[Congressional Record (Bound Edition), Volume 161 (2015), Part 3]
[Senate]
[Pages 4102-4113]
[From the U.S. Government Publishing Office, www.gpo.gov]




         CONCURRENT RESOLUTION ON THE BUDGET, FISCAL YEAR 2016

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of S. Con. Res. 11, which the clerk will report.
  The senior assistant legislative clerk read as follows:

       A concurrent resolution (S. Con. Res. 11) setting forth the 
     congressional budget for the United States Government for 
     fiscal year 2016 and setting forth the appropriate budgetary 
     levels for fiscal years 2017 through 2025.

  Pending:

       Sanders/Wyden amendment No. 323, to create millions of 
     middle class jobs by investing in our nation's infrastructure 
     paid for by raising revenue through closing loopholes in the 
     corporate and international tax system.

  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Colleagues, good morning. Working with Senator Sanders 
yesterday, we made good progress on opening day for the budget 
resolution. It might not have been as fun as being at opening day for 
baseball, but getting underway on the first balanced budget resolution 
this Senate has seen in nearly 20 years was pretty exciting for me, and 
I appreciate the good work and the full debate we have had.
  Today, I am looking forward to more work on a variety of amendment 
ideas for the resolution. Some Senators want to debate amendment ideas 
that have to do with the budget and some Senators want to debate 
amendment ideas that have nothing to do with the budget. So we will 
hear from some Senators today on issues such as our spending caps or 
the sequester, how best to preserve and protect Social Security, and 
what is the best way to ensure women are treated fairly in the 
workforce.
  Other Senators may want to discuss items such as how to treat the 
waterways of the United States, free from overreach from the EPA, or 
how our communities and localities are under siege from Washington when 
it comes to ideas about taxing carbon or coal, and Senators may wish to 
discuss how our national security is best served by the spending levels 
contemplated in the budget. But we will also hear about something that 
really interests me, as it marries the numbers our budget resolution 
carries with the work our committees and Congress can do once the 
budget is passed.
  I think one of the frustrations of the other side is this is a fairly 
general budget because it sets the spending limits for the committees 
and then builds in some reserve funds for some flexibility. It doesn't 
go into the specifics of exactly how the committees are to operate. The 
reason for that is the committees are the people who have at least an 
intense interest in that field or maybe even a lot of expertise. When 
we try to preclude what they are doing by what we do in the budget, it 
won't work.
  We will also hear about something that marries the numbers our budget 
resolution carries with the work our committees and Congress can do 
once the budget is passed. The statutory deadline for passing the 
budget is April 15. Just prior to that, we are going to have a 2-week 
recess, which shortens the amount of time we have to work.
  I would remind everybody that Republicans have only been in charge 
for a few weeks and are going to pass the first budget in 6 years. That 
is a pretty fast track to be on, but I am pleased with where we are at 
the moment.
  Later on this morning, the Senate will consider an amendment to help 
improve care for children with medical complexity within Medicaid. 
Children with medical complexity require intensive health care 
services. These children often have two or more serious chronic 
conditions, and often see six or more specialists and a dozen or more 
physicians. They also often require care that takes them across State 
lines. There are 2 million of these children on Medicaid.
  Reflecting a bipartisan bill, Senator Portman intends to offer an 
amendment to create a reserve fund in anticipation of committee action 
that recognizes the critical importance of Medicaid to children with 
medical complexity, and the need for greater coordination and 
integration of care for this population within Medicaid. If Congress 
can write a bill that fits this reserve fund, then we can benefit 
children with medical complexity and their families. I look forward to 
a good debate and several votes in the Senate today.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, I look forward to continuing to work with

[[Page 4103]]

Senator Enzi in a thoughtful and important process, and I thank the 
Senator for his civility. I think we are going to have an interesting 
few days.
  To my mind, the basic issue surrounding this budget debate is whether 
we address the enormous needs facing a declining middle class and 
whether we come forth with ideas that create the jobs--the millions of 
jobs our people need--whether we raise the wages that millions of 
workers desperately need who today are working for $7.50 an hour, $8 an 
hour, whether we deal with the scandal of pay equity in this country 
where women are making 78 cents on the dollar compared to men, whether 
we make sure we do not cut Social Security at a time when there are so 
many vulnerable seniors out there whose entire income or almost their 
entire income is Social Security.
  In my view, we cannot balance the budget on the most vulnerable 
people in this country. We cannot cut the Meals on Wheels Program. We 
cannot cut Head Start. Essentially at a time when the middle class is 
shrinking, we cannot balance the budget on the backs of the elderly, 
the children, the sick, and the poor.
  On my side of the aisle in the Democratic Caucus, what people are 
looking at is massive wealth and income inequality taking place in 
America. Senator Reid a few minutes ago made the point that in the last 
2 years alone--the last 2 years alone--the wealthiest 14 people in this 
country have seen their wealth increase by over $150 billion--in 2 
years. That is more wealth that they have increased in 2 years than the 
bottom 40 percent of the American people own. That is pretty crazy. The 
richer are becoming phenomenally richer, and we have tens of millions 
of Americans struggling to keep their heads above water.
  My Republican colleagues say, well, we want to deal with the deficit 
by cutting programs for the working families, lower income people, the 
people who are struggling, but we are not going to ask the wealthy or 
largest corporations in this country who are doing phenomenally well to 
pay an additional nickel in taxes. That does not make sense to me. I do 
not believe it makes sense to the American people.


                     Amendment No. 323, as Modified

  Having said that, what I wish to do now is get to an amendment that 
is currently at the desk, and I ask that the pending amendment be 
modified with the changes that are at the desk.
  The PRESIDING OFFICER. The amendment is so modified.
  The amendment, as modified, is as follows:

       On page 5, line 5, increase the amount by $25,001,000,000.
       On page 5, line 6, increase the amount by $51,201,000,000.
       On page 5, line 7, increase the amount by $65,879,000,000.
       On page 5, line 8, increase the amount by $71,784,000,000.
       On page 5, line 9, increase the amount by $72,916,000,000.
       On page 5, line 10, increase the amount by $73,405,000,000.
       On page 5, line 11, increase the amount by $48,535,000,000.
       On page 5, line 12, increase the amount by $22,338,000,000.
       On page 5, line 13, increase the amount by $7,660,000,000.
       On page 5, line 14, increase the amount by $1,755,000,000.
       On page 5, line 18, increase the amount by $25,001,000,000.
       On page 5, line 19, increase the amount by $51,201,000,000.
       On page 5, line 20, increase the amount by $65,879,000,000.
       On page 5, line 21, increase the amount by $71,784,000,000.
       On page 5, line 22, increase the amount by $72,916,000,000.
       On page 5, line 23, increase the amount by $73,405,000,000.
       On page 5, line 24, increase the amount by $48,535,000,000.
       On page 5, line 25, increase the amount by $22,338,000,000.
       On page 6, line 1, increase the amount by $7,660,000,000.
       On page 6, line 2, increase the amount by $1,755,000,000.
       On page 6, line 6, increase the amount by $79,667,000,000.
       On page 6, line 7, increase the amount by $79,667,000,000.
       On page 6, line 8, increase the amount by $79,667,000,000.
       On page 6, line 9, increase the amount by $79,667,000,000.
       On page 6, line 10, increase the amount by $79,667,000,000.
       On page 6, line 11, increase the amount by $79,667,000,000.
       On page 6, line 19, increase the amount by $25,001,000,000.
       On page 6, line 20, increase the amount by $51,201,000,000.
       On page 6, line 21, increase the amount by $65,879,000,000.
       On page 6, line 22, increase the amount by $71,784,000,000.
       On page 6, line 23, increase the amount by $72,916,000,000.
       On page 6, line 24, increase the amount by $73,405,000,000.
       On page 6, line 25, increase the amount by $48,535,000,000.
       On page 7, line 1, increase the amount by $22,338,000,000.
       On page 7, line 2, increase the amount by $7,660,000,000.
       On page 7, line 3, increase the amount by $1,755,000,000.
       On page 19, line 3, increase the amount by $3,000,000,000.
       On page 19, line 4, increase the amount by $30,000,000.
       On page 19, line 7, increase the amount by $3,000,000,000.
       On page 19, line 8, increase the amount by $480,000,000.
       On page 19, line 10, increase the amount by $3,000,000,000.
       On page 19, line 11, increase the amount by $1,530,000,000.
       On page 19, line 13, increase the amount by $3,000,000,000.
       On page 19, line 14, increase the amount by $2,580,000,000.
       On page 19, line 16, increase the amount by $3,000,000,000.
       On page 19, line 17, increase the amount by $2,880,000,000.
       On page 19, line 19, increase the amount by $3,000,000,000.
       On page 19, line 20, increase the amount by $3,000,000,000.
       On page 19, line 23, increase the amount by $2,970,000,000.
       On page 20, line 1, increase the amount by $2,520,000,000.
       On page 20, line 5, increase the amount by $1,470,000,000.
       On page 20, line 9, increase the amount by $420,000,000.
       On page 20, line 13, increase the amount by 
     $11,000,000,000.
       On page 20, line 14, increase the amount by $7,570,000,000.
       On page 20, line 17, increase the amount by 
     $11,000,000,000.
       On page 20, line 18, increase the amount by $9,760,000,000.
       On page 20, line 21, increase the amount by 
     $11,000,000,000.
       On page 20, line 22, increase the amount by 
     $10,380,000,000.
       On page 20, line 25, increase the amount by 
     $11,000,000,000.
       On page 21, line 1, increase the amount by $10,650,000,000.
       On page 21, line 4, increase the amount by $11,000,000,000.
       On page 21, line 5, increase the amount by $10,660,000,000.
       On page 21, line 8, increase the amount by $11,000,000,000.
       On page 21, line 9, increase the amount by $10,660,000,000.
       On page 21, line 13, increase the amount by $3,090,000,000.
       On page 21, line 17, increase the amount by $900,000,000.
       On page 21, line 21, increase the amount by $280,000,000.
       On page 21, line 25, increase the amount by $10,000,000.
       On page 23, line 20, increase the amount by $1,000,000,000.
       On page 23, line 21, increase the amount by $17,000,000.
       On page 23, line 24, increase the amount by $1,000,000,000.
       On page 23, line 25, increase the amount by $177,000,000.
       On page 24, line 3, increase the amount by $1,000,000,000.
       On page 24, line 4, increase the amount by $360,000,000.
       On page 24, line 7, increase the amount by $1,000,000,000.
       On page 24, line 8, increase the amount by $627,000,000.
       On page 24, line 10, increase the amount by $1,000,000,000.
       On page 24, line 11, increase the amount by $885,000,000.
       On page 24, line 13, increase the amount by $1,000,000,000.
       On page 24, line 14, increase the amount by $968,000,000.
       On page 24, line 18, increase the amount by $983,000,000.
       On page 24, line 22, increase the amount by $823,000,000.
       On page 25, line 1, increase the amount by $640,000,000.
       On page 25, line 5, increase the amount by $373,000,000.
       On page 25, line 9, increase the amount by $60,667,000,000.
       On page 25, line 10, increase the amount by 
     $14,494,000,000.
       On page 25, line 13, increase the amount by 
     $60,667,000,000.

[[Page 4104]]

       On page 25, line 14, increase the amount by 
     $37,754,000,000.
       On page 25, line 17, increase the amount by 
     $60,667,000,000.
       On page 25, line 18, increase the amount by 
     $50,344,000,000.
       On page 25, line 21, increase the amount by 
     $60,667,000,000.
       On page 25, line 22, increase the amount by 
     $54,432,000,000.
       On page 25, line 25, increase the amount by 
     $60,667,000,000.
       On page 26, line 1, increase the amount by $54,806,000,000.
       On page 26, line 4, increase the amount by $60,667,000,000.
       On page 26, line 5, increase the amount by $54,962,000,000.
       On page 26, line 9, increase the amount by $40,517,000,000.
       On page 26, line 13, increase the amount by 
     $17,260,000,000.
       On page 26, line 17, increase the amount by $4,670,000,000.
       On page 26, line 21, increase the amount by $582,000,000.
       On page 27, line 2, increase the amount by $4,000,000,000.
       On page 27, line 3, increase the amount by $2,890,000,000.
       On page 27, line 6, increase the amount by $4,000,000,000.
       On page 27, line 7, increase the amount by $3,030,000,000.
       On page 27, line 10, increase the amount by $4,000,000,000.
       On page 27, line 11, increase the amount by $3,265,000,000.
       On page 27, line 14, increase the amount by $4,000,000,000.
       On page 27, line 15, increase the amount by $3,495,000,000.
       On page 27, line 18, increase the amount by $4,000,000,000.
       On page 27, line 19, increase the amount by $3,685,000,000.
       On page 27, line 22, increase the amount by $4,000,000,000.
       On page 27, line 23, increase the amount by $3,815,000,000.
       On page 28, line 3, increase the amount by $975,000,000.
       On page 28, line 7, increase the amount by $835,000,000.
       On page 28, line 11, increase the amount by $600,000,000.
       On page 28, line 15, increase the amount by $370,000,000.

  Mr. SANDERS. Mr. President, what this amendment deals with is 
something I think virtually every Member of this body understands to be 
an enormously important issue, and the American people understand it as 
well, and that is our crumbling infrastructure and the fact we have to 
begin the process to substantially invest in our roads, our bridges, 
our water systems and our wastewater plants, our levees and our dams 
and our airports. The needs out there are enormous. When we do that, we 
can create millions of jobs at a time when we need to create millions 
of jobs. I heard Senator Enzi yesterday speaking on the issue. I think 
he reflects the views of many. I don't think there is a great debate on 
whether our infrastructure is crumbling. I don't think there is a great 
debate--and I speak as a former mayor--that if you allow your 
infrastructure to continue to crumble, it only becomes more expensive 
to rebuild it. I don't think there is a debate on that. The debate, of 
course, comes down to how you pay for it. That debate has been going on 
here for many years.
  If anyone had a magical solution, I suspect it would have been 
brought forth already. But the proposal we are bringing forth calls for 
a $478 billion investment over a 6-year period. That will be paid for 
by eliminating some outrageous corporate loopholes today that, among 
other things, allow large, profitable corporations to stash their 
profits in the Cayman Islands, in Bermuda, and in other tax havens and 
not have to pay one nickel in taxes to the U.S. Government. Our 
proposal is pretty simple. Let's eliminate some of those loopholes, 
let's take that money, let's invest in rebuilding our crumbling 
infrastructure, let's make our country more efficient, more productive, 
safer, and let us create millions of jobs.
  The need for rebuilding our infrastructure should not be in doubt. 
One out of every nine bridges in our country is structurally deficient, 
and nearly one-quarter are functionally obsolete. Almost one-third of 
our roads are in poor or mediocre condition. And as everybody stuck in 
a traffic jam at this moment knows, more than 42 percent of urban 
highways are congested.
  Much of our rail network is obsolete. We are competing against 
countries which have high-speed rail, which operates much more rapidly 
than our railroads do. America's airports are bursting at the seams and 
still rely on antiquated 1960s radar technology. More than 4,000 of our 
Nation's dams are considered deficient, and nearly 9 percent of all 
levees are likely to fail during a major flood. That is a pretty scary 
proposition. Our drinking water systems are nearing the end of their 
useful lives all over this country. Virtually every day there is 
another pipe which bursts, causing flooding in downtowns and wasting 
huge amounts of clean drinking water. Further, our wastewater plants 
routinely fail during heavy rains, allowing all kinds of crap to go 
into our lakes and our rivers, which should not be the case. Our aging 
electrical grid has hundreds of avoidable power failures each year and 
is unacceptably vulnerable to cyber attacks.
  Now $478 billion may seem like a lot of money. It is a lot of money, 
but the American Society of Civil Engineers tells us we need to invest 
an additional $1.6 trillion to get our infrastructure into a state of 
good repair by 2020. To be honest with you, while this amendment is a 
significant step forward, it does not go anywhere near as far as it 
should go.
  I would hope on this amendment we would have strong bipartisan 
support. It is not good enough for people to continue to say what 
everybody acknowledges--yes, we need to rebuild our crumbling 
infrastructure, but, no, we don't know how we are going to come up with 
the money to do it. It is too late to keep expressing that rhetoric. We 
have heard it for too many years. Every day we don't act, it becomes 
more expensive for us to act.
  I urge my colleagues on both sides of the aisle to today make an 
important statement that, A, we cannot continue to delay rebuilding our 
crumbling infrastructure; that, B, when real unemployment in this 
country is not 5\1/2\ percent but 11 percent, when youth unemployment 
is 17 percent, when African-American youth unemployment is off the 
charts, we need a major jobs program to put our people back to work at 
decent wages. That is what work on infrastructure does. The time for 
rhetoric is gone. The time for action is now. Let's rebuild our 
crumbling infrastructure. Let's put people to work. Let's end 
outrageous corporate tax loopholes. Let's make our country safer, more 
efficient, and more productive. I ask for support for that important 
amendment which comes up for a vote I believe at around 12:00 or so.
  I yield 5 minutes off the resolution to Senator Boxer.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Mr. President, if no one arrives, may I have 10 minutes?
  Mr. SANDERS. Mr. President, yes, of course.
  Mrs. BOXER. Mr. President, I am so grateful to Senator Sanders 
because he explains things like no one else. He takes it down to the 
average working family in America. That is really who we are here to 
protect, not the super top rich people. They are doing fine.
  Senator Sanders taught me something this morning. I am just going to 
make sure I remember it correctly. The wealth of the top 14 richest 
people in America in the last couple of years went up over $100 
billion.
  How much was it?
  Mr. SANDERS. It was $157 billion in a 2-year period.
  Mrs. BOXER. In a 2-year period--the wealthiest of the wealthiest, 14 
people--that wealth rose $157 billion. Yet when we look at this 
Republican budget, those people get every benefit we can imagine. They 
are not asked to do a thing--a thing. When people are struggling 
sending their kids to college, Lord knows, when people are struggling 
trying to afford a new home, when people are struggling every day to 
make ends meet--some even to put nutritious food on the table--this 
budget is a blueprint of unfairness. This budget, this Republican 
budget, is a blueprint for another recession. It is a terrible budget, 
and it makes believe it balances. It doesn't balance one bit.
  Our ranking member will explain the smoke and mirrors that have been 
used in this budget. I used to serve on the

[[Page 4105]]

Budget Committee. Let me be clear to anyone within the sound of my 
voice. In recent times the only time the budget was balanced was when 
President Clinton was President, and only Democrats voted for his 
budget. We balanced the budget. And you know what; we created 23 
million jobs because we invested in people, in education, in our 
children.
  Not this budget--they cut--deep cuts out of domestic spending. They 
take $236 billion over 10 years from nondefense. That means they are 
cutting education, scientific research, food safety, law enforcement, 
and every single program the middle class and working Americans depend 
on.
  I want to thank the ranking member of the Budget Committee. He is 
taking on such leadership in his position here and on the Environment 
and Public Works Committee by calling attention to our failing 
infrastructure. There are 63,500 bridges that are structurally 
deficient in America, and 50 percent of our roads are in less than good 
condition. And what does this Republican budget do? By the way, this is 
a big problem for our businesses. They cut 17 percent of overall 
spending, ignoring the fact that our roads are in disrepair and 
ignoring the fact that we face the prospect of crumbling bridges. That 
is a blow to everyone who drives on our roads.
  At a time when energy costs are weighing heavily on families and 
businesses, they cut 85 percent in overall energy spending, including 
weatherization funding. What are they thinking? When a middle class 
family weatherizes their home, the energy bill goes down. They are 
putting a tax on every middle class person who has to pay a heating 
bill. Energy efficiency grants, no--cut. Research to clean energy, cut. 
It is a blow to our consumers and to our efforts to mitigate climate 
change.
  At a time when college is a necessity and priority, they want to cut 
Pell grant funding by 30 percent over 10 years and to reduce overall 
spending on education and training by 15 percent--a blow to our 
students. Not for the students whose parents are in that top echelon--
there is no problem there. They can afford $40,000 a year college--
$30,000, $60,000. It is for our middle class and for those striving to 
be in the middle class. They are doomed with this budget.
  Now, President Obama has turned this great recession around, but our 
ranking member points out the problems that remain. The solutions 
aren't that hard to come by. You make investments--not wasteful 
spending but investments in energy, investments in transportation, 
investments in finding cures for diseases. And what do you do? You make 
this a greater country, and you make lives better across the board.
  There are 45 million people who are still recovering from the 
recession, including 16 million children who live in poverty. The 
Republicans leave the top echelon alone, who are making billions of 
dollars, and they are cutting $660 billion from income security over 10 
years. That means they are cutting supplemental nutrition assistance, 
school lunch, unemployment insurance, earned-income tax credit.
  I don't know who they think they represent, but I will tell you who 
they fight for--the wealthiest of the wealthiest few. That is who they 
fight for.
  That old notion that you give billionaires money and somehow it will 
trickle down to the rest of us doesn't work. It doesn't work to cut 
education funding. It doesn't work to cut transportation funding. It 
doesn't work to cut energy assistance programs.
  I have to say that it is a shock to see this budget. If that is why 
they think they got elected, then the people better pay attention.
  Listen to what they do with health care. They do away with the 
Affordable Care Act, when 16 million people now have insurance who 
didn't have it before. And guess what; do they have a replacement? They 
are working on it. Oh, good, we worked on it for 50 years. We finally 
got it done. It is not perfect, but it is working. In my State it is 
magnificent to see people who now know they won't lose everything if 
they get sick. At a time when 70 million Americans rely on Medicaid and 
children's health coverage, they want to block grant that program and 
cut it by more than $1.2 trillion. What will it mean for maternity care 
when half of all births in the U.S. are financed by Medicaid? This is 
another blow to our families, to our babies. They fight for your right 
to be born. How about after you are born? How about after you are born?
  At a time when more than 50 million seniors and disabled Americans 
are on Medicare and the baby boomers continue to age in, they want to 
cut Medicare by $430 billion. Now, look, they are afraid to spell out 
how they want to cut it. They kind of hide it in the documents, but we 
know what happens. People will be suffering, paying more, getting less 
care--a blow to our seniors.
  They do not close one tax loophole for the wealthiest corporations--
some of which pay no income tax--or these billionaires. Now, I have 
nothing against being a billionaire at all, but this Congress ought to 
ask everyone to pay their fair share, including billionaires--not just 
the middle class.
  Now, their gimmicks are unbelievable. They hide defense spending in 
an off-budget account called OCO. Oh no, OCO--they hide it, but we got 
their number. I think Al Sharpton says on his show: ``We gotcha.'' We 
know what you are doing. Where is the emergency fund for our children? 
Where is the emergency fund for education? Where is the emergency fund 
for transportation? No, there is no OCO for that, no.
  Then they claim they balance the budget. That is the biggest fib 
ever. Look at their record. When George W. Bush got elected, he had a 
surplus. It took him 15 minutes to blow it--two wars on the credit 
card, tax cuts for the rich on the credit card. This budget continues 
that legacy of shame--shame--hurting our seniors, hurting our children, 
hurting our middle class, all at the expense of the wealthy few.
  We see that President Obama has cut this deficit by more than half. 
We are on the right track. Let's not walk away from policies that work.
  I want to say to the ranking member, Senator Sanders, I am strongly 
supporting your amendment on infrastructure, because to be a great 
Nation we have to move people, we have to move goods. This is a global 
marketplace. Ships are coming in to California--40 percent of the 
imports. They are transferred to trucks, and they go on roads that are 
full of pot holes. They are a mess. They have rail crossings that are 
dangerous.
  So I will conclude in 20 seconds, if I might.
  The PRESIDING OFFICER. Without objection.
  Mrs. BOXER. I will conclude. I want to thank our ranking member on 
the Budget Committee because he talks from the heart, the soul, and 
from facts. If we follow his leadership, rather than the leadership of 
those on the other side of the aisle who want to go back to the days of 
high deficits, high unemployment, and chaos--and we were here; we know 
there was chaos--if not, then vote for this Republican budget. I hope 
we will vote no, and I hope we will support the amendment that will 
come forward to put us on the right track again.
  Thank you very much. I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  If no one yields time, it will be charged equally to both sides.
  The Senator from Wyoming.
  Mr. ENZI. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. PORTMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 349

  Mr. PORTMAN. Mr. President, I ask unanimous consent to set aside the 
pending amendment and call up my amendment No. 349.
  The PRESIDING OFFICER. Without objection, it is so ordered.

[[Page 4106]]

  The clerk will report.
  The senior assistant legislative clerk read as follows:

       The Senator from Ohio [Mr. Portman], for himself and Mr. 
     Bennet, proposes an amendment numbered 349.

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

(Purpose: To establish a deficit-neutral reserve fund to improve health 
 outcomes and lower the costs of caring for medically complex children 
                              in Medicaid)

       At the appropriate place, insert the following:

     SEC. ___. DEFICIT-NEUTRAL RESERVE FUND TO IMPROVE HEALTH 
                   OUTCOMES AND LOWER THE COSTS OF CARING FOR 
                   MEDICALLY COMPLEX CHILDREN IN MEDICAID.

       The Chairman of the Committee on the Budget of the Senate 
     may revise the allocations of a committee or committees, 
     aggregates, and other appropriate levels in this resolution 
     for one or more bills, joint resolutions, amendments, 
     amendments between the Houses, motions, or conference reports 
     relating to improving the health outcomes and lowering the 
     costs of caring for medically complex children in Medicaid, 
     which may include creating or expanding integrated delivery 
     models or improving care coordination, by the amounts 
     provided in such legislation for those purposes, provided 
     that such legislation would not increase the deficit over 
     either the period of the total of fiscal years 2016 through 
     2020 or the period of the total of fiscal years 2016 through 
     2025.

  Mr. PORTMAN. Mr. President, we are here talking about the budget. One 
of the issues on the budget is how we spend our money, including on 
health care and in this case on some of our most vulnerable young 
people, our children, who have what are termed to be ``complex medical 
conditions.''
  I appreciate the fact that Senator Bennet is cosponsoring this 
amendment with me. It is based on some bipartisan legislation we have 
been working on over the years that helps to ensure that these children 
have the opportunity to get better care, and also we can save some 
funds in what is a very inefficient Medicaid delivery system now for 
these children.
  It would allow, basically, health care providers to deliver health 
care services to these medically complex kids through models that 
coordinate care between providers, again helping to improve quality of 
care--and much better outcomes in the cases where this has been tried--
but also to lower costs for Medicaid.
  There are roughly 3 million children who fit in this category. It is 
about 1 in every 25 children. Of these children, by the way, most of 
them rely on Medicaid to access care, about 2 million out of the 3 
million.
  Although children with complex conditions represent only about 6 
percent of pediatric Medicaid patients, they comprise about 40 percent 
of the cost, so 6 percent of the kids, about 40 percent of the cost of 
all Medicaid spending on children.
  Children with these medically complex situations tend to have 
multiple and high acuity and chronic conditions that often require the 
service of a lot of different specialists. These circumstances call out 
for better coordination of care, particularly because a lot of it goes 
across State lines. Each Medicaid Program in each State has some 
different rules, but specialized care often requires these children to 
go to specialized providers outside of their State. This amendment 
would correct that fragmented system which those kids sometimes 
encounter now when they do seek that access across State lines.
  Not only would the amendment ensure that medically complex children 
have access to necessary care, it would also allow the Medicaid system 
to realize savings through these increased efficiencies, including 
reducing hospitalizations and emergency room visits, while providing 
the array of outpatient and community services and support that are 
needed by these children. So it is a more holistic approach to their 
care, avoiding, frankly, some of the costs associated with emergency 
room visits and other hospitalizations and other fragmented care. It is 
based on the experiences in the real world.
  There are programs that are doing quite well at improving those 
outcomes and saving costs. Some of the great children's hospitals have 
established their track record in developing these care-coordination 
models for kids with medical complexity. I have seen it in action in 
Ohio, where we are blessed to have a number of great children's 
hospitals. I have talked to medical professionals who are very pleased 
to have this better coordination of care. More importantly, I have 
talked to the parents and talked to some of the children themselves who 
are ecstatic about it. You know, many of them received their care 
through a different process previously that was not coordinated. What 
they tell me is they are deeply grateful for the coordination, partly 
because it saves them a lot of time and effort, partly because they are 
getting much better care, and partly because they just feel as if 
somebody cares. They are getting the love and support and care they 
need through the coordination. They are grateful for the difference.
  As the overall population of children with medical complexity 
continues to grow, thanks to some great advances in medical science and 
medical care, including care for premature babies, we are going to see 
more and more of this need for better coordination. I want to thank my 
colleague Senator Bennet and many others on both sides of the aisle who 
have been involved in this issue over the years. This is an important 
amendment for us to have in the Budget Committee because it shows where 
our heart is as a Senate--to be able to take better care of these kids 
and also have more efficient care in the Medicaid system, where, again, 
6 percent of these children now comprise about 40 percent of the cost 
in Medicaid for children.
  I encourage all of my colleagues to support this commonsense approach 
to provide better health care outcomes for some of the most vulnerable 
of our Nation's children.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Ernst). The Senator from Vermont.


                           Amendment No. 386

  Mr. SANDERS. Madam President, I ask unanimous consent to set aside 
the pending amendment so that I may call up my amendment No. 386.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report.
  The senior assistant legislative clerk read as follows:

       The Senator from Vermont [Mr. Sanders], for himself and Mr. 
     Wyden, proposes an amendment numbered 386.

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

   (Purpose: To establish a deficit-neutral reserve fund to protect 
               Medicaid beneficiaries from benefit cuts)

       At the appropriate place, insert the following:

     SEC. ___. DEFICIT-NEUTRAL RESERVE FUND TO PROTECT MEDICAID 
                   BENEFICIARIES FROM BENEFIT CUTS.

       The Chairman of the Committee on the Budget of the Senate 
     may revise the allocations of a committee or committees, 
     aggregates, and other appropriate levels in this resolution 
     for one or more bills, joint resolutions, amendments, 
     amendments between the Houses, motions, or conference reports 
     relating to Medicaid, which may include protecting children, 
     pregnant women, individuals with disabilities, low-income 
     adults, and Americans that need long-term services and 
     supports, including nursing home care, who are guaranteed 
     benefits under Medicaid, by the amounts provided in such 
     legislation for those purposes, provided that such 
     legislation would not increase the deficit over either the 
     period of the total of fiscal years 2016 through 2020 or the 
     period of the total of fiscal years 2016 through 2025.

  Mr. SANDERS. Madam President, Senator Portman's amendment touches 
upon a serious issue that I hope and expect will have broad bipartisan 
support, and that is the needs of children with serious chronic 
conditions.
  In the United States, over 3 million children have medically complex 
health conditions. Of those 3 million kids, 2 million rely on Medicaid 
for their health insurance. That is two out of three kids, which should 
tell every Member of the Senate how important Medicaid is.

[[Page 4107]]

  Let me repeat. Two out of three children rely on Medicaid. They have 
medically complex issues--the issues Senator Portman is speaking about.
  Last Congress, Senator Nelson offered a similar amendment during the 
budget process to address this important issue, and I was pleased to 
support it. I also plan to support this amendment today and hope that 
we have widespread bipartisan support for it.
  But what I must say is that given that the Republican budget 
eliminates the Affordable Care Act, which throws 15 million Americans 
off of health insurance--many of whom have just, for the first time in 
their lives, received health insurance--and given that the Republican 
budget cuts Medicaid by some $400 billion over a 10-year period, the 
amendment Senator Portman is offering deals with only one tiny and 
small part of what the Republican budget is doing. What the Republican 
budget is doing is decimating health care in the United States of 
America.
  Senator Portman says: Well, we have a situation with kids who have 
medically complex problems.
  He is right, but we have many other issues out there that the 
Republicans are decimating.
  Medicaid provides 6.4 million elderly seniors who rely on Medicaid, 
many of whom are living in nursing homes--6.4 million elderly seniors, 
some 80 or 90 years of age, rely on Medicaid for their nursing home 
care. In some cases, these seniors have incomes of $8,000 to $9,000 a 
year. The Portman amendment does not address the devastating cuts that 
happen to elderly Americans in nursing homes.
  Pregnant women who rely on Medicaid for vital prenatal care that 
improves the health and well-being of mothers and babies--those 
programs are going to be cut. The Portman amendment does not protect 
them in any way.
  Nearly 33 million children in our country rely on Medicaid for their 
health insurance. These are kids of low-income, working-class families, 
and they need important medical care when they are young, such as 
immunizations and well-child visits. The Portman amendment does not 
address the fact that many of those people will be thrown off of health 
insurance.
  Some 10 million Americans with disabilities rely on Medicaid to treat 
serious, sometimes life-threatening disabilities. The Portman amendment 
does not address what happens to people with disabilities who are on 
Medicaid.
  While I support this amendment, I am also concerned about the 
devastating impact the Republican budget will have on many millions of 
Americans by ending the Affordable Care Act--16 million Americans 
thrown off of health insurance, $400 billion in cuts in Medicaid, 
millions more.
  I believe we need a budget that strengthens health care in America, 
not decimates it. I believe we need a budget that doesn't force us to 
choose between a seriously ill child and a pregnant woman with small 
children at home. These are false choices which a great nation such as 
ours should not be forced to make, especially at a time, as Senator 
Boxer mentioned, when we have the wealthiest 14 people in this country 
seeing their wealth increase in the last 2 years by $157 billion. Our 
Republican friends say: No, these people should not be asked to pay 
more in taxes, but we should balance the budget by taking millions of 
people off of health insurance. I don't think anybody in America thinks 
those priorities make any sense at all.
  I am offering a side-by-side, and in doing so, I urge my colleagues 
to vote for the Portman amendment but also to vote for my amendment, 
cosponsored by Senator Wyden, which supports all Medicaid beneficiaries 
by opposing cuts to the program.
  Let's not sit around saying: Well, we are making some progress in one 
area, but we don't care about the millions of other people who have 
been thrown off of Medicaid.
  I urge support for the amendment Senator Wyden and I are offering.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Madam President, I ask unanimous consent that the time 
until 12 noon today be equally divided between the managers or their 
designees; that at 12 noon, the Senate vote in relation to the 
following amendments in the order listed, with no second-degree 
amendments in order prior to the votes: Sanders No. 323, as modified, 
Sanders No. 386, and Portman No. 349, with 2 minutes of debate equally 
divided before each vote; and that following the votes, the Senate 
recess under the previous order. I further ask that the time from 2:15 
p.m. to 3 p.m. be under the control of the minority and that the time 
from 3 p.m. to 3:45 p.m. be under the control of the majority.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ENZI. For the information of all Senators, there will be three 
rollcall votes at 12 noon today, with an additional stack of votes 
expected at 4:30 p.m. today.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  The Senator from Oklahoma.
  Mr. INHOFE. Madam President, despite the repeated statements and 
warnings from our military and some of our congressional leaders, 
including myself, we are again staring down the barrel of 
sequestration.
  This has been the great fear we have had, and I think we have come to 
a compromise here that might be liveable--not ideal, not where we 
should be, but where we are at this time.
  Each service chief and each Secretary--and I have never seen this 
before--has testified that no service will be able to meet the wartime 
requirements under sequestration--that is in the event we have to have 
sequestration of the military portion.
  Let me just mention that it was done wrong from the very beginning. 
When you talk about sequestration, it would seem to me that we would 
want to be sequestering or reducing in a relationship or proportion as 
to what that is of the budget. For example, our military is 16 percent 
of the budget, and yet we have had to take 50 percent of the cuts. So 
sequestration has gotten us to this point.
  This budget we will be voting on has kind of a temporary solution or 
relief from sequestration.
  Secretary Carter, our new Secretary of Defense, testified that 
``readiness remains at troubling levels across the force'' and ``that 
even with the FY16 budget, the Army, Navy and Marine Corps won't reach 
their readiness goals until 2020 and the Air Force until 2023.''
  This was interesting because we had a hearing where we had faces from 
the past--Henry Kissinger, George Shultz, and Madeleine Albright. So we 
had Democrats and Republicans, and they all agreed.
  Madeleine Albright testified about her concerns about the deep cuts 
to the Defense Department, saying that it ``jeopardizes America's 
military reach.'' This is a Democrat talking--Madeleine Albright.
  Over the last 6 years, significant cuts to the national security 
spending have forced our men and women in uniform to endure a steep and 
damaging drop in capabilities and readiness.
  All of them testified that our readiness is dropping. When you are 
talking about readiness, you are talking about risk. When you are 
talking about risk, you are talking about American lives. Our naval 
fleet is at a historical low level of ships. The Air Force is the 
smallest in its history. The Army is shrinking to a force not seen 
since before World War II.
  At a time when our security is being increasingly threatened by 
terrorism, a rising China, ISIL, ISIS, and rogue nations such as Iran 
and North Korea, the men and women charged with protecting this Nation 
are being undermined and forced to endure devastating cuts to the tools 
they need to keep America safe.
  What we are talking about is something that has happened up to this 
point--not the potential of sequestration, which hopefully we can avoid 
and I think we will avoid, but what has happened up to this point.
  The President believes the world is getting safer. He is negotiating 
a bad

[[Page 4108]]

deal with Iran. He thinks global warming is a bigger threat to 
Americans than terrorism, but top leaders inside and out of the 
administration disagree.
  Director of National Intelligence James Clapper--James Clapper has 
been in this kind of capacity for well over 40 years--said:

       When the final accounting is done, 2014 will have been the 
     most lethal year for global terrorism in the 45 years such 
     data has been compiled. . . . Roughly half of the world's 
     currently stable countries are at some risk of instability 
     over the next two years.

  The Director of the Defense Intelligence Agency, Lt. Gen. Vincent 
Stewart, before our committee just a couple of weeks ago, stated:

       A confluence of global, political, military, social, and 
     technological developments, taken in aggregate, have created 
     security challenges more diverse and complex than those we 
     have experienced in our lifetimes.

  That was Lt. Gen. Vincent Stuart, the DIA Director.
  Over the last three decades, we have built the most powerful fighting 
force in history and filled it with the most talented men and women 
ever to wear our uniform. We can't break our promise to them or our 
responsibility to protect the Nation.
  I believe our military--our men and women in uniform--will not accept 
failure and will do everything they can to succeed no matter how 
constrained they are by inadequate budgets. However, there will come a 
point when, without the training, equipment, and force size, it will 
fail because it was not given the resources to succeed. We cannot let 
our military get to this point, but that is what we are risking should 
we have another level of sequestration.
  Before sequestration even came into effect, the President cut some 
$500 billion from our military. We stood on this floor and talked about 
it at that time, about how we can't continue having cuts just to the 
military. That is what happened from this President before 
sequestration. Because of sequestration for fiscal year 2013, the Army 
had to cancel seven combat training center rotations, deferred 
maintenance on aircraft and vehicles, and postponed reset of weapons 
and equipment. The Air Force stood down 17 combat squadrons, cut 40,000 
flying hours for its remaining units, cut training, and deferred 
maintenance activities.
  This is a problem that we have, too, because we have to consider the 
difference between retraining and retaining in the Air Force. The 
pilots--to train a pilot to F-22 standards costs in excess of $9 
million, while retentions are something like $200,000 over a 9- or 10-
year period.
  Because of the sequestration in 2013, the Navy and Marine Corps 
canceled deployments, deferred maintenance on ships, aircraft, and 
vehicles, reduced purchases of spare parts, and reduced training 
activities. All the services had to cut or delay weapon system and 
infrastructure modernization.
  Modernization is one of the first things they do when they cut. They 
really can't do the readiness, they can't cut the personnel who are out 
there, the force strength, so modernization is what suffers because 
that is not something people are aware of today. Yet that is where the 
cuts were. They are still attempting to recover from all of these cuts.
  But recent budget turmoil has forced our generals and admirals to 
worry about our military's ability to fulfill its critical national 
security role in, arguably, the most dangerous time in our Nation's 
history.
  The Chairman of the Joint Chiefs of Staff--that is General Dempsey--
warned that continued national security cuts will ``severely limit our 
ability to implement our defense strategy.'' He means there the defense 
strategy to defend our country and to save lives out there. ``It will 
put the nation at greater risk of coercion, and it will break faith 
with men and women in uniform.'' That is General Dempsey, Chairman of 
the Joint Chiefs of Staff.
  Our Nation relies on less than 1 percent who volunteer to risk their 
lives on its behalf. I was trying to get a comparable figure to put 
that in perspective, but we are talking about 1 percent of our 
population is involved in protecting the other 99 percent. When these 
brave men and women are ordered into harm's way, they will salute with 
courage, they will go and do their job, their mission, and very 
effectively, but they do not have the right equipment to do it with. In 
return, they rightfully expect a supportive nation to provide them with 
the best training, technology, and equipment to accomplish their 
mission and then to come home safely. Tragically, we are not doing 
that.
  Put simply, top military leaders are telling us that continued cuts 
to national security spending are making this country less safe. These 
cuts are making it more likely that our military men and women will not 
return from the battlefield alive, and this is immoral.
  We must increase our defense budget, and I prefer to increase its 
base budget in fiscal year 2016 and over the next 5 years to give our 
military leadership the required and predictable funding they need. 
Because of Senate rules, however, we aren't able to do this without 
changing the law. I am committed to working to the point where we can 
replace sequestration with cuts to mandatory spending, as was 
originally planned with the Budget Control Act.
  We went through the Budget Control Act assuming some of these things 
would happen. For the purposes of a Senate budget resolution, however, 
I am proud of the Budget Committee and the hard work they have done for 
adopting an amendment during their markup to provide additional funding 
for the Department of Defense through overseas contingency operations. 
That is OCO. This is far from ideal. OCO money is better than no money 
at all, and until we provide the solution to sequestration we need, 
this is the best we can do.
  Our country is at war and will be for the foreseeable future and we 
are going to have to do something to keep America strong. I don't like 
this alternative. We have had nothing but a series of bad alternatives 
and this is the least bad alternative. So I salute Senator Enzi and 
others who are responsible for coming up with something that still is 
going to defend our Nation, particularly as we are faced with another 
potential round of sequestration. We can't let that happen to our men 
and women in uniform nor to America.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. INHOFE. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ENZI. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ENZI. Madam President, I ask unanimous consent that even though 
we had an agreement for time to be equally divided--yesterday, we 
passed one that said whenever we are in a quorum call, the time would 
be equally divided--I hope that would continue through all these quorum 
calls, and so I ask unanimous consent that be the case.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ENZI. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. INHOFE. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                  Transportation Reauthorization Bill

  Mr. INHOFE. Madam President, first of all, I want to thank my good 
friend from Vermont for drawing attention to the critical importance of 
passing a long-term Transportation reauthorization bill. This is one 
that Senator Boxer and I have been working together on for a long 
period of time. We have gone through these reauthorizations for many 
years, and we know this is the way to do it.
  The reauthorization bill is far superior to just the short-term 
efforts for extensions. I think we all realize extensions cost about 30 
percent off the top.

[[Page 4109]]

And while I can't support the specific proposal of my good friend from 
Vermont, passing a bipartisan long-term fully funded bill is my top 
priority as chairman of the Environment and Public Works Committee.
  As we all know, the current Transportation reauthorization expires on 
May 31, and EPW will be prepared to move on a reauthorization bill 
before that deadline. That is our goal. My staff has been working 
closely with the staff of my good friend and partner from California, 
the ranking member, Senator Boxer, and we are getting close to having 
our bill ready.
  I know my colleagues on the Committees on Finance, Commerce, Science 
and Transportation, and Banking, Housing and Urban Affairs are also 
committed to passing a long-term bill as soon as possible, because this 
does involve not just the Environment and Public Works Committee but 
the other two committees as well.
  The PRESIDING OFFICER. The Senator from California.
  Mrs. BOXER. Madam President, I want to thank my colleague and friend 
from Oklahoma, and I also want to thank the ranking member of the 
Committee on Finance for being here because he is so right, we have to 
work together. On the EPW Committee, we know how critical this is. The 
Committee on Finance knows how critical it is because they have to 
figure out the pay-fors--let's be honest, the hardest part of all 
this--and the Committee on Commerce, Science, and Transportation also 
has to work. I am sure Senator Thune is very aware of that, and his 
ranking member as well.
  MAP 21, our transportation bill, is set to expire as the summer 
construction season is beginning. Several States--Arkansas, Georgia, 
Wyoming, and Tennessee--have already delayed or canceled construction 
projects due to the uncertainty in the Federal transportation funding 
system. Other States are considering similar actions as the 
construction season fast approaches.
  I want to make this point. We are going to hear from all of our 
States. I am fortunate, I have such a large State they can go a little 
longer with the uncertainty, but even California, which receives quite 
a bit from the highway trust fund, is going to start to hurt pretty 
soon.
  I am so proud that my friend, my chairman, is here, because we have 
such a great history of working together on infrastructure projects--
not so good on the environment; we go toe to toe and don't work 
together on that, but we work together on infrastructure. He talks 
about it as a proud conservative and I talk about it as a proud 
liberal, and we see why it is so critical for our Nation.
  So we do have to work carefully to craft another bipartisan MAC-21, 
and I look forward to bringing that bill to the floor.
  I want to make sure that when we do bring that bill to the floor we 
have no controversial riders on it to bring it to a dead stop. We have 
seen that on so many bills already. I am really looking forward to 
bringing such a bill that is a clean bill that addresses our 
transportation funding to the floor with Chairman Inhofe, with the 
support of Chairman Hatch and Ranking Member Wyden and others.
  Mr. INHOFE. Madam President, let me say I agree and look forward to 
that.
  Sometimes people forget some of the things we are supposed to be 
doing around here. The Constitution says roads and bridges. That is 
what we are supposed to be doing. So I will work closely with my friend 
from California to achieve this.
  Mrs. BOXER. I thank the Senator.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Madam President, the Senate is going to spend much of this 
week debating the contours and the details of the Federal budget. Our 
colleagues are going to offer a variety of amendments, and we will 
undoubtedly cast a lot of votes. Those watching are going to hear 
speeches that are peppered with numbers and statistics. So I would like 
to start out the debate by setting aside, to the extent we can, this 
flood of numbers and statistics, and focus on what this means to 
working families in my home State of Oregon and across the country.
  My view is the great economic challenge of our time is expanding 
opportunity for these families. It is about strengthening the middle 
class and adding sturdier rungs to America's economic ladder so 
everybody has the chance to climb upward.
  Seven years after a crippling economic collapse, we have seen our 
unemployment rate go down, home foreclosures have gone down, gas prices 
have gone down. We are finally starting to see wages beginning to grow, 
and manufacturing is picking up steam. The American economy is now 
performing better than at any recent time in memory.
  But the fact is there are still millions of Americans who feel stuck. 
They listen to all of the positive economic news that ricochets across 
the news media and wonder when things are actually going to get better 
for them and their families. I hear it firsthand in every townhall 
meeting I hold in our State, including several this month. These are 
young parents who are overwhelmed by the cost of childcare. There are 
students practically in shock over the sticker price of a college 
education. We have workers who are nearing retirement age, confirmed by 
the Finance Committee, who have hardly been able to save at all.
  What the Senate budget is all about is not just facts and figures but 
about the hopes and aspirations of those people I have described who 
want things to change. In my view, the budget the Congress sets should 
take on those middle-class challenges directly. It ought to help 
working-class families and give more Americans a chance to get ahead in 
life.
  This week, our colleagues on the other side of the aisle are putting 
forward a different kind of budget--a budget that would poke some new 
holes in the safety net and, in my view, would worsen inequality. We 
would see millions of Americans face cuts in programs that are a 
lifeline for them. I have to ask, How will cutting a Pell grant and 
education tax credits help a disadvantaged student in La Grande, OR, 
who wants to work hard, play by the rules, and get ahead? How is 
cutting food stamps going to help a single mother in Ashland who is 
walking on an economic tightrope every month? How is it going to help 
her keep food on the table? How will slashing Medicaid help a 
struggling family in Roseburg, OR, stay healthy and out of the 
emergency room? And, finally, how would repealing the Affordable Care 
Act help a cancer survivor in Corvallis who has finally been able to 
get health insurance for the first time in years?
  So my bottom line is pretty direct: Our middle class declines with 
every rung that is pulled from the ladder of opportunity. So what we 
all ought to say is the budget is about trying to help Americans climb 
upward with a budget that is designed to give all Americans the 
opportunity to get ahead.
  To me, we start by investing in America's infrastructure. We simply 
cannot have big league economic growth with a little league 
infrastructure. The roads and highways in Oregon and across our country 
are now pocked by ruts and potholes, making it harder to do business 
and harder to travel. Dozens of people have been killed or injured in 
bridge collapses. Without adequate roads, bridges, and transit, drivers 
spend far too much time sitting in traffic choking on exhaust.
  This also has taken a big toll on America's ability to compete 
internationally. We have to have big league infrastructure to draw jobs 
and investment to our country, and that depends on the quality of our 
roads and ports and airports and railways. We know investing in 
infrastructure creates thousands of jobs in America right away and 
supports millions more over the long term.
  In my view, effective, targeted investments in infrastructure ought 
to be a no-brainer on both sides of the aisle.
  Second, the Congress ought to strengthen programs that assist rural

[[Page 4110]]

communities and brighten their economic futures. For example, homes in 
Oregon and across the West are being threatened by fires that are 
growing bigger and hotter and more damaging each year.
  Chairman Enzi's budget took several steps in the right direction to 
improve the way governments budget for fires, but with a growing 
threat, more resources are needed to fight and prevent fires. Having 
just visited Medford, OR, they told me it was going to be the driest in 
25 years, and we take out a map and California just looks dry, dry, 
dry. Passing the bipartisan legislation that Senator Crapo and I have 
authored is urgent.
  I also feel funding for agricultural research is another vital tool 
for giving rural communities a chance to get ahead. Each dollar that 
goes into agricultural research will be far outstripped by the value 
created in crops and croplands.
  I was told just recently by wheat farmers in Eastern Oregon that 
investing in agricultural research is going to give them and people all 
through Eastern Oregon a better chance to get ahead and be more 
successful with their farms.
  I want to make mention of the important low-income and middle-class 
tax challenge. We ought to make the tax cuts for middle-class and low-
income Americans permanent. There is a very big tax looming in 2018, 
unless the Congress moves to prevent it. Millions of families in Oregon 
and across the Nation depend on the expansion of the earned-income tax 
credit, the child tax credit, and the American opportunity tax credit. 
These are all set to expire, and the longer families sit in the dark 
wondering what their tax obligations will be, the harder it is for 
these families--already struggling to get ahead--for them to predict 
how to budget. In my view, it would be legislative malpractice to leave 
these low-income and middle-class tax cuts teetering on a cliff while 
others are permanently enshrined into the law. Furthermore, taking that 
uncertainty off the table is going to make comprehensive tax reform 
easier to accomplish.
  My colleagues and I on the Finance Committee are working hard to 
bring our broken Tax Code into the 21st century. I have worked for more 
than a decade, first with our former colleague Senator Gregg and most 
recently with our current colleague Senator Coats, to produce the first 
bipartisan Federal income tax reform plan in more than a quarter 
century. So I know it is possible to make the Tax Code simpler and 
fairer. It ought to give everybody the chance to climb the economic 
ladder, and making the critical low-income and middle-class tax cuts 
permanent is a big step in that direction.
  Next, I think the question of college affordability and doing more to 
help students get to graduation day ought to be a focus of this budget. 
The skyrocketing price of tuition keeps far too many young people from 
enrolling in college, and it keeps too many others from completing it. 
In effect, the price of college can reinforce inequality. Millions of 
students are buried up to their eyeballs in debt before they ever put 
on that cap and gown.
  It is time to come at this challenge from every angle. For one, it is 
important to make student debt more manageable so graduates don't spend 
decades weighed down by loan payments. It is absolutely essential to 
help students take on less debt from the start. That will get more 
students in the door to challenge and free graduates from a lifetime of 
debt. That is why, in my view, cutting the Pell grant is the wrong way 
to go, and the Byzantine web of tax incentives for higher education 
needs to be cleaned up as well. It should not take dozens of 
calculations and hours of time for students to navigate the Byzantine 
tax rules. It should be simpler and easier so more students see a more 
meaningful benefit. Some student loan debt may be unavoidable, but 
leaving students with less debt is possible.
  My next concern with respect to the budget is making sure needless 
cuts are made in essential health care programs. The cuts to Medicaid, 
in my view, that have been proposed by the other side are a guaranteed 
formula to make life harder for struggling families.
  Just contemplate--and having been to Iowa, I know of the many seniors 
in Iowa--seniors who rely on Medicaid to cover the cost of nursing home 
care. That is, to a great extent, what the Medicaid budget is all 
about. Medicaid for those frail seniors--whether it is Oregon or 
Vermont or Iowa, Medicaid is what keeps a lot of those frail seniors 
from falling into absolute destitution. In another era, impoverished 
seniors might have been thrown into almshouses or poor farms. Today, 
Medicaid is a lifeline for tens of millions. But the budget proposal we 
have seen from the other side, in my view, would inflict substantial 
cuts on Medicaid, endanger our future. I don't believe that is the 
right course for frail seniors who rely on Medicaid for nursing home 
care.
  The last point I would make deals with the effects of repealing the 
Affordable Care Act. If we repeal the Affordable Care Act, make no 
mistake about it, America goes back to the days when health care is for 
the healthy and the wealthy because no longer will we have protections 
for people with preexisting conditions. It is fine if you are healthy 
and it is fine if you are wealthy, but that is not most Americans. 
There are plenty of ways to improve the Affordable Care Act in a 
bipartisan fashion. That is not what the budget from the other side 
does. I hope we will not go back to the days in America when health 
care is for the healthy and wealthy, which is the bottom-line 
consequence of full repeal.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.


                     Amendment No. 323, as Modified

  Mr. SANDERS. Madam President, first I wish to thank Senator Wyden for 
his remarks. I concur with what he said, and I thank him for 
cosponsoring the amendment on infrastructure that we will be voting on 
in a few minutes.
  Senator Wyden and I understand that you cannot be a great nation if 
your roads and bridges, water systems, wastewater plants, airports, 
levees, dams, and railroad system are crumbling. That is not what a 
great nation is about.
  Years ago, the United States used to be the envy of the world in 
terms of infrastructure. Countries all over the world looked to the 
United States and asked: How do you do it? How do you provide clean 
water to your people? How do you have such an efficient transportation 
system? How do you have such great roads?
  That is no longer the case. Today we are in 12th place, and I don't 
think any of my Republican colleagues would deny that. In fact, our 
infrastructure is crumbling. We have to address this issue. We cannot 
kick the can down the road. We can't say: Well, let's wait a few years 
until we come up with some magic funding formula.
  We have to do it, and we have to do it now. The reason we have to do 
it now is that every year we delay, the problem only becomes worse. We 
are spending billions of dollars just to maintain the status quo, 
patching up a deteriorating system--whether it is transit, rails, roads 
or bridges. We have to rebuild our crumbling infrastructure. There is 
no disagreement, I believe, in the Senate on that.
  Second of all, I hope there is no disagreement that unemployment in 
this country is much too high. Real unemployment is at 11 percent, 
counting those who have given up looking for work and those who are 
working part-time. Youth unemployment is 17 percent, and African-
American youth unemployment is higher than that. We need a major jobs 
program to put millions of people back to work at decent wages, and 
that is what rebuilding our infrastructure does.
  The economists tell us that if we want to create jobs, the fastest 
way to create jobs in America is to rebuild our roads, bridges, and 
rail system. That is the fastest way to do it. Many of my Republican 
colleagues probably understand that as well. Where we disagree is how 
we fund the front.
  Some on the Republican side will say: Well, we are looking at tax 
reform, and we are looking at this and looking

[[Page 4111]]

at that, and maybe it will happen, but maybe it will not happen. We 
certainly have not had a lot of luck on these issues in recent years. 
Our Republican friends are not particularly interested in investments 
in America. Their idea of dealing with the deficit is to cut, cut, cut.
  What we are proposing here is a $478 billion infrastructure package 
for 6 years, and it is funded by something I hope all of us can agree 
is unacceptable, and that is that at a time when corporate profits are 
at an all-time high, many corporations are stashing their profits in 
the Cayman Islands, Bermuda, Luxembourg, tax havens around the world. 
Guess what they are paying in American income tax to the United States 
Government. Zero.
  We eliminate those loopholes. We raise substantial sums of money. We 
put that money into rebuilding our infrastructure, creating jobs, and 
making our country more efficient, safer, and more productive. That is 
what happens when you have a strong infrastructure.
  I ask that Americans try to imagine what America will look like when 
we have some 9 million workers. This proposal would create some 9 
million good-paying jobs in all of our States. People would be working 
to improve our roads and our water systems, and we can try to begin to 
compete effectively with the rail systems of other countries throughout 
the world. Think of what America will look like when we become and 
develop a first-rate infrastructure, not a third-rate infrastructure. I 
know people think this is a lot of money, but it is nowhere near what 
the American Society of Civil Engineers is telling us that we need.
  If you are interested in creating a 21st century infrastructure, 
please vote for my amendment. If you are interested in creating and 
maintaining some 9 million jobs over a 6-year period, please vote for 
my amendment. If you are interested in ending an outrageous corporate 
loophole, which in some cases enables large, profitable multinational 
corporations to pay zero in Federal income tax, please vote for this 
amendment. It will send a powerful message that now is the time to 
rebuild our crumbling infrastructure and put our people to work and end 
absurd loopholes.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Madam President, I will be very brief. My colleague has 
expressed his thoughts on this issue well, and we have had a number of 
discussions on infrastructure with the distinguished chairman of the 
committee.
  I come back to the fact that all Americans have a stake in this 
amendment--whether you are a commuter, whether you are an exporter, 
whether you are someone who lives in rural Wyoming or rural Oregon.
  The PRESIDING OFFICER. The Democrats' time has expired.
  Mr. SANDERS. Madam President, I ask unanimous consent for 1 more 
minute.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WYDEN. Madam President, I will be very brief. I thank my 
colleagues for their courtesy.
  This amendment is about more than bumpy roads, popped tires, and 
broken axles. It is about jobs and economic growth in every nook and 
cranny in our country, and the key to that growth is infrastructure. 
Attracting investment depends on the condition of our infrastructure. 
Suffice it to say that our competitors in a tough global marketplace 
are increasing their investments in infrastructure. It is time to adopt 
this amendment and for us to do the same.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Madam President, I get a little upset when I hear one side 
say that the other side doesn't care about infrastructure. That is not 
true. We even had a colloquy just a little while ago where the two 
sides said we need infrastructure. I agree that we need infrastructure, 
but I will oppose this amendment because it is telling the tax 
committee exactly what to do to provide infrastructure. One committee 
is getting into another committee's jurisdiction to say exactly how to 
do it, and that is not right. That is not the way we handle legislation 
around here.
  Senator Wyden is on the tax committee. He is the ranking member on 
that committee. Senator Hatch is the chairman of that committee. They 
are both concerned about infrastructure. There is already a provision 
in the bill that allows for the money to be put into place to do it, 
but that provision does not tell the Finance Committee that it must 
plug a certain tax loophole and put it into infrastructure. The 
committee can do that, and the President's budget--one of the reasons 
there is some excitement here--on money that is held overseas by 
companies, puts a mandatory 14 percent tax on that and expects it to be 
brought back right away to fund these things. That is a proposal that 
has been in the tax committee before--but not at 14 percent. It has 
been at a lower rate. Fourteen percent is more money than both the 
highway committee and the defense committee are talking about. We 
cannot produce a budget in which we tell committees exactly how to do 
their work. We need to build in the flexibility so they can do their 
job.
  The chairman of the committee is convinced that we can do the job of 
fixing our infrastructure. Of course, we will never fix the 
infrastructure as well as we would like to have it fixed. I think the 
ranking member on the Budget Committee mentioned that we have four 
times as much need as what his proposal addresses. He has a proposal 
for $468 billion. There is a couple trillion dollars' worth of need out 
there. Of course, we hope we can get a lot of people involved in fixing 
these problems. It is not just a Federal problem. It is a local and 
State problem as well. We hope everybody will participate so that we 
can improve the infrastructure. It does put people to work, just as 
Keystone would put people to work.
  I ask that my colleagues vote against the bill because we are telling 
one committee exactly where to get the money for another committee.
  I yield the floor and reserve the remainder of our time.
  Madam President, I yield the balance of our time for the Senator from 
Oklahoma.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. Madam President, in a few minutes we will be voting, and 
while I sincerely appreciate the effort of my good friend Senator 
Sanders, I will be opposing this approach mostly because I don't think 
we need to go through what I consider to be a massive tax increase in 
order to do this. But just for a moment, I wish to talk about the 
seriousness of the transportation reauthorization bill. I know this 
issue has been talked about during the budget conversation and debate, 
but I think sometimes we ought to drag up that old document that hardly 
anyone pays attention to anymore--the Constitution.
  The Constitution specifically says in article I, section 8 that there 
are some things we are supposed to be doing here. The two major things 
that are mentioned in the article I, section 8 are, No. 1, defending 
America--that is our military--and the other is roads and bridges.
  I think we are concentrating and working very hard. A minute ago I 
had a colloquy with my friend from California, Senator Boxer. Senator 
Boxer observed that she is a proud liberal and recognized me as a proud 
conservative. Yet here is something we agree on, something we can do, 
something that is very important and that we need to take care of.
  Now, I won't say anything about the defense problem. We have a 
serious problem in our defense system right now, but that is not the 
discussion for today. I do believe that while we have an amendment that 
would address a highway reauthorization bill--and how critical that 
is--we are working on that.
  I have to remind people that there is a reserve fund in Chairman 
Enzi's budget that serves as a placeholder for Chairman Hatch to 
address a long-term highway bill later this year.
  The last bill we had was a 27-month bill. Again, that was to setup 
this idea

[[Page 4112]]

of having a long-term bill. The last good bill we had was in 2005, and 
that was a 5-year bill. It was really produced very well. The problem 
with extensions--and I think we all know this--is that extensions take 
about 30 percent off the top because short-term extensions--and anyone 
who has been in business knows this--are things you cannot do in the 
short term. You cannot get the streamlining. Our 27-month bill had a 
lot of really good streamlining provisions in there. You cannot do that 
on short-term extensions.
  I look forward to having a very large bill. We have a deadline at the 
end of May to make this a reality, and I believe we are going to be 
able to do that. We are meeting on a regular basis, including a meeting 
today with Senator Hatch. We will be coming up with ways that we can 
pay for this.
  Again, I can remember in the very beginning we used to have a problem 
in the highway trust fund because we had too much surplus. Well, it is 
not that way anymore. We all know how we got in the mess we are in 
right now. We will have to address that, and I look forward to doing 
that and providing some of the leadership, right along with Senator 
Boxer and Senator Sanders, in making this a reality.
  With that, noting that 12 noon is here, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. SANDERS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Sasse). Without objection, it is so 
ordered.
  Mr. SANDERS. Mr. President, I wish to thank Senator Inhofe for his 
remarks on infrastructure. I hope we can all work together for what I 
would suspect every Member here sees as a serious problem.
  But this amendment says let's not kick the can down the road. Our 
infrastructure is crumbling. We used to be the envy of the world; today 
we are in 12th place. This impacts not just people who are driving 
cars, it impacts every business in America. We need now to start the 
process of rebuilding our roads and bridges and dams and levees and 
airports. When we do that, this amendment, over a 6-year period, can 
create and maintain 9 million jobs--9 million jobs--at a time when we 
need decent-paying jobs.
  I understand the difference of opinion stems from how we get the 
funding for this. Our approach is pretty simple. It eliminates an 
outrageous loophole that allows large, profitable corporations to stash 
their money around the world and, in some cases, pay zero in Federal 
income taxes.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mr. SANDERS. I ask for support for this amendment.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. Mr. President, I ask unanimous consent to be recognized 
for 1 minute in opposition.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. INHOFE. Mr. President, as I said a few minutes ago, I agree with 
Senator Sanders, the author of this amendment, in terms of what is the 
problem we have. We have to have a transportation reauthorization bill 
and we are going to have it.
  I know Senator Sanders has characterized his bill as being paid for 
by closing tax loopholes, but I would still say that, in my opinion and 
my analysis of this, this would equate to nearly a half a trillion 
dollar tax increase, and this is not the way I want to have a 
transportation reauthorization bill.
  Let me remind my colleagues that there is a reserve fund in Chairman 
Enzi's budget that serves as a placeholder for Chairman Hatch to 
address a long-term highway bill later this year. We have a deadline of 
May 31, and I think we can meet that deadline. We are working with 
Senator Hatch right now to come up with that plan.
  So I urge my colleagues to vote against the Sanders amendment and 
pursue our bill.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I ask unanimous consent that the votes 
following the first vote in the series be 10 minutes in length.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Under the previous order, the question is on agreeing to amendment 
No. 323, as modified, offered by the Senator from Vermont.
  Mr. SANDERS. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz) and the Senator from Illinois (Mr. Kirk).
  Mr. DURBIN. I announce that the Senator from West Virginia (Mr. 
Manchin) is necessarily absent.
  The PRESIDING OFFICER (Mr. Tillis). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 45, nays 52, as follows:

                      [Rollcall Vote No. 78 Leg.]

                                YEAS--45

     Baldwin
     Bennet
     Blumenthal
     Booker
     Boxer
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Coons
     Donnelly
     Durbin
     Feinstein
     Franken
     Gillibrand
     Heinrich
     Heitkamp
     Hirono
     Kaine
     King
     Klobuchar
     Leahy
     Markey
     McCaskill
     Menendez
     Merkley
     Mikulski
     Murphy
     Murray
     Nelson
     Peters
     Reed
     Reid
     Sanders
     Schatz
     Schumer
     Shaheen
     Stabenow
     Tester
     Udall
     Warner
     Warren
     Whitehouse
     Wyden

                                NAYS--52

     Alexander
     Ayotte
     Barrasso
     Blunt
     Boozman
     Burr
     Capito
     Cassidy
     Coats
     Cochran
     Collins
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Enzi
     Ernst
     Fischer
     Flake
     Gardner
     Graham
     Grassley
     Hatch
     Heller
     Hoeven
     Inhofe
     Isakson
     Johnson
     Lankford
     Lee
     McCain
     McConnell
     Moran
     Murkowski
     Paul
     Perdue
     Portman
     Risch
     Roberts
     Rounds
     Rubio
     Sasse
     Scott
     Sessions
     Shelby
     Sullivan
     Thune
     Tillis
     Toomey
     Vitter
     Wicker

                             NOT VOTING--3

     Cruz
     Kirk
     Manchin
  The amendment (No. 323), as modified, was rejected.


                           Amendment No. 386

  The PRESIDING OFFICER. There is now 2 minutes of debate equally 
divided prior to a vote in relation to amendment No. 386, offered by 
the Senator from Vermont, Mr. Sanders.
  The Senator from Vermont.
  Mr. SANDERS. Mr. President, Senator Portman's amendment touches on a 
very serious issue that I believe has broad bipartisan support, the 
need to deal with children who have serious, chronic conditions. In 
fact, over 3 million kids in this country have medically complex health 
conditions.
  Senator Portman appropriately is calling attention to that issue. I 
support him. But when you look at the overall Republican budget, it 
throws 16 million people off of health insurance by ending the 
Affordable Care Act and millions more through a $400 billion cut in 
Medicaid. What happens to a pregnant woman on Medicaid who needs 
prenatal care? No health insurance for her. What about a kid who was in 
an automobile accident whose family has no health insurance and is 
thrown off of Medicaid? No health insurance for that kid. What about an 
elderly person in a nursing home? There are millions of elderly people 
on Medicaid in nursing homes.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. SANDERS. Please support this amendment. No cuts to Medicaid for 
all our kids.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I appreciate the comments and support for 
the Portman amendment. I want you to know I support the Sanders 
amendment. We support pregnant women and kids who are hurt in car 
accidents or face other unfortunate circumstances.

[[Page 4113]]

  So we would be happy to take this by voice vote.
  Mr. SANDERS. I think it would be better to do a rollcall vote. We 
appreciate your support.
  Mr. ENZI. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  Under the previous order, the question is on agreeing to the Sanders 
amendment.
  The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz) and the Senator from Illinois (Mr. Kirk).
  Mr. DURBIN. I announce that the Senator from West Virginia (Mr. 
Manchin) is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 94, nays 3, as follows:

                      [Rollcall Vote No. 79 Leg.]

                                YEAS--94

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Franken
     Gardner
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Klobuchar
     Lankford
     Leahy
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Portman
     Reed
     Reid
     Risch
     Roberts
     Rounds
     Rubio
     Sanders
     Sasse
     Schatz
     Schumer
     Scott
     Shaheen
     Shelby
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Vitter
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                                NAYS--3

     Flake
     Lee
     Sessions

                             NOT VOTING--3

     Cruz
     Kirk
     Manchin
  The amendment (No. 386) was agreed to.


                           Amendment No. 349

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes of debate equally divided prior to a vote in relation to 
amendment No. 349, offered by the Senator from Ohio, Mr. Portman.
  The Senator from Ohio.
  Mr. PORTMAN. Mr. President, this is a very simple amendment. It is a 
deficit-neutral reserve fund to help the most vulnerable kids among us 
to have better coordinated care under Medicaid.
  It allows health care providers to deliver health care services to 
medically complex kids through models that coordinate care between 
providers, resulting in better care but also lower costs, including 
helping with regard to a problem, including across State lines.
  These children with complex medical conditions make up about 6 
percent of the children who get health care under Medicaid, but it is 
about 40 percent of the cost of pediatric care under Medicare and 
Medicaid.
  This is an opportunity for us on a bipartisan basis, I know, to be 
able to help these kids to get the necessary care they need and 
actually allow the Medicaid system to realize some savings through 
efficiencies, such as reduced emergency room stays, hospitalizations, 
and other procedures.
  I thank my colleague Senator Bennet, who will speak in a second on 
his cosponsorship.
  I urge all my colleagues to support this commonsense measure to help 
these vulnerable kids.
  The PRESIDING OFFICER. The Senator from Colorado.
  Mr. BENNET. Mr. President, I also rise to speak in favor of the 
Portman amendment. This amendment is based on a bill I introduced 
earlier this year called the ACE Kids Act that recognizes the critical 
importance of Medicaid to children with severe medical conditions. It 
highlights the need for greater coordination and integration of care 
across the country for 2 million children.
  Earlier this month, I met with Everett Ediger at Children's Hospital 
of Colorado in Denver. Everett is 8 years old and has spina bifida, a 
neurological disorder of the spine. It took his mom Maureen 2 years to 
get him signed up under Medicaid and to establish a system to 
coordinate all of his care.
  While Everett was beating me at air hockey, he let his mom explain to 
me about the frustrating experience of trying to coordinate all of her 
son's specialists and the payments for his care.
  We need to focus on children such as Everett all across this country.
  I thank my colleague Senator Portman for his leadership in offering 
this amendment.
  I urge my colleagues to vote yes.
  Mr. ENZI. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the Portman amendment.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz) and the Senator from Illinois (Mr. Kirk).
  Mr. DURBIN. I announce that the Senator from West Virginia (Mr. 
Manchin) and the Senator from Nevada (Mr. Reid) are necessarily absent.
  The PRESIDING OFFICER (Mr. Perdue). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 96, nays 0, as follows:

                      [Rollcall Vote No. 80 Leg.]

                                YEAS--96

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gardner
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Klobuchar
     Lankford
     Leahy
     Lee
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Portman
     Reed
     Risch
     Roberts
     Rounds
     Rubio
     Sanders
     Sasse
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Vitter
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--4

     Cruz
     Kirk
     Manchin
     Reid
  The amendment (No. 349) was agreed to.

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