[Congressional Record (Bound Edition), Volume 158 (2012), Part 10]
[Senate]
[Pages 13519-13527]
[From the U.S. Government Publishing Office, www.gpo.gov]




     VETERANS JOBS CORPS ACT OF 2012--MOTION TO PROCEED--Continued

  The PRESIDING OFFICER. The Senator from Michigan.


                             The Farm Bill

  Ms. STABENOW. Madam President, as we come back into session this 
evening and into September, as Chair of the Agriculture Committee I 
have one message for colleagues in the House of Representatives--for 
the Speaker, for the Republican leadership--and that is, we need a farm 
bill now.
  We have 20 days until the farm bill expires--only 20 days. If that 
happens, if the Republican leadership does not work with us to pass a 
5-year farm bill, they are going to reset the clock for rural America 
all the way back to 1949. Because if the farm bill expires, we go back 
to Depression-era policies that include government planting 
restrictions and expensive price supports--absolutely unacceptable.
  Some of those policies even reference prices from before World War I. 
This would be terrible for our family farmers and ranchers. It would 
throw the markets into complete disarray. There is no reason this 
should be allowed to happen. The full Senate has worked together and 
passed a bipartisan farm bill. The House Agriculture Committee worked 
together and passed a bipartisan farm bill. It is time for the House to 
complete its work. The House Republican leadership has refused to let 
the bipartisan bill come up for a vote.
  Despite our best efforts in speaking with colleagues and working 
together over the August break to try to come up with a way to get this 
done, we find ourselves in a position now where our only opportunity is 
for the House to take up the bill that was passed by their committee 
and get this done. I have never seen a situation where a farm bill--
this is my fourth one I have been involved with--comes out of committee 
on a bipartisan basis, and then the House will not take it up, which is 
exactly where we are.
  Instead, they sent us a so-called disaster relief bill that, 
unfortunately, only helps some livestock producers with the drought 
this year. It does nothing for the rest of the Nation's farmers who 
have been hurt so badly this year by frost and freezes. Our farm bill 
does that. In fact, our farm bill is better for livestock. It is a 
permanent livestock disaster assistance program with a better structure 
and support than that which was sent by the House of Representatives.
  A full 5-year farm bill gives much more comprehensive disaster 
assistance to livestock producers and to other farmers who have been 
hit. Other farmers who have watched as their crops withered under the 
unforgiving Sun want to know that not only will we have a 5-year policy 
in place, but that we are going to strengthen crop insurance, which is 
really the backbone of supporting farmers in these kinds of situations.
  We strengthen crop insurance and expand it so more farmers can have 
access to risk management tools on their farms. That was the No. 1 
issue that we heard in all of our hearings, to strengthen crop 
insurance. And that is what we did. That is one of the reasons we need 
to get a 5-year farm bill done.
  I am looking at my colleague from Iowa, the distinguished Senator who 
chaired the committee before me. I know he shares the same feeling that 
I do, that we need to get this bill done in the House of 
Representatives.
  We know our farm bill also fixes dairy support so dairies do not go 
through what they went through in 2009, when thousands of farms went 
bankrupt. Frankly, not changing the policy for dairy is a disaster 
waiting to happen. So we need to get the farm bill done.
  We also reform programs. We know we have ended direct payments and 
altogether four different subsidies, saving $15 billion while 
strengthening crop insurance. We streamline and address duplication, 
crack down on waste, fraud, and abuse. In the end, our bill saves $23 
billion for taxpayers--$23 billion to pay down the debt. The only real 
deficit reform we passed in the Senate was our farm bill, which we 
worked on together.
  Unbelievably, the House Republican leadership still stands in the way 
of passing our bipartisan bill or their own committee's bipartisan 
bill. On Wednesday we are going to see thousands of farmers around the 
country coming to Washington with a simple message: We need a farm bill 
now. Members are going to have visits from farmers and ranchers from 
their States. House Members will be hearing from members in their 
districts. They have one simple message. Those farmers knew when there 
is work to be done you do not put it off to another day. Not if you are 
going to be successful as a farmer. And we shouldn't be kicking the can 
down the road either. They

[[Page 13520]]

can't say: I don't want to harvest my crops right now. I think I will 
do it in a few months or next year or tell the banker to wait until 
later so I can figure out what I have to make decisions on for next 
year. They know that when the crops need to be harvested, the work 
needs to get done now.
  Well, we have 19 days left. This is day 20. We are going to count it 
down every day because we have to get this done in the House of 
Representatives. We did our job in the Senate on a bipartisan basis. I 
was very proud to join with our colleague Senator Roberts and all of 
our committee who worked so well together and worked so hard, and I 
again thank the leadership on both sides of the aisle for giving us the 
time to get it done. We got it done, and we did it in enough time to 
give the House time to do it in July before the August break. But that 
didn't happen. Now it is time to get it done. The House Agriculture 
Committee did its job. It is time for the House Republican leadership 
to schedule a vote to get this done, to support rural America--our 
farmers and ranchers and families who are counting on the safest, most 
affordable food system in the world to be able to continue. We don't 
need to kick this can down the road and create another crisis for farm 
country.
  Madam President, I wish to thank my colleagues who are waiting to 
talk about another very important subject. I appreciate their giving me 
the time for a few words.
  Mr. HARKIN. Madam President, would the Senator yield for a question?
  Ms. STABENOW. I would be happy to yield.
  Mr. HARKIN. Madam President, I would like to compliment the Senator 
from Michigan for her great leadership on agriculture policy, food 
policy. A big part of this bill is making sure that our kids in America 
get adequate nutrition, that our elderly get good nutrition. Our summer 
and afterschool feeding programs and feeding programs for our seniors 
are all wrapped up in this bill too.
  I was in Iowa in August and met with a lot of farmers, and they were 
a little perplexed.
  They said: Wait a minute. You passed a bill in the Senate?
  I said: Yes.
  So I ask the Senator from Michigan, did not that bill have the 
support of all the major farm organizations?
  Ms. STABENOW. Absolutely. We had the support of farm groups and 
conservation groups all across the country.
  Mr. HARKIN. I ask the Senator from Michigan, did not her bill, the 
bill she engineered and got through here, have the support of consumer 
groups and parent groups?
  Ms. STABENOW. Absolutely.
  Mr. HARKIN. It had all that support?
  Ms. STABENOW. Absolutely. And because of the wonderful work of the 
Senator from Iowa on our school nutrition efforts and the Fresh Fruit 
and Vegetable Program, we had the strong support of families, 
educators, and schools across the country.
  Mr. HARKIN. Conservation groups supported the bill?
  Ms. STABENOW. Absolutely.
  Mr. HARKIN. Well, what farmers asked me was this: If you had a bill 
that passed the Senate, a bipartisan bill supported by all the major 
farm groups, supported by consumer and conservation groups, why didn't 
the House just pick it up and pass it?
  I didn't have an answer. Does the Senator from Michigan have an 
answer? Because I don't understand why the House can't take a bill that 
is so widely supported and is such a bipartisan bill and just pass it.
  Ms. STABENOW. Well, the distinguished Senator is absolutely right. 
One would think this would be the time to just pass it. And frankly, if 
not, because we know the House committee has a little different view on 
commodities, we offered to sit down all through August to work that out 
so we could come back now and come up with something that was a 
compromise. But the House committee wasn't able to do that because they 
do not have the support of the leadership to get that done. So here is 
where we are. What I know is that we have to have movement. We have to 
have the House act or we are not going to be able to get this done.
  Mr. HARKIN. I say to my friend from Michigan, my leader on 
agricultural policy, she knows there is enough anxiety in farm country 
now because of the terrible droughts we are having around the country, 
the shortages that are looming, that now is not the time to add more 
anxiety to farmers and to farm families and our rural communities 
across America. So I thank the Senator for her great leadership and for 
pointing out that as well as acting. Our committee has acted, the 
Senate has acted, and what the House is doing I just can't figure out.
  Again, I compliment the chairwoman of our committee for pointing out 
that we have 20 days left and we are counting down. I am hopeful the 
House will hear the voices of our farm country and the bipartisan 
voices here in the Senate and get a bill passed--or agree to the bill 
passed in the Senate. I thank the Senator from Michigan.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Madam President, I ask unanimous consent that when I have 
completed my statement, Senator Harkin be permitted to take the floor 
at that time.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                            The Ryan Budget

  Mrs. BOXER. I wish to thank Senator Harkin because he and I were 
spending a little time together in the great State of our Presiding 
Officer, and he and I agreed that one of the issues that ought to be 
talked about a little bit more involves the stark choice we are facing 
in November in large part due to the budget of Paul Ryan, who is now 
the Vice Presidential nominee for the Republicans. And Governor Romney 
has endorsed and embraced the Ryan budget.
  I think it was Senator Harkin's idea that we ought to explain that 
Ryan budget, so I am going to do my best to talk about it as the 
chairman of the Environment and Public Works Committee, which has the 
jurisdiction of highways, bridges, transportation systems, and the 
environment, and I will also make a couple of comments about Medicare. 
I know Senator Harkin is going to go into that in great depth.
  I want to make sure everybody understands that what I am talking 
about comes straight from the budget. So if you look at page 78 of the 
report accompanying the Ryan budget resolution, Mr. Ryan makes it clear 
he wants to make devastating cuts to transportation. What do I mean 
when I say that? I mean devastating. I mean a 50-percent cut, which 
means about 1 million jobs would be lost if the Ryan budget were to go 
into effect. We are talking about construction jobs--an area that has 
been hit so hard. We still haven't come back from this recession. And 
if there is one thing we learned when we were in the Presiding 
Officer's great State at that convention, it was the depth of this 
recession--the worst since the Great Depression. What a time Paul Ryan 
picks to bring devastating cuts to the construction industry. I am 
talking about businesses and jobs mostly in the private sector, not the 
public sector.
  We have to think about the fact that 70,000 of our bridges are 
deficient and 50 percent of our roads are not in good condition. We 
know bridges fail. We have seen it happen. We are not only talking 
about devastating cuts to the construction industry and its workers but 
a devastating situation for people who use our bridges--the 70,000 of 
which are structurally deficient--and our roads, which need help. So no 
country can lead the world if we can't move people and goods, and we 
cannot be a world power when it comes to transportation.
  The Ryan budget is a jobs killer. I am talking about 1 million jobs 
that would be lost--in the private sector mostly--and it would put our 
families at risk by neglecting our bridges, our highways and our 
transit systems. Now, President Obama, on the other hand--and, frankly, 
a lot of us here on both sides of the aisle--reject the notion that we 
can walk away from rebuilding our infrastructure. So this is a very key 
issue.
  I said I wanted to speak as the chairman of the Environment and 
Public

[[Page 13521]]

Works Committee, and I have talked a little bit about public works, but 
what does the Ryan budget do to the environment? What he does is he 
undermines the public health protections provided by the Clean Air Act, 
the Clean Water Act, the Safe Drinking Water Act, and other landmark 
laws.
  If we look at pages 13 to page 15 of his budget, we can see he cuts 
$62 billion for activities such as protecting our drinking water, 
protecting our air, and preserving our public lands. Let's face it: 
When kids get asthma, when people are too sick to go to work, when 
children are too sick to go to school, and when people die prematurely 
from heart attacks because of the air quality, there are no real 
savings. He says he is cutting $62 billion from the budget. Let me just 
say that for every dollar we spend on clean air protections, we know we 
get $30 worth of benefits. In 2010 alone, the Clean Air Act prevented 
160,000 premature deaths. Ask a family who stands to lose the 
breadwinner in that family: Did we save money? No.
  Let me cite some numbers: 1.7 million asthma attacks, 130,000 heart 
attacks, 86,000 emergency room visits, 13 million lost workdays, and 
3.2 million lost schooldays. In 2010 the Clean Air Act prevented all 
that.
  So what is the point, Mr. Ryan? What is the point? It will cost the 
American public dearly out of their pockets and out of their lives if 
they suffer more asthma attacks, emergency room visits, lost workdays, 
lost schooldays, and they have more heart attacks and premature deaths. 
That is shortsighted. The American Lung Association--and they are not 
Republican or Democratic--says that 40 percent of our population lives 
in areas with unhealthy levels of smog or toxic soot.
  So let's remember that when we look at a budget, there is a set of 
values that accompany the numbers. And I don't think it is an American 
value to say to our people that we don't care if they get sick, they 
miss work, or they go to the emergency room.
  Finally, I want to set the stage for Senator Harkin's very in-depth 
discussion about health care. I am just going to talk about Medicare 
and Medicaid as someone who is privileged to represent, along with 
Senator Feinstein, the largest State in the Union, with the most senior 
citizens. We have almost 38 million people. So whenever I talk about 
this Ryan budget and how many people get hurt, believe me, I speak from 
the heart when I say we can't let it happen.
  The American people know Medicare, they like it, and they do not want 
to change it. Now, the Republicans tell us their plan saves Medicare. 
But just ask someone. Ask someone who is going to be the victim of the 
Paul Ryan plan if we don't stop it. That person will find they are 
getting a voucher; they are not getting Medicare. Medicare will be 
gone. They will get a voucher, and experts tell us and the studies show 
that voucher will be almost $6,000 a year short. Imagine an older 
person who really is struggling for a quality of life having to have 
the added worry of not knowing whether he or she will be able to find 
health insurance.
  Look, putting Republicans in charge of Medicare is like putting the 
Cookie Monster in charge of your favorite bakery. And I am not 
overstating it. No one would put the Cookie Monster in charge of their 
favorite bakery. Well, we can't put the Republicans in charge of 
Medicare, and I will prove why. This isn't just rhetoric. Listen. In 
1995 Newt Gingrich said he thought Medicare, in his words, should 
wither on the vine. In his 1996 Presidential campaign, Senate majority 
leader Bob Dole bragged:

       I was there fighting the fight, voting against Medicare, 
     because we knew it wouldn't work in 1965.

  Really? Really. Medicare works. Why would we end it? We are not going 
to end it. But if Paul Ryan gets into power, he will have a good chance 
of ending it with his friend and Presidential candidate Mitt Romney who 
has endorsed the Ryan budget.
  Listen to what Michael Steele, the head of the Republican National 
Committee, said in 2009:

       I mean, the reality of it is this single-payer program 
     known as Medicare is a good example of what we should not 
     have happen.

  The Ryan budget at page 53 shreds Medicare. As if he hasn't slammed 
Medicare enough, look what he does to Medicaid. He cuts it by more than 
$800 billion. Where are low-income families going to go?
  Senator Harkin is the expert, but I can tell you this. So many of our 
elderly rely on Medicaid for nursing home costs. It is a disaster. We 
know that in addition to all these terrible cuts--and by the way, when 
Paul Ryan attacks President Obama for cutting money from Medicare, what 
he isn't telling us is the President has found savings from 
overpayments to providers. Do you know what he does with the money? He 
puts it right back into Medicare, extends the life of the program for 8 
years, closes the doughnut hole to help seniors, and gives senior 
citizens preventive health care, well checkups, and the like.
  To quote President Clinton, that ``takes a lot of brass.'' Because 
the fact is, President Obama has strengthened Medicare and has extended 
the life of Medicare. What Paul Ryan does is he takes those cuts and he 
gives tax breaks to millionaires and billionaires.
  I yield to my friend.
  Mr. HARKIN. I thank the Senator for yielding, and I thank the Senator 
for her keen eye on the Ryan budget and what it does.
  I listened to the Senator's explanation of President Obama's goal to 
cut down overpayments, fraud and abuse, and to put that money back into 
helping beneficiaries. I ask the Senator, isn't it true that both Ryan 
budgets incorporate those very same cuts President Obama wants to do?
  Mrs. BOXER. Absolutely. Both his budgets take the same amount. But 
instead of putting it back into Medicare, he robs Medicare, and 
Medicare will go broke--my understanding--in 2016 under the Ryan plan; 
whereas, President Obama puts the money back into Medicare, extends the 
life 8 years, and gives more benefits.
  I am going to finish up and just say this. However you look at this, 
this Ryan budget is a roadmap for disaster for the American people. He 
cuts the heart out of things the American people like. The American 
people want clean air, they want safe drinking water, they want 
Medicare, they want to make sure our seniors can be safe in nursing 
homes. The American people want transportation--and they don't want to 
be worried if a car is on a bridge that is going to fall down into the 
water below. It has happened.
  Here is the deal. If we were to say to Mr. Ryan: Are you cutting all 
this so you could balance the budget today, he would say: Oh, no; that 
is 25 years from now.
  What is he doing with the ``savings''? He is giving these huge tax 
breaks. I will close with this. People earning more than $1 million a 
year are going to receive $400,000 more in tax breaks every year. So he 
cuts everything to give these tax breaks to the people who already have 
millions and billions, but it is still not enough. As President Obama 
has pointed out, he will then have to go after the middle class and 
take away middle-class tax deductions, such as the home mortgage 
deduction, because he doesn't even get enough money from these 
Draconian cuts. He has to go ahead and raise taxes on the middle class.
  I watched Presidential nominee Romney be asked this question: What 
are you going to cut? He said: Well, we will discuss it later. Mr. 
Ryan, the Republican Vice Presidential nominee, said: We will work with 
Congress on it. Right.
  Listen, they know they have to make Draconian tax increases on the 
middle class and the working poor. They have to cut the things America 
wants in order to pay for their tax cuts. No wonder Mr. Romney picked 
Mr. Ryan. Mr. Romney will be in the 1-percent tax bracket--that is what 
the experts say--can you imagine?--while his secretaries and everybody 
else pay through the nose.
  These next 60 days or so is an important time for us. I wish to thank 
my friend from Iowa because I was very interested in laying out some of 
these issues and he encouraged me to do so. I am very delighted to be 
here with him.

[[Page 13522]]

  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. HARKIN. Madam President, let me thank my colleague Senator Boxer 
for always being on point and for always being very eloquent in her 
focus and explanation of the fallacies of the Ryan-Romney budget and 
how it is going to affect our middle-class families in the future.
  Since we recessed around the 1st of August and have been out of 
session, Congressman Paul Ryan--our colleague in the House--has become 
the Vice Presidential nominee of the Republican Party, and, of course, 
Mr. Romney has accepted the nomination to be President. Congressman 
Ryan is not an unknown quantity. He has been here quite a few years, 
and as the head of the Budget Committee he has put forward a couple 
budgets. Budgets are blueprints. If one is going to build a building or 
a house, they need a blueprint. If you are going to try to move the 
country in a certain direction, you need a blueprint, and that 
blueprint is a budget. A budget sort of tells us where it is that the 
proponent of that budget wants to take us as a country--a Federal 
budget. If it was a State budget, we would say that is where they want 
to take the State.
  So we on this side intend, over the next several days, couple weeks--
however long we are in session--to let the American people know what is 
in the Ryan budget and where it would take America: What is the 
blueprint they have for America?
  Our Nation faces an absolutely fundamental choice in November: Are we 
going to rescue, restore, and rebuild the struggling middle class in 
this country or are we going to continue to shift even more wealth and 
advantage to those at the top at the expense of the middle class? 
Republicans have made it very clear where they stand on this critical 
choice. They did so when nearly every Republican in Congress voted in 
favor of the Ryan budget plan, and Governor Romney embraced that plan 
as marvelous--not exactly a word most average Americans would use to 
describe something they like. But if you are having tea at the Ritz, I 
guess ``marvelous'' kind of fits for some people. Anyway, he embraced 
the plan as marvelous.
  The very centerpiece of the Ryan budget is a dramatic shift of even 
more wealth to those at the top, huge new tax cuts for the richest 2 
percent. As the Senator from California pointed out, if we take the 
Bush tax cuts and extend those--which Mr. Romney would do and Mr. 
Ryan's budget does--then add on to it the tax cuts in the Ryan budget--
which Mr. Romney supports, so I can call it the Romney-Ryan budget or 
the Ryan-Romney budget. If we do that and you make over $1 million a 
year, you are going to get nearly $400,000 a year in new tax cuts. 
Think about it. It takes your breath away--$129,000 in the Bush tax 
cuts would be extended, plus an additional $265,000 that would be in 
the Ryan budget.
  We hear a lot about entitlements; we are going to cut entitlements. 
But this is an entitlement. Think about it. If someone makes over $1 
million a year, they are entitled to that. They don't have to do 
anything else. They don't have to jump through any hoops. They don't 
have to show any hurt or anything else. Just if someone makes over $1 
million, they are entitled to it. How about this entitlement? 
Republicans always want to make it seem as though entitlements only go 
to poor people or the elderly or children. They talk about Medicaid as 
an entitlement. What about this? This is an entitlement to those who 
are rich.
  How do the Republicans pay for this? They don't want to say how, but 
all we have to do is look at the Ryan budget and that will tell us how 
they pay for it. They pay for it by massive Draconian cuts to programs 
that undergird the middle class and essential to the quality of life in 
this country, such as education cuts, student grants and loan cuts, law 
enforcement, clean air and clean water, food safety, medical research, 
highways, bridges and other infrastructure that was focused on by the 
Senator from California--all those would be cut.
  The Republican plan would end Medicare, period. It would turn it into 
voucher care. So now we have a new word, not Medicare but voucher care, 
that would force seniors to pay nearly $6,000 more per year out of 
pocket for their health care in future years. We don't get Medicare; we 
get a voucher. That plan would strip tens of millions of Americans of 
their health care coverage and cut millions of poor kids from nutrition 
programs. Their plan would leave America with a less-skilled workforce, 
a deteriorating infrastructure, making us less competitive in the 
global marketplace.
  Lastly, Republicans offset these big new tax cuts by actually raising 
taxes on the middle class. That is a dirty little secret you won't find 
unless you dig into the Ryan budget. It is true. Here is why: Under the 
Republican plan, under the Ryan-Romney budget, middle-class families 
are net losers, paying significantly higher taxes. The wealthy are huge 
net winners. The nonpartisan Tax Policy Center estimates that under the 
Romney-Ryan budget, middle-class families with children would see their 
taxes go up, on average, by more than $2,000 a year.
  The bottom line is that the Romney-Ryan budget does not reduce the 
deficit. I hear Congressman Ryan and Mr. Romney out there talking on 
the stump about the budget and the deficit, and they go on and on. Why 
don't they own up to it? The Ryan budget keeps us in a deficit for 28 
more years. Yes, you heard me right. The Ryan budget keeps us in the 
red for 28 more years.
  When President Clinton was inaugurated in January of 1993 and we put 
through the Clinton budget--which, I might point out, not one 
Republican supported--it turned those deficits right around, and within 
5 or 6 years we were in a surplus. It doesn't take 28 years. It only 
took a Democratic President and a Democratic Congress passing the 
legislation in 1993 to end the slide into deficits and turn it into a 
surplus in only 5 or 6 years. The Ryan budget keeps us in a deficit for 
28 years. Again, the savings they gain by slashing spending and raising 
taxes on the middle class go to partially offsetting the $4.5 trillion 
in new tax cuts, most of which goes to the wealthiest Americans.
  The truth is Representative Ryan is not interested in balancing the 
budget. That is not his interest. Even under his most rosy assumptions, 
the budget would not balance until 2040. The reality is the Ryan 
budget's overriding goal is not to balance the budget but to reduce 
taxes on those at the top. Congressman Ryan has turned out to be a true 
acolyte of former Vice President Cheney, who famously said in an 
unguarded moment: ``Deficits don't matter.'' Do you remember that? Vice 
President Cheney, ``Deficits don't matter.'' I guess they didn't to him 
and President George W. Bush because look at the deficits they plunged 
us into. Now Congressman Ryan is basically, with his budget--he will 
not say it publicly, but with his budget he is saying the same thing: 
Deficits just don't matter. What matters are tax cuts for the wealthy.
  Never in our history have we seen a deficit proposal so radical and 
extreme. I was here. I was in the House and then later in the Senate 
when President Reagan was President. He was conservative, but he was 
not radical and as extreme as this budget. When I tell people back in 
Iowa about the Ryan budget, they say: Come on. That approach is so 
extreme and unbalanced you must be making it up.
  The Romney-Ryan plan is extreme and unbalanced, and I am not making 
it up. Don't take my word for it. Listen to former House Speaker Newt 
Gingrich. He criticized the Ryan budget. He called it ``rightwing 
social engineering.'' All I can say is, Newt, you got that one right.
  Representative Ryan believes in radically shrinking the size of 
government to what it was over a half century ago. His aim is to use 
the deficit crisis as a pretext for degrading and dismantling 
everything from Medicare and Medicaid to education, environmental 
protection, workplace safety, medical and scientific research, and on 
and on. It doubles down, as President Clinton said--it doubles down on 
the theory

[[Page 13523]]

that if we just give more and more of our national wealth to those at 
the top, it will magically trickle down.
  We have tried that before. It sure does not work.
  I would like to focus some more of my remarks this evening on the 
devastating impact of the Romney-Ryan budget on Medicare and Medicaid, 
but health care more generally. Since he first arrived in Congress, 
Representative Ryan has consistently pushed a very radical health care 
program--to end Medicare. End Medicare, as we say, ``as we know it'' 
but to go to voucher care. Give everybody a voucher. Under his 
proposal, seniors would no longer have the guaranteed medical benefits 
they have enjoyed for decades. Instead, they would get a voucher from 
the Federal Government and they can go out and buy individual private 
insurance or Medicare.
  That is the catchy little thing. We will hear Mr. Ryan and Mr. Romney 
say they can buy Medicare if they would like to or they can buy private 
insurance. Let's look at that.
  They say this is a tough-minded solution to our debt problem, but it 
is just a scheme, a scheme to shift costs onto America's seniors rather 
than making debt reduction a shared sacrifice for all of us.
  Again, let's look at this voucher system. They would get a voucher 
program. A senior could buy traditional Medicare or health insurance. 
So what is the catch? The voucher will not be enough to cover health 
care costs. So seniors' out-of-pocket health care costs will steadily 
increase. The nonpartisan Congressional Budget Office has projected 
that the Ryan budget proposal could increase annual out-of-pocket costs 
for seniors by more than $1,200 in 2030 and $6,000 in 2050.
  What this chart shows is the increase in health care costs in today's 
dollars, constant dollars, that elderly persons will have to pay for 
during their expected lifetime, their average life expectancy from the 
time they retire. In 2023 the average senior living an average lifespan 
would pay $59,500 more. Senator Boxer rounded that off and said $60,000 
more. But look what happens when we get to 2030. The average senior 
will pay $124,600 more over their expected lifespan; in 2040, $216,000 
more. By 2050, $331,000 more for their retirement years they would have 
to pay in health care costs. That is in constant 2012 dollars.
  They say: But a senior can go out and buy traditional Medicare or 
private health insurance. Here is the catch on that. What they do is 
put Medicare in a death spiral. Here is how.
  If a person is a very healthy senior they can go out in the private 
insurance market and probably get a pretty good deal. If they have no 
preexisting conditions, if they have never had cancer, no one in their 
family has had it, if they are very healthy, they have never smoked, 
they are just in great physical shape, they can probably go out and get 
a private, cheap private insurance policy with their voucher.
  So who stays in Medicare then? The oldest and the sickest, and 
therefore the costs of Medicare spiral up and spiral up and it becomes 
untenable. It is a death spiral. That is Mr. Ryan's way of killing 
Medicare.
  Yes, he says people will get a voucher, and they can buy Medicare or 
they can buy private insurance, but it puts Medicare into a death 
spiral. The Ryan budget turns this successful, reliable, comprehensive 
source of health care that seniors have relied on for decades--and have 
paid into, I might add, during their years of hard work--into some 
unproven, unpredictable, rightwing, conservative experiment. I do not 
want to experiment with the elderly. I want them to have good health 
care they can afford, that is universal, and that they can count on.
  President Obama has fought to strengthen Medicare, and he believes, 
as we do, it is a sacred contract. He has made a commitment to 
strengthen Medicare in the Affordable Care Act. For example, by 
eliminating the gaps in coverage, closing the doughnut hole--which we 
have already started to do--elderly Iowans, I think, received over $600 
back this year just from closing the doughnut hole.
  Reducing the cost of prescription drugs. According to Medicare's own 
actuaries, the Affordable Care Act, ObamaCare, extends the program 
solvency from 2016 to 2024. Again, how? As the Senator from California 
said, by fighting waste, fraud, abuse and by getting rid of wasteful 
subsidies to insurance companies. Our plan for Medicare is basically 
summed up: Mend it but don't end it.
  I was taken a little aback yesterday. Over the weekend Governor 
Romney stated he would keep some of the popular provisions of the 
Affordable Care Act. Like what? Well, like kids staying on their 
parents' insurance plans until they are 26 and ensuring coverage for 
folks with preexisting conditions.
  I said: Wait a second. I thought he said on the first day he was 
going to repeal ObamaCare? But now he says he wants to keep those. I 
was a little confused, but my confusion was short-lived because his 
campaign then came out with a clarifying statement. They clarified what 
Governor Romney said, and this is the quote:

       Governor Romney will ensure that discrimination against 
     individuals with preexisting conditions who maintain 
     continuous coverage is prohibited.

  The Washington Post reports that 89 million Americans would be left 
out of Romney's preexisting condition plan. Why? They were working and 
they had a health plan. They were out of work for a month or two--maybe 
went someplace else to work and got a different plan: Sorry, you didn't 
have continuous coverage. You don't get covered.
  These are the little games that Governor Romney and Congressman Ryan 
are playing with the American people.
  Mr. DURBIN. Will the Senator from Iowa yield for a question?
  Mr. HARKIN. I am delighted to yield to my friend from Illinois.
  Mr. DURBIN. I was trying to understand this Republican position. It 
used to be crystal clear. In 23 debates we heard Republican candidates 
say, one after another after another: First day in office ObamaCare is 
gone. But I heard the same thing the Senator did, and I have tried to 
understand it.
  I do give Governor Romney some credence in this regard. I have said, 
when asked, he is the baby daddy of ObamaCare because it was Governor 
Romney who created the first version of ObamaCare in the Commonwealth 
of Massachusetts, and he understood--I hope the Senator from Iowa can 
help me to understand, and those listening--he understood the concept 
of insurance. If everyone who bought an insurance policy wrecked their 
car or got sick the next day, insurance would not work. The only way it 
works is most people are safe drivers. They buy insurance and a small 
percentage use it. So there is a pool of money collected from premiums 
creating a reserve for accidents.
  Here we have a situation where Governor Romney has agreed with us--I 
commend him--that people with preexisting conditions when it comes to 
health care should not be discriminated against. But the Senator from 
Iowa, as chair of the committee that dealt with ObamaCare, knows what 
adverse selection means. It means if people wait until they are sick to 
buy health insurance the whole system falls apart. So in Massachusetts 
they required everybody to buy health insurance.
  Mr. HARKIN. I think that is called an individual mandate?
  Mr. DURBIN. An individual mandate, some critics might say. Some of us 
call it individual responsibility. And we did the same, when it came to 
health care reform, keeping in mind if people currently have health 
insurance and like their doctor, like their hospital, we are not going 
to change their lives one bit. But for those who are out in the 
marketplace, the availability of health insurance would be there, but 
everyone has the responsibility to buy it.
  We don't think twice when we have a closing on a home. We need fire 
insurance on this home. My home has never burned down, thank goodness, 
but I buy fire insurance. That is individual responsibility so there is 
something to pay the mortgage off if the house burns down.
  But in this circumstance what I understand Governor Romney to say is 
we

[[Page 13524]]

don't think insurance companies should discriminate against people with 
preexisting conditions. OK, I am with him. But then he goes on to say--
I think the point the Senator made--let's kind of bear on this for a 
minute--what he goes on to say is so long as people have had continuous 
insurance.
  What if a person was unlucky enough to lose a job? Out of luck. Their 
preexisting conditions just disqualified them from health insurance. 
They are stuck, under the Romney approach. What if they had any kind of 
interruption whatsoever in their insurance coverage? They are dead in 
the water. So when we talk about taking uninsured people, bringing them 
into insurance that has quality to it, quality coverage where they 
cannot discriminate against people, we are saying whatever their 
previous insurance experience we are all going to get into this 
together. We are all coming into the tent together and they cannot be 
discriminated against because they are a woman, had a baby--all the 
different things they have used.
  So when we listen closely to it, here was Governor Romney basically 
saying he is against the discrimination on preexisting conditions, but 
then footnoted down at the bottom of the page--as long as people have 
had continuous coverage. It is an empty promise. It doesn't give people 
anywhere near the protection and insurance that ObamaCare gives. That 
is what I understand to be the difference.
  Is that the way the Senator understands Governor Romney's 
clarification of his statement of yesterday?
  Mr. HARKIN. I thoroughly agree with my friend from Illinois. Governor 
Romney makes the statement. It is on a very popular well-viewed Sunday 
talk show, ``Meet The Press.'' So the average American says: Oh, 
Governor Romney, he is for keeping coverage for preexisting conditions. 
That is good. That is nice to know.
  They do not hear the clarification that came about later because that 
was not on ``Meet The Press.'' That was sort of under the radar, when 
they said they wanted to clarify what Governor Romney meant was he 
would prevent discrimination against individuals with preexisting 
conditions who maintain continuous coverage. As the Washington Post 
pointed out, there are 89 million Americans who would be disqualified 
because they had a plan, they lost it because they moved or something 
like that, and picked up another plan. There goes their coverage. Just 
think about that. You are a family. Let's say your spouse has a 
preexisting condition--it could be diabetes, it could be cancer, it 
could be anything--but you have been covered under a plan. President 
Obama, with the Affordable Care Act, ObamaCare, says beginning in 2014, 
just as we now cover children, no plan can discriminate against you 
because of a preexisting condition. What Romney is saying with his 
clarification is only if you have always had that plan. What if you are 
a family that moved from one State to another due to a job issue? You 
move and your spouse or maybe one of your children who is perhaps still 
on your policy and has a preexisting condition won't be covered. They 
will not cover them. Mr. Romney didn't say that on ``Meet the Press.''
  Mr. DURBIN. I say to the Senator from Iowa that I met so many people 
in my State of Illinois who said, I cannot leave my job because I don't 
know if I can ever find health insurance again. I am stuck because I 
have a child or a spouse with a problem. The real world of human 
experience tells us this happens all the time. It makes me wonder 
sometimes. There are 8 or 9 million Americans--almost one out of three 
Americans--not covered by this Romney plan. How does this solve any 
problems? If we are not going to have health insurance we can count on 
when we need it, it is worthless. It is a subsidy the insurance company 
doesn't pay off when the family needs it.
  I didn't mean to interrupt the Senator from Iowa, but I wanted to 
make that point very strongly.
  Mr. HARKIN. I want to say one other thing about this idea of the 
individual mandate then-Governor Romney supported in Massachusetts. We 
all have it within us--I think especially as Americans--that we don't 
like to be told anything. We don't like to have a mandate put on us. 
Well, as the chair of the health committee, and someone who is very 
much involved in this process of getting the Affordable Care Act 
through, I want to make it very clear, you don't have to buy insurance. 
There is no individual mandate that says you have to buy insurance. I 
want to make that clear, and I want to keep making that point. I have 
been making that point for months now. You don't have to buy insurance. 
It just says if you don't buy it and you get real sick and want to get 
in line to get health insurance, you pay a penalty. They call it a 
free-rider penalty.
  Have we ever seen that before? How about Medicare? We have it in 
Medicare. When you turn 65, you don't have to get Part B. No one tells 
you that you have to do that. If you wait until you are 67, 68, 69, or 
70, you pay more. You will pay a lot more than if you picked it up at 
62 or 65 when you retired because it is a free-rider penalty. So we 
have to get rid of this idea that this is some kind of individual 
mandate that you are forced to do something. No, you are not forced to 
do it. But if you are a free rider, and you say I will only go when I 
get sick--like the car accident the Senator pointed out--yes, you pay a 
penalty. That is all. You don't have a mandate. You just have to pay a 
penalty. I think when we describe that, I would say that sounds fair. 
If you are not going to be in the insurance pool--it is as though I am 
not going to have car insurance, but if I have a wreck, I want to call 
the insurance company and they will insure me to the moment right 
before the wreck. That is nonsense. Of course, we don't do that.
  Well, as I said, I intend to take the floor today, tomorrow, and for 
the next several days to point out what the Ryan plan does overall but 
basically in health care.
  We mentioned Medicare. Let's talk about Medicaid. How about Medicaid? 
What does Medicaid do? Basically, as I have said many times, it is 
there to give a decent quality of health care and a quality of life to 
the hopeless, the helpless, and the hapless. It is for people who 
otherwise sort of fall through the cracks, people who need health care 
who cannot afford it or who, because of their life situation, have 
never been able to get any kind of health care coverage.
  Well, here is what he does. I will get into this more. The Medicaid 
funding, which the Senator from California mentioned, over 10 years 
takes over $810 billion--that is with a ``b,'' not million--out of 
Medicare. What does that mean? Who does that hurt? Well, 1 out of every 
2 Americans with a disability uses Medicaid. That is who is hurt. 
Services in the Medicaid Program allow our citizens with disabilities 
to live with dignity and purpose in their homes and in their 
communities. Three million seniors and people with disabilities use the 
program to avoid having to go into a nursing home.
  How about Medicaid for middle-class families? We always think that 
Medicaid is just for people with disabilities or just for poor people. 
How about Americans in the middle class? How about American middle-
class families? There are hundreds of thousands of American families 
who have children with lifelong disabilities such as Down's syndrome or 
autism. Medicaid gives them a lifeline or middle-class families would 
be paying out of their pockets for the health care costs of their 
children for their entire lifetimes. Yes, this is one of the 
entitlements they want to cut. Medicaid is an entitlement.
  Well, how about that tax plan? If you are a millionaire--that is all 
you have to be. All you have to do is have an income of over $1 million 
a year and you get huge tax benefits. How about that entitlement? No, 
they don't touch that one. At the center of the Ryan budget is his 
promise to repeal the Affordable Care Act, ObamaCare, a commonsense 
health reform that led the Commonwealth of Massachusetts to have one of 
the lowest uninsurance rates in the country. ObamaCare--I know the 
Republicans have been using that as a pejorative. I say it proudly.

[[Page 13525]]

  I was with President Obama in Iowa a couple of weeks ago when he 
spoke to a huge group of students at my alma mater, Iowa State 
University. There was a big sign in the back that said ``ObamaCare.'' 
President Obama looked at it and said, yes, ObamaCare. Speaking of 
himself in the third person, he said: Yes, Obama does care. He said, I 
care about making sure everyone is covered who has a preexisting 
condition. I want to make sure that kids can stay on their parents' 
policy while they are in college. Yes, I want to make sure that the 
elderly have a good, affordable Medicare Program. Yes, I want to make 
sure that people have good preventive health care systems in America. 
Obama cares, that is what ObamaCare is. Obama cares, and he cares very 
deeply that we have a health care system for all and not just for a 
few. As was said by President Clinton in his speech, an American policy 
based upon ``we're all in this together is much better than the policy 
of tough luck, you're on your own,'' which is the Ryan budget 
philosophy.
  When we get past the political theater and look at what the Ryan 
budget actually means, it is not a very pretty picture. The Ryan budget 
would repeal the prescription drug doughnut hole closure we are doing. 
It would allow insurance companies to charge as much as $300 for 
preventive services. One of the key elements we put in ObamaCare: 86 
million Americans received at least one free preventive service last 
year, and more this year. Almost 1 million Iowans received one free 
preventive service in 2011. That means they got preventive care so they 
don't get sicker and cost us more money. Again, the Ryan budget would 
allow people to deny you coverage or increase your premiums if you have 
a preexisting condition.
  This protection means a lot to this person right here. This is 
Eleanor Pierce from Cedar Falls, IA. I spoke about her before. She was 
denied health insurance when she lost her job because of her 
preexisting condition of high blood pressure. Without coverage she 
racked up $60,000 in medical debt. The Ryan budget would repeal 
ObamaCare. They would tell people like Eleanor Pierce: Tough luck, you 
are on your own. We are not all in this together. You mean you are not 
worth $1 million? Tough luck, you are on your own.
  Repeal will allow insurance companies to put limits on the coverage 
of more than 100 million Americans, stopping benefits right when they 
get sick. Repeal would kick more than 3 million young people off their 
parents' policy.
  This is Emily Schlichting who testified before the committee. She is 
an elegant young woman going to college in Omaha. She said young people 
are the future of this country and we are the most affected by reform. 
We are the generation that is most uninsured. We need the Affordable 
Care Act because it is literally an investment in the future of this 
country. She suffers from a rare autoimmune disorder that would totally 
make her uninsurable in the old days and under the Ryan budget, which 
brings back those old days. Thanks to the Affordable Care Act, she can 
stay on her parents' policy until she is 26. By 2014, regardless of her 
preexisting condition, she will get affordable health insurance 
coverage.
  Repeal under the Ryan budget would allow insurance companies to spend 
America's premium dollars on CEO bonuses, marketing, and fancy 
buildings rather than actual health care. Under the health reform 
medical loss ratio requirement, policyholders nationwide will receive 
more than $1 billion in rebates from insurers this year. That is $1 
billion in rebates this year that goes back to policyholders and 
families; otherwise, that $1 billion would be going into CEO bonuses, 
marketing, private jets, company planes, fancy buildings, and things 
such as that. These are just a few of the ways the Romney-Ryan budget 
would repeal ObamaCare and drag America back to the bad old days.
  Again, I will repeat that over the last few weeks Representative Ryan 
has been telling everyone how the President's health reform plan robs 
Medicare. That is totally fallacious. First, the nonpartisan economists 
have certified that ObamaCare strengthens the Medicare Program and 
extends its solvency by 8 years. What President Obama did--as the 
Senator from California previously pointed out--was make the program 
more efficient and save money on wasteful overpayments to private 
insurance companies and cracking down on fraud.
  What Mr. Ryan won't tell us is that the very reforms President Obama 
has in our Affordable Care Act are the same he has in his Ryan budget 
plan. What he doesn't tell us is that while President Obama takes those 
savings and puts them back into Medicare, Mr. Ryan takes those 
savings--yes, you guessed it--and puts them into more tax breaks for 
the wealthy.
  By repealing the Affordable Care Act, the Ryan plan would again put 
Americans at the mercy of insurance companies and deprive more than 30 
million people of affordable coverage.
  I was just going to get the chart for my own State of Iowa. I had one 
here on Iowa I wanted to point out, because I am obviously very 
interested in my seniors in Iowa. This chart shows that the Ryan plan 
means almost 440,000 Iowa seniors would be forced onto vouchers when 
they retire. We have to get those vouchers, right? Sixty thousand Iowa 
seniors would be forced back into the prescription drug doughnut hole. 
The doughnut hole would open again. Four hundred thousand Iowa seniors 
would pay more for preventive services this year.
  I can tell my colleagues our seniors in Iowa are flocking to get 
their preventive health care services. They know an ounce of prevention 
is worth a pound of cure. But before those preventive services cost 
money. Now they get them free. It is going to make their lives better 
and save us a lot of money.
  ObamaCare decreases the deficit by almost $110 billion over the first 
10 years and more than $1 trillion in the next decade. Mr. Romney and 
Mr. Ryan won't tell us that, but it is true. It reduces the deficit. It 
insures more than 94 percent of all Americans. Over 94 percent of all 
Americans will have that coverage.
  The bottom line is very simple, and I will be talking about this in 
the days ahead. President Obama will protect Medicare, will protect 
health care not only for our seniors but for young people, for middle-
class Americans and, yes, for those at the bottom rung of the ladder 
who need Medicaid to sustain them and to give them quality health care. 
The Ryan budget rolls back all of this. So, again, we are faced with 
this choice: the Ryan budget or what President Obama has come forward 
with in his budget and with his ObamaCare to make sure America remains 
a good middle-class country where people on the bottom, at the lowest 
rung of the ladder, can get into that middle class; where the middle 
class knows they can leave a job and go to another job and not lose 
their health care plan; where someone can start a small business and 
know they will have health care coverage for themselves and the one or 
two or three or four or five workers who work for them or small 
businesses now can become more competitive with the big businesses in 
America.
  I think it is safe to say that if only the American people will study 
the Ryan budget, the blueprint, they will find that this is where they 
want to take you and me and all of America--back to an America that our 
parents moved beyond; where our parents said, no, we are going to move 
forward; where we have buttressed ourselves in our own lifetimes, in 
moving America forward to a country where we truly are all in this 
together; where we are not just a lottery country in which if a person 
wins the lottery, they are OK, they have it made; if a person doesn't 
win, then tough luck, sucker, they are on their own. That is not the 
America our parents fought for in World War II or Korea or Vietnam; it 
is not the kind of America Martin Luther King, Jr., marched for and 
died for. It is not the kind of America we want to see for our kids and 
our grandkids.
  We have a choice. The choice is clear. Let's move forward.
  I yield the floor, and I note the absence of a quorum.
  The PRESIDING OFFICER (Mr. Merkley). The clerk will call the roll.

[[Page 13526]]

  The assistant bill clerk proceeded to call the roll.
  Mr. DURBIN. 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. DURBIN. Mr. President, most commissions appointed in Washington--
at least in my experience--hardly make a ripple, people hardly notice 
them. After a lot of hard work, a report is published and that is about 
it. Some historian at a later date may look at the work they have done 
and the research they have done and that is about it, that is the 
extent of it.
  There are a few exceptions. I was fortunate enough almost 2 years ago 
to be appointed to one of those exceptions and that was President 
Obama's deficit reduction commission, the Simpson-Bowles Commission. I 
was appointed because I am a member of the Appropriations Committee and 
Senator Reid said we should have someone from Finance, Appropriations, 
and Budget. I took the assignment of one of the three Democratic 
Senators. There were three Republican Senators, three Republican House 
Members, three Democratic House Members, and an additional six public 
members. The public members consisted of a number of people, including 
Alice Rivlin, respected in Washington, as well as a number of business 
and community leaders.
  We met for about a year and considered the budget deficit and all of 
the Federal spending and came to know one another a little bit during 
that period of time. One of the members of that commission was Paul 
Ryan, a Congressman from Janesville, WI, just over the border from my 
State of Illinois. I knew Paul before and got to know him a little 
better during the course of that commission. He is a very bright 
person. We have some common friends in the Janesville area, and I know 
he worked with Senator Feingold, a Democrat from Wisconsin, on some 
issues before.
  What surprised me at the end of the day was despite his obvious 
training and knowledge on the budget deficit, when it came time for a 
vote on this bipartisan deficit commission report, all three House 
Republican Members, including Congressman Paul Ryan, voted no. I voted 
yes. Two out of the three Democratic Senators voted yes. I was 
surprised, in a way, because I thought that although the Simpson-Bowles 
plan had its shortcomings--things I disagreed with and said so--it was 
a dramatic step forward to try to deal with our deficit in a fair 
fashion.
  Jeb Hensarling of Texas was another Republican Congressman, along 
with Dave Camp of Michigan, the chair of the House Finance Committee, 
and Congressman Paul Ryan, who all voted no.
  I was surprised that at the Republican convention in Tampa, FL, 
Congressman Ryan, the Republican Vice Presidential nominee, criticized 
President Obama over the Simpson-Bowles Commission report, saying he 
had worked hard to implement. I thought that was a curious position for 
Congressman Ryan to take, because he had voted against it. Now he was 
criticizing President Obama for not working hard enough on the 
commission report. But I came to understand that a little more when I 
took a closer look at Congressman Paul Ryan's budget plan for America.
  Before he was chosen to run as Governor Romney's running mate, Paul 
Ryan, the Congressman and chairman of the House Budget Committee, 
issued his vision of what America should be doing over the next several 
years. One of the most controversial sections relates to Medicare. 
Medicare, of course, is the insurance policy for the elderly and many 
disabled in our country. It is a lifeline for 40 million-plus 
Americans. It means even in their old age they will have good 
protection for health insurance because they have paid into it during 
all of their working years. Paul Ryan observed that the Medicare 
Program would come to an end if it weren't changed. We know it has 
about 12 years of solvency left and change will be needed. His 
proposal, though, would do more than change Medicare; it would end it 
as we know it. The Ryan approach would create vouchers--coupons--for 
senior citizens to buy health insurance. It would force them to pay 
more out of pocket for Medicare. According to the CBO--the 
Congressional Budget Office--the Romney-Ryan plan would force Medicare 
beneficiaries to pay up to $1,200 more by 2030 and almost $6,000 by 
2050. That is about $500 a month, ultimately.
  Congressman Ryan said seniors could choose to stay in traditional 
Medicare or they could basically go into a private health insurance 
market. A senior who is both healthy and wealthy would have an option. 
Those not so healthy or wealthy would find the only option traditional 
Medicare, and more and more people with a history of illness would be 
forced into traditional Medicare, making it a very expensive insurance 
program and difficult to maintain.
  The Paul Ryan voucher plan puts Medicare in competition with private 
insurance companies and, as I said, many seniors would find that the 
competition wouldn't want them and they would be stuck with traditional 
Medicare, much different than it is today. Medicare would be taking 
care of the seniors whose care costs more, so Medicare premiums would 
increase. As they go up and seniors begin to leave Medicare, it causes 
premiums to rise further, which would cripple the program.
  The Paul Ryan program eliminates all the consumer protections in the 
Affordable Care Act, putting insurance companies back in the driver's 
seat. I don't think most Americans believes that is a good place to be, 
at the mercy of an insurance company, an adjuster who will decide what 
they are covering and how much one will pay.
  Young adults would no longer stay on their parents' insurance plan 
under the Romney-Ryan proposal to eliminate ObamaCare. People with 
preexisting conditions would be denied coverage--going back to the 
conversation I had earlier, my dialog with Senator Harkin on the floor. 
Families would once again face lifetime limits on coverage, and seniors 
would be forced back into the doughnut hole, meaning paying more out-
of-pocket expenses for their Medicare prescription drugs.
  I don't think this is a good plan for America and I don't think 
Americans, once they hear the details, are going to like it.
  The ObamaCare program has already helped a lot of people. A report 
today said there was a 16-percent increase in coverage of younger 
Americans because of ObamaCare. These are younger Americans up to the 
age of 26 who now can stay on their family plans. And 1.6 million 
Americans have been added into coverage under their parents' plan 
because of this change in the law.
  Now, those who say ``I will repeal ObamaCare'' would repeal that 
protection, forcing 1.6 million young people, without jobs or coverage, 
out of the protection they have today. I cannot imagine 125,000 young 
adults in Illinois who have benefited from ObamaCare would believe that 
is a good idea, nor would their families.
  Since the Affordable Care Act was signed into law, Medicare 
beneficiaries in Illinois have saved over $171 million on their 
prescription drugs.
  There was a discussion earlier about the Medicaid Program. Medicaid 
is an important program in Illinois and most States. I asked Julie 
Hamos, who administers our program in Illinois, to explain it in a few 
words. Here is what she said: One out of three children in Illinois is 
covered by Medicaid. That is their health insurance--one out of three. 
In Illinois, Medicaid pays for 52 percent of the births; that is, 
prenatal care and the delivery of the child--52 percent paid for by 
Medicaid. But those two things--child coverage and coverage for new 
moms and their babies--do not even represent half the cost of Medicaid 
in Illinois.
  Sixty percent of the cost of Medicaid in Illinois is for the elderly 
and disabled, many of whom are completely out of luck and out of money. 
They live on Social Security, Medicare, and Medicaid. They are in 
nursing homes and convalescent centers. They do not have anyplace to 
turn. So Medicaid is a critical insurance program for some of the most 
vulnerable people in America.
  Many seniors and disabled people on Medicare also receive State 
Medicaid. The ``dual-eligibles'' they are called.

[[Page 13527]]

That is 15 percent of Medicaid enrollees, but 39 percent of Medicaid 
spending--low-income elderly people who have no place else to turn.
  So when Paul Ryan, in his budget, suggests he is going to cut back on 
Medicaid payments each year, giving a smaller amount of money to 
States, saying: Make do, who is at risk? Children: one out of three in 
Illinois is on Medicaid; moms having babies: over half of the moms 
having babies in our State; and the elderly folks who have no place to 
turn.
  Think about what that means. A child without basic health insurance, 
Medicaid, in my State or anywhere, is less likely to have a doctor, 
immunizations when needed, and an office visit to avoid a trip to an 
emergency room. A mother without prenatal care is, unfortunately, more 
likely to give birth to a child with a problem. And we do not want to 
see that for the sake of the child first, certainly for the mom, for 
the family, or for taxpayers, for goodness' sake. There is no money 
saved by scrimping on Medicare for new moms. The Ryan plan would force 
that kind of scrimping.
  The Ryan plan converts Medicaid into a block grant and cuts Federal 
funding for the program by 34 percent over the next 10 years--34 
percent.
  So I would ask Congressman Ryan: Which of those groups do you want to 
cut back on in terms of coverage? According to CBO, cuts at the level 
the Ryan plan calls for would mean States would have to reduce 
eligibility for Medicaid and children's health insurance or cover fewer 
services.
  I might add--I am sure it is true in the State of Oregon; it is 
certainly true in Illinois--one of the most critical areas of medical 
need is dental care. I talk to doctors every time I go back home in 
emergency rooms at hospitals who have people coming in to see them in 
pain because of problems with their teeth, and they end up getting pain 
medication but nothing is taken care of.
  So when we talk about restricting care, as Paul Ryan has suggested in 
his budget, I have to tell you, I think it is extremely shortsighted. A 
tooth ache can turn into a life-threatening situation for some people, 
not to mention the pain and discomfort they are going through. So if 
anything, we ought to review basic Medicaid services to expand at least 
into dental care. I would support that. I think it is extremely 
shortsighted for us not to include it.
  This Paul Ryan budget would not expand Medicaid. It would cut it back 
dramatically. States would lower payments to doctors and nurses by one-
third. Can you imagine what that would do? It would reduce the number 
of providers, which makes it more difficult.
  Just to give you an example, in the Quad Cities in Illinois, there is 
a great clinic put together by a friend of mine in the Hispanic section 
of Moline. They provide basic, basic primary health care. If you need a 
specialist, you are referred, with at least an hour-and-a-half drive, 
to Peoria or with an almost 3-hour drive to Chicago. Remember, these 
are the poorest people living in our towns. Do they make it to the 
specialist? Usually not. The Paul Ryan approach, reducing the amount of 
money that is paid to providers, would mean even fewer specialists 
would be willing to help those who are poor.
  But the thing that troubles me the most about Congressman Ryan is--at 
least in his budget views and his deficit views--as he talks a good 
game about reducing the deficit and voted against the Simpson-Bowles 
Commission report, he comes up with a budget that he produces in the 
House and says he and Governor Romney are going to protect the Bush tax 
cuts for the wealthiest people in America and increase defense 
spending. This does not work. It does not add up. It does not pass what 
President Clinton called the arithmetic test. You cannot increase tax 
cuts and increase spending on defense without, as President Clinton 
said, digging the hole deeper and deeper.
  So they sound pretty good when they give the speeches about fiscal 
conservatism and that we have to be serious about the deficit, but 
their proposals just do not match. The idea of lowering tax rates, as 
they proposed, even below the Bush tax cuts--they said: Well, we will 
use tax reform to get to it. The estimates suggest that the middle-
income families will end up losing in that. As a result of tax reform 
as proposed by Romney-Ryan, they think middle-income families face a 
higher tax of $2,000 a year to protect tax cuts for the wealthiest 
people. That certainly is not a positive thing in terms of deficit 
reduction or helping a lot of working families living paycheck to 
paycheck.
  We have debated Congressman Ryan's plan for 2 years now. The only 
people who seem to like it are some Republicans serving in Congress. 
The majority of Americans would oppose the Paul Ryan budget plan to end 
Medicare as we know it. The majority of Americans certainly oppose his 
idea of raising taxes on middle-income families to pay for tax breaks 
for the wealthiest. Congressman Ryan has had his chance to make his 
case to the American people for his view of where we are going, and it 
will not work. I wish he had joined us in the bipartisan effort of 
Simpson-Bowles. His vote in favor of that would have given him more 
credibility and maybe a better understanding of the reality of budget 
deficit reduction.

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