[Congressional Record (Bound Edition), Volume 159 (2013), Part 13]
[Senate]
[Pages 18634-18638]
[From the U.S. Government Publishing Office, www.gpo.gov]




   NOMINATION OF DEBORAH LEE JAMES TO BE SECRETARY OF THE AIR FORCE--
                               Continued

  Mr. TOOMEY. This was also something that everybody who had anything 
to do with this bill knew was going to be untrue. Insurance plans 
differ. Some cover certain doctors, others cover other doctors. Since 
some plans were certainly going to be canceled, inevitably some people 
were going to lose the plans that covered their doctor. This was no 
great mystery, and it was not some unintended and unforeseeable 
consequence. It was part of the design of the bill. Yet people were 
told: If you like your doctor, you will be able to keep your doctor.
  I got this email from a woman who lives in Westmoreland County. She 
says:

       I have been self-employed for 13 years and have never been 
     without health insurance. 3 years ago I was diagnosed with 
     multiple sclerosis. Having an expensive preexisting condition 
     was not a problem for me as I had never let my insurance 
     lapse. My medications cost (without insurance) $4,000+ per 
     month. I received notice several weeks ago that they were 
     going to cancel my plan and were doing so as of Jan. 1 and I 
     had to sign up for new coverage through the health insurance 
     exchange.

  My staff reached out to this woman to see if we could help. It turns 
out that where she lives and given her circumstances there were two 
different plans available to her. One plan covered her doctors, the 
other plan covered the medicine she needed to treat her multiple 
sclerosis. Neither plan would do both. What kind of a choice is it that 
this woman is going to have to make?
  I have another email that arrived last week:

       I finally got to where I could compare plans on the 
     government website, only to find that my insurance premiums 
     would go from $512 per month for a plan with a $500 
     deductible/$2500 out of pocket plan to $799 for a plan with a 
     $500 deductible and a $2700 out of pocket expense.
       Where is the savings? None of the plans include my current 
     doctor, whom I want to desperately keep. Obamacare is such a 
     disaster!!! Please stand firm and continue to work towards 
     REPEALING it.

  Finally, there is one more false promise--I am going to give some 
examples of responses I have gotten--and

[[Page 18635]]

that is the promise that premiums for a family would decrease by $2,500 
per year. In fact, the data I have seen suggests that on average 
premiums in the individual market have been increasing. Consider the 
case of some of the people who have reached out to my office from 
Pennsylvania.
  This is a small business owner from Carbon County, PA, who sent me 
this email last week. He said:

       I have had an HSA high deductible plan . . . for several 
     years for my employees. I have paid 100% percent of the 
     premiums and contributed 50% of the deductible every year 
     that they paid the other 50% percent. I just received notice 
     that my insurance premiums are going up 100%.
       What can be done to enforce the president's statements that 
     we can keep our current plans? There is no way I can pay this 
     new premium. My employees will be the ones hurt the most. 
     They loved the coverage they had and I hate that we can no 
     longer provide this benefit.

  Here is an email I got from a father of two from Bucks County, PA.

       I received notice last week that my healthcare will more 
     than triple. Currently I am paying $265 a month for me and my 
     two young sons . . . my monthly premium will go up to $836 a 
     month!!!
       The president promised ``you can keep your plan'' and 
     ``families will save $2500 per year'' . . . I can keep my 
     plan, I just can't afford it . . . I do qualify for subsidies 
     . . . $80 bucks a month.

  I got this email from a man from Mercer County, PA, 2 days ago.

       I just became another Obamacare victim. Because my 
     employer's health plan costs are going up almost 100% I will 
     have $400 less in my pocket each month. At 58 I will have to 
     cut way back on how much money I can put into my local 
     economy. Obamacare needs to be scrapped.

  This email is from a man from Crawford County, PA:

       I am a small business owner, and I speak with many vendors 
     in my field. One of said vendors says that his monthly cost 
     would increase to $9.00 an hour on insurance alone. Another 
     said he feared he would not even be able to stay in business 
     because of the insurance costs. My own situation is just as 
     dire. Currently, I personally pay about $1,500 a month for 
     insurance, and under Obamacare I have seen costs go up by 
     $375. On top of that, my wife, who is an insurance agent, 
     fears that she will lose her coverage next fall due to the 
     law.

  Here is an email I got last week from a father from Luzerne County.

       Please keep fighting the disaster that is happening to the 
     thousands of working men and women that will be losing their 
     health care along with some of us retired folks.
       Our son is one of them and the alternative is unthinkable--
     his plan cost doubled to $300 a month . . . but the 
     deductible is $4500. Now how can anyone say everyone will 
     have affordable health care insurance on top of the statement 
     no one will lose their plan or doctor if they are satisfied 
     with them? Your fight is hard, but our prayers are with you.

  Here is an email I got from a small business owner from Cumberland 
County, PA. He writes:

       I am a small business in the Carlisle area. We have been in 
     business for 30 years . . . I offered insurance to the full 
     time employees for many years . . . If it weren't for the 
     rising costs of health care I could hire another employee 
     because we could use the help but with the anticipated 
     increases I won't be able to. I have been told by our 
     insurance carrier that we can expect up to 50% increases.

  Finally, a small business owner from Chester County, PA, wrote this 
email last week:

       We just got our Insurance coverage options for my small 
     business. Previous rate was $470.00 per month with $0.00 
     deductible, a good plan. The new plan is $692.00 per month 
     with a $2,000.00 deductible, a bad plan. OK, I cannot keep my 
     plan. To get close to the one I need to pay more and incur a 
     ridiculous deductible.
       This is not free market. I don't like the government 
     telling me what is best for me.
       I have several older employees and their rates are up over 
     $1,000.00 per month each. I cannot pay for their insurance 
     and they cannot afford to either. I am forced to drop the 
     plan or remove them from employment.
       This is out of control.

  This is a small sample of the emails I have gotten. I am one Senator 
from one State. The fact is the vast majority of people who experience 
these problems don't send an email to their Senator.
  So we have this tiny little sliver of the hundreds of thousands--
actually millions--of Americans who are suffering from the direct 
consequences--and I would argue intended consequences--of this bill. 
They are unable to keep their health insurance plan, unable to keep 
their doctors, not experiencing savings but, rather, experiencing 
increases in costs. These are just a few of the terrible consequences 
of ObamaCare.
  There are many others I could cite, but I was just focusing on broken 
promises tonight. There are too many to list.
  I do want to also stress that these are symptoms of a completely and 
impossibly flawed bill. The real underlying problem of ObamaCare is 
something that Friedrich Hayek warned us about; he called it the fatal 
conceit. This is the idea that a small group of really smart people can 
know more than the combined, accumulated knowledge and wisdom that is 
disbursed across an entire population. It is an absurd notion. Yet it 
is at the heart of all kinds of big government plans, socialism 
everywhere, and it is clearly at the heart of ObamaCare.
  The idea is that these Mandarins who are so smart and know so much, 
they should be able to force their will on everyone else. It is an 
extraordinarily insulting premise that this is based on, but it is.
  The premise is that individual men and women across America are 
certainly not qualified, they are certainly not smart enough to know 
what is good enough for them. They should not be free to decide what 
kind of health plan they want to buy for their family. There are 
tradeoffs that you make when you buy something like a health insurance 
plan, such as how important is a higher deductible versus lower 
premiums or the importance of having maternity coverage or the 
importance that someone might attach to a particular doctor.
  All of those judgments, which are so personal, are taken away from 
individuals in ObamaCare. That is not for Americans to decide. You will 
take the plan that is available to you and approved by the government, 
period. By the way, you are breaking the law if you don't, and you will 
be assessed a fine.
  This is outrageous. This is not the society we have always been, but 
it is really just the most recent and egregious example of this warning 
that Hayek gave us--this arrogance of big government. I would argue 
that it is an offensive affront to the freedom of the American people, 
and it is predictably and sensationally a failure.
  I note the absence of a quorum.
  The PRESIDING OFFICER (Mr. Booker). The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  (Mr. MURPHY assumed the Chair.)
  (Mr. DONNELLY assumed the Chair.)
  Mr. BARRASSO. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. King). Without objection, it is so 
ordered.
  Mr. BARRASSO. Mr. President, I ask unanimous consent to speak until 
the top of the hour.
  The PRESIDING OFFICER (Mr. Pryor). Without objection, it is so 
ordered.
  Mr. BARRASSO. Mr. President, I come to the floor today, as I have 
over the past several years, to talk about issues affecting this 
country. I know there is a nomination we are discussing on the floor, 
and I have concerns about the issues related to that nominee and the 
way that nomination has been brought forward because it was done by 
what I believe to be an abuse-of-power move in a way that resulted in 
voting in the middle of the night, discussions in the middle of the 
night--all, in my opinion, to distract from the disaster of the Obama 
health care law.
  The Obama health care law continues to affect people all across the 
country. What we saw on October 1 in the great debacle of the rollout 
of the Web site was really just about a Web site on October 1. But come 
January 1, it will be about real people who have lost their insurance 
who are going to be hurt personally in terms of their own health by 
this terrible law.
  So I come to the floor, as I have week after week since the law 
passed, to talk about concerns I have as a doctor, someone who has 
practiced medicine in Wyoming for 24 years as an orthopedic

[[Page 18636]]

surgeon, taking care of people from around the State, and someone who 
as a medical doctor was director of a program called the Wyoming Health 
Fairs aimed at giving people low-cost blood screens, having health 
fairs people can attend from around the State where they can check 
their blood results and visit with doctors and nurses and others in the 
community about issues of heart disease, diabetes, all aimed at 
preventing disease, early detection of problems, and lowering the cost 
of their care.
  So I had great interest when this health care law was proposed and 
while watching it unfold. The concerns I had as it was passed continue 
today, and I think more and more Americans are seeing that those 
concerns are being realized in their own lives. And that is what it is 
about--people's lives.
  The Web site failures are just the tip of the iceberg. What people 
are seeing now all across the country are higher premiums, and there 
are stories rampant around the country.
  I still recall the President of the United States saying that by the 
end of his first term, insurance premiums would be down $2,500 per 
family. Instead, families are paying much more for health insurance. 
There are concerns, obviously, because of canceled coverage. Around the 
country, over 5 million folks, I understand from recent accounts, have 
received letters saying that they have lost their insurance, that their 
insurance will be canceled effective January 1.
  The President promised: ``If you like your doctor, you can keep your 
doctor.'' But now we are seeing that many people aren't keeping their 
doctors. Even though they like their doctors and want to keep their 
doctors, they can't.
  There are issues of fraud and identity theft that we are hearing 
about on a daily basis. The chief of staff of one of the Members of the 
Senate was applying on the Obama health care Web site, the government 
Web site, trying to get insurance just this Monday, and it sure looked 
like the Federal Web site and he thought he was on the Federal Web site 
and was putting in information. Then it goes to a screen where they 
wanted to know his bank account number and his PIN number.
  He said: This can't be right.
  He called the help line and spent over an hour on the phone, and they 
ultimately said: No. Get off of that. It can't be the Federal 
Government Web site. Get off of it.
  He was focused enough to think, this can't be right, but the fraud is 
going to be rampant, we know that, and identity theft as well.
  And then we are seeing huge problems with higher copays and 
deductibles.
  I have with me a couple articles. Wednesday's Wall Street Journal has 
their recent poll numbers. ``Health Law Hurts President Politically.'' 
The subheadline is that the disapproval rate of Obama's job performance 
rises. ``The disapproval rate of the President's job performance now 
rises to an all-time high of 54 percent,'' it says, ``even as Americans 
are upbeat on the economy.'' So it is not the economy that has people 
so disappointed and disapproving of the President.
  Let me read a couple paragraphs because this is about the President 
of the United States and what we would want in a President of the 
United States in terms of credibility with the American people.

       The Federal health-care law is becoming a heavier political 
     burden for President Barack Obama and his party, despite 
     increased confidence in the economy and the public's own 
     generally upbeat sense of well-being, a new Wall Street 
     Journal/NBC News poll suggests.

  They go through how the poll was conducted, but people across the 
country believe the NBC/Wall Street Journal poll is a true reflection 
of what is happening nationwide.
  It says:

       Disapproval of Mr. Obama's job performance has hit an all-
     time high in the poll, at 54 percent, amid the flawed rollout 
     of the health law. Half of those polled now consider the law 
     a bad idea, also a record high.

  This is a big-time survey of 1,000 adults, and this is really a 
disturbing part for us as a nation and should sadden all America:

       The survey of 1,000 adults conducted between Dec. 4 and 
     Dec. 8 found a sharp erosion since January in many of the 
     attributes--honesty, leadership, ability to handle a crisis . 
     . .

  These are abilities we want in a President. We want a President who 
is honest and who is perceived by the public as honest. We want a 
President who can handle a crisis and is perceived by the public as 
being able to handle a crisis. But they say there has been ``a sharp 
erosion since last January in many of the attributes--honesty, 
leadership, ability to handle a crisis--that had kept Mr. Obama aloft 
through the economic and political turmoil of his first term.''
  The poll goes on and asks: In terms of the impact of the President's 
health care law, is this going to have a positive impact on you and 
your family? Fewer than one out of eight people in the country today 
believes this health care law will have a positive impact on them and 
their family. We are changing the entire health care system of the 
country, and only one out of eight people believes it is actually going 
to help them?
  The performance of the President is considered to be very bad, a 
significant disapproval, and it is because of the health care law.
  People look at this and they say: What does this mean to me? How is 
this going to affect my life? Those are the issues we talked about 
here. People are being hit with the incredible increased costs. They 
say: Well, there are some policies that may be a little bit cheaper, 
the so-called bronze policies. So the New York Times took a look at 
that. Again, these are articles from just this week.
  This is from Monday, December 9: ``On Health Exchanges, Premiums May 
Be Low, but Other Costs Can Be High.'' This is by Robert Pear this 
Monday, a well-known writer who does his research and gets the facts. 
He says, ``But as consumers dig into the details . . . ''--boy, that is 
a key phrase because I believe that so many people who voted for this 
health care law never looked into the details, didn't know what it 
meant, didn't know what was going to be in it because Nancy Pelosi 
famously said: First you have to pass it before you get to find out 
what is in it. Well, Americans are now looking at it, digging into it.
  Robert Pear in the New York Times said:

       But as consumers dig into the details, they are finding 
     that the deductibles and other out-of-pocket costs are often 
     much higher than what is typical in employer-sponsored health 
     plans.

  So what they actually have to pay out of their pockets is much higher 
than in employer-sponsored health plans.
  Well, people really care about what they have to pay personally for 
things.
  The same day, the Wall Street Journal, Monday, December 9, page 1.
  ``High Deductibles Fuel New Worries of Health-Law Sticker Shock''--
the same information that we have seen there in the New York Times.
  It says the average individual deductible for what is called the 
bronze plan on the exchange, the plan I was talking about a little 
earlier, which is the lowest priced average deductible is $5,081 a 
year, according to a new report on insurance offerings in 34 of the 36 
States that rely on the federally--Washington-run--online marketplace. 
That is 42 percent higher than the average deductible last year on 
plans that were purchased. This is before the Federal law took place. 
``High Deductibles Fuel New Worries of Health-Law Sticker Shock.''
  I heard the President say the States that have done it have done it 
very well. It is astonishing. When you turn to the second part of this 
article, page A6 says ``Deductibles Fuel New Worries of Health-Law 
Sticker Shock.'' What about the States doing their own plan? The 
headline above that: ``Health-Site Snafus Plague Maryland,'' a State 
that has decided to do their own Web site.
  This is from Monday:

       Maryland is struggling to fix its troubled health-insurance 
     website more than two months after it opened, showing how 
     technology woes are affecting more than just the federal 
     system.

  We see it is not just the Web site--one article about the bad Web 
site, the

[[Page 18637]]

next article is about higher copays and deductibles. Interestingly, the 
official in charge of Maryland's insurance marketplace resigned after 
criticism of her decision to take a vacation in the Cayman Islands 
during Thanksgiving week. New statistics released Friday showed just a 
trickle of customers signing up for private coverage in the State.
  It is interesting that States are having problems and the Federal 
Government is having problems. People wanted to keep their insurance. 
They wanted to keep their insurance. They liked their insurance.
  I talked to a woman--a rancher in Wyoming--at the Farm Bureau 
meeting. She lost her insurance. Her insurance worked very well for her 
and her family, but she lost it because it didn't meet President 
Obama's criteria of the 10 different standards that had to be met. She 
knows me and called me Doc because I had known her, and I am a doctor 
in Wyoming. She said it is interesting that the reason she lost her 
insurance is because it didn't include maternity coverage.
  She said, Doc, I had a hysterectomy. I don't need maternity coverage. 
She said, I know I don't need maternity coverage, but apparently 
President Obama believes she needs maternity coverage. The Democrats in 
the Senate believe she needs maternity coverage.
  The question is, Who is the best judge for you and your family? Is it 
the government or the Democrats who believe they know better than you 
do or the freedom-loving Americans who believe they can make their own 
decisions about their lives and their families and what insurance they 
want or do not want.
  People wanted to keep their insurance. They weren't allowed to, but 
the President said they could. Time and time again, the President said 
people could keep their insurance if they liked their insurance. I 
think that is one of the major reasons the President's credibility has 
dropped.
  As a matter of fact, there is a nonpartisan fact checker called 
PolitiFact, and each year they go through lots of comments and lots of 
statements that are made, and they came out last night with their lie 
of the year. They do this every year--the lie of the year. The lie of 
the year that came out from PolitiFact for the year 2013 was: If you 
like your health care plan, you can keep it. We all know who said it--
the President of the United States.
  They go on to say he didn't just say it once. We counted dozens of 
times that President Barack Obama said if people like their health 
plan, they can keep it. They go on to say:

       It was a catchy political pitch and a chance to calm nerves 
     about his dramatic and complicated plan to bring historic 
     change to America's health insurance system. ``If you like 
     your health plan, you can keep it,'' President Barack Obama 
     said many times, but the promise was impossible to keep.

  This fall, as cancellation letters were going out to approximately 4 
million Americans, the public realized the President's breezy 
assurances were wrong and, therefore, they have given it the lie of the 
year.
  People saw this coming. Republicans saw this coming. My colleague 
from Wyoming, Senator Mike Enzi, saw this coming. That is why he came 
to the floor years ago and said: People are going to lose their 
coverage. People are going to lose it. He brought a resolution to the 
floor because he actually reads the Federal Register, and he saw the 
regulations that came out.
  He came to this floor with legislation to say: Wait a second. If you 
truly believe people can keep their coverage, you have to adopt this 
piece of legislation so people truly can keep their coverage. Yet we 
saw Republicans vote with Senator Enzi, saying let people keep their 
coverage. We saw Democrats say, forget it, Senator Enzi, we don't 
believe you are right.
  The President was wrong; Senator Enzi was right.
  There was a letter to the editor in the Powell Tribune in Powell, WY, 
with the headline ``Enzi saw ACA impacts beforehand, shows value of 
Senator Enzi.''

       Dear Editor: Fox News had a very interesting and 
     informative program Tuesday evening Nov. 6 on ``The Kelly 
     Files with Megyn Kelly.''
       As anyone who watches Fox News knows, they are covering the 
     beginning effects of the Affordable Care Act, also known as 
     ObamaCare, as it is being implemented. Megyn Kelly began her 
     program stating she had a special guest who had predicted 
     three-and-one-half years ago almost exactly what will happen 
     when the ObamaCare law guess into effect this October.

  Her special guest was our own Wyoming senior Senator Mike Enzi and he 
had made his predictions in a speech on the Senate floor three-and-one-
half years ago. He was then called a fearmonger by the Democrats and a 
radical rightwinger. Senator Enzi was probably one of a very few 
elected officials who had actually read the bill.
  Senator Enzi reads all the bills. He understands the bills and the 
implications and then reads the Federal Register so he knows what is in 
them. He then brings to the floor thoughtful pieces of legislation to 
actually make things better for the American people, not worse.
  What we are now seeing is that people can't keep their insurance. 
They are losing their insurance, their doctor, and losing their 
hospitals. It is interesting in terms of being able to not even keep 
your doctor, not being able to go to the hospital you prefer.
  I would like to talk for a few seconds about the doctor-patient 
relationship and why when the President says: ``If you like your 
doctor, you can keep your doctor, period,'' that actually caused 
comfort for people. But, again, that is another broken promise. It is 
not necessarily ranked by PolitiFact to the level of, ``If you like 
your coverage, you can keep your coverage,'' because people have gotten 
the letters. Next year we will see more and more people who will not be 
able to keep their doctor.
  As a doctor, I wrote an article that appeared on Wednesday of this 
week in Investors Business Daily called ``ObamaCare Disrupts the 
Delicate Relationship Between Patient and Doctor.'' I would like to 
share parts of it now specifically because this past weekend on one of 
the Sunday talk shows Rahm Emanuel's brother Ezekiel Emanuel, who was 
one of the architects of the President's health care law, which was 
written behind closed doors, was on one of his talk shows responding to 
a question about the President's comment, ``If you like your doctor, 
you can keep your doctor.'' Can you really keep your doctor?
  What I wrote in this column December 11 was:

       A central architect of the President's health care law 
     admitted this week that the often repeated promise that ``if 
     you like your doctor, you can keep your doctor'' simply isn't 
     true.
       Instead, Dr. Ezekiel Emanuel explained that if you like 
     your doctor, you will simply need to pay more to keep your 
     doctor.
       As a physician, I know firsthand how this will hurt many 
     Americans.

  I write about how families look to doctors as trusted friends, 
confidants, counselors, and turn to them for advice in making life-and-
death decisions.
  In Wyoming, patients have included me in graduations, weddings, and 
asked me to serve as a pallbearer at funerals. They have asked me to 
pray with them, referee family disputes, and provide reassurance when a 
doctor they didn't know was called in to consult.
  Norman Rockwell's painting ``Doctor and Doll'' tells the story. A 
little girl holds up the doll as the trusted family doctor listens with 
a stethoscope. A caring and compassionate physician takes the time to 
reassure a concerned little girl.
  The doctor-patient relationship is a very special bond. It requires 
faith and trust for a patient to allow me to cut into their body to 
remove a tumor, to replace a wornout joint, to fix a broken bone, to 
repair a torn ligament, and above all else, to do no harm.
  The President knew of that special relationship between people and 
their doctors. That is why when he was trying to gain support for the 
health care law, he made a clear and simple promise to the American 
people. The President said: ``If you like your doctor, you can keep 
your doctor, period.''
  Now people all across the country are finding out that they can't 
keep their doctor. The same law that has caused

[[Page 18638]]

millions of Americans to lose the health insurance that worked for them 
is now causing them to lose their doctor.
  People who are shopping for insurance on government exchanges are 
being forced to purchase insurance for things they don't want, don't 
need, and will never use. To keep costs down, many of these policies 
limit the doctors and hospitals that patients can use.
  Some of the Nation's premier hospitals--including the Mayo Clinic and 
Cedars-Sinai Medical Center--are excluded from many insurance exchanges 
in their networks. Some of the best children's hospitals in the country 
are also excluded from the exchanges. This means a child with cancer 
may lose access to his or her doctor and their specialty hospital. Why? 
Because of the law.
  In New Hampshire, 10 of the State's 26 hospitals are excluded from 
the only carrier that offers insurance in the exchange. The head of the 
medical staff at one of the excluded hospitals in New Hampshire has 
learned that her plan does not even let her, the chief of staff of the 
hospital, seek treatment at her own hospital.
  The situation can be equally bad for seniors on Medicare. Thousands 
of doctors caring for seniors on Medicare Advantage have been dropped 
from their networks. Those Medicare patients are now going to be 
challenged to find a new doctor to take care of them.
  The President's health care law is making it harder for doctors as 
well as for patients. Doctors know their patients. They know their 
health history, they know their lives, and doctors value the personal 
relationship as much as the patient does.
  People become doctors in the first place to take care of their 
patients. Even if someone is able to keep their doctor, they will not 
necessarily be able to spend as much time with them as they might like 
to. That is because nearly two-thirds of doctors expect to have to 
spend more time on paperwork under the requirements of the law.
  This isn't at all what the President promised the American people. 
People all across America put their faith and their trust in Barack 
Obama when they elected him President. It is the same kind of faith and 
trust they have in their own doctor. When patients lose trust in their 
doctor, as citizens they are now losing faith in their President, it is 
extremely difficult to regain that trust.
  So I continue to hear from my patients in Wyoming. They have always 
had my home phone number. They are anxious. They are angry. They know 
what they want from the health care reform. They want access to quality 
affordable care. That is not what they got with this law. Now many face 
losing the doctor who has always been there for them.
  If President Obama wants to regain the trust of the American people, 
he will sit down with Republicans to deliver reforms that will help all 
Americans and fully protect the doctor-patient relationship. After all, 
President Obama has his own doctor at the White House, a doctor who is 
dedicated to the President's care. I am sure the President values his 
relationship just as much as other Americans value their relationship 
with their doctor.
  I continue to come to the floor. I see my colleagues are arriving. I 
would call their attention to this issue, as they say we have to make 
the coverage for all these things, they feel they know what is best for 
American patients, we need to provide psychiatric insurance an 
coverage, and I have voted to provide parity for psychiatric care, but 
yesterday's New York Times article by Robert Pear, ``Fewer 
Psychiatrists Seen Taking Health Insurance.'' So the insurance the 
President is providing for people doesn't actually help them. It maybe 
makes the President feel better, but it is not helping people get care.
  The President has been very confused and used the word ``coverage'' 
when he should have been talking about actual health care for people, 
providing physicians to take care of them so people can get what they 
need in health care reform, the care they need, from a doctor they 
choose, at lowers costs.
  Thank you, Mr. President. I yield the floor.
  The PRESIDING OFFICER. The question occurs on the nomination.
  The question is, Will the Senate advise and consent to the nomination 
of Deborah Lee James, of Virginia, to be Secretary of the Air Force?
  Mr. BARRASSO. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The clerk will call the roll.
  The assistant bill clerk called the roll.
  Mr. DURBIN. I announce that the Senator from New Jersey (Mr. Booker), 
the Senator from South Dakota (Mr. Johnson), the Senator from Maryland 
(Ms. Mikulski), the Senator from West Virginia (Mr. Rockefeller), and 
the Senator from Hawaii (Mr. Schatz) are necessarily absent.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Tennessee (Mr. Alexander), the Senator from Missouri (Mr. 
Blunt), the Senator from Indiana (Mr. Coats), the Senator from Oklahoma 
(Mr. Coburn), the Senator from Tennessee (Mr. Corker), the Senator from 
Idaho (Mr. Crapo), the Senator from South Carolina (Mr. Graham), the 
Senator from Utah (Mr. Hatch), the Senator from Oklahoma (Mr. Inhofe), 
and the Senator from Illinois (Mr. Kirk).
  Further, if present and voting, the Senator from Tennessee (Mr. 
Alexander) would have voted ``nay.''
  The PRESIDING OFFICER (Mr. Levin). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 79, nays 6, as follows:

                      [Rollcall Vote No. 270 Ex.]

                                YEAS--79

     Ayotte
     Baldwin
     Barrasso
     Baucus
     Begich
     Bennet
     Blumenthal
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Cochran
     Collins
     Coons
     Cornyn
     Cruz
     Donnelly
     Durbin
     Enzi
     Feinstein
     Flake
     Franken
     Gillibrand
     Grassley
     Hagan
     Harkin
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Isakson
     Johnson (WI)
     Kaine
     King
     Klobuchar
     Landrieu
     Leahy
     Lee
     Levin
     Manchin
     Markey
     McCaskill
     McConnell
     Menendez
     Merkley
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Portman
     Pryor
     Reed
     Reid
     Rubio
     Sanders
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Tester
     Thune
     Toomey
     Udall (CO)
     Udall (NM)
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                                NAYS--6

     Fischer
     Johanns
     McCain
     Risch
     Roberts
     Vitter

                             NOT VOTING--15

     Alexander
     Blunt
     Booker
     Coats
     Coburn
     Corker
     Crapo
     Graham
     Hatch
     Inhofe
     Johnson (SD)
     Kirk
     Mikulski
     Rockefeller
     Schatz
  The nomination was confirmed.

                          ____________________