[Congressional Record (Bound Edition), Volume 156 (2010), Part 2]
[Senate]
[Pages 1549-1561]
[From the U.S. Government Publishing Office, www.gpo.gov]




 COMMERCE, JUSTICE, SCIENCE, AND RELATED AGENCIES APPROPRIATIONS ACT, 
                            2010--Continued

  The PRESIDING OFFICER. The Senator from Maryland.
  Ms. MIKULSKI. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              Metro Safety

  Ms. MIKULSKI. Mr. President, I rise to speak about the current state 
of affairs in the Washington Metro and why we need to bring about 
change. The Washington Metro, America's subway, is in trouble. I fear 
for its safety. I fear for its operational reliance. I fear for the 
well-being of both the passengers and the workers who ride Metro.
  Every morning, I am afraid to wake up and find out that there has 
been another accident or death on the Washington Metro. Most recently, 
a Metro

[[Page 1550]]

 train carrying 345 passengers derailed underground in the heart of 
downtown. It was Friday when the Federal Government reopened after our 
big No. 2 blizzard. The train somehow managed to get on the wrong track 
as it was leaving the station. Thank God a safety device actually 
worked and pushed the train off of the wrong track to prevent it from 
crashing into another train. Thankfully, a near miss.
  In June, there was a terrible crash of the Metro, cars upon cars upon 
cars. Since that time, 13 people have died on the Metro, and there have 
been countless injuries. That is why that terrible day after our No. 2 
blizzard, many sat in the dark, scared to death. They were afraid of 
being crashed into, which had happened before. They were afraid of 
fire. They were afraid of smoke. They were afraid of being trapped and, 
most of all, they were afraid that Congress would fail to act.
  I wish to salute the Subcommittee on Housing, Transportation, and 
Community Development chaired by my good colleague Senator Bob 
Menendez, for taking a great interest in this and introducing 
legislation that the administration sanctions to begin to get Metro on 
the right track. We need to do this.
  Last year, after the nine people were killed, I introduced 
legislation to give the Transportation Secretary the authority to 
establish Federal safety standards for Metro systems around the 
country. There had been none. It would require the Transportation 
Secretary to implement the National Transportation Safety Board's most 
wanted safety recommendations.
  After accidents on subways, after accidents on our Metro, the NTSB 
comes in and investigates. Gee, are we glad to see them. They are the 
CSI meets Metro. At the end, they not only tell us what went wrong, but 
what we have to do to get it right. Well, guess what. We don't listen 
to them. After every accident, there is press--we are going to make 
changes--but nothing happens. So, for example, the issues they have 
recommended relating to crashworthiness standards for cars, emergency 
entry and evacuation standards, data event recorders, often go 
unheeded. We have to make those changes, and we need to take another 
step.
  Today, I take another step by joining Senator Menendez, Senator Dodd, 
and Senator Cardin on the Public Transportation Safety Program Act. 
This is an idea that we have worked on, along with the administration, 
to give the Transportation Secretary the authority to establish Federal 
safety standards. It also strengthens State oversight programs that 
inspect and regulate the Metro systems. Because Washington Metro is in 
two States and in the District of Columbia--Maryland, Virginia, and 
DC--it has the Tri-State Oversight Committee. But you know what. The 
Metro board doesn't have to pay any attention. In fact, we had to raise 
cane and pound the table to allow them to work with the safety 
inspectors and actually walk the tracks to try to get some action. We 
had to muscle our way in, just trying to get the Tri-State folks 
involved in safety.
  Well, for me, right now, the spotlight is the Washington Metro. My 
obligation is here. There are other Metro systems around the country 
that this bill will also deal with, but right now, myself and Senator 
Cardin, John Warner--Mark Warner--John Warner in his time--Jim Webb, 
and Congresswoman Eleanor Holmes Norton want to work together. We want 
to work with the Banking Committee to pass legislation that would bring 
about change. We want to make sure that when we make recommendations, 
the FTA--the Federal Transit Authority--has the authority to implement 
the changes and to make sure that Metros both here and around the 
country implement them.
  We also want to require that the implementation of the NTSB's most 
wanted list is absolutely done so when we say let's have crashworthy 
standards for our cars, it is actually implemented. Did you know we 
have standards for everything that is involved in transportation but 
not standards for the safety or the crashworthiness of these cars? 
These two bills are important because there are no Federal safety 
standards for Metro systems. Rail transit is the only transportation 
mode without safety standards oversight or enforcement. As I said, we 
have safety standards for airplanes, commuter rail systems, even buses, 
but Metro systems do not have standards, even though the rail transit 
has 14 million daily riders. Up until now, safety has been left to the 
States. Each State has its own safety enforcement practices, but in our 
case of the Washington Metro, which travels in two States and the 
District of Columbia, we need to make sure we have a system that is 
appropriately regulated.
  The bill that was introduced by the Banking Committee and Senator 
Menendez yesterday, which I support, does two things. It gives the 
Transportation Secretary authority to establish safety standards for 
Metro, light rail, and bus systems nationwide. It provides a framework 
for developing and enforcing those safety standards, and it will look 
at existing industry standards and best practices. It would also have 
to consider the NTSB's recommendations.
  I think about those 13 people a lot. I think about the people who 
ride the Metro. I think about the people who work on the Metro. So when 
we talk about this legislation, we have to think of it not in terms of 
rail cars and money but in terms of people and in terms of safety.
  That is why I introduced the National Metro Safety Act in July after 
the accident, joined by my colleague Senator Cardin. It enables the 
Transportation Secretary to develop, implement, and enforce those 
national safety standards, and it requires DOT to implement the NTSB, 
the National Transportation Safety Board's, most wanted safety 
recommendations. They have what they call their top 10. It would have 
standards for the crashworthiness of cars. It would mandate evacuation 
standards so that people could get out of these cars in the event of an 
accident. It would have the black box data recording device so we could 
trace what happens on a car and have the lessons learned. It would also 
deal with the hour of service regulations for train operators. It 
requires that we do these actions.
  So for these issues--the crashworthiness, the train cars, the 
emergency entry and evacuation, data--all of this has been recommended 
in the past by the NTSB. In 2002 they recommended data event recorders. 
Nothing happened. They recommended emergency evacuation standards in 
2006. Nothing happened. They recommended hours of service to make sure 
our people were fresh and fit for duty. Nothing happened. We know what 
happens: accidents in which people die, are maimed, burned, or injured.
  It is time we listened to the experts who advise us. It is time that 
we ensure the safety of the people who ride the Metro here. It is time 
that we take action and be able to bring this under the Federal Transit 
Authority. The people who count on us when they get on a subway should 
be able to count on us to do all we can to ensure their safety.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mr. GREGG. Mr. President, I rise today to take on a cause which I 
know is close to the hearts of my colleagues on the other side of the 
aisle, which is to assert the privilege of pay-go. I have heard 
innumerable arguments made on the other side of the aisle about the 
importance of the pay-go mechanisms in this Congress: how pay-go will 
be used to discipline our spending as a Congress and how pay-go is the 
way we get to financial and fiscal responsibility as a Congress. In 
fact, 2 weeks ago, I believe it was, the majority leader came to the 
floor and offered a brandnew pay-go resolution as a matter of statute 
and said that this is one of the key pillars of the majority party and 
the President in the area of how you discipline spending and bring our 
spending house in order. The President has mentioned pay-go on numerous 
occasions also.
  Why all this talk about pay-go? Because I think people are beginning 
to realize--certainly our constituents--that the government is spending 
too

[[Page 1551]]

much money; that we are running up too much debt; that we are passing 
bill after bill after bill in this Congress which we are not paying 
for. The cost of those bills is going to our children. We are going to 
double the Federal debt here in 2013. We are going to triple the 
Federal debt in 2019 under the President's budget and the budget passed 
by the Democratic leadership in this Congress. The Federal debt 
increases by $11 trillion over the next 9 years of this budget that is 
being proposed by the President--$11 trillion. We get to a point where 
our Nation is basically spending so much and borrowing so much that our 
financial house is unsustainable.
  Those are not my words. Those are the words actually of the Secretary 
of the Treasury and the head of OMB. They both said their own budget 
that they sent up here was unsustainable in its present form because it 
spends so much more money than we have, and those bills get passed 
right on to our kids.
  Well, in defense of their sending up a budget that spends all of this 
money we don't have and doubles the debt in 2013 and triples it in 
2019, they said they were going to assert pay-go rules which would 
discipline this Senate on the issue of spending. At the time they made 
that assertion I said, Oh, come on, give us a break. Over the last 3 
years that this Congress has been under Democratic control, under 
liberal control, in over 20 instances, pay-go as it presently exists in 
the law was waived, costing over $\1/2\ trillion in new spending. 
Approximately $\1/2\ trillion that should have been subject to pay-go 
rules was waived--simply waived--by the other side of the aisle: We are 
not going to pay attention to pay-go rules, we are going to spend the 
money and add the debt to our children's backs.
  I think the American people notice this and are certainly frustrated 
about this, because they intuitively understand--it is called common 
sense--if you spend all of this money you don't have, the debt is going 
to come back to roost on our children's backs and it reduces their 
quality of life. Obviously, if you have a government that runs up 
deficits which exceed the capacity of our ability to repay them, it is 
our children who end up paying the cost of that profligate spending. It 
is our children who end up with these bills. Their standard of living 
will be reduced as a result of all of this new deficit and debt this 
Congress has passed and which this Congress has proposed.
  So for political cover, they called up a couple of weeks ago this 
pay-go resolution and said we are going to assert pay-go around here on 
everything that comes through this Congress. We are going to make sure 
the financial house of this Congress is disciplined by the rule of pay-
go.
  Well, that is why I want to help them, because here is a new bill on 
the floor of the Senate.
  It violates pay-go. It violates their own rules. It violates this 
great sanctity that they claim was going to be the cause of fiscal 
discipline--the pay-go rule. Just a few weeks ago, we passed a pay-go 
resolution here. What did we get? Within 2 weeks, we have a bill that 
violates the pay-go rules.
  The pay-go rules, as we have them--and they are the law, the rule of 
the Senate today--say that pay-go will apply for any legislation that 
increases the deficit in the first 5-year period or in the first 10-
year period. This bill has been scored by CBO as violating that rule. 
It increases the deficit by $12 billion, unpaid for, in the first 5-
year period. This bill is, therefore, subject to a pay-go point of 
order.
  We are going to hear a specious argument from the other side of the 
aisle that, well, in the year 2020 we account for all this and we get 
the money back. Well, I don't believe that. I don't believe the check 
is in the mail either. The American people don't believe that. More 
importantly, the rules of the Senate don't allow that. The rules of the 
Senate make it very clear that if it adds to the deficit in the first 5 
years, it is subject to a pay-go point of order. And this is not a 
small amount here; $12 billion is a lot of money. I know that under the 
way we function here, and we talk about trillions--and the President 
rolled out just yesterday a new $100 billion or $200 billion package of 
health care, added to a $2.4 trillion package of health care--I know 
that billions become lost sometimes in that debate. But $1 billion is a 
lot of money, and this is $12 billion added to our children's backs in 
the way of deficit and debt. Most Americans see that as a lot of money. 
You could run the entire State government of New Hampshire for about 3 
years on that. Yet we are going to run up the deficit by $12 billion, 
in violation of our own rules.
  There is something even more outrageous about this bill. It is pretty 
outrageous that we would have all the sanctimonious discussion from the 
other side of the aisle about how they are going to live by pay-go 2 
weeks ago and then have the first bill they bring forth violate the 
rules of pay-go. That is pretty outrageous in and of itself. But this 
bill, in an act of gamesmanship that really deserves a special award--
maybe a gold medal at the Vancouver Olympics for gamesmanship in fiscal 
policy and how you basically pass on to your children a major new debt 
without telling them it is coming--certainly this bill would deserve a 
gold medal in that category.
  On top of the pay-go violation, this bill creates $140 billion of 
deficit and debt. Now, even on the other side of the aisle, that has to 
be considered a lot of money. Maybe they don't consider $12 billion a 
lot of money, but $140 billion has to be big money. So $140 billion of 
deficit and debt is built into this bill even though the bill, on its 
face, states that it only spends $12 billion or $15 billion, something 
like that. How do they do that? How could that possibly be? Because 
what they have done here--and as I said, this deserves a gold medal for 
manipulating the financial house of the Senate and the Congress in a 
way that is avoiding actual accountability for the debt you are adding 
onto our children's shoulders--is they have put into the baseline the 
highway money. So the billions in highway money for this year in this 
bill, multiplied out over 10 years, comes to $140 billion, and then 
they have claimed that is all offset, all that money is offset. How do 
they claim it is offset? Well, it is tactical, but follow this because 
it is the ultimate game in double bookkeeping--something Al Capone 
might have done were he running the books of the Senate. There is a 
highway trust fund that doesn't have enough money to pay for the roads 
they want to build--the highway committee in this Congress, the EPW 
Committee. They want to build more roads than the trust fund has money 
coming in for, so they take money from the general fund and transfer it 
to the highway trust fund.
  They allege that 10 years ago or so, the highway trust fund lent 
money to the general fund and no interest was paid on that money lent 
to the general fund. First off, at the time they passed the law that 
said no interest was to be paid on it--but it would be ridiculous to 
pay interest between the two funds anyway--even if you accepted that 
argument, you couldn't get to the numbers they are talking about. What 
they have done is claimed that any money that comes out of the general 
fund to fund the highway fund is an offset. That is an interesting 
concept. Therefore, it doesn't get scored against the deficit by the 
highway fund.
  Where do we get the money we took from the general fund to fund the 
highway fund? The answer is pretty simple: We borrow it from China, 
from Saudi Arabia, from Americans, and our kids get a bill called a 
piece of debt that they have to pay off. This double-entry bookkeeping, 
in the tradition of Al Capone basically, when simplified, means that it 
adds $140 billion of new deficit and debt to the general fund, which 
has to be paid by our kids--not offset, unpaid for, simply money spent.
  Do you know something. We are spending a lot of money around here 
that we don't have, and it is not right. I think the American people 
would like us to stop that. If we are going to spend this money on 
roads, then let's pay for it. Don't hide the fact that you are not 
paying for this with some gamesmanship called offsetting highway fund 
with general fund money. I think that

[[Page 1552]]

is a pretty cynical act. If you don't have the courage to stand before 
this Congress and say publicly that we want to spend $140 billion and 
don't want to pay for it, then you are not fulfilling your 
responsibility to your constituents, because that is what you are 
doing. You have an obligation not to try to hide what you are doing in 
some sort of bookkeeping manipulation, which gets you a gold medal for 
bookkeeping manipulation but certainly doesn't do anything for 
transparency and honesty in government, on top of having a pay-go 
violation--$12 billion as scored by CBO.
  This point of order lies. There is $140 billion of new spending 
proposed in this bill, which isn't paid for. It is spending that isn't 
paid for, and it is authorized and going to be spent. That is pretty 
inexcusable because it is claimed that it is paid for, which is the 
real hypocrisy of what we are seeing.
  My colleagues on the other side may vote against this point of order. 
I cannot understand how they can do that, and I cannot understand how, 
when the majority leader comes down here--and I am sure he will or one 
of his representatives will--and says pay-go should not lie here 
because in 2020 we are going to pay for all this, that they can claim 
anything other than the fact that a pay-go point of order lies. I mean, 
it does lie.
  What is a pay-go point of order? It is the CBO telling us that we 
have violated our own rules, called pay-go, and we are spending money 
that goes to the deficit--in this case, $12 billion.
  So as a very practical matter this is a pretty black-and-white 
situation: either you are for enforcing fiscal discipline here with a 
pay-go point of order or you are not. I have to say, if this pay-go 
point of order fails, then I think we ought to follow it up with a 
unanimous consent that says we are going to rid ourselves of pay-go as 
an enforcement mechanism because we are then saying it doesn't mean 
anything. Clearly, that would be the only conclusion you could reach.
  A pay-go point of order makes it clear: There is $12 billion of 
deficit spending in the first 5-year window, which violates the pay-go 
rules set up by this Senate and specifically proposed and promoted by 
the Democratic majority as a way to give us fiscal discipline, and we 
are ignoring it, overruling it, and we are bypassing it with this piece 
of legislation if we do waive the pay-go rule.
  At this point, I make a point of order that the pending amendment 
offered by the Senator from Nevada, Mr. Reid, would increase the on-
budget deficit for the sum of years 2010 to 2014. Therefore, I raise a 
point of order against the amendment pursuant to section 201(a) of S. 
Con. Res. 21, Concurrent Resolution on the Budget for Fiscal Year 2008.
  Mr. CARDIN. Mr. President, I move that the point of order be waived.
  Mr. GREGG. Mr. President, I ask for the yeas and nays on the motion.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The yeas and nays were ordered.
  Mr. GREGG. Mr. President, I yield the floor and suggest the absence 
of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CARDIN. 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. CARDIN. Mr. President, I ask unanimous consent that my waiver of 
the relevant point of order that was recently entered into include all 
relevant points of order that were raised.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. Mr. President, I ask unanimous consent to speak for up to 
10 minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. Mr. President, I rise today on the occasion of Black 
History Month to recognize the accomplishments of three leading 
Marylanders in American medicine. Established by Howard University 
historian Carter G. Woodson in 1927 as Black History Week, this now 
month-long celebration is an opportunity to elevate awareness of Black 
Americans' contributions to our Nation's history.
  It is customary for American families to spend time in February 
learning more about famous Black Americans who helped shape our Nation, 
including Marylanders Harriet Ross Tubman, the ``Moses of her people,'' 
who ran the Underground Railroad, and Justice Thurgood Marshall, the 
first black Supreme Court Justice and the architect of the legal 
strategy leading to the 1954 landmark Brown v. Board of Education 
decision.
  Today, I come to the Senate floor to highlight the contributions of 
three Marylanders who are currently at the pinnacle of the medical 
profession--Dr. Ben Carson, Dr. Eve Higginbotham, and Dr. Donald 
Wilson.
  I have spoken before on the crushing burden of health disparities on 
our health care system and the urgent need to eliminate them. It is an 
issue directly affecting one out of every three Americans: 37 million 
African Americans, 45 million Latinos, 13 million Asians, 2.3 million 
Native Americans and Alaskan Natives, and 400,000 Hawaiians and Pacific 
Islanders in our Nation. While minorities represent one-third of our 
Nation's population, they are fully one-half of the uninsured. So when 
we enact legislation that expands access to millions of uninsured 
Americans, it will make a difference in minority communities, in 
minority health overall, and in the health of our Nation.
  But providing access to comprehensive health insurance addresses only 
one of the factors contributing to health disparities. Research informs 
us that even after accounting for those who lack health insurance, 
minority racial and ethnic groups face inequities in access and 
treatment; and they have adverse health care outcomes at higher rates 
than whites. Even when insurance status, income, age, and severity of 
conditions are comparable, racial and ethnic minorities tend to receive 
lower quality health care. Therefore, coverage is not enough.
  Despite many attempts over the years by health policymakers, 
providers, researchers, and others, wide disparities still persist in 
many facets of health care. When it comes to equitable care for 
minorities, low-income, geographic, cultural and language barriers, and 
racial bias are found to be common obstacles. These inequities carry a 
high cost in terms of life expectancy, quality of life, and efficiency, 
and they cost our Nation billions of dollars each year.
  Researchers from Johns Hopkins University and the University of 
Maryland found that between 2003 and 2006, racial and ethnic 
disparities cost the Nation more than $229 billion in excess direct 
medical costs. Adding indirect costs reveals a staggering $1.24 
trillion from lost wages and premature and preventable deaths and 
disabilities. By elevating the focus on health disparities, we can 
bring down these costs and improve the quality of care across the 
board.
  If we are to improve the health care status of Americans, we must 
focus on and eliminate these disparities. One step is ensuring every 
community has a sufficient supply of well-trained medical 
professionals, and this is where our Nation's academic medical centers 
play an essential role. All three physicians--Drs. Carson, 
Higginbotham, and Wilson--shine as leaders in their medical profession 
and have devoted their careers to academic medicine.
  First is Dr. Benjamin Carson, a world-renowned pediatric neurosurgeon 
who works daily to save and improve the lives of children as director 
of pediatric neurosurgery at Johns Hopkins. Dr. Carson's story is truly 
inspiring. He was born and raised in Detroit by a mother who encouraged 
Ben and his brother to work hard and succeed in school. Dr. Carson 
graduated high school with honors and was admitted to Yale University 
to study psychology. He attended the University of Michigan Medical 
School, specializing in neurosurgery. Dr. Carson completed neurosurgery 
residency at Johns Hopkins Hospital, where at age 33 he became the 
youngest physician ever to head a major division there. Dr. Carson

[[Page 1553]]

has surgically separated several pairs of conjoined twins and has 
pioneered new, groundbreaking procedures to save children's lives.
  Most notable among Dr. Carson's numerous accolades and honors is the 
Presidential Medal of Freedom, the Nation's highest civilian award, 
which he received in 2008. In addition to his surgical acumen, Dr. 
Carson is a dedicated community activist. He is president and cofounder 
of the Carson Scholars Fund which recognizes young people of all 
backgrounds for exceptional academic and humanitarian accomplishments. 
He is also president and cofounder of the Benevolent Endowment Network 
Fund, an organization that works to cover the medical expenses of 
pediatric neurosurgery patients with complex medical conditions.
  Second, I wish to recognize Dr. Eve Higginbotham, an internationally 
recognized physician who was recently appointed senior vice president 
and executive dean for health services at Howard University. Dr. 
Higginbotham is the first woman to chair a university-based 
ophthalmology department in the United States, and she held this 
position at the University of Maryland School of Medicine in Baltimore 
from 1994 to 2006. Her next appointment was dean and senior vice 
president for academic affairs at Morehouse School of Medicine in 
Atlanta.
  Dr. Higginbotham is a frontline warrior in the fight to eliminate 
health disparities. As a member of the Friends of the Congressional 
Glaucoma Caucus Foundation, she developed a glaucoma screening training 
program that has been implemented in more than 40 medical schools 
nationwide. Through this program, medical students provide glaucoma 
screening to elderly residents in underserved communities, making 
possible early detection and treatment for the leading cause of 
blindness among African Americans.
  Dr. Higginbotham was recently inducted into the American Academy of 
Arts and Sciences. She has served on the boards of the American Academy 
of Ophthalmology, Women in Ophthalmology, and the National Space 
Biomedical Research Institute. She is also a past president of the 
Baltimore City Medical Society and the Maryland Society of Eye 
Physicians and Surgeons.
  Finally, I wish to recognize Dr. Donald Wilson, who was Dr. 
Higginbotham's immediate predecessor at Howard University. Dr. Wilson 
served as dean of the University of Maryland School of Medicine from 
1991 to 2006. The University of Maryland's medical research funding 
increased nearly fivefold, from $77 million to $341 million during Dr. 
Wilson's leadership. His tenure at Maryland distinguished him as the 
Nation's first African-American dean of a nonminority medical school. 
While at the University of Maryland, Dr. Wilson also served as the 
director of the Program in Minority Health and Health Disparities 
Education and Research.
  Dr. Wilson has also chaired Federal health committees at the NIH and 
the FDA, as well as serving on the advisory council of HHS's Agency for 
Health Care Policy and Research. He was chairman of both the 
Association of American Medical Colleges and the Council of Deans of 
U.S. Medical Schools. And he was the first African American to hold 
each of these positions. He is a member of several medical and research 
societies, including the Institute of Medicine of the National Academy 
of Sciences and the Association of American Physicians. He is a master 
of the American College of Physicians, an honor bestowed on fewer than 
1 percent of its members. Dr. Wilson also cofounded the Association for 
Academic Minority Physicians in 1986.
  Numerous honors and awards have been bestowed upon Dr. Wilson, 
including the Baltimore Urban League's Whitney M. Young, Jr., 
Humanitarian Award. In 2003, he received the prestigious Frederick 
Douglass Award from the University System of Maryland Board of Regents. 
Dr. Wilson is also the recipient of the Institutional Leadership 
Diversity Award from the Association of American Medical Colleges Group 
on Student Affairs-Minority Affairs Section.
  Drs. Carson, Higginbotham, and Wilson are three living reasons why we 
celebrate Black History Month. Their contributions have made invaluable 
contributions to American medicine, but they are just the tip of the 
iceberg in terms of African Americans who have made a noteworthy impact 
upon our Nation.
  I ask my colleagues to join me in recognizing the contributions of 
these three noteworthy physicians as this body seeks to make health 
care available to everyone, and join me in celebrating their 
accomplishments during Black History Month.
  Mr. President, to clarify, my intention on my previous motion to 
waive was to waive the Budget Act and budget resolutions with respect 
to the motion to concur with an amendment and that the yeas and nays 
previously ordered be considered as ordered on the motion as modified. 
I ask unanimous consent for this request.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARDIN. Mr. President, I yield the floor and suggest the absence 
of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. SCHUMER. 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. SCHUMER. Mr. President, I ask to be recognized.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SCHUMER. Mr. President, I rise today to speak about two issues. 
First, the jobs bill and the provision that Senator Hatch and I worked 
on that helped break the partisan logjam, and also the need for the 
Senate to take up and pass up to $25 billion in FMAP assistance to the 
States. First, the jobs portion.
  During our break, I traveled all around my State from Cheektowaga to 
Oswego, from Syracuse to Poughkeepsie, from Long Island to New York 
City. In each place, I talked with people who had lost their jobs. It 
was heartbreaking. These are people who are looking desperately to find 
work.
  One of the sadder points of this recession is, of course, its depth. 
It is deeper than all but one recession we have had since World War II. 
But, second, it seems to affect people at all income levels. If you are 
poor, if you are middle class, even if you are upper middle class, you 
can lose your job. Perhaps most painful of all, the amount of time that 
people are out of work is much longer than previous recessions. In 
other words, in previous recessions, you would lose your job, it would 
be horrible, but you would say to yourself: In 3 or 4 months, I can 
find a new job quite easily. That has not happened.
  In fact, I met people such as a woman in Rochester who worked for a 
major firm in human resources. She is about 50. She does not have a 
family, but her job was her life. She was told she had to leave a year 
and a half ago. She has been looking and looking. Her salary was in the 
low six figures. She was a very talented person upon meeting her. No 
work. No job.
  I met somebody who came from a blue-collar background. The family had 
no education. He climbed his way to the top of the tool-and-die 
industry. He was making a good living. He has six children and a wife 
who stayed home because when you have six kids, it is not easy to work. 
He was laid off about a year ago. Again, he has been looking and 
looking, first with his high skills in his industry, and then he kept 
looking lower and lower and lower on the pay scale, to no avail. No 
job. I could repeat this story over and over.
  I can see why the people of Massachusetts voted the way they did. I 
did not agree with it, but I understand it. In my judgment, what they 
were saying was simple. If you look at the exit polls, about 50 percent 
of the people in Massachusetts supported the President's health care 
bill and an equal number against it. But, overwhelmingly, they were 
saying to us, whether they were for the bill or against it, focus on 
issue No. 1, jobs--jobs, the economy, helping the middle class stretch 
that paycheck so they can make ends meet.

[[Page 1554]]

  That is why I think Senator Reid, our majority leader, was so wise to 
put together the bill he did, the HIRE Act. That is why he reached out 
to those across the aisle, as did I. That is why I am pleased this 
vital legislation--hardly a panacea; it is not going to cure all our 
problems--looks as though it will move forward late this afternoon or 
this evening.
  I am very proud--we are all proud--that we have bipartisan support. I 
believe the vote later on will be even more bipartisan than the vote to 
move forward on the bill yesterday. Bipartisan victories such as this 
have been few and far between. But this could be the start of something 
good. I hope the bipartisanship will not end with this afternoon's 
vote.
  Unemployment, of course, is not simply a blue State problem or a red 
State problem; it is an everywhere problem. It will take more than one 
party's solutions to solve it. So if there is only one issue that we 
can find common ground on this year, let it be jobs.
  We all know unemployment, which is hovering just below 10 percent, is 
unacceptably high. When you hear the number 10 percent, it is an 
abstract figure. But if you are a husband or wife, a son or daughter 
who is out of work, or one in your family is out of work, unemployment 
is 100 percent.
  As the economy shows signs of life, unfortunately millions of 
Americans remain out of work, struggling to make ends meet with savings 
and unemployment benefits. There are more than 15 million unemployed 
Americans. That is not even counting those who have stopped looking for 
work. There are more than 6 million people who have been out of work 
for 6 or more months. Each one has a story, a life, usually a family, 
such as the woman from Rochester I mentioned.
  When I go to sleep at night, I sometimes think of the people I talked 
with last week while we were on break and about their pain at losing 
their job and their quest to find a new one. Unfortunately, despite 
their efforts, most of them have not found work.
  This recession is unlike anything we have seen since the 1930s. It 
has created immeasurable hardship and heartache for tens of millions of 
American families. It doesn't matter if you are in a red State or a 
blue State. If you are unemployed, you want a job.
  Last year, Congress took bold steps to bring our economy back from 
the brink of collapse, and GDP growth in the last quarter was as high 
as 5.7 percent. The purpose of the provision Senator Hatch and I have 
introduced is to take that growth and translate it into jobs because 
while the economy grew at a very rapid clip--5.7 percent--hardly a job 
was created. That is a problem because we cannot continue to grow at 
that rate unless people start going back to work. Until the 
unemployment rate drops significantly, Congress must do more to help 
families across the country who are desperately struggling to find 
work, and this bill is a step in the right direction.
  Last year, I believe Congress was right not to add a jobs tax credit 
to the stimulus package. Economists told us that with the economy 
shrinking and losing 700,000 jobs a month when the President took 
office, our focus had to be on stimulating demand. But now that the 
economy is beginning to grow--at the very worst is flat--a tax credit 
is what is needed because there are companies that have seen sales blip 
up and they are wondering whether to hire that additional worker. The 
Schumer-Hatch tax credit may push them over the edge and they may say: 
OK, I will hire somebody. Then, instead of the vicious cycle of 
downward employment we have seen, a virtuous cycle will begin. That 
company will hire a worker, that worker will go to the stores and buy 
things, those stores may hire another worker and more money circulates 
in the economy and we start moving upward as opposed to downward.
  After reviewing the criticisms of past tax credit proposals, Senator 
Hatch and I set out to develop an idea that would address some of the 
past concerns while honing in on the problem we are trying to solve, 
which is persistently high and long-term unemployment. I felt we needed 
a solution that was simple, immediate, focused, fiscally responsible, 
and potentially bipartisan. That is what our proposal does.
  Let me talk about each word. It is simple. Small business, we know, 
is the job growth engine in America. But if you tell a small 
businessperson they have to fill out 40 pages or even hire an 
accountant before they get a tax credit, they are going to say: Forget 
about it. But this is immediate. Again, if you tell a small 
businessperson: Yes, you will get a tax credit, but it will be a year 
from April when your tax returns come in, they are not going to do it.
  Our proposal is immediate. The minute the worker is hired, the 
benefit begins. As I said, it is simple: All the employer must do is 
show that the person they are hiring has been unemployed for 60 days--
and that is easy to do because they can show 60 days of unemployment 
benefits--and that is that.
  Third, our program is fiscally responsible. It is not a big, huge 
bureaucracy. It is not a new government agency. The money goes directly 
to the small business that makes the new hire, and that is why it has 
bang for the buck. It is estimated that if 3 million people were hired 
by this credit, it would cost about $15 billion. Mr. President, $15 
billion sounds like a lot of money, but compared to the stimulus--
again, for a different purpose a year ago when the economy was 
collapsing--the cost of ours is about one-sixtieth, and dollar for 
dollar it will be focused on jobs.
  So it meets all these criteria. It will focus like a laser on the 
unemployed and will create jobs right away at a reasonable cost. In 
this day when communication is so important, it can be explained in a 
single sentence. Any private sector employer that hires a worker who 
has been unemployed for 60 days will not have to pay payroll taxes on 
that worker for the rest of the year. That is it. Nothing else. It 
explains the whole program from start to finish. By the way, if the 
employer keeps that worker for at least a year, they will receive an 
additional $1,000 tax credit.
  Our plan is good for business and good for workers. The more a 
business pays a worker, the bigger benefit they get. Many of the 
previous programs were aimed, understandably, at workers at the lower 
income level. But these days, when you have people in our State who 
make $60,000, $80,000, $100,000 or $120,000 a year and who can't find 
work, they will benefit by the same percentage as somebody at the lower 
end of the spectrum. The sooner the employer hires, the bigger the 
break because it lasts this year. The employer doesn't pay taxes and 
the benefits go immediately into the business's cashflow. Unlike other 
proposals, there is no waiting to receive a tax credit. The employer 
doesn't pay the taxes to the government in the first place.
  Obviously, employers decide to hire workers when it makes business 
sense. If your sales are declining, no tax incentive is going to 
encourage you to hire somebody. But we are now finding--at this stage 
of this Nation's incipient and all-too-small recovery--that many 
businesses, large and small, are finding orders are beginning to rise, 
sales beginning to increase. It is those businesses that our tax credit 
is aimed at. This proposal may give them the push they need to add a 
few workers or hire them a few months sooner than they otherwise might. 
Either would be a good thing.
  I don't wish to delude my colleagues, and I know Senator Hatch, the 
coauthor of this proposal, would agree, that this provision is not a 
panacea. There are other proposals Congress could, should, and must 
consider to aid job creation, but I look forward to considering those 
ideas in the weeks to come. In the meantime, we ought to take advantage 
of the bipartisan camaraderie, which I hope lasts, and move this 
proposal forward.
  I wish to thank a number of people who helped. At the top of the list 
is Chairman Baucus. When Senator Hatch and I--both members of his 
committee, the Finance Committee--brought him the proposal, he thought 
it was a good idea and helped champion it. I wish to thank Leader Reid, 
who jumped right at the opportunity to

[[Page 1555]]

pass the proposal. I wish to recognize Senator Casey and Senator 
Gillibrand, my colleague, for the hard work they put into an 
alternative tax credit idea, which could end up complementing, not 
replacing, our idea. Finally, last but certainly not least, I wish to 
thank my colleague, Senator Hatch, as well as Senator Grassley, who 
worked with us on this proposal to refine it and make it possible to 
pass, which I believe we will do shortly.
  I wish to turn the subject to another pressing issue; that is, the 
pressing issue of State fiscal relief. While our top priority is 
putting unemployed Americans back to work, nothing we do on job 
creation will be truly effective unless we also stop the bleeding 
caused by State and local budget cuts across the Nation. We cannot, 
with one hand, incentivize private sector employment while, on the 
other hand, through inaction, force State and local governments to lay 
off thousands of firefighters, teachers, health care providers, and 
other public servants.
  Right now, States face the steepest ever dropoff in revenues. My 
State of New York and so many of the localities I have visited--from 
large major cities such as New York City and Buffalo, to the smaller 
towns and villages--are desperate for help. If they do not receive it, 
they are going to have to lay off thousands and thousands of workers. 
In the city of New York, they are talking about laying off teachers. 
That is hurting our seed corn. The number of police officers, at a time 
of crime and terrorist threats, is declining. That hurts our economy as 
well as our localities.
  New York is not alone. From California to Arizona, to Alabama, to 
Maine, and to Mississippi, State Governors have laid out proposals that 
will unfortunately eliminate jobs and cut critical services in the 
coming months. In fact, it is estimated, if there is no help, State and 
local governments will have to lay off 1 million workers-- something we 
can ill afford at a time of this incipient recovery. The cuts couldn't 
come at a worse time for our fledgling economy. States will be forced 
to make massive layoffs and they will be cornered into raising taxes on 
hard-working, middle-class Americans at a time when families can't 
afford to take another hit and at a time when taking money out of the 
economy makes no sense at all. It oftentimes makes no sense but now 
more particularly.
  Last week, the Nation's Governors nearly unanimously endorsed a 6-
month emergency extension of FMAP, the Federal Medicaid Assistance 
Program, which would send up to $25 billion to the States. They know 
firsthand that job losses in their States would have been much more 
severe were it not for the significant relief Congress provided for 
them in last year's stimulus package, particularly through the FMAP 
program. I know our economy is growing, but out in the States it sure 
doesn't feel like a recovery yet. Cutting off this assistance now, as 
the stimulus expires, would be like pulling the rug from under the 
States just as they are maybe beginning to turn the corner.
  I was an ardent supporter of the Recovery Act's FMAP aid because, 
plain and simple, it saves jobs, and I argued for it then. I am 
especially proud to have authored a provision that ensured a stream of 
funding that went directly to county governments. In my State, the 
Medicaid burden, much of it--too much of it--falls on localities. If we 
were just to give Albany the money--not just the Albany share but the 
county share--the counties and New York City might never see that money 
ever again. So I was able to--with the help of Leader Reid and Chairman 
Baucus--write a provision into law that said the locality gets its 
share directly, and I am urging the Senate to include this language in 
a new emergency extension as well.
  We cannot afford to delay any longer. This economic downturn didn't 
come with an end-of-the-year deadline. This critical aid to States 
shouldn't either. So I hope that in the next jobs bill we pass FMAP is 
a vital part, and I hope, just as with the provision Senator Hatch and 
I put together, it will get broad bipartisan support. I believe an 
overwhelming majority of Governors--Democratic and Republican--have 
already signed a letter urging that that happen, and I hope we will get 
people from both sides of the aisle to make sure the next jobs bill 
contains a healthy and robust FMAP extension. The House has already 
passed it. It is up to us.
  We have much yet to do on the job front, but our efforts will be 
undermined if our Nation's Governors are forced to lay off workers and 
raise property taxes. We need to plug the holes in the dam so our 
recovery efforts are not washed away. We need to put this great Nation 
back on a path to prosperity by passing the tax credit Senator Hatch 
and I have offered and then by moving forward and making sure FMAP is 
extended for at least another 6 months.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER (Mrs. Gillibrand). The clerk will call the 
roll.
  The assistant legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER (Mr. Kaufman). The Senator from Vermont.
  Mr. SANDERS. 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. SANDERS. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                             Reconciliation

  Mr. SANDERS. Mr. President, I think all across this country people 
are wondering about what is going on in Congress and, specifically, 
what is going on in the Senate. People are using the expression that 
government is broken and that we seem to be a dysfunctional 
institution.
  The reason for the alarm is pretty obvious. The United States today 
faces the most serious set of crises we have seen since the Great 
Depression. Today, some 17 percent of our people are either unemployed 
or underemployed. This is on top of coming out of a decade where the 
median family income actually declined. So people by the millions are 
today working longer hours for lower wages. They are wondering what 
kind of life is going to be available for their kids. They are having a 
hard time affording childcare. They are having a hard time affording 
higher education. We have 46 million people who are uninsured. We have 
45,000 people who die every single year because they can't get to a 
doctor. If we don't get a handle on health care, their costs are going 
to be doubling in the next 8 years. We recently saw Blue Cross in 
California asking for a 39-percent rate increase for their premiums. It 
is not unusual. It is going on all over the country.
  People are saying, What is going on? Is the middle class going to 
continue to collapse? Is poverty going to continue to increase? Are you 
guys going to get your act together and begin to do something that 
benefits working families in this country?
  It goes without saying that the American people want--I want, you 
want, we all want--bipartisan efforts to solve these problems, but, 
most importantly, we want to solve these issues. We have to deal with 
the economy. We have to deal with our friends on Wall Street whose 
recklessness and illegal behavior has driven this country into this 
terrible recession. We have to deal with it. We have to deal with 
health care. We don't have a choice. We have to deal with the $12 
trillion national debt. We have to do it.
  Unfortunately, I think what the American people are beginning to 
catch onto is that to have bipartisanship, you need a ``bi,'' you need 
two sides coming together. What we have here in the Senate is not two 
sides coming together but one side, our Republican friends who are 
saying: No, no, no. If it is good for Obama, it is bad for us. No, no, 
no. We have had a record-breaking number of filibusters, a record-
breaking number of other obstructionist tactics. The end result is the 
American people are becoming very frustrated.
  I do a national radio show every week and every week on that program

[[Page 1556]]

somebody is calling me up and saying, I don't understand it. When the 
Republicans were in control of the Senate, they were able to bring 
forth sweeping proposals. They didn't have 60 votes. What is going on? 
You guys on your side, those who are Independents and in the Democratic 
caucus, you have 59 votes, why aren't you doing it? It is a good 
question.
  I think more and more people are talking about using the 
reconciliation process, which is simply a parliamentary procedure which 
enables us to pass legislation with the end result of saving taxpayers' 
money and lowering the deficit. The beauty of that approach is you can 
go forward with 51 votes, not the 60 votes we are having a very 
difficult time obtaining, because we are not getting much support from 
the other side. Some people say, Well, this reconciliation approach is 
unfair. This is a radical idea. Why are you bringing it forth? The 
answer is that this has been done time after time after time, mostly, 
in fact, by Republicans. So it seems to me if this is a concept the 
Republicans have used year after year after year for very major pieces 
of legislation, it is appropriate for the Democratic caucus to do that 
as well.
  Let me give a few examples. Many Americans will remember the Contract 
With America. That was Newt Gingrich's very big idea. I thought it was 
a very bad idea, but nonetheless it was a very comprehensive approach. 
The Contract With America in 1995 was passed in the Senate through 
reconciliation. This was a broad, comprehensive bill, and this is what 
President Clinton said. This is what the Washington Post reported 
President Clinton saying when he vetoed that legislation, and I am glad 
he did. This is what Clinton said:

       Today I am vetoing the biggest Medicare and Medicaid cuts 
     in history, deep cuts in education, a rollback in 
     environmental protection, and a tax increase on working 
     families.

  This was Clinton's veto message of the Republican Contract With 
America that was passed through reconciliation.
  That is not the only effort the Republicans mounted through 
reconciliation. In 1996, Republicans passed legislation to enact 
welfare reform through reconciliation. In 1997, Congress used 
reconciliation to establish new health coverage programs or to 
substantially expand existing ones, including SCHIP passed through 
reconciliation. In 2005, Republicans pushed through reconciliation 
legislation that reduced spending on Medicaid and raised premiums on 
upper income Medicare beneficiaries. In 2003, Republicans used 
reconciliation to push through President Bush's 2003 tax cuts. In 2001, 
Republicans used reconciliation to pass President Bush's $1.35 trillion 
tax cut, much of it going to the wealthiest people in this country.
  What is my point? My point is that it would be the utmost hypocrisy 
for Republicans to tell us we should not use reconciliation when they 
have used it time and time and time again.
  Let me conclude by saying this country faces enormous problems. What 
has occurred over the last year, year and a half, is an unprecedented 
level of obstructionism and delaying tactics on the part of our 
Republican colleagues. The American people are hurting. They want to 
see this government begin the process of creating millions of decent-
paying jobs. They want to see a transformation of our energy system so 
we can move from fossil fuel to energy efficiency and sustainable 
energy and jobs doing that. The American people want to see us rebuild 
our infrastructure which is presently crumbling and we can create jobs 
doing that. In the short term, the American people want us to do 
something about the high cost of a college education by expanding Pell 
grants and by also addressing the very serious problems with childcare 
and the needs for school construction. We can do that as well.
  My point is the American people are angry. They are frustrated. They 
want action. If the Republicans choose, as is their right, to try to 
obstruct and try to use the rules to delay action, I think we should do 
what they have done time after time after time and that is use the 
reconciliation process. That is what I think we should do, and I hope 
we will.
  Thank you very much, Madam President. I yield the floor and note the 
absence of a quorum.
  The PRESIDING OFFICER (Mrs. Hagan). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CASEY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Udall of Colorado). Without objection, it 
is so ordered.
  Mr. CASEY. Mr. President, I ask unanimous consent that I be permitted 
to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                        Nuclear Nonproliferation

  Mr. CASEY. Mr. President, I rise tonight to express support for the 
Obama administration's efforts on nuclear nonproliferation. We know--
and I believe this is a consensus in our country--that nuclear 
terrorism poses the most serious threat to our security, as well as the 
security of other nations around the world. I believe we have a solemn 
responsibility to do what we can to combat the threat of nuclear 
weapons.
  The Obama administration has set forth a vision which puts American 
security first in pursuit of a world where terrorists cannot acquire 
weapons of mass destruction. The Senate also has an important 
leadership role to play. Our No. 1 obligation should be to protect the 
American people.
  In Prague last April, President Obama described the steps the United 
States is prepared to take toward a world without nuclear weapons. In 
expressing this goal, the President acknowledged the necessity of 
maintaining our weapons complex while simultaneously working to 
negotiate agreements that decrease the number of nuclear weapons in the 
world. He said:

       Make no mistake, as long as these weapons exist, the United 
     States will maintain a safe, secure, and effective arsenal to 
     deter any adversary, and guarantee that defense to our allies 
     . . . but we will begin the work of reducing our arsenal.

  This January, a bipartisan group of American national security 
leaders came together to help guide our thinking on these important 
issues. Former Secretary of State George Shultz, former Secretary of 
Defense William Perry, former National Security Adviser and Secretary 
of State Henry Kissinger, and former Senator Sam Nunn all have stellar 
national security experience and credentials. They wrote together:

       Nuclear weapons today present tremendous dangers, but also 
     an historic opportunity. U.S. leadership will be required to 
     take the world to the next stage--to a solid consensus for 
     reversing reliance on nuclear weapons globally as a vital 
     contribution to preventing their proliferation into 
     potentially dangerous hands, and ultimately ending them as a 
     threat to the world.

  President Obama is willing and able to provide this leadership at 
this critical point in history.
  The administration is in the final stages of negotiating START with 
Russia. This treaty would reduce deployed nuclear weapons in the United 
States and Russia and would provide crucial verification measures that 
would allow a window into the Russian nuclear program.
  While the Treaty has taken a little longer than expected to complete, 
I applaud Assistant Secretary for Verification, Compliance and 
Implementation, Rose Gottemoeller, for her leadership and her efforts 
to pursue a strong agreement as opposed to an immediate agreement.
  A new START agreement is in our national security interest, 
especially in terms of maintaining verification and transparency 
measures. Once completed, this agreement can help to strengthen the 
U.S.-Russian relationship and potentially increase the possibility of 
Russian cooperation on an array of thorny international issues, 
including North Korea and Iran.
  The START follow-on treaty is also a clear demonstration that the 
United States is upholding our disarmament obligation under the Nuclear 
Nonproliferation Treaty, one of the treaty's three pillars, in addition 
to nonproliferation and peaceful uses of nuclear energy. START is a 
necessary

[[Page 1557]]

step in reaffirming U.S. leadership on nonproliferation issues. Without 
a clear commitment to our nonproliferation responsibilities through a 
new START agreement, it will be increasingly difficult for the United 
States to secure international support in addressing the urgent 
security threats posed by the spread of nuclear weapons.
  An essential element of securing our nuclear weapons complex begins 
at home. Last Thursday, Vice President Biden spoke at the National 
Defense University about the administration's efforts to maintain a 
safe, secure, and effective nuclear arsenal.
  Mr. President, I ask unanimous consent to have printed in the Record 
the Vice President's speech.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

   The Path to Nuclear Security: Implementing the President's Prague 
                                 Agenda

       Ladies and gentlemen; Secretaries Gates and Chu; General 
     Cartwright; Undersecretary Tauscher; Administrator 
     D'Agostino; members of our armed services; students and 
     faculty; thank you all for coming.
       At its founding, Elihu Root gave this campus a mission that 
     is the very essence of our national defense: ``Not to promote 
     war, but to preserve peace by intelligent and adequate 
     preparation to repel aggression.'' For more than a century, 
     you and your predecessors have heeded that call. There are 
     few greater contributions citizens can claim.
       Many statesmen have walked these grounds, including our 
     Administration's outstanding National Security Advisor, 
     General Jim Jones. You taught him well. George Kennan, the 
     scholar and diplomat, lectured at the National War College in 
     the late 1940s. Just back from Moscow, in a small office not 
     far from here, he developed the doctrine of Containment that 
     guided a generation of Cold War foreign policy.
       Some of the issues that arose during that time seem like 
     distant memories. But the topic I came to discuss with you 
     today, the challenge posed by nuclear weapons, continues to 
     demand our urgent attention.
       Last April, in Prague, President Obama laid out his vision 
     for protecting our country from nuclear threats.
       He made clear we will take concrete steps toward a world 
     without nuclear weapons, while retaining a safe, secure, and 
     effective arsenal as long as we still need it. We will work 
     to strengthen the Nuclear Non-Proliferation Treaty. And we 
     will do everything in our power to prevent the spread of 
     nuclear weapons to terrorists and also to states that don't 
     already possess them.
       It's easy to recognize the threat posed by nuclear 
     terrorism. But we must not underestimate how proliferation to 
     a state could destabilize regions critical to our security 
     and prompt neighbors to seek nuclear weapons of their own.
       Our agenda is based on a clear-eyed assessment of our 
     national interest. We have long relied on nuclear weapons to 
     deter potential adversaries.
       Now, as our technology improves, we are developing non-
     nuclear ways to accomplish that same objective. The 
     Quadrennial Defense Review and Ballistic Missile Defense 
     Review, which Secretary Gates released two weeks ago, present 
     a plan to further strengthen our preeminent conventional 
     forces to defend our nation and our allies.
       Capabilities like an adaptive missile defense shield, 
     conventional warheads with worldwide reach, and others that 
     we are developing enable us to reduce the role of nuclear 
     weapons, as other nuclear powers join us in drawing down. 
     With these modern capabilities, even with deep nuclear 
     reductions, we will remain undeniably strong.
       As we've said many times, the spread of nuclear weapons is 
     the greatest threat facing our country.
       That is why we are working both to stop their proliferation 
     and eventually to eliminate them. Until that day comes, 
     though, we will do everything necessary to maintain our 
     arsenal.
       At the vanguard of this effort, alongside our military, are 
     our nuclear weapons laboratories, national treasures that 
     deserve our support. Their invaluable contributions range 
     from building the world's fastest supercomputers, to 
     developing cleaner fuels, to surveying the heavens with 
     robotic telescopes.
       But the labs are best known for the work they do to secure 
     our country. Time and again, we have asked our labs to meet 
     our most urgent strategic needs. And time and again, they 
     have delivered.
       In 1939, as fascism began its march across Europe, Asia, 
     and Africa, Albert Einstein warned President Roosevelt that 
     the Nazis were racing to build a weapon, the likes of which 
     the world had never seen. In the Southwest Desert, under the 
     leadership of Robert Oppenheimer, the physicists of Los 
     Alamos won that race and changed the course of history.
       Sandia was born near Albuquerque soon after the Second 
     World War and became our premier facility for developing the 
     non-nuclear components of our nuclear weapons program.
       And a few years later the institution that became Lawrence 
     Livermore took root in California. During the arms race that 
     followed the Korean War, it designed and developed warheads 
     that kept our nuclear capabilities second to none.
       These examples illustrate what everyone in this room 
     already knows--that the past century's defining conflicts 
     were decided not just on the battlefield, but in the 
     classroom and in the laboratory.
       Air Force General Hap Arnold, an aviation pioneer whose 
     vision helped shape the National War College, once argued 
     that the First World War was decided by brawn and the Second 
     by logistics. ``The Third World War will be different,'' he 
     predicted. ``It will be won by brains.''
       General Arnold got it almost right. Great minds like Kennan 
     and Oppenheimer helped win the Cold War and prevent World War 
     Three altogether.
       During the Cold War, we tested nuclear weapons in our 
     atmosphere, underwater and underground, to confirm that they 
     worked before deploying them, and to evaluate more advanced 
     concepts. But explosive testing damaged our health, disrupted 
     our environment and set back our non-proliferation goals.
       Eighteen years ago, President George H.W. Bush signed the 
     nuclear testing moratorium enacted by Congress, which remains 
     in place to this day.
       Under the moratorium, our laboratories have maintained our 
     arsenal through the Stockpile Stewardship Program without 
     underground nuclear testing, using techniques that are as 
     successful as they are cutting edge.
       Today, the directors of our nuclear laboratories tell us 
     they have a deeper understanding of our arsenal from 
     Stockpile Stewardship than they ever had when testing was 
     commonplace.
       Let me repeat that--our labs know more about our arsenal 
     today than when we used to explode our weapons on a regular 
     basis. With our support, the labs can anticipate potential 
     problems and reduce their impact on our arsenal.
       Unfortunately, during the last decade, our nuclear complex 
     and experts were neglected and underfunded.
       Tight budgets forced more than 2,000 employees of Los 
     Alamos and Lawrence Livermore from their jobs between 2006 
     and 2008, including highly-skilled scientists and engineers.
       And some of the facilities we use to handle uranium and 
     plutonium date back to the days when the world's great powers 
     were led by Truman, Churchill, and Stalin. The signs of age 
     and decay are becoming more apparent every day.
       Because we recognized these dangers, in December, Secretary 
     Chu and I met at the White House with the heads of the three 
     nuclear weapons labs. They described the dangerous impact 
     these budgetary pressures were having on their ability to 
     manage our arsenal without testing. They say this situation 
     is a threat to our security. President Obama and I agree.
       That's why earlier this month we announced a new budget 
     that reverses the last decade's dangerous decline. It devotes 
     $7 billion to maintaining our nuclear stockpile and 
     modernizing our nuclear infrastructure. To put that in 
     perspective, that's $624 million more than Congress approved 
     last year--and an increase of $5 billion over the next five 
     years. Even in these tight fiscal times, we will commit the 
     resources our security requires.
       This investment is not only consistent with our 
     nonproliferation agenda; it is essential to it. Guaranteeing 
     our stockpile, coupled with broader research and development 
     efforts, allows us to pursue deep nuclear reductions without 
     compromising our security. As our conventional capabilities 
     improve, we will continue to reduce our reliance on nuclear 
     weapons.
       Responsible disarmament requires versatile specialists to 
     manage it.
       The skilled technicians who look after our arsenal today 
     are the ones who will safely dismantle it tomorrow.
       And chemists who understand how plutonium ages also develop 
     forensics to track missing nuclear material and catch those 
     trafficking in it.
       Our goal of a world without nuclear weapons has been 
     endorsed by leading voices in both parties. These include two 
     former Secretaries of State from Republican administrations, 
     Henry Kissinger and George Shultz; President Clinton's 
     Secretary of Defense Bill Perry; and my former colleague Sam 
     Nunn, for years the Democratic Chairman of the Senate Armed 
     Services Committee.
       Together, these four statesmen called eliminating nuclear 
     weapons ``a bold initiative consistent with America's moral 
     heritage.''
       During the 2008 Presidential campaign, both the President 
     and Senator McCain supported the same objective. We will 
     continue to build support for this emerging bipartisan 
     consensus like the one around containment of Soviet 
     expansionism that George Kennan inspired.
       Toward that end, we have worked tirelessly to implement the 
     President's Prague agenda.

[[Page 1558]]

       In September, the President chaired an historic meeting of 
     the UN Security Council, which unanimously embraced the key 
     elements of the President's vision.
       As I speak, U.S. and Russian negotiators are completing an 
     agreement that will reduce strategic weapons to their lowest 
     levels in decades.
       Its verification measures will provide confidence its terms 
     are being met. These reductions will be conducted 
     transparently and predictably. The new START treaty will 
     promote strategic stability and bolster global efforts to 
     prevent proliferation by showing that the world's leading 
     nuclear powers are committed to reducing their arsenals.
       And it will build momentum for collaboration with Russia on 
     strengthening the global consensus that nations who violate 
     their NPT obligations should be held to account.
       This strategy is yielding results. We have tightened 
     sanctions on North Korea's proliferation activities through 
     the most restrictive UN Security Council resolution to date--
     and the international community is enforcing these sanctions 
     effectively.
       And we are now working with our international partners to 
     ensure that Iran, too, faces real consequences for failing to 
     meet its obligations.
       In the meantime, we are completing a government-wide review 
     of our nuclear posture.
       Already, our budget proposal reflects some of our key 
     priorities, including increased funding for our nuclear 
     complex, and a commitment to sustain our heavy bombers and 
     land and submarine-based missile capabilities, under the new 
     START agreement.
       As Congress requested and with Secretary Gates' full 
     support, this review has been a full interagency partnership.
       We believe we have developed a broad and deep consensus on 
     the importance of the President's agenda and the steps we 
     must take to achieve it. The results will be presented to 
     Congress soon.
       In April, the President will also host a Nuclear Security 
     Summit to advance his goal of securing all vulnerable nuclear 
     material within four years. We cannot wait for an act of 
     nuclear terrorism before coming together to share best 
     practices and raise security standards, and we will seek firm 
     commitments from our partners to do just that.
       In May, we will participate in the Non-Proliferation Treaty 
     Review Conference. We are rallying support for stronger 
     measures to strengthen inspections and punish cheaters.
       The Treaty's basic bargain--that nuclear powers pursue 
     disarmament and non-nuclear states do not acquire such 
     weapons, while gaining access to civilian nuclear 
     technology--is the cornerstone of the non-proliferation 
     regime.
       Before the treaty was negotiated, President Kennedy 
     predicted a world with up to 20 nuclear powers by the mid-
     1970s. Because of the Non-Proliferation Treaty and the 
     consensus it embodied, that didn't happen.
       Now, 40 years later, that consensus is fraying. We must 
     reinforce this consensus, and strengthen the treaty for the 
     future.
       And, while we do that, we will also continue our efforts to 
     negotiate a ban on the production of fissile materials that 
     can be used in nuclear weapons.
       We know that completing a treaty that will ban the 
     production of fissile material will not be quick or easy--but 
     the Conference on Disarmament must resume its work on this 
     treaty as soon as possible.
       The last piece of the President's agenda from Prague was 
     the ratification of the Comprehensive Test Ban Treaty.
       A decade ago, we led this effort to negotiate this treaty 
     in order to keep emerging nuclear states from perfecting 
     their arsenals and to prevent our rivals from pursuing ever 
     more advanced weapons.
       We are confident that all reasonable concerns raised about 
     the treaty back then--concerns about verification and the 
     reliability of our own arsenal--have now been addressed. The 
     test ban treaty is as important as ever.
       As President Obama said in Prague, ``we cannot succeed in 
     this endeavor alone, but we can lead it, we can start it.''
       Some friends in both parties may question aspects of our 
     approach. Some in my own party may have trouble reconciling 
     investments in our nuclear complex with a commitment to arms 
     reduction. Some in the other party may worry we're 
     relinquishing capabilities that keep our country safe.
       With both groups we respectfully disagree. As both the only 
     nation to have used nuclear weapons, and as a strong 
     proponent of non-proliferation, the United States has long 
     embodied a stark but inevitable contradiction. The horror of 
     nuclear conflict may make its occurrence unlikely, but the 
     very existence of nuclear weapons leaves the human race ever 
     at the brink of self-destruction, particularly if the weapons 
     fall into the wrong hands.
       Many leading figures of the nuclear age grew ambivalent 
     about aspects of this order. Kennan, whose writings gave 
     birth to the theory of nuclear deterrence, argued 
     passionately but futilely against the development of the 
     hydrogen bomb. And Robert Oppenheimer famously lamented, 
     after watching the first mushroom cloud erupt from a device 
     he helped design, that he had become ``the destroyer of 
     worlds.''
       President Obama is determined, and I am as well, that the 
     destroyed world Oppenheimer feared must never become our 
     reality. That is why we are pursuing the peace and security 
     of a world without nuclear weapons. The awesome force at our 
     disposal must always be balanced by the weight of our shared 
     responsibility.
       Every day, many in this audience help bear that burden with 
     professionalism, courage, and grace.
       A grateful nation appreciates your service. Together, we 
     will live up to our responsibilities. Together, we will lead 
     the world.
       Thank you.
       May God bless America. May God protect our troops.

  Mr. CASEY. Mr. President, the Vice President said that recent years 
have seen a slow but steady decline in support for our nuclear 
stockpile and infrastructure and for our highly trained nuclear 
workforce. The four national security statesmen I previously referred 
to agree. In January, all four of these experts wrote:

       These investments are urgently needed to undo the adverse 
     consequences of deep reductions over the past 5 years in the 
     laboratories' budgets for the science, technology and 
     engineering programs that support and underwrite the Nation's 
     nuclear deterrent.

  We know that JASON, an independent defense advisory group of senior 
scientists, has also echoed these same concerns in a recent study. The 
JASON group found that the lifetimes of today's warheads could be 
extended for decades. That was the good news. While the weapons are in 
good shape, JASON is concerned that maintenance of the stockpile relies 
on the ``renewal of expertise and capabilities in science, technology, 
engineering, and production unique to the nuclear weapons program'' and 
that this expertise was ``threatened by lack of program stability, 
perceived lack of mission importance, and degradation of the work 
environment.''
  The Obama administration's budget request reflects these concerns. 
The fiscal year 2011 budget request devotes $7 billion to maintaining 
our nuclear weapons stockpile and complex and for related efforts. 
Delivering on promises made in Prague and elsewhere, this 
administration has demonstrated a clear commitment to a nuclear 
nonproliferation strategy that is an integral part of our security and 
that of our allies.
  As Under Secretary of State for Arms Control in International 
Security, Ellen Tauscher, a former Member of the House, said recently:

       Nuclear disarmament is not the Holy Grail. As long as we 
     see the rise of nuclear weapons in other countries, we will 
     maintain deterrence that is second to none.

  This approach by Ellen Tauscher is smart, strategic, and measured, 
and it puts American security first.
  As I stand in support of full funding for the administration's 
nuclear weapons stockpile and complex request, I believe it is very 
important that we stand together--all of us, Democrats, Republicans, 
and Independents.
  Key dimensions of our nuclear stockpile are the nuclear labs and 
resident scientific expertise. We need to be able to continue to 
recruit the most highly qualified and motivated experts tasked with 
stockpile maintenance. Our three National Laboratories--Lawrence 
Livermore in California, Los Alamos in New Mexico, and Sandia in New 
Mexico and California--are staffed by gifted public servants who have 
established methods for verifying the safety, security, and reliability 
of our stockpile. This budget presented by the administration will help 
to ensure that the most talented scientists continue to be attracted to 
our labs and that these labs continue to be state of the art.
  The administration's 2011 budget request also bolsters the case for 
eventual ratification of the Comprehensive Test-Ban Treaty. A full 
investment in our nuclear weapons infrastructure will mean the United 
States can continue to maintain its nuclear weapons infrastructure 
without testing. We have not tested a nuclear weapon since 1992 because 
we now have the technical means to ensure the reliability and safety of 
our stockpile without testing.
  This is an issue of national security and preventing nuclear 
terrorism. By working to diminish access to fissile material, by 
working to ensure Russia and the United States decrease nuclear 
stockpiles, and by promoting a ban on nuclear testing and by ensuring 
our nuclear arsenal is safe and secure--all of

[[Page 1559]]

these measures, as well as others--will help to create an international 
environment where a terrorist's access to fissile material is 
diminished.
  I should mention as well the work of Senator Lugar. Senator Lugar has 
been a remarkable leader in regard to promoting the Nunn-Lugar program 
all these years. I agree with Senator Lugar's efforts to secure more 
funding as the mandate of the program is expanded without commensurate 
resources. Senator Lugar reports that the program ``has eliminated more 
nuclear weapons than the combined nuclear arsenals of France, China, 
and the United Kingdom for less than $3 billion--a striking return on 
investment.'' I have to agree that is a striking return, indeed.
  Finally, I also express support for the administration's requested 
increase in funding for the International Atomic Energy Agency, which 
we all know by the acronym IAEA. For too the long, the IAEA's technical 
assistance and cooperation programs have been underfunded. 
International nonproliferation efforts face an uncertain future. Iran 
and North Korea are our primary concerns, but potential nuclear 
flashpoints remain between India and Pakistan, and the security of 
fissile material, while improving, remains a vital concern. In order 
for the IAEA to be best positioned to confront proliferation efforts in 
North Korea and Iran, as well as monitor the peaceful nuclear energy 
programs in countries around the world, its budget needs to reflect 
this growing portfolio. U.S. leadership in nonproliferation is 
essential. A fully funded IAEA will complement U.S. efforts to combat 
proliferation at this critical time.
  These investments in our national security are substantial, but there 
is no greater threat than that of nuclear terrorism. We must remain 
vigilant in doing everything we can to ensure terrorists do not get 
their hands on weapons of mass destruction. The nonproliferation 
measures mentioned above all help to address this threat.
  To keep America safe, Democrats, Republicans, and Independents must 
work together--let me say that again--must work together to promote 
nonproliferation and confront nuclear terror by ensuring that our 
existing nuclear arsenal is safe, secure, and effective.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ENSIGN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ENSIGN. Mr. President, in a moment, I will ask unanimous consent 
to be able to offer an amendment, but first I wish to talk about that 
amendment because I understand the other side is going to object.
  Currently, there are seven States that collect no income tax from 
their residents. Those States are my home the State of Nevada, Florida, 
South Dakota, Tennessee, Texas, Washington, and Wyoming.
  Under current Federal tax law, in all the States that have an income 
tax, individuals are allowed to deduct those income taxes from their 
Federal tax form. Your property taxes can also be deducted. Even when 
you register your car and pay your registration fee on your car, you 
are allowed to deduct that because that is a local tax. The tax that 
you are not allowed to deduct, if we don't extend current law, will be 
the sales tax.
  My State relies more on a sales tax for its revenue sources. That is 
what it decided to do. Other States have chosen to set their taxes up 
differently. But States have the flexibility to set up their taxes in 
the way they feel is best for their residents. My State actually has a 
constitutional amendment against collecting a State income tax from its 
residents.
  Nevadans don't want a State income tax, but they want to be treated 
fairly. So a few years ago, we passed a law so that Nevada and these 
six other States would be treated fairly; so that residents would have 
the option of deducting a sales tax or an income tax. It is just a 
matter of fairness, but it also allows people to keep more of their own 
income. At the end of last year, the deductibility for the sales tax 
expired, and I would like to be able to offer an amendment to extend it 
in this jobs bill.
  I believe if people have more of their own money--money they can 
count on--they will make good decisions, and they will actually go out 
and spend some of that money. I believe this would actually be a good 
measure to put in the jobs bill. It was in the original bipartisan bill 
that Chairman Baucus and Ranking Member Grassley came up with and 
introduced. So I am hoping the other side will not object, although I 
understand they are going to.
  Mr. President, I ask unanimous consent that it be in order to offer 
an amendment to allow for the deduction of State and local sales tax.
  The PRESIDING OFFICER. Is there objection?
  In my capacity as a Senator from Colorado, I object.
  Objection is heard.
  Mr. ENSIGN. Mr. President, I knew that was going to happen because 
the majority party has decided to allow no amendments on this bill, 
which is a shame. It is the reason I voted against cloture on the bill 
yesterday, because I think it is only fair that we get to offer 
amendments on such an important and expensive bill. This is one of the 
amendments that I think should be allowed.
  We will be making other efforts during the year to get the sales tax 
deductibility enacted into law because it is a question of fairness for 
these seven States. I know the Senators from those seven States join me 
in fighting for this. We fought together before, and we are going to 
continue to fight to try to make sure this deductibility, as a matter 
of fairness for our citizens, is maintained in Federal law.
  I yield the floor.
  Mr. GRASSLEY. Mr. President, as I stated earlier today, I had worked 
to put together a bipartisan package with my colleague, Finance 
Committee Chairman Baucus, to address some time-sensitive matters that 
need to be considered.
  I was under the impression that the Senate Democratic leadership 
genuinely wanted to work on a bipartisan basis but, unfortunately, I 
was mistaken.
  Although the majority leader was deeply involved in the development 
of our bipartisan bill, as soon as it was released he announced that he 
would not take it up, and he arbitrarily decided to replace it with a 
bill he plans to jam through the Senate.
  I addressed my concerns earlier about the removal of the tax extender 
provisions.
  Now I want to discuss another significant change between the 
bipartisan package Chairman Baucus and I put together and the Senate 
Democratic leadership's bill that we will be voting on this week.
  A package of expired and expiring Medicare health provisions has been 
removed without any explanation. These bipartisan provisions are 
essential to the health and well-being of Medicare beneficiaries. They 
have been routinely supported by both sides and passed repeatedly in 
recent years.
  So where does that leave us? We are now less than a week away from 
the end of February, and Medicare beneficiaries around the country will 
suffer from the Senate Democratic leader's decision to remove these 
provisions without any explanation. Medicare beneficiaries should not 
be held hostage to whatever partisan goals the Senate Democratic 
leadership envisions.
  To make matters worse, they have decided to ``fill the tree,'' as the 
procedure is called, so there will be no opportunity to offer these 
essential health provisions known as ``Medicare extenders'' as 
amendments to his bill.
  The decision to abandon a bipartisan approach is especially ironic 
considering the fact that later this week President Obama is hosting a 
bipartisan meeting with Senators and Members of the House to discuss 
health care reform.

[[Page 1560]]

  It is too early to tell if that meeting will lead to a true 
bipartisan effort to address health care reform issues, at least in 
some areas where there is broad agreement on both sides. But I commend 
the President for his bipartisan outreach and invitation to meet and 
discuss these important issues. It is an approach that the Senate 
Democratic leadership abandoned last year.
  Apparently, political games have become more important than ensuring 
that critical legislation is passed to protect Medicare beneficiaries' 
access to health care.
  Many individuals, in fact, are already in jeopardy of suffering 
adverse consequences to their health because of the failure by the 
Senate Democratic leadership to ensure that these critically needed 
Medicare provisions would be enacted by the end of last year. These are 
the same provisions that had broad, bipartisan support when they were 
considered by the Finance Committee and included in the health care 
bill the committee reported last fall.
  I am going to review some of these provisions and the impact they 
have on Medicare beneficiaries and their access to health care.
  First, there is the need for a physician payment update, what we 
commonly refer to as the ``SGR'' or the ``doc fix.'' A 2-month 
extension that was passed in December is scheduled to expire on 
February 28, just 5 days from now. Unless a physician update is enacted 
by March 1, physicians, nurses, and other health care practitioners 
will experience severe payment cuts of 21 percent as of that date.
  These payment cuts would be even more disastrous for physicians in 
rural States, such as Iowa, where Medicare reimbursement is already 
about 30 percent lower than in other areas. But payment cuts of this 
magnitude will severely impact physicians and health care practitioners 
throughout the country, and they will significantly threaten 
beneficiary access to care.
  Should these cuts occur and continue for any length of time, they 
will have a truly disastrous effect on the ability of seniors to find, 
or keep, physicians who take Medicare patients.
  I am appalled that Medicare beneficiaries' access to physicians and 
other needed medical care is being jeopardized because of the political 
games that are being played by the Senate Democratic leadership.
  Let's look at beneficiaries who are already being affected by other 
Medicare provisions that should have been extended, as they have been 
in the past, but that were allowed to expire at the end of last year.
  One of the most pressing is an extension of the exceptions process 
for therapy caps. The law puts annual payment limits or financial caps 
on therapy services. There are annual dollar limits on outpatient 
physical therapy and speech-language pathology therapy combined and on 
occupational therapy.
  While the law provided for an exceptions process to these caps when 
additional therapy was medically necessary, that provision expired at 
the end of 2009. Medicare beneficiaries who have suffered strokes or 
serious debilitating injuries, such as a hip fracture, have significant 
rehabilitation needs. Some of these beneficiaries have already exceeded 
their therapy limits for 2010.
  Since the exceptions process that would have allowed these patients 
to receive more needed therapy has expired, beneficiaries with the 
greatest need for therapy will be the hardest hit. Congress must 
address this issue immediately.
  A second issue of major concern is the need for additional payment 
for mental health services. A provision that expired at the end of last 
year provided an additional 5-percent payment for Medicare mental 
health services provided by psychologists and mental health counselors. 
This provision has been key to improving access to mental health care 
services for veterans and other military personnel suffering from post-
traumatic stress and other disorders since TRICARE coverage is based on 
Medicare rates.
  Significant shortages of mental health personnel have made it 
exceedingly difficult for Medicare beneficiaries and some of our 
military returning from overseas to find this critically needed help. 
The expiration of this provision has made it even more difficult for 
them to obtain these services. Congress needs to act immediately to 
help Medicare beneficiaries and members of the Armed Forces in need of 
mental health services.
  A third issue concerns additional payments for ambulance services 
that are routinely extended, year after year. Many ambulance providers 
need them to survive. But those provisions also expired at the end of 
last year.
  Another provision would ensure that Medicare beneficiaries can 
continue to get vital medical supplies such as diabetic test strips, 
canes, nebulizers, and wound care products from their local community 
pharmacies.
  Under current law, suppliers of durable medical equipment, 
prosthetics, orthotics, and other supplies must get accredited to prove 
they comply with quality standards. Many eligible professionals, such 
as physicians, nurse practitioners, physical therapists, and others are 
specifically exempted from this requirement. This provision would 
exempt pharmacies from being accredited under certain circumstances. 
Pharmacies must have been enrolled as a Medicare supplier with a 
provider number for at least 2 years, have DME billings that are less 
than 5 percent of their total sales, be in good standing with Medicare, 
and meet other criteria.
  Medicare beneficiaries living in rural and underserved areas are 
particularly at risk of losing access to these critical medical 
products. This provision is essential to ensure they do not.
  There are also a number of expired provisions in this package that 
improve payment for hospitals, especially rural hospitals. These 
hospitals rely on these provisions to keep their doors open.
  The impact of a hospital shutting its doors would be especially hard 
on rural and underserved areas where hospitals are the only point of 
access for health care.
  Our country is facing record unemployment and Americans are 
struggling to make ends meet. The failure to extend these essential 
Medicare provisions immediately will make access to health care or 
needed medical services simply unavailable for many beneficiaries. The 
impact will be even worse for those in rural areas already facing 
health care access problems.
  These examples show some of the damage that failing to extend these 
Medicare provisions will do to our seniors' health care.
  We need to get back to work on the bipartisan package that was in the 
works until the Senate Democratic leadership's dramatic change in 
direction.
  Medicare beneficiaries are counting on us to work together and get 
this done.
  Mr. President, 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. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. REID. Mr. President, I ask unanimous consent that when the Senate 
convenes Wednesday, February 24, all postcloture time be considered 
expired, except for any time available until 9:55 a.m., and that at 
9:55 a.m. the Senate proceed to vote on a motion to waive the 
applicable budget points of order; further, that if the points of order 
are waived, without further intervening action, the second-degree 
amendment be withdrawn and no further amendments be in order; the 
Senate then proceed to vote on the Reid motion to concur in the House 
amendment to the Senate amendment to H.R. 2847, with amendment No. 
3310; provided further that upon disposition of the House message with 
respect to H.R. 2847, the Senate proceed to a period of morning 
business, with Senators permitted to speak for up to 10 minutes each.
  The PRESIDING OFFICER. Without objection, it is so ordered.

[[Page 1561]]



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