship aside, put the 
ideological divide aside, and figure out a way--can't we do renewables? 
Can't we do conservation? Can't we do production? It doesn't mean 
drilling in every corner of the universe.
  If there ever was a moment for us to come together as a nation to 
protect and preserve our freedom and our liberty, that moment is now.
  Mr. President, I yield the floor and I note the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CHAMBLISS. 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. CHAMBLISS. Mr. President, I ask unanimous consent that I be 
allowed to speak for up to 7 minutes. I know it is unusual, but I ask 
unanimous consent that the time be charged to the Democrats.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CHAMBLISS. Mr. President, I rise today to speak on the issue of 
Medicare reimbursement for doctors. Doctors are reimbursed through 
Medicare by a formula known as the sustainable growth rate, SGR. Due to 
the formula's methodology, it has mandated physician fee cuts in recent 
years. This has forced Congress to place a band-aid over the possible 
cuts that doctors and their practices have hanging over their heads.
  So every year, or now 6 months, doctors must come to Washington, DC 
and plead with their Representatives and Senators to pass legislation 
that will allow them to receive the adequate Medicare reimbursement 
they need.
  Medicare reimbursement is already well below the actual cost of 
providing patient services, and physicians tell me every year that if 
these cuts go into effect, they will be faced with the tough decision 
of either laying off employees or no longer treating Medicare patients, 
or both.
  Oftentimes, we in Congress wait until the last possible moment of 
each year to pass legislation that will provide these physicians with 
their much-needed relief. While we all know that there is a need to 
replace the current SGR formula, this afternoon I want to focus on the 
relevant legislation pending before the Senate.
  The bill before the Senate would alleviate the 10.6 percent physician 
fee cut and replace it with a 1.1 percent increase over 18 months. I 
support this element of the legislation and believe that an 18-month 
fix will not only keep physicians from worrying that their 
reimbursements will be cut, but will also give Congress time to look at 
possible alternatives to the SGR.
  However, I do not agree with other aspects of this legislation. First 
and foremost, the President has threatened to veto this legislation. In 
December of last year, we passed legislation that would remove the SGR 
cuts until June 30 of this year.
  Even if this legislation had overwhelming support, which it does not, 
the process of this bill passing both Houses, getting vetoed by the 
President, and returning for a veto override would be quite a feat to 
accomplish in 18 days, and simply cannot practically happen.
  Second, this legislation expands entitlement spending such as the 
Part D Low-Income Subsidy and Medicare Savings Program. While these are 
good programs, I do not understand why we would expand these programs 
when there are already significant numbers of seniors who are eligible 
for the programs at current levels but are not enrolled.
  This is not the time to expand entitlement spending when it is 
already out of control and unsustainable.
  Here we are trying to put a bandaid on reimbursement to our doctors 
and, at the same time, talking about additional expenditures in 
Medicare, so that the next year when we come back, it is going to be 
even harder if we don't have a permanent fix to use this bandaid 
approach for physicians and hospitals.
  Third, this legislation reduces access to Medicare advantage plans.
  These plans aren't perfect, but Medicare Advantage has been the one 
reform in the Medicare system we have seen that works. It needs some 
modification to it, but the fact is it is working.
  These plans, which are approved by medicare, save beneficiaries an 
average of $86 per month compared to premiums in traditional fee-for-
service medicare. They have been especially important in enrolling low-
income and rural beneficiaries.
  We should have learned from past congresses' mistakes that cutting 
payments to medicare advantage plans results in them being forced to 
drop seniors. In my home State of Georgia, more than 138,000 
beneficiaries rely on these plans.
  Senator Grassley has introduced alternative legislation that would 
provide physicians with the exact same 1.1 percent fee increase that is 
included in the pending legislation. And it would do this while 
eliminating duplicative indirect medical education payments to medicare 
advantage plans, making reforms to curb controversial and abusive 
medicare advantage marketing practices, and spending 25 percent less 
than the pending legislation.
  Most importantly, this alternative legislation would not be vetoed by 
the President and could be signed into law before the July 1 deadline. 
Unfortunately, the majority will not allow us to bring this legislation 
to the floor. I hope that decision changes.
  Doctors and seniors deserve a serious and responsible effort that 
addresses the impending fee cut without playing politics, cutting 
essential services, and creating a major expansion of entitlement 
spending.
  It is my hope that Congress will work toward a bipartisan agreement 
that will provide doctors with the relief they need before July 1. With 
that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Maine is recognized.
  Ms. SNOWE. Mr. President, I am pleased to join Chairman Baucus in 
sponsoring this bipartisan legislation, which both abrogates severe 
cuts to provider payments, and also takes steps to reform Medicare 
spending to address the distressing fiscal trajectory of this critical 
health entitlement.
  The bill before us today represents a product of what has become an 
annual--and recently a semiannual task--that of extending Medicare 
financing. It is a sad state of affairs when we see two Medicare bills 
emerge from the Finance Committee. For months Chairman Baucus and 
Ranking Member Grassley have worked to build consensus on Medicare--
just as they did last year. In fact, their reputation for 
bipartisanship is legendary.
  Ranking Member Grassley saw that we achieved the landmark benefit 
that is in part enhanced in this bill--the coverage of prescription 
drugs under Medicare. I have long regarded his leadership so highly, 
and I am confident that--as this debate continues--we will see him 
forge agreement to address critical Medicare issues because of his 
bipartisanship.
  And in fact--but for intransigence to compromise from the 
administration last December--we would not need to be here today 
debating these issues. But instead only a 6-month extender bill could 
be enacted--and now our providers and beneficiaries face cuts on July 
1.
  The fact is, that just a few weeks ago, with compromise achieved on 
so many issues, we appeared to be separated by approximately $3 billion 
in spending directed to beneficiaries. The fact is, that amount of 
funding represents less than what should be committed to meet critical 
needs of our

[[Page 12405]]

most economically challenged beneficiaries, and it represents less than 
two-tenths of 1 percent of total Medicare spending. And under this 
legislation, these funds would be obtained from fiscal savings which 
Medicare must begin to realize. Not from taxes. Not from deficit 
spending.
  And as we debate this difference between these two Medicare bills, we 
must enact sound fiscal policy--not ideological dogma. As CBO has told 
us repeatedly, the factors of an expanding senior population--and more 
significantly, as this chart illustrates, a rise in per capita health 
care spending--are working together to make Medicare the number one 
fiscal concern on the horizon. So it is critical that we take 
substantial steps to ensure the fiscal health of Medicare for future 
generations.
  It was an attempt to do so which set us on this course. The creation 
of the sustainable growth rate formula--or ``SGR''--was originally 
intended to serve as a limiter of spending, and it did so effectively 
for a time. Yet, today, the SGR operates crudely and irrationally to 
simply restrain payments to physicians. Next month, without 
intervention, physician payments will be reduced 10.6 percent. Yet it 
is also essential to recognize that these annual Medicare bills 
encompass more than just the SGR. A number of other programs are 
renewed on this same schedule. We call these ``extenders'' and they 
represent critical parts of Medicare--including items such as 
assistance to low income beneficiaries and programs which support rural 
health delivery--and they face termination without our action.
  As we consider this bill today, it must be viewed in the light of how 
it will address two crucial issues. First, does it fairly assure 
reasonable payments to those who serve our beneficiaries to preserve 
access to care? And second, does it take action to change the course of 
health spending to help assure the fiscal security of Medicare--
particularly when you see the growth and trajectory of growth in 
Medicare spending?
  First, as it must, this legislation takes action to prevent a large 
reduction in payments to physicians. So too it enacts a number of 
critical extensions to programs critical to assure that beneficiaries 
will have secure access to health care.
  We act to see that health centers receive relief from an artificial 
cap which prevents them from being fully reimbursed for the services 
they provide to beneficiaries. This bill grants some relief from that 
cap and is a step towards the reform which my legislation with Senator 
Bingaman would achieve to prevent health centers from serving Medicare 
at a loss.
  In similar fashion this bill would ensure that pharmacies will be 
paid promptly for the medications they provide seniors under the Part D 
drug benefit. And just as critical, we assure that Medicaid payment 
policy does not discourage the dispensing of generic drugs through 
inadequate reimbursement.
  And as we avert a pending physician payment cut it is unconscionable 
that we would leave the most vulnerable beneficiaries behind. In 
passage of the Medicare Modernization Act in 2003, we worked in a 
bipartisan fashion to assure that our most vulnerable beneficiaries 
would receive a low income subsidy, LIS, to provide extra assistance 
with drug costs. Today, a beneficiary qualified for full LIS support 
must have income below 135 percent of the Federal poverty level and 
assets not exceeding $7,790 for an individual and $12,440 for a married 
couple.
  Yet, our Medicare Savings Plans--which assist very low income 
beneficiaries outside of Part D--utilize a very different assets test 
standard--just $4,000 for an individual and $6,000 for a couple--
despite even more stringent income standards. In fact, the Qualified 
Medicare Beneficiary--Quimby program--enacted in 1988--has not seen an 
update in the assets test over two decades. Were the amount to have 
been indexed to a measure of inflation such as the Consumer Price 
Index, today that amount would nearly equal the assets limit for full 
Low Income Subsidy under Part D. So it is common sense that we align 
the assets tests for Medicare savings program with the full LIS limit 
so that truly needy seniors will realize the help we intended. We act 
to index these asset tests to inflation, and critically, extend 
outreach including through the Social Security Administration. These 
provisions represent long-overdue corrections--not an entitlement 
expansion.
  As I stated earlier, this bill should also help us to change our 
spending trajectory. Because what we spend is in fact more critical to 
Medicare's fiscal health than even the aging demographics of our 
population, this legislation aims to help re-orient our spending to 
assure that Medicare implements more ``best practices,'' beginning with 
greater support for preventive services. This follows what we began 
with the enactment of the Medicare Modernization Act in 2003.
  This bill allows the HHS Secretary to add support for services 
recommended by the U.S. Preventive Services Task Force. This is a key 
step in payment reform. Because the fact is, we can no longer expend 
our first dollar on a disease for an individual's hospitalization. We 
must be more proactive and cost effective.
  Similarly, we address the inequity of access to mental health 
services. Today, beneficiaries pay 50 percent of the cost of outpatient 
mental health services--compared to 20 percent for other care. So as 
the Senate acts to ensure mental health parity in the private sector, 
we must not leave our beneficiaries behind. Tragically, only half of 
seniors with mental health problems receive treatment, and the toll is 
seen in the fact that suicide rates among older Americans far exceed 
those of other age groups.
  This legislation includes provisions of legislation that I introduced 
with Senator Kerry and accomplishes a phased-in elimination of the 
copayment disparity.
  This legislation takes a balanced approach, one which averts unfair 
cuts to providers, and meets the critical needs of our most vulnerable 
beneficiaries.
  Then one could rightly ask: Why are we here? If there was some 
agreement on such priorities, what is the obstacle?
  The answer to that question, as it is so often, lies in how spending 
is paid for. Today, as we consider legislation affecting provider 
payments in particular, the issue of equity is central. When equity is 
considered, the subsidies of private plans in Medicare constitute an 
issue which must be addressed.
  Today we are subsidizing such private Medicare plans by paying an 
average of at least 112 percent above the rate of traditional fee-for-
service Medicare. Last year, the 5-year subsidy cost was estimated at 
$50 billion over 5 years. This year, we have already received revisions 
of cost projections which may indicate the total cost is much higher.
  One might ask why, at a time when we are concerned about the fiscal 
health of Medicare and when we face critical needs, such as those of 
the lowest income beneficiaries, would we spend this sort of subsidy?
  The Chairman of the Medicare Payment Advisory Commission, Glenn 
Hackbarth, succinctly stated the problem last year when he stated that 
``right now, Medicare is sending the signal that we want private plans 
even if they cost substantially more than the traditional Medicare.'' 
He added:

       I think what we need, not just in Medicare, but in the 
     country more broadly, is to send the signal that we want 
     plans that more efficiently manage care.

  I think we have an agreement that we expect these plans to deliver 
value for beneficiaries and taxpayers alike--to employ prevention, 
early screening and detection, and prompt effective care to improve 
health and reduce costs.
  Yet what we have seen in Medicare Advantage is deeply troubling. 
First, there is the paucity of data regarding outcomes. This chart 
quotes the CBO Director Orszag, who decried the absence of 
substantiation of performance, stating he was ``continuing to beg'' for 
data from plans demonstrating performance. He noted the subsidies these 
plans enjoy. He said:


[[Page 12406]]

       It's almost as if they're conducting a variety of 
     experiments in disease management and various other things. 
     And they are doing so with public subsidies.

  Yet while the average Medicare Advantage plan receives a subsidy at 
least 12 percent above traditional Medicare, a new plan type receives 
much more, as much as 121 percent of fee-for-service rates. These 
private fee-for-service plans primarily involve a redesign of the 
Medicare benefits package. So a beneficiary might initially see a plan 
as offering better value, such as offering vision benefits. Yet while 
private fee-for-service plans must cover the same benefits as fee for 
service, they can substantially alter a senior's cost sharing so one's 
out-of-pocket costs can be much higher.
  But the enticement of new benefits and aggressive and even abusive 
marketing practices, as we learned in a number of hearings--I know, Mr. 
President, you were there at some of those hearings in the Senate 
Finance Committee--has resulted in explosive growth in these plans.
  As we see on this chart, it demonstrates the increased enrollment 
from less than 26,000 beneficiaries in 2003 to 1.5 million at the 
beginning of this year. So far this year, another 400,000 beneficiaries 
have enrolled.
  I am pleased we have seen bipartisan agreement to address the 
grievous marketing abuses which have plagued beneficiaries. Many of our 
constituents have been confronted in their homes by high-pressure, 
door-to-door, and telemarketing sales efforts. We have seen seniors 
enticed to events by free meals and gifts and frequently enrolled 
unknowingly in new plan coverage they neither needed nor wanted. Much 
of this has been fueled by high commissions.
  Such abuses led me to introduce a bill with Senator Rockefeller in 
March to ban these practices and protect beneficiaries. In fact, I can 
say my State of Maine has been in the forefront passing legislation on 
its own. States are taking unilateral action to foreclose these 
practices that get people to join plans unnecessarily and adding to 
their costs and their problems.
  The legislation Senator Rockefeller and I introduced has provisions 
that will include prohibitions on the activities I described earlier.
  It is abundantly clear such plans not only cost more and are plagued 
by marketing abuses, but they lack the mandates which HMO and PPO plans 
carry to actually act to improve care. In fact, the Congressional 
Budget Office Director, Peter Orszag, said again, ``The type of things 
we are talking about--disease management, care coordination--is much 
less salient and much less prevalent in private fee-for-service.''
  Also, because private fee-for-service plans are not required to 
establish contracted networks of providers, such plans use deeming, a 
practice in which, by serving a patient, a provider is deemed to have 
accepted the plan's terms. That shortchanges providers. Since these 
plans are also not required to provide care management, they 
shortchange beneficiaries. So we are paying more through subsidies and 
they are providing less and are capturing them through the deeming 
process, which is inherently unfair and extremely costly.
  With these deficits, private fee-for-service plans require subsidies 
to function, and today they are paid far more than the traditional fee 
for service--which I mentioned earlier--and are a large and growing 
share of Medicare Advantage costs. They are subsidized, as I said, as 
much as 121 percent above the rates Medicare was paying local providers 
before this so-called innovation.
  So as we see an escalation in the cost of subsidizing Medicare 
Advantage, it is wholly appropriate that we examine a reduction in 
unfair subsidies to these plans, subsidies that are provided by the 
taxpayers.
  We recognize, as does the administration, that built into these 
higher Medicare Advantage rates is a duplication of the institutional 
medical education payment which institutions already receive directly 
today. The cost of that duplication was estimated at $8.7 billion 
earlier this year. Yet today, with rapid growth in these plans, the 
Congressional Budget Office tells us the cost of the unnecessary 
subsidy is now an estimated $12.5 billion. The fact is, that estimate 
does not reflect a deeper rate of reduction than we discussed 6 months 
ago. It simply reflects the escalation in costs as a growth of these 
subsidized, uncompetitive plans continue.
  So as we examine areas in which we could save, there can be no doubt 
that the duplicate payment is a prime candidate. In fact, the Medicare 
Payment Advisory Commission, MedPAC, recommended we bring all Medicare 
Advantage plans to parity and specifically recommended eliminating this 
duplicate payment, as indicated by their comments on this chart.
  On the latter recommendation, the President has agreed we must 
eliminate the duplicate payment. I note the President included a 
proposal in his budget this year to eliminate it, but he has imposed 
reductions which would affect the rate of reduction we have now 
discussed, which would reduce subsidy spending by $12.5 billion. The 
President also prefers to eliminate payments to the institutions 
responsible for this Institutional Medical Education Program and 
instead would rely on plans to funnel payments to teaching 
institutions. Although we differ with him in terms of how to eliminate 
the duplicate payment, reducing the plan subsidy for this savings is 
reasonable, and agreement should be possible.
  As I said earlier in my statement, it is a difference of $3 billion, 
and therein lies the difference in the subsidy. The Congressional 
Budget Office recalculated the original cost of savings of achieving 
this reduction in the Institutional Medical Education Program earlier 
this year at $8.5 billion. They recalculate to $12.5 billion. You say: 
Why won't the President support that now? It is the same savings, the 
same plan. It has been recalculated, and we achieve greater savings in 
order to offset the additional provisions we provided for the lowest 
income beneficiaries. So it seems to me this is an area in which we 
should achieve agreement. If we agree we should eliminate the duplicate 
payment--and it has now been estimated in savings from the 
Congressional Budget Office at $12.5 billion instead of $8.7 billion--
we ought to be able to agree on the pending legislation.
  This legislation effects a second savings in Medicare Advantage by 
eliminating deeming wherever two managed care plans have succeeded in 
establishing networks. It simply makes sense that if managed care plans 
can contract providers, these private fee-for-service plans should as 
well.
  By reducing the duplicate IME payment by $8.7 billion and modifying 
the deeming provisions for plans, this legislation realizes $12.5 
billion in savings. Still just less than one-fourth of the current 
Medicare Advantage subsidy cost.
  I note these savings fall far short of the fiscal responsibility 
which MedPAC, the Congressional Budget Office, and others suggest is 
absolutely necessary and vital. Yet some still claim these savings 
jeopardize Medicare Advantage. But the fact is, they are modest in 
terms of changing an environment which is both fiscally irresponsible 
and anticompetitive.
  For those who suggest subsidies should be maintained, they must 
answer some critical questions: When will these plans be economically 
viable? When will savings be realized by the taxpayers who are 
providing these subsidies to private insurance companies, in fact, far 
more than the traditional fee for service? When will more effective 
care be demonstrated? Again, they don't provide for prevention, 
effective disease management, screening or many of those tests that are 
so essential today that a provider in traditional fee for service, and 
yet not under these private plans, who are getting paid more than what 
we pay under fee for service in Medicare. What costs must the rest of 
Medicare bear as a result of these anticompetitive subsidies?
  The fact is the limited savings we accomplish in this legislation do 
not even threaten the continued operations of these uncompetitive 
plans. Even Wall

[[Page 12407]]

Street knows that. I note in this final chart that an analyst for 
Goldman Sachs actually stated that savings exceeding those we make here 
do not affect the viability of these plans and that the Medicare 
Advantage Programs actually could ``absorb $15 billion in cuts over 5 
years without materially undermining the fundamentals.''
  As I said earlier, we are using $12.5 billion, not even $15 billion, 
and they are saying it would have no negative impact on those private 
programs.
  Further, we should, in fact, be fostering competition. In fact, that 
is what it was all about originally, providing those subsidies so there 
would be some competition. Business will respond, they said, and 
thereby achieve some of the objectives on which these plans were 
predicated.
  There is always political risk. As Simon Stevens of United Health 
Care noted, ``There is always political risk in government programs,'' 
he said, ``but we will weather it by evolving as Medicare evolves.''
  There are urgent Medicare financing needs today which must be met. We 
must fix the physician payment formula. We must reform Medicare to see 
that care is improved and beneficiaries and taxpayers receive better 
value. We have so much more to do. Yet here we are being stymied by a 
difference of less than two-tenths of 1 percent of Medicare spending, 
that all is accomplished by reducing the subsidies to private health 
insurance companies. That is the difference in the pending legislation 
and those who object to it.
  This legislation, in fact, reflects many issues on which we have had 
bipartisan agreement. It bridges the critical gap between us in 
considering the vital and essential requirements of beneficiaries, by 
taking actions to see best practices emphasized and low-income 
assistance standards are at least updated for inflation. It also acts 
to see that Medicare policies are not penny-wise and pound-foolish.
  I hope we will see this very modest compromise on this legislation 
that will produce progress for the providers, for current 
beneficiaries, and for generations to come to achieve the savings we 
think is essential--and it is offset because we think that is the 
fiscally responsible approach to take--and also not to skew 
disproportionately the subsidies we are providing to private health 
insurance companies for private fee for service, for both to work in a 
competitive fashion, and what we are seeing are subsidies growing by 
leaps and bounds.
  To reach that compromise, we have to support this legislation. 
Hopefully, the Senate will express its support for sound fiscal policy. 
Hopefully, we can override the cloture. If that fails, I hope we can, 
again, come to together and resolve these differences and demonstrate 
to the American people that we have the capacity to solve problems at 
this very crucial juncture in our Nation's history.
  Mr. SPECTER. Mr. President, this is a very important bill for reasons 
which I am discussing in this statement. I believe that it is vital for 
the Senate to take up this important measure to have open debate to 
give Senators an opportunity to offer amendments and to have the Senate 
work its will on these important questions.
  As noted in previous floor statements, I have been concerned about 
the majority leader's practice of employing a procedure known as 
filling the tree, which precludes Senators from offering amendments. 
That undercuts the basic tradition of the Senate to allow Senators to 
offer amendments. Regrettably, this has been a practice developed in 
the Senate by majority leaders on both sides of the aisle, so both 
Republicans and Democrats are to blame.
  I announced publicly at a Senate Judiciary Committee executive 
session this morning, June 12, 2208, that I would vote with Senator 
Baucus for cloture if I knew the majority leader would not fill the 
tree. In a telephone conversation this afternoon, June 12, 2008, 
Majority Leader Harry Reid advised me that he would not fill the tree.
  This will provide an opportunity for a full range of debate and 
decisions by the Senate on many important issues.
  On the Medicare bill specifically, S. 3101 has a number of issues 
which are important to Medicare beneficiaries in Pennsylvania and 
across the Nation. Foremost of those issues is the prevention of a 
10.6-percent reduction in the Medicare reimbursement for physicians. A 
decrease of this size could result in doctors limiting the number of 
Medicare beneficiaries they take on as patients or refusing to take 
them on as patients at all. To resolve this grave problem, the 
legislation prevents the scheduled reduction, continues the current .5 
percent increase for 2008, and provides an increase of 1.1 percent for 
2009. This is a needed increase that will improve access to physicians 
for seniors.
  This legislation also contains an important provision to extend the 
section 508 wage index reclassification program. This program, 
established in the Medicare Modernization Act in 2003, provides 
important funding for hospitals that have been disadvantaged by 
Medicare's wage index reclassification. This is of particular 
importance in northeastern Pennsylvania where hospitals struggle to 
meet the wages needed to keep employees from commuting to other areas 
which have a higher reimbursement rate. This is an important extension; 
however, a permanent solution is needed to solve this problem for all 
hospitals.
  I am informed that the bill will include a delay in the Medicare 
durable medical equipment, DME, competitive bidding program. This is 
critical to western Pennsylvania, as it is one of the regions selected 
to begin the program. While competitive bidding can be productive in 
lowering the cost of medical equipment, the manner in which this 
program was implemented was unacceptable. During the competition for 
bids, half of the bids were disqualified, often for clerical problems. 
Further, the program is set to begin in just over 2 weeks and seniors 
have not been notified of these changes. This legislation will delay 
the implementation of this program to allow for the proper 
implementation of this program and correction of these problems.
  I am also informed that the bill will include a provision to increase 
Medicare payments to oncologists and other physicians for the cost of 
patient treatment. Physicians are facing shortfalls in their 
reimbursement, especially pertaining to cancer treatment. This 
provision will provide an accurate and up-to-date reimbursement for 
drug costs, ensuring cancer treatment will be accessible to Medicare 
beneficiaries.
  I am concerned about a change that this legislation makes in the 
ability of beneficiaries to purchase power wheelchairs. S. 3101 
requires the rental of standard wheelchairs for 13 months instead of a 
physician determining if the beneficiary should purchase the equipment 
immediately. This provision removes the problem of purchasing 
wheelchairs for short term users but increases the cost 5 percent for 
the purchase after those 13 months. To insure that beneficiaries get 
the wheelchairs they need without overspending, a physician should be 
required to certify that a power wheelchair is needed for at least 13 
months. I am confident as we consider this bill we can work out the 
differences we have and come to an agreement.
  Mr. ENZI. Mr. President, today, we will continue to discuss the 
political exercise surrounding the Medicare ``doc fix'' bill. I am 
hopeful that after the vote this afternoon, bipartisan discussions can 
resume so that we can get a bill to the Senate floor that we can all 
support. While others have fully outlined all of the problems with the 
process and content of S. 3101--the Democrats version of the bill--I 
want to take the time to discuss a small aspect of the Republican 
version of the bill.
  Just last week, I came to the floor to discuss Senator Thomas, 
acknowledging that just over a year ago the State of Wyoming and our 
Nation lost one of the great cowboys ever to ride this land. Although a 
year has passed since Craig left us, his spirit is alive and it is felt 
by all of us within this body. Work he championed on behalf of Wyoming 
residents and all Americans is ongoing today. In fact, we continue to 
acknowledge his great work to improve health care in rural areas within

[[Page 12408]]

the Grassley Medicare bill--the Preserving Access to Medicare Act.
  There is a whole subtitle named after Senator Thomas with provisions 
to assist providers and patients in rural areas. These provisions will 
help keep the doors open for rural hospitals so that critical care is 
available. In addition, they will ensure that individuals in rural 
areas have the emergency transport services available to get them from 
the scene of an accident to immediate care, to expand access to 
laboratory services so one can quickly obtain test results for a 
potential cancer diagnosis, and to ensure greater access to telehealth 
capabilities at skilled nursing facilities and dialysis centers. These 
are just to name a few of the key rural health provisions. Given the 
work of Senator Thomas, I do hope that these provisions can be 
maintained in future bipartisan discussions.
  Mr. CARDIN. Mr. President, I rise in strong support of S. 3101, the 
Medicare Improvements for Patients and Providers Act of 2008.
  This bill merits the support of every Senator. Action on this 
legislation is mandatory now because, in 18 days, the temporary fix we 
passed at the end of last year for providers will expire. If we fail to 
act, reimbursements to physicians and other providers who are paid 
under the physician fee schedule will be cut by 10.6 percent.
  On Tuesday, I met for over an hour with several physicians from 
Maryland. They cannot sustain a 10 percent cut in their Medicare 
payments, and they know that if these cuts are put into effect, many of 
their colleagues will stop accepting new Medicare patients into their 
practices.
  These pending cuts are the result of a flawed system that pegs 
reimbursement to the growth of GDP. We all recognize that this system, 
known as SGR, does not work. Every year since 2001, Congress has had to 
act to prevent the cuts from going into effect. We know that SGR must 
be repealed.
  I have introduced legislation in past years to eliminate SGR and 
replace it with a system that reimburses based on the actual reasonable 
costs of providing care. S. 3101 provides another temporary fix through 
December 31, 2009. That is sufficient time for Congress, working with a 
new administration and the provider community, to develop a new system 
of reimbursement that will contain unnecessary increases in volume 
while ensuring that reasonable costs are covered.
  But this bill is so much more than a ``doctor fix bill.'' Also 
expiring on June 30 is the exceptions process for outpatient therapy 
services. Therapy caps for physical, occupational and speech language 
therapy were added to Medicare law more than 10 years ago for purely 
budgetary reasons. The authors of that provision had no policy 
justification for limiting services, and the amount of the caps was 
purely arbitrary.
  Unless the exceptions process is extended, seniors recovering from 
more complex conditions, such as hip replacement and stroke, will face 
unreasonable and arbitrary dollar limits on the rehabilitation services 
available to them.
  This urgently needed legislation will help not just providers, but 
also the millions of seniors that Medicare was created to serve. This 
Senator is proud that the bill's title reflects the right priorities 
for Medicare--this is The Medicare Improvements for Patients and 
Providers Act.
  The 43 million seniors and persons with disabilities who rely on 
Medicare deserve a program that meets their health care needs. Our goal 
should be to ensure that Medicare provides comprehensive, affordable, 
quality care. S. 3101 makes important steps toward a better Medicare.
  It is significant that Chairman Baucus has led with important 
beneficiary improvements. In 1997, I worked in a bipartisan way to add 
to the Balanced Budget Act the first-ever package of preventive 
benefits to the traditional Medicare Program. That was 11 years ago. At 
that time, the members of the Ways and Means Committee recognized what 
medical professionals had long known--that prevention saves lives and 
reduces overall health care costs.
  Preventive services such as mammograms and colonoscopies are vital 
tools in the fight against serious disease. The earlier that breast and 
colon cancer are detected, the greater the odds of survival. For 
example, when caught in the first stages, the 5-year survival rate for 
breast cancer is 98 percent. But if the cancer has spread, the survival 
rate drops to 26 percent. If colon cancer is detected in its first 
stage, the survival rate is 90 percent, but only 10 percent if found 
when it is most advanced.
  Seniors are at particular risk for cancer. In fact, the single 
greatest risk factor for colorectal cancer is being over the age of 50 
when more than 90 percent of cases are diagnosed. Sixty percent of all 
new cancer diagnoses and 70 percent of all cancer-related deaths are in 
the 65 and older population. Cancer is the leading cause of death among 
Americans aged 60-79 and the second leading cause of death for those 
over age 80. So preventing cancer is essential to achieving improved 
health outcomes for seniors. Screenings are crucial in this fight.
  In addition to improving survival rates, early detection can reduce 
Medicare's costs. Under Chairman Conrad's leadership on the Budget 
Committee, we have had fruitful debates about the long-term solvency of 
Medicare. A more aggressive focus on prevention will help produce a 
healthier Medicare Program.
  Let me give you some examples. Medicare will pay on average $300 for 
a colonoscopy, but if the patient is diagnosed after the colon cancer 
has metastasized, the costs of care can exceed $58,000.
  Medicare will pay $98 for a mammogram, but if breast cancer is not 
detected early, treatment can cost tens of thousands of dollars. One 
drug used to treat late stage breast cancer can cost as much as $40,000 
a year. There is no question that these vital screenings can produce 
better health care and more cost-effective health care.
  The 1997 law established place improved coverage for breast cancer 
screenings, examinations for cervical, prostate, and colorectal cancer, 
diabetes self-management training services and supplies, and bone mass 
measurement for osteoporosis. Since then, Congress has added screening 
for glaucoma, cardiovascular screening blood tests, ultrasound 
screening for aortic aneurysm, flu shots, and medical nutrition therapy 
services. In addition, in 2003, a Welcome to Medicare Physical 
examination was added as a one-time benefit for new Medicare enrollees 
available during the first 6 months of eligibility.
  But we can only save lives and money if seniors actually use these 
benefits. Unfortunately, the participation rate for the Welcome to 
Medicare physical and some of the screenings is very low. I have spoken 
with primary care physicians across my State of Maryland about this. 
One problem is the requirement to satisfy the annual deductible and 
copays for these services.
  Patients are responsible for 20 percent of the cost of a mammogram, 
between $15 and $20. Most colonoscopies are done in hospital outpatient 
departments, where their copay is 25 percent, or approximately $85. Our 
seniors have the highest out of pocket costs of any age group and they 
will forgo these services if cost is a barrier.
  The other barrier to participation is the limited 6-month eligibility 
period for the one-time physical examination. By the time most seniors 
become aware of the benefit, the eligibility period has expired. In 
many other cases, it can take more than six months to schedule an 
appointment for the physical exam and by that time, the patients are no 
longer eligible for coverage.
  I have introduced legislation to eliminate the copays and deductibles 
for preventive services and to extend the eligibility for the Welcome 
to Medicare physical from 6 months to 1 year. My bill would also 
eliminate the time consuming and inefficient requirement that Congress 
pass legislation each time a new screening is determined to be 
effective in detecting and preventing disease in the Medicare 
population. It would empower the Secretary of Health and Human Services

[[Page 12409]]

to add ``additional preventive services'' to the list of covered 
services. They must meet a three part test: (1) They must be reasonable 
and necessary for the prevention or early detection of an illness; (2) 
they must be recommended by the U.S. Preventive Services Task Force, 
and (3) they must be appropriate for the Medicare beneficiary 
population.
  S. 3101, the Baucus bill, incorporates several elements of my bill in 
the very first section, and I want to thank the Finance Committee for 
including them. It will waive the deductible for the physical 
examination, extend the eligibility period from 6 months to 1 year, and 
allow the Secretary to expand the list of covered benefits.
  These provisions are supported by the American Cancer Society, AARP, 
the Alliance for Retired Americans, the Leadership Council of Aging 
Organizations, SEIU, the National Committee to Preserve Social Security 
and Medicare, the American College of Preventive Medicine, the National 
Hispanic Medical Association, the American Academy of Nursing, and many 
more groups.
  This bill will also help low income seniors by raising asset test 
thresholds in the Medicare Savings Programs and targeting assistance to 
the seniors who most need it.
  As this Congress continues to make progress toward passing a 
comprehensive mental health parity bill, the Baucus-Snowe bill steps up 
for our seniors and provides mental health parity for Medicare 
beneficiaries, moving their copayments from 50 percent to 20 percent 
gradually over 6 years. Depression, bipolar disorder, and other mental 
illnesses are prevalent among seniors, and yet fewer than half receive 
the treatment they need. This provision will help them get needed 
services.
  Section 175 of the Baucus bill will ensure that a category of drugs 
called benzodiazepines are covered in Medicare Part D. When the 
Medicare prescription drug benefit took effect on January 1, 2006, 
millions of beneficiaries found that the prescription medicines they 
took were not covered by the new law. A little-known provision in the 
Medicare prescription drug bill actually excluded from coverage an 
entire class of drugs called benzodiazepines. These are anti-anxiety 
medicines used to manage several conditions, including acute anxiety, 
seizures, and muscle spasms. The category includes Xanax, Valium, and 
Ativan. Most are available as generics.
  They constitute the 13th leading class of medications in the U.S., 
with 71 million prescriptions dispensed in 2002. A study of dual-
eligibles in nursing homes found that 12 percent of patients had at 
least one prescription for a benzodiazepine. This exclusion has led to 
health complications for beneficiaries, unnecessary complexity for 
pharmacists, and additional red tape for the states. Beneficiaries who 
are not eligible for Medicaid have had to shoulder the entire cost of 
these drugs or substitute other less effective drugs. In 2005, I first 
introduced legislation that would add benzodiazepines to the categories 
of prescription drugs covered by Medicare Part D and Medicare advantage 
plans.
  I want to thank Chairman Baucus for recognizing the importance of 
this coverage and adding section 175 to this bill. Without this 
provision, dual eligibles would have to rely on continued Medicaid 
coverage for benzodiazepines. Medicare beneficiaries who are not 
eligible for Medicaid will have to continue to pay out-of-pocket for 
them. For those who cannot afford the expense, their doctors would have 
to use alternative medicines that may be less effective, more toxic, 
and more addictive. This is a significant improvement for our seniors 
who are enrolled in Part D and for the fiscal health of our States.
  The Baucus bill is paid for by slight reductions to the overpayments 
that the federal government makes to private health plans. The 
nonpartisan Medicare Payment Advisory Commission, MedPAC, has 
recommended that we equalize payments between Medicare Advantage and 
traditional Medicare.
  As we discuss the solvency of the Medicare Program, we must take note 
that private health plans are not saving the Federal Government money. 
In fact, they are costing us money. I was a member of the Ways and 
Means Committee when health plans approached us with an offer. If the 
Federal Government would pay them 95 percent of what we were spending 
on the traditional Medicare Program, they would create efficiencies 
through managed care that would save the Federal Government billions of 
dollars each year. They promised to provide enhanced coverage, meaning 
extra benefits as well as all the services covered by traditional 
Medicare, for 95 percent of the cost of fee for service. Congress gave 
them a chance to do just that.
  Instead, what we saw across the country was cherry-picking of 
younger, healthier seniors. Each time Congress indicated that it would 
roll back their overpayments to a more reasonable level, they responded 
by pulling out of markets. In Maryland, the number of plans declined 
over a 3-year period from eight to one, abandoning thousands of 
seniors. Since 2003, when payments were substantially increased, the 
number of plans has steadily increased as well, but at too high a cost 
to beneficiaries, taxpayers, and the future of the Medicare Program.
  Right now, these plans are paid up to 19 percent more than the amount 
that we would pay if these seniors were in fee-for-service Medicare. 
Over 10 years, we are overpaying them by more than $150 billion.
  That is enough to make significant valuable improvements in the 
overall Medicare Program, or to permanently repeal the sustainable 
growth rate formula. It is time, for the health of the Medicare 
Program, to pay these plans appropriately. This bill would make small 
reductions to these overpayments as well as prohibit the abusive 
marketing practices, such as cold calling, door-to-door sales, and 
offering incentives such as free meals, which have led to many seniors 
being enrolled in private plans without their knowledge or consent.
  This is a balanced and responsible bill that addresses immediate 
reimbursement concerns while setting the foundation for a higher 
quality, more cost-effective Medicare Program. I urge my colleagues to 
support the motion to proceed to S. 3101 and to vote for this well-
crafted bill.
  I yield the floor. I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Salazar). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                                 Taxes

  Mr. GRASSLEY. Mr. President, yesterday afternoon I discussed the 
burden that high gas prices are having on all Americans, and not just 
on my constituents in Iowa but all over this great country. I think now 
that most of my colleagues in the House and Senate know that high gas 
prices mean less discretionary income for people--less discretionary 
income to spend at the mall, to spend at the farmers market, less 
discretionary income to buy ice cream on hot summer days, and less 
discretionary income to save for a rainy day.
  I can assume my Democratic colleagues know that actions that take 
discretionary income away from the American people are detrimental to 
those people and detrimental to the overall economy--detrimental to 
their way of life and detrimental to our country's future. I guess I 
don't have to assume folks on the other side know this. This body has 
been debating the issue of escalating oil prices and energy for the 
better part of this week. I heard countless accounts from my Democratic 
colleagues about how their constituents are hurting. So I think my 
friends on the other side get it. They get that taking the hard-earned 
dollars out of the pockets of their constituents is detrimental to 
those constituents.
  What my Democratic friends don't get is that raising taxes has the 
same effect. Raising taxes takes hard-earned

[[Page 12410]]

dollars out of the pockets of their constituents. Don't folks on the 
other side think this is a problem? It is a problem for their 
constituents' way of life, and it multiplies into problems for our 
economy. It is a problem for our country's future. But I don't think 
the leadership on the other side understands this fundamental fact. So 
I guess folks on the other side just don't get it.
  Is this change Americans can believe in? If they are not being told 
the entire story, how can they know what to believe? If the leadership 
on the other side isn't telling the entire story, the folks in the 
media need to. And I believe folks in the media are well enough 
educated to know what the truth is and to spread the truth. So I 
challenge our media friends and beltway pundits--a little like I did 
yesterday in remarks here--to report that higher taxes means less 
discretionary income, it means slower economic growth, and it won't 
mean more revenue for the Government to spend. It is too bad that 
people are of the frame of mind that if you raise tax rates, you bring 
in more revenue, and if you reduce tax rates, you lower revenue. I like 
to disabuse people of those facts.
  Yesterday, I also told the beltway punditry and related press people 
to stop referring to the bipartisan tax relief of 2001 as the Bush tax 
cuts. These are the talking points of the leadership on the other side 
of the aisle that the press seems to somehow eat up because it gets 
repeated. It is just a fact of life: Bush gets all the credit for the 
tax cuts. Well, it is intellectually dishonest, and it gives Americans 
the impression that the bipartisan tax relief that was passed back 
then--7 years ago--is bad.
  But then again, what should we expect from the other side of the 
aisle and their leadership's campaign? Everything coming out of that 
shop tends to be poll-driven. Take a poll the night before, and 
whatever the people are telling you the night before, that is what the 
message is the next day as opposed to being more concerned about good 
policy being good politics.
  The 2001 tax relief put more money into the pockets of hard-working 
Americans, and they are better off for it. Sure, the leadership on the 
other side of the aisle wants the voters to believe tax relief is bad. 
The junior Senator from Illinois wants the voters to believe raising 
taxes will solve all problems. The distinguished Senator also wants 
voters to believe taxes will only be raised on people who earn lots of 
money, where there isn't the money to solve all the problems. His party 
wants people to believe there are no downsides for taxpayers, no 
downsides for economic growth if income taxes go up by 10 percent, even 
if taxes are raised on families making $250,000 or more.
  Now, it is too bad, but the media seems to believe this propaganda 
and ignores the fact that the economics behind it are not responsible 
and factual, because that is the report they put out there, so that is 
what the people hear.
  The Democratic leadership has also successfully convinced the media 
that raising taxes will bring in more revenue. I want to remind the 
media that the bipartisan tax relief brought in more revenue than was 
projected, much more revenue than what the 1993 Clinton tax increase 
brought in over a comparable period.
  I have a chart here that I would like the media to take a look at, a 
chart which illustrates that lower taxes have generated record 
revenues.
  See, you have the actual revenues that came in and you have the 
projected revenues before we lowered taxes. This chart illustrates that 
Federal tax revenues have been and generally continue to be coming into 
the Federal Treasury at or above the historical average--and the 
historical average, the way I say it, is the last four decades--of 
about 18.2 percent of gross domestic product. Now, what does that 18.2 
percent of gross domestic product mean? It means that by lowering the 
tax rates, as we did in 2001, it does not in any way gut Federal tax 
revenue.
  But how easy is it to explain to people who don't look at economics 
every day that if you lower tax rates, you are going to bring in less 
revenue; if you raise tax rates, you are going to bring in more 
revenue? Because that is kind of what common sense might tell you. But 
the study of economics and what really happens by the facts are two 
different things. You can keep tax rates where they historically have 
been for the last 40 years, about 18 to 19 percent of gross domestic 
product--and when they were at 20, we reduced them down to that point; 
in fact, even a little bit less growth has brought them back up--and 
you can do it without hurting the Federal Treasury. In fact, you can 
enhance it. Do you know why? Because of the dynamics of our economic 
system, of our market system. When you let 137 million taxpayers, with 
more money in their pockets, decide how to spend the money--and 
probably in 137 million different ways--it does more economic good than 
when 535 Members of Congress decide how to do it. But you know, some 
have the attitude around here that the judgment of 535 Members of 
Congress is much better than the judgment of 137 million taxpayers, so 
we don't need to raise taxes in order to generate revenue.
  So to the media people: Don't believe the Chicken Littles. I have a 
chart here of Chicken Little, who says that the sky is going to fall if 
we keep taxes low.
  I can't let my colleagues on the other side and some of the skeptics 
in the press say to the American public that if you earn less than 
$250,000 a year, you won't see higher taxes, so I have these news 
flashes:
  News flash: You don't have to be earning $250,000 to invest money in 
the stock market.
  News flash: You don't have to be earning $250,000 to have real estate 
holdings.
  News flash: You don't have to be earning $250,000 to have your 
savings in mutual funds.
  All those flashes prove that if you earn less than $250,000 a year 
and you hold these investments, guess what--you will be paying more 
taxes. Let me take a closer look so I can demonstrate that is what is 
going to happen.
  In 2003, Congress reduced the top tax rate on capital gains, lowering 
taxes again from 20 percent to 15 percent. Congress also did the same 
thing for dividend income, tied it with the capital gains tax rate at 
15 percent. For lower income taxpayers, we thought they ought to have 
an incentive to save, so the tax rate on capital gains and dividends 
for low-income taxpayers is zero--that is zero with a ``z.'' Millions 
of low-income taxpayers receive dividends and capital gains. All of 
these taxpayers are not making more than $250,000.
  To help out the media, I will illustrate these points with yet 
another chart. As you can see from this chart, over 24 million tax 
returns reported dividend income. In Iowa, for instance--my State--over 
299,000 families and individuals claimed dividend income on their 
returns.
  Another chart we have deals with capital gains. The first one dealt 
with dividends, now this one with capital gains. Nationally, 9 million 
families and individuals claimed capital gains--9 million families--and 
in my State of Iowa, over 127,000 of them. Now, that is a lot of 
taxpayers who are not earning a lot of money. So I want the media to 
report that. It doesn't seem to get reported. I want to see news 
reports that say something like this: ``Even if the other side's 
Presidential candidate's plan raises taxes on folks making $250,000, 
millions of taxpayers make less than $250,000 and will still see a tax 
increase.''
  That is end of my proposed quote, but you will never see it in the 
newspaper.
  I also want my friends in the punditry and media to connect the dots. 
If more people are paying higher taxes, the result is less 
discretionary income and of course slower economic growth. That is the 
same thing that is going on with high gas prices. The press doesn't 
seem to have a problem reporting that fact, but it still ends up with 
the consumer having less discretionary income.
  I fought both Democrats and Republicans. I hope I have a reputation 
of taking on a cause and not worrying about whether it is a Republican 
cause or Democrat cause. So I have fought both to ensure that our 
country is on

[[Page 12411]]

the right course. That course must be and is economic prosperity. I 
wish to see a real discussion of the negative implications of changing 
current economic policy. With high gas prices squeezing taxpayers, it 
is more compelling than ever.
  Let's clear away the fog about what is meant to be negative about the 
Bush tax cuts, because broad-based tax increases are not gauzy ``feel 
good'' economic changes. Let's examine the benefit of keeping taxes 
low.
  While I have the floor, I wish to speak on an issue that is coming up 
for a vote. This is the Medicare vote in a little while.
  The vote we are going to take later today is a very important one--
important for our senior citizens and important for all health care 
practitioners around the country. The outcome of that vote will 
determine whether we begin working together again on a bill that the 
President will sign. For the sake of 40 million Medicare beneficiaries, 
I am here now to urge my colleagues to defeat the cloture motion today. 
Then we can get to work on a bipartisan basis and write a bill that can 
be signed into law. That is something Senator Baucus and I know how to 
do.
  This afternoon the Senate will be voting to move forward on a bill 
that will be vetoed and will mean a lot of lost time--not only for the 
Senate, but we have to get these things done by July 1. With a 
Presidential veto, I doubt we will. This is a pointless exercise, then, 
that can be stopped in its tracks by a ``no'' vote on cloture.
  What is worse, the reality is that the bill is not even ready for 
serious consideration. Members of the Senate, it is very incomplete, 
obviously incomplete. It was introduced with blanks and brackets. It 
will not become law.
  It cuts oxygen reimbursement. It cuts power wheelchair reimbursement. 
It threatens future physician updates. The danger is July 1, doctors 
get cut 10.6 percent if we do not intervene. It is a partisan bill that 
delays bipartisan consideration of the Medicare bill.
  While the Senate wastes time with this bill, millions of taxpayers' 
dollars in administrative costs are also going to be wasted because the 
Center for Medicare Services has to program their system to not have 
the physicians' pay cut go into effect July 1. But they can only do 
that if Congress can pass a bill that can be signed by the President.
  Voting for this bill is the same as asking for the physician pay cut 
to go into effect. If it does, then CMS has to potentially hold 
millions of claims, to process them later. That costs millions and 
millions of dollars a week. If the Senate votes cloture on this bill, 
we may as well be taking a match to millions of taxpayers' dollars.
  We had been working in a bipartisan process that could get us a bill 
that could be signed into law. For some reason the majority walked away 
from the table. That was kind of recently, during the end of May. With 
all due respect to my friends on the other side of the aisle, in the 3 
weeks since they have produced a bill that, for all the rhetoric we are 
hearing about it, is not worth the paper it is printed on. It will not 
become law. It will be vetoed.
  Meanwhile, doctors in this country are looking at the calendar, 
wondering what their payment will be after June 30, and wondering 
whether they can still afford to see Medicare patients. They are 
wondering if they have enough cash reserves if Congress doesn't get its 
act together.
  I want to say something to the doctors back home who are listening to 
this debate. They tend to be very busy, so I don't expect a lot of them 
to be listening, but if they are I want to have them hear this. Your 
insider Washington lobbyists are telling you that supporting cloture is 
the best way to prevent the physician pay cut from going into effect 
July 1. I think these high-paid lobbyists here in Washington are giving 
you, the family practitioners and surgeons and interns back home, bad 
advice. It is a good thing they are not giving the advice to real 
patients, as you do, if this is the kind of judgment they would use. 
The fact is, a vote in support of cloture is the absolute worst thing 
that could happen if you want the physician payment update addressed by 
the date it ought to be ready for CMS to carry it out, July 1.
  If 60 Senators support cloture we will move to pass a bill out of the 
Senate. Of course that will be a bill that will be vetoed. Then the 
Senate will sit down with the House on a partisan basis and produce a 
compromise that has even more spending yet, and is even more liberal 
and more certain to be vetoed. Then it will be voted on in the House 
and come back here for a vote. Then, finally, it will go to the 
President where it will be vetoed. Then we will have a veto override 
that will certainly fail.
  Then and only then--how many weeks away that is I don't know--we will 
sit down again on a bipartisan basis to write a bill that will become 
law. Given how quickly things move around here, that could well be at 
election time. If cloture fails, I am ready to roll up my sleeves and 
go to work tonight. So, to all the doctors listening to this wherever 
you are--in your hospitals, your homes--and to folks who pay dues to 
groups such as the American Medical Association and to the American 
College of Physicians, hear me when I say the people telling you that 
supporting cloture is the way to get the physician payment update done 
fastest do not deserve the jobs they hold and the hundreds of thousands 
of dollars you pay them. The answer is a simple one. We need to defeat 
the cloture motion today and we need to get back to bipartisan work to 
protect Medicare for America's seniors and the providers who serve 
them.
  Yesterday Senator McConnell, the Republican leader, and I introduced 
a bill, S. 3118, to address the problems we face in Medicare. The 
Democrats are blocking our bill from getting a vote today. It is too 
bad, because this is a very good bill. I spoke of some of the 
provisions of this bill in the last several days. It is a bill that 
clearly serves Medicare beneficiaries. Our bill reduces medication 
errors with stronger e-prescribing provisions. This will help ensure 
that our seniors' health care is not compromised by duplicative, 
dangerous, and incompatible prescriptions.
  Our bill helps patients who have had a heart attack with cardiac and 
pulmonary rehab. Our bill ensures that seniors who need access to 
outpatient therapy services will continue to receive the therapy they 
need.
  I am very pleased our bill pays a tribute to our beloved departed 
colleague, Senator Craig Thomas of Wyoming, by including a number of 
provisions that protect access for beneficiaries in rural America. 
Specifically, our bill would accomplish helping rural America by 
addressing inequitable disparities in the Medicare reimbursement 
between rural and urban providers, and helps ensure these providers are 
able to keep their doors open.
  By continuing to fund two important and very successful programs to 
combat diabetes, our bill helps people with that dread health problem.
  Finally, our bill includes a number of extensions to help low-income 
seniors and families.
  As we close this debate--and the vote is about 35 minutes away--I 
think the vote is a very simple one. The President will sign a bill 
that preserves Medicare for American seniors and the providers who 
serve them. The President will sign a bill that will provide increases 
in payments for rural health care in America. The President will sign a 
bill that reduces payments to Medicare Advantage. The President will 
also sign a bill promoting value-based purchasing, electronic 
prescribing, and electronic health records. The President will then 
sign a bill that does not require cuts in oxygen payments or payments 
for power wheelchairs.
  Unfortunately, regarding the bill we will be voting cloture on, the 
vote is to move forward on a bill that is not a bill. I have described 
that. I am not going to go into greater detail.
  People back home often don't understand votes on procedural motions 
such as the one we call cloture, which we will have at 3. But this one 
ought to be very easy to understand. Voting for this bill is a step 
backward; it is not a step forward. It will not become law, and we have 
to get something to the

[[Page 12412]]

President that he will sign by July 1 to avoid doctors taking Medicare 
cuts of 10.6 percent.
  I ask my colleagues to vote ``no'' on the cloture motion so we can 
get to work on a bill the President will sign. Let's set aside partisan 
games and get to work protecting Medicare for America's seniors.
  I yield the floor.
  Mr. President, since I do not see other speakers, I suggest the 
absence of a quorum.
  The PRESIDING OFFICER (Mr. Nelson of Nebraska). 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. Mr. President, unless we act, on July 1 the law will cut 
Medicare payments to doctors by 10 percent. Today, we have an 
opportunity to vote on proceeding to a bill that will stop that cut. In 
addition to averting the 10-percent payment cut, the bill on which we 
will vote today will also make important improvements for 
beneficiaries.
  It will help those with very modest incomes to get the help they 
need, and it will expand access to preventative benefits in Medicare. 
We should all agree that prevention is critical to moving our health 
care system from one that treats disease to one focused on wellness.
  The bill includes a provision intended to give a boost to primary 
care physicians. These represent a downpayment on changes that I would 
like to consider in the near future to advance the role of our front-
line physicians.
  The bill will improve access to health care in rural areas. The bill 
includes many policies from the Craig Thomas Rural Hospital and 
Provider Equity Act, all supported so strongly by so many Senators.
  The bill will lend a hand to pharmacists. Pharmacists face so many 
challenges right now. And the bill will help ambulance providers. 
Today, these first responders must contend with record high and rising 
gas prices.
  That is what this bill will do. It is a good bill, it is a balanced 
bill, and it is a bill that my colleagues should be proud to support. 
Let me also talk about what this bill would not do. I have heard some 
claims made about the bill. I would like to set the record straight.
  First, the bill would not make drastic cuts to Medicare Advantage 
payments. This is not the House-passed CHAMP bill. Although I believe 
there is justification for making significant reductions to Medicare 
Advantage benchmarks, this bill will not do that. This bill would not 
affect the benchmarks in Medicare Advantage.
  Second, this legislation will not eliminate private fee-for-service 
plans. What it will do instead is take away the ability of these plans 
to ``deem'' doctors and hospitals into their networks. Right now 
private fee-for-service plans are permitted to circumvent network 
requirements. They can deem any Medicare provider to be part of the 
plan network. They can do so without any formal agreement between the 
provider and the private fee-for-service plan.
  What does that mean? That means that doctors and hospitals are 
automatically considered by the plan to have agreed to all the terms 
and conditions of the plan automatically. They are automatically 
considered to have agreed to payment levels, to patient cost-sharing 
obligations, and to billing procedures, even when they have not made 
such agreements.
  So it is no wonder that we hear from providers that they do not like 
dealing with these plans. I would go so far as to say that forcing 
doctors and hospitals to accept the terms that plans lay out, without a 
chance to negotiate, seems un-American.
  How will this legislation address deeming? It will eliminate this 
deeming authority in 2011--yes, 2011; not right now but 2011; not next 
year, not 2010 but 2011. The plans would have 2.5 years to develop a 
network. I believe that is plenty of time.
  Moreover, the bill will protect choice in rural areas. The deeming 
provisions will only affect areas where there are already two or more 
plan options available that have a network. In those areas where 
existing plans have contracted with providers to form a network, 
private fee for service has a competitive advantage. This bill will 
level the playing field across all plans.
  Second, this bill will not cut teaching hospitals. It will not 
jeopardize access to plans in areas where academic medical centers are 
most prevalent.
  Right now, Medicare pays twice for indirect medical education on 
behalf of patients in Medicare Advantage plans. Medicare pays once when 
it reimburses teaching hospitals directly for IME costs, and Medicare 
pays a second time by inflating payments to Medicare Advantage plans 
for the same costs. So under this bill, teaching hospitals will 
continue to receive IME payments directly from Medicare, but the 
unnecessary double payments will be eliminated.
  Third, this bill will not allow wealthy seniors to qualify for low-
income subsidies, as has been claimed. The bill will raise the asset 
test from $4,000 to just under $8,000 for individuals. And it will 
raise the asset test from $6,000 to $12,000 for couples. The bill will 
give more seniors with very limited means the ability to qualify for 
additional subsidies.
  The income cut-offs to qualify for the subsidies will remain the 
same. Beneficiaries will need to have incomes below $10,200 for the 
Qualified Medicare Beneficiaries Program, and below $12,500 for the 
Specified Low-Income Medicare Beneficiaries Program. That is under 
current law, no change.
  I think we all would agree that anyone with an annual income below 
$12,500 and personal assets below $8,000 is someone we should want to 
help. And if we can get the 60 votes to get to this bill, I will do 
something else. I will offer an amendment to delay implementation of 
the competitive bidding program for durable medical equipment. That is 
a pledge that I made to many of my colleagues, and it is a pledge that 
I make publicly, a promise I intend to keep.
  I will offer as an amendment the language of the bipartisan bill 
introduced earlier today in the House by Representatives Stark, Camp, 
Boehner, and Pallone. Their bill is thoughtful, it is balanced, and it 
responds to many of the concerns we have all heard from the DME 
industry. If we get to this Medicare bill, we will include that 
language in this bill.
  Another policy in S. 3101 that I intend to revisit is oxygen cuts. 
Congress needs to address overpayments to oxygen. In some cases, 
Medicare pays 1,000 percent above what these supplies cost, and 
beneficiaries pay the price through inflated copayment rates.
  But this is a limited bill. It is not intended to fix all that ails 
Medicare. We will revisit oxygen payments when the Congress next takes 
up Medicare. By my estimate, that would be next fall when the 18-month 
physician fix and other policies will expire.
  In sum, time is running out. It is running short. We need to complete 
a bill by June 30. That is not many days away. The options before us 
are few and fraught with pitfalls. By far, the best option for getting 
a Medicare bill done this year is a bill on which we will vote today.
  This bill is bipartisan. It is carefully balanced. It does what we 
need to do. I urge my colleagues to vote for cloture on the motion to 
proceed.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mr. GREGG. Mr. President, I yield myself 5 minutes from time that is 
reserved for the leader or, alternatively, from time that is available 
at this point that is open.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GREGG. I ask the Chair if there is time presently available?
  The PRESIDING OFFICER. There is 10 minutes for the minority leader.
  Mr. GREGG. Mr. President, I rise to raise my concerns about the 
procedure and about the substance. We all know there has to be a fix 
relative to the doctors. We all know we cannot have this sort of 
reduction in payments to physicians. That is just a fact.

[[Page 12413]]

  My own personal preference is that we fix this permanently. It is 
going to cost a lot of money, but that is the way it should be done. We 
should not be fixing this every year. And, in fact, it is becoming a 
geometric progression which is spiraling downward, with every year 
becoming a much more difficult effort.
  We should basically do Medicare reform. But short of that, we should 
do a permanent doctor fix so that the physicians in this country know 
they are going to get a reasonable upgrade of their reimbursement every 
year. We should not have to go through this.
  However, this bill does not accomplish that. In fact, this bill 
aggravates the problem significantly. I genuinely wish the 
bipartisanship effort which Senator Baucus and Senator Grassley had 
been pursuing had been the effort that had come to floor, but it did 
not.
  What has come to the floor is a partisan effort; regrettably, it is 
not a very good one. It has a couple of practical problems, and then it 
has a very substantive problem. The substantive problem is that it 
spends $2 trillion that we do not have, not to fix the doctor problem 
but to add new benefits in certain elements for certain recipients 
under Medicare Part D. Well, Medicare Part D is already $36 trillion in 
debt, unfunded liabilities. Put $2 trillion more on top of that, it 
means we are passing a huge cost on to our children. It is not fair. It 
is not appropriate.
  The practical problem this bill has--I find it incredible that we are 
being asked to vote on it, quite honestly--is that it has blanks. This 
is the first time I have ever seen this. This bill literally has blanks 
in it. We are being asked to vote on a bill where the numbers, which 
are operative relative to how much this bill is going to cost, are left 
out. There are actually parentheses with nothing in them. There are 
lines where there is a blank. And we are being asked to vote to close 
the debate on this and move to final passage on this without even 
knowing what the numbers are going to be which are to fill in those 
blanks.
  This is so egregious, so egregious, that the CBO, which is the 
independent scorekeeper around here, which is the fair umpire around 
here, has written us and said: They cannot score this bill. They cannot 
give us a cost estimate since the introduced version has blanks.
  The Congress should not work this way. The Senate should not work 
this way. This is totally inappropriate. It is a terrible precedent. It 
is worse than a terrible precedent. It is an incompetent precedent to 
set to bring to the floor a bill that does not tell us how much it is 
going to spend because the other side of the aisle does not want to 
tell us how much it wants to spend or, alternatively, because they are 
not competent enough to put numbers into the bill.
  It is incredible to me that we would be asked to vote cloture on a 
bill that the Congressional Budget Office says they cannot estimate the 
cost of, which is their responsibility, because it has blanks.
  I ask unanimous consent that the letter be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                  Congressional Budget Office,

                                    Washington, DC, June 11, 2008.
     Hon. Judd Gregg,
     Ranking Member, Committee on the Budget, U.S. Senate, 
         Washington, DC.
       Dear Senator: As you requested, enclosed are CBO estimates 
     of the costs of the provisions of S. 3101, the Medicare 
     Improvements for Patients and Providers Act of 2008, as 
     introduced on June 6, 2008.
       As you noted in your request letter, some of the provisions 
     of the introduced bill are incomplete: there are some 
     elements that are necessary to producing a cost estimate for 
     the bill that are not included in the current language. In 
     addition, a number of elements in the bill are bracketed and 
     thus could be considered subject to change.
       The enclosed table contains estimates for those provisions 
     of the bill for which we can estimate the costs, but does not 
     include a CBO estimate for the total cost of the bill since 
     the introduced version has blanks for some of the values for 
     key provisions. For the purposes of these estimates, CBO 
     assumed that all bracketed language would have full force and 
     effect.
       If you wish further details on this estimate, we will be 
     pleased to provide them. The CBO staff contact is Tom 
     Bradley.
           Sincerely,
                                                  Peter R. Orszag.

  The PRESIDING OFFICER. The Republican leader is recognized.
  Mr. McCONNELL. Mr. President, our greatest successes in this Congress 
have come when both sides have worked together. We saw it last year on 
the Energy bill when we increased the CAFE standards to historic levels 
and, more recently, the first thing this year on the economic stimulus 
package.
  We started initially down the path of compromise when we began the 
Medicare discussions. Both sides wanted to prevent cuts to physicians 
in the Medicare Program and to preserve access to the quality of 
medical care our seniors have come to depend upon.
  Unfortunately, the majority walked away from these bipartisan 
discussions. In an effort to preserve some of the progress, protect 
benefits for seniors, and to produce a bill that can be signed into 
law, Senator Grassley crafted a Medicare bill which, if it were to be 
passed today, it would be signed by the President of the United States.
  Senator Grassley's alternative, which I will shortly ask consent to 
go to, includes a 1.1 percent increase in the physician update, 
protection for patients who need extensive therapies following a 
stroke, 2 years of funding for the special diabetes program, a new 
cardiopulmonary rehabilitation benefit--this is, by the way, especially 
important to Kentucky where far too many of our citizens struggle with 
pulmonary diseases.
  There is a new program to improve care and save money by encouraging 
doctors to write prescriptions electronically, a very important step in 
the right direction. And it also preserves patient choice and access to 
Medicare Advantage, which helps retired Kentucky teachers.
  We all know what is going to happen. Once this bill is not proceeded 
to, we will have bipartisan negotiations, which is the way this process 
started out in the first place and, frankly, the way it will ultimately 
end. That is the way the Senate does its best work. Having said that, I 
have notified my friend, the majority leader, that I did have a consent 
agreement to propound. I see that he is now on the Senate floor. I will 
ask that consent at this time.
  I ask unanimous consent that the pending motion be temporarily set 
aside and that it be in order for the Republican leader to move to 
proceed to S. 3118, a bill introduced by Senator Grassley to extend 
expiring provisions under the Medicare Program and to file cloture on 
that motion. I further ask that the cloture vote on the motion to 
proceed to S. 3118 occur immediately following the cloture vote on the 
motion to proceed to S. 3101. I further ask that if the motion to 
proceed to either Medicare bill is adopted, no other pending business 
be displaced.
  The PRESIDING OFFICER. Is there objection?
  Mr. REID. Reserving the right to object, on the floor now is the 
Presiding Officer and the chairman of the Finance Committee. Two more 
bipartisan Senators we do not have in the Democratic Caucus, Senators 
always willing to work with the other side. They both have 
reputations--Baucus in Montana, Nelson of Nebraska--of working with the 
other side. There is no partisan advantage in the minds of either one 
of these Senators.
  Why can't we move to this bill? If there is a way to improve it, 
let's improve it. That is all we want.
  Mr. McCONNELL. Parliamentary inquiry: Is this an objection?
  Mr. REID. Why do we have to go through this routine of stopping--
  The PRESIDING OFFICER. Is the leader asking for the regular order?
  Mr. REID. I object, Mr. President.
  The PRESIDING OFFICER. Objection is heard.
  Mr. REID. I have time set aside at this time. Why in the world do we 
want to object again?
  Mr. President, downtown this morning one of the Republican Senators 
whose name I won't mention said, meeting with a number of people 
downtown--this Republican Senator said: There is a lot of frustration 
within the

[[Page 12414]]

Republican caucus about blocking motions to proceed.
  Of course, there is. The Republicans don't like it. Why do they 
continue to do this? We want to legislate on this important piece of 
legislation. It is not only a doctors fix, it is a fix to our health 
care delivery system.
  I am disappointed very much that the Nelsons of the world, the 
Baucuses of the Senate world can't work together in a bipartisan basis. 
They want to. I received a call before lunch, before I went to our 
policy luncheon, from a Republican Senator. He said: Are you going to 
fill the tree? I said: Of course, I am not going to fill the tree. Why 
would I? He said: OK. I will vote with you. So I know at least we have 
one Republican vote. He told me he is going to vote with us on cloture. 
I hope others would follow with that.
  In 1965, President Lyndon Baines Johnson traveled from Washington, DC 
to Independence, MO to join former President Harry Truman in Harry 
Truman's hometown of Independence, MO. The purpose of the trip and the 
meeting between the current and former Presidents was to sign into law 
a bill Harry Truman had conceived and Johnson had championed. The new 
law created Medicare.
  I know a little bit about Medicare. My first elective job was in 
1966. I was elected to the Southern Nevada Memorial Hospital board of 
trustees. It might not sound like much to anybody but to me that was 
important. I beat an incumbent. At the time I took that job--I was 
there for 2 years--40 percent of the senior citizens who came into our 
hospital had no insurance. What did we do? We had them sign a 
certificate or we would not let them in the hospital, unless a father, 
a mother, a husband, a wife, a brother, a sister, or a friend agreed to 
pay their bill. If they didn't pay the bill, we had a collection 
department, and we went after them big time, as they did every place in 
the country.
  Medicare came into being. When I was there, before I left, Medicare 
came into being. Now 99-plus percent of older people who go into 
hospitals in America have Medicare insurance, a pretty good deal. That 
is why Truman thought of it. That is why Johnson implemented his 
thought process. The new law they were there to celebrate created the 
Medicare Program, a program that has ensured quality health care to 
America's senior citizens for more than four decades. Since Johnson 
signed the bill and gave Truman the first ceremonial Medicare card, 
hundreds of millions of senior citizens have also received their 
Medicare card. With each new Medicare card issued, our country renews 
its commitment to bedrock values of those who have worked hard and made 
their contribution to society, and they deserve to know they will be 
cared for as they reach those golden years.
  But even on the day that bill was signed, President Johnson 
acknowledged the bill was imperfect. Who were the Senators who voted 
against Medicare when it came into being? Who were the Senators who 
recognized they would not vote for that bill? All Republicans. Every 
person who voted against Medicare's implementation was a Republican 
Senator. They haven't changed. They reluctantly do what they can for 
Medicare, but they don't support it.
  President Johnson acknowledged it was imperfect. For all the good 
Medicare has done our Nation's seniors through the years, for all the 
good it has done for them today, it could be better. Our efforts to 
make Medicare work better continue today with the Medicare Improvements 
Act. That is what the chairman of the committee was trying to do, make 
it better. That is what this is all about.
  I am grateful for the work of Senator Baucus, chairman of our 
committee. Anyone who knows, I repeat, the Senator from Montana is well 
aware of his ability to work with both sides of the aisle to forge 
bipartisan solutions. On this legislation, Senator Baucus worked 
tirelessly with Democrats and Republicans. He reached out to the Bush 
administration and to the Republican leader. In these efforts, though, 
he was met with a reluctance to move forward, reluctance that has sadly 
become the rule, not the exception, among our Republican colleagues. 
Nevertheless, Senator Baucus moved forward. He worked side by side with 
Democrats and willing Republicans to create a bill that would make 
Medicare work better for millions of senior citizens.
  Senator Baucus laid out the many virtues of this legislation 
yesterday so I will do no more than summarize the key points of this 
most important legislation. The Medicare Improvements Act provides 
increased coverage for Medicare. This is so important. There is no 
better way to treat illness than true preventive care. Not only will 
this enhanced preventive coverage improve the health of Medicare 
recipients, but it will also save taxpayers in the long run from the 
astronomically higher costs associated with treating serious illnesses 
which could have been avoided with preventive care.
  This legislation also makes mental health care more affordable. I 
have worked throughout my time in Congress to shed light on the tragic 
but all too often hidden cost of depression and other mental health 
problems among older Americans. Sometimes depression among seniors 
leads to suicide. There is no group of Americans that dies more than 
seniors from suicide. Medicare currently discourages beneficiaries from 
seeking care for mental illness by requiring a 50-percent copayment for 
mental health services versus a 20-percent copayment for physical 
health services. This legislation will eliminate that disparity and 
expand coverage for medications to treat mental health illnesses.
  The Medicare Improvements Act also makes it easier for low-income 
seniors to access benefits by extending the Qualified Individuals 
Program, increasing eligibility for the Medicare Savings program and 
eliminating the drug benefit penalty. And for all seniors, this bill 
provides funds for State and local programs to help navigate through 
the program and ensure the greatest benefits possible.
  When President Johnson signed Medicare into law in 1965, he 
acknowledged that for all the good this program would do, I repeat, it 
wasn't perfect. That has not changed today. For all its virtues, far 
too many seniors are not accessing the care they earned and to which 
they are entitled. Far more can be done to prevent and treat physical 
and mental illness to provide older Americans with the very best 
quality care we can provide them. Will the Medicare Improvements Act 
make Medicare perfect? No. But there is no question it will make it 
better, far better. There is no question it will help millions of 
Americans access Medicare and get the most of its benefits once they 
do.
  There has been some talk of Republicans refusing to join Democrats to 
support the motion to proceed to this legislation. That is what the 
Republican leader said today. He told all of his Republicans: Don't 
vote for this. We will work out something better. That is the process. 
The process is not the status quo. If there are improvements they want 
to make, there is no bigger listener than Max Baucus of the Finance 
Committee. He will manage this bill. But if they follow the lead of the 
Republican leader, they are being led off a cliff. Republicans wouldn't 
just be refusing to support the bill, they would be refusing to let us 
even move to debate it. They would be stopping this crucial legislation 
in its tracks and deny any possibility of progress or compromise in the 
near future.
  I hope people on the other side will follow what I read to them from 
a Republican Senator downtown this morning: There is a lot of 
frustration within the Republican caucus on blocking motions to 
proceed.
  And well there should be.
  I will use leader time, Mr. President.
  I can't imagine why all 100 Senators would not flock to quickly pass 
this legislation, much less why they would not all vote eagerly for the 
motion to proceed. Denying debate on the Medicare Improvements Act and 
denying its passage would be a grave disservice to tens of millions of 
Americans over age 65. It would be a slap in the face to all those who 
suffer silently through mental illness because they can't afford the

[[Page 12415]]

treatment that would make them well. Opposing this legislation and 
clinging to the status quo, as I fear some Republicans may choose to 
do, would be an abandonment of our decades-old commitment to honoring 
and caring for senior citizens in the manner they deserve.
  In Independence, MO, 43 years ago, President Johnson said this:

       Many men can make many proposals. Many men can draft many 
     laws. But few have the piercing and humane eye which can see 
     beyond the words to the people they touch.
       Few can see past the speeches and political battles to the 
     doctor over there that is tending the infirmed, and to the 
     hospital that is receiving those in anguish, or feel in their 
     heart the painful wrath at the injustice which denies the 
     miracle of healing to the old and to the poor.
       And fewer still have the courage to stake reputation, and 
     position, and the effort of a lifetime upon such a cause when 
     there are so few that share it.
       But it is just such men who illuminate the life and history 
     of [this] nation.

  Because times have changed in 43 years, I call upon the men and women 
of the Senate to do the right thing and let us move to this 
legislation. It is the right thing to do. President Johnson's words go 
to the heart of this country. People need to vote their conscience, not 
the status quo.
  Mrs. BOXER. Will my friend yield for a brief question?
  Mr. REID. I have time? OK.
  Mrs. BOXER. In a minute or less, I am rather stunned to hear that the 
Republican leader is suggesting that Republican Senators vote no to 
move to a bill for the purpose of making improvements in Medicare. I 
ask my friend, because people sometimes lose track of what happens, 
would this not be the third straight bill in a row where the 
Republicans have been fierce defenders of the status quo--global 
warming, gas prices, and now fixing Medicare? Am I correct on that?
  Mr. REID. I say to my distinguished friend from California, it has 
gotten so out of hand that we are having trouble keeping up. We now 
have on filibusters 75, but we have it on Velcro because we know they 
will add another one to it in the near future. We also have Velcro as 
to what they are blocking on a given day. We pull it off because 
yesterday they were blocking global warming. The day before they were 
blocking gas prices, today Medicare improvements. It has gotten so 
difficult around here that we have Velcro as to what they are stopping.
  If there is no more time to be used on the Republican side, we could 
start the vote early. We are going to start the vote early. We were 
going to consider having it started at 3 o'clock. There are some people 
who want to leave and we have some coming back. Anyway, I have gotten a 
nod to yield back all time for both Democrats and Republicans, and I 
ask that the vote start.


                             Cloture Motion

  The PRESIDING OFFICER. Under the previous order, pursuant to rule 
XXII, the clerk will report the motion to invoke cloture.
  The legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     hereby move to bring to a close debate on the motion to 
     proceed to Calendar No. 772, S. 3101, the Medicare 
     Improvements for Patients and Providers Act of 2008.
         Harry Reid, Max Baucus, Jon Tester, Barbara Boxer, 
           Benjamin L. Cardin, Bernard Sanders, John F. Kerry, 
           Patty Murray, Maria Cantwell, Blanche L. Lincoln, Ken 
           Salazar, Charles E. Schumer, Ron Wyden, Patrick J. 
           Leahy, Jeff Bingaman, Debbie Stabenow, John D. 
           Rockefeller, IV, Jack Reed.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call has been waived.
  The question is, Is it the sense of the Senate that debate on the 
motion to proceed to S. 3101, the Medicare Improvements for Patients 
and Providers Act of 2008, shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from New York (Mrs. Clinton), 
the Senator from Hawaii (Mr. Inouye), the Senator from Massachusetts 
(Mr. Kennedy), the Senator from Louisiana (Ms. Landrieu), and the 
Senator from Illinois (Mr. Obama) are necessarily absent.
  I further announce that, if present and voting, the Senator from 
Louisiana (Ms. Landrieu) would vote ``yea.''
  Mr. KYL. The following Senators are necessarily absent: the Senator 
from Arizona (Mr. McCain) and the Senator from New Hampshire (Mr. 
Sununu).
  The PRESIDING OFFICER (Ms. Klobuchar). Are there any other Senators 
in the Chamber desiring to vote?
  The result was announced--yeas 54, nays 39, as follows:

                      [Rollcall Vote No. 149 Leg.]

                                YEAS--54

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

                                NAYS--39

     Alexander
     Allard
     Barrasso
     Bennett
     Bond
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Corker
     Cornyn
     Craig
     Crapo
     DeMint
     Domenici
     Ensign
     Enzi
     Graham
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchison
     Inhofe
     Isakson
     Kyl
     Lugar
     Martinez
     McConnell
     Reid
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich
     Warner
     Wicker

                             NOT VOTING--7

     Clinton
     Inouye
     Kennedy
     Landrieu
     McCain
     Obama
     Sununu
  The PRESIDING OFFICER. On this vote, the yeas are 54, the nays are 
39. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  Mr. REID. Madam President, I enter a motion to reconsider the vote by 
which cloture was not invoked on the motion to proceed to S. 3101.
  The PRESIDING OFFICER. The motion is entered.
  Mr. REID. Madam President, I now withdraw the motion to proceed.
  The PRESIDING OFFICER. The motion is withdrawn.
  The majority leader is recognized.
  Mr. REID. Madam President, first of all, let me say I really 
appreciate the nine Republicans who voted to proceed. I appreciate 
that. We want to legislate. I think there is an indication that maybe 
things are getting to a point where we are going to be able to do that. 
I hope that, in fact, is the case.

                          ____________________