The Senate Will Convene At 10:00 AM Today
Senate Session - December 8, 2009

Day 9 of the Senate health care reform debate. Senators discuss an amendment, submitted by Senator Ben Nelson (D-NE), restricting the use of federal funds for abortions and Senator John McCain’s (R-AZ) motion to commit on Medicare Advantage beneficiaries. The Nelson Amendment failed on a vote of 54 to 45. The Senate also took up Senator Dorgan’s prescription drug re-importation amendment.
In addition, the Senate reached an agreement on health care legislation that would no longer include a new government-run insurance program, or “public option.”

Speakers:
Time
Action
  • 10:00:47 AM

    none

    ON VOTE TIMES. OFF THE OOH FLOOR, NEGOTIATIONS CONTINUE OVER THE PUBLIC…

    ON VOTE TIMES. OFF THE OOH FLOOR, NEGOTIATIONS CONTINUE OVER THE PUBLIC OPTION. LIVE COVERAGE OF THE U.S. SENATE NOW HERE ON C-SPAN2.

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  • 10:01:04 AM

    THE CHAPLAIN

    PRAY. GOD OF WONDER, BEYOND ALL MAJESTY, MAY OUR LIVES AND OUR WORLD BE…

    PRAY. GOD OF WONDER, BEYOND ALL MAJESTY, MAY OUR LIVES AND OUR WORLD BE AWAKENED BY YOUR GRACE. OPEN OUR EYES TO YOUR WORKS AND OUR EARS TO YOUR WORDS OF LIFE. STIR WITHIN OUR LAWMAKERS A DESIRE TO PLEASE YOU. ENABLE THEM TO HEAR WITH OBJECTIVITY AND RESPOND WITH INTEGRITY, AS THEY COMPREHEND THEIR INDIVIDUAL AND COLLECTIVE RESPONSIBILITIES. LORD, MAKE THEM EXEMPLARY MODELS OF THE HIGHEST AND FINEST IN FAITHFUL, LOYAL, AND DEDICATED LEADERSHIP. GIVE THEM WISDOM, STRENGTH, AND CLARITY TO MEET TODAY'S DAUNTING CHALLENGES. WE PRAY IN YOUR GREAT NAME. AMEN.

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  • 10:02:28 AM

    THE PRESIDING OFFICER

    PLEASE JOIN ME IN RECITING THE PLEDGE OF ALLEGIANCE TO THE FLAG. I PLEDGE…

    PLEASE JOIN ME IN RECITING THE PLEDGE OF ALLEGIANCE TO THE FLAG. I PLEDGE ALLEGIANCE TO THE FLAG OF THE UNITED STATES OF AMERICA AND TO THE REPUBLIC FOR WHICH IT STANDS, ONE NATION UNDER GOD, INDIVISIBLE, WITH LIBERTY AND JUSTICE FOR ALL.

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  • 10:02:49 AM

    THE PRESIDING OFFICER

    THE CLERK WILL READ A COMMUNICATION TO THE SENATE.

  • 10:02:54 AM

    THE CLERK

    WASHINGTON, D.C, DECEMBER 8, 2009. TO THE SENATE: UNDER THE PROVISIONS OF…

    WASHINGTON, D.C, DECEMBER 8, 2009. TO THE SENATE: UNDER THE PROVISIONS OF RULE 1, PARAGRAPH 3, OF THE STANDING RULES OF THE SENATE, I HEREBY APPOINT THE HONORABLE ROLAND W. BURRIS, A SENATOR FROM THE STATE OF ILLINOIS, TO PERFORM THE DUTIES OF THE CHAIR. SIGNED: ROBERT C. BYRD, PRESIDENT PRO TEMPORE.

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  • 10:03:11 AM

    MR. REID

    SNRP.

  • 10:03:12 AM

    THE PRESIDING OFFICER

    THE MAJORITY LEADER IS RECOGNIZED MENT.

  • 10:03:14 AM

    MR. REID

    FOLLOWING LEADER REMARKS THE SENATE WILL RESUME CONSIDERATION OF THE…

    FOLLOWING LEADER REMARKS THE SENATE WILL RESUME CONSIDERATION OF THE HEALTH REFORM LEGISLATION. FOLLOWING THE LEADER REMARKS THE TIME UNTIL 12:30 WILL BE FOR DEBATE ONLY. THE MAJORITY WILL CONTROL THE FIRST HALF OF THE TIME THAT'S ALLOTTED UNTIL 12:30. THE REPUBLICANS WILL CONTROL THE NEXT HALF. THE REMAINING TIME WILL BE EQUALLY DIVIDED AND CONTROLLED BETWEEN THE TWO LEADERS OR THEIR DESIGNEES. THE SENATE WILL RECESS FROM 12:30 UNTIL 2:15 P.M. TO ALLOW FOR THE WEEKLY CAUCUS LUNCHEONS. THERE ARE TWO AMENDMENTS NOW PENDING. ONE IS THE NELSON OF NEBRASKA AMENDMENT OF THE OTHER IS THE McCAIN AMENDMENT, MOTION TO COMMIT. SENATORS SHOULD EXPECT VOTES AFTER THE RECESS IN RELATION TO THE PENDING AMENDMENTS. SHOULD I SAY, AMENDMENT AND MOTION. MR. PRESIDENT, WE HAVE SCHEDULED THIS MORNING -- AS SOON AS THE LEADER TIME IS USED -- A GROUP OF SENATORS, DEMOCRATS SENATORS. THESE ARE ALL NEW SENATORS. I HOPE THOSE PEOPLE THAT ARE WATCHING UNDERSTAND THE QUALITY OF THE PEOPLE WHO ARE NOW GOING TO MAKE A PRESENTATION BEFORE THIS BODY. THE STATES THAT WILL BE REPRESENTED HERE TODAY WILL BE STATE OF OREGON, THE STATE OF DELAWARE. WE OF COURSE HAVE NEW HAMPSHIRE, COLORADO. WE HAVE TWO COLORADO SENATORS WHO ARE GOING TO SPEAK, A NEW SENATOR FROM MASSACHUSETTS, NEW MEXICO, VIRGINIA, ILLINOIS, ALASKA, AND THE OPENING WILL BE BY SENATOR MERKLEY AND THE CLOSING BY SENATOR MERKLEY. SUCH QUALITY INDIVIDUALS, MR. PRESIDENT, WE'RE SO FORTUNATE TO HAVE IN THE SENATE. AND I AM GRATEFUL FOR THE TIME THAT THEY'VE TAKEN TO SPEAK ON THIS ISSUE. MUCH OF WHAT THEY HAVE DONE IS SET THE TONE FOR THIS DEBATE ON OUR SIDE OF THE AISLE. IT'S BEEN CONSTRUCTIVE, IT'S BEEN POSITIVE, AND IT'S BEEN VERY, VERY LUCID, AND IT ALL -- WE'RE ALL SUCCESSFUL INDIVIDUALS INDIVIDUALS -- AND THEY WERE ALL SUCCESSFUL INDIVIDUALS BEFORE THEY CAME TO THE SENATE. AND CERTAINLY THAT IS SO ACKNOWLEDGED EVERY TIME WE HEAR THEM SAY A WORD HERE ON THE SENATE FLOOR.

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  • 10:05:36 AM

    THE PRESIDING OFFICER

    UNDER THE PREVIOUS ORDER, THE LEADERSHIP TIME IS RESERVED. UNDER THE…

    UNDER THE PREVIOUS ORDER, THE LEADERSHIP TIME IS RESERVED. UNDER THE PREVIOUS ORDER, THE SENATE RESUME CONSIDERATION OF H.R. 3590, WHICH THE CLERK WILL REPORT.

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  • 10:05:48 AM

    THE CLERK

    NUMBER 175, H.R. 3590, AN ACT TO AMEND THE INTERNAL REVENUE CODE OF 1986…

    NUMBER 175, H.R. 3590, AN ACT TO AMEND THE INTERNAL REVENUE CODE OF 1986 TO MODIFY THE FIRST-TIME HOME BUYER'S CREDIT IN THE CASE OF MEMBERS OF THE ARMED FORCES AND CERTAIN OTHER FEDERAL EMPLOYEES, AND FOR OTHER PURPOSES.

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  • 10:06:04 AM

    THE PRESIDING OFFICER

    MR. PRESIDENT?

  • 10:06:47 AM

    MR. McCONNELL

    MR. PRESIDENT?

  • 10:06:48 AM

    THE PRESIDING OFFICER

    OFFICER: THE REPUBLICAN LEADER IS RECOGNIZED.

  • 10:06:50 AM

    MR. McCONNELL

    OVER THE PAST SEVERAL DAYS, AMERICANS HAVE SEEN IN VIVID DETAIL WHAT…

    OVER THE PAST SEVERAL DAYS, AMERICANS HAVE SEEN IN VIVID DETAIL WHAT SUPPORTERS OF THIS PLAN PLAN TO DO TO THE MEDICARE PROGRAM FOR SENIORS. THEY PLAN TO USE IT AS A GIANT PIGGY BANK TO PAY FOR AN ENTIRELY NEW GOVERNMENT PROGRAM, AND YESTERDAY WE HEARD FLOATED FOR THE VERY FIRST TIME THAT THEY WANT TO RADICALLY EXPAND MEDICARE. SO WHAT'S BECOMING ABUNDANTLY CLEAR IS THAT THE MAJORITY WILL MAKE ANY DEAL, AGREE TO ANY TERMS, SIGN ANY DOTTED LINE THAT BRINGS THEM CLOSER TO FINAL PASSAGE OF THIS TERRIBLE BILL. THEY ENTERTAIN ADDING NEW EXPERIMENTS WITHOUT ANY ASSESSMENT OF THE IMPACT THAT THE DEAL MAKING WILL HAVE ON THE AMERICAN PEOPLE OR OUR ECONOMY. THEY ARE, FOR LACK OF A BETTER TERM, WINGING IT ON ONE OF THE MOST CONSEQUENTIAL PIECES OF LEGISLATION AFFECTING OUR COUNTRY IN MEMORY. WELL, LET ME SUGGEST TO THE MAJORITY, AMERICANS WOULD MUCH RATHER WE GET IT RIGHT THAN SCURRY AROUND, SCURRYING AROUND THROWING AROUND UNTESTED LAST-MINUTE EXPERIMENTS IN ORDER TO GET 60 VOTES BEFORE CHRISTMAS. LET ME JUST SAY THAT AGAIN. AMERICANS WOULD MUCH RATHER WE GET IT RIGHT THAN SCURRY AROUND, THROWING TOGETHER UNTESTED LAST-MINUTE EXPERIMENTS IN ORDER TO GET 60 VOTES BEFORE CHRISTMAS. OVER THE PAST SEVERAL DAYS, OUR FRIENDS ON THE OTHER SIDE REPEATEDLY VOTED TO PRESERVE NEARLY HALF A TRILLION DOLLARS IN MEDICARE CUTS TO FINANCE THEIR VISION OF REFORM. A VISION THAT INCLUDES CUTTING NEARLY $8 BILLION FROM HOSPICE CARE, $40 BILLION IN CUTS TO HOME HEALTH AGENCIES, $120 BILLION IN CUTS TO MEDICARE ADVANTAGE, $135 BILLION IN CUTS TO HOSPITALS THAT SERVE MEDICARE PATIENTS, AND NEARLY $15 BILLION IN CUTS TO NURSING HOMES. WELL, THESE CUTS REALLY ILLUSTRATE WHAT THESE -- WHAT THESE CUTS REALLY ILLUSTRATE IS A LACK OF VISION, BECAUSE CUTTING ONE TROUBLED GOVERNMENT PROGRAM IN ORDER TO CREATE ANOTHER IS A MISTAKE. I'LL SAY IT AGAIN. HAD A A TRILLION DOLLARS IN CUTS TO MEDICARE FOR SENIORS IS NOT REFORM. BUT MEDICARE CUTS ARE JUST ONE LEG OF THE STOOL HOLDING UP THIS MISGUIDED VISION OF REFORM. LET'S TAKE A LOOK AT ANOTHER. LET'S LOOK AT HOW THIS BILL PUNISHES NOT ONLY SENIORS BUT HOW IT KILLS JOBS AT A TIME WHEN ONE IN TEN WORKING AMERICANS IS LOOKING FOR ONE. THIS BILL DOESN'T JUST PUNISH SENIORS, IT PUNISHES JOB CREATORS, TOO. THAT'S THE MESSAGE WE GOT YESTERDAY FROM SMALL BUSINESSES ACROSS THE COUNTRY. THEY SENT US A LETTER OPPOSING THIS BILL BECAUSE IT DOESN'T DO THE THINGS PROPONENTS OF THIS BILL PROMISED IT WOULD. IT DOESN'T LOWER COST. IT DOESN'T HELP CREATE JOBS. AND IT DOESN'T HELP THE ECONOMY. HERE ARE JUST SOME OF THE GROUPS THAT SIGNED THAT LETTER: THE ASSOCIATED BUILDERS AND CONTRACTORS, THE ASSOCIATED GENERAL CONTRACTORS, THE INTERNATIONAL FOOD SERVICE DISTRIBUTORS ASSOCIATION, THE NATIONAL ASSOCIATION OF MANUFACTURERS, THE NATIONAL ASSOCIATION OF WHOLESALE DISTRIBUTORS, THE NATIONAL RETAIL FEDERATION, SMALL BUSINESS AND ENTREPRENEURSHIP COUNCIL, THE U.S. CHAMBER OF COMMERCE, AND HERE'S WHAT THESE GROUPS HAD TO SAY ABOUT THIS BILL. I'M READING NOW FROM THEIR LETTER DATED DECEMBER THE 7th, 2009, A LETTER THAT WAS ADDRESSED TO EVERY MEMBER OF THE SENATE. QUOTE -- "IN ORDER TO FINANCE PART OF ITS $2.5 TRILLION PRICE TAG, H.R. 3590 IMPOSES NEW TAXES, FEES, AND PENALTIES TOTALING NEARLY HALF A TRILLION DOLLARS. THIS FINANCIAL BURDEN FALLS DISPROPORTIONATELY ON THE BACKS OF SMALL BUSINESS, SMALL FIRMS ARE IN DESPERATE NEED OF THIS PRECIOUS CAPITAL FOR JOB CREATION, INVESTMENT, BUSINESS EXPANSION, AND SURVIVAL. " THE LETTER GOES ON TO DETAIL ALL THE WAYS IN WHICH THIS BILL PUNISHES SMALL BUSINESSES, THUS MAKING IT HARDER FOR THEM TO RETAIN OR HIRE WORKERS. THESE GROUPS POINT OUT THAT UNDER THIS BILL, SMALL BUSINESS IN THE U.S. WOULD SEE MAJOR COST INCREASE AS A RESULT OF NEW TAXES ON HEALTH BENEFITS AND HEALTH INSURANCE. COSTS THAT WILL BE PASSED ON TO EMPLOYEES AND WHICH WOULD MAKE HEALTH INSURANCE MORE EXPENSIVE, NOT LESS. UNDER THIS BILL, SELF-EMPLOYED BUSINESS OWNERS WHO BUY COVERAGE FOR THEMSELVES COULD SEE A DOUBLE-DIGIT JUMP IN THEIR INSURANCE PREMIUMS. FOR OTHER SMALL BUSINESSES, THE BILL WON'T LEAD TO A SIGNIFICANT DECREASE IN COST, SOMETHING THEY WERE PROMISED AS A RESULT OF THE BILL. UNDER THIS BILL, JOBS WOULD BE LOST AND WAGES WOULD BE PRESSED AS A RESULT OF A NEW LAW THAT WOULD REQUIRE BUSINESSES EITHER TO BUY SNRURNS FOR THEIR EMPLOYEES OR TO PAY -- INSURANCE FOR THEIR EMPLOYEES OR TO PAY A FINE. NEEDLESS TO SAY, THIS IS NOT THE KIND OF LEGISLATION THE AMERICAN WORKER NEEDS OR WANTS AT A MOMENT OF DOUBLE-DIGIT UNEMPLOYMENT. AND PERHAPS THAT'S THE REASON THAT POLL AFTER POLL -- POLL AFTER POLL PUBLIC OPINION SHOWS THAT THE AMERICAN WORKER OPPOSES THIS BILL. SOME BUSINESS GROUPS MAY HAVE SUPPORTED THIS PLAN EARLIER IN THE YEAR BECAUSE THEY THOUGHT IT WAS INEVITABLE. THEY DIDN'T WANT TO BE CRITICAL OF A BILL THEY THOUGHT THEY HAD NO POWER TO STOP. BUT SOMETHING HAPPENED BETWEEN THEN AND NOW. THE AMERICAN PEOPLE REALIZED WHAT THIS BILL MEANT FOR THEM. THEY REALIZE WHAT HAD IT WOULD MEAN FOR SENIORS, FOR BUSINESS OWNERS, FOR THE ECONOMY, FOR OUR FUTURE AS A COUNTRY, AND AMERICANS STOOD UP -- AMERICANS STOOD UP. THEY MADE THEIR VOICES HEARD, AND NOW THE TIDE HAS TURNED. THE AMERICAN PEOPLE OPPOSE THIS BILL. THEY WANT US TO START OVER. THEY WANT US TO MAKE COMMON SENSE, STEP-BY-STEP REFORMS THAT EVERYONE CAN SUPPORT, NOT SOME BACKROOM DEAL TO HAVE THE GOVERNMENT TAKE OVER THE HEALTH INSURANCE SYSTEM THAT'S THEN FORCED ON THE AMERICAN PEOPLE WITHOUT DISCUSSION. OUR FRIENDS ON THE OTHER SIDE CAN READ THE WRITING ON THE WALL. THEY KNOW THE AMERICAN PEOPLE OPPOSE THIS BILL. BUT THEY'VE APPARENTLY MADE A CALCULATION TO FORCE IT THROUGH CONGRESS OVER THE NEXT SEVERAL DAYS BEFORE THE AMERICAN PEOPLE EVEN HAVE A CHANCE TO ABSORB THE DETAILS. THE ONLY THING THAT CAN STOP THEM IS THE REALIZATION BY DEMOCRATS THEMSELVES THAT THIS PLAN WOULD BE A TRAGIC MISTAKE FOR SENIORS, FOR THE ECONOMY, AND FOR OUR COUNTRY. AND THAT A BETTER PATH WOULD BE THE KIND OF STEP-BY-STEP REFORMS THAT AMERICANS HAVE BEEN ASKING OF US, REFORMS AMERICANS REALLY WANT. AMERICANS DON'T THINK REFORM SHOULD COME AT THE EXPENSE OF SENIORS, AND THEY DON'T THINK IT SHOULD COME AT THE EXPENSE OF JOBS. THEY DON'T THINK IT SHOULD MAKE CURRENT PROBLEMS WORSE. NOW, ON ANOTHER MATTER, MR. PRESIDENT, WE'RE NOW HEARING TALK THAT THE ADMINISTRATION IS THINKING OF USING THE BANK BAILOUT TARP MONEY THAT TAXPAYERS RELUCTANTLY HANDED OVER DURING LAST YEAR'S CREDIT CRISIS ON ANOTHER SPENDING SPREE LIKE THE STIMULUS, WHICH THEY SAID WOULD STOP UNEMPLOYMENT AT 8% BUT HASN'T. $1 TRILLION LATER, UNEMPLOYMENT IS NOW AT 10%. THIS IS NOT ONLY IRRESPONSIBLE, SINCE THE PURPOSE OF THESE EMERGENCY FUNDS WAS TO PROP UP THE CREDIT SYSTEM IN THE MIDST OF A CRISIS, IT ALSO VIOLATES BOTH CURRENT LAW AND THE PLEDGE WE MADE THAT EVERY DOLLAR WE GOT BACK WOULD BE RETURNED TO THE TAXPAYER TO REDUCE THE NATIONAL DEBT. THAT'S THE PLEDGE WE MADE WHEN WE PASSED THE TARP PROPOSAL. THIS PROPOSAL OUT OF THE ADMINISTRATION IS COMPLETELY WRONGHEADED, BUT IT'S PERFECTLY ILLUSTRATIVE OF THE WAY DEMOCRATS IN CONGRESS HAVE BEEN DEALING WITH TAXPAYER MONEY ALL YEAR. BY THROWING IT AT ONE PROBLEM AFTER ANOTHER WITHOUT MUCH REGARD FOR THE CONSEQUENCES. WHETHER IT'S THE STIMULUS, CASH FOR CLUNKERS, OR THE BILL CURRENTLY ON THE FLOOR, AMERICANS ARE RUNNING OUT OF PATIENCE WITH POLITICIANS WHO PROMISE JOBS BUT DELIVER NOTHING MORE THAN DEBT, HIGHER TAXES AND LONGER UNEMPLOYMENT LINES. MR. PRESIDENT, I YIELD THE FLOOR.

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  • 10:15:34 AM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM MONTANA.

  • 10:15:38 AM

    MR. BAUCUS

    MR. PRESIDENT?

  • 10:18:19 AM

    MR. DODD

    THE SENATOR FROM CONNECTICUT IS RECOGNIZED.

  • 10:18:20 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM CONNECTICUT IS RECOGNIZED.

  • 10:18:23 AM

    MR. DODD

  • 10:20:59 AM

    MR. KAUFMAN

    THE SENATOR FROM DELAWARE IS RECOGNIZED.

  • 10:21:00 AM

    THE PRESIDING OFFICER

    THE SENATOR FROM DELAWARE IS RECOGNIZED.

  • 10:21:02 AM

    MR. KAUFMAN

    TO START BY AGREEING AS TO HOW WE GOT TO WHERE WE ARE AND WHY IT'S…

    TO START BY AGREEING AS TO HOW WE GOT TO WHERE WE ARE AND WHY IT'S IMPORTANT WE DO SOMETHING ABOUT IT. HE'S RIGHT. THE CHAIRMAN OF THE FINANCE COMMITTEE IS RIGHT TOO. THE FRESHMAN SENATORS WHO COME FROM ALL OVER THIS COUNTRY GOT TOGETHER AND, FRANKLY, WITH THE LEADERSHIP OF SENATOR WARNER FROM VIRGINIA, PUT TOGETHER A PACKAGE WHICH I THINK IS A VERY CONSTRUCTIVE PACKAGE FOR THE HEALTH CARE REFORM ACT THAT WE HAVE TO PASS. AND I REALLY APPRECIATE THE OPPORTUNITY TO JOIN WITH THE OTHER FRESHMEN, INCLUDING THE SENATOR IN THE CHAIR, TO DISCUSS THE UNIQUE OPPORTUNITY WE HAVE TO FINALLY ENACT MEANINGFUL HEALTH CARE REFORM. AND MAKE NO MISTAKE, WE NEED HEALTH CARE REFORM NOW. WHEN YOU LOOK OUT THERE AND YOU SEE THE RISING PREMIUMS, EVERYTHING FROM RISING PREMIUMS TO INSURERS DENYING COVERAGE TO PEOPLE WITH PREEXISTING CONDITIONS, THE HEALTH CARE SYSTEM IS FAILING INDIVIDUAL AMERICANS. THERE IS NO DOUBT ABOUT THAT. NOT ONLY IS IT DOING THAT, IT'S THREATENING THE FISCAL SOLVENCY OF OUR COUNTRY. MEDICARE AND MEDICAID SWALLOWING UP MORE AND MORE OF OUR FEDERAL SPENDING. IF WE DON'T ACT SOON TO BECOME THE LARGEST CONTRIBUTOR TO THE DEFICIT. THE TIME FOR REFORM IS NOW. WE CAN'T WAIT ANY LONGER. AS THE SENATOR FROM CONNECTICUT SAID, THIS ISN'T SOMETHING THAT JUST CAME OUT OF NOWHERE. IT'S BEEN THERE FOR A LONG TIME. WE HAVE TO ACT NOW. THANKS TO THE HARD WORK OF SENATORS REID, BAUCUS, DODD, HARKIN AND THEIR STAFFS, WE HAVE A BILL BEFORE US THAT CAN FINALLY REFORM OUR HEALTH CARE SYSTEM. IT IS A GOOD BILL. IT IS A BILL THAT TRULY PROTECTS WHAT WORKS IN OUR SYSTEM, AT THE SAME TIME FIXING WHAT'S BROKEN. NO LONGER WILL AMERICANS BE DENIED COVERAGE ON THE BASIS OF PREEXISTING CONDITIONS. NO LONGER WILL THEIR COVERAGE BE REVOKED WHEN THEY GET SICK AND NEED IT THE MOST. THIS BILL WILL HELP PROTECT SENIORS BY OFFERING NEW PREVENTIVE AND WELLNESS BENEFITS AND EXTEND THE SOLVENCY OF THE MEDICARE TRUST FUND BY AN ADDITIONAL FIVE YEARS. IT WILL ALSO HELP OUR ECONOMY BY SIGNIFICANTLY CUTTING HEALTH CARE COSTS AND REDUCING THE NATION'S DEFICIT BY $130 BILLION. YOU HEAR A LOT OF NUMBERS, YOU SEE A LOT OF NUMBERS, YOU READ ABOUT IT IN THE NEWSPAPER, ESPECIALLY ON THE OTHER SIDE OF THE AISLE, THIS WILL CUT THE DEFICIT FOR THE NEXT TEN YEARS BY $130 BILLION FOR THE FIRST TEN YEARS AND MAYBE UP TO $650 BILLION IN THE SECOND TEN. THIS WILL TRULY BEND THE CURVE, WHICH WE HAVE TO DO IF WE'RE NOT GOING TO GO INTO INSOLVENCY. IT'S INTERESTING WHEN THE OTHER SIDE TALKS ABOUT DEFICITS, DEFICITS, DEFICITS. THE THING THAT'S REALLY DRIVING THE DEFICIT IS HEALTH CARE COSTS, BECAUSE WHAT DRIVES MEDICARE AND MEDICAID COSTS IS HEALTH CARE COSTS. THIS BILL MAKES QUALITY, AFFORDABLE HEALTH CARE WITHIN REACH OF ALL AMERICANS. BUT THERE'S ALWAYS MORE WE CAN DO, AND THAT'S WHY I'M PLEASED IN JOINING MY OTHER FRESHMEN MEMBERS WITH A VERY PROMISING AMENDMENT TO THE BILL. SO MUCH OF WHAT HAS BROKEN OUR HEALTH CARE SYSTEM REVOLVES AROUND BASIC INEFFICIENCIES THAT DRIVE UP COSTS WHILE SIMULTANEOUSLY DRIVING DOWN QUALITY. THAT'S RIGHT, COSTS GO UP, QUALITY GOES DOWN. THAT'S NOT THE WAY WE WANT TO HAVE IT. WE WANT COSTS GO DOWN, QUALITY GOES UP. EVEN WORSE, INEFFICIENCIES IN THE SYSTEM OFTEN GIVE WAY TO THE WASTE, FRAUD, AND ABUSE THAT DRAINS SOMEWHERE BETWEEN $72 BILLION AND $220 BILLION ANNUALLY FROM DOCTORS, PATIENTS, PRIVATE SURERS AND THE STATE AND FEDERAL GOVERNMENT, THIS IS SIGNIFICANTLY INCREASING HEALTH CARE COSTS FOR AMERICANS. THESE ARE INEFFICIENCIES THAT CAN AND WILL BE CURBED. BY SEEKING INNOVATIVE WAYS TO LOWER HEALTH CARE COSTS ACROSS THE COUNTRY, THIS AMENDMENT COMPLEMENTS THE UNDERLYING HEALTH CARE BILL. IT ADOPTS THE FULL SPECTRUM OF 21st CENTURY TECHNOLOGIES AND INNOVATIVE METHODS OF DELIVERY TO FURTHER CUT THROUGH THE RED TAPE THAT CONTINUES TO PLAGUE OUR SYSTEM AND STIFLE INNOVATION. IT PROVIDES COMMONSENSE, PRACTICAL SOLUTIONS THAT HELP CONTAIN COSTS, IMPROVE QUALITY AND INCREASE VALUE. IT INCREASES PENALTIES FOR HEALTH CARE FRAUD AND ENHANCES ENFORCEMENTS AGAINST MEDICAL CROOKS AND UTILIZES THE MOST SOPHISTICATED TECHNOLOGY TO BETTER DETECT AND DETER FRAUD IN THE HEALTH CARE SYSTEM. IT QUICKENS THE IMPLEMENTATION OF UNIFORM ADMINISTRATIVE STANDARDS, ALLOWING FOR MORE EFFICIENT EXCHANGE OF INFORMATION AMONG PATIENTS, DOCTORS, AND INSURERS. IT PROVIDES MORE FLEXIBILITY TO ESTABLISHING ACCOUNTABLE CARE ORGANIZATIONS THAT REALIGN FINANCIAL INCENTIVES AND HELP INSURE AMERICANS RECEIVE HIGH-QUALITY CARE. IT PROVIDES GREATER INCENTIVES TO INSURERS IN THE EXCHANGE TO REDUCE HEALTH CARE DISPARITIES ALONG RACIAL LINES. THESE ARE JUST A FEW EXAMPLES OF THE PROVISIONS IN THE AMENDMENT THAT I BELIEVE WILL MESH WELL WITH THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. AS I'VE SAID BEFORE, IT IS TIME TO GATHER OUR COLLECTIVE WILL AND DO THE RIGHT THING DURING THIS HISTORIC OPPORTUNITY BY PASSING HEALTH CARE REFORM NOW. I THINK THIS AMENDMENT CAN HELP US REACH THAT GOAL. WE CAN'T AFFORD TO WAIT ANY LONGER. WE NEED TO ACT NOW. WE CAN DO NO LESS. THE AMERICAN PEOPLE DESERVE NO LESS. THANK YOU, MR. PRESIDENT. A SENATOR:

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  • 10:26:51 AM

    THE PRESIDING OFFICER

    THE SENATOR FROM VIRGINIA IS RECOGNIZED.

  • 10:26:53 AM

    MR. WARNER

    THANK YOU, MR. PRESIDENT. I WANT TO THANK MY COLLEAGUE, THE SENATOR FROM…

    THANK YOU, MR. PRESIDENT. I WANT TO THANK MY COLLEAGUE, THE SENATOR FROM DELAWARE, FOR HIS COMMENTS AND HIS LEADERSHIP ON THIS ISSUE. I WANT TO ALSO THANK ALL OF THE FRESH PH ERPB. THIS IS, I THINK -- ALL THE FRESHMEN. THIS IS, I THINK, THE SEVENTH TIME THE FRESHMEN HAVE COME TO THE FLOOR ON THIS ISSUE. I THINK OUR COLLEAGUES HAVE HAD TO ENDURE OVER 65 SPEECHES FROM THE FRESHMEN ON THE SUBJECT OF HEALTH CARE. BEFORE I GET INTO MY REMARKS, I WANT TO PERSONALLY THANK SENATOR BAUCUS AND SENATOR DODD AND THE MAJORITY LEADER, AND PARTICULARLY THEIR STAFFS FOR WORKING WITH THE 11 FRESHMEN MEMBERS WHO HAVE COME TOGETHER TO UNVEIL A PACKAGE OF HEALTH CARE AMENDMENTS AROUND THE ISSUE OF COST CONTAINMENT. WE'VE BEEN WORKING ON THIS FOR NOW CLOSE TO THREE MONTHS. LATER TODAY WE'LL HAVE A FORMAL PRESS CONFERENCE. LET ME SAY AT THE OUTSET, I'M PROUD OF THE ENORMOUS BROAD-BASED SUPPORT WE'RE RECEIVING FOR THIS PACKAGE OF AMENDMENTS. WE'RE GOING TO BE HAVING A BUSINESS ROUND TABLE COME IN A ENDORSE THE AMENDMENTS THAT WE HAVE IN COMPANIES LIKE WAL-MART AND INTEL AND TARGET AND QUAD GRAPHICS ENDORSE THIS PACKAGE. WE'RE GOING TO HAVE GROUPS LIKE THE AARP AND THE A.F.L. WE'RE GOING TO HAVE IMPORTANT THINK TANKS LIKE NEW AMERICAN FOUNDATION AND ACTUALLY MARK McCLELLAN, WHO WAS THE HEAD OF C.M.S. UNDER PRESIDENT BUSH, IS ENDORSING OUR PACKAGE. THE NOTION HERE BEING THAT WHILE THE MERGED BILL HAS -- STARTS TO MOVE THIS ENORMOUS SHIP OF HEALTH CARE SPENDING IN THE RIGHT DIRECTION, WHAT WE'RE TRYING TO DO WITH THIS PACKAGE IS PUT A FEW AFTERBURNERS ON THAT MOVEMENT AS WE REALLY TRY TO MOVE AWAY FROM OUR CURRENT SYSTEM THAT, LET'S FACE IT, DOESN'T MAKE MUCH GOOD BUSINESS SENSE, DOESN'T MAKE MUCH GOOD FINANCIAL SENSE, THAT BASICALLY REWARDS VOLUME OVER QUALITY, THAT HAS THE ABSURD SITUATION IN THIS COUNTRY WHERE A HOSPITAL THAT HAS A HIGHER READMISSION RATE GETS PAID MORE THAN A HOSPITAL THAT HAS A LOW READMISSION RATE. WE'RE TAKING ALL OF THE VARIOUS ASPECTS OF THE BILL AROUND PAYMENT REFORM, AROUND GREATER ACCOUNTABILITY, AROUND DATA MINING, AROUND ADMINISTRATIVE SIMPLIFICATION AND SAYING HOW CAN WE TAKE THE TOOLS THAT HAVE BEEN PUT IN THESE BILLS AND ACCELERATE THEM, GIVE THE SECRETARY, AS WE MOVE FORWARD THE ABILITY TO TAKE PILOT PROGRAMS AND BROADEN THEIR APPROACH AND BROADEN THEIR APPEAL. IF IT WORKS, LET'S BRING THAT REFORM TO OUR WHOLE SYSTEM. ONE OF THE THINGS THAT WE HAVE ALSO FOCUSED ON -- AND WHILE WE ANTICIPATE A VERY GOOD SCORE FROM THE C.B.O. IN TERMS OF OVERALL LOWERING HEALTH CARE COSTS, WHAT WE'RE TRYING TO DO IN THIS PACKAGE IS NOT JUST LOOK AT HEALTH CARE REFORM IN THE CONTEXT OF THOSE GOVERNMENT-RELATED PROGRAMS: MEDICARE, MEDICAID, WHAT HAVE YOU. BUT ALSO HOW WE PARTNER WITH THOSE IN THE PRIVATE SECTOR. ONE OF THE REASONS WHY THE BUSINESS ROUND TABLE IS SO SUPPORTIVE IS THE FACT THAT WE HAVE TO RECOGNIZE THAT WELL OVER HALF OF THE AMERICAN PUBLIC STILL RECEIVES THEIR HEALTH CARE THROUGH PRIVATE INSURANCE OR THROUGH THEIR HEALTH CARE THEY RECEIVE IN CONJUNCTION WITH THEIR EMPLOYERS. HOW DO WE TAKE THE BEST OF THE PRIVATE SECTOR? HOW DO WE TAKE THE LESSONS LEARNED FROM THE PRIVATE SECTOR, BRING THOSE INTO THE HEALTH CARE REFORMS THAT I HOPE THIS BODY WILL SOON PASS IN THE COMING WEEKS. THE NECESSITY -- MY FRIEND THE SENATOR FROM DELAWARE HAS RAISED THIS POINT, WHAT'S GOOD ABOUT THIS BILL. THERE ARE STILL ISSUES TO BE RESOLVED. I STILL HAVE CONCERNS, PARTICULARLY AROUND THE PUBLIC OPTION PORTION. BUT I KNOW THAT IN A GOOD-FAITH EFFORT WE'LL GET THOSE ISSUES RESOLVED. AND ONE THING THAT NEEDS TO BE REAFFIRMED TIME AND TIME AGAIN IS WHAT HAPPENS IF WE DON'T DO HEALTH CARE REFORM, BECAUSE NOT ACTING IS A POLICY CHOICE. NOT ACTING IS EVERY BIT AS MUCH A POLICY CHOICE AS MOVING FORWARD ON THIS BILL. IF WE FAIL TO ACT, OUR FEDERAL DEFICITS WILL CONTINUE TO EXPLODE BECAUSE THE LARGEST DRIVER OF OUR FEDERAL DEFICIT IS NOT EDUCATION FUNDING, IT'S NOT TRANSPORTATION FUNDING, IT'S NOT EVEN THE TARP OR THE STIMULUS MUCH THE LARGEST DRIVER OF OUR FEDERAL DEFICIT IS HEALTH CARE SPENDING. IF WE FAIL TO ACT, MEDICARE, WHICH PROTECTS THE HEALTH CARE OF MILLIONS -- COUNTLESS MILLIONS OF SENIOR CITIZENS -- WILL GO BANKRUPT IN THE NEXT EIGHT YEARS F WE FAIL TO ACT, FAMILIES IN VIRGINIA -- AN AVERAGE VIRGINIA FAMILY AND I WOULD IMAGINE AN AVERAGE FAMILY -- MY GOOD FRIEND FROM CONNECTICUT, THE FAMILIES OF CONNECTICUT, THEY WILL SEE HEALTH CARE INSURANCE EAT UP 40% OF THEIR INCOME. BUSINESS UNDERSTANDS THAT IF WE CAN'T DRIVE DOWN OUR OVERALL HEALTH CARE COSTS, THEN THE ABILITY FOR AMERICA TO COME OUT OF THIS RECESSION AND REMAIN COMPETITIVE WILL BE SERIOUSLY UNDERMINED BECAUSE AS LONG AS AMERICAN BUSINESS HAS TO PAY TWICE AS MUCH% PERSON, AS MUCH AS $3,000 TO $4,000 PER EMPLOYEE MORE FOR THEIR HEALTH CARE COSTS THAN ANY OF OUR COMPETITORS AROUND THE WORLD, THEN NO MATTER HOW COMPETITIVE THE AMERICAN WORKFORCE IS, AMERICAN BUSINESSES WON'T BE ABLE TO COMPETE AS WELL. OUR AMENDMENT PACKAGE -- AND I KNOW MY COLLEAGUES WILL GO THROUGH IN SOME MORE DETAILS -- AND I SEE SOME OF MY OTHER COLLEAGUES ARE HERE ON THE FLOOR, SO I'LL YIELD MY TIME AND BE HAPPY TO COME BACK AND GO THROUGH SOME MORE OF THESE PROVISIONS -- IT IS COMPLEX. IT IS A BIT DENSE. IT IS ABOUT 30-ODD DIFFERENT PROVISIONS HERE THAT TAKE VERY GOOD PART THAT ARE ALREADY IN THE COMBINED BILL AND AS INDICATED MOVE THEM QUICKER, MOVE THEM FASTER, TRY TO MAKE SURE THAT WE HAVE WHAT I THINK ALL OF US WANT -- MORE PRICE TRANSPARENCY IN OUR PRICING AROUND HEALTH CARE, MORE ABILITY TO TAKE PROGRAMS AND PILOTS AT WORK AND ROLL THEM OUT ON A RAGE -- ON A WIDER BASIS. MY GOOD FRIEND FROM COLORADO HAS BEEN WORKING HARD ON THE ADMINISTRATIVE REFORM PORTION. THIS IS A GOOD PACKAGE OF AMENDMENTS. I WAS ASKED YESTERDAY FROM SOMEBODY FROM THE PRESS WHAT IT IS LIKE. I WOULD SUM UP BECAUSE SOME OF THIS STUFF GETS FAIRLY DENSE, BUT SUM UP TWO THINGS THIS PACKAGE OF AMENDMENTS IS TRYING TO DO. I THINK WE ALL REMEMBER YEARS BACK WHEN YOU -- WHEN YOU WERE IN THE TRAVEL AREA AND YOU CALLED UP AND TRIED TO GET AN AIRLINE RESERVATION AND DEPENDING ON WHO YOU CALLED AN WHAT TIME YOU CALLED, YOU MIGHT GET A TOTAL DIFFERENT PRICE ON YOUR AIRLINE TICKET. WELL, WHAT THIS PACKAGE OF AMENDMENTS IS TRYING TO DO IS TRYING TO DO TO HEALTH CARE WHAT TRAVELOCITY DID TO THE AIRLINE BUSINESS. HOW DID WE BRING SOME TRUE PRICING COMPETITION? IT WON'T GET US THERE, BUT IT'LL MOVE US DOWN THE LINE. I SAY TO MY GOOD FRIEND, I SEE THE CHAIRMAN OF THE "HELP" COMMITTEE, WHO'S WORKED SO HARD AND SO LONG ON THIS ISSUE, BUT AS HE KNOWS, I WAS LUCKY ENOUGH IN THE OLD DAYS TO FALL INTO THE CELL PHONE INDUSTRY. I MANAGED TO EEOC EKE OUT A SMALL LIVING IN THAT INDUSTRY. IF WE TOOK -- IF WE THOUGHT THIS AMENDMENT -- IF WE THOUGHT THE ORIGINAL BILL WAS BASICALLY CREATING THE CELL PHONE OF THE 20th CENTURY, WHAT IS OUR PACKAGE OF AMENDMENTS IS, IT'S BASICALLY THE iPHONE VERSION TO YOUR MOTOROLA FLIP PHONE VERSION OF THE BILL. I HAVE TO KIND OF WORK ON THAT A LITTLE BIT BETTER BEFORE THE PRESS CONFERENCE. BUT YOU KIND OF GET WHERE I'M GOING. WE PROVIDE DOZENS OF APPLICATIONS 0 AN GOOD FRAMEWORK THAT'S PROVIDED ON THIS MERGED BILL. I'M VERY PROUD OF THE WORK THAT ALL OF THESE FRESHMEN SENATORS HAVE DONE OVER THE LAST FEW MONTHS. I THANK THE MAJORITY AND THEIR STAFFS FOR HELPING US WORK THROUGH THIS AMENDMENT PACKAGE. I LOOK FORWARD TO ITS ADOPTION AND I LOOK FORWARD TO LATER TODAY ALL OF THE COMING TO ENDORSE OUR EFFORTS. AND WITH THAT, I YIELD TO THE JUNIOR SENATOR FROM COLORADO, WHO IS NEXT UP ON THE AGENDA. THANK YOU, MR. PRESIDENT.

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  • 10:35:28 AM

    MR. BENNET

  • 10:35:29 AM

    THE PRESIDING OFFICER

    THE SENATOR FROM COLORADO IS RECOGNIZED.

  • 10:35:32 AM

    MR. BENNET

    THANK YOU. I'D LIKE TO THANK OUR COLLEAGUE FROM VIRGINIA, SENATOR WARNER,…

    THANK YOU. I'D LIKE TO THANK OUR COLLEAGUE FROM VIRGINIA, SENATOR WARNER, FOR HIS EXTRAORDINARY LEADERSHIP THROUGHOUT THIS PROCESS OF THE FRESHMEN COMING TOGETHER TO SEE WHAT WE CAN DO TO MOVE THIS LEGISLATION FORWARD, TO IMPROVE IT. I THINK A LOT HAS BEEN SAID ABOUT HOW THE BILL, AS DRAFTED BY THE "HELP" COMMITTEE, THE FINANCE COMMITTEE NOW BY THE MAJORITY LEADER IS DIRECTALLY CORRECT IN ITS EFFORTS TO GET A HANDLE ON THIGHS SKYROCKETING COSTS. I THINK THIS AMENDMENT PACKAGE WILL MOVE US MUCH FURTHER IN THE DIRECTION OF TRYING TO HOLD DOWN COSTS FOR OUR WORKING FAMILIES AND SMALL BUSINESSES ACROSS THE COUNTRY. THROUGHOUT THIS ENTIRE DEBATE AND GOING BACK TO THE VERY BEGINNING, WHAT I'VE SAID IS THAT NO MATTER WHERE YOU ARE ON MANY OF THE ISSUES HERE, THERE CAN'T REALLY BE ANY DISAGREEMENT THAT THE CURRENT SYSTEM WITH RESPECT TO COST IS COMPLETELY INSANE. OUR FAMILIES IN COLORADO FACE DOUBLE-DIGIT COST INCREASES EVERY YEEMPLET OVER THE LAST DECADE THEIR MEDIAN FAMILY INCOME HAS ACTUALLY GONE DOWN BY 97%. GONE DOWN BY $300, THE COST OF HEALTH CARE UP BY 97% OVER THAT SAME PERIODS OF TIME. OUR SMALL BUSINESSES ARE PAYING 18% MORE THAN LARGE BUSINESSES FOR HEALTH CARE JUST BECAUSE THEY'RE SMALL. WE ARE SPENDING AS A COUNTRY MORE THAN TWICE WHAT ALMOST ANY OTHER INDUSTRIALIZED COUNTRY IN THE WORLD IS SPENDING AS A PERCENTAGE OF OUR GROSS DOMESTIC PRODUCT ON HEALTH CARE. WE'RE SPEND ROUGHLY 18%, GOING TO 20% IN THE BLINK OF AN EYE. WE CAN'T HOPE TO COMPETE IN THIS GLOBAL ECONOMY IF WE'RE DEVOTING A FIFTH OF OUR ECONOMY TO HEALTH CARE AND EVERYONE ELSE IN THE WORLD IS DEVOTING LESS THAN HALF THAN THAT. AS THE SENATOR FROM VIRGINIA ALSO SAID, IF YOU HAVE ANY CORNERABOUT THESE DEFICITS THAT WARE FACING HERE IN WASHINGTON, WHICH HAVE BECOME COMPLETELY UNTENABLE, THE BIGGEST DRIVER OF THOSE ARE MEDICAID AND MEDICARE COSTS. MY VIEW HAS BEEN FROM THE START THAT NO MATTER WHAT YOUR ENTRY POINT WAS INTO THIS DEBATE, THE COST WAS THE CENTRAL QUESTION FOR OUR WORK FAMILIES AND FOR OUR SMALL BUSINESSES AND WE HAVE STRESSED THE NEED OVER AND OVER HERE FOR HEALTH CARE REFORM. THAT'S WHY I THINK THE SENATE NEEDS TO ADOPT FRESHMEN AMENDMENT PACKAGE WHICH WOULD CUT COSTS, SAVE THE TAXPAYERS MONEY AND MAKE OUR HEALTH CARE SYSTEM FUNCTION MORE EFFICIENTLY. THIS PACKAGE OF AMENDMENTS WILL HELP STRENGTHEN THE REFORM PROPOSAL'S ABILITY TO DELIVER AFFORDABLE, QUALITY HEALTH CARE TO ALL AMERICANS, WHETHER THEY ARE IN PRIVATE PLANS OR WHETHER THEY'RE IN PUBLIC PLANS. THESE PROVISIONS WILL REMOVE MUCH OF THE RED TAPE THAT FOR SO LONG AS SLOWED THE DELIVERY OF CARE. DOCTORS FROM ALL OVER COLORADO HAVE TOLD ME TIME AND TIME AGAIN THAT THEIR MEDICAL PRACTICES ARE MIRED IN PAPERWORK AND THAT THEIR STAFFS SPEND FAR TOO MUCH TIME AND MONEY JUMPING THROUGH ADMINISTRATIVE HOOP AFTER HOOP. THE THYME OUR DOCTORS AND NURSES SPEND ON UNNECESSARY PAPERWORK IS TIME THEY CAN'T SPEND BECOMING BETTER PROFESSIONALS AND, MOST IMPORTANT, PROVIDING QUALITY CARE TO THEIR PATIENTS. THIS AMENDMENT WILL REQUIRE THE SECRETARY OF HEALTH AND HUMAN SERVICES TO ADOPT AND REGULARLY UPDATE A SINGLE NATIONAL STANDARD FOR SOME OF THE MOST BASIC ELECTRONIC TRANSACTIONS THAT OCCUR BETWEEN INSURERS AND PROVIDERS, AND MEETING THESE STANDARDS WILL BE ENFORCEABLE BY PENALTIES IF INSURERS AND PROVIDERS DON'T TAKE STEPS TO COMPLY. MY PROVISION WILL MAKE SURE THAT WE IMPLEMENT HEALTH REFORM -- THAT AS WE IMPLEMENT HEALTH REFORM, WE ARE CONSISTENTLY IDENTIFYING AND IMPLEMENTING NEW STANDARDS. THERE ARE ALSO TERRIBLE INFINISH SIS IN THE WAY WE PAY HEALTH CARE PROVIDERS AND ALLOW THEM TO DELIVER CARE TO PATIENTS. THIS PACKAGE HELPS ELIMINATE BOTTLENEXT SO THAT BAISHTS ARE -- THIS PACKAGE HELPS ELIMINATE BOTTLENECKS SO THAT PATIENTS -- TO BETTER CRAFT STRATEGIES FOR MEDICARE AND MEDICAID AND PRIVATE-SECTOR PLANS TO IMPROVE CARE. IN THE CURRENT SYSTEM DOCTORS ARE FORCED INTO REQUESTING A MULTITUDE OF TESTS TO CONFIRM A DIAGNOSIS THEY'VE ALREADY MADE. THIS CREATES UNNECESSARY WORK FOR DOCTORS AND ADMINISTRATIVE STAFFS, LAB TECHNICIANS AND SO ON. IT IS TIME WE CREATE A SYSTEM THAT EMPOWERS DOCTORS TO PRACTICE MEDICINE AND DO THEIR JOBS EFFICIENTLY. AND UNDER THE CURRENT BROKEN SYSTEM, DOCTORS HAVE TO ENDURE NEEDLESS HURDLES TO EVEN SET UP A PRACTICE. IT IS NO WONDER THE NUMBER OF PRIMARY CARE DOCTORS HAS BEEN STEADILY DECLINING FOR SOMETIME NOW. THIS PACKAGE OF AMENDMENTS WOULD CREATE AN ENVIRONMENT THAT ATTRACTS DOCTORS BACK TO THE FIELD RATHER THAN MAKING IT MORE DIFFICULT FOR THEM TO PROVIDE CARE. ALONG WITH THE SAVINGS, THIS BILL ALREADY CREATES, THIS AMENDMENT WILL HELP DOCTORS REMOVE THE RED TAPE TO HELP PATIENTS IN A TIMELY MANNER. WE CANNOT GO ON ALLOWING THE MIDDLE CLASS TO ABSORB THE RISING COST OF OUR NATION'S HEALTH CARE SYSTEM. WE NEED HEALTH CARE REFORM THAT WILL CONTROL COSTS AND PUT US BACK ON A PATH TOWARD FISCAL RESPONSIBILITY THIS. PACKAGE OF AMENDMENTS WILL HELP US DO JUST THAT. MR. PRESIDENT, I WANT TO AGAIN SAY THANK YOU TO MY COLLEAGUES HERE FROM THE FRESHMEN CLASS FOR THEIR WORK. THIS SOMETIMES HAS SEEMED TEED YURKS IT SOMETIMES IS HARD TO DESCRIBE, BUT THESE AMENDMENTS ARE VERY CRITICAL IF WE ARE GOING TO GET AHOLD OF COSTS AS WE GO FORWARD AND THAT'S THE THING THAT WORKING FAMILIES IN THIS COUNTRY NEED MORE THAN ANYTHING ELSE IN ORDER TO HAVE STABILITY IN THEIR LIVES. WE HAVE GOT TO GET AHOLD OF OUR RISING HEALTH CARE COSTS. WITH THAT, MR. PRESIDENT, I YIELD THE FLOOR.

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  • 10:41:16 AM

    MR. KIRK

    MR. PRESIDENT?

  • 10:41:17 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM MASSACHUSETTS IS RECOGNIZED.

  • 10:41:19 AM

    MR. KIRK

    THANK YOU, MR. PRESIDENT. WITH GREAT JOY AND ENTHUSIASM, I CAN SAY THAT…

    THANK YOU, MR. PRESIDENT. WITH GREAT JOY AND ENTHUSIASM, I CAN SAY THAT TODAY WE ARE CLOSER THAN EVER TO GUARANTEEING THAT ALL AMERICANS, AT LONG LAST, WILL HAVE FULL ACCESS TO QUALITY, AFFORDABLE HEALTH CARE. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, WHICH OUR COLLEAGUE AND OUR FRESH IN OUR FRESHMAN CLASS, SENATOR MERKLEY OF OREGON, SUGGESTS, AS SENATOR KENNEDY FROM MASS WOULD HAVE SUBSCRIBED TO, THAT THIS IS THE HEALTH CARE BILL OF RIGHTS. IT WILL HELP FIX THE HEALTH CARE SYSTEM THAT IS FAILING TO MEET THE NEEDS OF THE AMERICAN PEOPLE. AND I AM EXTREMELY PROUD TO JOIN WITH MAJORITY LEADER REID, WITH SENATOR BAUCUS, MY GOOD FRIEND SENATOR DODD OF CONNECTICUT, AND WITH MY FELLOW FRESHMEN SENATORS. I WANT TO SINGLE OUT, IF I MAY, THE SENATOR FROM VIRGINIA, MARK WARNER, ONE OF THE MORE ENLIGHTENED BUSINESS LEADERS OF OUR TIME WHO BROUGHT HIS WISDOM AND INNOVATION, SKILLS, AND PRACTICES OF THE PRIVATE SECTOR TO HELP IMPROVE THE IMPORTANT CHALLENGE WE HAVE HERE IN THE PUBLIC SECTOR. AND I THANK THE SENATOR FOR HIS LEADERSHIP ON THIS EFFORT. IN CONTRIBUTING TO LEGISLATION THAT WILL MARK AN HISTORIC STRIDE FORWARD FOR THE AMERICAN PEOPLE. I WANT TO SAY JUST A WORD AS WELL, A PARTICULAR WORD ABOUT THE CHAIRMAN OF THE "HELP" COMMITTEE, WHO HAS ENORMOUS RESPONSIBILITIES IN THE SENATE OF THE UNITED STATES, CHAIRING THE EFFORT TO REFORM OUR FINANCIAL REGULATIONS AND FINANCIAL SYSTEM SO THAT THE AMERICAN PEOPLE WILL UNDERSTAND THAT WE ARE ONE COUNTRY WITH ONE IMPORTANT FINANCIAL SYSTEM AND THEY'RE NOT SOMEHOW A SECOND-TIER, UNRELATED AND UNCONNECTED TO THE DECISIONS THAT ARE MADE ON WALL STREET AND ELSEWHERE. WHEN SENATOR KENNEDY OF MASSACHUSETTS WAS STRICKEN, SENATOR DODD OF MASSACHUSETTS -- NOT ONLY BECAUSE SENATOR KENZIE KENNEDY IS A VERY CLOSE FRIEND, BUT BECAUSE THE SENATOR FROM CONNECTICUT UNDERSTOOD THE ENORMITY OF THE CHALLENGE AND IMPORTANT EFFORT THAT IS BEING MADE HERE TODAY IN THE UNITED STATES SENATE. AND I WANT TO SALUTE HIM FOR SHARING HIS WISDOM AND HIS STRENGTH AND HIS LEADERSHIP, NOT ONLY IN THE AREAS OF FINANCIAL REFORM BUT IN THIS IMPORTANT AREA AS WELL. AS I SAID, THIS IS NOTHING LESS THAN A BILL OF RIGHTS FOR THE AMERICAN PEOPLE ON THE ISSUES OF HEALTH CARE. WITH THIS LEGISLATION, ALL AMERICANS FINALLY WILL BE GUARANTEED ACCESS TO THE AFFORD AFFORDABLE HEALTH CARE COVERAGE THEY DESERVE. FAMILIES WHO NEED A HELPING HAND TO CARE FOR AN AGING RELATIVE WILL BE PROTECTED. INSURANCE COMPANIES WILL BE PROHIBITED FROM ARBITRARILY REFUSING COVERAGE AND FROM STOPPING BENEFITS JUST WHEN THEY ARE NEEDED MOST. DOCTORS WILL BE GIVEN THE SUPPORT THEY NEED TO PRACTICE THE BEST MEDICINE POSSIBLE. THAT'S WHY THEY TOOK THEIR OATH. AND WITH THE HELP OF THE MEASURES IN THIS TOTAL LEGISLATION AND SOME OF THE PARTICULAR REFORMS SUGGESTED BY OUR FRESHMEN COLLEAGUES, THAT BEST MEDICINE WILL BE PRACTICED. AND THE AMERICAN ECONOMY WILL BE PROTECTED FROM THE SKYROCKETING COSTS OF HEALTH CARE WITH WHICH EVERY AMERICAN FAMILY IS NOW AFFLICTED. OVER THE PAST MONTH I'VE HAD THE PRIVILEGE OF WORKING WITH MY FELLOW FRESHMEN COLLEAGUES ON A SERIES OF AMENDMENTS WE'RE DISCUSSING HERE THIS MORNING TO MAKE THIS HEALTH CARE BILL OF RIGHTS EVEN STRONGER. THESE AMENDMENTS PLANT THE SEEDS FOR AN INNOVATIVE 21st CENTURY HEALTH CARE SYSTEM THAT OFFERS WHAT AMERICAN FAMILIES WANT MOST: BETTER RESULTS FOR LOWER COSTS. IT'S AS SIMPLE AS THAT. THESE AMENDMENTS FOCUS ON THE ROOT CAUSES OF OUR SKYROCKETING HEALTH CARE COSTS. THEY PROVIDE MEDICARE THE SUPPORT IT NEEDS TO BECOME A LEADER IN MOVING AWAY FROM THE REIMBURSEMENT MODEL THAT INCREASE COSTS WITHOUT IMPROVING CARE. PUBLIC-PRIVATE ARRANGEMENTS WILL BE ESTABLISHED TO SMOOTHER REFORM AND PREVENT PRIVATE INSURERS FROM SHIFTING COSTS ON TO PUBLIC PLANS. THE RED TAPE WITH WHICH WE'RE ALL FAMILIAR WEIGHS DOWN THE CURRENT HEALTH CARE SYSTEM IN BOTH THE PUBLIC AND PRIVATE SECTORS WILL BE REDUCED. ALL OF THIS WILL CONTRIBUTE TO LOWER COSTS AND HIGHER QUALITY IN OUR HEALTH CARE SYSTEM. ONE FOCUS THAT IS OF PARTICULAR INTEREST AND IMPORTANCE TO ME IS THE DELIVERY SYSTEM REFORM. WE MUST MOVE TOWARD A SYSTEM OF PAYING HOSPITALS AND DOCTORS FOR THE QUALITY CARE THEY PROVIDE RATHER THAN THE QUANTITY OF TESTS AND PROCEDURE THEY PERFORM. OUR AMENDMENTS REWARD PROVIDERS OF MEDICARE WHO GIVE HIGH-QUALITY CARE RATHER THAN HIGH-VOLUME PROCEDURES. WE WILL ALSO ALLOW MEDICARE TO TEST PROMISING NEW MODELS TO REDUCE COSTS, INCREASE QUALITY AND IMPROVE PATIENT HEALTH. WE MUST MAKE THESE CHANGES FOR THE SAKE OF OUR PATIENTS AND FOR THE SAKE OF OUR ECONOMY. IN SHORT, OUR AMENDMENTS, MR. PRESIDENT, STRENGTHEN THE REFORMS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. I URGE ALL OF MY COLLEAGUES TO SUPPORT THESE AMENDMENTS AND TAKE THESE IMPORTANT STEPS WITH US TO BRING AMERICA'S HEALTH CARE SYSTEM INTO THE 21st CENTURY. ONCE AGAIN I THANK THE LEADERSHIP. I THANK THE SENATOR FROM VIRGINIA AND MY FRESHMEN COLLEAGUES FOR THEIR GOOD WORK ON THIS HISTORIC HEALTH CARE BILL OF RIGHTS. AND, MR. PRESIDENT, I THANK YOU AND I YIELD THE FLOOR. A SENATOR: MR. PRESIDENT?

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  • 10:48:07 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM COLORADO IS RECOGNIZED.

  • 10:48:11 AM

    MR. UDALL

    THE SENATOR FROM NEW HAMPSHIRE IS RECOGNIZED.

  • 10:52:17 AM

    THE PRESIDING OFFICER

    THE SENATOR FROM NEW HAMPSHIRE IS RECOGNIZED.

  • 10:52:20 AM

    MRS. SHAHEEN

    MR. PRESIDENT?

  • 10:56:26 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM NORTH CAROLINA IS RECOGNIZED.

  • 10:56:28 AM

    MRS. HAGAN

    THANK YOU. I RISE IN SUPPORT OF THE FRESHMEN VALUE AND INNOVATION PACKAGE…

    THANK YOU. I RISE IN SUPPORT OF THE FRESHMEN VALUE AND INNOVATION PACKAGE WHICH BUILDS ON EFFORTS TO PROVIDE QUALITY AFFORDABLE HEALTH CARE AT A LOWER COST TO FAMILIES. AND I TOO APPLAUD OUR COLLEAGUE, SENATOR MARK WARNER, FOR HELPING TO INITIATE THIS PACKAGE. I WANT TO TAKE A MOMENT TO TALK ABOUT TWO PROVISIONS IN THIS PACKAGE WHICH I INCLUDED: CURBING FRAUD AND ABUSE WITH 21st CENTURY TECHNOLOGY AND MEDICATION THERAPY MANAGEMENT. TODAY MEDICARE SPENDS ABOUT $430 BILLION ANNUALLY. MEDICAID APPROXIMATELY $340 BILLION AND THE STATE CHILDREN'S HEALTH INSURANCE PROGRAM AN ADDITIONAL $5 BILLION, FOR A TOTAL OF $775 BILLION. IN MEDICARE ALONE, ANNUAL WASTE AMOUNTS TO BETWEEN $23 BILLION AND $78 BILLION. YET, DESPITE THE SKY-HIGH NUMBERS, INVESTIGATIONS ARE PURSUED ONLY AFTER PAYMENT HAS BEEN MADE, WHICH MEANS THAT GOVERNMENT FRAUD INVESTIGATORS HAVE TO RECOVER FUNDS THAT HAVE ALREADY BEEN PAID. AS A RESULT, IT'S ESTIMATED THAT ONLY ABOUT 10% OF POSSIBLE FRAUD IS EVER DETECTED. AND OF THAT AMOUNT, ONLY ABOUT 3% IS EVER ACTUALLY RECOVERED. THIS MEANS THE GOVERNMENT RECOVERS AT BEST ABOUT $130 MILLION IN MEDICARE WASTE, FRAUD, AND ABUSE. WHEN ESTIMATES ARE BETWEEN $23 BILLION AND $78 BILLION, WE'RE ONLY RECOVERING $130 MILLION. DOCTOR SHOPPING IS AN EXAMPLE THAT WAS PRO"NO CHILD LEFT BEHIND" IN A RECENT -- THAT WAS PROFILED IN A RECENT "USA TODAY" REPORT. THIS INVOLVES A PATIENT RECEIVING MULTIPLE PRESCRIPTIONS FROM NUMEROUS DOCTORS IN A SHORT PERIOD OF TIME WITHOUT GETTING CAUGHT. AND EACH OF THE CLAIMS GETS PAID BY MEDICARE, MEDICAID, OR EVEN PRIVATE HEALTH INSURERS. BUT CURRENT TECHNOLOGY EXISTS TODAY TO ASSESS IN REALTIME IF A CLAIM WARRANTS FURTHER INVESTIGATION. AND THIS TECHNOLOGY WILL PRAOUFPBT -- PREVENT FRAUDULENT CLAIMS FROM BEING PAID ON THE FRONT END. A SOFTWARE COMPANY IN KERRY, NORTH CAROLINA, SASS, DEVELOPED THIS TECHNOLOGY. THIS AMENDMENT WILL REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN RESOURCES TO PUT IN PLACE SYSTEMS THAT WILL DETECT PATTERNS OF FRAUD AND ABUSE BEFORE ANY MONEY LEAVES OUR FEDERAL COFFERS. ANOTHER SOURCE OF WASTE IN THE SYSTEM IS PEOPLE NOT STICKING TO THEIR MEDICATION REGIMENT. AS MUCH AS ONE HALF OF ALL PATIENTS IN OUR COUNTRY DO NOT FOLLOW THEIR DOCTOR'S ORDERS REGARDING THEIR MEDICATIONS. THE NEW ENGLAND HEALTH CARE INSTITUTE ESTIMATES THAT THE OVERALL COST OF PEOPLE NOT FOLLOWING DIRECTIONS IS AS MUCH AS $290 BILLION PER YEAR. THIS WASTE CAN BE ELIMINATED WITH MEDICATION THERAPY MANAGEMENT. THAT'S A PROGRAM WHERE SENIORS BRING ALL OF THEIR PRESCRIPTIONS IN A LITTLE BROWN BAG, THEIR OVER-THE- COUNTER MEDICATIONS, THEIR VITAMIN SUPPLEMENTS TO THE PHARMACY TO BE THOROUGHLY REVIEWED IN A ONE-ON-ONE SESSION. THE PHARMACIST FOLLOWS UP AND EDUCATES THE PATIENT ABOUT HIS OR HER MEDICATION REGIMEN. NORTH HAS HAS SUCCESSFUL MEDICATION THERAPY MANAGEMENT PROGRAMS ALREADY IN PLACE. IN 2007, THE NORTH CAROLINA HEALTH AND WELLNESS TRUST FUND LAUNCHED AN INNOVATIVE STATEWIDE PROGRAM. WE'VE CALLED IT CHECK MEDS N.C. TO PROVIDE MEDICATION THERAPY MANAGEMENT SERVICES TO OUR SENIORS. DURING THE PROGRAM'S FIRST YEAR, MORE THAN 15,000 SENIORS AND 285 PHARMACISTS PARTICIPATED. JUST THIS SMALL PROGRAM SAVED AN ESTIMATED $10 MILLION AND COUNTLESS HEALTH PROBLEMS WERE AVOIDED FOR OUR SENIORS. THIS AMENDMENT TAKES THIS SUCCESSFUL NORTH CAROLINA MODEL AND IMPLEMENTS IT NATIONALLY, PERMITTING PHARMACIES AND OTHER HEALTH CARE PROVIDERS TO SPEND CONSIDERABLE TIME AND RESOURCES EVALUATING A PERSON'S DRUG ROUTINE AND EDUCATING THEM ON PROPER USAGE. MADAM PRESIDENT, I URGE PASSAGE OF THIS FRESHMEN AMENDMENT PACKAGE WHICH WILL FURTHER REDUCE HEALTH CARE COSTS FOR AMERICAN FAMILIES. THANK YOU. A SENATOR: MADAM PRESIDENT, I SEEK RECOGNITION.

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  • 11:00:54 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM NEW MEXICO.

  • 11:01:00 AM

    MR. UDALL

    MADAM PRESIDENT?

  • 11:05:22 AM

    MR. BURRIS

    THE SENATOR FROM L I WILL I WILL FROM ILLINOIS.

  • 11:05:23 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM L I WILL I WILL FROM ILLINOIS.

  • 11:05:31 AM

    MR. BURRIS

    PRIVILEGE TO STAND WITH THESE SENATORS AND GIVE RECOGNITION TO THOSE…

    PRIVILEGE TO STAND WITH THESE SENATORS AND GIVE RECOGNITION TO THOSE DISTINGUISHED SENATORS WHO HAVE PUT SO MUCH HEART INTO DRAFTING THIS IMPORTANT LEGISLATION, TO OUR LEADER REID AND TO SENATOR BAUCUS AND TO SENATOR DODD AND TO ALL OF THE INDIVIDUALS. IT IS A PLEASURE FOR ME TO BE A PART OF THIS FRESHMEN COLLOQUY ON THIS MAJOR PACKAGE. OVER THE PAST SEVERAL MONTHS, MY FRESHMEN COLLEAGUES AND I HAVE TAKEN THE FLOOR MANY TIMES TO SPEAK ABOUT THE NEED FOR COMPREHENSIVE HEALTH CARE REFORM. SO I'M PLEASED TO JOIN THEM TODAY AS WE DISCUSS OUR COST-CONTAINMENT PACKAGE. THIS SET F OF PROVISIONS WILL HELP REDUCE EFFICIENCY AND REDUCE DISPARITIES IN OUR HEALTH CARE SYSTEM. OUR AMENDMENT WILL IMPROVE THE PRINCIPLE OF HIGH VALUE, LOW-COST CARE THAT IS CENTRAL TO THE PATIENT PROTECTION AND AFFORDABLE CARE AFNLGT MADAM PRESIDENT, OUR AMENDMENT WILL STRENGTHEN MEDICARE'S ABILITY TO ACT AS A PAYMENT INNOVATOR, PAYING FOR VALUE AND NOT FOR VOLUME. SPEEDING THIS PROCESS, OUR AMENDMENT GIVES MEDICARE MORE AFTER RESOURCE THAT IS NEEDED TO GATHER DATA, EXPAND PROGRAMS THAT WORKS AND REACH THE NEEDIEST PATIENTS. SO WE ALSO WORK TO STRENGTHEN WASTE, FRAUD, AND ABUSE PROVISIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. MAKE SURE THAT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES HAS THE TOOLS NOT TO ONLY PUNISH OFFENDERS BUT PREVENT FRAUD FROM HAPPENING IN THE FIRST PLACE. THIS IS NOT JUST ABOUT OUR PUBLIC PROGRAM. WE ALSO PROMOTE PRIVATE PUBLIC DATA SHARING TO GET A BETTER PICTURE OF OUR WHOLE MEDICAL SYSTEM. OUR AMENDMENT FURTHER TAKES AIM AT ADMINISTRATIVE COSTS, ANOTHER BARRIER OFTEN CITED FOR GETTING THE MOST EFFECTIVE CARE BY ENCOURAGING PRIVATE-PUBLIC COLLABORATION, TO CREATE UNIFORM STANDARDS, AND REDUCE THE MOUNTAIN OF PAPERWORK THAT MAKES DOCTORS SPEND MORE TIME -- TAKES DOCTORS' TIME AWAY FROM THEIR PATIENTS. FINALLY, MADAM PRESIDENT, WE PUT PRESSURE ON PRIVATE INSURERS TO CHANGE THE WAY THAT THEY PAY, BY ENCOURAGE INSURERS TO REWARD PROGRAMS THAT PRODUCE -- TO REDUCE DISPARITIES. PROVIDERS WILL INCREASINGLY FOCUS ATTENTION ON POPULATION THAT NEED IT MOST. BY PROACTIVE TARGETING THESE NEEDY FOLKS THROUGH CULTURALLY COMPETITIVE TRAINING, LANGUAGE SERVICE, AND COMMUNITY OUTREACH. OUR AMENDMENT WILL INCREASE WELLNESS AND REDUCE THE USE OF COSTLY EMERGENCY ROOM CARE. MY COLLEAGUES AND I ARE SUPPORTIVE -- SUPPORTED BY TOP BUSINESS GROUPS, CONSUMER GROUPS AND PROVIDERS BECAUSE THEY ALL KNOW THAT WE HAVE TO TRANSFORM THE WAY CARE IS DELIVERED IN THIS COUNTRY. BUSINESSES KNOW THAT WITHOUT THE REDUCED COST OF CARE AND PROMOTING TRANSPARENCY, THE COST OF PREMIUMS WILL CONTINUE TO RISE, PUTTING A STRANGLEHOLD ON WAGES INCREASING AND MAKING THEM LESS COMPETITIVE. CONSUMER GROUPS WANT TO ENSURE THAT PATIENTS GET MORE DOLLAR FOR THEIR DOLLAR. NOT JUST GET MORE CARE, BUT THEY GET THE TYPE OF COORDINATED, EFFECTIVE CARE THAT WILL KEEP THEM HEALTHY AND OUT OF THE EMERGENCY ROOMS AND OUT OF THE HEALTH CARE SYSTEM. THOSE PROVIDERS WHO FOCUS ON TARGETED CARE TO GET THE BEST PATIENT OUTCOME WANT TO BE REWARDED FOR DOING SO. THE THE EVIDENCE EVIDENCE COULD NOT BE CLEARER THAT THE PATIENT PROTECTION AND AFFORDABLE CARE ACT WILL LOWER COSTS FOR ORDINARY AMERICANS. SO I CALL UPON MY COLLEAGUES TO TAKE AN HONEST LOOK AT WHAT WE'RE DOING, AND I DEFY THEM TO SAY THAT HEALTH CARE REFORM WILL NOT REDUCE COSTS AND IMPROVE THE FUNCTIONING OF OUR HEALTH CARE SYSTEM. THE DEBATE ON HEALTH CARE REFORM CANNOT BE ABOUT SCORING POLITICAL POINTS. IT MUST BE ABOUT THE HEALTH AND WELL-BEING OF THE AMERICAN PEOPLE. ALL OF OUR GREAT WORK WILL BEAR FRUIT AND WE WILL REFORM OUR NATION'S HEALTH SYSTEM BECAUSE THERE IS NO OTHER OPTION. OUR CITIZENS DEMAND IT, AND THEY DESERVE NO LESS. MADAM PRESIDENT, I WANT TO THANK OUR DISTINGUISHED COLLEAGUES AND I YIELD THE FLOOR. AND I'M HAPPY TO BE A PART OF THIS FRESHMEN COOING COLLOQUY AND PRESENTING SUCH AN IMPORTANT ISSUE AT THIS TIME IN HISTORY ANDS IN THIS GREAT COUNTRY OF OURS. I YIELD THE FLOOR, MADAM PRESIDENT. A SENATOR: MADAM PRESIDENT?

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  • 11:10:36 AM

    THE PRESIDING OFFICER

    THE SENATOR FROM ALASKA. BEG THANK YOU VERY MUCH, MADAM PRESIDENT. I -- AT

  • 11:10:42 AM

    MR. BEGICH

    MADAM PRESIDENT?

  • 11:14:51 AM

    MR. WARNER

    THE SENATOR FROM VIRGINIA.

  • 11:14:52 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM VIRGINIA.

  • 11:14:55 AM

    MR. WARNER

    IS ABOUT TO EXPIRE. I WANT TO BEGIN TO CLOSE BY THANKING ALL MY FRESHMEN…

    IS ABOUT TO EXPIRE. I WANT TO BEGIN TO CLOSE BY THANKING ALL MY FRESHMEN COLLEAGUES FOR THE GREAT WORK THEY'VE DONE ON THIS AND THEIR STAFFS. I SEE A NUMBER OF MY COLLEAGUES FROM THE OTHER SIDE. THIS IS AN AMENDMENT PACKAGE THAT BRINGS GREATER ACCOUNTABILITY, GREAT EFFICIENCY AND GREATER INNOVATION, SUPPORTED BY THE BUSINESS ROUND TABLE, SUPPORTED BY BUSINESSES AND HEALTH CARE SYSTEMS AROUND THE COUNTRY. I'D ASK THEIR CONSIDERATION. I THANK AGAIN THE CHAIR, SENATOR DODD, FOR HIS -- THE FACT THAT HE ALLOWED TO US LAY OUT THIS PEAFNLG AMENDMENTS. I THINK IT WILL ADD AN IMPORTANT COMPONENT TO THIS BILL ON TRYING TO REIN IN COSTS, NOT JUST ON THE GOVERNMENTAL SIDE, BUT SYSTEMWIDE. THANK YOU, I YIELD THE FLOOR.

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  • 11:15:39 AM

    MR. DODD

    PRESIDENT, I WANT TO COMMEND 10 OF THE 11 FRESHMEN KHROEGZ HAVE SPOKEN --…

    PRESIDENT, I WANT TO COMMEND 10 OF THE 11 FRESHMEN KHROEGZ HAVE SPOKEN -- COLLEAGUES HAVE SPOKEN WITH GREAT PASSION ON THIS ISSUE. WE OWE THEM A DEBT OF GRATITUDE FOR PUTTING TOGETHER WHAT I THINK TO BE A FINE PACKAGE. I WANT TO PARTICULARLY THANK SENATOR WARNER WHO LED THIS EFFORT. BUT AS HE POINTED OUT THIS ONLY HAPPENED BECAUSE OF THE COOPERATION OF IDEAS EACH MEMBER BROUGHT ON COST CONTAINMENT. ALL AMERICANS OWE THEM A DEEP DEBT OF GRATITUDE. YOU CAN FEEL PRETTY GOOD ABOUT THE FUTURE OF OUR COUNTRY WITH THIS FINE GROUP OF FRESHMEN SENATORS.

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  • 11:16:21 AM

    THE PRESIDING OFFICER

    --

  • 11:16:26 AM

    MR. BAUCUS

    --

  • 11:16:27 AM

    THE PRESIDING OFFICER

    OFFICER: THE MINORITY HAS 60 MINUTES.

  • 11:16:32 AM

    MR. BAUCUS

    THE SENATOR FROM ARIZONA.

  • 11:17:44 AM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM ARIZONA.

  • 11:17:46 AM

    MR. McCAIN

    WITHOUT OBJECTION.

  • 11:18:24 AM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 11:18:30 AM

    MR. McCAIN

    ABOUT C-SPAN. I'M A GREAT ADMIRER OF C-SPAN AND HOW THE PRESIDENT WHEN HE…

    ABOUT C-SPAN. I'M A GREAT ADMIRER OF C-SPAN AND HOW THE PRESIDENT WHEN HE WAS RUNNING ALSO TALKED ABOUT C-SPAN. AND HE SAID C-SPAN WOULD BE IN THE RUNNING. IT WAS QUOTED RIGHT NOW A GROUP OF SENATORS IS MEETING BEHIND CLOSED DOORS TO TRY TO HASH OUT A COMPROMISE ON THE PUBLIC OPTION. REPORTERS WAITING FOR THE MEETING TO BREAK WERE SHUNTED AROUND THE CORNER MAKE IT GO HARDER FOR THE PRESS TO CATCH SENATORS AS THEY LEAVE. C-SPAN, THIS IS NOT. THE BEAT GOES ON. COULD I JUST REMIND MY COLLEAGUES OF THE AMENDMENT THAT WE ARE DISCUSSING HERE IS DRAFTED TO PREVENT DRASTIC MEDICARE ADVANTAGE CUTS FROM IMPACTING ALL SENIORS UNDER MEDICARE ADVANTAGE. I WANT -- THIS AMENDMENT SAYS SIMPLY LET'S GIVE SENIORS WHO ARE MEMBERS OF MEDICARE, WHO ENROLLED IN MEDICARE ADVANTAGE THE SAME DEAL THAT SENATOR NELSON WAS ABLE TO GET FOR THE STATE OF FLORIDA. AT LEAST MOST OF THE SENIORS WHO ENROLLED IN THE MEDICARE ADVANTAGE SRAPL. THERE ARE 1 -- MEDICARE ADVANTAGE PROGRAM. THIS AMENDMENT WOULD ALLOW ALL 11 MILLION TO HAVE THE SAME BENEFITS. THERE WOULD BE NO CARVEOUTS FOR VARIOUS GROUPS OF SENIORS JUST BECAUSE OF THE INFLUENCE OF A MEMBER OF THIS BODY. I JUST WANT TO QUOTE AGAIN "THE NEW YORK TIMES," MY FAVORITE SOURCE OF INFORMATION. QUOTE -- "SENATOR TRIES TO ALLAY FEARS ON HEALTH OVERHAUL. MR. NELSON, A DEMOCRAT, HAS A BIG PROBLEM. A BILL TAKEN UP THIS WEEK BY THE COMMITTEE WOULD CUT MEDICARE PAYMENTS. THE PROGRAM KNOWN AS MEDICARE ADVANTAGE IS POPULAR." ET CETERA, ET CETERA. "IT WOULD BE INTOLERABLE TO ASK SENIOR CITIZENS TO GIVE UP SUBSTANTIAL HEALTH BENEFITS THEY ARE ENJOYING UNDER MEDICARE, SAID MR. NELSON, WHO HAS BEEN DELUGED WITH CALLS AND COMPLAINTS FROM CONSTITUENTS. I'M OFFERING AN AMENDMENT TO SHIELD SENIORS FROM THOSE BENEFIT CUTS." I AM OFFERING AN AMENDMENT TO SHIELD ALL SENIOR CITIZENS, THE 11 MILLION OF THEM THAT ARE UNDER MEDICARE ADVANTAGE, AS THE SENATOR FROM FLORIDA SAID, TO SHIELD SENIORS FROM BENEFIT CUTS. THAT'S WHAT THIS AMENDMENT IS ALL ABOUT. WE SHOULD NOT CARVE OUT FOR SOME SENIORS WHAT OTHER SENIORS ARE NOT ENTITLED TO. THAT'S NOT AMERICA. THAT'S NOT THE WAY WE SHOULD TREAT ALL OF OUR CITIZENS. AND I HOPE THAT MY COLLEAGUES WILL UNDERSTAND THAT THIS IS SIMPLY IN THE NAME OF FAIRNESS THAT THIS AMENDMENT IS PROPOSED. AND I WOULD ASK THE SENATOR FROM TENNESSEE AND THE SENATOR FROM TEXAS, LARGE NUMBERS OF ENROLLEES IN THE MEDICARE ADVANTAGE PROGRAM, ALSO HOW THIS WOULD BE UNFAIR AS WELL.

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  • 11:21:38 AM

    MR. ALEXANDER

    I THANK THE SENATOR FROM ARIZONA FOR HIS AMENDMENT, AND I THANK THE…

    I THANK THE SENATOR FROM ARIZONA FOR HIS AMENDMENT, AND I THANK THE SENATOR FROM FLORIDA FOR HIS AMENDMENT BECAUSE MEDICARE ADVANTAGE IS VERY IMPORTANT TO TENNESSEEANS. WE HAVE 243,000 TENNESSEEANS WHO HAVE OPTED FOR MEDICARE ADVANTAGE. ABOUT ONE-FOURTH OF ALL AMERICANS WHO ARE ON MEDICARE HAVE CHOSEN MEDICARE ADVANTAGE BECAUSE IT PROVIDES THE OPTION FOR INCREASED DENTAL CARE, FOR VISION CARE, FOR HEARING COVERAGE, FOR REDUCED HOSPITAL DEDUCTIBLES. THIS IS ESPECIALLY HELPFUL TO LOW-INCOME AND MINORITY AMERICANS. THIS IS ESPECIALLY HELPFUL TO PEOPLE IN RURAL AREAS. AND WHAT THE REPUBLICANS HAVE BEEN ARGUING ALL WEEK IS THAT CONTRARY TO WHAT OUR FRIENDS ON THE OTHER SIDE ARE SAYING, THIS BILL CUTS THOSE MEDICARE ADVANTAGE BENEFITS, AND THE DIRECTOR OF THE CONGRESSIONAL BUDGET OFFICE SAYS THAT FULLY HALF -- FULLY HALF -- THE BENEFITS OF MEDICARE ADVANTAGE FOR THESE 11 MILLION AMERICANS WILL BE CUT. WELL, OUR DEMOCRATIC FRIENDS SAY NO, THAT'S NOT TRUE. WE'RE GOING TO CUT $1 TRILLION OUT OF MEDICARE OVER A FULLY IMPLEMENTED TEN YEARS AS PART OF THIS BILL, BUT NOBODY'S GOING TO BE AFFECTED BY IT. WELL, THE SENATOR FROM FLORIDA APPARENTLY DOESN'T BELIEVE THAT. HE SAYS WE HAVE 900,000 FLORIDIANS WHO DON'T WANT THEIR MEDICARE ADVANTAGE CUT. AND WE DON'T TRUST, HE IS SAYING IN EFFECT, WE DON'T TRUST THIS DEMOCRATIC BILL TO PROTECT THESE SENIORS' MEDICARE ADVANTAGE. SO I WOULD ASK THE SENATOR FROM TEXAS IF THE PEOPLE FROM FLORIDA AND THE SENATOR FROM FLORIDA DON'T TRUST THE DEMOCRATIC BILL TO PROTECT MEDICARE ADVANTAGE, WHY SHOULD 240,000 TEN SEEANS TRUST THE -- TENNESSEANS TRUST THE DEMOCRATIC BILL TO PROTECT MEDICARE ADVANTAGE?

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  • 11:23:36 AM

    MR. CORNYN

    GOOD ENOUGH FOR THE SENIORS IN FLORIDA OUGHT TO BE GOOD ENOUGH FOR ALL…

    GOOD ENOUGH FOR THE SENIORS IN FLORIDA OUGHT TO BE GOOD ENOUGH FOR ALL SENIORS. IN MY STATE, THE STATE OF TEXAS, WE HAVE 532,000 SENIORS ON MEDICARE ADVANTAGE, AND THEY LIKE IT FOR THE REASONS THAT THE SENATOR FROM TENNESSEE MENTIONED. AND THEY DON'T WANT US CUTTING THOSE BENEFITS. BUT I WOULD ASK THE SENATOR FROM ARIZONA AND TENNESSEE, I SEEM TO RECALL WE HAD AMENDMENTS EARLIER WHICH WOULD HAVE PROTECTED EVERYBODY FROM CUTS IN THEIR MEDICARE BENEFITS. AND NOW WE HAVE A TARGETED EFFORT NEGOTIATED BEHIND CLOSED DOORS TO PROTECT STATES LIKE FLORIDA AND PENNSYLVANIA AND OTHERS. AND I WONDER WHETHER THIS, THE NELSON AMENDMENT TO PROTECT THE SENIORS IN FLORIDA WOULD EVEN BE NECESSARY IF OUR COLLEAGUES ACROSS THE AISLE HAD AGREED WITH US THAT NO MEDICARE BENEFITS SHOULD BE CUT.

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  • 11:24:26 AM

    MR. McCAIN

    AS THE SENATOR FROM TEXAS POINTS OUT, JUST A FEW DAYS AGO WE, BY 100-0…

    AS THE SENATOR FROM TEXAS POINTS OUT, JUST A FEW DAYS AGO WE, BY 100-0 VOTE PASSED AN AMENDMENT PROPOSED BY THE SENATOR FROM COLORADO, SENATOR BENNET THAT SAYS -- QUOTE -- "PROTECTING GUARANTEED MEDICARE BENEFITS. PROTECTING AND IMPROVING GUARANTEED MEDICARE BENEFITS." NOTHING IN THE PROVISION OF OR AMENDMENTS MADE BY THIS ACT SHALL RESULT IN THE REDUCTION OF GUARANTEED BENEFITS UNDER TITLE 18 OF THE SOCIAL SECURITY ACT. IS THERE ANY MEMBER ON THE OTHER SIDE THAT CAN GUARANTEE SENIORS IN HIS OR HER STATE IN MEDICARE ADVANTAGE THAT THEY WILL NOT LOSE A SINGLE BENEFIT THAT THEY HAVE TODAY? NOT THE GUARANTEED BENEFIT THAT THE OTHER SIDE GOES TO GREAT PAINS TO TALK ABOUT. I THINK THOSE WHO ARE ENROLLED IN THE MEDICARE ADVANTAGE SYSTEM BELIEVE SINCE THEY RECEIVED THOSE BENEFITS THAT THEY ARE GUARANTEED BENEFITS AS WELL. AND I'D ASK MY -- WE HAVE OUR TWO PHYSICIANS HERE ON THE FLOOR WHO BOTH HAD THE OPPORTUNITY OF DEALING DIRECTLY WITH THE MEDICARE ADVANTAGE PROGRAM. IF YOU HAVE A PATIENT COME IN, YOU SAY, BY THE WAY, YOU'RE HAVING YOUR MEDICARE ADVANTAGE PROGRAM CUT, BUT DON'T WORRY. WE ARE PROTECTING YOUR GUARANTEED MEDICARE BENEFITS, YOU THINK THEY UNDERSTAND THAT LANGUAGE?

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  • 11:25:49 AM

    MR. COBURN

    I'D RESPOND TO THE SENATOR FROM ARIZONA WITH THE FOLLOWING: FIRST OF ALL,…

    I'D RESPOND TO THE SENATOR FROM ARIZONA WITH THE FOLLOWING: FIRST OF ALL, THEY WON'T UNDERSTAND THAT LANGUAGE. IF YOU LOOK AT THE LAW THERE'S MEDICARE-A, MEDICARE-B, MEDICARE-C, MEDICARE-D. THEY'RE ALL A LAW. WHAT IS GUARANTEED UNDER THE LAW IS THAT IF YOU WANT MEDICARE ADVANTAGE, SRUBG IT. WHAT'S GOING TO CHANGE IS WE'RE GOING TO TAKE AWAY THAT GUARANTEE. WE'RE GOING TO MODIFY MEDICARE PART-C, WHICH IS MEDICARE ADVANTAGE. SO WE HAVE THIS CONFUSING STATE TO SAY WE'RE NOT TAKING AWAY ANY OF YOUR GUARANTEED BENEFITS, BUT MEDICARE ADVANTAGE IS GUARANTEED TO ANYBODY WHO WANTS TO SIGN UP FOR IT. IT IS DUPLICITOUS TO SAY WE'RE NOT CUTTING YOUR BENEFITS WHEN IN FACT WE ARE. I'LL YIELD TO MY COLLEAGUE, AN ORTHOPEDIC SURGEON FROM WYOMING. WHAT IS GOOD ABOUT MEDICARE ADVANTAGE? WE HEAR IT'S A MONEY POT TO PAY FOR A NEW PROGRAM FOR OTHER PEOPLE. HERE'S WHAT'S GOOD ABOUT IT: AS WE GET COORDINATED CARE FOR POOR MEDICARE FOLKS, MEDICARE ADVANTAGE COORDINATES THE CARE. AND WHEN YOU COORDINATE CARE, WHAT YOU DO IS YOU DECREASE THE NUMBER OF TESTS. YOU PREVENT HOSPITALIZATIONS. YOU GET BETTER OUTCOMES. AND CONSEQUENTLY, YOU HAVE HEALTHIER SENIORS. SO WHEN IT'S REALLY LOOKED AT, MEDICARE ADVANTAGE DOESN'T COST MORE. IT ACTUALLY SAVES MEDICARE MONEY ON AN INDIVIDUAL BASIS BECAUSE IF YOU FOREGO THE INTEREST OF A HOSPITAL WHERE YOU REALLY START INCURRING COSTS, WHAT YOU'VE DONE IS SAVE THE MEDICARE TRUST FUND. BUT AOUFLS GIVEN BETTER -- YOU'VE ALSO GIVEN BETTER CARE. THE SECOND POINT IS MANY PEOPLE ON MEDICARE ADVANTAGE CANNOT AFFORD TO BUY A SUPPLEMENTAL POLICY. 94% OF THE PEOPLE IN THIS COUNTRY ON MEDICARE WHO ARE NOT MEDICARE ADVANTAGE ARE BUYING A SUPPLEMENTAL POLICY. WHY IS THAT? BECAUSE THE BASIC UNDERLYING BENEFIT PACKAGE OF MEDICARE IS NOT ADEQUATE. AND SO HERE WE HAVE THIS GROUP OF PEOPLE WHO GET BENEFITED BECAUSE THEY CHOSE A GUARANTEED BENEFIT OF MEDICARE PART-C. AND ALL OF US WE'RE SAYING TIME OUT, YOU DON'T GET THAT ANYMORE.

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  • 11:28:16 AM

    MR. McCAIN

    WHO ENROLL IN MEDICARE ADVANTAGE ARE LOW-INCOME PEOPLE AND A LOT OF THEM…

    WHO ENROLL IN MEDICARE ADVANTAGE ARE LOW-INCOME PEOPLE AND A LOT OF THEM ARE RURAL RESIDENTS?

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  • 11:28:23 AM

    MR. COBURN

    A LOT OF RURAL. I DON'T KNOW THE INCOME LEVELS. BUT I KNOW THERE IS A…

    A LOT OF RURAL. I DON'T KNOW THE INCOME LEVELS. BUT I KNOW THERE IS A PROPENSITY, YOU ACTUALLY GET A SAVINGS BECAUSE YOU DON'T HAVE A TO BUY A SUPPLEMENTAL POLICY IF YOU'RE ON MEDICARE ADVANTAGE.

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  • 11:28:38 AM

    MR. BARRASSO

    ON WITH MY COLLEAGUE FROM OKLAHOMA, THERE IS THE COORDINATED CARE. THAT IS…

    ON WITH MY COLLEAGUE FROM OKLAHOMA, THERE IS THE COORDINATED CARE. THAT IS ONE OF THE ADVANTAGES OF MEDICARE ADVANTAGE. THERE IS ALSO THE PREVENTIVE COMPONENT OF THIS. IF WE TALK ABOUT WAYS TO HELP PEOPLE KEEP THEIR HEALTH CARE COSTS DOWN, IT HAS TO DO WITH COORDINATING CARE AND PREVENTING ILLNESS. A SENATOR: WE JUST HEARD WE WANT TO PUT A NEW PREVENTIVE PACKAGE IN THE PROGRAM BY THE FRESHMEN ON THE OTHER SIDE. YET WE WANT TO TAKE THE PREVENTIVE CARE OUT OF THE PACKAGE. INTERESTING MIX, ISN'T IT?

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  • 11:29:09 AM

    MR. BARRASSO

    KEEP OUR SENIORS HEALTHY. THAT IS ONE WAY THEY CAN STAY OUT OF THE…

    KEEP OUR SENIORS HEALTHY. THAT IS ONE WAY THEY CAN STAY OUT OF THE HOSPITAL, OUT OF THE NURSING HOME. STAY ACTIVE. YET THIS CUTS MEDICARE ADVANTAGE. THE DEMOCRATS HAVE VOTED TO DO JUST THAT, CUT ALL THIS MONEY OUT OF THIS PROGRAM THAT SENIORS LIKE. 11 MILLION AMERICAN SENIORS WHO DEPEND UPON MEDICARE FOR THEIR HEALTH CARE CHOOSE THIS BECAUSE THERE IS AN ADVANTAGE TO THEM. AS MY COLLEAGUE FROM OKLAHOMA, THE OTHER PHYSICIAN IN THE SENATE, HAS TALKED AS I HAVE EXTENSIVELY ABOUT PATIENT-CENTERED HEALTH CARE. NOT INSURANCE-CENTERED, NOT GOVERNMENT-CENTERED. MEDICARE ADVANTAGE HELPS KEEP IT PATIENT-CENTERED. SO WHEN I SEE ABOUT THE DEALS THAT ARE BEING CUT BEHIND CLOSED DOORS, THEY'RE CUTTING OUT PEOPLE FROM ALL ACROSS THE COUNTRY, AND IT SEEMS AS IF THERE IS A SWEETHEART DEAL TO HELP THE SENIORS ON MEDICARE ADVANTAGE IN FLORIDA TO TRY TO ENCOURAGE ONE MEMBER OF THE SENATE TO VOTE A CERTAIN WAY. WHAT ABOUT THE SENIORS FROM THE REST OF THE COUNTRY, WHETHER IT'S TEXAS, OKLAHOMA, TENNESSEE, ARIZONA? A LOT OF SENIORS WHO HAVE GREAT CONCERNS. AND I WOULD HOPE THEY WOULD CALL UP AND SAY HEY, THIS IS WRONG. WE NEED TO KNOW WHAT'S GOING ON AND WHY IS IT THAT THERE'S A SWEETHEART DEAL FOR ONE SELECTED SENATOR AND ONE SELECTED STATE WHEN WE WANT TO HAVE THAT SAME ADVANTAGE? WHY ARE THE DEMOCRATS VOTING IT ELIMINATE TO CUT ALL OF THIS MEDICARE MONEY?

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  • 11:30:28 AM

    MR. CORNYN

    MY COLLEAGUES A QUESTION, MAYBE STARTING WITH THE SENATOR FROM ARIZONA, A…

    MY COLLEAGUES A QUESTION, MAYBE STARTING WITH THE SENATOR FROM ARIZONA, A RELATED ISSUE, WHICH IS, MEDICARE ADVANTAGE IS A PRIVATE-SECTOR ALTERNATIVE OR CHOICE TO MEDICARE, WHICH IS A GOVERNMENT-RUN PROGRAM. AND I'M DEDUCTING THROUGHOUT ALL OF THIS BILL SORT AFTER BIAS AGAINST THE PRIVATE SECTOR AND WANTING TO ELIMINATE CHOICES THAT AREN'T GOVERNMENT-RUN PLANS. AM I READING TOO MUCH INTO THIS, OR DO ANY OF MY COLLEAGUES SEE A DOLLAR PROPENSITY IN THIS BILL?

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  • 11:31:06 AM

    MR. ALEXANDER

    SAY TO THE SENATOR FROM TEXAS, I THINK HE'S EXACTLY RIGHT. THERE'S A LOT…

    SAY TO THE SENATOR FROM TEXAS, I THINK HE'S EXACTLY RIGHT. THERE'S A LOT OF VERY APPEALING TALK THAT WE HEAR FROM THE ADVOCATES OF THE SO-CALLED HEALTH REFORM BILL. BUT WHEN WE GET RIGHT DOWN TO IT AND WE EXAMINE IT CHOSELY, WE FIND BASICALLY A BIG INCREASE IN GOVERNMENT-RUN PROGRAMS, AND WHAT DOES THAT MEAN FOR LOW-INCOME AMERICANS AND WHAT DOES IT MEAN FOR SENIORS WHO DEPEND UPON OUR BIGGEST GOVERNMENT-RUN PROGRAMS, THAT'S MEDICARE AND MEDICAID? THE RISK THAT THEY MAY NOT HAVE ACCESS TO THE DOCTOR THEY WANT. THE SENATOR FROM WYOMING MENTIONED ON THE FLOOR OF THE ROAR DAY THAT THE MAYO CLINIC, WIDELY CITED BY THE PRESIDENT AND OTHERS ON THE OTHER SIDE, AS AN EXAMPLE OF CONTROLLING COSTS, IS BEGINNING TO SAY WE CAN'T TAKE PATIENTS FROM THE GOVERNMENT-RUN PROGRAMS, IN SOME CASES, BECAUSE -- BECAUSE WE'RE NOT REIMBURSED PROPERLY FOR THEM. SO WHAT'S GOING TO HAPPEN, YOU KNOW, BEHIND ALL OF THIS HAPPY TALK WE'RE HEARING ABOUT HEALTH CARE, IS THAT WE'RE GOING TO FIND MORE AND MORE LOW-INCOME PATIENTS DUMPED INTO A PROGRAM CALLED MEDICAID WHERE HALF THE DOCTORS WON'T SEE A NEW MEDICAID PATIENT -- IT'S LIKE GIVING SOMEONE A BUS TICKET TO A BUS LINE THAT RUNS HALF THE TIME -- AND MEDICARE IS GOING TO INCREASINGLY FIND ITSELF IN THE SAME SHAPE, JUST AS THE MAYO CLINIC AND PERHAPS OTHERS WILL SAY, WE CAN'T AFFORD TO SERVE PATIENTS FROM THE GOVERNMENT-RUN PROGRAM. SO I THINK -- I THINK THE SENATOR FROM TEXAS IS EXACTLY RIGHT. WE DON'T HAVE TO -- WE DON'T HAVE TO PERSUADE THE 11 MILLION AMERICANS WHO'VE CHOSEN MEDICARE ADVANTAGE. IT IS A GOOD PROGRAM. THEY LIKE IT. IN RURAL AREAS BETWEEN 2003 AND 2007 MORE THAN 600,000 PEOPLE SIGNED UP FOR IT. THEY -- THEY LIKE TMENT AND I THINK, IN A WAY, THE SENATOR FROM FLORIDA MAY HAVE A SWEETHEART DEAL, BUT IN A WAY HE'S DONE US A FAVOR, BECAUSE WE'VE BEEN TRYING TO SAY ALL WEEK THAT THE DEMOCRATS ARE CUTTING MEDICARE. THEY'RE SAYING, TRUST US. WE'R NOT CUTTING MEDICARE. THE SENATOR FROM FLORIDA IS SAYING, FLORIDIANS DON'T TRUST YOU. YOU'RE CUTTING THEIR MEDICARE ADVANTAGE, AND I WANT TO HAVE AN AMENDMENT TO PROTECT THEM. AND SENATOR McCAIN IS SAYING, LET'S PROTECT ALL SENIORS' MEDICARE ADVANTAGE.

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  • 11:33:24 AM

    MR. McCAIN

    POINT OUT TO MY COLLEAGUES AND FOR THE RECORD, AGAIN, ON SEPTEMBER 20,…

    POINT OUT TO MY COLLEAGUES AND FOR THE RECORD, AGAIN, ON SEPTEMBER 20, 2003, THERE WAS A LETTER TO THE CONFEREES IN MEDICARE URGING THEM TO INCLUDE A MEANINGFUL INCREASE IN MEDICARE ADVANTAGE FUNDING FOR FISCAL YEARS 2004, 2005, A GROUP OF 18 SENATORS, INCLUDING SENATORS SCHUMER, LAUTENBERG, CLINTON, WYDEN, ET CETERA, INCLUDING SENATOR KERRY, WHO NOW OBVIOUSLY WANTS TO REDUCE THE FUNDING FOR MEDICARE ADVANTAGE, AGAIN PERHAPS HE WAS FOR IT BEFORE HE WAS AGAINST IT. BUT, AGAIN, I WOULD ALSO LIKE TOO POINT OUT AS SHORT -- I WOULD ALSO LIKE TO POINT OUT AS SHORT A TIME AGO AS SEPTEMBER 2009, A GROUP OF SENATORS INCLUDING WYDEN, MURRAY, SPECTER, BENNET, KLOBUCHAR, OTHERS WROTE TO MR. CHARLES FRIZERA, ACTING ADMINISTRATIVE FOR THE CENTERS FOR MED CAINDERS MEDICAID SERVICES, "WE WRITE TO EXPRESS OUR CONCERNS REGARDING THE PROPOSED CHANGES TO MEDICARE ADVANTAGE RATES FOR CALENDAR YEAR 2010. THE ADVANCE NOTICE HAS RAISED TWO IMPORTANT ISSUES THAT IF IMPLEMENTED WOULD RESULT IN HIGHLY PROBLEMATIC PREMIUM INCREASES AND BENEFIT REDUCTIONS FOR MEDICARE ADVANTAGE ENROLLEES ACROSS THE COUNTRY." SO, AGAIN, AS SHORT A TIME AGO AS LAST APRIL THERE WAS CONCERN ON THE OTHER SIDE ABOUT CUTS IN MEDICARE ADVANTAGE PROGRAM.

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  • 11:35:03 AM

    MR. ALEXANDER

    I WONDER IF THE SENATOR IS AWARE, IN ALABAMA THERE'S 181,000 PEOPLE WHO…

    I WONDER IF THE SENATOR IS AWARE, IN ALABAMA THERE'S 181,000 PEOPLE WHO ARE GOING TO GET THE CUT. IN CALIFORNIA, 1,106,000 PEOPLE, SENIORS, ARE GOING TO HAVE THEIR BENEFITS CUT.

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  • 11:35:21 AM

    MR. COBURN

    WITHOUT OBJECTION.

  • 11:36:22 AM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: WITHOUT OBJECTION.

  • 11:36:24 AM

    MR. McCAIN

    OF ALL OF THIS THAT THE SENATOR FROM FLORIDA, A MEMBER OF THE FINANCE…

    OF ALL OF THIS THAT THE SENATOR FROM FLORIDA, A MEMBER OF THE FINANCE COMMITTEE, FELT SO STRONGLY THAT MEDICARE ADVANTAGE WAS AT RISK THAT HE DECIDED TO CARVE OUT -- WAS ABLE TO GET A MAJORITY ON A PARTY-LINE VOTE OF THE FINANCE COMMITTEE TO CARVE OUT A SPECIAL STATUS FOR A GROUP OF SENIORS UNDER MEDICARE ADVANTAGE IN HIS STATE. THIS AMENDMENT SIMPLY SAYS THAT EVERYONE THAT THE SENATOR FROM OKLAHOMA JUST MADE REFERENCE TO HAS THAT SAME PROTECTION. THAT'S ALL THAT THIS AMENDMENT IS ABOUT.

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  • 11:37:05 AM

    MR. CORNYN

    IF THE SENATOR WOULD YIELD FOR A QUESTION, IF THIS AMENDMENT DOES NOT…

    IF THE SENATOR WOULD YIELD FOR A QUESTION, IF THIS AMENDMENT DOES NOT PASS, WHICH PROTECTS ALL MEDICARE ADVANTAGE BENEFICIARIES, ALL 11 MILLION OF THEM, 532,000 IN MY STATE, AND AS A RESULT OF NOT ONLY THESE CUTS BUT PERHAPS ADDITIONAL CUTS TO COME IN THE FUTURE TO MEDICARE ADVANTAGE, WHICH MAKES IT HARDER AND HARDER TO -- FOR MEDICARE BENEFICIARIES TO GET COVERAGE, I WOULD ASK OUR COLLEAGUES, PARTICULARLY OUR DOCTOR COLLEAGUES, WHAT'S -- WHAT'S THE IMPACT ON ELIMINATING MEDICARE ADVANTAGE AND LEAVING PEOPLE WITH MEDICARE FEE-FOR-SERVICE, WHICH IS THE, AS I RECALL, THE BENNET AMENDMENT EARLIER, WHICH IS YOU HAVE TO PARSE THE LANGUAGE CLOSELY. THEY TALK ABOUT GUARANTEED BENEFITS. BUT I THINK THE SENATOR FROM OKLAHOMA MAKES A GOOD POINT. RIGHT NOW MEDICAID -- MEDICARE, MEDICARE ADVANTAGE ARE GUARANTEED BENEFITS. BUT WHAT'S THE CONSEQUENCE OF BEING FORCED ONLY ON A MEDICARE FEE-FOR-SERVICE PROGRAM?

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  • 11:38:10 AM

    MR. COBURN

    PREVALENCE SCREENING, NO COORDINATED CARE, LOSS OF ACCESS TO CERTAIN…

    PREVALENCE SCREENING, NO COORDINATED CARE, LOSS OF ACCESS TO CERTAIN DRUGS, ACCESSORY THINGS LIKE VISION AND HEARING SUPPLEMENTALS, BUT MORE IMPORTANTLY, WHAT'S GOING TO BE IS POORER HEALTH OUTCOMES SMS THAT'S WHAT IT'S GOING TO BE. OR A MUCH SMALLER CHECKBOOK. ONE OR THE OTHER. A SMALLER CHECKBOOK, BECAUSE NOW THE GOVERNMENT ISN'T GOING TO PAY FOR IT, YOU ARE; OR POORER HEALTH OUTCOME. IF YOUR CHECKBOOK IS LIMITED, THE THING THAT'S GOING TO HAPPEN IS YOU'RE GOING TO GET THE POORER HEALTH OUTCOME.

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  • 11:38:48 AM

    MR. BARRASSO

    THE SENATOR FROM ARIZONA STARTED TALKING ABOUT THE CLOSED-DOOR MEETINGS,…

    THE SENATOR FROM ARIZONA STARTED TALKING ABOUT THE CLOSED-DOOR MEETINGS, SECRETLY TRYING TO COME UP WITH THINGS. THERE WAS AN ARTICLE IN THE PAPER TODAY THAT THE DEMOCRATS ARE TURNING TO ACTUALLY THROW MORE PEOPLE ON THE MEDICARE ROLLS AND MEDICAID ROLLS AS THEY'RE TRYING TO COME UP WITH SOME COMPROMISE. THE IDEA BEING IT'S GOING TO BE COMPROMISING THE CARE OF THE PEOPLE OF AMERICA. THEY'RE TRYING TO PUT MORE PEOPLE ONTO MEDICAID ROLLS. AND THE SENATOR FROM TENNESSEE HAS SAID, YOU KNOW, IT'S -- MANY IFPHYSICIANS DON'T TAKE THOSE PATIENTS BECAUSE THE REIMBURSEMENT IS SO POOR, AND IT'S PUTTING MORE PEOPLE INTO A BOAT THAT'S ALREADY SINKING. SO THEY WANT TO PUT MORE PEOPLE ON MEDICAID AND MORE ON MEDICARE. BUT AT THE SAME TIME, THEY'RE CUTTING MEDICARE BY $464 BILLION. THIS IS A PROGRAM THAT WE KNOW IS ALREADY GOING BROKE AND YET THEY WANT TO NOW PUT PEOPLE AGED 55 TO 64, ADD THOSE TO THE MEDICARE ROLLS, WHICH IS A PROGRAM OF I HAVE GREAT CONCERNS B SO SPECIAL DEALS FOR SOME, CUTTING OUT MANY OTHERS AND NOW ADDING MORE PEOPLE TO THE MEDICARE ROLLS-TO-. TO ME, THIS IS NOT SUSTAINABLE. YET THESE ARE THE DEALS THAT ARE BEING CUT LESS THAN 100 FEET FROM HERE, OFF OFF OF THE FLOOR OF THE SENATE WHILE WE'RE OUT HERE DEBATING FOR ALL OF THE AMERICAN PEOPLE TO SEE THE THINGS THAT WE THINK ARE IMPORTANT ABOUT HEALTH CARE. JOBS ARE GOING TO BE LOST IN OUR ECONOMY AS A RESULT IF THIS BILL GETS PASSED. PEOPLE THAT HAVE INSURANCE, THEY'RE GOING TO END UP PAYING MORE IN PREMIUMS IN THIS BILL IS BEING PASSED. AND PEOPLE WHO DEPEND ON MEDICARE FOR THEIR HEALTH, WHETHER IT IS MEDICARE ADVANTAGE OR REGULAR MEDICARE ARE GOING TO SEE THEIR HEALTH CARE DETERIORATE AS A RESULT OF THIS PROPOSAL. BUT I TURN TO THE SENATOR FROM ARIZONA, WHO'S BEEN A SPECIAL STUDENT OF THIS.

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  • 11:40:38 AM

    MR. McCAIN

    BY LOSING MEDICARE ADVANTAGE, WOULD THEN LOSE CERTAIN PROVISIONS THAT…

    BY LOSING MEDICARE ADVANTAGE, WOULD THEN LOSE CERTAIN PROVISIONS THAT MEDICARE ADVANTAGE PROVIDES THEM AND THEN THEY WOULD BE FORCED, IF THEY CAN AFFORD IT, TO -- WHICH THEY'RE NOW PAYING ZERO BECAUSE IT'S UNDER MEDICARE ADVANTAGE, THEN THEY WOULD HAVE TO BUY MEDIGAP POLICIES, RIGHT, MEDIGAP POLICIES THAT WOULD MAKE UP FOR THE BENEFITS THEY LOST WHEN THEY LOST MEDICARE ADVANTAGE. AND GUESS WHO OFFERS THOSE MEDIGAP INSURANCE POLICIES? OUR FRIENDS AT AARP, WHICH AVERAGE $175 A MONTH. SO WE'RE TELLING PEOPLE, WHO ARE IN MEDICARE ADVANTAGE TODAY, WHEN THEY LOSE IT, THEY WILL BE -- CAN BE GUARANTEED IF THEY WANT TO MAKE UP FOR THOSE BENEFITS THEY'RE LOSING, THEY WOULD BE PAYING $175 A MONTH, MINIMUM, FOR A MEDIGAP POLICY,. A LOT OF AMERICAN SENIORS CANNOT AFFORD THAT. AND THAT'S JUST A FACT. $2,000 A YEAR. THEY CAN'T AFFORD IT.

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  • 11:41:41 AM

    MR. COBURN

    THERE'S 35 MINUTES MINUTES REMAINING.

  • 11:42:25 AM

    THE PRESIDING OFFICER

    THERE'S 35 MINUTES MINUTES REMAINING.

  • 11:42:29 AM

    MR. McCAIN

    OTHER WORDS, FIVE MINUTES FOR THIS --

  • 11:42:31 AM

    THE PRESIDING OFFICER

    DR. BARRASSO, HAVE YOU TREATED PEOPLE UNDER MEDICARE ADVANTAGE?

  • 11:42:35 AM

    MR. McCAIN

    DR. BARRASSO, HAVE YOU TREATED PEOPLE UNDER MEDICARE ADVANTAGE?

  • 11:42:38 AM

    MR. BARRASSO

    I HAVE. THE PEOPLE OF WYOMING KNOW THERE'S AN ADVANTAGE TO BEING IN THIS…

    I HAVE. THE PEOPLE OF WYOMING KNOW THERE'S AN ADVANTAGE TO BEING IN THIS PROGRAM. THAT'S WHY THEY SIGN UP. THAT'S WHY CITIZENS ALL AROUND THE COUNTRY HAVE SIGNED UP FOR MEDICARE ADVANTAGE BECAUSE THEY REALIZE THERE'S VALUE IN PREVENTION. AND THERE'S VALUE IN COORDINATED CAVERCARE. THERE IS VALUE IN HAVING EYE CARE, DENTAL CARE, HEARING CARE. THERE IS -- THERE ARE ADVANTAGES TO WANT TO STAY HEALTHY, TO KEEP DOWN THE COST OF THEIR CARE.

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  • 11:43:07 AM

    MR. McCAIN

    MAY COST MORE, THE FACT THAT YOU HAVE A WELLER AND FITTER GROUP OF SENIOR…

    MAY COST MORE, THE FACT THAT YOU HAVE A WELLER AND FITTER GROUP OF SENIOR CITIZENS, YOU IN THE LONG RUN REDUCE HEALTH CARE COSTS BECAUSE THEY TAKE ADVANTAGE OF THE KIND OF CARE THAT OVER TIME WOULD KEEP THEM FROM GOING INTO THE HOSPITAL EARLIER OR HAVING TO SEE A DOCTOR MORE OFTEN.

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  • 11:43:29 AM

    MR. BARRASSO

    ONE OF THE REASONS THAT MEDICARE ADVANTAGE WAS BROUGHT FORTH. I KNOW A LOT…

    ONE OF THE REASONS THAT MEDICARE ADVANTAGE WAS BROUGHT FORTH. I KNOW A LOT OF SENATORS FROM RURAL STATES SUPPORTED IT BECAUSE IT WOULD ALLOW PEOPLE FROM SMALL COMMUNITIES TO BE IN A PROGRAM LIKE THAT. IT WOULD ENCOURAGE DOCTORS TO GO INTO THOSE COMMUNITIES TO KEEP THOSE PEOPLE WELL. THE 11 MILLION PEOPLE WHO ARE ON MEDICARE ADVANTAGE IN THIS COUNTRY, THEY KNOW THEY'RE ON COMPLAIR ADVANTAGE. THEY HAVE CHOSEN IT. IT IS THE FAST HE HAVE-GROWING COMPONENT BECAUSE PEOPLE REALIZE THE ADVANTAGES OF BEING ON MEDICARE ADVANTAGE. IF THEY WANT TO STAY INDEPENDENT, THEY WANT TO STAY HEALTHY, THEY WANT TO STAY FIT, THEN SIGN YOU FOR MEDICARE ADVANTAGE. I WOULD THINK PEOPLE ALL ACRUELS THE COUNTRY WHO ARE LISTENING TO THIS DEBATE WHO ARE SORNS MEDICARE BUT ARE NOT ON MEDICARE ADVANTAGE WOULD WANT TO SAY, HEY, WHY DIDN'T I KNOW ABOUT THIS PROGRAM? SENIORS TALK ABOUT THIS AT SENIOR CENTERS AND I GO TO SENIOR CENTERS AND HAVE TOWN MEETINGS THERE AND SHIFT WITH FOLKS, HEAR THEIR CONCERNS. THEY'RE CONVERTING OVER AND JOINING, SIGNING UP FOR MEDICARE ADVANTAGE BECAUSE THEY KNOW THERE ARE ADVANTAGES TO IT. AND NOW FOR THIS SENATE AND THE DEMOCRATS TO SAY, NO, I WANT TO SLASH OVER $1 BILLION FROM MEDICARE ADVANTAGE, I THINK THE PEOPLE OF AMERICA UNDERSTAND THAT THIS IS AT A GREAT LOSS TO THEM AND AT PERIL TO THEIR OWN HEALTH AS THEY LOSE THE COORDINATED CARE AND THE PREVENTIVE NATURE OF THE CARE. CANING CANED A ASK THE SENATOR FROM TENNESSEE, DO YOU --

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  • 11:44:47 AM

    MR. McCAIN

    I'D ASK THE SENATOR FROM TENNESSEE, DO YOU KNOW OF ANY ECONOMIST, ANY…

    I'D ASK THE SENATOR FROM TENNESSEE, DO YOU KNOW OF ANY ECONOMIST, ANY EXPERT ON HEALTH CARE THAT BELIEVES THAT YOU CAN MAKE THESE KINDS OF CUTS IN MEDICARE ADVANTAGE AND STILL PRESERVE THE SAME BENEFITS THAT THE ENROLLEES HAVE TODAY?

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  • 11:45:00 AM

    MR. ALEXANDER

    THE ANSWER TO THE SENATOR FROMS FROM ARIZONA IS NO. I KNOW OF ONE SENATOR…

    THE ANSWER TO THE SENATOR FROMS FROM ARIZONA IS NO. I KNOW OF ONE SENATOR AT LEAST WHO DOES NOT BELIEVE IT AND HE IS THE SENATOR FROM FLORIDA. AND ITS U.A.E. IT'S INTERESTING THAT ALL WEEK WE'VE BEEN GOING BACK AND FORTH. WE'VE BEEN SAY, YOU'RE CUTTING MEDICARE BENEFITS. THEY'VE BEEN SAYING US TO, OH, NO WE'RE NOT. THE PEOPLE AT HOME MUST SAY, WHO'S RIGHT ABOUT THIS WELL, THE SENATOR FROM FLORIDA WHO SITS OVER THERE HAS SAID, I'M NOT WILLING TO GO BACK TO FLORIDA AND SAY TO THE PEOPLE OF FLORIDA THAT YOUR BENEFITS AREN'T GOING TO BE CUT IF YOU'RE ON MEDICARE ADVANTAGE, SO I WANT AN AMENDMENT TO PROTECT YOU. AND SO DOES THE SENATOR FROM TEXAS, AND SO DO THE SENATOR FROM OKLAHOMA, THE SENATOR FROM LOUISIANA, AND FROM TENNESSEE. AND SO THE SENATOR FROM ARIZONA IS SAYING WE BELIEVE YOU'RE CUTTING MEDICARE ADVANTAGE BENEFITS FOR 11 MILLION AMERICANS. THE SENATOR FROM FLORIDA DOESN'T TRUST YOUR BILL. WE DON'T EITHER. WE WANT AN AMENDMENT THAT PROTECTS 11 MILLION SENIORS.

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  • 11:46:10 AM

    MR. CORNYN

    LIKE ALL OF THE DISCUSSION ABOUT HEALTH CARE REFORM IS A BIT ABOUT…

    LIKE ALL OF THE DISCUSSION ABOUT HEALTH CARE REFORM IS A BIT ABOUT ACCOUNTABLE CARE ORGANIZATIONS COORDINATING CARE PARTICULARLY IN THE LATTER PART OF LIFE, AVOIDING CHRONIC DISEASES AND THE LIKE. WHEN I WAS AT KELSEY SEBOLD CLINIC, THEY TOLD ME IT IS MEDICARE ADVANTAGE WHICH ALLOWS THEM TO BE ABLE TO COORDINATE CARE TO HOLD DOWN COSTS TO KEEP PEOPLE HEALTHIER LONGER. YET, THE IRONY TO ME, IT SEEMS THAT BY CUTTING MEDICARE ADVANTAGE BENEFITS IS WE ARE GOING BACKWARD RATHER THAN FORWARD WHEN IT COMES TO THAT KIND OF COORDINATED LESS EXPENSIVE CARE. WOULD YOU CONCUR WITH THAT?

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  • 11:46:50 AM

    MR. BARRASSO

    I WOULD CONCUR THIS IS TAKING A STEP BACKWARD. THAT IS WHY THE SENATOR…

    I WOULD CONCUR THIS IS TAKING A STEP BACKWARD. THAT IS WHY THE SENATOR FROM FLORIDA DEMANDED THEY MAKE ACCOMMODATIONS FOR PEOPLE OF FLORIDA. THE PEOPLE OF AMERICA, 11 MILLION AMERICANS WHO HAVE CHOSEN THE MEDICARE ADVANTAGE PROGRAM BECAUSE IT DOES HELP COORDINATED CARE, IT GOES WITH PREVENTIVE CARE, IT KEEPS IT MORE PATIENT-CENTERED AS OPPOSED TO GOVERNMENT-CENTERED, THAT IS THE WAY FOR PEOPLE TO STAY HEALTHY, LIVE LONGER LIVES. WE'VE SEEN CUTS ACROSS THE BOARD ON HOME HEALTH CARE, WHETHER IT'S HOSPICE CARE, THEY'RE ACROSS, THEY'RE CUTTING. THE SENIORS ACROSS THE COUNTRY DO NOT DESERVE. THEY PAID INTO THE PROGRAM FOR MANY YEARS AND DESERVE THEIR BENEFITS.

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  • 11:47:36 AM

    MR. ALEXANDER

    ONE OTHER THING, WE'VE TALKED A LOT ABOUT OUR GOOD FRIEND, THE SENATOR…

    ONE OTHER THING, WE'VE TALKED A LOT ABOUT OUR GOOD FRIEND, THE SENATOR FROM FLORIDA. NOW HE'S BEEN SO PERCEPTIVE ON NOTICING THAT HIS FLORIDIANS WITH MEDICARE ADVANTAGE MAY LOSE THEIR MEDICARE BENEFITS. I HOPE HE'S AS PERCEPTIVE --

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  • 11:47:51 AM

    THE PRESIDING OFFICER

    THE SENATOR'S TIME HAS EXPIRED.

  • 11:47:56 AM

    MR. McCAIN

    AN ADDITIONAL 30 SECONDS.

  • 11:47:58 AM

    MR. ALEXANDER

    I BELIEVE THERE ARE OUR MEDICARE BENEFITS LIKELY TO BE CUT. AREN'T THERE…

    I BELIEVE THERE ARE OUR MEDICARE BENEFITS LIKELY TO BE CUT. AREN'T THERE CUTS TO HOSPICES? AREN'T THERE CUTS TO HOSPITALS? AREN'T THERE CUTS TO HOME HEALTH CARE THAT WE TALKED ABOUT YESTERDAY? IF FLORIDIANS DON'T TRUST THE DEMOCRATIC BILL, WHY SHOULD THEY TRUST THE DEMOCRATIC BILL TO TRUST ANY OF THEIR MEDICARE BENEFITS?

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  • 11:48:23 AM

    MR. McCAIN

    MADAM PRESIDENT?

  • 11:48:52 AM

    MRS. HUTCHISON

    MADAM PRESIDENT?

  • 11:48:54 AM

    MRS. HUTCHISON

    MADAM PRESIDENT, I RISE TODAY TO TALK ABOUT ANOTHER AMENDMENT THAT IS…

    MADAM PRESIDENT, I RISE TODAY TO TALK ABOUT ANOTHER AMENDMENT THAT IS PENDING, THE NELSON-HATCH-CASEY AMENDMENT. AND THIS IS THE AMENDMENT THAT I THINK HAS BEEN DISCUSSED IN THE LAST DAY AS WELL THAT IS THE AMENDMENT THAT WOULD ASSURE THAT NO FEDERAL FUNDS ARE SPENT FOR ABORTION. THAT WAS UNCLEAR. IT IS UNCLEAR IN THE UNDERLYING BILL. AND I THINK IT IS VERY IMPORTANT THAT WE TALK ABOUT IT, THAT WE MAKE SURE THAT IT IS VERY CLEAR EXACTLY WHAT THE NELSON-HATCH-CASEY AMENDMENT DOES. AND THAT IS IT WOULD BAR FEDERAL FUNDING FOR ABORTION, WHICH IS BASICALLY APPLYING THE HYDE AMENDMENT TO THE PROGRAMS UNDER THIS HEALTH CARE BILL. SINCE THE HYDE AMENDMENT WAS FIRST PASSED IN 1977, THE SENATE HAS HAD TO VOTE ON THIS ISSUE MANY, MANY TIMES, PROBABLY JUST ABOUT EVERY YEAR. AND I HAVE CONSISTENTLY VOTED TO PROHIBIT FEDERAL FUNDING FOR ABORTIONS, AS I KNOW MY COLLEAGUE AND FRIEND FROM UTAH HAS DONE, AS WELL AS THE DEMOCRATIC SPONSORS OF THIS AMENDMENT. AND YET, IT SEEMS THAT SOME MEMBERS WERE ON THE FLOOR LAST NIGHT MISCONSTRUING EXACTLY WHAT THE HATCH-CASEY-NELSON AMENDMENT DOES. SPECIFICALLY, THEIR CLAIM WAS THAT THE HYDE LANGUAGE ONLY BARS DIRECT FUNDING FOR ELECTIVE ABORTIONS WHILE THE NELSON-HATCH-CASEY PACKAGE IS UNPRECEDENTED. SO I WOULD JUST LIKE TO ASK THE DISTINGUISHED SENATOR FROM UTAH WHAT EXACTLY DID THE HATCH -- DID THE HYDE LANGUAGE SAY? LET'S CLARIFY WHAT HYDE WAS SO WE CAN THEN DETERMINE IF YOUR AMENDMENT IS THE SAME.

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  • 11:50:48 AM

    MR. HATCH

    MUCH. THE CURRENT HYDE LANGUAGE CONTAINED IN FISCAL YEAR 2009 LABOR-H.H.S.…

    MUCH. THE CURRENT HYDE LANGUAGE CONTAINED IN FISCAL YEAR 2009 LABOR-H.H.S. APPROPRIATIONS ACT SAYS THE FOLLOWING: SECTION 507-A. NONE OF THE FUNDS APPROPRIATED IN THIS ACT AND NONE OF THE FUNDS IN ANY TRUST FUND TO WHICH FUNDS ARE APPROPRIATED IN THIS ACT SHALL BE EXPENDED FOR ANY ABORTION. B, NONE OF THE FUNDS APPROPRIATED IN THIS ACT AND NONE OF THE FUNDS IN ANY TRUST FUND TO WHICH FUNDS ARE APPROPRIATED IN THIS ACT SHALL BE EXPENDED FOR HEALTH BENEFITS COVERAGE THAT INCLUDES COVERAGE OF ABORTION.

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  • 11:51:25 AM

    MRS. HUTCHISON

    SO THAT IS FEDERAL FUNDS PROHIBITED FROM BEING USED IN ABORTIONS FOR THAT…

    SO THAT IS FEDERAL FUNDS PROHIBITED FROM BEING USED IN ABORTIONS FOR THAT PARTICULAR PWEUFPLT WHAT ABOUT PROGRAMS LIKE CHIP? THAT WAS CREATED IN THE BALANCED BUDGET ACT, AND IN 2009 WAS REAUTHORIZED BY CONGRESS AND SIGNED BY THE PRESIDENT EARLIER THIS YEAR. SO WHAT ABOUT THE CHIP PROGRAM?

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  • 11:51:43 AM

    MR. HATCH

    LITTLE BIT ABOUT KHEUFP. IT WAS THE HATCH -- ABOUT CHIP. IT WAS THE…

    LITTLE BIT ABOUT KHEUFP. IT WAS THE HATCH -- ABOUT CHIP. IT WAS THE HATCH-KENNEDY BILL. I INSISTED THAT THE FOLLOWING LANGUAGE BE INCLUDED IN THE LIMITED STATUTE. IN GENERAL, PAYMENTS SHALL NOT BE MADE TO A STATE UNDER THIS SECTION FOR ANY AMOUNT EXPENDED UNDER THE STATE PLAN TO PAY FOR ANY ABORTION OR TO ASSIST IN THE PURCHASE IN WHOLE OR IN PART OF HEALTH BENEFIT COVERAGE THAT INCLUDES COVERAGE OF ABORTION. B, EXCEPTION: SUBPARAGRAPH A SHALL NOT APPLY TO AN ABORTION ONLY IF NECESSARY TO SAVE THE LIFE OF THE MOTHER OR IF THE PREGNANCY IS THE RESULT OF AN ACT OF RAPE OR INSIST. THAT IS WHAT THE CHIP BILL SAID, AND THAT WAS THE HATCH-KENNEDY BILL.

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  • 11:52:26 AM

    MRS. HUTCHISON

    I ASSUME YOU DO KNOW WHAT IS IN THAT BILL. WHAT ABOUT THE FEDERAL…

    I ASSUME YOU DO KNOW WHAT IS IN THAT BILL. WHAT ABOUT THE FEDERAL EMPLOYEES HEALTH BENEFIT PLAN? WHAT DOES IT SAY?

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  • 11:52:33 AM

    MRS. HUTCHISON

    ISN'T THAT THE SAME AS THE LANGUAGE OF THE NELSON-HATCH-CASEY AMENDMENT?

  • 11:53:20 AM

    MRS. HUTCHISON

    ISN'T THAT THE SAME AS THE LANGUAGE OF THE NELSON-HATCH-CASEY AMENDMENT?

  • 11:53:30 AM

    MR. HATCH

    RIGHT. LET ME READ THAT LANGUAGE FOR YOU. IN GENERAL, NO FUNDS AUTHORIZED…

    RIGHT. LET ME READ THAT LANGUAGE FOR YOU. IN GENERAL, NO FUNDS AUTHORIZED OR APPROPRIATED BY THIS ACT OR AN AMENDMENT MADE BY THIS ACT MAY BE USED TO PAY FOR ANY ABORTION OR TO COVER ANY PART OF THE COST OF ANY HEALTH PLAN THAT INCLUDES COVERAGE OF ABORTION.

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  • 11:53:47 AM

    MRS. HUTCHISON

    BASED ON WHAT YOU'VE SAID, THIS IS NOT NEW FEDERAL ABORTION POLICY? THE…

    BASED ON WHAT YOU'VE SAID, THIS IS NOT NEW FEDERAL ABORTION POLICY? THE HYDE AMENDMENT CURRENTLY APPLIES TO THE PLANS DISCUSSED, INCLUDING THE PLANS THAT MEMBERS OF CONGRESS HAVE, AND THE ABORTION PROTECTIONS FOR ALL OF THE FEDERAL HEALTH PROGRAMS ALL SAY EXACTLY THE SAME THING AND THAT WE SHOULD -- THE AMENDMENT THAT WE ARE GOING TO VOTE ON, THAT IS THE NELSON-HATCH-CASEY AMENDMENT, WOULD PRESERVE THE THREE-DECADES LONG PRECEDENT. THAT'S WHAT YOUR AMENDMENT DOES. AND THAT WE MUST PASS IT IF WE ARE GOING TO GUARANTEE THAT THE BILL THAT IS ON THE FLOOR IS PROPERLY AMENDED SO THAT IT IS THE SAME AS OUR 30 YEARS OF ABORTION FEDERAL POLICY IN THIS COUNTRY?

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  • 11:54:42 AM

    MR. HATCH

    SO CRITICAL THAT WE PASS THE NELSON-HATCH-CASEY AMENDMENT IS THAT IT IS…

    SO CRITICAL THAT WE PASS THE NELSON-HATCH-CASEY AMENDMENT IS THAT IT IS THE ONLY WAY TO GUARANTEE THAT TAXPAYER DOLLARS ARE NOT USED BY THE INSURANCE PLANS UNDER THE DEMOCRATS' BILL TO PAY FOR ABORTIONS. IN OTHER WORDS, THE HYDE LANGUAGE IS IN THE APPROPRIATIONS PROCESS. WE HAVE TO DO IT EVERY YEAR RATHER THAN MAKING IT A SOLID AMENDMENT. BUT THIS BILL IS NOT SUBJECT TO APPROPRIATIONS. SO THIS BILL, IF WE LEAVE THE HYDE LANGUAGE OUT OF THIS BILL AND THE LANGUAGE THAT WE HAVE IN THE AMENDMENT, THE NELSON-HATCH-CASEY AMENDMENT, THEN WE WOULD BE OPENING UP A DOOR FOR PEOPLE WHO BELIEVE THAT ABORTION OUGHT TO BE PAID FOR BY THE FEDERAL GOVERNMENT TO DO SO. AND WE SHOULD CLOSE THAT DOOR BECAUSE THAT'S BEEN THE RULE SINCE 1977.

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  • 11:55:37 AM

    MRS. HUTCHISON

    I JUST THANK YOU FOR THE EXPLANATION. I THANK THE SENATOR FROM UTAH,…

    I JUST THANK YOU FOR THE EXPLANATION. I THANK THE SENATOR FROM UTAH, BECAUSE I DO THINK IT'S IMPORTANT THAT PEOPLE KNOW. THERE HAS BEEN A LOT OF QUESTION RAISED ABOUT THE BILL AND WHETHER IT WOULD BE A FOOT IN THE DOOR FOR A -- FOR CHANGING A POLICY THAT REALLY HAS BEEN THE LAW OF OUR COUNTRY AND ACCEPTED AS SUCH, WHETHER IT WAS A DEMOCRATICALLY CONTROLLED CONGRESS OR REPUBLICAN-CONTROLLED CONGRESS. I THINK EVERYONE HAS AGREED THAT THIS HYDE AMENDMENT LANGUAGE HAS PROTECTED FEDERAL TAXPAYERS WHO MIGHT HAVE A VERY FIRM CONVICTION AGAINST ABORTION WOULD NOT HAVE TO BE SUBSIDIZING THIS PROCEDURE.

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  • 11:56:22 AM

    MR. HATCH

    MADAM PRESIDENT, WOULD THE SENATOR FROM UTAH BE WILLING TO YIELD FOR A…

    MADAM PRESIDENT, WOULD THE SENATOR FROM UTAH BE WILLING TO YIELD FOR A QUESTION?

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  • 11:57:33 AM

    MR. SPECTER

    MADAM PRESIDENT, WOULD THE SENATOR FROM UTAH BE WILLING TO YIELD FOR A…

    MADAM PRESIDENT, WOULD THE SENATOR FROM UTAH BE WILLING TO YIELD FOR A QUESTION?

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  • 11:57:37 AM

    MR. HATCH

    SURE.

  • 11:57:39 AM

    MR. SPECTER

    MY QUESTION RELATES TO THE PROVISIONS OF THE PENDING BILL, SECTION…

    MY QUESTION RELATES TO THE PROVISIONS OF THE PENDING BILL, SECTION 1303-2-B WHICH SPECIFIES THAT THE PLAN WILL NOT ALLOW FOR ANY PAYMENTS OF ABORTION AND WHERE THERE IS AS PROVIDED OUT OF SECTION 1303-2-A, THERE WOULD BE A SEGREGATION OF FUNDS. SO THAT UNDER THE EXISTING STATUTE, THERE IS NO FEDERAL FUNDING USED FOR ABORTION. BUT AN INDIVIDUAL MAY BILE ADDITIONAL FUNDS -- MAY BUY ADDITIONAL FUNDS, A WOMAN HAVING THE RIGHT TO PAY FOR HER OWN ABORTION COVERAGE. AND WITH THE STATUS OF MEDICAID, WHERE THE PROHIBITION APPLIES TO ANYBODY, ANY FEDERAL FUNDS BEING USED TO PAY FOR AN ABORTION, THERE ARE 23 STATES WHICH ALLOW FOR PAYMENT FOR ABORTION COVERAGE COMING OUT OF STATE FUNDS. SO AREN'T THE PROVISIONS OF THIS STATUTE WHICH ENABLE THE WOMAN TO PAY FOR ABORTION ON HER OWN EXACTLY THE SAME AS WHAT IS NOW COVERED UNDER MEDICAID WITHOUT RUNNING AGAINST THE VIOLATION PROVISIONS OF THE HYDE AMENDMENT?

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  • 11:59:24 AM

    MR. HATCH

    THE WAY WE VIEW THE CURRENT LANGUAGE IN THE BILL IS THAT THERE'S A…

    THE WAY WE VIEW THE CURRENT LANGUAGE IN THE BILL IS THAT THERE'S A LOOPHOLE THERE WHEREBY THEY CAN EVEN USE FEDERAL FUNDS TO PROVIDE FOR ABORTION IN THIS, UNDER THIS SEGREGATION LANGUAGE. AND THAT'S WHAT WE'RE CONCERNED ABOUT. WANT TO CLOSE THAT LOOPHOLE AND MAKE SURE THE FEDERAL FUNDS ARE NOT USED FOR ABORTION. LIKE I SAY, THERE ARE MILLIONS OF PEOPLE WHO ARE PRO-CHOICE WHO AGREE WITH THE HYDE LANGUAGE. ALL WE'RE DOING IS PUTTING THE HYDE LANGUAGE INTO THIS BILL IN A WAY THAT WE THINK IT WILL WORK BETTER.

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  • 11:59:59 AM

    MR. SPECTER

    IF THE SENATOR -- A SENATOR: WOULD THE SENATOR YIELD FOR A COMMENT?

  • 12:00:10 PM

    MR. BROWNBACK

    TO QUOTE BART STUPAK WHO CARRIED THIS AMENDMENT, THE SAME SORT OF…

    TO QUOTE BART STUPAK WHO CARRIED THIS AMENDMENT, THE SAME SORT OF AMENDMENT YOU'RE PUTTING FORWARD ONLY ON THE HOUSE SIDE AND THE SAME SORT OF QUESTIONS NATURALLY WERE COMING UP, SAYING YOU'RE BLOCKING ABORTION FUNDING OF THE INDIVIDUAL. AND I'M QUOTE RON GOLDMAN FROM REPRESENTATIVE STUPAK, THE CAP AMENDMENT DEPARTED FROM HYDE IN SEVERAL IMPORTANT AND TROUBLING WAYS, BY MANDATING THAT AT LEAST ONE PLAN IN THE HEALTH INSURANCE EXCHANGE PROVIDE ABORTION COVERAGE. BY REQUIRING A MINUTE NUMBER $1 MONTHLY CHARGE FOR ALL COVERED INDIVIDUALS THAT WOULD GO TOWARD PAYING FOR ABORTIONS BY ALLOWING INDIVIDUALS RECEIVING FEDERAL AFFORDABILITY CREDITS, THOSE ARE FEDERAL DOLLARS, TO PURCHASE HEALTH INSURANCE PLANS THAT COVER ABORTION. IN ALL THOSE WAYS, THE CAP AMENDMENT, WHICH IS IN THE REID BILL, EXPANDS AND DOES FEDERAL FUNDING OF ABORTION THAT WE HAVEN'T DONE FOR 33 YEARS. GOING ON WITH STUPAK, HYDE CURRENTLY PROHIBITS DIRECT FEDERAL FUNDING OF ABORTION MUCH THE STUPAK AMENDMENT, WHICH IS ALSO THE NELSON-HATCH AMENDMENT, IS A CONTINUATION OF THIS POLICY OF THE HYDE AMENDMENT. NOTHING MORE. NOTHING LESS. AND I THINK IT'S IMPORTANT THAT WE CLARIFY THAT THIS IS A CONTINUATION OF WHAT WE'VE BEEN DOING FOR 33 YEARS THAT THE SENATOR FROM UTAH, THE SENATOR FROM NEBRASKA IS PUTTING FORWARD IN THIS AMENDMENT. AND I THANK MY COLLEAGUE FOR YIELDING FOR THAT.

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  • 12:01:35 PM

    MR. HATCH

    SURE.

  • 12:02:01 PM

    MR. HATCH

    SURE.

  • 12:02:03 PM

    MR. JOHANNS

    JUST HAVE A THOUGHT ON THIS LANGUAGE. THE NATIONAL RIGHT TO LIFE GROUP SAW…

    JUST HAVE A THOUGHT ON THIS LANGUAGE. THE NATIONAL RIGHT TO LIFE GROUP SAW THROUGH THAT LANGUAGE IMMEDIATELY. IT TOOK THEM ABOUT 20 SECONDS TO FIGURE OUT WHAT WAS HAPPENING HERE AND I THINK THEY REFERRED TO IT AS A BOOKKEEPING GIMMICK THAT THERE WOULD BE SEGREGATION IF THE FEDERAL MONEY WENT IN THE LEFT POCKET BUT YOU PAID FOR ABORTIONS OUT OF YOUR RIGHT POCKET. AND IT DOESN'T MAKE ANY SENSE. THAT SEGREGATION ISN'T GOING TO WORK. THEY SAW THROUGH IT. THEY SAW THE GIMMICK IT WAS. LET ME JUST SAY I SUPPORT YOUR AMENDMENT. I APPLAUD YOU AND SENATOR NELSON AND SENATOR CASEY FOR BRINGING THIS VERY IMPORTANT ISSUE FORWARD. I APPLAUD YOU FOR KEEPING THIS EFFORT THAT STARTED WITH THE HYDE AMENDMENT OR HYDE LANGUAGE, RATHER. BECAUSE WHAT WE'RE DOING HERE IS SAYING CLEARLY TO THE AMERICAN PEOPLE, WHETHER DIRECTLY OR INDIRECTLY, YOUR TAX DOLLARS ARE NOT GOING TO BE USED TO BUY ABORTIONS. AND THANK YOU FOR YOUR LEADERSHIP ON THIS ISSUE. I'M HAPPY TO BE HERE TO SUPPORT THAT. A SENATOR: WOULD THE SENATOR FROM UTAH RESPOND TO MY QUESTION?

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  • 12:03:17 PM

    MR. SPECTER

    YOU DISAGREE WITH THE PROVISIONS OF SECTION 1303, 2A, THE BILL WHICH IS…

    YOU DISAGREE WITH THE PROVISIONS OF SECTION 1303, 2A, THE BILL WHICH IS PENDING WHICH SPECIFIES THAT IF A QUALIFIED HEALTH PLAN PROVIDES FOR SERVICES FOR ABORTION -- THIS IS THE ESSENCE OF IT -- IF A QUALIFIED HEALTH PLAN QUALIFIES FOR SERVICES FOR ABORTION, THE ISSUE OF THE PLAN SHALL NOT USE ANY AMOUNT OF THE FEDERAL FUNDS FOR ABORTION. SO THERE IS A FLATOUT PROHIBITION FOR USE OF FEDERAL FUNDS. AND UNDER SECTION 1303, 2B, THERE IS A SEGREGATION OF FUNDS WHICH IS IDENTICAL TO MEDICAID. SO HOWEVER YOU MAY WANT TO CHARACTERIZE IT, THE -- HOW DO YOU RESPOND TO THE FLAT LANGUAGE OF THE STATUTE WHICH ACCOMPLISHES THE PURPOSE OF THE HYDE AMENDMENT AND ALLOWS -- ALLOWS FOR PAYMENT BY COLLATERAL FUNDS JUST AS MEDICAID PAYS FOR ABORTIONS WITHOUT FEDERAL FUNDS.

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  • 12:04:20 PM

    MR. HATCH

    WILL THE SENATOR YIELD? MADAM PRESIDENT?

  • 12:08:21 PM

    MR. VITTER

    WILL THE SENATOR YIELD? MADAM PRESIDENT?

  • 12:08:26 PM

    MR. SPECTER

    THE SENATOR FROM UTAH HAS NOT YET ANSWERED THE QUESTION.

  • 12:08:29 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM LOUISIANA.

  • 12:08:33 PM

    MR. VITTER

    SUPPORT THE SENATOR FROM UTAH'S AMENDMENT AND ALONG WITH SENATOR NELSON…

    SUPPORT THE SENATOR FROM UTAH'S AMENDMENT AND ALONG WITH SENATOR NELSON AND SENATOR CASEY. I THINK THAT THIS EXCHANGE AND COLLOQUY IS VERY HELPFUL. IN FACT, I THINK IT PROVES THE POINT AND THE SENATOR FROM PENNSYLVANIA'S PARTICIPATION IN IT. THE ONLY FOLKS DEFENDING THE LANGUAGE IN THE REID BILL ARE FOLKS WHO ARE STRONGLY AND CLEARLY PRO-CHOICE AN PROABORTION. -- AND PROABORTION. FOLKS WHO HAVE A PROBLEM WITH THAT SAY THAT THE UNDERLYING LANGUAGE IN THE REID BILL HAS HUGE LOOPHOLES. AND THAT INCLUDES THE PEOPLE WHO WANT TO SUPPORT THE BILL OTHERWISE. AS SENATOR BROWNBACK MENTIONED, REPRESENTATIVE STUPAK WANTS TO SUPPORT THE UNDERLYING BILL, SUPPORTED IT IN THE HOUSE, BUT HE WAS VERY CLEAR IN HIS EFFORTS ON THE HOUSE FLOOR THAT THAT UNDERLANGUAGE, WHICH IS NOW IN THE REID BILL, HAD HUGE LOOPHOLES, WASN'T GOOD ENOUGH. NEEDED TO BE FIXED. THAT'S WHY HE CAME UP WITH THE STUPAK LANGUAGE, AND THAT'S ESSENTIALLY EXACTLY WHAT WE HAVE IN THIS AMENDMENT. SIMILARLY THE U.S. CONFERENCE OF BISHOPS. THEY'RE VERY SUPPORTIVE OF THE CONCEPTS OF THE UNDERLYING BILL. IT SAID CLEARLY THAT THE REID BILL IS CLEELLY COMPLETELY UNACCEPTABLE, CLOSE QUOTE, ON THIS ABORTION. AND -- QUOTE -- "-- SO THIS COLLOQUY INVOLVING THE DISTINGUISHED SENATOR FROM PENNSYLVANIA, THAT GENERAL DEBATE, I THINK, PROVES THE POINT CLEARLY. AND I, AGAIN, COMPLIMENT THE SENATOR FROM UTAH, ALONG WITH SENATOR NELSON, SENATOR CASEY, OTHERS. I'M A COSPONSOR OF THE AMENDMENT. WE NEED TO PASS THIS ON THE BILL. THIS WILL DO AWAY WITH THE LOOPHOLE. THIS WILL BE REAL LANGUAGE TO TRULY PROHIBIT TAXPAYER FUNDING OF ABORTIONS. THIS CONSTITUTES EXACTLY THE SAME AS THAT LONG TRADITION SINCE 1977 OF THE HATCH AMENDMENT. THIS MIRRORS THE STUPAK LANGUAGE. SO IT SHOULD BE CRYSTAL CLEAR. WHAT WILL THIS AMENDMENT SPECIFICALLY DO? IT WILL MEAN THAT THERE ARE NO MANDATES FOR ELECTIVE ABORTION COVERAGE. PLANS AN PROVIDERS ARE FREE FROM -- AND PROVIDERS ARE FREE FROM ANY GOVERNMENT MANDATE OF ABORTION UNDER THIS AMENDMENT LANGUAGE. IT WOULD MEAN THAT THERE IS NO FEDERAL FUNDING OF ELECTIVE ABORTION OR PLANS THAT INCLUDE ELECTIVE ABORTION, EXCEPT IN THE CASES WHEN THE LIFE OF THE MOTHER IS IN DANGER OR IN CASES OF RAPE OR INCEST. THIS MEANS THAT THIS AMENDMENT WOULD ALLOW INDIVIDUALS TO PURCHASE A SUPPLEMENTAL POLICY OR A PLAN THAT COVERS ELECTIVE ABORTION AS LONG AS THAT SEPARATE POLICY IS PURCHASED COMPLETELY WITH PRIVATE DOLLARS. IT WOULD PROHIBIT THE PUBLIC PLAN FROM COVERING THOSE ELECTIVE ABORTIONS AN PREVENT THE FEDERAL GOVERNMENT FROM MANDATING ABORTION COVERAGE BY ANY PRIVATE PLAN. INSURANCE PLANS ARE NOT PREVENTED FROM SELLING TRULY PRIVATE ABORTION COVERAGE, INCLUDING THROUGH THE EXCHANGE, BUT TAXPAYER DOLLARS WOULD HAVE NOTHING ABSOLUTELY -- ABSOLUTELY NOTHING TO DO WITH IT. BOTTOM LINE, THE EFFECT ON ABORTION FUNDING AND MANDATES IS EXACTLY THE SAME AS THE LONG DISTINGUISHED TRADITION OF THE HYDE AMENDMENT WITH THIS AMENDMENT AND IT WOULD BE EXACTLY THE SAME AS THE STUPAK LANGUAGE ON THE HOUSE SIDE. NOW, I ALSO AGREE WITH THE DISTINGUISHED SENATOR FROM UTAH WHEN HE SAID THIS SHOULD NOT BE OF ANY GREAT CONTROVERSY. ABORTION IS A DEEPLY DIVISIVE ISSUE IN THIS COUNTRY. BUT TAXPAYER DOLLARS BEING USED TO PAY FOR ABORTION IS NOT. THERE IS A BROAD AND A WIDE AND A DEEP CONSENSUS AGAINST USING ANY TAXPAYER DOLLARS TO PAY FOR ABORTION. THE SENATOR FROM UTAH MENTIONED POLLS. THAT'S WHY THE HYDE AMENDMENT HAS BEEN LONGSTANDING SINCE 1977. THAT'S WHY IT'S BEEN VOTED AND SUPPORTED AND PASSED AGAIN AND AGAIN AND AGAIN. IN CONGRESSING WITH DEMOCRATIC MAJORITIES AND REPUBLICAN MAJORITIES. IT IS A SOLID CONSENSUS. IT DOES REPRESENT THE COMMONSENSE OF THE AMERICAN PEOPLE. -- COMMON SENSE OF THE AMERICAN PEOPLE. I WILL FOLLOW IN A SIMILAR PROUD TRADITION OF LOUISIANA SENATORS SUPPORTING THAT CONSENSUS. EVERY U.S. SENATOR FROM LOUISIANA SINCE THE HYDE AMENDMENT WAS ORIGINALLY ADOPTED HAS STRONGLY SUPPORTED THIS COMMONSENSE CONSENSUS VIEW. EVERY SENATOR. AN EVERYONE, BUT ME, HAS BEEN DEMOCRAT. EVERY SITTING SENATOR FROM LOUISIANA HAS SUPPORTED THAT COMMONSENSE CONSENSUS VIEW, AND I SURELY HOPE THAT TRADITION, AS WELL, CONTINUES TODAY. AGAIN, I APPLAUD THE SENATOR FROM UTAH AND HIS LEADING COSPONSOR, SENATOR NELSON, SENATOR CASEY ON THIS EFFORT AND I ENCOURAGE ALL OF MY COLLEAGUES, DEMOCRATS AND REPUBLICANS, TO COME TOGETHER AROUND WHAT THE AMERICAN PEOPLE CONSIDER A REAL NO BRAINER. A NEW CONSENSUS. SOMETHING THAT CLEARLY REFLECTS THE COMMON SENSE OF THE AMERICAN PEOPLE. IS ABORTION A DIVISIVE ISSUE? YES. IS USING TAXPAYERS TO FUND ABORTION A CLOSE QUESTION? NO. THERE IS A CLEAR CONSENSUS IN AMERICA NOT TO USE ANY TAXPAYERS' DOLLARS TO FUND ABORTION. IT'S CRYSTAL CLEAR TO CONTINUE THAT. WE NEED TO PASS THIS AMENDMENT AND THE UNDERLYING LANGUAGE IN THE REID BILL IS COMPLETELY UNACCEPTABLE. WITH THAT, I THANK YOU, MADAM PRESIDENT. I YIELD THE FLOOR.

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  • 12:14:45 PM

    MR. HATCH

    I'M APPRECIATIVE OF THE DISTINGUISHED SENATOR FROM TEXAS, THE…

    I'M APPRECIATIVE OF THE DISTINGUISHED SENATOR FROM TEXAS, THE DISTINGUISHED SENATOR FROM LOUISIANA AND THE DISTINGUISHED SENATOR FROM NEBRASKA AND, OF COURSE, THE DISTINGUISHED SENATORS FROM KANSAS AND -- AND MONTANA -- NOT MONTANA BUT SOUTH DAKOTA, WHO ARE HERE ON THE FLOOR AND PARTICIPATING IN THIS. I BELIEVE WE HAVE UNTIL 12:27. SO I'M GOING TO RELISTENING WISH THE FLOOR AND LEAVE IT UP -- RELINQUISH THE FLOOR AND LEAVE IT UP TO YOU. A SENATOR: I WANT TO PUT A FINE POINT ON SOMETHING THAT WAS SAID BY THE SENATOR FROM PENNSYLVANIA ABOUT THE USE OF MEDICAID FUNDS IN THE STATES. THERE ARE A NUMBER OF STATES THAT DO PROVIDE PROGRAMS THAT HAVE ABORTION FUNDING, BUT I THINK THERE IS A VERY CLEAR DISTINCTION THAT NEEDS TO BE MADE IN MEDICAID FUNDS WHICH ARE MATCHING FUNDS, AND NONE OF THOSE FUNDS CAN BE USED TO FUND ABORTIONS. AND YOU SAID THAT IN RESPONSE TO HIS QUESTION, BUT I THINK THAT POINT NEEDS TO BE MADE VERY CLEAR BECAUSE THE SENATOR FROM PENNSYLVANIA WAS IMPLYING THAT SOMEHOW SINCE STATES HAD CREATED PROGRAMS THAT FUND ABORTIONS AND SINCE MEDICAID IS A FEDERAL-STATE PROGRAM, THAT SOMEHOW THOSE TWO ARE BEING MIXED AND THAT THIS IDEA THAT BECAUSE WE'RE -- THEY'RE CALLING FOR -- QUOTE -- SEGREGATION, THAT REALLY DOESN'T EXIST IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM, THOSE ARE MATCHING FUNDS. THAT IS A FEDERAL-STATE PROGRAM, AND THE FEDERAL DOLLARS THAT GO INTO THE MEDICAID PROGRAM, THE PROHIBITION THAT EXISTS ON FEDERAL FUNDING OF ABORTIONS APPLIES TO MEDICAID DOLLARS THAT GO TO THE STATES. TO THE DEGREE THAT STATES HAVE ADOPTED PROGRAMS THAT FUND ABORTIONS, THOSE ARE STATE FUNDS AND NOT MEDICAID FUNDS WHICH ARE MATCHING FUNDS.

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  • 12:16:23 PM

    MR. HATCH

    THE DISTINGUISHED SENATOR MADE THAT EVEN MORE CLEAR. LAST NIGHT, A NUMBER…

    THE DISTINGUISHED SENATOR MADE THAT EVEN MORE CLEAR. LAST NIGHT, A NUMBER OF DEMOCRATS GOT ON THE FLOOR AND I THINK COMPLETELY DISTORTED THIS ISSUE. LOOK, IF THEY -- IF THEY THINK THAT THE CAPS LANGUAGE EQUALS THE HYDE LANGUAGE, WHY NOT PUT THE HYDE LANGUAGE IN? THEY DON'T WANT IT IN BECAUSE THEY WANT TO BE ABLE TO FUND ABORTION ANY WAY THEY POSSIBLY CAN. AND THEY WILL NOT ONLY BE ABLE TO FUND IT IN A VARIETY OF WAYS WITH FEDERAL DOLLARS IF WE DON'T PUT THE -- THE HYDE LANGUAGE IN. SO THAT'S WHAT THIS IS ABOUT. I WOULD BE HAPPY TO YIELD THE FLOOR. A SENATOR: I HAVE ANOTHER POINT ON THIS AS WELL F YOU'RE NOT CLEAR ABOUT THIS, THEN ABORTION WILL ALSO BE FUNDED.

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  • 12:17:08 PM

    MR. BROWNBACK

    IF THERE IS ANY SORT OF THIS LET'S KIND OF BE FUZZY ABOUT THIS AND NOT BE…

    IF THERE IS ANY SORT OF THIS LET'S KIND OF BE FUZZY ABOUT THIS AND NOT BE CLEAR, THE COMMONWEALTH OF MASSACHUSETTS RECENTLY PASSED ITS STATE-MANDATED INSURANCE, COMMONWEALTH CARE WITHOUT AN EXPLICIT EXCLUSION ON ABORTION, AND GUESS WHAT? ABORTIONS THERE WERE ALSO FUNDED IMMEDIATELY. IN FACT, ACCORDING TO COMMONWEALTH CARE WEBSITE, ABORTION IS CONSIDERED COVERED AS AN OUTPATIENT MEDICAL CARE. SO THAT'S THE POINT ABOUT BEING CLEAR WITH THE HYDE TYPE LANGUAGE, WHICH IS THE NELSON-HATCH LANGUAGE, IS IT SPECIFICALLY SAYS NO, WE'RE NOT GOING TO FUND THIS, WE'RE GOING TO CONTINUE THIS 33-YEAR POLICY. AND IF WE DO FUND ABORTION, IF WE PUT THE CAPS FUNDING IN THAT DOES FUND ABORTIONS, LAST TIME THE FEDERAL GOVERNMENT FUNDED ABORTIONS WAS THE THREE-YEAR PERIOD AFTER ROE BUT BEFORE HYDE, ANNUALLY WE WERE FUNDING ABOUT 300,000 ABORTIONS A YEAR, FEDERAL TAXPAYER DOLLARS FUNDING OF ABORTION THROUGH MEDICAID. I CANNOT BELIEVE THAT ANY OF MY COLLEAGUES WOULD SAY YES, I WOULD BE WILLING TO BUY INTO THAT, 300,000, WHEN PRESIDENT OBAMA, PRESIDENT CLINTON BEFORE SAID WE WANT TO MAKE ABORTION SAFE, LEGAL, AND RARE. WELL, 300,000 A YEAR WOULDN'T BE IN THAT BALLPARK, AND THAT'S THE PAST NUMBER THAT HAPPENED WHEN YOU DIDN'T HAVE HYDE LANGUAGE IN PLACE AT THE FEDERAL LEVEL.

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  • 12:18:28 PM

    MR. HATCH

    BIG EXCUSE. ALL THIS YELLING AND SCREAMING WHEN THEY SAY WELL, IT EQUALS…

    BIG EXCUSE. ALL THIS YELLING AND SCREAMING WHEN THEY SAY WELL, IT EQUALS THE HYDE LANGUAGE. IT DOESN'T EQUAL THE HYDE LANGUAGE. THAT'S THE PROBLEM. AND IF THEY -- IF THEY WANT TO SOLVE THE PROBLEM, WHY NOT USE THE HYDE LANGUAGE THAT HAS BEEN ACCEPTED BY EVERY CONGRESS SINCE 1977. AND YOU'RE RIGHT. 300,000 ABORTIONS BETWEEN 1973- 1977 BECAUSE WE DIDN'T HAVE THE HYDE LANGUAGE, WE GOT TIRED OF IT, TIRED OF THE TAXPAYERS -- WHY SHOULD -- PAYING FOR IT. WHY SHOULD TAXPAYERS WHO ARE PRO-LIFE, FOR RELIGIOUS REASONS OR OTHERWISE, HAVE TO PAY FOR ABORTIONS, ELECTIVE ABORTIONS BY THOSE WHO ARE NOT? THEY SHOULDN'T HAVE TO. AND TO BE HONEST WITH YOU, THE LANGUAGE IN THE CURRENT BILL IS AMBIGUOUS, IT WOULD ALLOW THAT, AND ANYBODY WHO IS ARGUING THAT THIS IS THE SAME AS THE HYDE LANGUAGE JUST HASN'T READ THE CAPS LANGUAGE. AND WE WANT TO CHANGE IT SO THAT WE GO WITH HYDE. IT DOESN'T AFFECT THE RIGHT TO AN ABORTION AT ALL EXCEPT THAT WE'RE NOT GOING TO HAVE TAXPAYERS PAYING FOR IT.

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  • 12:19:34 PM

    MR. THUNE

    SENATOR'S POINT IF HE WOULD YIELD ON THAT POINT. THAT'S WHAT THE STUPAK…

    SENATOR'S POINT IF HE WOULD YIELD ON THAT POINT. THAT'S WHAT THE STUPAK AND OTHER MEMBERS OF THE HOUSE OF REPRESENTATIVES SAW, THAT THIS CREATED TREMENDOUS AMBIGUITY, AND THEY SOUGHT TO TIGHTEN IT UP AND REINSTATE WHAT HAS BEEN LONG-STANDING POLICY WITH REGARD TO FEDERAL FUNDS AND THEIR USE TO FINANCE ABORTIONS SINCE 1977 AND THE HYDE LANGUAGE. AND SO THE STUPAK AMENDMENT TO THE HOUSE BILL, AS YOU RECALL, PASSED WITH 240 VOTES. THERE WAS A SIZABLE DECISIVE MAJORITY OF MEMBERS IN THE HOUSE OF REPRESENTATIVES WHO SAW THROUGH WHAT THE -- THE AM AMBIGUITY THAT EXISTS WITH REGARD TO THE HOUSE BILL AND NOW THE SENATE BILL. BUT THIS IS INTENTIONALLY AMBIGUOUS FOR THE REASON YOU JUST MENTIONED. ALL THIS SIMPLY DOES IS CLARIFY ONCE AND FOR ALL WHAT HAS BEEN STANDARD POLICY HERE AT THE FEDERAL LEVEL GOING BACK TO 1977. AND AS WAS STATED EARLIER, I BELIEVE REPRESENTS THE CONSENSUS VIEW IN AMERICA, BOTH REPUBLICANS AND DEMOCRATS I THINK BELIEVE THAT THIS IS GROUND THAT WE ALL CAN STAND ON, IRRESPECTIVE OF WHERE PEOPLE COME DOWN ON THIS ISSUE, THAT THE IDEA THAT SOMEHOW FEDERAL FUNDS OUGHT TO -- TAXPAYER FUNDS OUGHT TO FINANCE ABORTIONS IS SOMETHING THAT MOST AMERICANS DISAGREE WITH, AND THAT'S WHY I THINK THERE HAS BEEN SUCH BROAD BIPARTISAN SUPPORT GOING BACK TO 177 FOR THIS PARTICULAR POLICY AND WHY IT SHOULD BE EXTENDED INTO THE FUTURE. AND AS YOU SAID, THE SENATOR FROM UTAH SAID 61%. I'VE SEEN POLLS THAT SUGGEST IT'S MUCH HIGHER THAN THAT. IT CERTAINLY WOULD BE MUCH HIGHER THAN THAT IN MY STATE OF SOUTH DAKOTA. BUT I COMMEND THE SENATOR FOR SEEING HIS WAY TO OFFER AN AMENDMENT THAT CLARIFIES AND REMOVES ALL THIS AMBIGUITY AND WHAT TO ME IS CLEARLY INTENTIONAL AMBIGUITY WITH REGARD TO THIS ISSUE AND THE UNDERLYING BILL.

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  • 12:21:21 PM

    MR. HATCH

    FOUR MINUTES, 48 SECONDS.

  • 12:21:38 PM

    THE PRESIDING OFFICER

    FOUR MINUTES, 48 SECONDS.

  • 12:21:42 PM

    MR. JOHANNS

    THE SENATOR FROM KANSAS.

  • 12:25:01 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM KANSAS.

  • 12:25:04 PM

    MR. BROWNBACK

    THE SENATOR'S TIME HAS EXPIRED.

  • 12:26:40 PM

    THE PRESIDING OFFICER

    MADAM PRESIDENT?

  • 12:26:44 PM

    MR. BAUCUS

    MADAM PRESIDENT?

  • 12:26:45 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM MONTANA.

  • 12:26:48 PM

    MR. BAUCUS

    THREE MINUTES AND 17 SECONDS.

  • 12:26:50 PM

    THE PRESIDING OFFICER

    THREE MINUTES AND 17 SECONDS.

  • 12:26:52 PM

    MR. BAUCUS

    GREAT. THANK YOU. MADAM PRESIDENT, FIRST, I HAVE FIVE UNANIMOUS CONSENT…

    GREAT. THANK YOU. MADAM PRESIDENT, FIRST, I HAVE FIVE UNANIMOUS CONSENT REQUESTS FOR COMMITTEES TO MEET DURING TODAY'S SESSION OF THE SENATE. THEY HAVE THE APPROVAL FROM THE MAJORITY AND MINORITY LEADERS. I ASK CONSENT THAT THESE REQUESTS BE AGREED TO, THAT THESE REQUESTS BE PRINTED IN THE RECORD.

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  • 12:27:07 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 12:27:09 PM

    MR. BAUCUS

    WITHOUT OBJECTION.

  • 12:30:33 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 12:30:37 PM

    MR. BAUCUS

    THE THE -- IT'S -- I'VE SAID THAT THESE MEDICARE ADVANTAGE PLANS ARE…

    THE THE -- IT'S -- I'VE SAID THAT THESE MEDICARE ADVANTAGE PLANS ARE OVERPAID. NOBODY DISAGREES WITH THAT. THEY ARE OVERPAID. THE SENATOR FROM OKLAHOMA, SENATOR COBURN, I ASKED HIM A FEW DAYS AGO IF HE THOUGHT THEY WERE OVERPAID. HE SAID YEAH, THEY ARE, THEY'RE OVERPAID. MEDPAC ADVISORY BOARD TELLS US, SAYS YEAH, THEY'RE OVERPAID. HERE'S ALSO A STATEMENT MADE BY BY -- A FEW DAYS AGO BY TOM SKULLY, THE FORMERER ADMINISTRATOR FOR MEDICARE AND MEDICAID SERVICES -- QUOTE -- "I THINK CONGRESS SHOULD TAKE SOME OF IT AWAY. THERE'S HUGE OVERFUNDING." AND I'VE GOT LOTS OF OTHER CITATIONS, SOME FROM WALL STREET ANALYSTS, OTHERS FROM -- OTHERS IN THE INDUSTRY SAYING CLEARLY THE MEDICARE ADVANTAGE PLANS ARE OVERPAID. AND, FRANKLY, WE ARE IN CONGRESS -- DUE TO THE STATUTORY PROVISION WE HAVE IN LAW HAVE CAUSED THIS OVERPAYMENT. SO I THINK CLEARLY WE SHOULD -- WE SHOULD FIX IT. IN ADDITION, SOMETHING THAT'S PRETTY ALARMING, MADAM PRESIDENT. ACCORDING TO A STUDY I SAW, ABOUT ONLY 14 CENTS ON THE DOLLAR OF EXTRA PAYMENTS TO MEDICARE ADVANTAGE PLANS GOES TO BENEFICIARIES. ONLY 14 CENTS, WHICH MEANS 86% -- 86 CENTS ON THE DOLLAR GO TO THE COMPANY, NOT TO THE BENEFICIARIES, NOT TO ENROLLEES BUT TO THE COMPANIES. THE COMPANIES, MEANING THE OFFICERS, THE DIRECTORS, ADMINISTRATIVE COSTS, MARKETING COSTS, RATE OF RETURN YOU HAVE TO PUSH UP. IT'S TO THE COMPANY. LIKE ANY OTHER GARDEN VARIETY COMPANY. AND I THINK, THEREFORE, IT BEHOOVES US TO FIND A BETTER WAY TO -- TO -- TO PAY MEDICARE ADVANTAGE COMPANIES SO THAT THE THE -- IT'S EFFICIENT, THERE'S NO WASTE AND PAYMENTS GO PRIMARILY TO -- TO THE ENROLLEES, TO THE BENEFICIARIES. SO HOW DO WE DO THAT? THIS LEGISLATION MOVES AWAY FROM THE CURRENT ARCANE SYSTEM WHICH SETS STATUTORY AMOUNTS IN EFFECT. RATHER, WE SAY, OKAY, WHY NOT HAVE THESE COMPANIES BID, LET THEM COMPETE BASED ON COSTS IN CERTAIN -- IN THEIR REGIONS? ONE REGION OF THE COUNTRY IS A BIT DIFFERENT THAN ANOTHER REGION OF THE COUNTRY. WE'RE GOING TO SAY OKAY, WHAT'S FAIR HERE, SO GET RID OF THE WASTE AND OVERPAYMENTS, IS TO PROVIDE THAT MEDICARE ADVANTAGE PLANS CAN COMPETE IN THEIR AREA BASED ON COST. AND THE -- AND THE PLAN WILL BE PAID THE AVERAGE BIDS THAT ARE -- THAT ARE BASED ON COMPETITION IN THE AREA. I THINK, WE THINK, AUTHORS OF THIS BILL THINK THAT'S A FAR BETTER WAY OF PAYING FOR MEDICARE ADVANTAGE. AND WILL THAT REDUCE PAYMENTS TO BENEFICIARIES? CERTAINLY, NO. ALL GUARANTEED BENEFITS ARE GUARANTEED IN THIS LEGISLATION. IN FACT, I'M GOING TO CHECK UP ON ANOTHER STATISTIC I'VE HEARD SOMEWHERE, THAT UNDER THIS LEGISLATION THAT WE INCREASE ENROLLEES. INCREASE NOT DECREASE, BUT INCREASE ENROLLEES. I'VE GOT TO TRACK THAT DOWN BECAUSE I WANT TO MAKE SURE THAT I'M ACCURATE WITH THAT STATEMENT. BUT IT'S -- I'LL JUST CONCLUDE, MADAM PRESIDENT, BECAUSE I WANT TO TALK MORE ABOUT THIS LATER. THERE MAY BE A SEPARATE AMENDMENT ON THIS SUBJECT OFFERED BY SOME ON OUR SIDE. BUT BY ASK LARGE, IT'S WRONG TO CONTINUE A -- BUT BY AND LARGE, IT'S WRONG TO CONTINUE A SYSTEM THAT DRAMATICALLY OVERPAYS AND WHERE 86% OF THE OVERPAYMENT GOES TO THE COMPANY, ONLY 14 CENTS GOES TO THE BENEFICIARIES. WE HAVE TO COME UP WITH A FAIR WAY OF PAYING MEDICARE ADVANTAGE AND I THINK A FAIR WAY IS TO HAVE THE COMPETITIVELY BID BASED ON COST IN THEIR AREAS. THAT WAY THEY'RE GOING TO GET REIMBURSED AT A -- AT A LEVEL THAT'S -- THAT'S RELEVANT TO THEIR AREA, IT'S ALSO RELATIVE TO THE COSTS THAT THEY INCUR WHEN THEY RUN THEIR PLANS. I'LL HAVE MORE TO SAY ABOUT THAT LATER. I YIELD THE FLOOR.

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  • 12:34:30 PM

    THE PRESIDING OFFICER

    OFFICER: UNDER THE PREVIOUS ORDER, THE SENATE STANDS IN RECESS

  • 02:15:31 PM

    none

    TO BRING YOU LIVE COVERAGE OF THE SENATE LEADERS. SOME ARE COMING TO THE…

    TO BRING YOU LIVE COVERAGE OF THE SENATE LEADERS. SOME ARE COMING TO THE PODIUM NOW. YOU CAN WATCH THAT LIVE NOW AT C-SPAN.ORG. WE'LL TAKE YOU LIVE TO THE U.S. SENATE PENDING BUSINESS INCLUDES AN ABORTION COVERAGE AND AMENDMENT AND ALSO A MOTION BY SENATOR McCAIN FOR CHANGES IN THE MEDICARE PROGRAM. DAY NUMBER NINE OF HEALTH CARE DEBATE IN THE SENATE LIVE HERE ON C-SPAN 2.AJORITY CONTROLLING THE FIRST 30 MINUTES AND THE REPUBLICANS CONTROLLING THE SECOND 30 MINUTES. FURTHER THAT NO AMENDMENTS BE IN ORDER DURING IN TIME.

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  • 02:16:08 PM

    THE PRESIDING OFFICER

    OFFICER: IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED.

  • 02:16:17 PM

    MRS. BOXER

    MR. PRESIDENT, SINCE THIS IS THE 30 MINUTES OF TIME FOR OUR SIDE, I WOULD…

    MR. PRESIDENT, SINCE THIS IS THE 30 MINUTES OF TIME FOR OUR SIDE, I WOULD ASK THAT I BE RECOGNIZED FOR 10 MINUTES, SENATOR MURRAY FOR FIVE, SENATOR LAUTENBERG FOR FIVE, SENATOR HARKIN FOR FIVE, SENATOR CARDIN FOR FIVE. WE HAVE MANY MEMBERS WISHING TO COME AND SPEAK AND I WOULD URGE THEM TO CONTACT US. AND I WILL JUST TAKE A MINUTE JUST TO GET MY NOTES IN ORDER AND I WOULD NOTE THE ABSENCE A QUORUM AND THE TIME SHOULD BE TAKEN OFF OUR TIME FROM THAT.

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  • 02:16:54 PM

    THE PRESIDING OFFICER

    I ASK THAT THE QUORUM CALL BE DISPENSED DISPENSED WITH.

  • 02:17:18 PM

    MRS. BOXER

    WITHOUT OBJECTION.

  • 02:17:23 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 02:17:24 PM

    MRS. BOXER

    THANK YOU. MR. PRESIDENT, WE ARE IN THE MIDDLE OF A VERY IMPORTANT DEBATE…

    THANK YOU. MR. PRESIDENT, WE ARE IN THE MIDDLE OF A VERY IMPORTANT DEBATE ABOUT WHETHER OR NOT WE'RE GOING TO MOVE FORWARD AND MAKE SURE THAT OUR PEOPLE IN AMERICA HAVE HEALTH CARE. THAT'S THE -- THAT'S REALLY WHAT IT'S ABOUT. AND I'M GOING TO THROW OUT A FEW NUMBERS THAT ARE ALWAYS ON MY MIND AS I TALK ABOUT THIS ISSUE. ONE OF THEM IS 14,000. EVERY DAY 14,000 AMERICANS LOSE THEIR HEALTH INSURANCE. IT'S NOT BECAUSE THEY DID ANYTHING WRONG. A LOT OF TIMES IT'S JUST BECAUSE THEY GET SICK AND THEIR INSURANCE COMPANY WALKS AWAY FROM THEM OR THEY MAY REACH THE LIMIT OF THEIR COVERAGE. THEY DIDN'T REALIZE THEY HAD IT AND THEY'RE DONE FOR. THEY COULD LOSE THEIR JOB AND THEY CAN'T AFFORD TO PAY THE FULL BRUNT OF THEIR PREMIUM. THEY COULD GET SICK AND THEN ALL OF A SUDDEN THEY ARE NOW BRANDED WITH A P.C., AND THAT'S NOT A PERSONAL COMPUTER. IT'S A PREEXISTING CONDITION, AND THEY CAN'T GET HEALTH CARE. SO WE'RE IN TROUBLE IN THIS COUNTRY WITH 14,000 AMERICANS A DAY LOSING THEIR HEALTH CARE. A LOT OF THEM WORKING AMERICANS. AS A MATTER OF FACT MOST OF THEM. SOMETIMES A CHILD, FOR EXAMPLE, WILL REACH THE AGE WHERE THEY CAN NO LONGER BE COVERED THROUGH THEIR PARENTS' PLAN AND THE CHILD MIGHT HAVE HAD ASTHMA. WHEN THEY GO TO THE DOCTOR, THEY BEG THE DOCTOR NOT TO SAY THEY HAVE ASTHMA. I HAVE DOCTORS WRITING TO ME SAYING PARENTS ARE BEGGING THEM, PLEASE, DON'T WRITE DOWN THAT MY CHILD HAS ASTHMA. SAY SHE HAS BRONCHITIS. BECAUSE WHEN SHE GOES OFF MY MEDICAL PLAN, SHE'S GOING TO BE BRANDED WITH A PREEXISTING CONDITION. SO 14,000 AMERICANS A DAY. REMEMBER THAT NUMBER. THEN, MR. PRESIDENT, 66%. THAT'S A BIG PERCENT. 66% OF ALL BANKRUPTCIES ARE DUE TO A HEALTH CARE CRISIS. BANKRUPTCIES. PEOPLE ARE GOING BANKRUPT. NOT BECAUSE THEY DIDN'T MANAGE THEIR MONEY WELL OR THEY DIDN'T WORK HARD AND SAVE. BUT BECAUSE THEY'RE HIT WITH A HEALTH CARE CRISIS AND EITHER THEY HAVE NO INSURANCE OR THE INSURANCE REFUSED THEM. THE STORIES THAT COME ACROSS MY DESK, LIKE YOURS, ARE VERY HEARTBREAKING. SO PEOPLE ARE GOING BANKRUPT. THEY LOSE THEIR DIGNITY. THEY LOSE EVERYTHING BECAUSE OF A HEALTH CARE CRISIS. AND YESTERDAY I BROUGHT UP A COUPLE OF NUMBER NUMBERS, 39 OUT OF 50 INDUSTRIALIZED NATIONS. WE'RE NOT DOING VERY WELL. AND IT'S NO WONDER. MORE THAN 50% OF THE WOMEN IN THIS NATION, MR. PRESIDENT, ARE NOT SEEKING HEALTH CARE WHEN THEY SHOULD. THEY'RE PUTTING IT OFF OR THEY'RE NEVER GETTING IT AND NO WONDER WE DON'T DO WELL WITH INFANT MORTALITY. AND WHY DON'T WOMEN DO THIS? BECAUSE THEY EITHER DON'T HAVE INSURANCE OR THEY DON'T HAVE GOOD ENOUGH INSURANCE OR THEY CAN'T AFFORD THE CO-PAY OR THEY'RE FEARFUL. THEY'RE FEARFUL THAT MAYBE IF THEY GO THIS TIME, THE INSURANCE COMPANY WILL SAY NO MORE. 24 OUT OF 30. THAT'S WHERE WE RATE. 34 OUT OF 30 -- 24 OUT OF 30 INDUSTRIALIZED THAT'S WHERE WE RATE ON LIFE EXPECTANCY. MY COLLEAGUES ARE SHOCKED BY THAT, THEY'RE SHOCKED AT THE INFANT MORTALITY AND THE LIE EX PECK TRANSYISM I HEARD MY COLLEAGUES TRY TO RATIONALIZE THIS. IT'S BECAUSE OUR POPULATION IS DIVERSE. THIS IS THE RICHEST, MOST POWERFUL NATION ON EARTH. THERE'S NO REASON THAT WE HAVE TO BE 24 OUT OF 30 IN TERMS OF OUR LIFE EXPECTANCY. ESPECIALLY WHEN YOU KNOW THAT SO MUCH OF OUR PROBLEM DEALS WITH ABOUT FIVE DISEASES. DISEASES LIKE DIABETES THAT CAN BE PREVENTED AN CERTAINLY TREATED. AND THE LAST NUMBER I'LL TALK ABOUT 45%. THE AVERAGE FAMILY IN AMERICA BY 2016, IF WE DO NOTHING WILL BE PAYING 45% OF THEIR INCOME ON PREMIUMS. NOW THIS IS DISASTROUS. 2016 IS AROUND THE CORN ARE BY MY CALCULATIONS. AND THAT MEANS MORE AND MORE OF US WILL NOT BE ABLE TO AFFORD INSURANCE. AND WE'RE GOING TO SHOW UP AT HOSPITAL EMERGENCY ROOMS, COST A LOT, THE OUTCOMES ARE BAD, AND AMERICA WILL REALLY CONTINUE THIS DOWNWARD SPIRAL IN RELATION TO OUR HEALTH CARE SYSTEM. SO WHY DO I TAKE TIME TO TALK ABOUT THIS? IT'S BECAUSE WE NEED TO KEEP OUR EYE ON THE BIG PICTURE. AND THE BIG PICTURE IS NOT A PRETTY PICTURE FOR OUR PEOPLE RIGHT NOW. THE STATUS QUO IS NOT NEUTRAL. IT'S CRUEL. AND EVERY ONE OF US COULD WAKE UP IN THE MORNING, HAVING LOSS A JOB AND HAVING NO HEALTH CARE. IT -- WHAT WE'RE DOING IS GOING TO HELP EVERY AMERICAN. AND I THINK ONE OF THE -- THE BEST THINGS WE DO IN THE UNDERLYING BILL IS TO MAKE SURE THAT HEALTH CARE PREMIUMS ARE AFFORDABLE FOR EVERYONE. THAT'S THE KEY. WE DO IT IN A NUMBER OF WAYS. WELL, IN THE MIDDLE OF ALL OF THIS WE HAVE AN AMENDMENT THAT WOULD ROLL BACK THE CLOCK ON WOMEN'S RIGHTS. AND I'M HERE TO SAY, AS I SAID LAST NIGHT, I'M SO HAPPY TO SEE OTHER COLLEAGUES JOINING, THAT IT IS UNACCEPTABLE TO SINGLE OUT ONE GROUP OF PEOPLE, NAMELY THE WOMEN OF THIS COUNTRY, AND TELL THEM THAT THEY CAN'T USE THEIR OWN PRIVATE MONEY TO BUY AN INSURANCE POLICY THAT COVERS THE RANGE OF REPRODUCTIVE HEALTH CARE. WHY ARE WOMEN BEING SINGLED OUT HERE? IT'S SO UNFAIR. WE'VE HAD A FIRE FIREWALL IN PLACE FOR 30 YEARS. IT SAID THIS: NO FEDERAL FUNDS CAN BE USED FOR ABORTION, BUT PRIVATE FUNDS CAN BE USED AS LONG AS ABORTION IS LEGAL, AND IT IS. ROE V. WADE MADE IT LEGAL IN THE EARLY STAGES OF A PREGNANCY. WOMEN HAVE THAT RIGHT. WHAT THIS AMENDMENT DOES IS SAYS, THERE'S ONE GROUP OF WOMEN HERE WE'RE GOING TO TREAT DIFFERENTLY. WE'RE GOING TO TAKE 1 PROCEDURE THAT ONLY APPLIES TO THEM AND SAY THEY CAN'T BUY HEALTH INSURANCE FOR THAT TOADURE. ONLY IF IT'S A -- PROCEDURE. ONLY IF IT'S A SEPARATE RIDER, WHICH EVERYONE KNOWS IS UNAFFORDABLE, IMPRACTICAL AND WILL NOT WORK. I DON'T SEE ANY AMENDMENT HERE SAYING TO MEN THAT IF THEY WANT TO HAVE A PROCEDURE THAT RELATES TO THEIR REPRODUCTIVE HEALTH, THEY CAN'T USE THEIR OWN PRIVATE MONEY TO BUY COVERAGE FOR IT. NO, IT'S NOT IN THERE. WE DON'T TELL MEN THAT IF THEY WANT TO MAKE SURE THEIR CAN BUY INSURANCE COVERAGE THROUGH THEIR PHARMACEUTICAL PLAN FOR VIAGRA THAT THEY CAN'T DO IT. NO, WE DON'T DO THAT AND I WOULDN'T SUPPORT THAT. IT WOULD BE WRONG. WELL, IT'S WRONG TO SINGLE OUT WOMEN AND TO SAY TO WOMEN OF THIS COUNTRY, THEY CAN'T USE THEIR OWN PRIVATE FUNDS TO PURCHASE INSURANCE THAT COVERS THE WHOLE RANGE OF REPRODUCTIVE HEALTH CARE. NOW YOU HAVE TO LOOK BEHIND AT THIS AMENDMENT TO REALLY UNDERSTAND HOW PERNICIOUS IT REALLY IS. BECAUSE THE WHOLE POINT OF IT IS, AND I -- FIVE MALE COLLEAGUES ON THE OTHER SIDE OF THE AISLE WERE ON THE FLOOR FOR, I DON'T KNOW, AT LEAST AN HOUR PAWCKINGTALKING ABOUT THIS AMENDMENT. AND EACH AND EVERY ONE OF THEM WANT TO MAKE ABORTION ILLEGAL. THERE'S NO QUESTION ABOUT IT. THEY WANT TO TAKE AWAY A WOMAN'S RIGHT TO CHOOSE, EVEN IN THE EARLIEST STAGES OF A PREGNANCY. EVEN IF IT IMPACTS HER HEALTH, HER ABILITY TO REMAIN FERTILE, HER ABILITY TO AVOID A VERY SERIOUS HEALTH ISSUE, SUCH AS, A HEART PROBLEM OR A STROKE. THEY DON'T WANT TO HAVE AN EXCEPTION FOR WOMEN'S HEALTH. NO QUESTIONS THAT WHAT THEY WANT.

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  • 02:26:30 PM

    THE PRESIDING OFFICER

    THE SENATOR'S 10 MINUTES IS UP.

  • 02:26:32 PM

    MRS. BOXER

    I ASK UNANIMOUS CONSENT FOR AN ADDITIONAL 30 SECONDS AND THEN I'LL TURN TO…

    I ASK UNANIMOUS CONSENT FOR AN ADDITIONAL 30 SECONDS AND THEN I'LL TURN TO SENATOR LAUTENBERG.

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  • 02:26:41 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 02:26:45 PM

    MRS. BOXER

    PART HERE, THE AMENDMENT OFFERED BY NELSON, HATCH, VITTER,ET AL,…

    PART HERE, THE AMENDMENT OFFERED BY NELSON, HATCH, VITTER,ET AL, BROWNBACK, IT HURTS WOMEN. IT SINGLES OUT ONE LEGAL PROCEDURE AND SAYS, YOU KNOW WHAT? YOU CAN'T USE YOUR OWN PRIVATE FUNDS TO BUY INSURANCE, SO IN CASE YOU NEED TO USE IT FOR THAT LEGAL PROCEDURE, YOU CAN'T. I WILL YIELD THE FLOOR AND NOTE THAT SENATOR LAUTENBERG IS HERE FOR FIVE MINUTES. I'M SORRY, IT WAS SENATOR MURRAY FOR FIVE --

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  • 02:27:21 PM

    THE PRESIDING OFFICER

    SORRY.

  • 02:27:24 PM

    MRS. BOXER

    SORRY.

  • 02:27:25 PM

    MRS. MURRAY

    WITHOUT OBJECTION.

  • 02:33:09 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM CALIFORNIA.

  • 02:33:11 PM

    MRS. BOXER

    WANTED TO AMENDMENT THE UNANIMOUS CONSENT REQUEST TO GIVE SENATOR…

    WANTED TO AMENDMENT THE UNANIMOUS CONSENT REQUEST TO GIVE SENATOR LAUTENBERG EIGHT MINUTES AND MYSELF TWO MINUTES FOLLOWED BY SENATOR CARDIN FOR FIVE.

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  • 02:33:20 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION, SO ORDERED. THE SENATOR FROM NEW JERSEY.

  • 02:33:25 PM

    MR. LAUTENBERG

    MR. PRESIDENT, THROUGHOUT MY SERVICE IN THE SENATE, I HAVE BEEN A STRONG…

    MR. PRESIDENT, THROUGHOUT MY SERVICE IN THE SENATE, I HAVE BEEN A STRONG SUPPORTER FOR HEALTH CARE REFORM, BUT WE CAN'T ALLOW REFORM TO BE USED AS AN EXCUSE TO ROLL BACK WOMEN'S RIGHTS THEY HAVE HAD FOR ALMOST A HALF A CENTURY. AND THAT'S WHY I STRONGLY OPPOSE THE AMENDMENT OFFERED BY MY FRIEND, THE SENATOR FROM NEBRASKA. I THINK HE'S WRONG. WHAT THIS AMENDMENT DOES IS REMOVE A WOMAN'S RIGHT TO MAKE HER OWN DECISION AS A PRACTICAL MATTER. IT'S TO PROHIBIT ANY OF THE HEALTH PLANS ON THE EXCHANGE FROM COVERING ABORTION. AND IT WILL BAN COVERAGE EVEN FOR WOMEN WHO DON'T GET A DIME IN FEDERAL SUBSIDIES. WOMEN'S REPRODUCTIVE RIGHTS ARE ALWAYS BEING CHALLENGED HERE IN THE CONGRESS, BUT WHAT ABOUT MEN'S REPRODUCTIVE RIGHTS? SO, MR. PRESIDENT, LET'S TURN THE TABLES HERE FOR A MOMENT. WHAT IF WE WERE TO VOTE ON A VIAGRA AMENDMENT, RESTRICTING COVERAGE FOR MALE REPRODUCTIVE SERVICES. THE SAME RULES WOULD APPLY FOR VARGAS BEING PROPOSED FOR ABORTION, AND OF COURSE THAT MEANS THAT NO HEALTH PLAN ON THE EXCHANGE WOULD COVER VIAGRA AVAILABILITY. HOW POPULAR WOULD THAT DEMAND BE AROUND HERE? MR. PRESIDENT, I UNDERSTAND THAT ABORTION AND DRUGS LIKE VIAGRA PRESENT DIFFERENT ISSUES, BUT THERE IS A FUNDAMENTAL PRINCIPLE THAT IS THE SAME, RESTRICTING ACCESS TO REPRODUCTIVE HEALTH SERVICES FOR ONE GENDER. AND THIS AMENDMENT IS EXCLUSIVELY DIRECTED AT A WOMAN'S RIGHT TO DECIDE FOR HERSELF. IT DOESN'T DARE TO CHALLENGE MEN'S PERSONAL DECISIONS. MR. PRESIDENT, I HAVE THE GOOD FORTUNE OF BEING A FATHER OF THREE DAUGHTERS AND GRANDFATHER OF SIX GRANDDAUGHTERS, AND I AM DEEPLY CONCERNED BY THE PRECEDENT THAT THIS AMENDMENT WOULD SET. I DON'T WANT PLIGZ MAKING DECISIONS -- I DON'T WANT POLITICIANS MAKING DECISIONS FOR MY DAUGHTERS OR MY GRANDDAUGHTERS WHEN HE IT COMES TO THEIR HEALTH AND WELL-BEING, BUT THAT'S EXACTLY WHAT THIS AMENDMENT DOES. NOTHING MADE ME HAPPIER THAN WHEN ANY OF MY DAUGHTERS ANNOUNCED THEIR PREGNANCY AND WHILE I WATCHED THEM GROW AND PROSPER IN THEIR HEALTH AND WELL-BEING AS THEY WERE CARRYING THAT CHILD. AND I WAS FULLY PREPARED TO SUPPORT A DECISION THAT THEY MIGHT MAKE FOR THE BEST HEALTH OF THAT NEW BABY AND PROTECTING HER HEALTH TO BE ABLE TO OFFER HER LOVE AND CARE FOR A NEW CHILD AS I SAW IN MY YEARS. AND I DON'T -- I DON'T WANT TO STAND HERE AND THINK THAT SOMEBODY IS GOING TO MAKE A DECISION IN THIS ROOM THAT AFFECTS WHAT MY GRANDDAUGHTERS OR MY DAUGHTERS HAVE TO THINK ABOUT. THEY WANT TO -- IF THEY WANT TO RESTRICT THEMSELVES, LET THEM DO IT, BUT WHY DO -- CAN WE STAND HERE AND PERMIT THIS TO TAKE PLACE WHEN WE ARE TRYING TO MAKE PEOPLE HE HEALTHIER AND BETTER INFORMED? BUT THIS AMENDMENT WANTS TO TAKE AWAY THAT RIGHT. RIGHT NOW, THE MAJORITY OF PROPER HEALTH INSURANCE PLANS DO OFFER ABORTION COVERAGE. NOW, THIS AMENDMENT WOULD FORCE PRIVATE HEALTH INSURANCE COMPANIES TO ABANDON THOSE POLICIES, ELIMINATE SERVICES, AND LIMIT A WOMAN'S OPTION. THE AMENDMENT DOES NOT, CONTRARY TO STATEMENTS MADE -- BEING MADE HERE ON THIS FLOOR, SIMPLY PRESERVE THE HYDE LANGUAGE THAT HAS BEEN IN PLACE FOR MORE THAN THREE DECADES. MAKE NO MISTAKE, THIS AMENDMENT GOES WELL BEYOND THE CONCEPT OF LIMITING FEDERAL FUNDS FROM PAYING FOR ABORTION. THIS AMENDMENT WOULD MAKE IT IMPOSSIBLE FOR A WOMAN WHO PAYS FOR HER PREMIUMS OUT OF HER OWN POCKET TO PURCHASE A PRIVATE HEALTH PLAN THAT OFFERS HER THE RIGHT TO CHOOSE WHAT IS BEST FOR HER, FOR HER HEALTH, AND HER FAMILY'S WELL-BEING. WE HAVE BEEN WORKING HARD FOR A LONG TIME TO ELIMINATE DISCRIMINATION AGAINST WOMEN IN OUR CURRENT HEALTH CARE SYSTEM, AND RIGHT NOW OUR HEALTH CARE BILL TAKES A BALANCED APPROACH TO ABORTION COVERAGE. IT PRESERVES EXISTING FEDERAL LAW. WOMEN HAVE FOUGHT THIS NATION'S -- SINCE THIS NATION'S FOUNDING TO HAVE FULL RIGHTS UNDER THE LAW, INCLUDING SUFFRAGE, INCLUDING MANY OTHER THINGS, BUT UNFORTUNATELY THIS AMENDMENT WOULD FORCE THEM TO TAKE A STEP BACKWARDS, AND I DON'T WANT TO SEE IT HAPPEN, AND I URGE MY COLLEAGUES PLEASE USE YOUR JUDGMENT, MAKE YOUR OWN CHOICES ABOUT YOUR OWN FAMILIES, MAKE YOUR DECISIONS AS TO WHAT YOU WOULD RECOMMEND TO A DAUGHTER OR A WIFE, BUT FOR GOD'S SAKE, LET THE WOMAN CHOOSE WHAT'S BEST FOR HER. AND I URGE MY COLLEAGUES TO VOTE AGAINST IT. WITH THAT, I YIELD THE TIME.

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  • 02:39:13 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM MARYLAND.

  • 02:39:15 PM

    MR. CARDIN

    MR. PRESIDENT, THANK YOU VERY MUCH. I RISE IN STRONG OPPOSITION TO THE…

    MR. PRESIDENT, THANK YOU VERY MUCH. I RISE IN STRONG OPPOSITION TO THE NELSON-HATCH AMENDMENT. AND LET ME START OFF BY SAYING THAT I SUPPORT A WOMAN'S RIGHT OF CHOICE. IT'S A CONSTITUTIONALLY AFFIRMED RIGHT. AND I UNDERSTAND HOW DIFFICULT AND DIVISIVE THIS ISSUE IS. THAT IS WHY THE UNDERLYING BILL THAT WE HAVE BEFORE US CARRIES OUT THE COMPROMISE THAT HAS ALREADY BEEN REACHED BETWEEN THE PRO-CHOICE AND PRO-LIFE SUPPORTERS. IT REPRESENTS MAINTAINING THE FEDERAL PROHIBITION ON FUNDS, FEDERAL FUNDS FOR ABORTION BUT ALLOWS A WOMAN TO PAY FOR ABORTION COVERAGE THROUGH USE OF HER OWN FUNDS. THAT'S THE CURRENT LAW AND THAT'S WHAT THE UNDERLYING BILL MAKES SURE THAT WE CONTINUE. MANY OF US THOUGHT THAT THE HEALTH CARE DEBATE IS CRITICALLY IMPORTANT, IT'S CONTROVERSIAL. LET'S NOT BRING THE ABORTION ISSUE INTO THE BILL. THE NELSON-HATCH AMENDMENT WOULD GO BEYOND THAT. IT WOULD RESTRICT A WOMAN'S ABILITY TO USE HER OWN FUNDS FOR COVERAGE TO PAY FOR ABORTIONS. IT BLOCKS A WOMAN FROM USING THEIR PERSONAL FUNDS TO PURCHASE INSURANCE PLANS WITH ABORTION COVERAGE. IF ENACTED FOR THE FIRST TIME IN FEDERAL LAW, THIS AMENDMENT WOULD RESTRICT WHAT INDIVIDUAL PRIVATE DOLLARS CAN PAY FOR IN THE PRIVATE INSURANCE MARKETPLACE. I MIGHT ALSO POINT OUT THAT WHEN YOU LOOK AT THOSE WHO ARE SUPPORTING THIS AMENDMENT, YOU CAN'T HELP BUT HAVE SOME CONCERN THAT THIS AMENDMENT IS BEING OFFERED AS A WAY TO DERAIL AND DEFEAT THE HEALTH CARE REFORM BILL, BECAUSE MOST OF THE PEOPLE WHO ARE GOING TO BE SUPPORTING THAT AMENDMENT WILL VOTE IN OPPOSITION TO THE BILL. IT'S QUITE CLEAR THAT THE SENATE HEALTH REFORM BILL ALREADY INCLUDES THE LANGUAGE BANNING THE FEDERAL FUNDS FOR ABORTION SERVICES, SO THE SUPPORTERS OF THIS BILL ARE NOT SATISFIED WITH THE CURRENT FUNDING BAN. THEY'RE TRYING TO USE THIS TO MOVE THE EQUATION FURTHER IN AN EFFORT TO DEFEAT THE BILL. I ALSO WOULD POINT OUT THAT THIS IS REALLY WRONG AS IT RELATES TO WOMEN IN AMERICA. I AM OUTRAGED THAT THE SUGGESTION THAT WOMEN WHO WANT ABORTION SHOULD BE ABLE TO PURCHASE A SEPARATE RIDER TO COVER THEM. WHY WOULD WE EXPECT THIS OVERWHELMINGLY MALE SENATE TO EXPECT WOMEN TO SHOP FOR A SUPPLEMENTAL PLAN IN ANTICIPATION OF AN UNINTENDED PREGNANCY OR A PREGNANCY WITH HEALTH COMPLICATIONS? WHO PLANS FOR THAT? THE WHOLE POINT OF HEALTH INSURANCE IS TO PROTECT AGAINST UNEXPECTED INSTANCES. CURRENTLY THERE ARE FIVE STATES -- IDAHO, KENTUCKY, OKLAHOMA, MISSOURI, AND NORTH DAKOTA -- THAT ONLY ALLOW ABORTION COVERAGE THROUGH RIDERS. GUESS WHAT? THE INDIVIDUAL MARKET DOES NOT ACCEPT THIS TYPE OF A POLICY, IT DOESN'T EXIST. ABORTION RIDERS SEVERELY UNDERMINE PATIENT PRIVACY. AS A WOMAN WOULD BE PLACED IN THE POSITION OF HAVING TO TELL THEIR EMPLOYER OR THEIR INSURER, AND IN MANY CASES THEIR HUSBAND'S EMPLOYER, THAT THEY ANTICIPATE TERMINATING A PREGNANCY. ALSO REQUIRING WOMEN TO SPEND ADDITIONAL MONEY TO HAVE COMPREHENSIVE HEALTH CARE COVERAGE IS DISCRIMINATORY. WE DON'T DO THAT FOR SERVICES THAT AFFECT MEN'S REPRODUCTIVE RIGHTS. AND THE LAST POINT I WOULD MENTION IS I HEAR FREQUENTLY FROM MY FRIENDS ON THE OTHER SIDE OF THE AISLE THAT THE STATEMENTS THAT WE MAKE -- THAT IS, THOSE WHO SUPPORT THE BILL, UNDERLYING BILL, THAT THIS ALLOWS INDIVIDUALS WHO HAVE THEIR CURRENT INSURANCE TO BE ABLE TO MAINTAIN THEIR CURRENT INSURANCE, BUILDS ON WHAT'S GOOD IN OUR HEALTH CARE SYSTEM. WELL, THIS AMENDMENT TAKES AWAY RIGHTS THAT PEOPLE ALREADY HAVE. SO IF YOU HAVE INSURANCE TODAY AS AN INDIVIDUAL THAT COVERS ABORTION SERVICES, IF THIS AMENDMENT WERE ADOPTED, YOU'RE NOT GOING TO BE ABLE TO GET THAT. SO WE ARE DENYING PEOPLE THE ABILITY TO MAINTAIN THEIR OWN CURRENT INSURANCE IF THIS AMENDMENT WERE ADOPTED. IT'S THE WRONG AMENDMENT. THE POLICY IS WRONG, BUT CLEARLY ON THIS BILL IT'S WRONG. I JUST URGE MY COLLEAGUES TO ACCEPT THE COMPROMISE THAT WAS REACHED ON THIS BILL, THE COMPROMISE. MANY OF US WHO WOULD LIKE TO SEE US BE MORE PROGRESSIVE IN DEALING WITH THIS ISSUE, REMOVE SOME OF THE DISCRIMINATORY PROVISIONS THAT ARE IN EXISTING LAW, WE UNDERSTAND THAT WE'LL HAVE TO WAIT FOR ANOTHER DAY TO DO THAT. LET'S NOT CONFUSE THE ISSUE OF HEALTH CARE REFORM. LET'S DEFEAT THIS AMENDMENT THAT WOULD BE DISCRIMINATORY AGAINST -- AGAINST WOMEN. THAT'S WRONG. I URGE MY COLLEAGUES TO REJECT THE NELSON-HATCH AMENDMENT. WITH THAT, I WOULD YIELD THE FLOOR.

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  • 02:44:09 PM

    MRS. BOXER

    MR. PRESIDENT? I WOULD LIKE TO THANK SENATORS MURRAY, LAUTENBERG, AND…

    MR. PRESIDENT? I WOULD LIKE TO THANK SENATORS MURRAY, LAUTENBERG, AND CARDIN FOR PARTICIPATING IN OUR HALF-HOUR OF DEBATE AT THIS TIME. OUR BLOCK OF TIME IS ALMOST USED. BUT I'D LIKE TO CLOSE THIS HALF-HOUR BY SAYING ONE WORD THAT I THINK IS A BEAUTIFUL WORD, AND THAT WORD IS FAIRNESS. FAIRNESS IS A BEAUTIFUL WORD, AND IT SHOULD ALWAYS BE THE CENTERPIECE OF OUR WORK HERE. WE SHOULD NEVER SINGLE OUT ONE GROUP OF PEOPLE FOR -- AS TARGETS. WE SHOULD TREAT PEOPLE THE SAME. AND IT'S BEEN VERY CLEARLY STATED THAT THE NELSON-HATCH AMENDMENT, LIKE THE STUPAK AMENDMENT IN THE HOUSE, SINGLES OUT AN AREA OF REPRODUCTIVE HEALTH CARE THAT ONLY IMPACTS ONE GROUP, AND THAT'S WOMEN. AND IT SAYS TO WOMEN THEY CAN'T USE THEIR OWN PRIVATE FUNDS TO BUY COVERAGE FOR THE FULL RANGE OF REPRODUCTIVE HEALTH PROCEDURES. IT DOESN'T SAY THAT TO A MAN. IT DOESN'T SAY TO MEN YOU CAN'T USE YOUR OWN FUNDS TO COVER THE COSTS OF A PHARMACEUTICAL PRODUCT THAT YOU MAY WANT FOR YOUR REPRODUCTIVE HEALTH. IT DOESN'T SAY THAT THEY CAN'T USE THEIR OWN PRIVATE FUNDS FOR A SURGICAL PROCEDURE THAT THEY MAY CHOOSE. THAT IS IN THE ARSENAL THAT THEY MAY CHOOSE FOR THEIR OWN REPRODUCTIVE RIGHTS. SO WE SAY TO THE MEN OF THIS COUNTRY, LOOK, WE'RE NOT SINGLING OUT ANY PROCEDURE OR ANY PHARMACEUTICAL PRODUCT THAT YOU MAY WANT TO USE FOR YOUR REPRODUCTIVE HEALTH CARE. WE'RE SAYING IF A PRIVATE INSURER OFFERS IT, YOU HAVE THE RIGHT TO BUY IT. WE ARE SINGLING OUT WOMEN. AND, AGAIN, LET ME SAY THIS AS CLEARLY AS I CAN, MR. PRESIDENT. WE'VE HAD A FIREWALL BETWEEN THE USE OF PRIVATE FUNDS AND FEDERAL FUNDS. SENATOR REID HAS KEEP THAT IN PLACE IN THE UNDERLYING BILL. HE KEEPS THE STATUS QUO OF THE HYDE AMENDMENT. THE GROUP HERE WHO ARE COMING ON THE FLOOR CONTINUALLY -- MOSTLY MEN; I THINK SO FAR ALL MEN, THERE MAY BE SOME WOMEN THAT SPEAK IN THEIR BEHALF BUT I HAVEN'T HEARD IT -- ARE BASICALLY SAYING FORGET THE FIREWALL, FORGET IT. WOMEN, YOU CAN'T USE YOUR PRIVATE FUNDS AND GOVERNMENT WILL TELL YOU WHAT YOU CAN OR CAN'T DO. YOU KNOW, I'LL TELL YOU SOMETHING, THAT'S NOT WHAT UNCLE SAM SHOULD DO. UNCLE SAM SHOULD RESPECT WOMEN, WE SHOULD RESPECT MEN, AND I HOPE WE DEFEAT THIS AMENDMENT. AND I YIELD THE FLOOR.

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  • 02:46:51 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM WYOMING.

  • 02:46:54 PM

    MR. ENZI

    THE SENATOR FROM ARIZONA.

  • 02:46:59 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM ARIZONA.

  • 02:47:02 PM

    MR. KYL

  • 02:54:34 PM

    MR. ENZI

  • 02:54:35 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM WYOMING.

  • 02:54:38 PM

    MR. ENZI

    UP TO MEN MINUTES TO THE SENATOR FROM HIGHWAY HIGH, SENATOR VOINOVICH.

  • 02:54:42 PM

    MR. VOINOVICH

    MR. PRESIDENT?

  • 02:59:33 PM

    MR. ENZI

    MR. PRESIDENT?

  • 02:59:34 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM WYOMING.

  • 02:59:37 PM

    MR. ENZI

    TEN MINUTES TO THE SENATOR FROM IDAHO, SENATOR CRAPO.

  • 02:59:42 PM

    MR. CRAPO

  • 03:06:18 PM

    MR. ENZI

    THE SENATOR WYOMING.

  • 03:06:19 PM

    THE PRESIDING OFFICER

    THE SENATOR WYOMING.

  • 03:06:21 PM

    MR. ENZI

    MR. PRESIDENT?

  • 03:16:32 PM

    MRS. BOXER

    THE SENATOR FROM CALIFORNIA.

  • 03:16:33 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM CALIFORNIA.

  • 03:16:34 PM

    MRS. BOXER

    I ASK UNANIMOUS CONSENT THE FOLLOWING ORDER: BOXER 1 MINUTE, DURBIN 5.…

    I ASK UNANIMOUS CONSENT THE FOLLOWING ORDER: BOXER 1 MINUTE, DURBIN 5. STABENOW 5. SHAHEEN 5. DODD 5. MENENDEZ 5. BAUCUS 4.

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  • 03:16:45 PM

    THE PRESIDING OFFICER

    IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED.

  • 03:16:50 PM

    MRS. BOXER

    I GAVE BIRTH TO TWO BEAUTIFUL CHILDREN, AND I AM PROUD TO SAY I HAVE NOW…

    I GAVE BIRTH TO TWO BEAUTIFUL CHILDREN, AND I AM PROUD TO SAY I HAVE NOW FOUR GRANDCHILDREN, LIGHT OF MY LIFE. LIGHT OF MY LIFE. AND I AM JUST HERE TO SAY AS A MOTHER AND AS A GRANDMOTHER AND AS A SENATOR FROM CALIFORNIA, I TRUST THE WOMEN OF THIS COUNTRY. AND I DON'T WANT TO TELL THE WOMEN OF THIS COUNTRY AND TELL NOBODY ELSE ANYTHING LIKE THIS, THAT THEY CAN'T BUY INSURANCE WITH THEIR OWN PRIVATE MONEY TO COVER THEIR WHOLE RANGE OF LEGAL REPRODUCTIVE HEALTH CARE. WE DON'T DO THAT TO THE MEN. WE DON'T SAY YOU CAN'T GET ANY SURGERY IF YOU MIGHT NEED IT FOR YOUR REPRODUCTIVE HEALTH CARE. WE DON'T SAY YOU CAN'T GET CERTAIN DRUGS IN THE PHARMACEUTICAL BENEFIT THAT YOU MAY NEED FOR YOUR REPRODUCTIVE HEALTH CARE. WE DON'T SAY THAT TO MEN, NOR SHOULD WE. IMAGINE IF THE MEN IN THIS CHAMBER HAD TO FILL OUT A FORM AND GET A RIDER FOR VIAGRA AND IT WAS PUBLIC. FORGET ABOUT IT. THERE WOULD BE A RAGE IN THIS CHAMBER. WE'RE SAYING NOW TREAT WOMEN FAIRLY. TREAT WOMEN THE SAME WAY YOU TREAT MEN. LET THEM HAVE ACCESS TO THE FULL RANGE OF LEGAL REPRODUCTIVE HEALTH CARE. THAT'S ALL WE'RE SAYING. VOTE "NO" ON THIS AMENDMENT, THE NELSON-HATCH AMENDMENT BECAUSE HARRY REID TAKES CARE OF THIS FIRE WALL BETWEEN --

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  • 03:18:18 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR HAS USED HER ONE MINUTE.

  • 03:18:24 PM

    MRS. BOXER

    THE SENATOR FROM MICHIGAN IS RECOGNIZED.

  • 03:18:43 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM MICHIGAN IS RECOGNIZED.

  • 03:18:46 PM

    MS. STABENOW

    I'M SORRY. I HAD UNDERSTOOD FROM OUR MANAGER OF THE AMENDMENT THAT SENATOR…

    I'M SORRY. I HAD UNDERSTOOD FROM OUR MANAGER OF THE AMENDMENT THAT SENATOR DURBIN WOULD BE GOING FIRST. THANK YOU VERY MUCH. I FIRST WANT TO THANK THE SENATOR FROM CALIFORNIA FOR HER PASSION, ADVOCACY IN STANDING UP FOR ALL OF US, STANDING UP FOR THE WOMEN OF THIS COUNTRY. I WANT TO THANK HER VERY MUCH. AS SHE SAID, SHE IS A MOM. I TOO AM A MOM. AS HARD AS IT IS FOR ME TO BELIEVE, I ALSO AM A GRANDMOTHER WITH A WONDERFUL TWO-YEAR-OLD, LILY, AND LITTLE GRANDSON, WALT, WHO WAS BORN ON HIS DADDY'S BIRTH TKAEURBGS ON MY SON'S BIRTHDAY, IN AUGUST. OBVIOUSLY THEY ARE THE LIGHT OF MY LIFE AS WELL. ONE OF THE REASONS I FEEL SO PASSIONATELY ABOUT THE BROADER BILL ON HEALTH CARE REFORM, MR. PRESIDENT, IS THIS IS ABOUT EXTENDING COVERAGE TO BABIES SO THEY CAN BE BORN HEALTHY. IT'S ABOUT PRENATAL CARE. IT'S ABOUT MAKING SURE THAT IN THE NEW INSURANCE EXCHANGE THAT WE HAVE BASIC COVERAGE FOR MATERNITY CARE. I WAS SHOCKED TO LEARN THAT 60% OF THE INSURANCE POLICIES THAT ARE OFFERED RIGHT NOW IN THE INDIVIDUAL MARKET DON'T OFFER MATERNITY CARE AS BASIC CARE. WE HAPPEN TO THINK THAT'S INCREDIBLY IMPORTANT. WE ARE 29th IN THE WORLD IN THE NUMBER OF BABIES -- 29th IN THE WORLD, BELOW THIRD-WORLD COUNTRIES IN THE NUMBER OF BABIES THAT SURVIVE THEIR FIRST YEAR OF LIFE. THIS HEALTH CARE REFORM BILL IS ABOUT MAKING SURE THAT WE HAVE HEALTHY BABIES, HEALTHY MOMS. IT'S ABOUT SAVING LIVES. IT'S ABOUT MOVING FORWARD IN A WAY THAT IS POSITIVE, EXPANDING COVERAGE, NOT TAKING AWAY IMPORTANT COVERAGE FOR WOMEN WHO, FRANKLY, FIND THEMSELVES IN A CRISIS SITUATION. THAT'S REALLY WHAT WE'RE DOING, UNFORTUNATELY, THROUGH THE NELSON-HATCH AMENDMENT. I HAVE GREAT RESPECT FOR BOTH OF MY COLLEAGUES WHO HAVE OFFERED THIS, FOR OTHERS WHO FEEL DEEPLY ABOUT THIS. I THINK WHAT WE HAVE DONE IN THE BILL THAT HAS COME BEFORE US ON THE FLOOR IS TO RESPECT ALL SIDES AND TO KEEP IN PLACE THE LONG-STANDING BAN ON FEDERAL FUNDING FOR ABORTION SERVICES. AND NO ONE IS OBJECTING TO THAT. NO ONE IS TRYING TO CHANGE THAT. BUT AS MY FRIENDS HAVE SAID, THIS IS ABOUT WHETHER OR NOT WE CROSS THAT LINE INTO PRIVATE INSURANCE COVERAGE, WHETHER OR NOT WE SAY TO A WOMAN, TO A FAMILY, "YOU KNOW, YOU'RE GOING TO HAVE TO DECIDE NOW WHETHER OR NOT WHEN YOU HAVE A CHILD YOU'RE GOING TO HAVE A CRISIS IN THE THIRD TRIMESTER AND MIGHT NEED SOME KIND OF CRISIS ABORTION SERVICE. OR WHETHER OR NOT YOU'RE GOING TO FIND YOURSELF IN A SITUATION WHERE YOU'RE GOING TO NEED ABORTION SERVICES, AND YOU'RE GOING TO HAVE TO PUBLICLY INDICATE THAT AND BUY A RIDER ON INSURANCE BECAUSE YOU CAN'T USE YOUR OWN MONEY AND GO OUT AND BUY AN INSURANCE POLICY." HERE'S WHAT WE KNOW RIGHT NOW. WE KNOW THAT IN FIVE STATES THAT -- HAVE RIDERS RIGHT NOW, ALLOW ABORTION COVERAGE THROUGH RIDERS. IDAHO, KENTUCKY, OKLAHOMA, MISSOURI. THERE'S NO EVIDENCE THAT THERE ARE ANY RIDERS AVAILABLE IN THE INDIVIDUAL MARKET. EVEN THOUGH TECHNICALLY COLLEAGUES WILL SAY YOU CAN BUY ADDITIONAL COVERAGE, IT'S NOT OFFERED. IT IS NOT AVAILABLE. WE ARE TOLD BY THE INSURANCE CARRIERS THAT IN FACT IT PROBABLY WON'T BE AVAILABLE. SO WE ALL KNOW WHAT THIS IS REALLY ABOUT. THIS IS ABOUT EFFECTIVELY BANNING ABORTION SERVICES COVERAGE IN THE NEW INSURANCE EXCHANGE WE'RE SETTING UP AND COULD IN FACT HAVE A BROADER IMPLICATION OF ELIMINATING THIS COVERAGE FOR HEALTH PLANS OUTSIDE THE EXCHANGES. SO THAT'S REALLY WHAT THIS IS ABOUT, WHICH IS WHY IT'S SO IMPORTANT. AGAIN, WE ARE AGREEING ON THE ELIMINATION OR THE BANNING OF FEDERAL FUNDING FOR ABORTIONS OTHER THAN EXTREME CRISIS CIRCUMSTANCES. WE HAVE DONE THAT IN FEDERAL LAW. THIS IS ABOUT WHETHER WE GO ON TO ESSENTIALLY CREATE A SITUATION WHERE EFFECTIVELY PEOPLE CANNOT GET THAT COVERAGE WITH THEIR OWN MONEY. THE CENTER FOR AMERICAN PROGRESS NOTED THAT BECAUSE APPROXIMATELY 86% OF THE PEOPLE WHO ARE GOING TO BE OFFERED NEW OPPORTUNITIES FOR INSURANCE, SMALL BUSINESS, INDIVIDUALS IN THE PRIVATE MARKET, THAT BECAUSE 86% OF THEM WILL IN FACT RECEIVE SOME KIND OF TAX CREDIT, A TAX CUT, THAT IN FACT AGAIN WE ARE TALKING ABOUT ELIMINATING THIS OPTION ALTOGETHER BECAUSE THE MAJORITY OF PEOPLE WILL GET SOME KIND OF A TAX CUT DURING THIS PROCESS. I THINK THERE IS ALSO SOME BROADER IMPLICATIONS AROUND TAX POLICY, MR. PRESIDENT. IF WE'RE SAYING THAT SOMEONE CAN'T PURCHASE AN INSURANCE POLICY OF THAT LIKING IF THEY ARE GETTING A TAX CREDIT --

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  • 03:23:50 PM

    THE PRESIDING OFFICER

    THE SENATOR HAS USED FIVE MINUTES.

  • 03:23:53 PM

    MS. STABENOW

    -- IF I COULD HAVE 30 MORE SECONDS TO COMPLETE THIS SENTENCE? THE FACT IS…

    -- IF I COULD HAVE 30 MORE SECONDS TO COMPLETE THIS SENTENCE? THE FACT IS WHAT ABOUT OTHER TAX CREDITS. WHAT ABOUT OTHER KINDS OF WAYS IN WHICH PEOPLE GET TAX CREDITS OR TAX CUTS TODAY? THE IMPLICATIONS OF THIS ARE EXTREMELY BROAD. I WOULD URGE A "NO" VOTE. LET US KEEP FEDERAL POLICY IN PLACE THAT DOES NOT ALLOW FEDERAL FUNDING FOR ABORTION BUT RESPECT THE WOMEN OF THIS COUNTRY. THANK YOU.

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  • 03:24:22 PM

    MR. DURBIN

    MR. PRESIDENT?

  • 03:24:23 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE MAJORITY WHIP.

  • 03:24:25 PM

    MR. DURBIN

    MR. PRESIDENT?

  • 03:29:38 PM

    MR. DODD

    MR. PRESIDENT?

  • 03:29:39 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM CONNECTICUT IS RECOGNIZED.

  • 03:29:42 PM

    MR. DODD

    MY COLLEAGUE FROM ILLINOIS, THE DEMOCRATIC WHIP, FOR HIS ARGUMENTS. HE'S…

    MY COLLEAGUE FROM ILLINOIS, THE DEMOCRATIC WHIP, FOR HIS ARGUMENTS. HE'S LAID THEM OUT, BASICALLY HE SPEAKS FOR ME WHEN HE IDENTIFIES WHAT WOULD HAVE BEEN THE PILLARS OF OUR VIEWS ON THIS ISSUE. I WAS ELECTED TO THE HOUSE OF REPRESENTATIVES IN 1974, TWO YEARS AFTER ROE VS. WADE. AND I'VE BEEN IN CONGRESS NOW FOR 35 YEARS, AND WE HAVE LIVED WITH THOSE GUIDELINES, WHICH WHILE STILL HAVE NOT RESOLVED THE MATTER IN THE MINDS OF MANY PEOPLE WHO HAVE STRONGLY HELD VIEWS IN THIS MATTER, BUT HAVE SERVED US WELL. AND WHAT WE HAVE IN THIS BILL IS A REFLECTION OF A CONTINUATION OF THOSE PILLARS. HAVING BEEN THE ACTING CHAIR OF THE HEALTH, EDUCATION, LABOR, AND PENSIONS COMMITTEE DURING THE MARKUP OF THIS BILL -- IN FACT, SENATOR KENNEDY, WHO VOTED BY PROXY, AS THEY CALL IT IN THAT PROCESS, WE INSISTED UPON THE ADOPTION OF THE KENNEDY AMENDMENT, WHICH MAINTAINED THE NOTION OF CONSCIENCE IN THESE MATTERS. SO WE'RE NOT FORCING INDIVIDUALS TO ENGAGE IN ABORTION PRACTICES IF THEY FELT OTHERWISE. WE HAVE LONG HELD THE VIEW IN THIS CONGRESS, UNDER DEMOCRATIC AND REPUBLICAN LEADERSHIP, DESPITE THE DIFFERENCES, AND OTHERS HAVE DIFFERENT VIEWS ON THIS MATTER, THAT CLEARLY PUBLIC MONEY SHOULD NOT BE USED. WE HAVE DONE THAT AGAIN WITH THIS BILL. DESPITE THE ARGUMENTS TO THE CONTRARY, IT HAS BEEN DONE IN A WAY RESPECTIVE TO HOW WE MANAGE ISSUES LIKE THIS AND OTHER MATTERS FOR DECADES. THE SENATOR FROM ILLINOIS MADE A POINT ABOUT THE MEASURES IN THE BILL THAT DEAL WITH WELLNESS AN REPRODUCTIVE RIESSMENTS WE MINIMIZED THE LIKELIHOOD OF THERE BEING DEMAND FOR ABORTION ON THE PART OF MANY. I APPRECIATE THE FACT THAT OUR LEADERSHIP HAS MADE THIS MATTER, THE NELSON-HATCH AMENDMENT MATTER CONSCIENCE. THERE IS NO CAUCUS ON THIS, AND NEVER HAS BEEN IN MY VIEW. I WANT TO MENTION ANOTHER ARGUMENT, IN ADDITION TO THE ELOQUENT ONES MADE BY THE SENATOR FROM ILLINOIS. WE RANK, I THINK, 29th, 28th OR 29th IN INFANT MORTALITY IN THE UNITED STATES. IT IS AN INCREDIBLE STATISTIC. I WORKED WITH LAMAR ALEXANDER ON PREMATURE BIRTHS, INFANT SCREENING, A WHOLE HOST OF MATTERS TRYING TO PROVIDE RESOURCES AND HELP FOR FAMILIES THAT SUFFER THESE DEBILITATING IF NOT FATAL PROBLEMS THAT INFANTS CAN SUFFER FROM AND LOSE THEIR LIVES FROM THERE'S A VAST DIFFERENCE FROM SOMEONE GOING THROUGH A PROBLEM THAT CAUSES INFANT MORTALITY RATES. BUT THIS LEGISLATION TAKES A MAJOR STEP FORWARD, MR. PRESIDENT, IN TAKING THE UNITED STATES OUT OF THE BASEMENT WHEN IT COMES TO INFANT MORTALITY AND GETS US BACK TO THE POINT WHERE WE ARE IN THE POSITION WE OUGHT TO BE IN REDUCING THE TRAGEDY THAT OCCURS WITH INFANT MORE AT ICY. SO WHILE THERE'S A DISTINCTION CLEARLY BETWEEN ABORTION AND INFANT MORTALITY, THE IDEA THAT WE WOULD ABANDON OUR EFFORTS TO INCLUDE THE QUALITY OF LIFE FOR OPPORTUNITIES FOR CHILDREN WHO ARRIVE PREMATURELY AS MANY DO IN OUR COUNTRY TODAY, MANY DON'T SURVIVE THE PREMATURITY. WOMEN AREN'T GETTING THE SUPPORT THEY NEED DURING THE PREGNANCY THUS INCREASING THE LIKELIHOOD OF PREMATURE BIRTHS OCCURRING OR THE SCREENINGS THAT OCCUR IMMEDIATELY SO YOU AVOID THE TERRIBLE PROBLEMS THAT CAN ENSURE THEREAFTER. THIS LEGISLATION TAKES A MAJOR STEP IN THAT DIRECTION. WHILE WE HAVE DONE DONE WHAT IS NECESSARY TO DO AND THAT IS PROTECT THE LONGSTANDING DISTINCTION BETWEEN PRIVATE AND PUBLIC DOLLARS WHEN IT COMES TO ABORTION. WE HAVE GONE FURTHER IN PROVIDE THE KIND OF SUPPORT FOR FAMILIES WHEN IT COMES TO MINIMIZING THE LIKELIHOOD THAT A CHILD WILL BE LOST BECAUSE THEY'RE NOT GETTING THOSE SUPPORT SERVICES AS WELL AS THE REPRO DEMOCRATTIVE ISSUES THAT ARE SO IMPORTANT SO THAT A FAMILY HAS THE ABILITY TO SURVIVE THAT PREGNANCY AND HAVE A CHANCE TO BE BORN. MY COLLEAGUES KNOW THAT I'M A LATE BLOOMER. I'M A PARENT OF A 4-YEAR-OLD AND 8-YEAR-OLD. I ALWAYS SAID I WAS THE ONLY CANDIDATE THAT USED TO GET MAIL FROM AARP AND DIAPER SERVICES, HAVING QUALIFIED FOR MEDICARE BEING 65 AND BEING THE FATHER OF INFANT CHILDREN. TWO LITTLE GIRLS, MR. PRESIDENT, GRACE AND CHRISTINA. I WANT THEM TO HAVE ALL OF THE RIGHTS OF YOUNG WOMEN IN THIS COUNTRY. HOPEFULLY I'LL BE AROUND TO BE A GRANDPARENT WEEP WORKED HARD TO -- WE WORKED HARD TO MAKE SURE THAT THOSE CHILDREN HAD ALL OF THE ADVANTAGES THEY COULD TO BE BORN HEALTHY AND SOUNDISM HAVE A GREAT HEALTH CARE -- SOUND. I HAVE A GREAT HEALTH CARE PLAN AS A FEDERAL EMPLOYEE TO MAKE SURE THAT HAPPENS. I WANT EVERY AMERICAN TO HAVE THE SAME SENSE OF SECURITY WHEN THE SAME BLESSING OCCURS WITH THE ARRIVAL OF A CHILD OR GRANDCHILD. THIS BILL DOES THAT IN WAYS THAT WERE NOT IMAGINABLE WEEKS AGO. THIS AMENDMENT SHOULD BE DEFEATED. THIS BILL OUGHT TO BE SUPPORTED AND ACHIEVE A GREAT SUCCESS. I YIELD THE FLOOR. A SENATOR: MR. PRESIDENT?

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  • 03:34:50 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM NEW HAMPSHIRE IS RECOGNIZE RECOGNIZED.

  • 03:34:54 PM

    MRS. SHAHEEN

    I RISE TODAY TO SPEAK IN OPPOSITION TO THE NELSON-HATCH AMENDMENT. THE…

    I RISE TODAY TO SPEAK IN OPPOSITION TO THE NELSON-HATCH AMENDMENT. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT THAT WE BEFORE US DOES SO MANY GOOD THINGS. IT GIVES WOMEN ACCESS TO PREVENTIVE CARE. IT MAKES HEALTH CARE MORE ACCESSIBLE TO FAMILIES ACROSS THE COUNTRY, IT CHANGES THE WAY THAT PATIENTS RECEIVE THE CARE THEY NEED. MR. PRESIDENT, WE MUST NOT LET THE ISSUE OF REPRODUCTIVE CHOICE OVERSHADOW ALL OF THE THINGS THAT THIS BILL GETS RIGHT. FOR OVER THREE DECADES THE HYDE AMENDMENT, WHICH PROHIBITS THE USE OF FEDERAL FUNDS TO PAY FOR ABORTIONS, EXCEPT IN CASES OF RAPE, INCEST, OR THE LIFE OF THE MOTHER IS AT RISK, HAS BEEN THE LAW OF THIS LAND. ABORTION SHOULD PLAY NO ROLE IN THIS HEALTH CARE DEBATE. THE FINANCE AND "HELP" COMMITTEE SPENT COUNTLESS HOURS DRAFTING LEGISLATION THAT'S PART OF THE LANGUAGE IN OUR HEALTH CARE BILL TO MAKE SURE THAT IT REMAINS NEUTRAL ON THE ISSUE OF CHOICE. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT THAT'S CURRENTLY BEFORE US MAINTAINS THE HYDE AMENDMENT PROHIBITING FEDERAL FUNDING OF ABORTIONS. AS A RESULT NEITHER THE PRO-CHOICE NOR THE PRO LIFE AGENDAS ARE ADVANCED. THIS IS CLEARLY EXPLAINED IN AN ANALYSIS DONE BY THE NONPARTISAN CONGRESSIONAL RESEARCH SERVICE, AND I WOULD LIKE TO ASK THAT THIS ANALYSIS BE ENTERED INTO THE RECORD.

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  • 03:36:22 PM

    THE PRESIDING OFFICER

    OFFICER: WITHOUT OBJECTION, SO ORDERED.

  • 03:36:27 PM

    MRS. SHAHEEN

    REFORM LEGISLATION BEFORE US PRESERVE THE HYDE LANGUAGE AND MAINTAINS THE…

    REFORM LEGISLATION BEFORE US PRESERVE THE HYDE LANGUAGE AND MAINTAINS THE STATUS QUO IN THIS COUNTRY. AND WE SHOULD KEEP IT SO. THIS SHOULD BE A DEBATE ABOUT HEALTH CARE. IT SHOULD BE ABOUT PATIENTS AND ABOUT ENSURING THAT THEY HAVE ACCESS TO QUALITY CARE AT ALL STAGES OF THEIR LIVES REGARDLESS OF WHAT MAY HAPPEN IN THEIR LIVES. IT'S A MISTAKE TO MAKE THIS DEBATE ONE ABOUT ABORTION. THE AMENDMENT THAT'S BEFORE U THE NELSON-HATCH AMENDMENT, WOULD RESTRICT ANY HEALTH PLAN OPERATING IN THE EXCHANGE THAT ACCEPTS AFFORDABILITY CREDITS FROM OFFERING ABORTION SERVICES. IN ESSENCE, THE AMENDMENT BEFORE US WOULD AMOUNT TO A BAN ON ABORTION COVERAGE IN THE HEALTH INSURANCE EXCHANGE REGARDLESS OF WHERE THE MONEY COMES FROM. SO PUT ANOTHER WAY, A WOMAN WHO PAYS FOR INSURANCE WITH MONEY OUT OF HER OWN POCKET WOULD MOST LIKELY NOT BE ABLE TO GET INSURANCE THAT COVERS ABORTION. SO MAKE NO MISTAKE ABOUT IT, THIS AMENDMENT IS MUCH MORE THAN A DEBATE ON WHETHER FEDERAL FUNDS SHOULD BE USED FOR ABORTION, WHICH IS ALREADY ESTABLISHED LAW. IT'S ESTABLISHED LAW THAT IS MAINTAINED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT BEFORE US. THE NELSON-HATCH AMENDMENT IS A VERY FAR-REACHING INTRUSION INTO THE LIVES OF WOMEN AND HOW WE WOULD GET PRIVATE INSURANCE. IT IS UNPRECEDENTED. AND IT WOULD MEAN THAT MILLIONS OF WOMEN WOULD LOSE COVERAGE THEY CURRENTLY HAVE. IT IS TRUE THAT, AS WE'VE HEARD FROM THOSE PEOPLE WHO SUPPORT THIS AMENDMENT, THAT A WOMAN WOULD BE ABLE TO BUY AN ABORTION RIDER. WELL, WHAT WE HEARD FROM SENATOR STABENOW AND WHAT WE -- SEEF SEEN FROM THE NATIONAL LAW CENTER, THAT FROM THE FIVE STATES THAT DO REQUIRE SUCH A RIDER, THAT THERE IS NO EVIDENCE THAT SUCH PLANS EXIST. AND EVEN IF THEY DID EXIST, WHO WOULD PURCHASE THAT KIND OF A RIDER? NO WOMAN EXPECTS TO NEED AN ABORTION. THIS IS NOT SOMETHING YOU GO INTO PLANNING AHEAD OF TIME. FINALLY, THIS AMENDMENT WOULD HAVE AFFECTS THAT REACH WELL INTO THE PRIVATE INSURANCE MARKET. AN INDEPENDENT ANALYSIS BY THE SCHOOL OF PUBLIC HEALTH AND HEALTH SERVICES AT GEORGE WASHINGTON UNIVERSITY CONCLUDED THAT A SIMILAR AMENDMENT ADOPTED IN THE HOUSE, WAS COMMONLY KNOWN AS THE STUPAK AMENDMENT, WILL HAVE -- QUOTE -- "AN INDUSTRY-WIDE EFFECT ELIMINATING COVERAGE OF MEDLEY INDICATED ABORTIONS OVER TIME -- MEDICALLY INDICATED ABORTIONS OVER TIME FOR ALL WOMEN." THAT MEANS, MR. PRESIDENT, THAT ANY TYPE OF ABORTION FOR WHICH THERE IS A MEDICATION OF NEED WOULD GO UNCOVERED. AGAIN, I WOULD ASK UNANIMOUS CONSENT TO ENTER IN THIS REPORT ALSO.

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  • 03:39:29 PM

    THE PRESIDING OFFICER

    IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED.

  • 03:39:36 PM

    MRS. SHAHEEN

    PASS THIS LEGISLATION THAT WILL REFORM OUR HEALTH CARE SYSTEM, IT SHOULD…

    PASS THIS LEGISLATION THAT WILL REFORM OUR HEALTH CARE SYSTEM, IT SHOULD NOT BE DONE IN A WAY THAT WOULD LOSE BENEFITS FOR WOMEN. ALL WOMEN SHOULD HAVE ACCESS TO COMPREHENSIVE HEALTH CARE, INCLUDING REPRODUCTIVE HEALTH CARE FROM THE PROVIDER OF OUR CHOICE. I URGE MY COLLEAGUES TO OPPOSE ANY AMENDMENT THAT THREATENS REPRODUCTIVE CARE WOMEN HAVE COUNTED ON FOR OVER 30 YEARS. THANK YOU. A SENATOR: MR. PRESIDENT?

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  • 03:40:07 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM NEW JERSEY'S RECOGNIZED. A SENATOR: MR.…

    OFFICER: THE SENATOR FROM NEW JERSEY'S RECOGNIZED. A SENATOR: MR. PRESIDENT, HEALTH CARE REFORM LEGISLATION WE'RE CONSIDERATION IS GOOD FOR AMERICA, WOMEN, AND FAMILIES.

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  • 03:40:19 PM

    MR. MENENDEZ

    THE SENATOR HAS SPOKEN FOR FIVE MINUTES.

  • 03:45:15 PM

    THE PRESIDING OFFICER

    THE SENATOR HAS SPOKEN FOR FIVE MINUTES.

  • 03:45:18 PM

    MR. MENENDEZ

    OTHER BENEFITS THEY DESERVE. AND THAT'S WHAT WE SHOULD DO IN TERMS OF…

    OTHER BENEFITS THEY DESERVE. AND THAT'S WHAT WE SHOULD DO IN TERMS OF PRESERVING THE UNDERLYING BILL. LET'S VOTE DOWN THIS AMENDMENT. LET'S NOT TURN BACK THE CLOCK.

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  • 03:45:31 PM

    MRS. BOXER

    UNANIMOUS CONSENT THAT IN Ly -- IN LIEU OF NOR BAUCUS' FOUR MINUTES, THAT…

    UNANIMOUS CONSENT THAT IN Ly -- IN LIEU OF NOR BAUCUS' FOUR MINUTES, THAT SENATOR CASEY TAKE THAT TIME.

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  • 03:45:42 PM

    THE PRESIDING OFFICER

    IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED. THE GENTLEMAN FROM…

    IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED. THE GENTLEMAN FROM PENNSYLVANIA IS RECOGNIZED.

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  • 03:45:48 PM

    MR. CASEY

    YOU, MR. PRESIDENT. I RISE TODAY IN SUPPORT OF THE NELSON AMENDMENT, FOR…

    YOU, MR. PRESIDENT. I RISE TODAY IN SUPPORT OF THE NELSON AMENDMENT, FOR TWO REASONS. AND I SPEAK FOR MYSELF, NOT FOR OTHER MEMBERS OF THE SENATE, OBVIOUSLY, AND I KNOW THERE IS A GOOD BIT OF DISAGREEMENT ON BOTH SIDES OF THE AISLE. BUT I SUPPORT THIS AMENDMENT FOR TWO REASONS. ONE, I WANT TO MAKE SURE THAT WE ENSURE THROUGH THIS HEALTH CARE LEGISLATION THE CONSENSUS THAT WE HAVE HAD AS PART OF OUR PUBLIC POLICY FOR MANY, MANY YEARS NOW, THE TAXPAYER DOLLARS DON'T PAY FOR ABORTIONS, AND I BELIEVE WE CAN AND SHOULD AND WILL GET THIS RIGHT BY THE END OF THIS DEBATE. SECONDLY, THE SECOND REASON I SUPPORT THIS IS I BELIEVE IT'S IMPORTANT TO RESPECT THE CONSCIENCE OF TAXPAYERS, BOTH WOMEN AND MEN, ACROSS THE COUNTRY WHO DON'T WANT TAXPAYER DOLLARS TO SUPPORT ABORTIONS. IF THERE'S ONE AREA OR MAYBE ONE OR TWO AREAS WHERE BOTH SIDES CAN AGREE, PEOPLE WHO ARE PRO-LIFE AND PRO-CHOICE, WE CAN AGREE ON A COUPLE OF BASIC PRINCIPLES. ONE IS WE DON'T WANT TO TAKE ACTIONS TO INCREASE THE NUMBER OF ABORTIONS IN AMERICA. I THINK THAT'S A PREVAILING VIEW ACROSS THE DIVIDE OF THE -- OF THIS ISSUE. AND SECONDLY, THAT WE ALSO HAVE TO DO MORE TO HELP THOSE WOMEN WHO ARE PREGNANT, AND I DON'T BELIEVE WE'RE DOING ENOUGH AND WE'LL TALK MORE ABOUT THAT. BUT EVEN AS WE DEBATE THIS AMENDMENT, THE THIRD THING I THINK WE CAN AGREE ON IS THAT NO MATTER WHAT HAPPENS ON THIS VOTE, THIS DEBATE WILL CONTINUE EVEN IN THE CONTEXT OF THIS BILL , AND I BELIEVE WE HAVE TO PASS HEALTH CARE LEGISLATION THIS YEAR, AND THERE ARE ALL KINDS OF CONSUMER PROTECTIONS IN THIS BILL THAT WILL HELP MEN AND WOMEN, PREVENTION SERVICES THAT ARE -- HAVE NEVER BEEN PART OF OUR HEALTH CARE SYSTEM BEFORE. INSURANCE REFORMS TO PROTECT FAMILIES. AND FINALLY, THE KIND OF SECURITY THAT WE'RE GOING TO GET BY PASSING HEALTH CARE LEGISLATION FOR THE AMERICAN PEOPLE. I BELIEVE WE CAN GET THIS ISSUE, THIS DIVISIVE ISSUE CORRECT IN THIS BILL. WE'RE NOT THERE YET. I BELIEVE WE CAN. I ALSO BELIEVE WE MUST PASS HEALTH CARE LEGISLATION THIS MONTH THROUGH THE SENATE AND THEN ON FROM THERE TO GET IT ENACTED INTO LAW, AND I YIELD THE FLOOR.

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  • 03:48:05 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM CALIFORNIA.

  • 03:48:07 PM

    MRS. BOXER

    BEFORE WE TURN THIS OVER TO THE REPUBLICAN SIDE, I ASK UNANIMOUS CONSENT…

    BEFORE WE TURN THIS OVER TO THE REPUBLICAN SIDE, I ASK UNANIMOUS CONSENT TO PLACE INTO THE RECORD A LETTER FROM RELIGIOUS LEADERS WHO SUPPORT MAINTAINING THE UNDERLYING BILL AND OPPOSE THIS AMENDMENT. CATHOLICS FOR CHOICE, DISCIPLES JUSTICE ACTION CENTER, EPISCOPAL CHURCH, JEWISH WOMEN INTERNATIONAL, PRESBYTERIAN CHURCH WASHINGTON OFFICE, RELIGIOUS COALITION FOR REPRODUCTIVE CHOICE, UNION OF REFORMED JUDAISM, UNITED CHURCH OF CHRIST, GENERAL BOARD OF CHURCH AND SOCIETY, UNITARIAN UNIVERSALIST ASSOCIATION OF CONGREGATIONS. WE'RE PROUD TO HAVE THEIR SUPPORT FOR OUR POSITION.

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  • 03:48:45 PM

    THE PRESIDING OFFICER

    OFFICER: IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERE

  • 03:48:49 PM

    MR. ENZI

    MR. PRESIDENT, I ASSUME THAT ADDED A FEW ADDITIONAL MINUTES TO OUR TIME AS…

    MR. PRESIDENT, I ASSUME THAT ADDED A FEW ADDITIONAL MINUTES TO OUR TIME AS WELL.

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  • 03:48:53 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM WYOMING IS RECOGNIZED.

  • 03:48:58 PM

    MR. ENZI

    MR. PRESIDENT?

  • 03:49:03 PM

    MR. JOHANNS

    MR. PRESIDENT?

  • 03:49:04 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM NEBRASKA.

  • 03:49:06 PM

    MR. JOHANNS

    MR. PRESIDENT, LET ME START MY REMARKS BY OFFERING MY WORDS OF SUPPORT AND…

    MR. PRESIDENT, LET ME START MY REMARKS BY OFFERING MY WORDS OF SUPPORT AND REALLY COMMENDATION TO SENATORS NELSON AND HATCH FOR OFFERING THIS AMENDMENT. THEY -- THEY HAVE LONG BEEN CHAMPIONS OF THE PRO-LIFE CAUSE, AND I APPLAUD THEM FOR PUTTING THE TIME AND EFFORT INTO THIS AMENDMENT TO GET IT RIGHT, BRINGING IT TO THE FLOOR AND OFFERING IT, AND I'M VERY PROUD TO STAND HERE TODAY, MR. PRESIDENT, AS A COSPONSOR OF THIS LEGISLATION. AND FUNDAMENTALLY WHAT THIS LEGISLATION IS ABOUT, REALLY, IS IT'S SIMPLY THE RIGHT THING TO DO. IT ENSURES THAT CURRENT FEDERAL LAW IS UPHELD. IT JUST AT ITS MOST BASIC FORM SAYS THIS. IT SAYS TAXPAYER DOLLARS ARE NOT GOING TO BE USED DIRECTLY OR INDIRECTLY TO FINANCE SELECTIVE ABORTIONS. IN FACT, THIS HAS BEEN THE LAW OF OUR COUNTRY NOW DATING BACK FOR THREE DECADES. BASICALLY, WHAT THIS AMENDMENT DOES IS IT APPLIES THE HYDE AMENDMENT TO THE HEALTH CARE REFORM BILL. IT BARS FEDERAL FUNDING FOR ABORTION EXCEPT IN THE CASE OF RAPE OR INCEST OR TO PROTECT THE LIFE OF THE MOTHER. THE HYDE AMENDMENT, AS WE HAVE HEARD SO MANY TIMES DURING THIS DEBATE, FINDS ITS GENESIS IN 1977. THE LANGUAGE IN THE NELSON-HATCH AMENDMENT IS VIRTUALLY IDENTICAL TO THE STUPAK LANGUAGE THAT WAS INCLUDED IN THE HOUSE BILL. 240 REPRESENTATIVES IN THE HOUSE SUPPORTED THIS, AND IT PASSED ON A VOTE OF 240-194. IT JUST VERY CLEARLY PROHIBITS FEDERAL FUNDING OF ABORTIONS. IT SAYS THIS. ONE, THE GOVERNMENT-RUN PLAN CANNOT COVER ABORTIONS. THAT SEEMS VERY STRAIGHTFORWARD. NUMBER TWO, AMERICANS WHO RECEIVE A SUBSIDY CANNOT USE IT TO BUY HEALTH INSURANCE THAT COVERS ABORTION. THREE, THE FEDERAL GOVERNMENT CANNOT MANDATE ABORTION COVERAGE BY PRIVATE PROVIDERS OR PLANS. AND THEN FINALLY, AS HAS BEEN THE CASE FOR 30 YEARS, PRIVATE INSURANCE PLANS MAY COVER ABORTION AND INDIVIDUALS MAY PURCHASE A PLAN THAT COVERS IT, BUT TAXPAYER DOLLARS CANNOT BE IN THE MIX TO PURCHASE THAT. COMPARE THAT TO WHAT IS IN THE CURRENT SENATE BILL. THE GOVERNMENT-RUN PLAN CAN COVER ABORTION. AMERICANS WHO RECEIVE A SUBSIDY CAN USE IT TO BUY HEALTH INSURANCE POLICY THAT COVERS ABORTION. THE FEDERAL GOVERNMENT CAN AND DOES MANDATE ABORTION COVERAGE BY AT LEAST ONE PROVIDER OR PLAN. AND THERE'S A STIPULATION IN THE CURRENT BILL THAT REQUIRES HEALTH AND HUMAN SERVICES SECRETARY TO ENSURE THE SEGREGATION OF FUNDS, THE TAX CREDIT OF FEDERAL DOLLARS CAN'T BE USED. BUT THE REALITY IS THAT'S LIKE SAYING HERE, PUT THOSE FEDERAL DOLLARS IN YOUR LEFT POCKET. NOW, WHEN YOU'RE PURCHASING THE ABORTION COVERAGE, MAKE SURE THAT IT IS YOUR RIGHT HAND THAT IS REACHING INTO YOUR RIGHT POCKET. AND HOW DO YOU SEGREGATE THOSE FUNDS? IT'S IMPOSSIBLE. WHAT IT DOES IS IT JUST SIMPLY ERASES THE LINE BETWEEN TAXPAYER DOLLARS AND FUNDING OF ABORTIONS. ACCORDING TO THE NATIONAL RIGHT TO LIFE -- AND I'M QUOTING HERE -- "SENATOR REID INCLUDED IN HIS SUBSTITUTE BILL LANGUAGE THAT SOME HAVE CLAIMED WOULD PRESERVE THE PRINCIPLES OF THE HYDE AMENDMENT." SUCH CLAIMS ARE HIGHLY MISLEADING. IN REALITY, THE REID LANGUAGE EXPLICITLY AUTHORIZES DIRECT FUNDING OF ELECTIVE ABORTION BY A FEDERAL GOVERNMENT PROGRAM." WELL, I FEEL VERY STRONGLY WE MUST ENSURE THAT FEDERAL DOLLARS ARE NOT USED TO FUND ABORTION DIRECTLY OR INDIRECTLY. HEALTH CARE REFORM UNDER THE REID LANGUAGE HAS BECOME A VEHICLE FOR CHANGING CURRENT LAW OF THE LAND REGARDING ABORTION COVERAGE. HERE'S WHAT SOME OF MY CONSTITUENTS HAVE SAID TO ME, AND I'M QUOTING FROM A GENTLEMAN IN CARNEY. "IT IS TIME TO MAKE SURE THAT ABORTION IS EXPLICITLY PROHIBITED BY ANY LANGUAGE THAT IS PUT FORWARD. ANOTHER NEBRASKAN SAID TO ME -- AND AGAIN I'M QUOTING -- I KNOW THE HEALTH CARE BILL IS NOT THE ONLY IMPORTANT ISSUE TO CONSIDER BUT IT IS PROBABLY THE MOST IMPORTANT CONCERN I HAVE IN THIS BILL. ABORTION SHOULD NOT BE IN HEALTH CARE." FROM CENTRAL NEBRASKA, I HEARD THIS -- "I'M TAKING A MINUTE TO SEND A NOTE TO SAY THANK YOU FOR STANDING UP FOR LIFE. LIFE IS PRECIOUS, WHETHER YOU'RE JUST CONCEIVED OR OVER 100 YEARS OLD." PRO-LIFE GROUPS ACROSS THE BOARD SUPPORT THIS AMENDMENT. NATIONAL RIGHT TO LIFE, CATHOLIC BISHOPS, FAMILY RESEARCH COUNCIL AND OTHERS. THEY REPRESENT MILLIONS OF AMERICANS. BUT THE REALITY IS AMERICANS SUPPORT THIS. IN A RECENT CNN SURVEY, WE CONFIRMED THAT SIX IN TEN AMERICANS FAVOR A BAN ON THE USE OF FEDERAL FUNDS FOR ABORTION. A RECENT "WASHINGTON POST"/ABC NEWS POLL INDICATES 65% OF ADULTS BELIEVE PRIVATE INSURANCE PLANS PAID FOR WITH GOVERNMENT ASSISTANCE SHOULD NOT INCLUDE COVERAGE OF ABORTION. I WAS IN McCOOK, NEBRASKA, A WHILE BACK DOING A TOWN HALL IN AUGUST. AFTER EVERYBODY HAD LEFT, A GENTLEMAN CAME UP TO ME. HE TOLD ME SOMETHING ABOUT THIS THAT I'LL REMEMBER ALL OF THE YEARS I'M IN THE SENATE. FIRST HE SPOKE ABOUT HIS FAITH. AND THEN HE SAID I HOPE YOU UNDERSTAND, SENATOR, I CANNOT UNDER ANY CIRCUMSTANCES AGREE TO ANYTHING THAT WOULD ALLOW MY TAXPAYER DOLLARS EITHER DIRECTLY OR INDIRECTLY TO FUND ABORTIONS. HE SAID I CANNOT GO THERE. HE SAID PLEASE DO EVERYTHING YOU CAN TO STOP THIS FROM HAPPENING. AND TODAY I STAND WITH THAT GENTLEMAN IN McCOOK, NEBRASKA, TO SAY THAT WE HAVE TO STOP THIS. I APPLAUD MY COLLEAGUE FROM NEBRASKA. I WANT TO END MY COMMENTS THERE. SENATOR NELSON HAS STOOD UP ON THIS ISSUE AND RECENTLY IN AN INTERVIEW, HE SAID THIS -- "I HAVE SAID AT THE END OF THE DAY, IF IT DOESN'T HAVE STUPAK LANGUAGE ON ABORTION IN IT, I WON'T MOVE -- I WON'T VOTE TO MOVE IT OFF THE FLOOR." I THINK THAT'S A COURAGEOUS STATEMENT. I DON'T MIND STANDING HERE AND SAYING I'M VERY, VERY PLEASED TO ASSOCIATE MYSELF WITH SENATOR NELSON AND SENATOR HATCH ON THIS IMPORTANT AMENDMENT. HOW MUCH TIME DO I HAVE LEFT?

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  • 03:56:22 PM

    THE PRESIDING OFFICER

    THE SENATOR HAS TWO MINUTES AND 45 SECONDS LEFT.

  • 03:56:26 PM

    MR. JOHANNS

    I WILL YIELD MY TWO MINUTES AND 45 SECONDS TO SENATOR HATCH WHEN HE…

    I WILL YIELD MY TWO MINUTES AND 45 SECONDS TO SENATOR HATCH WHEN HE SPEAKS. THANK YOU, MR. PRESIDENT. I YIELD THE FLOOR.

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  • 03:56:35 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION. THE SENATOR FROM KANSAS IS RECOGNIZED.

  • 03:56:46 PM

    MR. BROWNBACK

    MR. PRESIDENT?

  • 04:06:26 PM

    MR. HATCH

    MR. PRESIDENT?

  • 04:06:27 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM UTAH. WHO YIELDS TIME?

  • 04:06:32 PM

    MR. GRASSLEY

    THE SENATOR FROM UTAH.

  • 04:06:36 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM UTAH.

  • 04:06:38 PM

    MR. HATCH

    WITHOUT OBJECTION.

  • 04:21:10 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 04:21:12 PM

    MR. HATCH

    ASK UNANIMOUS CONSENT THAT THE BALANCE OF MY REMARKS -- I UNDERSTAND THAT…

    ASK UNANIMOUS CONSENT THAT THE BALANCE OF MY REMARKS -- I UNDERSTAND THAT THERE IS A DESIRE TO MOVE AHEAD HERE -- AND THE BALANCE OF MY REMARKS BE PLACED IN THE RECORD AT THIS POINT.

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  • 04:21:19 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION. A SENATOR: MR. PRESIDENT? MR. PRESIDENT?

  • 04:21:25 PM

    THE PRESIDING OFFICER

    MR. PRESIDENT, I --

  • 04:21:29 PM

    MR. BAUCUS

    THE SENATOR FROM MONTANA.

  • 04:21:30 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM MONTANA.

  • 04:21:32 PM

    MR. BAUCUS

    THE SENATOR FROM NEBRASKA NOW BE ALLOWED TO SPEAK FOR UP TO TEN MINUTES.

  • 04:21:36 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 04:21:41 PM

    MR. NELSON

    MR. PRESIDENT, I RISE TO DISCUSS THE BIPARTISAN AMENDMENT WHICH I HAVE…

    MR. PRESIDENT, I RISE TO DISCUSS THE BIPARTISAN AMENDMENT WHICH I HAVE PROPOSED WITH SENATORS HATCH AND THE PRESIDING OFFICER AND OTHERS. AS MY GOOD FRIEND AND COLLEAGUE FROM UTAH HAS SO ELOQUENTLY EXPLAINED, OUR AMENDMENT MIRRORS THE LANGUAGE OFFERED BY REPRESENTATIVE STUPAK THAT WAS ACCEPTED INTO THE HOUSE HEALTH CARE BILL. OUR VIEW IS THAT IT SHOULD BECOME PART OF THE SENATE HEALTH CARE BILL WE'RE DEBATING AS WELL. IT'S A FACT THAT THE ISSUE OF ABORTION STIRS VERY STRONG EMOTIONS INVOLVING STRONGLY HELD PRINCIPLES ALL ACROSS AMERICA FROM THOSE WHO SUPPORT THE PROCEDURE AND THOSE WHO DO NOT. AND WE'RE HEARING THAT PASSION AT TIMES HERE ON THE SENATE FLOOR. BUT WE'RE NOT HERE TO DEBATE FOR OR AGAINST ABORTION. THIS IS A DEBATE ABOUT TAXPAYER MONEY. IT'S A DEBATE ABOUT WHETHER IT IS APPROPRIATE FOR PUBLIC FUNDS TO, FOR THE FIRST TIME IN MORE THAN THREE DECADES, COVER ELECTIVE ABORTIONS. IN MY OPINION, MOST AMERICANS AND MOST OF THE PEOPLE IN MY STATE WOULD SAY "NO." AND AS IT IS CURRENTLY WRITTEN, THOUGH THE SENATE HEALTH CARE BILL ENABLES TAXPAYER DOLLARS DIRECTLY AND INDIRECTLY TO PAY FOR INSURANCE PLANS THAT COVER ABORTION, WE SHOULD NOT OPEN THE DOOR TO DO SO. AND AS I SAID YESTERDAY WHEN WE INTRODUCED THE AMENDMENT, SOME SUGGEST THAT THE STUPAK LANGUAGE IMPOSES NEW RESTRICTIONS ON ABORTION, BUT THAT'S NOT REALLY THE CASE. WE'RE SEEKING TO JUST APPLY THE SAME STANDARDS TO THE SENATE HEALTH CARE BILL THAT ALREADY EXIST FOR MANY FEDERAL HEALTH PROGRAMS. BUT THE BILL DOES SET A NEW STANDARD. IT'S STANDARD IN FAVOR OF PUBLIC FUNDING OF ABORTION. AND OUR AMENDMENT DOESN'T LIMIT THE PROCEDURE, NOR PREVENT PEOPLE FROM BUYING INSURANCE THAT COVERS ABORTION WITH THEIR OWN MONEY; IT ONLY ENSURES THAT WHEN TAXPAYER DOLLARS ARE INVOLVED, PEOPLE AREN'T REQUIRED TO PAY FOR OTHER PEOPLE'S ABORTIONS. AND SOME HAVE CLAIMED THAT THE AMENDMENT RESTRICTS ABORTION COVERAGE, EVEN THOSE -- FOR THOSE WHO PAY FOR THEIR OWN PLAN. THAT ISN'T TRUE. ACCORDING TO POLITIFACT.COM, A PRIZE-WINNING FACT-CHECKING WEB SITE WHICH LOOKED AT SIMILAR CLAIMS BY A HOUSE MEMBER DURING HOUSE DEBATE ON THE STUPAK AMENDMENT, POLITIFACT FOUND, FIRST SHE SUGGESTS THE AMENDMENT APPLIES TO EVERYONE IN THE PRIVATE INSURANCE MARKET WHEN IT JUST APPLIES TO THOSE IN THE HEALTH CARE EXCHANGE. SECOND, HER STATEMENT THAT THE RESTRICTIONS WOULD AFFECT WOMEN, EVEN WHEN THEY WOULD PAY PREMIUMS WITH THEIR OWN MONEY IS INCORRECT. IN FACT, WOMEN ON THE EXCHANGE WOULD PAY THE PREMIUMS WITH THEIR OWN MONEY, WILL BE ABLE TO GET ABORTION COVERAGE, SO WE FIND HER STATEMENT FALSE. END OF THE QUOTE. NOW, THE NELSON-HATCH-CASEY AMENDMENT ONLY INCORPORATES THE LONG-STANDING RULES OF THE HYDE AMENDMENT WHICH CONGRESS APPROVED IN 1976 TO ENSURE THAT NO FEDERAL FUNDS ARE USED TO PAY FOR ABORTION IN THE LEGISLATION. THIS STANDARD NOW APPLIES TO FEDERAL HEALTH PROGRAMS COVERING SUCH WIDE AND BROAD GROUPS AS VETERANS, FEDERAL EMPLOYEES, NATIVE AMERICANS, ACTIVE DUTY SERVICE MEMBERS, AND OTHERS, ALL OF WHOM ARE COVERED UNDER SOME FORM OF A FEDERAL HEALTH PROGRAM. THUS, THE STANDARD APPLIES TO INDIVIDUALS PARTICIPATING IN THE CHILDREN'S HEALTH INSURANCE PROGRAM, MEDICARE, MEDICAID, INDIAN HEALTH SERVICES, VETERANS HEALTH, AND MILITARY HEALTH ORGANIZATIONS. AND I'D LIKE TO EMPHASIZE ANOTHER POINT. ALL CURRENT FEDERAL HEALTH PROGRAMS DISALLOW THE USE OF FEDERAL FUNDS TO HELP PAY FOR HEALTH PLANS THAT INCLUDE ABORTION. OUR AMENDMENT ONLY CONTINUES THAT ESTABLISHED FEDERAL POLICY. SOME HAVE SAID THAT THE HYDE AMENDMENT ALREADY IS IN EFFECT IN THIS BILL, BUT THAT'S REALLY NOT THE CASE AT ALL. THE BILL SAYS THAT THE SECRETARY OF HEALTH AND HUMAN SERVICES MAY ALLOW ELECTIVE ABORTION COVERAGE IN THE COMMUNITY HEALTH INSURANCE OPTION -- THE PUBLIC OPTION -- IF THE SECRETARY BELIEVES THERE IS SUFFICIENT SEGREGATION OF FUNDS TO ENSURE FEDERAL TAX CREDITS ARE NOT USED TO PURCHASE THAT PORTION OF THE COVERAGE. THE BILL WOULD ALSO REQUIRE THAT AT LEAST ONE INSURANCE PLAN COVER ABORTION AND ONE THAT DOES NOT COVER ABORTION BE OFFERED ON EVERY STATE INSURANCE EXCHANGE. FEDERAL LEGISLATION ESTABLISHING A PUBLIC OPTION THAT PROVIDES ABORTION COVERAGE AND FEDERAL LEGISLATION ALLOWING STATES TO OPT OUT OF THE PUBLIC OPTION THAT PROVIDES ABORTION COVERAGE EASES -- LET ME REPEAT THE WORD -- EASES THE STANDARDS ESTABLISHED BY THE HYDE AMENDMENT. THE CLAIM THAT THE SEGREGATION OF FUNDS ACCOMPLISHES THE HYDE INTENT FALSE SHORT. SEGREGATION OF FUNDS IS AN ACCOUNTING GIMMICK. THE REALITY IS, TAXPAYER-SUPPORTED FEDERAL DOLLARS WOULD HELP BUY INSURANCE COVERAGE THAT INCLUDES COVERING ABORTION. I'D LIKE TO OFFER SOME OTHER POINTS ABOUT THE EFFECT OF THE NELSON-HATCH-CASEY AMENDMENT. UNDER THE AMENDMENT, NO FUNDS AUTHORIZED OR APPROPRIATED BY THE BILL COULD BE USED FOR ABORTIONS OR FOR BENEFITS PACKAGES THAT INCLUDE ABORTION. THE AMENDMENT WOULD PROHIBIT THE USE OF THE AFFORDABILITY TAX CREDITS TO PURCHASE A HEALTH INSURANCE POLICY THAT COVERS ABORTION. IT WOULD ALSO PROHIBIT FEDERAL FUNDING FOR ABORTION UNDER THE COMMUNITY HEALTH INSURANCE OPTION. IN ADDITION, THE AMENDMENT MAKES EXCEPTIONS IN THE CASE -- CASES OF RAPE OR INCEST OR IN CASES OF DANGER TO THE MOTHER'S LIFE. IN ADDITION, THE AMENDMENT ALLOWS AN INDIVIDUAL TO USE THEIR OWN PRIVATE FUNDS TO PURCHASE SEPARATE SUPPLEMENTAL INSURANCE COVERAGE FOR ABORTIONS. PERHAPS EVEN WHAT IS CALLED A RIDER TO AN EXISTING PLAN. THE AMENDMENT ALLOWS AN INDIVIDUAL WHOSE PRIVATE HEALTH CARE COVERAGE IS NOT SUBSIDIZED BY THE FEDERAL GOVERNMENT TO PURCHASE OR BE COVERED BY A PLAN THAT INCLUDES ELECTIVE ABORTIONS, PAID FOR WITH THAT INDIVIDUAL'S OWN PREMIUM DOLLARS. AND YOUR UNDER THE AMENDMENT, A PRIVATE INSURER PARTICIPATING IN THE EXCHANGE CAN OFFER A PLAN THAT INCLUDES ELECTIVE ABORTION COVERAGE TO NONSUBSIDIZED INDIVIDUALS ON THE EXCHANGE AS LONG AS THEY ALSO OFFER THE SAME PLAN WITHOUT ELECTIVE ABORTION COVERAGE TO THOSE WHO RECEIVE FEDERAL SUBSIDIES. AND ON ANOTHER POINT, UNDER FEDERAL LAW, STATES ARE ALLOWED TO SET THEIR OWN POLICIES CONCERNING ABORTION. MANY STATES OPPOSE THE USE OF PUBLIC FUNDS FOR ABORTION. MANY STATES HAVE ALSO PASSED LAWS THAT REGULATE ABORTION BY REQUIRING INFORMED CONSENT AND WAITING PERIODS, REQUIRING PARENTAL INVOLVEMENT IN CASES WHERE MINORS SEEK ABORTIONS, AND PROTECTING THE RIGHTS OF HEALTH CARE PROVIDERS WHO REFUSE AS A MATTER OF CONSCIENCE TO ASSIST IN ABORTIONS. BUT PERHAPS MOST IMPORTANTLY, THERE IS NO FEDERAL LAW, NOR IS THERE ANY STATE LAW, THAT REQUIRES A PRIVATE HEALTH PLAN TO INCLUDE ABORTION COVERAGE. BUT THE BILL BEFORE US, AS WRITTEN, DOES. SO, MR. PRESIDENT, AS I'VE SAID, THE CURRENT HEALTH CARE BILL WE'RE DEBATING SHOULD NOT BE USED TO OPEN A NEW AVENUE FOR PUBLIC FUNDING OF ABORTION. WE SHOULD PRESERVE THE CURRENT POLICIES WHICH HAVE STOOD THE TEST OF TIME, WHICH ARE SUPPORTED BY MOST NEBRASKANS AND AMERICANS. THE SENATE BILL, AS PROPPED PROPOSED, GOES AGAINST THAT MAJORITY OPINION. I THINK MOST AMERICANS WOULD PREFER THAT THIS HEALTH CARE BILL REMAIN NEUTRAL ON ABORTION, NOT CHART A NEW COURSE PROVIDING PUBLIC FUNDS FOR THE PROCEDURE. PUBLIC OPINION SUGGESTS SO. SO DOES THE FACT THAT OVER THE LAST 30-PLUS YEARS, CONGRESS HAS PASSED NEW FEDERAL LAWS THAT HAVE NOT BROKEN WITH PRECEDENT. FINALLY, AS PRESIDENT OBAMA HAS SAID, THIS IS A HEALTH CARE REFORM BILL. IT IS NOT AN ABORTION BILL. SO IT'S TIME TO SIMPLY EXTEND A LONG-STANDING STANDARD DISALLOWING PUBLIC FUNDING OF ABORTION TO NEW PROPOSED FEDERAL LEGISLATION. MR. PRESIDENT, I YIELD THE FLOOR.

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  • 04:30:10 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM MONTANA.

  • 04:30:11 PM

    MR. BAUCUS

    MR. PRESIDENT, I YIELD TO THE SENATOR FROM CALIFORNIA. IT IS OUR…

    MR. PRESIDENT, I YIELD TO THE SENATOR FROM CALIFORNIA. IT IS OUR UNDERSTANDING THAT SENATOR REID WILL SOON COME TO THE FLOOR TO SPEAK.

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  • 04:30:23 PM

    MRS. FEINSTEIN

    THE SENATOR FROM CALIFORNIA.

  • 04:30:27 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM CALIFORNIA.

  • 04:30:29 PM

    MRS. FEINSTEIN

  • 04:38:41 PM

    MR. NELSON

  • 04:38:42 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM NEBRASKA.

  • 04:38:46 PM

    MR. NELSON

    TO SUMMARIZE THE REASONS FOR THE INTENT OF THE AMENDMENT THAT SENATOR…

    TO SUMMARIZE THE REASONS FOR THE INTENT OF THE AMENDMENT THAT SENATOR HATCH AND YOU AND I, TOGETHER WITH OTHERS, HAVE PROPOSED TO THE HEALTH CARE BILL. FIRST OF ALL, I SHOULD SAY THAT THE EXAMPLES THAT OUR VERY GOOD FRIEND FROM CALIFORNIA HAVE OUTLINED WOULD NOT HAVE BEEN COVERED UNDER THE FEDERAL EMPLOYEES HEALTH BENEFIT PLAN BECAUSE THE FEDERAL EMPLOYEES HEALTH BENEFIT PLAN DOES NOT PROVIDE ABORTION COVERAGE FOR SUCH CIRCUMSTANCES. NOW, OUR AMENDMENT MIRRORS THE LANGUAGE THAT'S OFFERED BY -- HAS BEEN OFFERED BY REPRESENTATIVE STUPAK THAT WAS ADOPTED INTO THE HOUSE HEALTH CARE BILL, AND WE BELIEVE THAT IT SHOULD BE APPLIED TO THE SENATE BILL AS WELL. AND AS I SAID EARLIER, THE ISSUE OF ABORTION CERTAINLY PROMPTS STRONG OPINIONS, FIERCE PASSIONS AND DEEP-SEATED PRINCIPLES FOR MILLIONS AND MILLIONS OF AMERICANS, THOSE WHO SUPPORT THE PROCEDURE AND THOSE WHO DON' BUT OUR AMENDMENT DOES NOT TAKE SIDES ON ABORTION. IT'S ABOUT THE USE OF TAXPAYER MONEY. THE QUESTION BEFORE US IS WHETHER PUBLIC FUNDS FOR THE FIRST TIME IN MORE THAN THREE DECADES SHOULD COVER ELECTIVE ABORTIONS. NUMEROUS PUBLIC OPINION POLLS HAVE SHOWN THAT MOST AMERICANS, INCLUDING THE NUMBER WHO SUPPORT ABORTION, DO NOT SUPPORT PUBLIC FUNDS PAYING FOR ABORTION. BUT THE SENATE BILL WE'RE DEBATING ALLOWS TAXPAYER DOLLARS DIRECTLY AND INDIRECTLY TO PAY FOR INSURANCE PLANS THAT COVER ABORTION, AND THAT'S OUT OF STEP WITH THE MAJORITY OF NEBRASKANS AND OF ALL AMERICANS. OUR AMENDMENT DOES NOT IMPOSE NEW RESTRICTIONS ON WOMEN DESPITE WHAT SOME HAVE CLAIMED. AND I RESPECT -- EXPECT THEY STRONGLY DISAGREE WITH THEM. WE'RE SEEKING TO APPLY THE SAME STANDARDS TO THE SENATE HEALTH CARE BILL THAT ALREADY EXISTS FOR EVERY FEDERAL HEALTH PROGRAM. OUR AMENDMENT DOES NOT ADD A NEW RESTRICTION, BUT THE BILL DOES ADD A NEW RELAXATION OF A FEDERAL STANDARD THAT HAS WORKED WELL FOR MORE THAN 30 YEARS. UNDER OUR AMENDMENT ABORTION ISN'T LIMITED NOR WOULD PEOPLE BE PREVENTED FROM BUYING INSURANCE ON THE PRIVATE MARKET WITH THEIR OWN MONEY. OUR AMENDMENT ONLY INSURES THAT WHEN TAXPAYER MONEY ENTERS THE PICTURE PEOPLE ARE NOT REQUIRED TO PAY FOR OTHER PEOPLE'S ABORTIONS. THE NELSON-HATCH-CASEY AMENDMENT INCORPORATES THE LONGG STANDING STANDARD ESTABLISHED BY THE HYDE AMENDMENT WHICH CONGRESS APPROVED IN 1976. TODAY IT APPLIES TO EVERY FEDERAL HEALTH PROGRAM. THAT INCLUDES PLANS THAT COVER VETERANS, FEDERAL EMPLOYEES, INCLUDING MEMBERS OF CONGRESS, NATIVE AMERICANS, ACTIVE-DUTY SERVICE MEMBERS, AND A WHOLE HOST OF OTHERS. NOW SOME PEOPLE HAVE CALLED OUR AMENDMENT RADICAL. NOTHING COULD BE FURTHER FROM THE TRUTH. IT IS REASONABLE. IT IS RATIONAL BECAUSE IT FOLLOWS ESTABLISHED FEDERAL LAW. AND IT'S RIGHT. TAXPAYERS SHOULDN'T BE REQUIRED TO PAY FOR PEOPLE'S ABORTIONS. IT'S JUST THAT SIMPLE. THANK YOU, MR. PRESIDENT, AND I YIELD THE FLOOR, AND I NOTE THE ABSENCE OF A QUORUM.

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  • 04:42:04 PM

    THE PRESIDING OFFICER

    MR. PRESIDENT?

  • 04:46:00 PM

    Quorum Call

  • 04:51:21 PM

    MR. REID

    THE MAJORITY LEADER.

  • 04:51:22 PM

    THE PRESIDING OFFICER

    OFFICER: THE MAJORITY LEADER.

  • 04:51:29 PM

    MR. REID

    ARE WE IN A QUORUM CALL?

  • 04:51:31 PM

    THE PRESIDING OFFICER

    I ASK CONSENT THAT IT IS RESCIND.

  • 04:51:34 PM

    THE PRESIDING OFFICER

    I ASK CONSENT THAT IT IS RESCIND.

  • 04:51:37 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 04:51:41 PM

    MR. REID

    ORDER IN THE SENATE.

  • 05:09:38 PM

    MRS. BOXER

    I ASK UNANIMOUS CONSENT THAT THE SENATE PROCEED TO A VOTE IN RELATION TO…

    I ASK UNANIMOUS CONSENT THAT THE SENATE PROCEED TO A VOTE IN RELATION TO THE NELZ--- NELSON-HATCH NUMBER 2 62. THAT THERE BE TWO MINNEAPOLIS OF DEBATE PRIOR TO A VOTE IN RELATION TO THE McCAIN MOTION TO COMMIT, EQUALLY DIVIDED AND CONTROLLED IN THE USUAL FORM. THAT UPON YIELDING BACK THE USE OF THAT TIME, THE SENATE PROCEED TO VOTE IN RELATION TO THE McCAIN MOTION TO COMMIT.

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  • 05:10:19 PM

    THE PRESIDING OFFICER

    OFFICER: IS THERE OBJECTION? WITHOUT OBJECTION, SO ORDERED.

  • 05:10:22 PM

    MRS. BOXER

    MR. PRESIDENT, I MOVE TO TABLE THE NELSON AMENDMENT AND I ASK FOR THE YEAS…

    MR. PRESIDENT, I MOVE TO TABLE THE NELSON AMENDMENT AND I ASK FOR THE YEAS AND NAYS.

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  • 05:10:26 PM

    THE PRESIDING OFFICER

    IS THERE A SUFFICIENT SECOND? THERE APPEARS TO BE. THERE IS. THE QUESTION…

    IS THERE A SUFFICIENT SECOND? THERE APPEARS TO BE. THERE IS. THE QUESTION IS ON THE MOTION TO TABLE. THE CLERK WILL CALL THE ROLL. VOTE: VOTE:

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  • 05:10:47 PM

    Senate Vote 369 - On the Motion to Table (Motion to Table Nelson Amdt No 2962)

    To prohibit the use of Federal funds for abortions.

    Motion to Table Agreed to (54 - 45)
    Yea
    Nay

    Vote Details: Yea - 53
    Democratic - 49
    Independent - 2
    Republican - 2

    Vote Details: Nay - 45
    Republican - 38
    Democratic - 7

  • 05:33:26 PM

    THE PRESIDING OFFICER

    ARE THERE ANY SENATORS IN THE CHAMBER WISHING TO VOTE OR CHANGE THEIR…

    ARE THERE ANY SENATORS IN THE CHAMBER WISHING TO VOTE OR CHANGE THEIR VOTE? IF NOT, THE YEAS ARE 54, THE NAYS ARE 45RBG THE MOTION TO TABLE HAS BEEN AGREED TO. UNDER THE PREVIOUS ORDER, THERE WILL BE TWO MINUTES OF DEBATE EQUALLY DIVIDED PRIOR TO A VOTE IN RELATION TO THE MOTION TO COMMIT OFFERED BY THE SENATOR FROM ARIZONA, MR. McCAIN. COULD WE HAVE ORDER IN THE SENATE, PLEASE. WITHOUT OBJECTION.

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  • 05:34:27 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM MONTANA. COULD WE HAVE ORDER IN THE SENATE,…

    OFFICER: THE SENATOR FROM MONTANA. COULD WE HAVE ORDER IN THE SENATE, PLEASE. PLEASE MOVE YOUR CONVERSATIONS OFF THE FLOOR. THE SENATOR PROSECUTE MONTANA.

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  • 05:34:38 PM

    MR. BAUCUS

    THE SENATE IS NOT IN ORDER.

  • 05:34:42 PM

    THE PRESIDING OFFICER

    OFFICER: WOULD YOU PLEASE -- ORDER IN THE SENATE. WOULD YOU PLEASE MOVE…

    OFFICER: WOULD YOU PLEASE -- ORDER IN THE SENATE. WOULD YOU PLEASE MOVE OUT OF THE WELL. THE SENATOR FROM MONTANA.

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  • 05:34:56 PM

    MR. BAUCUS

    THE SENATORS'S TIME HAS EXPIRED.

  • 05:35:55 PM

    THE PRESIDING OFFICER

    THE SENATORS'S TIME HAS EXPIRED.

  • 05:35:57 PM

    MR. BAUCUS

    FOR ALL THESE REASONS AND THE OTHERS I HAVE IN MY STATEMENT HERE, I URGE…

    FOR ALL THESE REASONS AND THE OTHERS I HAVE IN MY STATEMENT HERE, I URGE US TO VOTE AGAINST THE McCAIN AMENDMENT BECAUSE THAT WOULD BE A VOTE -- TO VOTE AGAINST McCAIN IS A VOTE IN FAVOR OF SENIORS.

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  • 05:36:10 PM

    MR. McCAIN

    THE SENATE WILL BE IN ORDER.

  • 05:36:14 PM

    THE PRESIDING OFFICER

    THE SENATE WILL BE IN ORDER.

  • 05:36:17 PM

    MR. McCAIN

    PRESIDENT, THIS AMENDMENT IS JUST ABOUT AN EARMARK. THAT'S ALL IT IS. IT…

    PRESIDENT, THIS AMENDMENT IS JUST ABOUT AN EARMARK. THAT'S ALL IT IS. IT IS ABOUT A SPECIAL DEAL CUT FOR A SPECIAL GROUP OF PEOPLE THAT HAPPEN TO RESIDE IN THE STATE OF FLORIDA. AND I'VE NEVER -- I'M NEVER SO PRESUMPTUOUS. I'VE LOST TOO MANY VOTES TRYING TO ELIMINATE EARMARKS. WHAT I'M TRYING TO DO ALLOW EVERY -- WHAT I AM A TRUEING TO DO IS ALLOW EVERY AMERICAN ENROLLED IN MEDICARE ADVANTAGE TO HAVE THE SAME PROTECTION OF THEIR MEDICARE ADVANTAGE PROGRAM AS THE SENATOR FROM FLORIDA HAS CUT OUT IN THIS BILL. THAT'S ALL IT'S ABOUT. IT'S ABOUT EQUALITY. IT'S ABOUT NOT LETTING ONE SPECIAL GROUP OF PEOPLE WHO RESIDE IN A PARTICULAR STATE GET A BETTER DEAL THAN THOSE WHO LIVE IN THE REST OF THE COUNTRY. THAT'S ALL THIS AMENDMENT IS B AND SO WE IT WILL PROBABLY BE VOTED DOWN

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  • 05:37:27 PM

    THE PRESIDING OFFICER

    OFFICER: IS THERE A SUFFICIENT SECOND? THERE IS A SUFFICIENT SECOND. THE…

    OFFICER: IS THERE A SUFFICIENT SECOND? THERE IS A SUFFICIENT SECOND. THE QUESTION IS ON THE McCAIN MOTION TO COMMIT. THE CLERK WILL CALL THE ROLL. VOTE: # VOTE:

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  • 05:37:41 PM

    Senate Vote 370 - On the Motion (McCain Motion to Commit HR 3590 to the Committee on Finance)

    Health care reform bill

    Motion Rejected (42 - 57)
    Yea
    Nay

    Vote Details: Yea - 42
    Republican - 40
    Democratic - 2

    Vote Details: Nay - 56
    Democratic - 54
    Independent - 2

  • 05:58:07 PM

    THE PRESIDING OFFICER

    ARE THERE ANY SENATORS IN THE CHAMBER WHO WANT TO VOTE OR CHANGE THEIR…

    ARE THERE ANY SENATORS IN THE CHAMBER WHO WANT TO VOTE OR CHANGE THEIR VOTE? IF NOT, ON THIS VOTE THE YEAS ARE 42, NAYS 57. UNDER THE PREVIOUS ORDER REQUIRING 60 VOTES FOR THE ADOPTION OF THIS MOTION, THE MOTION IS WITHDRAWN. THE SENATOR FROM TEXAS.

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  • 05:58:26 PM

    MR. DORGAN

    WITHOUT OBJECTION.

  • 05:58:56 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 05:58:57 PM

    MR. DORGAN

    MR. PRESIDENT, SENATOR KAUFMAN WOULD BE RECOGNIZED AS A PART OF THE…

    MR. PRESIDENT, SENATOR KAUFMAN WOULD BE RECOGNIZED AS A PART OF THE COLLOQUY WITH SENATOR KLOBUCHAR.

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  • 05:59:03 PM

    THE PRESIDING OFFICER

  • 05:59:04 PM

    MRS. HUTCHISON

  • 05:59:05 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM TEXAS.

  • 05:59:07 PM

    MRS. HUTCHISON

    MR. PRESIDENT, WE HAVE SPENT THE LAST FEW DAYS HIGHLIGHTING HOW THIS…

    MR. PRESIDENT, WE HAVE SPENT THE LAST FEW DAYS HIGHLIGHTING HOW THIS HEALTH CARE REFORM BILL IS PAID FOR BY CUTTING BENEFITS TO SENIORS, JEOPARDIZING THEIR ACCESS TO CARE. ALMOST $500 BILLION WILL BE CUT FROM THE MEDICARE PROGRAM. BUT THIS BILL ALSO IMPOSES $500 BILLION IN NEW TACKS. THESE ARE -- IN NEW TAXES. THESE ARE TAXES THAT HIT EVERY AMERICAN AND VIRTUALLY EVERY BUSINESS AND HEALTH CARE-RELATED BUSINESSES. THESE TAXES WILL DISCOURAGE INVESTMENT AND HIRING. WE ARE IN ONE OF THE WORST ECONOMIC DOWNTURNS IN THE HISTORY OF OUR COUNTRY. WE DON'T NEED TO TELL ANYBODY THAT. WE'RE ALL FEELING IT. WE KNOW PEOPLE WHO ARE REALLY SUFFERING RIGHT NOW. I LOOK AT WHAT HAS BEEN DONE IN THE PAST WHEN WE'VE HAD ECONOMIC DOWNTURNS, AND I LOOK AT PRESIDENT KENNEDY, PRESIDENT REAGAN, PRESIDENT BUSH. THEY LOWERED TAXES. AND WHAT HAPPENED? THE ECONOMY WAS SPURRED. LOWER TAXES ARE PROVEN TO SPUR THE ECONOMY. AND YET, IN THIS BILL WE SEE $500 BILLION IN NEW TAXES ON FAMILIES AND SMALL BUSINESSES. LET'S WALK THROUGH SOME OF THESE TAXES. EMPLOYER TAXES, $28 BILLION IN NEW TAXES IS IMPOSED ON BUSINESSES THAT DON'T PROVIDE HEALTH INSURANCE TO THEIR EMPLOYEES. AND TO AVOID THE TAX, AN EMPLOYER HAS TO PROVIDE THE RIGHT KIND OF INSURANCE, INSURANCE THAT THE FEDERAL GOVERNMENT APPROVES. IT'S GOING TO BE A CERTAIN PERCENTAGE AND HAVE CERTAIN COVERAGE REQUIREMENTS. EMPLOYERS WHO DON'T PROVIDE THE RIGHT KIND OF INSURANCE COULD SEE A PENALTY AS HIGH AS $3,000 PER EMPLOYEE. MADAM PRESIDENT, WE SHOULD BE ENCOURAGING PEOPLE TO HIRE IN THIS KIND OF ENVIRONMENT. THAT SHOULD BE JOB NUMBER ONE -- CREATING JOBS. AND YET, IMPOSING TAXES AND FINES ARE WHAT IS IN THIS BILL, AND THAT IS NOT GOING TO ENCOURAGE HIRING -- IT IS GOING TO DISCOURAGE HIRING. THAT IS ECONOMICS 101. INDIVIDUAL TAXES. THERE ARE $8 BILLION IN TAXES FOR THOSE WHO DON'T PURCHASE INSURANCE ON THEIR OWN. THE TAX IS $750 PER PERSON. AGAIN, BECAUSE YOU ARE INSURED TODAY DOES NOT MEAN YOU WILL AVOID THE TAX. YOU MUST HAVE THE RIGHT KIND OF INSURANCE. INSURANCE THAT THE FEDERAL GOVERNMENT APPROVES AND SAYS IS THE RIGHT AMOUNT OF INSURANCE. HOW ABOUT THE TAXES ON HIGH BENEFIT PLANS? THERE ARE $149 BILLION TAXES ON BENEFIT PLANS THAT THE GOVERNMENT SAYS ARE TOO ROBUST MUCH THESE HIGH-BENEFIT PLANS, CADILLAC PLANS, SOME CALL THEM, WOULD BE SUBJECT TO A 40% EXCISE TAX. TO MAKE IT WORSE, THE TAX IS NOT INDEXED, SO IT'S REALLY A NEW A.M.T., A NEW ALTERNATIVE MINIMUM TAX THAT EVERYONE SAYS WAS NOT SUPPOSED TO ENCROACH ON LOWER-INCOME PEOPLE, BUT, IN FACT, IT HAS BECAUSE IT'S NOT INDEXED FOR INFLATION. HERE WE ARE IN THIS BILL, YOU GET TAXED IF YOU DON'T PROVIDE ENOUGH BENEFITS, AND YOU GET TAXED IF YOU PROVIDE TOO MANY BENEFITS. SO THIS IS BEGINNING TO TO SOUND LIKE GOVERNMENT-RUN HEALTH CARE TO ME. AND I CAN ONLY IMAGINE HOW THE UNIONS FEEL BECAUSE THEY'RE THE ONES WHO HAVE THE HIGH-BENEFIT PLANS. AND HERE THEY ARE UNDER FIRE BECAUSE THEY HAVE TOO MUCH COVERAGE. MEDICARE PAYROLL TAX. THIS IS THE NEW PAYROLL TAX THAT IS IMPOSED ON INDIVIDUALS MAKING MORE THAN $200,000 AND COUPLES MAKING MORE THAN $250,000. THAT TAX RAISES ANOTHER ANOTHER $54 BILLION. THIS ADDITIONAL PAYROLL TAX IS A MARRIAGE PENALTY. IT IS NOT INDEXED TO INFLATION, MEANING, IT IS ANOTHER A.M.T. IN THE MAKING. BECAUSE TODAY THAT MAY SOUND HIGH, $200,000 AND $250,000, BUT IT IS A HUGE PENALTY, AND IT COULD BEGIN TO GO DOWN IN NUMBER SO THAT MORE AND MORE PEOPLE ARE AFFECTED. YOU KNOW, THIS BODY VOTED UNANIMOUSLY DURING THE BUDGET DEBATE UNANIMOUSLY THAT A POINT OF ORDER WOULD BE AGAINST LEGISLATION THAT WOULD IMPOSE -- IMPOSE A MARRIAGE PENALTY IN THE BUDGET. SO WE HAVE VOTED UNANIMOUSLY THAT A BUDGET POINT OF ORDER WOULD LIE IF THERE IS A MARRIAGE PENALTY IN THE BUDGET. SO NOW HERE WE ARE A FEW MONTHS LATER AND THE MAJORITY IS IN THE ONLY RETREATING FROM THE OPPOSITION TO THE MARRIAGE PENALTY, BUT WE NOW HAVE FOR THE FIRST TIME IN OUR TAX CODE, OR WILL WHEN THIS BILL PASSES, A PAYROLL TAX MARRIAGE PENALTY. HOW ON EARTH CAN WE DO THAT? I AM GOING TO FIGHT THIS MARRIAGE PENALTY AND I HOPE THAT THE SENATE THAT VOTED AGAINST THIS CONCEPT -- IT IS A NEW PRECEDENT THAT COULD BE SET IN OTHER AREAS THAT WOULD SAY IF YOU ARE MARRIED, YOU ARE GOING TO GET FEWER BENEFITS THAN IF YOU ARE SINGLE. THAT IS NOT A PRECEDENT THAT WE OUGHT TO BE SETTING. AND THEN THERE IS THE MEDICAL DEDUCTION CAP. THERE IS A CHANGE IN OUR TAX CODE THAT WOULD LIMIT THE ITEMIZED DEDUCTION FOR MEDICAL EXPENSES. WE ALWAYS HAD ONE THAT SAID IF YOUR MEDICAL EXPENSES GO ABOVE 7% OF YOUR INCOME, THAT YOU WOULD BE ABLE TO DEDUCT ANYTHING ABOVE THAT. THIS BILL INCREASES THAT THRESHOLD TO 10%. SO THAT IF YOU -- IF YOU ARE GOING TO GET DEDUCTIONS, THEN THIS IS GOING TO AFFECT PEOPLE WHO REALLY HAVE CATASTROPHIC ACCIDENTS, REALLY, REALLY BAD, BIG MEDICAL BILLS, DEBILITATING HEALTH CONDITIONS OR VERY, VERY EXPENSIVE MEDICINES. IF YOU GO ABOVE 7.5% TODAY YOU WOULD BE ABLE TO DEDUCT. BUT IN THIS BILL, IT'S GOING TO BE 10% OF YOUR INCOME BEFORE THE GOVERNMENT IS GOING TO ALLOW TO YOU DEDUCT THESE ADDED EXPENSES. AND THEN THERE IS THE DRUG DEVICE AND INSURANCE COMPANY TAX. $60 BILLION IN TAXES ASSESSED TO INSURANCE COMPANIES. $22 BILLION TO PRESCRIPTION DRUG MANUFACTURERS, AND $20 BILLION ON MEDICAL DEVICE MANUFACTURERS. THE EXPERTS HAVE SAID ALL, ALL OF THE ECONOMISTS HAVE SAID THAT THESE TAXES WILL BE PAID BY THE GOVERNMENT. OF COURSE THEY'RE GOING TO BE PASSED ON HIGHER PREMIUMS FOR EVERY INSURANCE POLICIES THAT ALREADY THERE AND HIGHER PRICES FOR MEDICATIONS AND MEDICAL EQUIPMENT. SO MEDICATIONS THAT YOU TAKE FOR DIABETES, HEART DISEASE, MEDICATIONS OR MEDICAL DEVICES THAT YOU NEED TO FIGHT CANCER WOULD ALL BECOME MORE EXPENSIVE BECAUSE EVERY ONE OF THEM WOULD HAVE A HIGHER COST BECAUSE THE COMPANY IS GOING TO PAY AN ADDED FEE JUST FOR PRODUCING THESE MEDICINES AND EQUIPMENT. SO MANY PEOPLE TODAY ARE STRUGGLING WITH THEIR MEDICAL BILLS. THEY'RE STRUGGLING TO FILL PRESCRIPTIONS. WHY ARE WE BRINGING COSTS DOWN? ISN'T MEDICAL COSTS PART OF THE REASON FOR REFORM BECAUSE THEY ARE GOING UP? THE COSTS ARE GOING UP? WASN'T POINT OF REFORM TO BRING THE COSTS DOWN SO MORE PEOPLE WOULD HAVE AFFORDABLE OPTIONS FOR HEALTH CARE COVERAGE? WHAT HAPPENED TO THAT WITH ALL OF THESE TAXES ON INDIVIDUALS AND BUSINESSES THAT ARE GOING TO DRIVE PRICES AND COSTS UP? IN CLOSING, MADAM PRESIDENT, THE BILL THAT IS BEFORE US IMPOSES HALF A TRILLION DOLLARS NEW TAXES AT A TIME WHEN UNEMPLOYMENT IS SOARING AND OUR ECONOMY IS STRUGGLING. YOU'VE GOT HALF A TRILLION DOLLARS IN CUTS TO MEDICARE, WHICH IS GOING TO SEVERELY HURT OUR SENIOR CITIZENS AND THEIR ACCESS TO HEALTH CARE. AND THEN A HALF A TRILLION DOLLARS IN TAX INCREASES, TAXING MARRIAGE, TAXING TYLENOL, TAXING HIGH BENEFIT PLANS, TAXING LOW-BENEFIT PLANS, TAXES IF YOU OFFER EMPLOYEE HEALTH CARE COVERAGE, AND IT'S NOT QUITE ENOUGH. THIS IS A TAX AND SPEND BILL. REPUBLICANS HAVE REPEATEDLY PUT FORWARD IDEAS THAT WOULD REFORM OUR HEALTH SYSTEM, BRING THE COST DOWN WITHOUT BURDENING OUR EMPLOYERS WITH MORE TAXES THAT WOULD KEEP THEM FROM HELPING OUR ECONOMY BY HIRING MORE PEOPLE. IDEAS THAT WOULD INCREASE COMPETITION AND TRANSPARENCY AND ENSURE ACCESS TO AFFORDABLE CARE. SO I HOPE THAT WHILE OUR COLLEAGUES ARE MEETING TO TRY TO GET THEIR 60 VOTES, WHICH WE KNOW THEY ARE, THAT MAYBE THEY MIGHT CONSIDER BRINGING EVERYBODY INTO THIS PROCESS AND LISTENING TO OTHER IDEAS THAT WOULD NOT BE A GOVERNMENT TAKEOVER OF OUR HEALTH CARE SYSTEM, THAT WOULD NOT BE MORE GOVERNMENT MANDATES, MORE TAXES, CUTS FROM MEDICARE SERVICES. THIS IS A RECIPE FOR DISASTER FOR OUR COUNTRY, MADAM PRESIDENT. AND I HOPE THAT IT IS NOT TOO LATE FOR THE DEMOCRATIC MAJORITY TO SAY, OKAY, LET'S GET TOGETHER AND TRY TO PUT TOGETHER A BIPARTISAN PLAN THAT WILL NOT HURT THE QUALITY OF HEALTH CARE THAT AMERICANS HAVE KNOWN AND EXPECTED IN OUR COUNTRY. ONE THAT WILL BRING COSTS DOWN AND MAKE HEALTH CARE MORE AFFORDABLE. ONE THAT WILL CARROTS TO OUR EMPLOYERS, NOT STICKS THAT WILL SWITCH THEM IF THEY DON'T HAVE THE RIGHT KIND OF COVERAGE OR THE GOVERNMENT-APPROVED COVERAGE OR THE RIGHT PERCENTAGE OF COVERAGE. MADAM PRESIDENT, WE CAN DO BETTER AND I HOPE THAT WE WILL. THANK YOU, MADAM PRESIDENT. AND I YIELD THE FLOOR.

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  • 06:09:57 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM NORTH DAKOTA.

  • 06:10:00 PM

    MR. DORGAN

    MADAM PRESIDENT, I WANT TO CALL UP S. 2793 AS MODIFIED. IT'S AN AMENDMENT…

    MADAM PRESIDENT, I WANT TO CALL UP S. 2793 AS MODIFIED. IT'S AN AMENDMENT AT THE DESK AND -- S. 2793 AS MODIFIED AND ASK FOR ITS IMMEDIATE CONSIDERATION.

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  • 06:10:15 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE CLERK WILL REPORT.

  • 06:10:17 PM

    THE CLERK

    I ASK THAT IT BE CONSIDERED READ.

  • 06:10:28 PM

    MR. DORGAN

    WITHOUT OBJECTION.

  • 06:10:30 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 06:10:32 PM

    MR. DORGAN

    FROM IDAHO IS TO BE RECOGNIZED NEXT FOR LAYING DOWN AN AMENDMENT. A…

    FROM IDAHO IS TO BE RECOGNIZED NEXT FOR LAYING DOWN AN AMENDMENT. A SENATOR: MADAM PRESIDENT?

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  • 06:10:42 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM IDAHO. A SENATOR: I HAVE A MOTION AT THE DESK TO…

    OFFICER: THE SENATOR FROM IDAHO. A SENATOR: I HAVE A MOTION AT THE DESK TO BE CALLED UP.

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  • 06:10:47 PM

    THE PRESIDING OFFICER

    THE CLERK WILL REPORT.

  • 06:10:51 PM

    THE CLERK

    PRESIDENT CRAPO MOVES TO COMMIT THE BILL TO REPORT THE SAME BACK TO THE…

    PRESIDENT CRAPO MOVES TO COMMIT THE BILL TO REPORT THE SAME BACK TO THE SENATE WITH CHANGES THAT PROVIDE NO PROVISION OF THIS ACT SHALL RESULT IN AN INCREASE IN FEDERAL TAX LIABILITY FOR INDIVIDUALS WITH ADJUSTED GROSS INCOME OF LESS THAN $200,000 AND MARRIED INDIVIDUALS WITH ADJUSTED GROSS INCOME OF LESS THAN $250,000.

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  • 06:11:15 PM

    MR. CRAPO

    THANK YOU, MADAM PRESIDENT. AS THE MOTION, WHICH HAS JUST BEEN READ…

    THANK YOU, MADAM PRESIDENT. AS THE MOTION, WHICH HAS JUST BEEN READ CLEARLY STATES, THIS MOTION WOULD BE TO RECOMMIT -- OR TO COMMIT THIS BILL TO THE FINANCE COMMITTEE. FOR THE FINANCE COMMITTEE TO DO ONE SIMPLE THING. AND THAT IS TO MAKE THE BILL CONFORM TO BARACK OBAMA'S PLEDGE FOR HEALTH CARE REFORM AND WHO WOULD PAY FOR HEALTH CARE REFORM. IN A SPEECH THAT HE HAS GIVEN IN A NUMBER OF DIFFERENT PLACES, PRESIDENT OBAMA HAS VERY CLEARLY STATED, "I CAN MAKE A FIRM PLEDGE, NO FAMILY MAKING LESS THAN $250,000 WILL SEE THEIR TAXES INCREASE. NOT YOUR INCOME TAXES. NOT YOUR PAYROLL TAXES. NOT YOUR CAPITAL GAIN TAXES. NOT ANY OF YOUR TAXES. YOU WILL NOT SEE ANY OF YOUR TAXES INCREASE ONE SINGLE DIME." ALL THIS MOTION DOES IS TO -- IS TO COMMIT THIS BILL TO THE FINANCE COMMITTEE TO HAVE THE FINANCE COMMITTEE ASSURE THAT ITS PROVISIONS COMPLY WITH THIS PLEDGE. NOW WHY WOULD WE WANT TO DO THAT? I THINK MOST AMERICANS ARE VERY AWARE TODAY THAT THIS BILL COMES AT A HUGE PRICE. $2.5 TRILLION OF NEW FEDERAL SPENDING. $2.5 TRILLION OF NEW FEDERAL SPENDING THAT IS OFFSET, IF YOU WILL, BY ABOUT $50 BILLION OF CUTS IN MEDICARE -- $500 BILLION IN CUTS TO MEDICARE, IN FACT, FACT, $493 BILLION WORTH OF CUTS IN THE FIRST 10 YEARS -- OR TAX INCREASES. $1.2 TRILLION TAX INCREASES IN THE FIRST REAL 10 YEARS OF THE FULL IMPLEMENTATION OF THE BILL. AND THERE'S NO QUESTION BUT THAT MUCH OF THE TAX INCREASE THAT IS INCLUDED IN THIS BILL TO PAY FOR THIS MASSIVE INCREASE IN FEDERAL SPENDING WILL COME SQUARELY FROM PEOPLE IN THE UNITED STATES WHO MAKE LESS THAN $250,000 AS A FAMILY OR LESS THAN $200,000 AS INDIVIDUALS. ALL THAT WE NEED TO DO IS TO GO THROUGH THIS BILL TO SEE THAT BY THE ANALYSIS THAT WE HAVE MADE SO FAR, IT APPEARS THAT AT LEAST 42 MILLION HOUSEHOLDS IN AMERICA WILL PAY A PORTION OF THIS THIS $1.2 TRILLION IN NEW TAXES. PEOPLE WHO ARE UNDER THESE INCOME LEVELS TO WHOM PRESIDENT OBAMA MADE THE PLEDGE. I'LL HAVE A GREATER OPPORTUNITY TOMORROW TO DISCUSS THIS MOTION IN MORE DETAIL. TONIGHT I JUST HAVE A FEW MINUTES TO MAKE THE INTRODUCTION AND TO CALL UP THE MOTION. AND WE WILL THEN GET INTO THE FULLER DISCUSSION OF HOW THIS BILL PROVIDES A HEAVY TAX BURDEN ON THE MIDDLE CLASS OF THIS COUNTRY IN DIRECT VIOLATION OF THE PRESIDENT'S PLEDGE. SO, MADAM PRESIDENT, AS I CONCLUDE, I WOULD SIMPLY SAY A VERY SIMPLE AMENDMENT. WE CAN DEBATE ABOUT WHETHER THE BILL DOES OR DOES NOT INCREASE TAXES. I THINK THAT'S ABSOLUTELY CLEAR, ON THOSE IN THE MIDDLE CLASS. BUT ALL THE AMENDMENT WOULD SAY -- ALL THE MOTION WOULD DO IS TO COMMIT THIS BILL TO THE FINANCE COMMITTEE TO HAVE THE FINANCE COMMITTEE MAKE THE BILL COMPORT WITH THE PRESIDENT'S -- THE PRESIDENT SAID, "I CAN MAKE A FIRM PLEDGE, NO FAMILY MAKING LESS THAN$2 50,000 WILL SEE THEIR TAXES INCREASE. NOT YOUR INCOME TAXES. NOT YOUR PAYROLL TAXES. NOT YOUR CAPITAL GAIN TAXES. NOT ANY OF YOUR TAXES. WILL YOU NOT SEE ANY OF YOUR TAXES INCREASE ONE SINGLE DIME. " THAT'S WHAT THIS MOTION ACCOMPLISHES. WITH THAT, MADAM PRESIDENT, I YIELD THE FLOOR.

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  • 06:15:17 PM

    MR. DORGAN

    THE SENATOR FROM NORTH DAKOTA.

  • 06:15:18 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM NORTH DAKOTA.

  • 06:15:21 PM

    MR. DORGAN

    MR. PRESIDENT?

  • 06:41:18 PM

    MR. GRASSLEY

    THE SENATOR FROM IOWA.

  • 06:41:19 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM IOWA.

  • 06:41:20 PM

    MR. GRASSLEY

    BEFORE THE SENATOR FROM NORTH DAKOTA LEAVES AND BEFORE I SPEAK ON ANOTHER…

    BEFORE THE SENATOR FROM NORTH DAKOTA LEAVES AND BEFORE I SPEAK ON ANOTHER ISSUE, I WANT TO TELL HIM TOMORROW, I'M GOING TO SPEAK IN SUPPORT OF HIS AMENDMENT BUT I'D LIKE TO ASK HIM A QUESTION NOW, IF HE WOULD ANSWER FOR ME, AND A FRIENDLY QUESTION BUT IT'S SOMETHING I DON'T KNOW ABSOLUTELY FOR SURE. BUT I BELIEVE, SENATOR FROM NORTH DAKOTA, THAT PHARMACEUTICALS IS ABOUT THE ONLY THING THAT A CONSUMER IN THE UNITED STATES CAN -- CAN'T BUY ANYWHERES IN THE WORLD THEY WANT TO BUY IT FROM. AND WE OUGHT TO GIVE THEM THAT SAME RIGHT WE DO ON EVERYTHING ELSE. NOW, THERE MAY BE SOME OTHER ITEMS I'M NOT AWARE OF BUT I THINK IT'S ONLY PHARMACEUTICALS THAT YOU CAN'T IMPORT FROM WHEREVER YOU WANT TO, TO BUY THAT.

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  • 06:42:11 PM

    MR. DORGAN

    I SAY THE SENATOR FROM IOWA, AND CIGARS FROM CUBA, WE HAVE A SPECIAL…

    I SAY THE SENATOR FROM IOWA, AND CIGARS FROM CUBA, WE HAVE A SPECIAL EMBARGO WITH CUBA. I DON'T THINK THERE IS A LEGAL PRODUCT THAT THE AMERICAN CONSUMER CANNOT ACCESS ANYWHERE ELSE IN THE WORLD. THIS IS ABOUT GIVING THE AMERICAN CONSUMER THE FREEDOM THAT THE GLOBAL ECONOMY SHOULD OFFER EVERYBODY. THE BIG SHOTS HAVE GOT. IT HOW ABOUT THE AMERICAN PEOPLE HAVING THE OPPORTUNITY TO SHOP AROUND THE WORLD FOR THE SAME PRODUCT AND PAY A FRACTION OF THE PRICES FOR WHAT'S IMPOSED ON THEM HERE IN THE UNITED STATES.

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  • 06:42:47 PM

    MR. GRASSLEY

    I'D LIKE TO THANK THE SENATOR FROM NORTH DAKOTA. I'D LIKE TO --

  • 06:42:56 PM

    MS. KLOBUCHAR

    TRYING TO FIGURE OUT THE ORDER OF WHO'S SPEAKING NEXT.

  • 06:43:03 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: UNDER THE PREVIOUS ORDER, THE NEXT SPEAKER IS TO BE THE…

    PRESIDING OFFICER: UNDER THE PREVIOUS ORDER, THE NEXT SPEAKER IS TO BE THE SENATOR FROM MINNESOTA, FOLLOWED BY THE SENATOR FROM DELAWARE.

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  • 06:43:13 PM

    MR. GRASSLEY

    UNANIMOUS CONSENT TO BE ABLE TO SPEAK NOW, IF I COULD.

  • 06:43:17 PM

    THE PRESIDING OFFICER

    HOW LONG --

  • 06:43:20 PM

    MR. KAUFMAN

    15 MINUTES.

  • 06:43:23 PM

    MR. GRASSLEY

    MINUTES.

  • 06:43:24 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM MINNESOTA.

  • 06:43:28 PM

    MS. KLOBUCHAR

    OUR SPEECH IS ABOUT 10 MINUTES AND IF THE SENATOR FROM IOWA COULD WAIT FOR…

    OUR SPEECH IS ABOUT 10 MINUTES AND IF THE SENATOR FROM IOWA COULD WAIT FOR 10 MINUTES, THEN WE'D BE ABLE TO COMPLETE OUR SPEECH AS WAS RECOGNIZED BY THE CHAIR.

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  • 06:43:42 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM IOWA.

  • 06:43:45 PM

    MR. GRASSLEY

    THE SENATOR SPEAK, AND I'LL SPEAK TOMORROW BECAUSE I HAVE TO GO TO A…

    THE SENATOR SPEAK, AND I'LL SPEAK TOMORROW BECAUSE I HAVE TO GO TO A MEETING. SO I'LL JUST LET THE UNANIMOUS CONSENT --

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  • 06:43:54 PM

    MS. KLOBUCHAR

    AWARE THAT THE SENATOR FROM IOWA HAS TO LEAVE. IF THAT'S FINE. IF HE COULD…

    AWARE THAT THE SENATOR FROM IOWA HAS TO LEAVE. IF THAT'S FINE. IF HE COULD KEEP IT TO 10 MINUTES. THAT WOULD BE HELPFUL TO US.

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  • 06:44:02 PM

    MR. GRASSLEY

    THANK YOU.

  • 06:44:09 PM

    MR. KAUFMAN

    THANK YOU.

  • 06:44:10 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM DELAWARE.

  • 06:44:12 PM

    MR. KAUFMAN

    THE SENATOR FROM MINNESOTA AND I WILL ENGAGE IN A COLLOQUY. WE RISE TODAY…

    THE SENATOR FROM MINNESOTA AND I WILL ENGAGE IN A COLLOQUY. WE RISE TODAY TO TALK ABOUT HEALTH CARE FRAUD ENFORCEMENT. FRAUD IS ONE OF THE MOST COSTLY CRIMES IN AMERICA TODAY. IN NO SMALL PART OUR CURRENT ECONOMIC CRISIS CAN BE LINKED TO FINANCIAL FRAUD. STARTING WITH THE UNCHECKED MORTGAGE FRAUD BY LOAN ORIGINATORS THROUGH SECURITY FRAUD THAT HASTENED THE MARKET CRASH AND MAXIMIZES IMPACT ON MAIN STREET AND THE AVERAGE INVESTOR. IN RESPONSE THIS BODY PASSED THE FRAUD RECOVERY ACT. WHICH DIRECTED CRITICAL RESOURCES AND TOOLS. I WAS PROUD TO WORK WITH MY FRIEND FROM MINNESOTA, A FOAM PROSECUTOR, WHO UNDERSTANDS VERY HE'LL WELL THE HARM THAT FINANCIAL FRAUD CAUSES ON AMERICANS AND THE IMPORTANCE OF DETERRING CRIMINAL BEHAVIOR BEFORE IT HAPPENS. SENATOR KLOBUCHAR?

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  • 06:45:08 PM

    MS. KLOBUCHAR

    WITH.

  • 06:48:12 PM

    MR. KAUFMAN

    THESE ARE THE KINDS OF EXAMPLES OF FRAUD THAT WE MUST STOP. AS WE TAKE…

    THESE ARE THE KINDS OF EXAMPLES OF FRAUD THAT WE MUST STOP. AS WE TAKE STEPS TO INCREASE THE NUMBER OF AMERICANS COVERED BY HEALTH INSURANCE, AND IMPROVE THE HEALTH CARE SYSTEM FOR EVERYONE, AND WE WILL DO THAT, WE MUST ENSURE THAT LAW ENFORCEMENT HAS THE TOOLS IT NEEDS TO DETER, DETECT AND PUNISH HEALTH CARE FRAUD. THE FINANCE AND "HELP" COMMITTEE AS WELL AS LEADERSHIP HAVE WORKED LONG AND HARD TO FIND WAYS TO FIGHT FRAUD AND BEND THE COST CURVE DOWN AND THEY HAVE DONE A GREAT JOB. BUT THERE'S MORE WORK TO BE DONE. THAT'S WHY SENATOR SENATOR KLOBUCHAR AND I AND LEAHY, KOHL, AND HARKIN, ENFORCED 2792.

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  • 06:48:56 PM

    MS. KLOBUCHAR

    LIKE ABOUT THIS AMENDMENT IS THAT IT WILL INCREASE OUR PROTECTION OF HELP…

    LIKE ABOUT THIS AMENDMENT IS THAT IT WILL INCREASE OUR PROTECTION OF HELP FOR AMERICANS IN THE -- WE DECIDED THAT PEOPLE SHOULDN'T BE THROWN OFF OF HEALTH INSURANCE BY PREEXISTING CONDITION. THE WAY THAT WE MAKE SURE THAT THE FUNDS ARE THERE TO HELP PEEP SL BY DOING THINGS LIKE INCREASING THE TOOLS THAT WE NEED TO PROSECUTE THESE KINDS OF CASES. THESE CRIMINALS SCHEME THE SYSTEM TO ROB THE AMERICAN TAXPAYERS OF MONEY THAT SHOULD BE USED TO PROVIDE HEALTH CARE TO THOSE THAT NEED IT MOST. WE MUST PUT A STOP TO THIS AND WE ARE DOING WITH THIS AMENDMENT. IT PROVIDES STRAIGHTFORWARD, BUT CRITICAL IMPROVEMENTS TO THE FEDERAL SENTENCING GUIDELINES, TO HEALTH CARE FRAUD STATUTES TO FOR FIT IEWRKS MONEY LAUNDERING, OBSTRUCTION STATUTES, WOULD STRENGTHEN THE PROSECUTOR'S ABILITY TO COMBAT HEALTH CARE FRAUD. AS A PROSECUTOR, WHEN WE HAD THESE TYPE OF CASES, EVERY TOOL YOU YOU COULD USE TO PUSH SOMEONE TO PLEAD GUILTY TO MAKE SURE THAT YOU COULD GET THE MAXIMUM SENTENCE THAT YOU COULD POSSIBLY GET TO SEND THE MESSAGE NOT ONLY TO THAT PARTICULAR CRIMINAL, BUT TO OTHER WHITE COLLAR OFFENDERS THAT THIS MAY BE A WAY TO MAKE A BUCK, THAT YOU CAN BE CAUGHT AND GO TO JAIL. SENATOR KAUFMAN, YOU HAVE BEEN TAKING A LEAD ON THIS. IF YOU COULD PROVIDE THE DETAIL ON THIS BILL.

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  • 06:50:21 PM

    MR. KAUFMAN

    THE INCREASE IN SENTENCING GUIDELINES FOR LARGE-SCALE HEALTH EXPENSES.…

    THE INCREASE IN SENTENCING GUIDELINES FOR LARGE-SCALE HEALTH EXPENSES. ANALYSIS FROM THE U.S. SENTENCING COMMISSION SUGGESTS THAT HEALTH CARE FRAUD OFFENDERS OFTEN RECEIVE, I KNOW THIS IS HARD TO BELIEVE, SHORTER SENTENCES THAN OTHER WHITE COLLAR OFFENSES IN CASES WITH SIMILAR LOSS AMOUNTS. FOR SOME REASON PEOPLE THINK THAT HEALTH CARE IS OK.

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  • 06:50:48 PM

    MS. KLOBUCHAR

    IF PEOPLE KNEW THIS, THEY WOULD BE SHOCKED. YOU'RE TAKING MONEY FROM THE…

    IF PEOPLE KNEW THIS, THEY WOULD BE SHOCKED. YOU'RE TAKING MONEY FROM THE PEOPLE WHO NEED IT MOST WHEN PEOPLE ARE IN THE HOSPITAL, THIS WOULD HAVE SHORTER SENTENCES THAN OTHER KINDS OF FRAUD.

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  • 06:50:59 PM

    MR. KAUFMAN

    THERE IS DATA TO SHOW, WHICH MAKES GOOD COMMON SENSE THAT CRIMINALS ARE…

    THERE IS DATA TO SHOW, WHICH MAKES GOOD COMMON SENSE THAT CRIMINALS ARE DRAWN TO HEALTH CARE. THEY DECIDE, WHAT KIND OF FRAUD WILL I DO? BECAUSE THE -- THE RISK TO REWARD RATIO IS SO MUCH LOWER. THAT'S RIDICULOUS. WE NEED TO ENSURE THAT THESE OFFENDERS ARE PUNISHED NOT ONLY WITH THE COST THAT THEY IMPOSE ON THE HEALTH CARE SYSTEM, BUT ALSO AS A LEVEL THAT WILL OFFER REAL DETERRENCE. PEOPLE HAVE TO UNDERSTAND THAT THEY CANNOT COMMIT HEALTH CARE FRAUD. THERE ARE SO MANY WAYS THAT CAN BE PRESENTED THAT IF IN FACT THEY DO IT THEY WILL GET REAL TIME FOR THE CRIME. OUR AMENDMENT DIRECTS THAT THE SENTENCING GUIDELINES, AS A PRACTICAL MATTER WILL INCREASE 20% TO 50% FOR HEALTH CARE CROOKS STEALING OVER $1 MILLION.

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  • 06:51:49 PM

    MS. KLOBUCHAR

    THE OTHER THING THAT'S GREAT ABOUT THIS BILL, SENATOR KAUFMAN, IS THAT IT…

    THE OTHER THING THAT'S GREAT ABOUT THIS BILL, SENATOR KAUFMAN, IS THAT IT UPDATES THE DEFINITION OF HEALTH CARE FRAUD OFFENSE IN THE FEDERAL CRIMINAL CODE, SO IT INCLUDES VIOLATION OF THE ANTI-KICKBACK STATUTE, THE FOOD AND DRUG COSMETIC ACT AND CERTAIN PROVISIONS OF ARISA, IT WILL ALLOW THE FULL ARRAY OF LAW ENFORCEMENT TOOLS TO BE USED AGAINST ALL HEALTH CARE FRAUD. THE AMENDMENT ALSO PROVIDES THE DEPARTMENT OF JUSTICE WITH SUBPOENA AUTHORITY TO INVESTIGATIONS CONDUCTED PURSUANT TO THE CIVIL RIGHTS ACT FOR INSTITUTIONALIZED PERSONS ACT. UNDER CURRENT LAW THE DEPARTMENT OF JUSTICE MUST RELY UPON THE COOPERATION OF THE NURSING HOMES, MENTAL HEALTH INSTITUTIONS AND RESIDENTIAL SCHOOLS FOR CHILDREN WITH DISABILITY THAT ARE THE TARGET OF THESE INVESTIGATIONS. WHILE SUCH TARGETS OFTEN COOPERATE, THEY SOMETIMES DO NOT. AND THE CURRENT LACK OF SUBPOENA AUTHORITY PUTS VULNERABLE VICTIMS AT NEEDLESS RISK. FINALLY, IN ADDITION TO THE VERY IMPORTANT PIECE OF THIS BILL THAT SENATOR KAUFMAN HAVE POINTED OUT, WHERE WE'RE ACTUALLY INCREASING THE ABILITY TO GET BETTER CRIMINAL PENALTIES, THE AMENDMENT CORRECTS AN APPARENT DRAFTING ERROR, BUT PROVIDING THAT OBSTRUCTION OF CRIMINAL INVESTIGATION INVOLVING SUBPOENA INVESTIGATIONS UNDER HIPPA, SHOULD BE TREATED IN THE SAME MANNER AS OBSTRUCTION OF CRIMINAL INVESTIGATIONS INVOLVING GRAND JURY SUBPOENAS. SENATOR KAUFMAN AND I PLAN TO FILE AN ADDITIONAL HEALTH CARE FRAUD AMENDMENT THAT WOULD REQUIRE DIRECT DEPOSITING MADE TO ALL PROVIDERS UNMAIR AND MEDICAID. THIS BILL IS INCREDIBLY IMPORTANT BECAUSE THE MEDICARE REGULATIONS ALREADY REQUIRE DIRECT DEPOSITING OR ELECTRONIC TRANSFER. BUT THESE REGULATIONS HAVE NOT BEEN UNIFORMLY ENFORCED AND CRIMINALS ARE TAKING ADVANTAGE OF THIS SYSTEM. AGAIN, I ASK THE QUESTION: WHY WOULD WE WANT THIS MONEY, MONEY, $60 BILLION ESTIMATED FOR MEDICARE FRAUD ALONE, WHY WOULD WE WANT THIS MONEY TO GO TO CONMEN AND CROOKS, PEOPLE SETTING UP FAKE STORE FRONTS WITH FAKE SIGNS THAT SAY DOCTOR'S OFFICE, THAT WE WANT THAT MONEY TO GO THERE INSTEAD OF TO THE HARD-WORKING PEOPLE OF THIS COUNTRY THAT CAN HARDLY AFFORD THEIR HEALTH INSURANCE. TRANSOUTRAGE. THAT'S WHY I'M SO GLAD THAT YOU, SENATOR KAUFMAN, HAS TAKEN A LEAD ON, THIS AND THAT WE HAVE PROSECUTORS WORKING ON THIS IN THE JUDICIARY COMMITTEE TO WORK ON THE HEALTH CARE REFORM BILL. AMERICANS HAVE WAITED TOO LONG FOR THESE KINDS OF CHANGES.

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  • 06:54:26 PM

    MR. KAUFMAN

    MADAM PRESIDENT?

  • 06:56:31 PM

    MR. KAUFMAN

    THE SENATOR FROM DELAWARE.

  • 06:56:32 PM

    THE PRESIDING OFFICER

    PRESIDING OFFICER: THE SENATOR FROM DELAWARE.

  • 06:56:35 PM

    MR. KAUFMAN

    WITHOUT OBJECTION.

  • 06:56:38 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION.

  • 06:56:40 PM

    MR. KAUFMAN

    I RISE TODAY TO SPEAK ABOUT THE AFGANISTAN STRATEGY PRESIDENT OBAMA…

    I RISE TODAY TO SPEAK ABOUT THE AFGANISTAN STRATEGY PRESIDENT OBAMA ANNOUNCED EARLIER THIS WEEK. THE DILEMMA FACING THE PRESIDENT AND OUR NATIONAL SECURITY TEAM IN AFGANISTAN IS ONE OF THE MOST COMPLEX AND DIFFICULT I'VE SEEN IN MORE THAN THREE DECADES OF PUBLIC SERVICE. PRESIDENT OBAMA'S SPEECH LAID OUT A BOLD PLAN AND HE IS DELIBERATIVE AND COURAGEOUS IN HIS APPROACH. AT THE SAME TIME, THOUGH, I SHARE THE CONCERNS ABOUT MANY AMERICANS ABOUT THE CHALLENGES THAT LIE AHEAD FOR OUR TROOPS. SENDING YOUNG WOMEN AND MEN INTO HARM'S WAY IS THE MOST DIFFICULT CHOICES WE FACE. EACH LIFE LOST IS ONE TOO MANY. AND EACH WARRIOR COMING HOME WOUNDED IS ONE TOO MANY. THE DECISION IN AFGANISTAN IS ESPECIALLY DIFFICULT BECAUSE FOUR PRIMARY QUESTIONS REMAIN. THE FIRST QUESTION IS: DO WE HAVE A TRUST AND EFFECTIVE PARTNER IN PRESIDENT KARZAI. NO MANY HOW MANY TROOPS WE DEPLOY, WE CANNOT SUCCEED WITH AN AFGHAN GOVERNMENT PLAGUED BY CORRUPTION MUCH WE CANNOT DEFEAT AL QAEDA WITHOUT PAKISTAN'S SUPPORT. THE THIRD QUESTION IS: CAN WE ACCELERATE THE TRAINING OF AFGHAN NATIONAL SECURITY FORCES? TODAY THERE ARE TOO FEW AFGHAN SECURITY FORCES TO CLEAR AND HOLD AGAINST THE TALIBAN AND THEY ARE NOT CAPABLE OF TAKING OVER FOR U.S. TROOPS. IN LIGHT OF THE PRESIDENT'S 18-MONTH DEADLINE, IT IS CLEAR THAT SELF-SUFFICIENCY FOR THE AFGHANS IS NOT OPTIONAL. IT'S MANDATORY. SECRETARY GATES CONFIRMED FOR ME IN LAST WEEK'S SENATE FOREIGN RELATION COMMITTEE HEARING THAT JULY 2011 IS A FIRM DEADLINE. IN 18 MONTHS WE WILL BEGIN OUR WITHDRAWAL. AND HE SAID, ALONG WITH SENATOR CLINTON AND CHIEF OF STAFF -- CHIEF OF OPERATIONS MULLENS, THAT UNDER NO CONDITIONS WILL WE SEND ADDITIONAL TROOPS AFTER THIS DEPLOYMENT. THE FOURTH QUESTION IS: DO WE HAVE ENOUGH QUALIFIED U.S. CIVILIANS IN AFGANISTAN TO PARTNER WITH THE AFGHAN PEOPLE IN PROMOTING GOVERNANCE AND ECONOMIC DEVELOPMENT? WE MUST SEND EVEN MORE. AN ENSURE THAT THE CIVILIAN SURGE EXTENDS TO ALL 34 PROVINCES SO THEY CAN PARTNER WITH THE AFGHANS IN THE FIELD. MADAM PRESIDENT, AS YOU KNOW, I VISITED AFGANISTAN IN APRIL AND SEPTEMBER AND HAD OPPORTUNITY TO SPEAK WITH OUR MILITARY AND CIVILIAN LEADERS, PRESIDENT KARZAI, AND NUMEROUS AFGHAN MINISTERS, I TRAVELED AND MET WITH THE LOCAL GOVERNMENT OFFICIALS AND TRIBAL ELDERS AND THE COMMUNITY COUNCIL. WHAT I HEARD FROM THE AFGHAN PEOPLE WAS FRUSTRATION WITH OUR GOVERNMENT'S INABILITY TO PROVIDE SECURITY AND ADMINISTER JUSTICE AND DELIVER THE VERY BASIC SERVICES. THEY WELCOMED INTERNATIONAL ASSISTANCE IN THE SHORT TERM, BUT SOUGHT IMPROVED SECURITY AND GOVERNANCE. MORE IMPORTANTLY, THEY WANT TO CONTROL TRANSFER TO AFGHAN SECURITY FORCES ONCE THEY WERE CAPABLE OF HOLDING AGAINST THE TALIBAN. LET ME REPEAT THAT. IN AFGANISTAN, THE PEOPLE THERE, THEY WANT TO CONTROL TRANSFER TO AFGHAN SECURITY FORCES ONCE THEY WERE CAPABLE OF HOLDING AGAINST THE TALIBAN. SINCE -- SINCE RETURNING FROM AFGHANISTAN, MY NUMBER ONE CONCERN HAS BEEN THE ABILITY OF THE KARZAI GOVERNMENT TO BE AN EFFECTIVE PARTNER. IN THE SECOND TERM, PRESIDENT KARZAI MUST ELIMINATE CORRUPTION, DELIVER ESSENTIAL SERVICES IN ORDER TO WIN THE TRUST OF THE AFGHAN PEOPLE. ULTIMATELY, ULTIMATELY, THE BATTLE IS NOT BETWEEN THE U.S. AND THE TALIBAN. IT'S A STRUGGLE BETWEEN THE AFGHAN GOVERNMENT AND THE TALIBAN AND THE FIGHT MUST BE WON BY THE AFGHANS THEMSELVES. THE NOTION OF A CORRUPT GOVERNMENT HAS EMBOLDENED THE TALIBAN AND FURRED UNDERMINED TRUST BETWEEN PRESIDENT KARZAI'S PEOPLE. PRESIDENT KARZAI MUST TRANSLATE HIS PROMISES IN HIS INAUGURATION SPEECH INTO ACTION BECAUSE INCREASED TRANSPARENCY IN GOVERNMENT ACCOUNTABILITY IS ABSOLUTELY CRITICAL. FOR ME, THE KEY POINT IN PRESIDENT OBAMA'S SPEECH WAS THAT OUR MILITARY COMMITMENT IS NOT OPEN-ENDED. IN JULY, 2011, WE WILL BEGIN OUR TROOP DRAWDOWN. THIS HAS CREATED AN 18-MONTH DEADLINE FOR PROGRESS. INJECTING A SENSE OF URGENCY TO OUR MISSION THAT HAS BEEN MISSING FOR THE PAST EIGHT YEARS. IT SENDS A CLEAR MESSAGE THAT THE CLOCK IS TICKING FOR THE AFGHAN GOVERNMENT TO ELIMINATE CORRUPTION. THEY WILL NO LONGER GET BLANK CHECK BECAUSE THE TIME FOR ACTION IS NOW. ON THE SECURITY FRONT, THE AFGHAN NATIONAL ARMY AND POLICE HAVE NO CHOICE BUT TO ASSUME GREATER RESPONSIBILITY GIVEN THE CERTAINTY OF A U.S. WITHDRAWAL. AS PRESIDENT OBAMA OUTLINED, PAKISTAN IS CENTRAL TO THIS FIGHT. WE CANNOT SUCCEED WITHOUT ITS COOPERATION BECAUSE DEVELOPMENTS IN THE REGION ARE INEXTRICABLY TIED TO BOTH SIDES OF THE BORDER. AFTER MY APRIL VISIT, I WAS CONCERNED ABOUT THE PAKISTANI COMMITMENT. WHEN I RETURNED IN SEPTEMBER, HOWEVER, I WAS IMPRESSED BY THE PAKISTANI MILITARY'S DECISION TO GO AFTER ELEMENTS OF THE TALIBAN IN THE SWAT VALLEY. HOWEVER, AT THE SAME TIME, PAKISTAN MUST TAKE ACTION AGAINST THE AFGHAN TALIBAN IN AL QAEDA WHICH CONTINUES TO FIND SAFE HAVENS IN PAKISTANI TRIBAL AREAS. IF EXTREMISTS CONTINUE TO OPERATE FREELY BETWEEN AFGHANISTAN AND PAKISTAN, IT WILL UNDERMINE SECURITY GAINS MADE ON THE AFGHAN SIDE OF THE BORDER, AND THE STAKES ARE EVEN HIGHER IN PAKISTAN WHICH HAS BOTH NUCLEAR WEAPONS AND DELIVERY VEHICLES. IN AFGHANISTAN, WE MUST BREAK THE MOMENTUM OF THE TALIBAN BY IMPROVING SECURITY AND STRENGTHENING OUR ABILITY TO PARTNER WITH THE AFGHANS. THAT IS WHY I SUPPORT EFFORTS TO ACCELERATE THE TRAINING OF THE AFGHAN NATIONAL SECURITY FORCES. I AM CONCERNED THAT THE PRESIDENT'S GOAL OF INCREASING THE AFGHAN ARMY TO 134,000 IN 2010 DOES NOT GO FAR ENOUGH IN BUILDING THE CAPACITY OF THE ANSF. BY COMPARISON, IT WORRIES ME, BY COMPARISON, IRAQ, A GEOGRAPHICALLY SMALLER COUNTRY WITH THE SAME SIZED POPULATION, HAS 600,000 TRAINED SECURITY FORCES. THAT IS WHY WE MUST ACCELERATE OUR TARGETS FOR BUILDING THE ARMY AND IMPROVE THE CAPABILITY OF THE POLICE WHICH HAS FACED EVEN GREATER CHALLENGES IN TERMS OF CORRUPTION IN ITS COMPETENCE AND ATTRITION. FINALLY, OUR SUCCESS IN AFGHANISTAN DEPENDS ON MORE THAN TROOPS, MUCH MORE THAN TROOPS. WE NEED AN INTEGRATED CIVILIAN MILITARY STRATEGY IN ORDER TO SUSTAIN PROGRESS. MANY DEDICATED U.S. CIVILIANS CONTINUE TO SERVE IN AFGHANISTAN, AND WE MUST FURTHER AUGUST MANY THESE NUMBERS AND ENSURE THEY CAN DIRECTLY INTERACT WITH AFGHANS IN THE FIELD. GIVEN THEIR ROLE AS A FORCE MULTIPLIER FOR THE MILITARY AND INTERNATIONAL NONGOVERNMENTAL ORGANIZATIONS, THIS IS AN AREA WHERE WE MUST CHANNEL EVEN MORE RESOURCES AND PEOPLE IN THE NEAR TERM. WE NEED A STRONGER CIVILIAN CAPACITY BECAUSE COUNTERINSURGENCY CANNOT AND SHOULD NOT BE CONDUCTED WITH THE MILITARY ALONE. OVER THE COMING MONTHS, I WILL CLOSELY MONITOR OUR PROGRESS IN AFGHAN GOVERNANCE, PARTNERING IN PAKISTAN, BUILDING THE AFGHAN NATIONAL SECURITY FORCES AND INCREASE THE U.S. CIVILIAN SURGE. IMPROVEMENTS IN THESE AREAS ARE CRITICAL TO OVERALL SUCCESS IN AFGHANISTAN AND WILL DETERMINE WHEN OUR BRAVE MEN AND WOMEN IN UNIFORM CAN RETURN HOME. THANK YOU, MR. PRESIDENT. AND I YIELD THE FLOOR. A SENATOR: MR. PRESIDENT, I NOTE THE ABSENCE OF A QUORUM.

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  • 07:04:51 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM ALABAMA.

  • 07:06:32 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM ALABAMA.

  • 07:06:36 PM

    MR. SESSIONS

    I WOULD ASK THAT THE QUORUM CALL BE DISPENSED WITH.

  • 07:06:38 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION, SO ORDERED.

  • 07:06:42 PM

    MR. SESSIONS

    PRESIDENT, I SEE MY GOOD FRIEND, SENATOR KAUFMAN AND KLOBUCHAR TALKED…

    PRESIDENT, I SEE MY GOOD FRIEND, SENATOR KAUFMAN AND KLOBUCHAR TALKED ABOUT ACTIONS WE COULD TAKE TO DEAL WITH FRAUD IN HEALTH CARE, AND I SUPPORT THAT AND HAD THE OPPORTUNITY IN THE PAST AS A UNITED STATES ATTORNEY TO LEAD A GROUP THAT WOULD DO THAT, BUT SOMETHING IS TROUBLING ME TODAY A GREAT DEAL, AND I'M UNEASY ABOUT IT AND IT GOES TO THE HEART OF HOW THE LEGISLATION THAT'S BEFORE US TODAY HAS BEEN PUT TOGETHER. WE HAD SENATOR McCAIN OFFERING AN AMENDMENT TO SAY THAT EVERY STATE SHOULD HAVE THE SAME POLICIES WITH REGARD TO MEDICARE ADVANTAGE THAT THE STATE OF FLORIDA HAS. PRESUMABLY THAT WAS AN EFFORT TO GAIN SOME SUPPORT. WE HAVE SEEN OTHER SITUATIONS LIKE THAT WITH LOUISIANA AND OTHER PLACES GETTING SPECIAL ADVANTAGES. LET ME TELL YOU ABOUT SOMETHING THAT'S PARTICULARLY TROUBLING TO ME. IT WAS WRITTEN ABOUT BY ROBERT REICH WHO WAS THE SECRETARY OF LABOR IN PRESIDENT CLINTON'S CABINET, A PROLIFIC WRITER ABOUT MANY MATTERS OF ECONOMICS AND HEALTH CARE. AND HE STARTS HIS SUNDAY, AUGUST 9, ARTICLE THIS WAY ON HIS BLOG. HE SAYS -- "I'M A STRONG SUPPORTER OF UNIVERSAL HEALTH INSURANCE." HE'S NOT PULLING ANY PUNCHES THERE. HE BELIEVES IN A SINGLE-PAYER GOVERNMENT POLICY. THEN HE GOES ON TO SAY -- "AND A FAN OF THE OBAMA ADMINISTRATION, BUT I'M APPALLED BY THE DEAL THE WHITE HOUSE HAS MADE WITH THE PHARMACEUTICAL INDUSTRY'S LOBBYING ARM TO BUY THEIR SUPPORT." NOW, THAT'S A PRETTY SERIOUS CHARGE. HE GOES ON TO SAY -- "LAST WEEK AFTER BEING REPORTED IN THE LOS ANGELES TIMES, THE WHITE HOUSE CONFIRMED IT HAD PROMISED BIG PHARMA THAT ANY HEALTH CARE LEGISLATION WILL BAR THE GOVERNMENT FROM USING ITS PURCHASING POWER TO NEGOTIATE LOWER DRUG PRICES. THAT'S BASICALLY THE SAME DEAL GEORGE W. BUSH STRUCK IN GETTING THE MEDICARE DRUG BENEFIT, AND IT'S A PROVEN BONANZA FOR THE DRUG INDUSTRY." AND I WILL SAY AS I RECALL THAT MR. REICH WAS A CRITIC AT THE TIME OF THAT. AND RIGHT OR WRONG, IT WAS DONE AND HE WAS A CRITIC OF IT. I GIVE HIM CREDIT FOR IT. AND HE SAID -- "A CONTINUATION OF THAT WOULD BE AN EVEN LARGER BONANZA." HE GOES ON TO DESCRIBE WHY HE THINKS IT'S A BONANZA. WELL, RIGHT OR WRONG, AS A MATTER OF POLICY AND SO FORTH, IT IS NO DOUBT THAT THAT IS SOMETHING THAT THE BIG FARMER WOULD LIKE, AND HE GOES ON TO SAY THIS -- "IN RETURN, BIG PHARMA ISN'T JUST SUPPORTING UNIVERSAL HEALTH CARE. IT'S ALSO SPENDING LOTS OF MONEY ON TV AND RADIO ADVERTISING IN SUPPORT. SUNDAY'S "NEW YORK TIMES" REPORTS THAT BIG PHARMA HAS BUDGETED $150 MILLION FOR TV ADS PROMOTING UNIVERSAL HEALTH INSURANCE STARTING THIS AUGUST." AND HE PUTS IN -- I'M QUOTING HIM. "THAT'S MORE MONEY THAN JOHN McCAIN SPENT ON TV ADVERTISING IN LAST YEAR'S PRESIDENTIAL CAMPAIGN," CLOSE PAREN. "AFTER HAVING ALREADY SPENT A BUNDLE THROUGH HEALTH ADVOCACY GROUPS AND FAMILIES U.S.A." WELL, I DON'T KNOW WHAT'S HAPPENED. THERE IS A MEMORANDUM IN I BELIEVE ONE OF THE BLOTION HERE ON THE HUFFINGTON POST THAT IS SUPPOSED TO BE THE MEMORANDUM THAT DOCUMENTS THE AGREEMENT. I DON'T KNOW WHAT THE FACTS ARE, BUT I KNOW THIS -- THAT IT'S NOT A HEALTHY THING THAT SOMEBODY WHO HAS BEEN INVOLVED IN FEDERAL LAW ENFORCEMENT OR A GOVERNMENT OFFICIAL UNDER THE COLOR OF RIGHT TO SAY TO A PRIVATE INDIVIDUAL YOU WILL HELP ME WITH AN ADVERTISING CAMPAIGN AND SPEND YOUR PRIVATE MONEY OR I WILL DO YOU A FAVOR IN EXCHANGE FOR AN $80 MILLION TELEVISION CAMPAIGN. I JUST WANT TO TELL YOU THAT'S NOT -- THAT'S BEYOND THE PALE, AND IF THINGS LIKE THIS HAVE BEEN DONE IN THE PAST, IT'S NOT THE KIND OF THING THAT OUGHT TO BE CONTINUED. AND I THINK IT'S A BIG DEAL, AND "THE NEW YORK TIMES" HAS REPORTED THAT AS THEY GO FORWARD FORWARD -- "SHORTLY AFTER STRIKING DOWN AGREEMENT, THE TRADE GROUP AND THE MANUFACTURERS OF AMERICA, PHRMA, ALSO SET ASIDE $150 MILLION FOR ADVERTISING TO SUPPORT HEALTH CARE LEGISLATION." "AN INDUSTRY OFFICIAL INVOLVED IN DISCUSSIONS" -- I'M QUOTING HERE OF THE "NEW YORK TIMES" ARTICLE BY DUFF WILSON -- "INDUSTRY OFFICIALS INVOLVED IN THE DISCUSSION SAID THE GROUP AND ITS ADVERTISING MONEY WOULD NOW BE AIMED SPECIFICALLY AT THE APPROACH BEING PUSHED BY MR. BAUCUS, DEMOCRAT OF MONTANA, AND THE CHAIRMAN OF THE SENATE FINANCE COMMITTEE." IS THAT THE WAY THIS THING IS BEING DONE? I HOPE NOT. AND I INTEND TO LOOK AT THAT IN MORE DETAIL, BUT I JUST WANT TO SAY RIGHT NOW AND TODAY I'M NOT HAPPY ABOUT IT. I DON'T LIKE THE LOOKS OF IT. IT DOESN'T SMELL GOOD TO ME. IT DOES NOT STRIKE ME AS SOMETHING THAT'S LEGITIMATE, AND I THINK MAYBE WE NEED TO FIND OUT MORE ABOUT IT, FRANKLY. MR. PRESIDENT, I HAVE -- I WOULD JUST WANT TO SHARE WITH MY COLLEAGUES A FUNDAMENTAL CONCERN I HAVE WITH THIS HEALTH CARE BILL. IT MADE A GREAT DEAL OF PROMISES. IT ALLEGED IT WOULD DO A LOT OF VERY GREAT SOUNDING THINGS, AND WE WERE ASKED TO SUPPORT IT ON THAT BASIS, BUT A CAREFUL EXAMINATION OF THE LEGISLATION SHOWS IT FAILS TO DELIVER ON ALMOST ALL OF THE MAJOR PROMISES THAT IT MADE, AND IT'S LIKELY TO CAUSE A GREAT DEAL OF ADVERSE CONSEQUENCES, SOME OF WHICH ARE UNANTICIPATED, AND AS A RESULT I THINK THE AMERICAN PEOPLE HAVE INTUITIVELY UNDERSTOOD THIS, AND THAT'S WHY THEY ARE SO STRONGLY OPPOSED TO IT, AND THEY CAN'T IMAGINE WHY THE LEADERSHIP OF THIS SENATE CONTINUES TO TRY TO PUSH DOWN ON THEIR BROW THIS PIECE OF LEGISLATION THAT DOES NOT DO WHAT IT PROMISED TO DO. FOR EXAMPLE, THE SPONSORS OF THE LEGISLATION SAY THE BILL'S TOTAL COST IS $848 BILLION. WELL, THEY DON'T START THE BENEFITS OF THE BILL UNTIL FIVE YEARS, AND THAT $848 BILLION IS THE COST OF EXPENDITURES OVER TEN YEARS. SO WHEN YOU BACK UP TO WHEN THE BENEFITS ACTUALLY START, FOR THOSE WHO WILL BE RECEIVING BENEFITS AND GO TEN YEARS FROM THAT, IT'S NOT $848 BILLION. IT'S $2.5 TRILLION. NOW, THAT IS A HUGE DIFFERENCE. IT'S A MONUMENTAL DIFFERENCE. IT'S A DIFFERENCE SO LARGE THAT I CAN'T UNDERSTAND HOW WE CAN WITH A STRAIGHT FACE TRY TO CONTEND THAT WE HAVE A SOUND BUDGET BILL THAT'S GOING TO COST COST $848 BILLION AND WE HAVE TAX INCREASES OF ABOUT HALF OF THAT AND RAIDS ON MEDICARE FOR ABOUT HALF OF THAT AND THAT'S HOW WE'RE GOING TO PAY FOR IT. REALLY, IT'S NOT WORKING THAT WAY, IN MY VIEW. ANOTHER PROMISE FOR THE BILL THAT WAS MADE BY THE PRESIDENT IN THE JOINT SESSION TO THE CONGRESS, HE SAID THIS -- "THIS BILL WOULD NOT ADD ONE DIME TO THE DEFICIT." THAT'S JUST NOT ACCURATE. YOU CAN MAKE ANYTHING BE DEFICIT NEUTRAL IF YOU PAY FOR IT BY SLASHING MEDICARE AND TAKING THE MONEY FROM MEDICARE AND PAY FOR IT, OR YOU CAN MAKE A BILL BE DEFICIT NEUTRAL IF YOU RAISE ENOUGH TAXES SO THEY ARE RAISING RAISING $494 BILLION IN TAXES, THEY ARE CUTTING MEDICARE BY BY $464 BILLION, AND THAT WAS THE PLAN. AND THEY CLAIM THEY HAVE A A $130 BILLION SURPLUS, SO DON'T WORRY ABOUT THE BUDGET. WE'VE CREATED A BILL THAT'S GOING TO REDUCE THE DEFICIT, AND THAT'S WHAT THEY HAVE SAID REPEATEDLY. BUT THEY FORGOT SOMETHING. THEY FORGOT WE HAVE TO PAY OUR PHYSICIANS. THAT WAS ALWAYS SUPPOSED TO BE PART OF HEALTH CARE REFORM. IN FACT, THE PHYSICIAN GROUPS WERE TOLD THEY WERE GOING TO BE PAID, BUT UNDER THIS BILL, TO SHOW YOU HOW IT'S BEEN DOCTORED -- AND THIS HAS BEEN DONE BEFORE. REPUBLICANS HAVE PARTICIPATED IN THIS IN THE PAST, AND IT'S BEEN SOMETHING THAT HAS BEEN GOING ON FOR A DECADE, BUT IT'S REALLY RELEVANT TODAY PARTICULARLY IN THIS LEGISLATION BECAUSE THIS LEGISLATION WAS SUPPOSED TO FIX THAT. UNDER THE BILL, THEY KEEP THE PHYSICIANS' RATES SLIGHTLY ABOVE LAST YEAR'S RATE FOR ONE YEAR, AND THEN FOR NINE YEARS IN THE TEN-YEAR BUDGET, THEY ASSUME THAT DOCTORS' PAYMENTS, PHYSICIAN REIMBURSEMENTS ARE GOING TO BE CUT 23%. WELL, THAT'S UNTHINKABLE. WE ARE NOT GOING TO CUT THE PHYSICIANS 23%. WE CAN'T CUT THE PHYSICIANS AT ALL BECAUSE THEY ALREADY ARE WONDERING WHETHER OR NOT THEY ARE GOING TO CONTINUE TO TAKE MEDICARE PATIENTS AND EVEN MORE SO MEDICAID PATIENTS WHERE THEY GET PAID LESS. AND WE COULD HAVE A MASS WALKOUT OF PHYSICIANS WHO COULDN'T AFFORD TO DO THIS IF WE WERE TO CUT IT 23%. AND, IN FACT, WE'RE NOT GOING TO DO IT. WE ALL KNOW THAT. SO WHAT DID THEY DO? I COULD KNOW THEY WERE MEETING DOWN NO THESE HALLWAYS SOMEWHERE AND THEY WERE PLOTTING OUT THIS BILL AND THEY SAID THE PRESIDENT SAID IT WILL NOT ADD TO THE DEBT,DEBT, WHAT ARE WE GOING TO DO? THE NUMBERS DON'T ADD UP. WE CAN'T RAISE TAXES ANYMORE, WE CAN'T CUT MEDICARE ANYMORE, WE'VE DONE ALL WE CAN DO, WHAT ARE WE GOING TO DO? AND SO WHAT THEY OBVIOUSLY DECIDED WAS TO TAKE THE PHYSICIAN PART OF THE BILL THAT NEEDED TO BE IN IT THAT WOULD -- FOR THE -- TO FIX THIS ABERRATIONAL LAW WE'VE GOT THAT REQUIRES IT TO BE CUT 23%. THEY PUT IT IN A SEPARATE BILL, EVERY PENNY OF IT WOULD BE PAID FOR BY INCREASED DEBT, NOT PAID FOR AT ALL. AND THEY OFFERED THAT BILL ON THE FLOOR AND ASKED -- AND IT GOT VOTED DOWN BECAUSE THE REPUBLICANS ALL VOTED AGAINST IT AS BEING UTTERLY FISCALLY IRRESPONSIBLE AND ENOUGH DEMOCRATS JOINED IN IT TO KILL THE BILL. THEY WOULDN'T SUPPORT IT EITHER. A NUMBER OF DEMOCRATS WHO KNOW THAT THE BUDGET HAS GOT TO HAVE SOME RATIONALEITY, SO THEY FAILED TO DO THAT. SO IF YOU PUT THE DOCTOR FIX IN HERE, YOU ALREADY ARE AT A $120 BILLION DEFICIT. SO IT DOES ADD TO THE DEFICIT. IT ADDS MORE THAN ONE DIME TO THE DEAD. IT ADDS IT ADDS MORE THAN ONE DIME TO THE DEBT T.. IT ADDS $120 BILLION TO THE DEBT. AND ANOTHER FICTION WAS THEIR PROMISE THAT THEY WOULD FIX THE PHYSICIANS' PAYMENTS AND MAKE A PERMANENT POLICY OF PAYING THEM SO EVERY YEAR THEY WOULDN'T HAVE TO RUN TO CONGRESS AND HIRE LOBBYISTS AND COME UP HERE AND MEET WITH THEIR SENATORS TO BEG THEM NOT TO HAVE A 23% CUT. THAT HAPPENS EVERY YEAR. IT'S RIDICULOUS. BUT THIS BILL DOES NOT DEAL WITH THAT. SO IT ONLY HAS A ONE-YEAR FIX AND FOR NINE YEARS, IT'S REDUCED. AND JUST LIKE HAS BEEN DONE IN THE PAST. AND THERE'S NO REFORM IN THAT PART OF HEALTH CARE THAT NEEDS TO BE DONE. AND ANOTHER FICTION IS THAT THEY'RE NOT CUTTING MEDICARE. THEY -- THEY'RE NOT -- THEY SAY, WELL, WE'RE NOT CUTTING MEDICARE MEDICARE, WE'RE CUTTING THAT BAD, OLD MEDICARE ADVANTAGE THAT 11 MILLION SENIORS ARE BENEFITING FROM AND ENJOY AND PARTICIPATE IN. THEY'RE CUTTING THAT $100 BILLION-PLUS, WHICH IS ABOUT A FOURTH OF WHAT THIS CUTS TO MEDICARE ARE. AND THEY SAY THAT'S NOT CUTTING MEDICARE, BUT THAT CLEARLY IS CUTTING MEDICARE BECAUSE THAT'S PART OF MEDICARE PROGRAM. AND IT IS CUTTING MEDICARE. AND HOWEVER YOU FEEL ABOUT MEDICARE ADVANTAGE, THIS IS A CUT TO MEDICARE PROGRAMS THAT MILLIONS OF SENIORS FAVOR, AND THAT'S WHAT THE -- WHY FLORIDA DIDN'T WANT TO HAVE THEIR MEDICARE ADVANTAGE CUT. SO THEY GOT A SPECIAL DEAL IN THIS LEGISLATION NOBODY ELSE IN AMERICA GETS. THEY WANT TO KEEP IT. BUT LET'S GO ON A LITTLE BIT FURTHER AND JUST TO SHOW YOU WHY THE AMERICAN PEOPLE ARE UNHAPPY WITH CONGRESS. AND THEY HAVE A RIGHT TO BE UNHAPPY. AND PEOPLE SAY, OH, THOSE -- THOSE PEOPLE OUT THERE AT THE TEA PARTIES AND TOWN HALL MEETINGS, WHY, THEY WERE JUST UPSET. THEY ARE POOR AMERICANS. THEY'RE NOT GOOD AMERICANS. GOOD AMERICANS WOULD COME IN AND SAY HOW MUCH MORE MONEY CAN WE GIVE YOU, BIG GOVERNMENT, TO TAKE CARE OF ALL OUR NEEDS FROM CRADLE TO THE GRAVE. I'VE GOT TO TELL YOU, THE PEOPLE AT THE TEA PARTIES UNDERSTAND THE KIND OF GAMES THAT ARE BEING PLAYED HERE AND THEY UNDERSTAND THAT THE CUTS TO HOME HEALTH CARE, THE CUTS TO HOSPICE PROGRAMS, THE CUT TO HOSPITALS, THE DISPROPORTIONATE SHARE MONEYS FOR POOR THAT DEAL WITH HOSPITAL CARE FOR POOR PEOPLE AND $23 BILLION FROM JUST GENERAL MEDICARE ACCOUNTS IS A CUT TO MEDICAID -- MEDICARE, WHICH IS OUR SENIORS' PROGRAM. ALL RIGHT. NOW, SO I WILL ASK THIS QUESTION QUESTION. HOW IS IT, THEN, THAT WE HAVE THIS DISAGREEMENT? HOW IS IT POSSIBLE THAT YOU CAN'T AGREE ON WHERE $465 BILLION COMES FROM? THE SPONSORS OF THE BILL, THIS IS WHAT THEY SAY. THEY SAY, WE'RE NOT -- WE PROMISED WE WOULDN'T CUT MEDICARE BENEFITS, ANY GUARANTEED BENEFIT, ANY SENIOR CITIZEN HAS, WE PROMISED NOT TO CUT IT. ALL WE'RE DOING IS CUTTING THE PROVIDERS, THE PEOPLE WHO PROVIDE THE BENEFIT. OH, GIVE ME A BREAK. AND SO YOU COME IN AND YOU CUT HOSPICES, NURSING HOMES, OTHER PROVIDERS, $118 BILLION FROM MEDICARE ADVANTAGE, $192 BILLION FROM THE HOSPICES, NURSING HOMES AND OTHER PROVIDERS, $43 BILLION FROM HOSPITALS THAT SERVE A DISPROPORTIONATE NUMBER OF POOR AND UNINSURED, $23 BILLION FROM UNSPECIFIED MEDICARE ACCOUNTS. AND THAT THIS DOESN'T WEAKEN MEDICARE. WELL, IF WE COULD CUT THAT, WHY HAVEN'T WE DONE IT ALREADY? IF THIS DIDN'T MAKE ANY DIFFERENCE, THIS DIDN'T REDUCE THE QUALITY OF CARE FOR SENIORS IF WE COULD REDUCE THESE HOSPITALS AND OTHERS AND THEY COULD STILL PROVIDE CARE TO OUR SENIORS, WHY HAVEN'T WE DONE IT ALREADY? MIKE HORSILY, THE HEAD OF OUR HOSPITAL ASSOCIATION IN ALABAMA, TELLS ME AS A RESULT OF AN ABOMINABLE WAGE INDEX PROGRAM THAT DETERMINES HOW MUCH HOSPITALS GET PAID PRIMARILY AND LEAN PAYMENTS IN GENERAL, TWO-THIRDS OF THE HOSPITALS IN ALABAMA ARE OPERATING IN THE RED RED. THEY DON'T NEED TO BE CUT ANY MORE. SO I GUESS WHAT I WOULD SAY TO YOU, THIS IS THE WAY THE GAME'S BEEN PLAYED. MY COLLEAGUES ARE SAYING, WE'RE NOT CUTTING GUARANTEED BENEFITS. WE'RE JUST CUTTING THE MONEY FROM THE PEOPLE WHO PROVIDE THE BENEFITS. WELL, HOW MANY OF THEM ARE GOING TO KEEP DOING SO, AS THE C.B.O., CONGRESSIONAL BUDGET OFFICE, QUESTIONED? HOW MANY OF THOSE WILL GIVE IT UP? AND FICTION NUMBER SIX -- I'VE GOT TEN AND I WON'T GO THROUGH ALL OF THEM TONIGHT BUT FICTION NUMBER SIX IS THAT HOSPITALS THAT TREAT THE POOREST AND SICKEST WILL SOMEHOW BE BETTER OFF UNDER THIS PROGRAM, BUT THEY'RE NOT FEELING THAT WAY. THEY'RE NOT FEELING THEY'RE GOING TO MAKE UP FOR THE FACT THAT THE HOSPITALS THAT QUALIFY AS DISPROPORTIONATE SHARE HOSPITALS, THOSE WHO SERVE A HIGH PERCENTAGE OF INDIVIDUALS WHO ARE VERY LOW INCOME OR WHO HAVE NO INSURANCE, THEY'RE GOING TO LOSE $43 BILLION IN CUTS UNDER THIS BILL, THAT THESE HOSPITALS THAT PROVIDE SO MUCH CHARITY CARE AND PROVIDE A SAFETY NET IN THE COMMUNITIES ARE GOING TO SUFFER UNDER THIS LEGISLATION, AND THEY ARE TELLING ME THAT. I DON'T KNOW WHO IN WASHINGTON MAY SAY THEY'RE NOT BUT THAT'S WHAT THEY'RE TELLING ME. AND I THINK THEY'RE TELLING THE TRUTH. AND, MR. PRESIDENT, ONE OF THE FICTIONS IS NUMBER FIVE, IS THAT AVERAGE PREMIUMS ARE GOING TO DECREASE. HAVE YOU HEARD THAT? THROUGH THIS PROPOSAL? AND SENATOR EVAN BAYH ASKED THE C.B.O. ABOUT THIS AND THEY SAID THAT FAMILIES THAT DO NOT RECEIVE COVERAGE FROM THEIR EMPLOYER WOULD SEE THEIR PREMIUMS RISE -- QUOTE -- "ABOUT 10% TO 13% HIGHER BY 2016" THAN UNDER THE CURRENT LAW. HIGHER THAN UNDER CURRENT LAW. AND THE ONES THAT CLAIM THEY'RE SEEING SOME REDUCTIONS, THOSE REDUCTIONS ARE ONLY THE SLIGHTEST REDUCTION, LESS THAN 1% IN MOST CASES OF THE 5% OR 6% INCREASE EXPECTED TO CONSIDER EVERY YEAR UNDER CURRENT LAW. SO INSTEAD OF GOING UP 5.27%, IT GOES UP 5.17% OR SOMETHING AND THEY'RE CLAIMING I GUESS THAT THAT'S SOME SORT OF CUT. BUT IT'S MISREPRESENTATION TO SAY THAT FAMILY PREMIUMS ARE GOING TO DECREASE, THAT PEOPLE WHO ARE NOT IN GROUP HEALTH PLANS THROUGH THEIR EMPLOYERS ARE THE ONES THAT ARE GOING TO SEE THE LARGEST INCREASES, PERHAPS 10% TO 13% BY 2016, MORE THAN WOULD OCCUR UNDER PRESENT LAW. MR. PRESIDENT, I AM PLEASED TO BE ABLE TO SERVE IN THE SENATE WITH SENATOR GRASSLEY, WHO'S CHAIRED THE FINANCE COMMITTEE, WHO'S RANKING MEMBER NOW ON THE FINANCE COMMITTEE, WHO DOES INTERESTING THINGS LIKE DOES 170 TOWN HALL MEETINGS A YEAR OR SOMETHING IN THE COUNTIES IN IOWA? AND MET WITH THOUSANDS OF PEOPLE AND GOT THE SAME MESSAGE I THINK THAT I GOT, WHICH IS ARE YOU PEOPLE IRRESPONSIBLE? IT LOOKS LIKE TO ME THEY'RE ASKING US THAT YOU GUYS ARE IRRESPONSIBLE, THE DEBT IS SURGING AND WILL DOUBLE IN FIVE YEARS, THE WHOLE DEBT OF AMERICA, AND TRIPLE IN TEN. SO I JUST WOULD WANT TO SAY THAT THAT -- THE AMERICAN PEOPLE ARE CONCERNED ABOUT THIS. AND SENATOR GRASSLEY WORKED SO HARD TO SEE IF HE COULD GET A BILL THAT WOULD BE BIPARTISAN, THAT WOULD WE ALL COULD SUPPORT, OR LARGE NUMBERS OF THE SENATE COULD SUPPORT, BUT WE GOT OFF TRACK. I TALKED TO ONE PERSON WHO DEALT WITH THIS ISSUE AND HE SAID THE WAY THINGS GOT OFF TRACK WAS THAT WE ABANDONED WAYS TO LEGITIMATELY CONTAIN COST INCREASES. THE WAY TO CREATE MORE COMPETITION, THE MORE PERSONAL STAKE IN YOUR HEALTH CARE, OTHER THINGS THAT WOULD ACTUALLY HELP REDUCE THE COSTS OF HEALTH CARE, THAT WE GOT AWAY FROM THAT AND IT BECAME DRIVEN BY PRESIDENT OBAMA'S DETERMINATION TO HAVE A GOVERNMENT OPTION. AND THAT'S, I GUESS, WAS THE DECISIVE EVENT IN THE NEGOTIATIONS BREAKING DOWN. BUT, MR. PRESIDENT, THIS IS A SERIOUS PIECE OF LEGISLATION. IT SEEMS SEEKS TO ALTER ONE-SEVENTH OF THE AMERICAN ECONOMY. IT'S NOT GOOD, IT DOES NOT DO WHAT IT PROMISES. IT SURGES SPENDING. IT INCREASES TAXES DRAMATICALLY, AND IT HAS A MAJOR GOVERNMENTAL TAKEOVER AND WILL ULTIMATELY UNDERMINE THAT SPECIAL RELATIONSHIP BETWEEN PATIENTS AND THEIR DOCTORS. AND IT WILL ALSO SUBSTANTIALLY THREATEN THE VIABILITY OF MEDICARE, BECAUSE THIS MONEY THAT'S BEING TAKEN OUT OF MEDICARE WILL ONLY ACCELERATE ITS INSOLVENCY. BY 2017, MEDICARE -- I THINK SENATOR GRASSLEY WOULD AGREE WITH THAT -- IS EXPECTED TO GO INTO DEFAULT. THAT IS, EXPENDITURES WILL BEGIN TO EXCEED THE INCOME FOR THE FIRST TIME IN THE MEDICARE HISTORY AND IT WILL GO DOWN RAPIDLY, ACTUALLY. AND THAT -- IS THAT CORRECT, SENATOR GRASSLEY, THAT BY 2017 UNDER CURRENT LAW, THAT MEDICARE IS PROJECTED TO GO INTO DEFAULT AND GO RAPIDLY INTO DEFAULT AND THAT IF WE COULD SAVE ANY MONEY OUT OF MEDICARE, IF WE CAN SAVE $400 BILLION, SHOULDN'T IT BE KEPT IN THE MEDICARE PROGRAM TO TRY TO EXTEND ITS LIFE AND MAKE IT A CONTINUED VIABLE PROGRAM THAT OUR SENIORS CAN RELY ON RATHER THAN CREATING A WHOLE NEW SPENDING PROGRAM FOR IT WITH THAT MONEY?

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  • 07:31:00 PM

    MR. GRASSLEY

    ME TO YIELD, I WOULD YIELD ON THAT QUESTION. I WOULD SAY HE'S ABSOLUTELY…

    ME TO YIELD, I WOULD YIELD ON THAT QUESTION. I WOULD SAY HE'S ABSOLUTELY RIGHT NOT BASED ON WHAT I SAY OR YOU SAY, BUT EVERY SPRING THE TRUSTEES OF SOCIAL SECURITY AND MEDICARE LOOK AHEAD 75 YEARS AND THEY PREDICT WHAT THE INCOME IS AND THE OUTGO IS GOING TO BE BASED ON THE POPULATION AN PROJECTED GROWTH OF THE -- AND PROJECTED GROWTH OF THE ECONOMY AND ALL OF THAT STUFF. RIGHT NOW THEY'RE PROJECTING $37 TRILLION -- $37 TRILLION OF SHORTFALL OVER THAT PERIOD OF TIME. AND THEY'VE ALREADY TOLD US AND IT HAS MATERIALIZED THAT IN THE YEAR 2008, WE STARTED PAYING MORE MONEY OUT OF SOCIAL SECURITY -- I MEAN OUT OF MEDICARE THAN COMING INTO MEDICARE. AND BY THE YEAR 2017, AS YOU CORRECTLY STATED, THE TRUST FUND WILL BE OUT OF RESERVES.

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  • 07:31:58 PM

    MR. SESSIONS

    MEDICARE.

  • 07:32:06 PM

    MR. GRASSLEY

    MEDICARE.

  • 07:32:07 PM

    MR. SESSIONS

    MEDICARE. I'M GOING TO YIELD THE FLOOR, SENATOR GRASSLEY. AND I APPRECIATE…

    MEDICARE. I'M GOING TO YIELD THE FLOOR, SENATOR GRASSLEY. AND I APPRECIATE YOUR LEADERSHIP AND INSIGHT INTO THAT ISSUE AND I VALUE YOUR WHOLE APPROACH TO IT. I THINK MOST AMERICANS, IF THEY UNDERSTOOD THIS -- THE INFORMATION AS YOU DO AND AS YOU HAVE ARTICULATED IT, THE OPPOSITION TO THE BILL WOULD BE EVEN GREATER THAN IT IS. SO I THANK THE CHAIR. I URGE MY COLLEAGUES TO EXAMINE THE FACT THAT THE BILL SIMPLY DOES NOT DO WHAT IT SETS OUT TO DO. DOES NOT MEET ITS PROMISES AND, AS A RESULT, WE ABSOLUTELY SHOULD NOT GO DOWN THIS ROAD TO A MAJOR FEDERAL TAKEOVER OF HEALTH CARE WITH RAMFICATIONS THAT GO FAR BEYOND WHAT IT MIGHT APPEAR TODAY. I THANK THE CHAIR AND WOULD YIELD THE FLOOR.

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  • 07:33:00 PM

    MR. GRASSLEY

  • 07:33:01 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM IOWA'S RECOGNIZED.

  • 07:33:05 PM

    MR. GRASSLEY

    MR. PRESIDENT?

  • 07:49:36 PM

    MR. CASEY

    MR. PRESIDENT?

  • 07:49:37 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM PENNSYLVANIA.

  • 07:49:39 PM

    MR. CASEY

    MR. PRESIDENT?

  • 08:15:04 PM

    MR. SANDERS

    MR. PRESIDENT?

  • 08:15:05 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATOR FROM VERMONT'S RECOGNIZED.

  • 08:15:07 PM

    MR. SANDERS

    MR. PRESIDENT, LET ME BEGIN BY THANKING SENATOR CASEY FOR HIS CONSISTENT…

    MR. PRESIDENT, LET ME BEGIN BY THANKING SENATOR CASEY FOR HIS CONSISTENT EFFORTS IN FIGHTING TO MAKE SURE THAT EVERY AMERICAN HAS GOOD-QUALITY, COST-EFFECTIVE HEALTH CARE. HE'S BEEN A LEADER ON THIS ISSUE AND I JUST WANT TO CONGRATULATE HIM. MR. PR -- MR. PRESIDENT, I JUST WANT TO TOUCH ON SOME OF THE HEALTH CARE ISSUES THAT ARE OUT THERE. TELL YOU WHAT I THINK IS POSITIVE IN THE BILL THAT WE ARE DEALING WITH HERE IN THE SENATE AND TELL YOU WHAT I THINK IS NOT SO POSITIVE. TO BEGIN WITH, AS SENATOR CASEY AS APTLY DESCRIBED, WE HAVE A SYSTEM WHICH IN MANY WAYS IS DISINTEGRATING. IT IS AN INTERNATIONAL EMBARRASSMENT THAT IN THE UNITED STATES OF AMERICA WE REMAIN THE ONLY NATION IN THE INDUSTRIALIZED WORLD WHO DOES NOT GUARANTEE HEALTH CARE TO ALL OF ITS PEOPLE AS A RIGHT. THE RESULT OF THAT IS SOME 46 MILLION AMERICANS TODAY HAVE NO HEALTH INSURANCE. EVEN MORE ARE UNDERINSURED WITH LARGE CO-PAYMENTS AND DEDUCTIBLES. WE HAVE SOME 60 MILLION AMERICANS TODAY WHO BECAUSE OF OUR VERY POOR PRIMARY HEALTH CARE OUTREACH NETWORK DO NOT HAVE ACCESS TO A DOCTOR ON A REGULAR BASIS AND THE RESULT OF THAT, MR. PRESIDENT, AS INCREDIBLE AS IT MAY SOUND, ACCORDING TO A RECENT STUDY AT HARVARD UNIVERSITY, SOME 45,000 PEOPLE DIE EVERY SINGLE YEAR BECAUSE THEY DON'T GET TO A DOCTOR WHEN THEY SHOULD HAVE. AND AS A RESULT, BY THE TIME THEY WALK INTO THE DOCTOR'S OFFICE, THEIR ILLNESS MAY BE TERMINAL. IN ADDITION TO THAT, GOD ONLY KNOWS HOW MANY PEOPLE END UP IN THE HOSPITAL AT GREAT EXPENSE TO THE SYSTEM BECAUSE THEY DO NOT GET CARE WHEN THEY SHOULD HAVE. MEANWHILE, AS SENATOR CASEY INDICATED, BANKRUPTCY IS AN AN ENORMOUS PROBLEM BECAUSE OF OUR HEALTH CARE SYSTEM. CLOSE TO ONE MILLION AMERICANS WILL GO BANKRUPT BECAUSE OF MEDICALLY RELATED BILL. WHEN WE TALK ABOUT ECONOMIC GROWTH IN AMERICA, ALL OF US UNDERSTAND, SMALL BUSINESSES, MEDIUM-SIZED BUSINESSES ARE PLOWING AN ENORMOUS AMOUNT OF MONEY INTO HEALTH CARE FOR THEIR WORKERS RATHER THAN REINVESTING THAT MONEY AND EXPANDING THEIR OPERATIONS TO CREATE JOBS THAT WE NEED AS A NATION IN THE MIDST OF A VERY DEEP RECESSION. SO WE HAVE GOT A MAJOR, MAJOR PROBLEM. AND AT THE END OF THE DAY, DESPITE SO MANY PEOPLE UNINSURED, UNDER INSURED, SO MANY PEOPLE DYING BECAUSE THEY DON'T HAVE IT, WE SPEND TWICE AS -- ALMOST TWICE AS MUCH ON HEALTH CARE PER CAPITA THAN ANY OTHER NATION. IT IS CLEAR TO ME AND THE VAST MAJORITY OF THE AMERICAN PEOPLE THAT WE NEED REAL HEALTH CARE REFORM. AND WHAT REAL HEALTH CARE REFORM MUST BE ABOUT ARE AT LEAST TWO THINGS. NUMBER ONE, PROVIDING COVERAGE TO ALL AMERICANS AS A RIGHT OF CITIZENSHIP AND, NUMBER TWO, DOING THAT IN THE MOST COST-EFFECTIVE WAY THAT WE POSSIBLY CAN. TO MY MIND, QUITE FRANKLY, THERE IS ONLY ONE WAY THAT I KNOW OF THAT YOU CAN PROVIDE UNIVERSAL COST-EFFECTIVE AND COMPREHENSIVE HEALTH CARE FOR ALL OF OUR PEOPLE. AND THAT IS A MEDICARE FOR ALL SINGLE-PAYER SYSTEM. AND, VERY BRIEFLY, THE VERY REASON FOR THAT IS THAT WE ARE WASTING ABOUT $400 BILLION EVERY SINGLE YEAR ON ADMINISTRATIVE COSTS, ON PROFITEERING, ON ADVERTISING, ON BILLING, ALL IN THE NAME OF PROFITS FOR THE PRIVATE INSURANCE COMPANIES WHO HAVE THOUSANDS AND THOUSANDS OF SEPARATE PLANS OUT THERE CREATING AN ENORMOUSLY COMPLICATED AND BURDENSOME SYSTEM. AND EACH ONE OF THEIR THOUSANDS OF PLANS. IF YOU'RE YOUNG AND YOU DON'T GET SICK AND YOU'RE HEALTHY, THEY HAVE A PLAN FOR YOU. IF YOU'RE OLDER AND GET SICK, THEY'VE GOT ANOTHER PLAN. 13,000 PRIVATE INSURANCE COMPANIES WITH THOUSANDS AND THOUSANDS OF PLANS AND TO ADMINISTER ALL OF THIS COSTS AND HUNDREDS AND HUNDREDS OF BILLION DOLLARS OF. THAT IS MONEY GOING INTO DOCTORS. NOT MONEY GOING INTO DENTISTS, MANY AREAS, INCLUDING VERMONT, SERIOUS DENTAL ACCESS PROBLEM, NOT MONEY GOING TO NURSES. WE HAVE A NURSING SHORTAGE. THIS IS MONEY GOING INTO BUREAUCRACY, PROFITEERING, AND EXCESSIVE SALARIES FOR THE C.E.O.'S OF INSURANCE COMPANIES, IT'S GOING INTO INFLATED PRICES FOR PRESCRIPTION DRUGS IN THIS COUNTRY AND AS A NATION WE PAY THE HIGHEST PRICES IN THE WORLD FOR PRESCRIPTION DRUGS. TO MY MIND AS A NATION, WHAT WE HAVE GOT TO FINALLY DEAL WITH IS THAT SO LONG AS WE HAVE THOUSANDS OF SEPARATE PLANS, EACH DESIGNED TO MAKE AS MUCH MONEY AS POSSIBLE, YOU'RE NOT GOING TO GET A HANDLE ON THE COST OF HEALTH CARE IN AMERICA. AND IN THE BILL THAT WE ARE NOW TALKING ABOUT HERE IN THE SENATE WE'VE GOT TO BE CLEAR THAT THE PROJECTIONS, ACCORDING TO THE C.B.O., IS THAT EVERYTHING BEING EQUAL OVER A 10-YEAR PERIOD, THE COST OF HEALTH CARE FOR MOST AMERICANS IS GOING TO CONTINUE TO SOAR. THAT IS THE REALITY. AND THIS IS BAD NOT ONLY FOR INDIVIDUALS, NOT ONLY FOR BUSINESSES, THIS IS BAD FOR OUR INTERNATIONAL COMPETITIVE CAPABILITIES. BECAUSE WE'RE STARTING OFF FROM THE POSITION THAT TODAY WE SPEND MUCH MORE THAN ANY OTHER COUNTRY. AND GUESS WHAT? WHILE THIS BILL DOES A NUMBER OF VERY GOOD THINGS, IT IS NOT STRONG ON COST CONTAINMENT. MR. PRESIDENT, IF WE ARE GOING TO DO AND TRY TO IMPROVE COST CONTAINMENT. AND I WONDER HOW MUCH WE CAN DO WITHIN THE CONTEXT OF THIS PARTICULAR APPROACH TO HEALTH CARE WITHOUT BEING A MEDICARE FOR ALL SINGLE-PAYER SYSTEM, AT THE VERY ACHILLES -- AT LEAST WE NEED A STRONG PUBLIC OPTION. THERE IS WIDESPREAD MISTRUST OF PRIVATE HEALTH INSURANCE COMPANIES FOR ALL OF THE RIGHT REASONS. MOST AMERICANS UNDERSTAND THAT THE FUNCTION OF A PRIVATE HEALTH INSURANCE COMPANY IS NOT TO PROVIDE HEALTH CARE, THE FUNCTION IS TO MAKE AS MUCH MONEY AS POSSIBLE. PEOPLE DO NOT TRUST PRIVATE HEALTH INSURANCE COMPANIES AND THEY ARE RIGHT IN TERMS OF THEIR PERCEPTIONS. PEOPLE ARE ENTITLED TO A CHOICE. IF YOU WANT TO STAY WITH YOUR PRIVATE HEALTH INSURANCE COMPANY, GREAT, YOU CAN DO IT. BUT AS MANY PEOPLE AS POSSIBLE IN THIS COUNTRY SHOULD BE ABLE TO SAY, YOU KNOW WHAT? I'M NOT COMFORTABLE WITH THE PRIVATE INSURANCE COMPANY. I'D RATHER HAVE A MEDICARE-TYPE PLAN. AND I THINK POLL AFTER POLL SUCTSSUGGESTS THAT THE AMERICAN PEOPLE WANT THAT PUBLIC OPTION MUCH SO THAT'S POINT NUMBER ONE. FREEDOM OF CHOICE. PEOPLE SHOULD HAVE THAT CHOICE. IF THEY DON'T WANT IT, THAT'S FINE. POINT NUMBER TWO MAY BE EVEN MORE IMPORTANT. IF WE'RE GOING TO GET A HANDLE ON EXPLODING HEALTH CARE COSTS, SOMEBODY IS GOING TO HAVE TO REIN IN THE PRIVATE INSURANCE COMPANIES WHOSE ONLY FUNCTION IN LIFE IS TO MAKE AS MUCH MONEY AS THEY POSSIBLY CAN. WE NEED A NONPROFIT GOVERNMENT-RUN PUBLIC PLAN TO DO THAT. AND IF WE DO NOT HAVE THAT IN THIS BILL, I AM NOT SURE HOW YOU'RE GOING TO GET ANY HANDLE ON COST CONTAINMENT. SO I WILL FIGHT TO MAKE SURE THAT WE HAVE A STRONG -- AS STRONG A PUBLIC OPTION AS WE POSSIBLY CAN. AS I HAVE SAID PUBLICLY MANY TIMES, MY VOTE FOR THIS LEGISLATION IS NOT AT ALL CERTAIN. I HAVE A LOT OF PROBLEMS WITH THIS BILL. AND WE'VE GOT TO HAVE AT LEAST, AMONG OTHER THINGS, A STRONG PUBLIC OPTION. LET ME TELL YOU SOMETHING ELSE THAT I THINK WE HAVE GOT TO ADDRESS IN THIS BILL. AS MENTIONED A MOMENT AGO, WE HAVE A DISASTER IN TERMS OF PRIMARY HEALTH CARE IN AMERICA. SOME 60 MILLION AMERICANS ARE FINDINGFINDING IT DIFFICULT TO GET TO A DOCTOR ON A REGULAR BASIS. AND THAT IS JUST DUMB IN TERMS OF THE HEALTH AND WELL BEING OF OUR PEOPLE AND IT IS ALSO DUMB IN TERMS OF TRYING TO CONTROL HEALTH CARE COSTS. IF SOMEBODY DOES NOT HAVE A DOCTOR THAT THEY CAN GO TO WHEN THEY GET SICK, WHERE DO THEY END UP? THEY END UP IN THE EMERGENCY ROOM. AND EVERYBODY KNOWS THAT THE EMERGENCY ROOM, BY FAR, IS THE MOST EXPENSIVE FORM OF PRIMARY HEALTH CARE. YOU HAVE MILLIONS OF PEOPLE -- YET, MILLIONS OF PEOPLE HAVE NO OTHER OPTIONS. THEY END UP IN THE EMERGENCY ROOM. IF THEY HAVE BAD COLD, MEDICAID MAY PAY $500 TO $600 FOR A VISIT TO THE EMERGENCY ROOM THAT. IS TOTALLY ABSURD. FURTHERMORE, IF YOU HAVE A PRIMARY HEALTH CARE PHYSICIAN, THAT PERSON IS WORKING WITH YOU ON DISEASE PROTECTION, HELPING YOU WITH GETTING YOU OFF CIGARETTES OR WITH ALCOHOL OR DRUG PROBLEMS AND A MYRIAD OF ISSUES IN TERMS OF DISEASE PREVENTION AND GOOD NUTRITION, ET CETERA, ET CETERA. SO IF WE HAVE A DISASTER IN PRIMARY HEALTH CARE WHICH IS DRIVING PEOPLE TO THE E.R. ROOMS MAKES NO SENSE AT ALL. AS I MENTIONED THE OTHER DAY, THERE IS A PROVISION IN THIS LEGISLATION IN THE SENATE WHICH AUTHORIZES A VERY SIGNIFICANT EXPANSION OF FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS, WHICH IN A NONPARTISAN WAY -- BIPARTISAN WAY IS WIDELY SUPPORTED BY I SUSPECT EVERYONE HERE IN THE SENATE AND IN THE HOUSE AS WELL. AND THESE COMMUNITY HEALTH CENTERS TODAY ALLOW 20 MILLION PEOPLE TO ACCESS NOT ONLY GOOD QUALITY PRIMARY HEALTH CARE, BUT DENTAL CARE WHICH IS A HUGE ISSUE, MENTAL HEALTH COUNSELING, A VERY BIG ISSUE, AN LOW-COST PRESCRIPTION DRUGS. WHILE THE HEALTH CENTERS DO AN EXCELLENT ON, THERE ARE NOT ENOUGH OF THEM. SO IN THIS LEGISLATION, WE HAVE GREATLY EXPANDED COMMUNITY HEALTH CENTERS. AND IF WE AS A CONGRESS ARE TALKING ABOUT BRINGING 13 MILLION, 14 MILLION, 15 MILLION MORE PEOPLE INTO MEDICAID, I AM NOT QUITE SURE HOW A MEDICAID PROGRAM IS GOING TO ACCOMMODATE THOSE PEOPLE UNLESS WE PROVIDE THE FACILITIES AND THE MEDICAL PERSONNEL TO TREAT THEM. SO WE NEED THIS. WE NEED TO EXPAND PRIMARY HEALTH CARE, COMMUNITY HEALTH CENTERS ARE THE MOST COST-EFFECTIVE WAY I KNOW AS TO HOW TO DO THAT. THERE ARE STUDIES OUT THERE TO SUGGEST THAT BY PROVIDING THAT KIND OF PRIMARY HEALTH CARE, KEEPING PEOPLE OUT OF EMERGENCY ROOMS, KEEPING THEM OUT OF HOSPITAL BECAUSE THEY'VE GOTTEN SICKER THAN THEY SHOULD HAVE GOTTEN, WE CAN, IN FACT, PAY FOR THESE COMMUNITY HEALTH CENTERS BY THEMSELVES OVER A PERIOD OF YEARS BY SIMPLY SAVING MONEY. SO IN THE SENATE WE HAVE VERY GOOD LANGUAGE AUTHORIZING AN EXPANSION. IN THE HOUSE THEY HAVE SIMILAR LANGUAGE, EXCEPT IN THE HOUSE THEY HAVE A TRUST FUND WHICH ACTUALLY PAYS FOR THIS. SO I'M GOING TO DO MY BEST TO MAKE SURE THAT WE ADOPT THE HOUSE RAGE WAGE, WHICH PAYS FOR THROUGH A -- HOUSE LANGUAGE THAT PAYS FOR THROUGH -- AND AN EXPANSION OF THE NATIONAL HEALTH SERVICE CORPS, WHICH IS THE FEDERAL PROGRAM THAT PROVIDES DEBT FORGIVENESS AN SCHOLARSHIPS FOR MEDICAL STUDENTS WHO ARE PREPARED TO SERVE IN MEDICALLY UNDERSERVED AREAS IN PRIMARY HEALTH CARE. WE DESPERATELY NEED MORE PRIMARY HEALTH CARE PHYSICIANS AN DENTISTS AND NURSES. SO MY HOPE IS THAT THE SENATE WILL ADOPT THE HOUSE PROVISION WHICH ALREADY HAS A TRUST FUND TO GREATLY EXPAND THE HEALTH SERVICE CORPS AND THE HEALTH SERVICE PROGRAMS. THAT IS AN ISSUE VERY IMPORTANT TO ME. LET ME TOUCH ON ANOTHER ISSUE THAT IS CLEARLY GOING TO BE CONTENTIOUS. AND THAT IS AT THE END OF THE DAY WE ARE GOING TO BE SPENDING ON HEALTH CARE SOMEWHERE AROUND $800 BILLION TO $1 TRILLION. AND THE AMERICAN PEOPLE WANT TO KNOW A COUPLE OF THINGS. THEY WANT TO KNOW, IS THIS GOING TO RAISE OUR NATIONAL DEFICIT? AND WHAT C.B.O. TELLS US IS, NO, IT WILL NOT. MORE MONEY IS GOING TO COME IN THAN GO OUT. THERE BE SAVINGS INKORPTD INTO THE LEGISLATION. -- INCORPORATED INTO THE LEGISLATION. WE HAVE A DZ 12-DZ $1 BILLION NATIONAL DEBT. SO PEOPLE ASK, HOW ARE YOU GOING TO PAY FOR THIS? AND HERE'S WHERE WE HAVE A DIFFERENCE OF OPINION. IN THE HOUSE, I THINK THAT THEY HAVE, ONCE AGAIN, DONE THE RIGHT THING. AND WHAT THE HOUSE HAS DONE IS RAISE $460 BILLION WITH A SURCHARGE ON THE TOP THREE TENTHS OF 1 -- THREE-TENTH OF 1% OF TAXPAYERS. THESE ARE THE WEALTHIEST PEOPLE IN THE COUNTRY. WHAT THE HOUSE HAS SAID IS THAT AT A TIME WHEN THE GAP BETWEEN THE RICH AND EVERYONE ELSE IS GOING WIDER AND THE TOP EARN MORE INCOME THAN THE BOTTOM 50%, IT IS APPROPRIATE TO ASK THE WEALTHY TO PAY THEIR FAIR SHARE OF TAXES SO THAT WE CAN PROVIDE HEALTH INSURANCE TO TENS OF MILLIONS OF AMERICANS. THAT, IN MY VIEW, IS EXACTLY THE RIGHT WAY TO GO. UNFORTUNATELY IN THE SENATE WE HAVE NOT DONE THAT. WHAT WE HAVE CHOSEN TO DO IN THE SENATE IS TO RAISE ABOUT -- WELL, I DON'T KNOW THE EXACT NUMBER RIGHT HERE. BUT WE HAVE CHOSEN TO IMPOSE AN EXCISE TAX OF 40% ON SO-CALLED CADILLAC PLANS. WELL, THE PROBLEM IS THAT GIVEN THE SUBSTANTIAL INCREASE IN HEALTH CARE COSTS IN THIS COUNTRY, A CADILLAC PLAN TODAY IN FIVE OR 10 YEARS MAY BE A JUNK CAR PLAN. AND I BELIEVE THAT WITH A STRUGGLING MIDDLE CLASS OUT THERE, WHERE PEOPLE -- WITH PEOPLE DESPERATELY TRYING TO HOLD ON TO THEIR STANDARD OF LIVING, THE LAST THING THAT THE UNITED STATES SENATE WANTS TO DO, IS TO IMPOSE A TAX ON MILLIONS AND MILLIONS OF WORKING PEOPLE WHO HAVE FOUGHT HARD TO GET A HALFWAY DECENT HEALTH CARE PLAN. LET ME VERY BRIEFLY, MR. PRESIDENT, READ RIGHT FROM A FAX SHEET THAT CAME FROM THE COMMUNICATION WORKERS OF AMERICA. C.W.A. IS ONE OF THE LARGEST UNIONS AND ALMOST LIKE EVERY UNITED YORUNION THEY ARE STRONGLY OH, PROSED TO THE EX CEASE -- OPPOSED TO THE EXCISE TAX. THIS IS DOCUMENT FROM THE CW.O. THE LEGS WILL VOTE ON -- EMPLOYER HEALTH PLANS. THE TAX WILL BE PASSED DIRECTLY ON TO WORKING FAMILIES TO AVOID THE TAX EMPLOYERS WILL TRY TO SIGNIFICANTLY CUT BENEFITS FOR ACTIVE WORKERS AND PREMEDICARE RETIREES. HOW THE HEALTH BENEFIT TAX WORKS, THEY DESCRIBE IT AGAIN. IT IS A 40% EXCISE TAX THAT WOULD BE ASSESSED ON THE VALUE OF HEALTH CARE PLANS, EXCEEDING $23,000 PER FAMILY AND $8,500 PER INDIVIDUAL STARTING IN 2013. LEVELS ARE HIGHER FOR PREMEDICARE RETIREE PLANS AND HIGH-RISK INDUSTRY PLANS. $26,000 AND $9,850. THESE THRESHOLDS WOULD INCREASE -- AND HERE'S AN IMPORTANT POINT, BECAUSE WHILE PEOPLE MAY NOT HAVE TO PAY THIS TAX IN A COUPLE OF YEARS WITH HEALTH CARE COSTS SOARING, THEY WILL HAVE TO PAY THIS TAX IN THE REASONABLY NEAR FUTURE. THESE THRESHOLDS WOULD INCREASE AT THE RATE OF GENERAL INFLATION PLUS 1 PERCENTAGE POINT OR 3%. THIS IS WELL BELOW THE MEDICAL INFLATION RIGHT, 4% AND ABOUT HALF THE RIGHT, 6%, AT WHICH EMPLOYER AND UNION PLAN COSTS HAVE BEEN INCREASING. IN OTHER WORDS, THE COSTS OF HEALTH CARE IS RISING A LOT FASTER THAN INFLATION WHICH TODAY IS ALMOST ZERO, AND MAY ACTUALLY EVEN BE BELOW ZERO. THE POINT BEING THAT A NUMBER OF YEARS SO-CALLED CADILLAC PLANS ARE GOING TO RISCH THE THRESHOLD UPON WHICH MIDDLE-CLASS WORKERS ARE GOING TO BE FORCED TO PAY A LOT IN TAXES. LET ME GO BACK TO THE C.W.A. NOW. THEY WRITE -- "HEALTH BENEFITS TAX WILL HIT C.W.A." -- AND WHEN THEY SAY C.W.A., THEY ARE TALKING ABOUT MANY UNION WORKERS. "C.W.A. PLANS RESULT IN DEEP CUTS. IN 40 OF 43 STATES EXAMINED OVER TEN YEARS, 2013-2022, THE AVERAGE EXCISE TAXES ASSESSED ON EACH WORKER AND C.W.A.'S MOST POPULAR PLANS WILL BE $13,300 PER ACTIVE WORKER IN THE FAMILY PLAN." THAT'S FOR A TEN-YEAR PERIOD. $13,300. $5,800 PER ACTIVE SIMILAR WORKER. $13,300 FOR PRE-MEDICARE RETIREE IN THE FAMILY PLAN. $1,400 FOR PRE-MEDICARE RETIREE IN THE SINGLE PLAN. THE BOTTOM LINE IS THE MIDDLE CLASS IN THIS COUNTRY IS STRUGGLING. WE ARE IN THE MIDST OF THE MOST SEVERE RECESSION SINCE THE GREAT DEPRESSION OF THE 1930'S. PEOPLE ARE WORKING LONGER HOURS FOR LOWER WAGES. MIDDLE CLASS IS ON THE VERGE OF COLLAPSE. THE UNITED STATES SENATE SHOULD NOT BE IMPOSING AN ADDITIONAL TAX ON MIDDLE-CLASS WORKERS. THE HOUSE GOT IT RIGHT. THE SENATE GOT IT WRONG. AND, MR. PRESIDENT, I INTEND TO OFFER AN AMENDMENT TO TAKE OUT THIS TAX AND REPLACE IT WITH A PROGRESSIVE TAX SIMILAR TO WHAT EXISTS IN THE HOUSE. LET ME CONCLUDE, MR. PRESIDENT, BY SIMPLY SAYING THIS: I UNDERSTAND THAT THE LEADERSHIP WANTS TO MOVE THIS BILL FORWARD AS QUICKLY AS POSSIBLE. I UNDERSTAND THAT. BUT IN MY VIEW, WE HAVE GOT A LOT OF WORK IN FRONT OF US TO IMPROVE THIS PLAN, AMONG MANY OTHER THINGS, MANY OTHER THINGS. AND I KNOW MANY MEMBERS HAVE DIFFERENT IDEAS. AT THE VERY LEAST, STATES IN THIS COUNTRY, INDIVIDUAL STATES, IF THEY SHOW CHOOSE, SHOULD BE ABLE TO DEVELOP A SINGLE-PAYER PLAN FOR THEIR STATES, BECAUSE AT THE END OF THE DAY, IN MY VIEW, THE ONLY WAY WE ARE GOING TO PROVIDE COMPREHENSIVE, COST-EFFECTIVE UNIVERSAL CARE IS THROUGH A SINGLE-PAYER. I KNOW SOME PEOPLE ARE SAYING WELL, WE'RE DEALING WITH HEALTH CARE, WE'RE NOT GOING TO BE BACK FOR A LONG TIME. IF THIS BILL WOULD PASS TOMORROW, TRUST ME, WE WILL BE BACK IN A FEW YEARS BECAUSE HEALTH CARE COSTS ARE GOING TO CONTINUE TO SOAR. WINSTON CHURCHILL ONCE SAID THAT THE AMERICAN PEOPLE ALWAYS DO THE RIGHT THING WHEN THEY HAVE NO OTHER OPTION, AND I THINK THAT'S WHAT WE'RE LOOKING AT RIGHT NOW. WE'RE RUNNING OUT OF OPTIONS. WHAT WE HAVE PUT TOGETHER IS AN ENORMOUSLY COMPLICATED PATCHWORK PIECE OF LEGISLATION. IT'S GOING TO HELP A LOT OF PEOPLE. IT INVOLVES INSURANCE REFORM WHICH IS ABSOLUTELY RIGHT. WE HAVE GOT A LOT OF MONEY INTO DISEASE PREVENTION, WHICH WE SHOULD HAVE. A LOT OF VERY GOOD THINGS IN THIS BILL, BUT IT AIN'T GOING TO SOLVE IN MY VIEW THE HEALTH CARE CRISIS. COSTS ARE GOING TO SOAR. AT LEAST IFWAY DON'T HAVE THE COURAGE AS A BODY TO TAKE ON THE INSURANCE COMPANIES, TO TAKE ON THE DRUG COMPANIES, AT THE VERY LEAST LET US GIVE STATES, WHETHER IT IS VERMONT, PENNSYLVANIA, CALIFORNIA, OR OTHER STATES THE RIGHT TO BECOME A MODEL FOR AMERICA, PROVIDE HEALTH CARE TO ALL PEOPLE, IN A COST-EFFECTIVE WAY THROUGH A MEDICARE FOR ALL SINGLE-PAYER SYSTEM. SO WE HAVE GOT TO DO THAT. THE OTHER THING WE HAVE GOT TO DO, IN MY VIEW, IS GET RID OF THIS TAX ON THE MIDDLE CLASS BY TAXING HEALTH CARE BENEFITS. MR. PRESIDENT, YOU WILL RECALL THAT A YEAR AGO WE WERE IN A HEAT -- A HIGHLY CONTROVERSIAL AND DIFFICULT PRESIDENTIAL CAMPAIGN, AND ONE CANDIDATE WHO HAPPENED TO HAVE LOST THAT ELECTION, A MEMBER OF THE SENATE, SENATOR McCAIN, CAME UP WITH A PLAN THAT WAS EXACTLY OR VERY CLOSE TO WHAT WE ARE TALKING TODAY, AND THE SENATOR BARACK OBAMA WHO WON THAT ELECTION CAME UP WITH A DIFFERENT PLAN. HE SAID THAT WASN'T A GOOD IDEA. WELL, HOW DO YOU THINK MILLIONS OF AMERICAN WORKERS ARE GOING TO FEEL WHEN THEY SAY WAIT A SECOND, THE GUY WHO WON TOLD ME HE WAS AGAINST TAXING HEALTH CARE PLANS AND NOW WE ARE ADOPTING THE PROGRAM OF THE GUY WHO LOST? HOW DO WE HAVE FAITH WITH THE AMERICAN PEOPLE? AND PEOPLE WHO VOTED IN THAT ELECTION IF WE DO EXACTLY WHAT WE SAID WE WOULD NOT DO? SO WE HAVE GOT TO MOVE TOWARD A PROGRESSIVE WAY OF FUNDING THIS HEALTH CARE PLAN. SO, MR. PRESIDENT, YOU KNOW, I SIT HERE RIGHT NOW SAYING THAT THIS PLAN HAS A LOT OF GOOD STUFF IN IT, BUT THERE ARE A LOT OF PROBLEMS IN IT, AND I VERY MUCH LOOK FORWARD TO THE OPPORTUNITY TO BE ABLE TO OFFER A NUMBER OF AMENDMENTS TO STRENGTHEN THIS BILL, AND IT IS VERY IMPORTANT, I THINK, FOR THE PEOPLE OF VERMONT AND PEOPLE ALL OVER THIS COUNTRY, NOT ONLY I BUT YOU AND OTHER PEOPLE HAVE A RIGHT TO OFFER AMENDMENTS, BECAUSE IF THIS BILL JUST GETS WHIZZED RIGHT THROUGH AND IS NOT AS STRONG AS IT POSSIBLY CAN BE, I THINK WE WILL NOT HAVE DONE THE JOB THAT WE NEED TO DO. MR. PRESIDENT, WITH THAT, I WOULD YIELD THE FLOOR AND THANK YOU.

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  • 08:37:11 PM

    MR. SANDERS

    THE SENATOR FROM VERMONT IS RECOGNIZED.

  • 08:37:13 PM

    THE PRESIDING OFFICER

    THE SENATOR FROM VERMONT IS RECOGNIZED.

  • 08:37:16 PM

    MR. SANDERS

    WITHOUT OBJECTION.

  • 08:37:24 PM

    THE PRESIDING OFFICER

    OFFICER: WITHOUT OBJECTION.

  • 08:37:27 PM

    MR. SANDERS

    MR. PRESIDENT, I ASK UNANIMOUS CONSENT THAT WHEN THE SENATE COMPLETES ITS…

    MR. PRESIDENT, I ASK UNANIMOUS CONSENT THAT WHEN THE SENATE COMPLETES ITS BUSINESS TODAY, IT ADJOURN UNTIL 9:30 A.M. WEDNESDAY, DECEMBER 9. THAT FOLLOWING THE PRAYER AND PLEDGE, THE JOURNAL OF PROCEEDINGS BE APPROVED TO DATE, THE MORNING HOUR BE DEEMED EXPIRED, THE TIME FOR THE TWO LEADERS BE RESERVED FOR THEIR USE LATER IN THE DAY, AND THE SENATE RESUME CONSIDERATION OF H.R. 3590, THE HEALTH CARE REFORM LEGISLATION. THAT FOLLOWING ANY REMARKS OF THE CHAIR AND RANKING MEMBER OF THE FINANCE COMMITTEE OR THEIR DESIGNEES FOR UP TO TEN MINUTES EACH THE NEXT TWO HOURS BE FOR DEBATE ONLY, WITH THE TIME EQUALLY DIVIDED AND CONTROLLED BETWEEN THE TWO LEADERS OR THEIR DESIGNEES, WITH SENATORS PERMITTED TO SPEAK FOR UP TO TEN MINUTES EACH, REPUBLICANS CONTROLLING THE FIRST 30 MINUTES AND THE MAJORITY CONTROLLING THE SECOND 30 MINUTES, WITH THE REMAINING TIME EQUALLY DIVIDED AND USED IN AN ALTERNATING FASHION. FURTHER, THAT NO AMENDMENTS ARE IN ORDER DURING THIS TIME.

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  • 08:38:22 PM

    THE PRESIDING OFFICER

    WITHOUT OBJECTION, SO ORDERED.

  • 08:38:28 PM

    MR. SANDERS

    ROLL CALL VOTES ARE POSSIBLE THROUGHOUT THE DAY TOMORROW. SENATORS WILL BE…

    ROLL CALL VOTES ARE POSSIBLE THROUGHOUT THE DAY TOMORROW. SENATORS WILL BE NOTIFIED WHEN ANY VOTES ARE SCHEDULED. IF THERE IS NO FURTHER BUSINESS TO COME BEFORE THE SENATE, I ASK THAT IT ADJOURN UNDER THE PREVIOUS ORDER.

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  • 08:38:39 PM

    THE PRESIDING OFFICER

    OFFICER: THE SENATE STANDS IN ADJOURNMENT UNTIL 9:30

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115th Congress - Senate
Total Hours: 2039 (After 652 days)
  • Debate1175 Hours
  • Quorum Calls474 Hours
  • Votes333 Hours

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Source: Resume of Congressional Activity (senate.gov)