Ryan White HIV/AIDS Treatment Modernization Act of 2006

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, in a moment I will request unanimous consent that the Senate pass S. 2823, the Ryan White HIV/AIDS Treatment Modernization Act.

Just last week, we made a unanimous consent request to pass this bipartisan, bicameral legislation. That means Members from both sides of the aisle and both ends of the building have agreed to the language in this reauthorization. It passed out of the House Committee on Energy and Commerce last week. However, Senators from three States are blocking the vote that would speed reauthorization programs that provide life-sparing treatment to individuals suffering from HIV and

I am sorry to hear we have an objection. We need to find a way to work through this objection. I have been working desperately across the aisle with Senator Kennedy, who has been joining me in this effort to help get it out of committee. We have been trying to find a way that the formula would work. One of the ways was to include in the bill 3 years of hold harmless for them to finish updating their system to the point where if they truly have the HIV numbers, they will truly get the money. If they don't have the HIV numbers, yes, they will lose the money.

Now, I don't know if the Senator from Minnesota is aware that our Ryan White reauthorization bill increases the funding for Minneapolis by $2 million and $2.5 million for the whole State. It is a net benefactor. There have been increases in HIV and AIDS cases in Minnesota, and this would move money to where the cases are. That is where the numbers show that his city and State would be significant beneficiaries.

I have a lot of statistics I can go through, but I wonder if the Senator is also aware that these increases are due to the inclusion of HIV/AIDS in the funding formula and that Minnesota has more HIV cases.

Mr. President, I appreciate that clarification.

I will ask the Senator for his help. He said he would vote for the bill. Anything we can do to move this forward. We have put a 3-year hold harmless in there for everyone.

On September 30, the world falls apart for a number of people. California, for one, will lose $18.5 million of their funding. There are a number of big losers. There are no big losers if we pass the bill, provided the numbers back up what they have.

I yield the floor.

Mr. President, I thank the Senator for his words. The increase in knowledge that I am sure he has created across the country--and also the

comments of the Senator from Oklahoma--both of them have made an excellent case for why we need to do this. We need to do it immediately. We need to do it for people who have HIV/AIDS. I would note that the person who raised the objection to us adopting the bill is not from one of the three States that have a hold on the bill. I would hope those people would take a look at the situation in their State, and take a look at the fact they are getting more than the average number of funds being expended on patients across the rest of the country, and see that the surpluses their States are running at the end of the year greatly exceed the rather minute loss they would have, and that they would agree for us to move forward on this bill and get it in place before that September 30 deadline that is going to be devastating to 13 States that will lose money for having done the right thing.

Now, having said that, I know there will be people who will say the Republicans cannot get anything done. Well, that particular issue, and many others are not Republican issues. They are issues of the United States. And that is one on which we worked across the aisle and had a great deal of agreement on. And I have to thank Senator Kennedy, the ranking member on my committee, for the extreme work he did to help us find, among the thousands of formulas we looked at, the one that was the most fair so it would follow the patients. I do appreciate the work he has helped us do in the committee during the year.

Accomplishments of the Help Committee

Mr. President, I want to take just a few minutes to talk about what the Health, Education, Labor, and Pensions Committee has done this year. This Ryan White reauthorization is extremely important, but it is not the only bill we have been working on. Because of the way we have done our work, some people may not be aware of what has been done. In fact, I know that to be the case.

This is a committee that has worked across the aisle. When you work across the aisle, a lot of times you can work out many of the difficulties, and when you work out the difficulties, there is not a big floor debate. And when there is not a big floor debate, there is nothing for the media to write up about the blood; consequently, it does not get coverage. So I want to correct that here today, and I would like to discuss the Senate Health, Education, Labor, and Pensions Committee's accomplishments for the 109th Congress.

We have heard some claims that this is a do-nothing Congress. Well, I am here to assure American workers, retirees, students, and parents that the Health, Education, Labor, and Pensions Committee has done a great deal to help you live more secure, productive, and healthy lives. Of course, we have more to do, but I am proud that during a time of intense partisanship on Capitol Hill, the HELP Committee has produced a lengthy list of legislative accomplishments.

Looking back over the past 2 years, most of these victories materialized when Senators were willing to work across party lines and across the Capitol to put finding a solution in front of exploiting an issue.

Mr. President, I ask unanimous consent that a list of bills and reports filed by the HELP Committee in the 109th Congress be printed in the Record

Mr. President, I joined the HELP Committee when I was first elected to the Senate in 1997. It was natural for me because of my small business background as an owner of family shoe stores. I had firsthand experience with burdensome government regulations, inadequate health care coverage for my workers, and adversarial workplace safety laws. I was energized about finding common sense solutions rather than more Washington bureaucracy.

Now, another reason I joined the HELP Committee is because its broad jurisdiction touches nearly every American.

Now, there were a lot of vacancies on the committee when I signed up. I asked why there were so many vacancies, and I was told, well, that is a contentious committee. I thought I knew what contentious committees were because I served on the labor committee in Wyoming. I found out that there is another level of contentious. I wanted to work with my colleagues to find smart solutions that would address some of the most important challenges faced by my constituents in Wyoming and, of course, other people across the country. I came from Wyoming as a firm believer in my 80-20 rule. The way that rule works is that we can usually find agreement on 80 percent of any issue. We agree across the aisle on about 80 percent the issues that comes up. Now, we are probably never going to reach agreement on the remaining 20 percent.

Unfortunately, for America, what they get to watch on any bill is the debate on the 20 percent we don't agree on, and probably will never compromise on. That is what makes this body seem so contentious--the 20 percent that we don't agree on, even though 80 percent can get done. The committee process will enable us to find that 80 percent, and that has been a principle that has guided my chairmanship.

I was honored and humbled when my colleagues selected me to chair the HELP Committee nearly 2 years ago. Since my chairmanship began, the vision for both the full committee and the subcommittees is to craft legislation that provides lifelong opportunities for people to be healthier, more competitive, and to be more secure at school, work, and in retirement.

Because we have such a broad jurisdiction, the HELP Committee has had an aggressive legislative schedule in the 109th Congress. Over the past 2 years, together with the subcommittees, we have held 57 hearings and reported 36 bills out of committee; 21 of these proposals were approved by the Senate and 12 were signed by the President and became public law. We also reviewed and approved 352 nominations that require Senate confirmation. I thank my colleagues, including their staffs, for doing the work needed to maintain this aggressive pace.

In this Congress, the HELP Committee has been privileged to have in its ranks active subcommittee chairmen and engaged members. This is largely the reason the committee has had legislative success. I thank them for their dedication, and I applaud them for the joint success as a committee. Our ranking member, Senator Kennedy, and I may disagree on a number of issues, but we have worked hard to find common ground and we share a commitment to improving the health, education, work, and retirement security of Americans.

The number of bills acted upon by the HELP Committee is certainly impressive. However, the numbers alone don't begin to tell the story of how the committee's activity will improve the lives of Americans now and in the years to come. One of the committee's most significant accomplishments came on August 17 of this year when President Bush signed into law the Pension Protection Act. That act marks the most comprehensive change to pension law since 1974. The Pension Protection Act is a real victory for working Americans who spend a lifetime working hard and saving for retirement. It dramatically strengthens pension funding rules and helps curb record pension failures. In doing so, the act better protects the retirement dreams of 45 million Americans. Not only were single employer fund rules significantly overhauled, but the rules regarding hybrid pension plans were finally clarified, and multi-employer funding rules were changed as well. The proposal strengthens current law and will better help Americans prepare and plan for retirement. It provides workers the security of knowing that moneys earned for retirement will be there when they are ready to retire.

It also secures the Pension Benefit Guaranty Corporation and secures that corporation without picking the pockets of taxpayers to keep the agency solvent. This legislation was no small undertaking. It took a year and a half of hearings, 5 months of deliberations in conference, and countless hours of negotiations on each provision of the bill.

Fortunately, pension issues are almost always handled in tag team fashion, involving both the HELP Committee and the Senate Finance Committee, which has jurisdiction over the Internal Revenue Code. While this tag team approach is a great asset and helped us get the bill through the Senate, it meant a complicated and extraordinarily large conference involving four committees in the House and Senate and 27 conferees.

Together with my ranking member, Senator Kennedy, Finance Committee Chairman Grassley, ranking member Senator Baucus, as well as HELP's Retirement Security and Aging Subcommittee Chairman DeWine, and Ranking Member Mikulski, our committees collaborated with House counterparts to make this sweeping reform happen. Because of this teamwork, the law passed the Senate 93 to 5. The result was a policy and a process that was truly bipartisan. Total floor time for the bill--Senate debate and conference report debate--totaled about one hour and fifteen minutes equally divided.

Some may think the conference took a long time to conclude, but history proves that it was ended in record time. The last big pension conference occurred in 1994. The conference was appointed in March of that year, but did not conclude until December. Prior to that, the most recent conference took place in 1987 and operated in the context of budget reconciliation. Again, that conference commenced in March but didn't end until December.

This year, our conference began in March and ended in July--just 5 months compared to a 10-month conference for earlier bills. Comparatively speaking, the Pension Protection Act conference finished quickly, but the impact will be felt for generations.

Another major accomplishment of the HELP Committee was the enactment of the Mine Improvement and New Emergency Response Act, MINER. From the tragic loss of life in the coal mines of West Virginia and Kentucky came the first reforms of mine safety laws in 28 years. These tragedies brought together leaders from the mining industry, from government, and from the labor unions, and helped to forge a commitment to improve mine safety. I traveled to the Sago mine with Senators Kennedy, Rockefeller, and Isakson. We met with the families of the miners who lost their lives. We met with other miners who worked there, and we met with people in the union. I felt a commitment to those families and miners in this country to try to ensure that this would never happen again.

The committee approved the MINER Act on May 17, and the President signed the bill in June. That has to be one of the fastest, most comprehensive changes to any safety law. I can't emphasize enough the cooperation of unions and company executives, and Republicans and Democrats.

Protecting the health and safety of those who work in the mining industry need not be a partisan issue. Mining, and coal mining in particular, is vital to our national and local economies, and to national energy security. Ensuring the safety of our miners is essential to protecting and preserving the industry and protecting the workers. I especially thank Senators Kennedy, Isakson, Byrd, Rockefeller, and McConnell for the tireless effort they extended. Their efforts contributed in large part to this proposal becoming law.

I should mention that the debate on the Senate floor was 1 hour equally divided with two votes. So nobody saw that. Nobody saw that debate, but it makes a significant difference for all the people in the country--the mining bill. You never saw any debate on the floor. It passed unanimously without debate. It passed in the House under suspension with limited debate--the same bill.

Sometimes the things that get done by unanimous consent that everybody agrees on nobody ever finds out about, except the people it does benefit; they know. That is why it is worth doing it that way. For a bill that has objections around here, there are ways to overcome it if you get 60 votes for it. But that is usually about a 3-week process. A unanimous consent doesn't use up much time, but it gets things done.

The committee has also made tremendous strides related to education and job training. This session the

HELP Committee initiated a comprehensive effort to authorize legislation that enhances knowledge and skills and helps American workers become leaders in the global economy. Some estimates suggest that 60 percent of the jobs created in the next decade will require skills that only 20 percent of the workers today currently possess, and 80 percent of the jobs will require education or training beyond high school. Eighty percent of the jobs will require education or training beyond high school. That is where the world is going. It is changing fast.

One important component of this effort is the reauthorization of the Carl Perkins Career and Technical Education Act. It was signed by the President in August, and it will help close the gap that threatens America's long-term competitiveness. The act addresses the needs of the Nation's changing workforce and prepares Americans for highly technical, higher-paying jobs. The reauthorization also made changes that will increase accountability at the State and local levels and will establish stronger links with businesses to build partnerships with high schools and colleges so they can better meet the needs of the changing workforce.

For many people, participation in these programs can mean the difference between a job with no possibility of advancement and a successful career. Passage of this legislation was a significant accomplishment. Again, limited floor debate, no debate on the conference report; unanimous consent across the aisle.

Another piece of this comprehensive effort is the reauthorization of the Higher Education Act. As my colleagues know, the mandatory portions of the higher education law were reauthorized in February under the Deficit Reduction Act of 2006. Before I elaborate, I want to stress that it is critical to reauthorize the remaining discretionary programs under the act, which I intend to make a top priority for 2007. We have the bill out of committee but haven't had the floor time to do the debate on it. I am making that a top priority for 2007 because postsecondary education is the key to the future success of our students, our communities, and our economy.

As I stated earlier, we reauthorized the mandatory components of the Higher Education Act through the budget reconciliation process. We found over $20 billion in savings by eliminating corporate subsidies for lenders and reworking the interest rate structure for many borrowers, among other revisions. A portion of the savings was used to pay for over $9 billion in enhanced students benefits. The law makes higher education more affordable for students who finance part of their education through loans by reducing borrow origination fees and increasing loan limits.

Another benefit is a $4 billion grant program for postsecondary students who major in science, math, and certain national-security- related foreign languages. These funds are dubbed ``SMART grants'' and are an important part of making higher education more affordable for low- and middle-income families. We invested resources where we need them the most, which will help ensure we have a workforce that can compete globally.

I was in India earlier this year and saw firsthand what Thomas Friedman discusses in his book, ``The World Is Flat.'' It doesn't take long to figure out that by sheer numbers alone, India has only to educate 25 percent of its population to have more literate and educated people than the total population of the United States.

By using the reconciliation process for these higher education reforms, the HELP Committee was able to produce meaningful deficit reduction. In fact, I am proud the HELP Committee led the entire Congress in deficit reduction and produced $15.5 billion in savings over five years. That is 40 percent of the entire Deficit Reduction Act of 2006. It is not right to overspend now and pass the bill on to our children and grandchildren to pay later.

I thank Chairman Gregg for his leadership on the Budget Committee and for his contribution on the authorizing committee that helped make the meaningful deficit reduction a reality.

Enactment of the Perkins reauthorization and the mandatory revisions of the Higher Education Act were critical components of a comprehensive effort to strengthen knowledge and skills. However, this effort also includes the reauthorization of the Workforce Investment Act. The reauthorization is essential because it will help train American workers to fill the good jobs being created so we can continue to be leaders in the global economy.

The reauthorization of the Workforce Investment Act has been a priority of mine since I chaired the Subcommittee on Employment and Workplace Safety in the previous Congress. Last Congress, I worked tirelessly to report the legislation from the committee, only to be held up on the Senate floor when it came time to appoint conferees. Now, that means the bill made it out of committee and cleared the Senate floor. The House passed a different version, so we need a conference committee to resolve the differences. However, we weren't allowed to appoint a conference committee. That was 2 years ago. Mr. President, 900,000 new jobs could be trained under that program. This year, once again, I have been procedurally hamstrung in my efforts to move to conference. The bill must be completed. It made it out of the committee unanimously. It made it through the floor of the Senate, again unanimously. That means everybody agreed with what is in the bill. Now the only problem left is we have to reconcile that with what the House passed.

America is facing an economic challenge that threatens our ability as a nation to compete on the world stage. This bill sends a clear message that we are serious about helping our workers and our employers remain competitive and about closing the skills gap that is putting America's long-term competitiveness in jeopardy.

Our commitment to lifelong learning never ends. It begins with giving our children the proper tools for a start down the pathway that leads to their education. The committee approved improvements to Head Start this last year, and the completion of this process is one of my top priorities.

On the health front, eight committee bills were signed into law by President Bush. One of the most significant new health care laws is the Patient Safety and Quality Improvement Act. The new law is a culmination of 6 years of work in response to the Institute of Medicine's 1999 report that found that nearly 100,000 Americans die needlessly every year due to medical errors.

The Patient Safety and Quality Improvement Act creates a protected legal environment in which patient safety organizations can analyze why medical errors happen and develop strategies to stop those errors from happening again. The law provides critical legal protection for doctors, nurses, and other health care workers who might fear coming forward with information about mistakes because the information could be used in a lawsuit against them.

This new law is the first important step toward creating a new culture of safety and continuous quality improvement in health care.

This new law is one of just several important pieces of legislation the HELP Committee produced in this Congress. I would mention again that this too took zero debate time on the floor. Another one is the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005, which will help patients with chronic diseases team up with health care experts who can help them find their way through the maze to the best treatment offered in this often complex health care system. Again, no floor debate time.

The Stem Cell Therapeutic and Research Act of 2005 supports the creation and maintenance of cord blood stem cells. Stem cells obtained from umbilical cord blood have already shown great promise in treating cancers, leukemia, and other diseases, and this law will accelerate our work in those areas. I have already had people who have reported back to me that their life may have been saved by that particular act already. I think we had 5 minutes of debate time on that bill.

The National All Schedules Prescription Electronic Reporting Act of 2005 enables physicians and other prescribers to find out whether patients are abusing and diverting narcotics and other dangerous drugs. Instead of enabling these patients and their self-destructive habits, physicians will now be able to identify them and treat them.

The State High Risk Pool Funding Extension Act of 2005 renewed a key law that funds State high-risk health insurance pools. These pools create access to health insurance for otherwise medically uninsurable individuals and are an important part of our strategy to make health insurance available to more Americans. The President also signed a bill to amend the Public Health Service Act and strengthen the National Foundation for the Centers for Disease Control and Prevention.

Finally, we passed two key laws to preserve access to medical technology. The Medical Device User Fee Stabilization Act of 2005 prevented the FDA's medical device user fee program from expiring. Without this law, patients' access to the latest medical innovations would have been compromised. Congress also acted to protect children from dangerous, unregulated cosmetic lenses, often used as part of costumes, by providing for the regulation of these lenses as medical devices.

The HELP Committee members worked together with our House counterparts in a bipartisan, bicameral way to complete action on these laws. I personally thank all of the committee members on both ends of the building for their active participation in this process.

We also scored a victory on the Senate floor this summer related to health insurance. Together with Senators Nelson and Burns, I introduced legislation that would allow business and trade associations to band their members together in small business health plans and offer group health coverage on a national or statewide basis. It would give small businesses the capability to group together across State lines to effectively negotiate against big insurance companies. It would bring down insurance rate significantly, particularly in the area of administrative costs.

This legislation, the Health Insurance Marketplace and Modernization and Affordability Act, is a direct response to the runaway costs that are driving Americans and businesses away from the health insurance marketplace. In May, this legislation received 55 votes on the Senate floor--a clear majority. Unfortunately, obstructionists used arcane Senate rules requiring 60 votes for passage to defeat consideration of the bill. I count this as a victory for the HELP Committee because the policy is supported by the majority of the Senate. This will not be a victory for Americans until it is signed by the President.

Enacting the Health Insurance Marketplace Modernization and Affordability Act will be a top priority for the HELP Committee and me personally in the 110th Congress. I intend to act on this legislation early next year and continue to work across party lines to find the solution that produces 60 votes in the Senate. The HELP Committee has a role to play in making employer-sponsored health care more accessible and affordable. Employer-provided health insurance is voluntary, and it is in critical condition. Sixty percent of the country's employers offer insurance today. That is down 9 percent from just 5 years ago. And the cost of health insurance for companies has nearly doubled in that same period, with employers expected to pay an average of $8,167 per employee family versus $4,248 5 years ago. My proposal would provide health care coverage to over 1 million small businesses and their working families.

This fall, I am also hopeful the committee can add two more victories to our list of accomplishments. That would be the Health Information Technology conference agreement and the reauthorization of the Ryan White Care Act.

Right now, my staff is working aggressively with the House to complete action on the Wired For Health Care Quality Act conference agreement. This legislation will enhance the adoption of a nationwide interoperable health information technology system, improve the quality of health care, and contain costs. Primarily, it will allow each individual to own their own health care record and to carry it around with them easily. They will have the permanent record to carry with them and release, to the degree they want to, to any health care provider. This will contain costs: just between Medicare, Medicaid and Veterans, this is expected to save $160 billion a year. The cost to implement: $40 billion, one time. A good investment anywhere.

The committee has also been working in a bipartisan, bicameral fashion to complete the reauthorization of the Ryan White Care Act. The measure was approved by the HELP Committee in May, and I am hopeful that we can swiftly clear compromise legislation through both Chambers by December--I was hoping we could pass it today, but I see it has been stopped. It is absolutely essential that this clear by September 30.

The reauthorization of the Older Americans Act will also have a significant impact on the everyday lives of Americans. The HELP Committee approved this legislation in June, and I am hopeful we can complete action on it this year as well. This reauthorization is important because it ensures that our Nation's older Americans, including 78 million aging baby boomers, are healthy, fed, housed, able to get where they need to go, and safe from abuse and scams. We have been in bicameral, bipartisan deliberations for several months. Again, there is a little hangup on the funding formula. Money has to follow the people in all of these programs.

The committee also conducted various investigations and held several oversight hearings that exposed waste, fraud, and abuse in Federal programs and used the findings to craft legislation to increase accountability. Our first oversight hearing last year focused on how an asset management company, Capital Consultants, defrauded workers out of approximately $500 million in retirement assets. The findings from this oversight effort were addressed in the new pension law.

The committee also held the first oversight hearing in almost 70 years on the Randolph Sheppard Act and the Javits Wagner O'Day Act. Both programs are supposed to find employment opportunities for people with disabilities. The committee's investigation and hearing established that some executives were using the programs for their own enrichment--making millions while exploiting people with disabilities. Following the hearing, Federal law enforcement took action against the worst actors, and we have collaborated across party lines to systematically overhaul both programs. My goal is to address these programs with legislation next year.

I thank my ranking member, Senator Kennedy, and his staff for their hard work these past 2 years. His assistance and cooperation are the main reasons we have been able to accomplish many of these priorities. We didn't always agree, but we were able to identify common ground to advance our mutual priorities.

I also thank each of our committee members. As I stated earlier, we have kept a full schedule. Many of the legislative victories were initiatives brought to my attention by our subcommittee chairs or individual committee members. Senators were also especially diligent about attending the committee hearings and particularly patient when we sometimes waited for a quorum during executive session. For the remainder of the year, I will be reaching out to each of our members to seek feedback on the 2007 agenda, which will serve as the blueprint for the year.

Finally, in closing, I would like to recognize two departing members of the committee: Majority Leader Frist and Senator Jeffords. We are fortunate they chose to serve, and we are grateful for their contributions. Senator Jeffords is a past chairman of the committee, and, of course, Majority Leade Frist has been the doctor on the committee and provided a perspective no one else could. I am proud of the work we have done here on the committee these past 2 years. By working together, we have established a track record of success.

I also wish to compliment the subcommittee chairmen for their extremely hard work. We gave them a lot of independence, and they didn't disappoint me. They took hold of programs. The competitiveness program is one of them that has reached a point where it can now be debated and pursued. The Senator from Tennessee, Mr. Alexander, did a tremendous job of working that bill, along with Senator Ensign, collaborating with three different committees on one piece of farsighted legislation.

Senators DeWine and Mikulski have done a marvelous job with the Elder Fall Act and Older Americans Act and have worked well together for a number of years across the aisle to make sure older Americans are taken care of.

I could go on and mention all of the subcommittees and the work they have done. Senator Burr has done some fantastic work on bioterrorism. He has put together a fantastic bill that contains new concepts which will allow better preparation for any of the possible terrorism acts that could happen on our own soil. Senator Isakson, of course, has been extremely active in handling labor issues. As I mentioned, he was a key player in the miner safety bill.

It has been an interesting year. I look forward to another interesting year. I am looking for suggestions from my colleagues on what needs to be done, and looking for that 80 percent that can be accomplished.

Our record of accomplishment is proof that we are a can-do Congress. Far from being a do-nothing Congress, we have shown our colleagues and our constituents that Congress can and is working hard to improve the lives of Americans.

One of the reasons America doesn't know more about this is because of the cooperation that has taken place. We didn't have to debate the 20 percent we didn't agree on here on the floor of the Senate, and consequently there was not a lot of coverage. But just the pensions bill and the miner safety bill, either of those, would be a major accomplishment for any committee during a 2-year period.

I am proud of the 12 bills the President signed and the 21 bills we got through this body. I think that is a record of accomplishment, and I thank all those who participated.

I yield the floor and suggest the absence of a quorum.

I thank the chair.

Mental Health Parity Act

Mr. President, in just a few weeks while we are in recess, we will mark the fourth anniversary of the untimely death of our former colleague from Minnesota, Paul Wellstone. Paul Wellstone died at the age of 58 in an airplane crash about 4 years ago. Paul and his wife Sheila and daughter Marcia were on their way to a campaign event in Eveleth, MN on October 25, 2002 when their plane crashed in a wooded field 2 miles short of the airport. We mourn for the surviving children Mark and David and for the families of the campaign staffers, Will McLaughlin, Tom Lapic, and Mary McEvoy, and for the families of the pilots flying that fated aircraft.

Paul's tragic and premature death silenced one of the leading voices in America on the issue of mental illness. Paul Wellstone understood the devastation that mental illness can bring: the stigma, the alienation, the broken families and, sadly, even broken lives.

In 1992, together with Senator Pete Domenici of New Mexico, Paul introduced legislation to require insurance companies to offer the same coverage for treating mental illness as for physical illness. The Mental Health Parity Act was passed and signed into law in 1996. The final version of the bill sadly was watered down and fell short of Paul's earliest goals.

A new bill to eliminate these disparities in insurance coverage was introduced in the last Congress. The Paul Wellstone Treatment Act attracted widespread bipartisan support: 69 Members of this Chamber and 245 Members of the House--a clear majority supporting Paul Wellstone's legacy. But unfortunately, during the past 2 years, this bill was not called for passage and did not pass.

Today I am honored to be joined by Senator Norm Coleman of Minnesota, Senator Ted Kennedy, Senator Tom Harkin, and Senator Mark Dayton of Minnesota in submitting a sense-of-the-Senate resolution, first to remember Paul Wellstone and honor his legacy, but also to publicly commit to finishing his work on mental health equity legislation.

Mental health disorders are the leading cause of disability. Without treatment, the consequences of mental illness for the individual and for all of us are staggering: disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide, and wasted lives. The economic costs of untreated mental illness is more than $100 billion each year in the United States. In my home State of Illinois, close to 4 million people, or 30 percent of the population, are affected by some form of mental illness each year, including depression. Suicide is the third leading cause of death among young people 15 to 24. Seventy-seven percent of adults with severe mental illness are unemployed.

Now, the good news is this: Mental illness is treatable but only for the people who have access to sound diagnosis and care. We have a good start, thanks to the Mental Health Parity law that Senators Wellstone and Domenici led to enactment in 1996. Our next challenge is to build on the work Paul Wellstone left behind.

Current law requires insurers offer mental health care and offer comparable benefit caps for mental health and physical health, but it does not require group health plans and their health insurance issuers to include mental health coverage in their benefits package. It doesn't prevent insurers from setting higher deductibles, higher copays, and fewer services covered for mental health illness. I commend Senators Kennedy and Domenici for their work in this Congress on working toward a consensus for reaching mental health parity for Americans.

I called Senator Domenici last week to tell him I was submitting this resolution and to cheer him on so that during the next session of Congress we can give the right tribute to Paul Wellstone and, more importantly, as Paul would see it and I see it as well, hope to millions of Americans.

This resolution honors Paul Wellstone. It commits us to continuing his work to ensure equity for people with mental illness. Paul fought against discrimination in any form. His life work was dedicated to creating a world in which everyone, regardless of race, religion, economic status, or health or mental health status, would be treated fairly and equally. I urge my colleagues to support this resolution and renew our commitment to ensuring mental health parity.

Paul Wellstone was often quoted as saying:

I don't think politics has anything to do with left, right,

or center. It has to do with trying to do right by the

people.

That was what Paul Wellstone said. And now we will have our chance in the next session of Congress to honor that commitment.

Mr. President, I yield the floor.

Mr. President, I at the outset thank my colleague from Minnesota who was quick to join with his colleague Senator Dayton as a cosponsor of this resolution.

Many times politics divides us, but when it comes to an issue such as mental illness, we are all in this together. I know my colleague from Minnesota has probably had the same experience I had, of raising this issue at a town meeting or a public meeting, and then I almost guarantee you that before you leave that hall, someone will come up to you and ask if they can speak to you privately to tell you the story of a child or a spouse who has bipolar disorder or schizophrenia or who has committed suicide. It touches so many of us. What Paul Wellstone was trying to remind us of is that mental illness is not a curse, it is an illness, and an illness that can be treated. Why shouldn't we include it in our health insurance for Americans so that every family can be spared the suffering that comes with mental illness today.

I thank my colleague from Minnesota for joining me on this resolution.

Mr. President, if the Senator will yield for a question, I would like to say by way of question through the Chair that I thank my colleague from Minnesota. I can recall when he first came to the Senate serving with our mutual friend, Paul Wellstone. It must have been tough to be that close to a dynamo. The man had boundless energy and committed to so many good causes.

The Senator from Minnesota has carried on the fine tradition for your State. I thank the Senator for joining us in this resolution.

Hope springs eternal, and maybe during the lame duck session Senator Kennedy and Senator Domenici will be able to give us some good news that will make us proud on this important issue.

I thank the Senator for his words today.

Mr. President, this morning one of my Republican colleagues came to the floor to talk about what appears to be the favorite topic of most Republican Senators: the estate tax. No matter what we are talking about on the floor, whether it is immigration reform, making America safe from terrorism, dealing with issues involving the funding for our troops, port security, without fail, you can count on one of my colleagues on the other side of the aisle trying to wedge in to this queue with what many of them consider to be at least equally important: the issue of the estate tax.

So my colleague came to the floor and mentioned my name over and over again as if I were his opponent. I would say to my colleague there are many Senators who disagree with his position, but I will be happy to address it for a moment or two.

The simple fact is this: If an American and a spouse have assets valued at less than $2 million at the time of their death, they will never pay one penny in estate taxes--not one. So if you ask who benefits from this repeal of the estate tax, well, sadly it turns out to be some of the wealthiest people in America. If you took 1 percent-- that is 1 out of 100--estates in America, people who die each year, only one-fourth of those will ever pay any estate tax. It is a very small number of people who have done very well in their lives in America who may end up paying estate tax.

I want my position to be clear. There is an exemption under the estate tax, an exempt amount that you can leave to your heirs, that will not be taxed. I think we need to increase that and regularly increase it to reflect reality. It is true, the real estate we own has gone up in value while we have lived there, businesses have increased in value, farms have increased in value, and I think the exemption should be increased as well.

Where I have a problem is where we have people who are very well off--multimillionaires--who end up owing the Government--in fact, owing their country--something for their success, and they will be left in a position with the proposal from the other side of the aisle where they may have no estate tax liability whatsoever.

The majority leader of the Senate, Senator Frist, has said he is for total repeal of the estate tax--total repeal so that Mr. Bill Gates of Microsoft, who has done so well and made so much money, would pay nothing back to America by way of estate tax when he passes away. Well, Mr. Gates is not asking for that. Many people who are well off are not asking for that. They understand this country has been very good to them, and they are also prepared to pay back so that future generations have a chance to succeed as well.

My colleague came to the floor and talked about farmers and is concerned about farmers. I am from downstate Illinois. A few years ago, after hearing all of the debate about estate taxes, I wrote to the Illinois Farm Bureau, the Illinois Farmers Union, and asked them: Tell me of any farm that you know of where the farmer's survivors had to sell the farm because of paying Federal estate tax. There was not one single instance in my State. They couldn't find one. Now, I understand some of those farmers may have to sell off a portion of their land or some of their acreage to pay their taxes at the time that the spouse finally passes away. But as far as losing farms, that is something that is said over and over again, but neither the Illinois Farm Bureau, the Farmers Union and, in fact, the American Farm Bureau could find a single example of a family being forced to sell its farm because of estate tax liability.

According to the Congressional Budget Office, only 123 family-owned farms and 135 family-owned businesses would pay any estate tax at all with a $2 million family exemption level.

So we often have to stop and wonder why are we dwelling on this or why are some Members of the Senate continuing to dwell on this. If their sympathy is for those who are struggling to survive in America, they should focus their spotlight not on the wealthiest among us but those who are struggling at lower levels.

Let's take a look at some of the realities, the economic realities in America today. This chart shows what has happened over the last 6 years. The minimum wage has been frozen under President Bush and this Republican Congress for 9 years. During that 9-year period of time, the President's pay has been increased substantially, pay for Members of Congress increased $31,600, and the $5.15 an hour minimum wage has not gone up.

It is always interesting to me that my colleagues on the other side of the aisle seem to think that it is fine for those making the lowest wages in America, some of them working very hard each day, to have no increase in their pay for 9 straight years, while they are struggling to make ends meet. They come to the floor and talk to us about those who have made millions of dollars in their lives and whether they will have to pay any taxes. I think it is a misplaced priority.

If we take a look at some of the real household income of Americans across the board, you can see what has happened from 2000 to 2005. Real household income has declined by $1,273. It means the average family, working hard, paying off the costs of living--utilities and mortgages, energy costs, education costs--is working harder and falling behind each and every year.

Our economic policies in this country really are not focused where they should be. We should be focusing on this middle-income American family that is struggling to make ends meet in a very difficult time.

The distribution of wealth in America has changed substantially over the last several years. The distribution of earnings has become even more unequal. When you look at this situation, you see the years between 1995 and 2000 with a violet color, 2000 to 2005 with the red. So in the year 1995 to 2000, the last term of President Clinton, you can see there was an increase in earnings, weekly earnings for full- time workers, across the board. All of these violet bars above show, for example, a 9.6-percent increase, a 7.4-percent increase. So in that 4-year period of time, we had the distribution of earnings increasing.

Now look at the period of time under President Bush. During that time period, in each of these categories of income in America, we have seen that earnings have been declining or rising very slowly, as they are at the highest levels of income in America

Take a look at the wealth as well under the tax breaks given under this administration the last several years. This is the Bush economic record: a $38,000 tax break for people who are making $1 million a year, but for middle-income families making $50,000 to $100,000, their tax break under the Bush administration has been $55, and for those in the lowest income categories a tax break of $6.

You can see where the priorities have been when it comes to taxes. But ask the average family making about $100,000 a year--let's take that as an example. Let's take someone who is a teacher and whose spouse may work part time, bringing in some income to the family, and together they make $100,000 a year. They have raised their kids and spent good money sending them to school. Then the kids apply to college. The families are inundated with a stack of forms--most families have seen them--to apply for student loans and students grants. Those making about $100,000 a year will find it difficult to apply for any financial assistance. So the students, their sons and daughters who finally got into the school of their dreams, may face an unconscionable debt.

Some students put off their education. Some give up on the best schools. Some go on to school and graduate with a mountain of debt, a mountain of debt which was made worse this year when, on July 1, a law signed by President Bush increased the interest rates on student loan debts by 2 percent. It doesn't sound like much, except it means the payback for that student loan has now been increased by 20 percent over the life of the loan. It means these students, borrowing money to go to school, deeper in debt, will now be paying off their student loan debt into their 50s. Imagine that student graduating today--23, 24 years

old, maybe--looking ahead to 20 or 30 years of paying off student loan debt. Finally, in their early 50s, they have paid it all off, and now they have a few years to contemplate their retirement.

What is wrong with that picture? What is wrong is students and families in middle-income circumstances are bearing this burden, and this burden is increasing, as I will show, as the cost of college education increases. So instead of talking about a $38,000 tax break for someone who makes $1 million a year, we believe on this side of the aisle that we should allow the deductibility of college education expenses. If you can deduct the amount of interest you pay on your home to encourage home ownership, why shouldn't a family be able to deduct some of the costs of college education from their tax expenses so we can encourage students to go on, further their education, and make this a better country? It is a question of tax priorities: on one side of the aisle, estate tax relief for those in the highest income categories; on this side of the aisle, we are talking about relief when it comes to tax deduction for the real cost of college education expenses.

Most of the families I represent in Illinois were quick to tell me, during the August break, how bad gasoline prices were. We know in the last 5 years they have increased 104 percent. They started coming down in the Midwest, but I think there is a false sense of security here. A lot of people were sacrificing to put more gasoline in the car, but we still don't have a national energy policy, and there is no guarantee that a few weeks from now those gasoline prices will not go back up again because we have no bargaining power.

We are so dependent on foreign oil today that we can't say to those who gouge us and those who want to really charge us the most that there is anything we will do about it. And this administration has not really called the oil company executives in, Exxon and others, to explain the absolutely unprecedented level of profits they took as the gasoline prices went up. That industry made more money more quickly than any industry in America, and they reached higher profit levels than any industry had recorded previously. Yet this administration sat back and said w can do nothing about it as Americans and families and businesses and farmers paid the price. As the cost of gasoline goes up, as prices have in the last several months, families have faced that sacrifice. Now comes the heating oil season for many, and that may again increase the cost of expenses for these families.

Take a look at what has happened as well when it comes to family health insurance premiums under this administration. Family health insurance premiums have increased 71 percent in the last 5 years. That means the average premium for family health insurance went from $6,348 when President Bush took office to $10,880. Is it any wonder families are feeling the squeeze? These premium increases, of course, translate into another $300 or $400 each month that a family has to come up with just to have the same health insurance as last year and maybe less coverage.

Have we discussed expanding health insurance or making it more affordable on the floor of the Senate? Only once and just for a few days. I salute Senator Enzi, Republican from Wyoming, chairman of the HELP Committee, for bringing a health insurance proposal to the floor. We had another proposal here. We tried, if we could, to work out something ahead of time to have a bipartisan approach. We didn't get it done. I hope that in the next Congress, we can find a way to bring real relief on a bipartisan basis to families that are struggling with these health insurance premiums.

I mentioned earlier the cost of education and student loans. This graph shows what has happened under this administration since the President took office with regard to the increased costs of college. They have gone up

$3,688, the average annual cost of a public 4-year college, tuition, fees, room, and board. So there was a 44-percent increase in just this 5-year period of time under this administration, increase in college cost. Again, wouldn't our Tax Code be more sensible if we helped families pay this difference, if we helped them put their kids through college to get a good degree and a good life and contribute to this country? Wouldn't that be a higher priority in terms of our Tax Code than whether Bill Gates is going to end up being excused from paying an estate tax when he passes away?

There is also a concern as well with retirement plans. Take a look at what has happened in the last 5 years. In the last 5 years, 3.7 million fewer Americans have retirement plans. The number of workers with employer-sponsored retirement plans has gone down from 56.2 million to 52.5 million, which means more vulnerability.

A lot of people who had paid into a retirement plan through the course of their work experience believed that they had paid their dues, taken the money out of their check every week, and that the day would come and they would see it, that they would finally get to retire and relax. Then came mergers and consolidations and corporate sleight of hand and legal work, and the next thing you know a lot of these pensions started disappearing. So many families are concerned, concerned about when or if they can retire.

You read the stories in the paper all the time in Illinois and every other State about those who had their future plans wrecked when they lost their pension benefits. It has happened at the airlines. It has happened in so many industries across our country. We know it makes a real difference in life. A lot of people who thought they would be spending their time worrying about where to go fishing now are acting as greeters at stores around America and trying to find part-time jobs just to keep it together.

We need to do something about retirement in this country, and one thing we do not need to do is privatize Social Security. Privatizing Social Security is, of course, supported by the President but not by the American people. They know the math doesn't work. Taking money out of the Social Security trust fund for people to experiment with their investments is going to weaken that fund unfortunately. They will be unable to make the payments our Social Security retirees need. If there is ever a time when we need Social Security to be strong, it is now, as we see fewer and fewer Americans with retirement plans.

The number of Americans without health insurance has gone up dramatically under this administration, from 39.8 million Americans with no health insurance to 46.6 million Americans. Those who are insured will tell you many times that their health insurance is not very good. They come up to me at town meetings in Illinois and talk about frightening scenarios where someone in their family had a serious illness, a diagnosis, and then when they tried to pay off the medical bills, it turns out the health insurance fought them all the way. These health insurance companies are spending a lot less on care and a lot more on battles with the people who have the health insurance, denying coverage whenever they can. So we have to really get back to this issue as part of the priorities of this Congress. I am sorry that this Republican Congress has not really come up with assistance that many of these Americans need with health insurance

Overall, as we go through this litany, you can understand as you go through this litany why this next chart is where it is today. In the last 5 years, under this administration, household debt has gone up over $26,000. Because Americans are struggling to make ends meet, because the cost of college and health care and gasoline and heating your home has gone up dramatically, Americans have had to borrow more and more just to keep up. They are right on the edge, trying to pay off very expensive credit card debt.

There has been a 35-percent increase in household debt in the last 5 years for the reasons I mentioned earlier, from an average inflation- adjusted debt per household of $75,000 to over $101,000. This debt is hanging over the heads of many Americans, and if there is any rock in the road that Americans families trip over--if someone gets sick, loses a job, a divorce, something unforeseen--they are going to find themselves then facing default on their debt and even higher interest rates.

While this has been going on for the average American, employee compensation has gone down some 4.6 percent. So while all the debts have been

piling up, the compensation that is being given to individuals has been going down. Meanwhile, corporate profits are up 8 percentage points. So we can see that the share of corporate income going to profits and employee compensation has gone in opposite directions, and those directions do not benefit those families that are struggling to get by.

Those who run the corporations are doing quite well, thank you. In the last 5 years, the pay for the chief executive officers of major corporations in America has gone up over $1.6 million individually. This average pay here of $5.2 million when the President took office is now up to $6.8 million. So while the pay for employees is going down and expenses are going up, in the boardrooms the median CEO compensation has gone up substantially.

When you take a look at the tax cuts under this administration, their economic record, tax cuts are over 150 times larger for millionaires than they are for most households in America. So we gave the tax cuts of $103,000 for those in the highest income levels and $684 for those making less than $100,000 a year. So the so-called tax cut program has not really helped those families struggling the hardest.

What has happened to employment, creation of jobs in America, is illustrated by this chart. We have seen the average annual growth rate of nonfarm employment in America under every President. You have to go back to Herbert Hoover and the Great Depression to see a decline of 6 percent in employment in America. You will see the lowest number of any President since Herbert Hoover has been registered by this administration, in the creation of jobs. That is the average annual growth rate of nonfarm employment. It is the slowest job growth in America in over 70 years.

The other sad reality is, while all of these things have taken place, this represents the famous wall of debt which Senator Conrad of North Dakota has brought to our attention over and over again. When President Bush took office, our national debt was $5.8 trillion. Today, it is over $8.5 trillion--a dramatic increase in America's debt in a 6-year period of time. With policies which this administration supports and many on the other side have been arguing for, we can see America's debt reaching $11.6 trillion in 2011. So in a 10-year period of time, we will have virtually doubled--not quite but almost doubled--the debt of America, which means we are leaving a burden for our children, a burden with which they will have to deal--a burden with which they will have to deal as we see more and more baby boomers in Social Security and Medicare. As we see fewer people working, those who remain in the workforce will not only have to face their own personal challenges economically, but they will have to deal with the debt that we are leaving behind.

If this is fiscal conservatism, I don't understand the meaning of the term.

Why is it that we have reached this point? Sadly, the economy is not going as planned. We are facing a war which costs between $1.5 billion and $3 billion every week, and the other side continues to come to the floor and ask for something that no administration has ever asked for in the history of the United States--a tax cut in the midst of a war. That is what the Senator from this morning was suggesting. He wants to cut the estate tax. By cutting the estate tax there will be less revenue for our Government, the war will continue, and our debt will grow. These numbers will have to be adjusted upwards for the debt we are going to leave our children.

Yesterday we had a hearing with the Democratic Policy Conference to discuss the war in Iraq. We had two generals and a Marine Corps colonel who spoke to us. They spoke on a lot of things that we need to do to make America safer and make sure we win this war in Iraq. But one thing that MG John Batiste said I really thought was important. He said--and I think we all believe--that America can rise to a challenge. America can meet a challenge. We have done it so many times in our history. We have won wars when we were not expected to. We put a man on the Moon when a lot of people scoffed at that possibility. We developed medical breakthroughs which no one would have dreamed of. We led the world in computer technology development and in so many areas one by one. Whether it was in agricultural production or in industrial development or innovation we have led the world. We have led the world because leaders have stepped forward--a President has stepped forward and challenged us and said we need to stick together, we need to work together to reach the goal.

General Batiste said yesterday--and I paraphrase his actual testimony, but I believe what he said. He said that what we need to be reminded of is we can meet any challenge as a nation. We need to be reminded, as well, if we are challenged and work together, we can win this war on terrorism. And he said it is going to involve sacrifice. It is not the first time Americans have been asked to sacrifice. They have done that many times. I believe that spirit of sacrifice is what is needed to make sure we keep America safe from terrorism and safe from other threats.

I see that Senator Ensign has come to the floor. I don't know whether he wishes to take the floor at this time. But I mentioned his name earlier. I commended him for bringing the health insurance issue to the floor. I hope in the next session that we can work together to try to find some bipartisan compromise to deal with this health insurance challenge. It is still out there and getting more challenging every day. Senator Enzi of Wyoming, as Republican chair of the committee, may have been the first one to bring the health issue to the floor of the Senate in the 10 years I have been here. I commend him for that.

Although we didn't see eye to eye on all of that, I hope we come back together and sit down and try to find some common bipartisan approach no matter who is in charge of the Senate in the next session.

I yield the floor. I suggest the absence of a quorum.

Earlier this afternoon, there were comments made in the Senate by the Senator from New York, Mrs. Clinton. Some of those comments distressed me a little bit. We have been trying to get the Ryan White Care Act, which passed out of committee and passed on the House floor, to pass in the Senate. This is one of those rare bipartisan, bicameral bills. We worked it out in advance with the House so the bill the House passed is essentially the bill we passed out of committee. It is a modernization act that would ensure equitable distribution of funds for HIV/AIDS treatment in the United States.

I am compelled to discuss some of the points that the Senator from New York made today about the Ryan White Care Act and our bipartisan bicameral legislation. I will talk about each of her claims in turn.

Senator Clinton claimed that when you look at the funding for the whole bill, New York is not receiving the most funds per case. I don't doubt those figures. However, those are deceptive numbers. As an accountant, I have to point that out. They are deceptive for two reasons. First, her statement dealt only with funds per AIDS case. We have been talking about including HIV cases as well. Why would she neglect to include HIV? I assume it is because 25 States have 50 percent of their HIV/AIDS cases not being counted today because those individuals have HIV, which has not progressed to AIDS.

Please note that all of my numbers have included both HIV and AIDS. We must include HIV in the funding formulas. Before, including only AIDS made sense because we were just waiting for people to die. Now, we have lifesaving treatment for those with HIV; therefore, we must count each person who can receive lifesaving care.

Additionally, Senator Clinton is looking at more than just the formula funding. Her figures include funding for community health centers, health care providers, providers who reach out to women and children. Thus, her figures include a lot of extra funding that is not at the heart of the debate.

If Senator Clinton wants to rely on these numbers, numbers outside of the formulas, then she can do so under the current bill. She can trust that the other portions of the CARE Act will assist those who she is saying are being harmed by the bill.

As for her claim that her State has not spent Ryan White funds for things such as dog-walking, I will note that the Senator from Oklahoma provided information for the record regarding that.

Now, Senator Clinton further claims that New York only carried over $3 million. Well, I find that surprising, given that New York, on the average, has carried over $29 million.

Mr. President, I ask unanimous consent to have printed in the Record a document from the Health Resources and Services Administration documenting the funds carried over for New York.

Now, the Senator from New York mentions her 1-year extension bill. I will also discuss the Senator's 1-year extension, her resolution for Ryan White, her solution that would simply delay the reauthorization for another year. It simply says to those States that have not been getting adequate funds: We do not care about you, and you are not going to get adequate funds. We are going to re-debate all of this again next year. We are not even going to move toward making it fair.

The underlying bipartisan, bicameral bill has a provision providing 3 years of hold harmless funds for New York. For 3 years, New York will not have to follow the formula. They would like to have 5 years. The 3 years already in the bill is at the expense of the other States. The 5 years would be at the expense of the other States, although I will cover a question that was asked yesterday in a little while.

This is not a time to delay. This is a time to act. We absolutely cannot delay the much needed updates to current formulas that ensure that all Americans with HIV and AIDS are treated fairly and have access to life-sparing treatments no matter their race, their gender, or where they live.

We have a chart that shows the losses that would occur under current law versus the gains that would occur after this reauthorization. The red States here are going to lose significant funding under the current law, beginning on October 1. One hundred thousand Americans are going to be left out. The chart on the right, the blue chart, shows the gains under the Ryan White authorization. All States gain except five, who lose less funds under the reauthorization than they would under current law. Only two of the five are asking for a difference.

The time is now or never. As soon as the clock strikes midnight tomorrow, thousands of Americans will begin losing access to life- sparing treatment unless we pass this bill now. This amendment does not address this fact. This amendment would extend a formula that will cause dramatic reductions in funding to many States and thousands of Americans.

The House has passed this critical legislation, and now five Senators must decide if they will stand in the way of bipartisan legislation with broad support--a bill that will ensure equitable treatment for all Americans living with HIV and AIDS. I would say, I believe that is down to four Senators now.

Now, my second problem with the bill of the Senator from New York is that it shuts out Americans infected with HIV and does not provide them with equal access to treatment. Rather, it focuses on outdated funding formulas that only examine AIDS, not the full spectrum of the disease.

Just like her numbers on funding per person, the Senator from New York refuses to acknowledge those with HIV. This chart shows that today, in over 25 States, half of the cases in those States are not counted because those Americans only have HIV, not AIDS. These States receive funding for less than half their total HIV/AIDS cases because of the current, outdated, failed formula. Half the Nation does not receive enough funds to provide the most basic care to their residents. Now, my third problem with the bill of the Senator from New York or the Senator from New Jersey is that it ducks the key issue. Rather than more equitable distribution for funding and more equitable access to treatment for all Americans, my colleagues supporting this bill are simply throwing more money at the problem, assuming it will ensure more equitable access to lifesaving treatments. We know this is simply not the case because it does not solve the inherent flaws in the funding formulas.

Now, this chart shows that under the current law, more than 3 percent of Ryan White funding is returned to the Treasury each year. That is more than 3 percent--much of this coming from New York and New Jersey, the very States that objected to the passage of the bill that would more equitably distribute funding across the Nation.

Again, you will see here that under the current law, New York is receiving $509 per case more than the national average. Under the new bill, they would still get $304 more than the average case per person across the United States. And they have an average $29 million unspent. New Jersey, the other State, is receiving $310 above the national average. They would still get $88 above the national average. This bill does not get to equity. This bill moves toward equity. And it does not move there until 3 years from now. Other bills we have done start transitioning immediately.

Now, I am surprised that the Senator from New York or New Jersey would offer a bill to increase funding, ignoring the outdated formula issues, only to increase the inequity of the program and allow more funds that could save lives to be returned to the Treasury each year. Why would we offer more money to States that are already grossly overpaid and unable to spend their money and increase the disparities of outdated funding formulas, further harming those States with an emerging crisis?

This amendment would have us give a few States even more money than they are receiving now, while the majority of the States will receive significantly less funding over the next year. The Senators from New York and New Jersey want to extend this inequity rather than fixing the formula, fixing the formula now, fixing it before the tomorrow-night deadline, to allow fair and equitable treatment and access to care for Americans who have none now.

I can tell you that the HIV/AIDS community and families want this bill now. Now, perhaps my colleague can explain why she wants to give more money to States that cannot spend what they already have, while taking money away from States that are struggling, as we speak, to provide the basic life-sparing treatments to their residents. We are talking about life and death here. It seems they want to throw money at States where the epidemic started and ignore the areas where the epidemic has spread, underfunding areas in a growing crisis.

When you look at the money being spent, what we are talking about in this amendment is saving institutions, not saving people, not saving lives. This is not an economic development bill. This is not meant to assure that institutions that might be interested in providing these services still get the same amount of funds to do so even though they do not have as many people to provide the services to as they are being paid for.

I wish putting more money into the program could fix these inequities but, unfortunately, these inequities stem from outdated funding formulas and a lack of accountability. We must address the problem at its core and ensure that we are not denying the growing number of minorities and women living with HIV and AIDS equal protection under the Ryan White CARE Act.

Now, another comment by the Senator from New York was that she needs more money because it is more expensive to provide care in New York. The big cost driver is HIV/AIDS medication, costs that are similar in every State. Therefore, I do not understand that claim, unless it is protection of the institutions rather than the people.

I have another unanimous consent request that I intend to propound, and I, again, am hoping that someone will be here to object who is actually objecting to the bill instead of sending a surrogate who has had to go through this ritual several times already, even though he supports the bill, because the request earlier, of course, was to have a chance to vote on the bill of the Senator from New York and the Senator from New Jersey. And I am going to offer that. I am going to offer a short time for debate and a vote on that and then a vote on the bipartisan, bicameral bill that has already passed the House.

I am hoping that somebody actually involved in the substitute bill will come to the floor to either agree or object. That should be fair. They can have a vote. It seems reasonable to me. But it really ought to be the people offering the amendment who say they have the better idea, even though it leaves out the HIV folks, hundreds of thousands of Americans. This amendment doesn't even provide a quick fix for 1 more year, because it keeps the flawed formulas that will cause tremendous funding shortfalls in place. They will come back in another year then and ask for 5 more years of being held harmless.

I want to get a vote on the bill that includes HIV and follows the patient.

We need to do that. We need to do it today, not tomorrow, not next month. Tomorrow night, a bunch of States will be in crisis--and their residents with HIV/AIDS will begin losing access to care. I would imagine in their amendment they have slipped in a little thing to protect the States that will fall into a trap tomorrow. But let's not just throw money at the problem, let's do the right thing for the long- term, for the entire Nation. Let's solve the formula. Let's do what we have done on a number of other bills that have gone through my committee, which is to look at the formula and say: What is fair to all the States?

I have to say, there are some people on my committee and others in this body who have said: If I look at the charts and I see what is happening to my State, yes, I may lose some money, but we are trying to come up with a solution that solves a problem across this country. And that is what we are here for, to solve problems across the country. I can tell you that the HIV/AIDS families and community want it to be fair and want the bill we have been asking unanimous consent on for several days now.

So I will be asking for unanimous consent. I will throw in this opportunity to have a vote on the other bill, to see if people want to do more of the same or if they want to fix this over a period of time, again, holding all States harmless for 3 years before we move into a transition to full fairness.

Just last night the House passed this critical, bipartisan, bicameral legislation by an overwhelming bipartisan vote, 325 to 98, and sent it to us to act upon it immediately. The House understood the critical, time-sensitive nature of this legislation. Now the Senate must act quickly to reauthorize this critical program by September 30; otherwise, hundreds of thousands of individuals in States and the District of Columbia will lose access to lifesaving services. The only thing standing between us and the President's signature to enact this bill is a Senate vote on the House bill--or perhaps a Senate vote on the possible substitute amendment and then a vote on the House bill.

Now, I have asked the Senate to move this critical legislation two other times. Currently, four Senators from two States are blocking a vote and thus may prevent many individuals and families from receiving critical AIDS and HIV treatment under a more equitable program.

I appreciate the number of my colleagues who have been on the floor to talk about the people in their States who are dying because they are on a waiting list and cannot get the treatment, because they have had huge influxes of population, huge increases in the number of people who have been infected by HIV and AIDS. We cannot let that happen. We cannot continue that. We cannot continue to say: Well, if we have been shipping money to one part of the country, we are going to continue to ship money to that part of the country even though the problem has shifted. So four Senators are blocking us.

Mr. President, I would like to take this opportunity to recognize the hard work of the Senators from California on this legislation. I appreciate their willingness to continue to talk to us to address their concerns. They have indicated they are no longer objecting to this legislation. I thank them. However, this bill, due to other objections, is still not moving forward.

This legislation ensures that Federal moneys are distributed more fairly and the dollars will follow the person. This is something our outdated funding formula failed to do. Hundreds of thousands of people living with HIV and AIDS, who live in these States, will be needlessly harmed if a few Senators continue obstructing good policy.

What is more, these four Senators will not come to the floor to defend their objection to this critical legislation at a time when we are talking about it. So today I will ask again for the Senators from New York and New Jersey to come to the floor themselves, lodge their objections, listen to the unanimous consent request, where I am going to offer them the right to have a vote on their bill, in exchange for the right to vote on the bill that came out of committee--the bill that is bicameral and bipartisan.

Now, as part of the unanimous consent request, I am also allowing those Senators to offer that amendment, of course, the opportunity for them to put forward their best solution for dealing with the concerns they have. We have run hundreds of programs trying to come up with the most equitable way to do this. The one we are presenting is the one we found that had the most people to support it. I was told this is identical to the bill introduced by the New York and New Jersey delegations this week. That is the amendment we would be voting on. This bill and/or amendment is not a solution; rather, it is a harmful delay, putting off what we should and must do today.

These States simply raise objections about what funds are received this year compared to last year. These States were grossly overpaid last year and will continue to be overpaid next year. However, they will no longer be grossly overpaid under the bill I am proposing. These few Senators keep saying they will lose money under the reauthorization. No matter the dollar formula they say they may lose on a given day, it doesn't add up to the amount of dollars they would stand to carry over from the current flawed formula. The State of New York would carry over an average of $150 million over 5 years.

According to GAO data, even with the formula adjustment that will allow for more equitable treatment, save lives in more places, New York would still carry over about $115 million based on their past spending. In the past, New York and New Jersey have been able to under-spend hundreds of millions of leftover dollars. At the same time, 25 other States are struggling to provide even the most basic life-sparing medications to their residents living with HIV/AIDS. Because of the current flawed formula, this amendment doesn't even count Americans living with HIV. New York can afford to generously offer more than 495 different medications to their residents. That is 23 times the number of medications that Louisiana is able to offer their HIV/AIDS residents because of a lack of appropriate funding. While New York offers a range of elective drugs, many other States are unable to provide the basic life-sparing treatments that every American should have access to. This is indefensible. New York carries over an average of $30 million each year; yet, 25 other States are having significant difficulty providing the basic drugs to all of its eligible residents. Eleven States have waiting lists--that is right, residents in 11 States are unable to receive life-sparing treatments because their States do not receive appropriate funds.

New York, in 2005, spent an astonishing $25 million on administration costs for just two titles of this law. That is more than the entire amount of money received by 38 States in 2005 for those two titles to provide care to their residents with HIV/AIDS. This inequity must be addressed, and it is addressed in this reauthorization. Stalling now because a couple States stand to lose a fraction of the money they already cannot spend is indefensible. Lives are at risk and a solution is on the table today. A solution has been passed by the House and is before us now.

I hope those four Senators will defend their objection and allow a vote on their amendment. The continued expansion of the AIDS epidemic in this country is a certainty. While the epidemic continues in the urban areas in the country, the number of new cases not diagnosed in small urban, suburban, and rural areas are reaching alarming levels. As the epidemic expands in all these areas, local health care systems have often been unable to meet the growing demands for medical and support services.

The problems created in rural areas are often similar to those experienced in large cities. However, these problems are exacerbated by poor health care infrastructure and limited experience with HIV/AIDS care. The lack of trained primary care providers, the absence of long- term care facilities, the scarcity of resources, and a scattered population are additional obstacles that may be faced in a developing, coordinated outpatient service program.

If New York thinks it is more expensive to handle a new problem, they ought to deal with the distances these people have to travel in some of the rural areas to get care for some of the most basic ailments. Small areas are

also often not able to provide the specialized services required by some persons with HIV. When primary services are unavailable, individuals and families must travel long distances to receive the necessary care. Furthermore, rural health care systems must address not only the epidemic but also other conditions, including substance abuse, mental illness, and sexually transmitted diseases which they may be poorly equipped to deal with.

Thus, as we think of the problem today in its expansion into rural areas, we must provide the same effort to those areas we did for urban areas in the early 1990s. We must target resources to those in need and assure that those infected with HIV and living with AIDS will receive our support and our compassion, regardless of their race, gender or where they live.

Finally, I want to answer the question posed by the Senator from Minnesota last night. Senator Dayton asked what it would cost to give these States, over the next 5 years, the same amount of money as they receive presently. Alarmingly, to keep those States whole, it would cost $614 million a year. That is over half a billion for the next 5 years.

It is not possible just to provide increases to New York and New Jersey due to the funding distribution; therefore, to ensure that everybody receives as much money per person with HIV that New York is currently receiving, it would cost over $3 billion--if we went to equity, it would cost $3 billion, or a 30 percent increase in Ryan White funding to maintain States' funding level that are grossly overpaid and unable to spend the money they do receive.

Our obligation as Senators is to the people of the United States. We still have four Senators who continue to obstruct the Senate from passing a bill because of the September 30 deadline--a bill which passed the House 325-to-98, a bill that can save more than 100,000 lives, including the lives of the growing number of women and minorities who are afflicted by this devastating disease, and provides the money to where it is needed most.

As I said last night, this is not an economic development project. The bottom line is simply, where States have more people with HIV/AIDS, they should get more money. Where States have less people with HIV/ AIDS, they should get less money. As we all know, the Ryan White program provides critical health care services for people infected with HIV and AIDS. These individuals rely on this vital program for drugs and other services. We need to pass this legislation so we can provide them with the treatment they desperately need.

I urge the Senators who are holding up the bill to stop playing the numbers game so the Ryan White CARE Act funding can address the epidemic of today, not yesterday.

I ask the Chair how much time remains.

Mr. President, I will yield 5 minutes to the Senator from Alabama, Mr. Sessions.

Mr. President, I yield 10 minutes to the Senator from Utah, Senator Hatch, who has been actively involved in the HIV/AIDS discussion for years. In fact, he selected the Ryan White name for this bill many years ago when he chaired this committee.

Mr. President, it is my understanding that I have 9 minutes remaining?

I thank the Chair, and since there is a Senator now here from one of the two states objecting to us moving on with the Ryan White HIV/AIDS Treatment Modernization Act, I would like to propound the unanimous consent.

Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 6143, which was received from the House. I ask unanimous consent that the only amendment in order be an amendment by Senator Lautenberg, which is the text of S. 3944, with 30 minutes of debate equally divided. I ask consent that following the disposition of that amendment, the bill, as amended, if amended, be read the third time and passed, a motion to reconsider be laid upon the table, and that any statements relating to the bill be printed in the Record.

Mr. President, I am sorry to hear the objection. We have been trying to find a way, any way, to be able to move on to a vote on this bill that is bipartisan, bicameral. It has already passed the House and I am sure it would pass here. So I am really disappointed.

Mr. President, I allocate 5 minutes of time to the Senator from North Carolina, Mr. Burr.

Mr. President, for the last few seconds I am going to just mention that the bill by the Senators from New York and New Jersey was introduced on Tuesday. Surely they have had time to think about having that amendment debated and voted on in that amount of time. I am really disappointed that they won't give some kind of an answer that will allow a vote on that amendment. If that is what they need for cover, that is OK with me. I just need to get this done.

New York and New Jersey are stealing the future from those with HIV, and that just cannot happen in the U.S. Senate. We have to worry about all the people from all of the United States, and that is what the reauthorization would do. That is why it is important to do it. I have asked those questions numerous times now trying to find a way to bring this bill up for a vote, and am being denied in every way--I am not being denied--those with HIV, those with AIDS, their families are being denied the right to have a vote on this bill in the U.S. Senate.

I ask unanimous consent to speak as in morning business.

Mr. President, I thank the Senator from New Mexico. He is overly generous. I learned as a staff aide in the Senate that if an idea has many fathers and many mothers, it has a much better chance of moving along than if it just has one.

Senator Domenici is being overly modest about his own role. This would not have gotten to first base--by ``this,'' I mean the competitiveness legislation--had not Senator Domenici created the environment in which it could succeed, and if he and Senator Bingaman had not had such a good partnership and been able to work together, set a good example and have been willing to step back and allow other good ideas that were progressing through the Commerce Committee and the HELP Committee.

It has been a remarkable exercise in restraint for many distinguished Senators, some among the most senior Members of the Senate, and at a time when politics is at a pretty high level.

I thank the Senator for what he said. It means a lot to me.

Mr. President, I ask unanimous consent to have printed in the Record a summary of the National Competitiveness Investment Act.

Mr. President, although most cannot hear it right now, I want to say how much all in the Senate appreciate the extra hours and the skill with which the staffs met and worked through August and over the last several weeks to bring the three committees together. Senator Ensign played a major role, and his staff did. There were many staffs. This was not a bill that Republicans wrote and Democrats looked at or vice versa. We did it together.

Future of Higher Education

Mr. President, today the Secretary of Education, Margaret Spellings, made an important speech at the National Press Club. In her remarks, she discussed the report from her Commission on the Future of Higher Education. This commission was chaired by Charles Miller, who was the former chairman of the board of regents of the University of Texas system and a leader in education reform at all levels.

I am very impressed with Secretary Spellings. I know her job. I once had it. I do not think we have had a more effective Secretary of Education. I am very impressed with Mr. Miller. I know about his work in Texas as part of a group of business leaders over the last 20 years who have led the country in terms of helping to set accountability standards in elementary and secondary education.

Mr. President, I encourage my colleagues to read Secretary Spellings' speech from today.

Secretary Spellings is the first U.S. Secretary of Education to assume the role of lead adviser to coordinate all of higher education. I am glad she is doing that because almost every Department of the Federal Government has something to do with higher education. Currently, no one is the lead person for that. It ought to be the Secretary of Education. She stepped up to do it. I applaud her, and I applaud President Bush for asking her to do that.

The Secretary's recommendations in her speech today are sensible and respect the prerogative of Congress to make major changes in higher education policy. In plain English, she laid out some very good recommendations, but she recognized that is one branch of Government, we are the Article I branch of Government, and if there are major changes in policy, we will make them here, and then it is their job to implement it.

But among the strong recommendations in her report are the following: Simplify the financial aid system. We are already doing that, having worked with the Secretary on a commission, and it is included in the higher education bill that has not passed. That is a very good recommendation. Another recommendation is expanding more access to more students. The initial cost estimates of her commission's report suggest its recommendations might cost $9 billion or $10 billion more in terms of Pell grants. That is a lot of money, but it is an important goal.

Another recommendation is increased competitiveness. The Secretary's commission spent quite a bit of time urging the Congress and the country to adopt the recommendations of the Augustine commission, to adopt the recommendations of the Council on Competitiveness, and to adopt the President's recommendations on competitiveness. That was a help in getting us come to the point in this body where tonight Senator Frist and Senator Reid will introduce the National Competitiveness Investment Act.

The Secretary's committee recommended less regulation for higher education, which is something I want to talk a little bit more about in a moment. I thoroughly agree with that. And, of course, another recommendation is to find ways to reduce costs, which every family who has a student headed toward higher education thinks about. In our own family, where we have two new grandchildren who are less than 1 year of age, the parents--our children--are already thinking about it: How in the world are we going to pay for college out of our budgets in 18 years? That is at the top of almost everyone's concern.

I want to wave one bright, yellow flag, a cautionary flag, at one troubling aspect of the report of the Secretary's commission. That is best captured by the following sentence on page 13 of the commission's report, and I quote: ``Our complex, decentralized post-secondary education system has no comprehensive strategy, particularly for undergraduate programs, to provide either adequate internal accountability systems or effective public information.''

``Our complex, decentralized post-secondary education system has no comprehensive strategy. . . .'' The commission apparently believes that is a weakness. I believe that is a strength. I believe that is the greatest strength of our higher education system. The key to the quality of the American higher education system is that it is not one system, but that it is a marketplace of over 6,000 autonomous systems, independent systems.

These autonomous or independent institutions--such as the University of Tennessee, or Fisk University, or the Nashville Auto Diesel College, or Yeshiva University--these institutions are regulated primarily by competition--competition for students, for faculty, and for research dollars--and by consumer choice, which is fueled by generous Federal dollars that follow more than one-half of American college students to the institutions of their choice.

There is, in addition, a system of independent accreditation to help regulate these independent and autonomous institutions. To be sure, there is still plenty of the traditional kind of command-and-control Government regulation. That is very hard to get away from. Every State has a regulatory body, such as the Tennessee Higher Education Commission. And each of the 6,000 institutions I described that accepts students with Federal grants or loans must wade through over 7,000 Federal regulations and notices. Those regulations exist today.

The president of Stanford University has said that 7 cents of every tuition dollar is spent on compliance with Government regulations. The last thing American higher education needs is a barrage of new Federal regulations requiring sending new data to Washington so someone here can try to figure out how to improve the Harvard Classics Department or the Nashville Auto Diesel College, both of whose students are eligible for Federal grants and loans.

I believe the overregulation of higher education is the greatest deterrent to maintaining the quality of American higher education, and that autonomy, competition, and choice are the greatest incentives to excellence.

I would, therefore, wish to lead the bandwagon or be on the bandwagon or

push the bandwagon for more deregulation and to increase the autonomy of institutions of higher education and to preserve competition for research dollars and to give students the broadest array of education choices possible.

Today in America we are doing that much better than any other country in the world. It is instructive that China and several European countries are deregulating their overly bureaucratized colleges and universities to try to catch up with the quality of ours. Of course, better information informs choices. And, of course, easier transfer policies between or among institutions could increase opportunities. Much is to be gained from research that will help institutions measure what value their classes add to students.

But I do not want rules about transfer policies to diminish institutional autonomy. I do not want to see rules from Washington substitute for choice and competition as the principal regulators of the quality of our colleges and universities. I do not want to see even more tuition dollars go to pay for complying with costly Government regulations instead of to improving research and teaching in the classroom.

By design or luck, the United States has created a magnificent marketplace environment that has resulted in, by far, the best higher education system in the world with remarkable access for students of all incomes. Our goal should be to improve that system, not to replace it with some command-and-control structure.

Mr. President, I spoke before the Secretary's Commission on December 9 of 2005, and I hope that those remarks were useful to the Commission.

Mr. President, I want to comment that it is important to keep all of this discussion in some perspective. For example, there is a great concern about the rising cost of tuition. Secretary Spellings, in her remarks, says she wants to know why. Well, I know why it has gone up. It has gone up because State funding for higher education has been flat. It has actually gone down in many cases. As State funding of colleges and universities in Minnesota or Tennessee or South Dakota has gone down, colleges and universities have had to raise their tuition to have enough funds to maintain quality.

Now, of course, there are plenty of ways to reduce costs, and we need to push that and encourage that. And the Secretary has many suggestions for that. She is right about that. But let's not overlook the fact that Federal spending for higher education has gone way up in the last several years, but State spending has been flat. If anyone wants to know why your tuition bills are higher, it is because your Governors and your legislatures have not been paying their fair share of what it takes to have a quality system of higher education in America. I talked about that in my testimony to the Commission, and I hope they listened to that. I hope the Administration and my colleagues understand that as well.

For example, during the 5-year period from 2000 to 2004, State spending for Medicaid, which is where the Governors have to put most of their extra money, was up 36 percent; State spending for higher education was up barely 7 percent. As a result, tuition went up 38 percent.

There is another way I think about it. When I left the Governor's office nearly 20 years ago in Tennessee, Tennessee was spending 51 cents of every State tax dollar on education and 16 cents on health care--mainly Medicaid. Today, instead of 51 cents on education, it is 40 cents on education. And instead of 16 cents on health care, it is 26 cents on health care. So if we do not get control of Medicaid spending here in this Chamber, and in the other Chamber, one of the unintended consequences will be that we will drive down the quality of higher education all across America because it will not have appropriate State funding and we will not create the new jobs that will help us compete with China and India.

On the question of cost, two other things: One is, I ask unanimous consent, Mr. President, to have printed in the Record a short column by the president of the University of Maryland, William E. Kirwan, who discusses State funding that I have just talked about, and talks about what some colleges and universities are doing to reduce costs to help control the rise of tuition.

Sometimes we talk so much about the high cost of higher education where families hear that and think no one can go to college. I was president of the University of Tennessee. Tuition has gone up there for the reasons I just talked about. But today tuition at the University of Tennessee, which is one of the leading research institutions in this country--the manager of the Oak Ridge National Laboratory--is $5,300 a year. It is $5,300 a year for tuition at the University of Tennessee. That is more than a lot of people have, but that is a very good bargain in today's marketplace.

Volunteer State Community College, a public 2-year college--we encourage many people to go to community colleges, and then to our research universities--the tuition there is $2,383 a year.

At Tennessee State University, in Nashville--an excellent institution--it is $4,300. It is the same story in many other States. At the University of North Carolina at Chapel Hill, for North Carolina students--one of the best universities in the world--it is $4,500 a year. At the University of Phoenix--a different kind of university, but I had a distinguished scientist from the University of Texas tell me he looked at colleges of education all over America, and he thought the college of education at the University of Phoenix was as good as any to get your teacher's degrees--the comparable cost there for a year's tuition is about $6,669. They do things a little differently, but they provide an education and a service that many people are asking for, and I think that reflects the strength of our autonomous system of higher education.

Now, if you want to go to Harvard, it is a lot more. If you want to go to Vanderbilt, it is a lot more. But the rest of that story is, if you show up at Harvard, or if you are admitted to Vanderbilt, and you do not have the money, they are going to do their best to help you pay for that.

So I would hope as we talk about the cost of higher education that we recognize that many of the State institutions are reasonably priced, that the failure of State funding over the last several years is the principal culprit in the rising increase for public schools, and that we do not get carried away up here in Washington by thinking if we pass some more regulations here, somehow we are going to solve the problem, and we are going to make our higher education system better.

My main point is this: Our greatest threat to quality higher education is overregulation. And our greatest incentive for it is deregulation, choice, and competition. Those are the incentives I would like to preserve.

Mr. President, I yield the floor.

Mr. President, I rise again today to ask unanimous consent that the Senate pass S. 2823, the Ryan White HIV/AIDS Treatment Modernization Act, and I will make the formal request in just a few moments.

I want to make a few comments first in hopes that some who have a hold on this bill will come down and lodge the objection themselves. Just last week we requested the unanimous consent agreement to pass this bipartisan, bicameral legislation as it passed out of the House Energy and Commerce Committee last week. At 9:30 tonight it will pass on the floor of the House, and I expect by significant margins. But five Senators from three States are blocking a vote to create a more equitable program for providing life-sparing treatment for individuals suffering from HIV and AIDS.

Now, 2 days ago I made this same request to pass this critical legislation, and the five Senators who are holding up this legislation chose not to come to the floor to discuss their concerns or to debate their issues. Instead, the Senator from Minnesota, Mr. Dayton, was gracious enough to notify us of his objection, even though he stated he would vote for the bill.

So today I ask again the Senators from New York, New Jersey, and California, those who have holds on this critical legislation, to come to the floor themselves and lodge their objections to explain why their parochial interests should be permitted to deny lifesaving care to people who don't live in their States.

Now, I have a chart here that shows the New York and New Jersey situation. You can see that New York, under the current law, receives $509 per case above the national average. Under the reauthorization, they would still receive $304 above the national average per case. And not only that, at the end of the year, they have $29 million left over.

In New Jersey, they get $310 per case above the national average. Now, under the reauthorization, they would still get $88 more per case above the national average, and they have a little slush fund at the end of the year: $17.7 million.

These States have simply raised objections about what funds they will receive this year compared to last year. These States will still be overpaid per case, just no longer grossly overpaid. For example, New York is paid $509 more per AIDS case, as I showed my colleagues, than the national average and would get $304. They have been unable to spend $29 million in Ryan White funding. They can't spend the money they are taking in now. Yet those States' Senators still want more at the expense of many other States that are currently underfunded.

Now, these States have not objected to the underlying policies. Again, I must emphasize that these couple of States have been grossly overpaid for years, receiving well over the national average per patient with HIV. Even under this new bill, they will continue to be overpaid, although not quite as much.

Now, California is a little different situation. When the law was passed last time, we put some provisions into law, and we set a deadline for HIV/AIDS cases for fiscal year 2005 to have a conversion. Now, the Secretary opted to delay that until 2007 to give the States more time, and the CDC in 2005 urged all the States to transition immediately. California decided to transition in 2006. CDC offered resources and people in 2006 to help them make the transition. California declined.

There is a deadline. California will lose $74 million in 4 years under the current law for not meeting the deadline. When we pass this bill, under the new law, California would gain $60 million over the 4 years and have more time. So it is kind of a win-win situation for California. Under some of the formula, they were hoping, I think, to gain even more. But they can meet the deadline; extra help has been offered. So if they would take the extra help, they could meet that timeline, and under this bill, they would gain $60 million over 4 years instead of losing $74 million over that same 4 years by not complying with the transition language.

This bill would ensure that every State in the Nation has the appropriate funding to care for their residents living with HIV and

Mr. President, I thank the Senator for his reluctant objection, although it still counts as an objection.

Mr. President, I will go ahead and answer the questions, then, and hope this changes your mind on being the one willing to make the objection.

Would I protect my State if my State were losing money? I think we are elected to the Senate by the people in our States, but our obligation is to the people of the United States. And were my State grossly overpaid on an average, and I was still going to be grossly overpaid afterwards, and my State couldn't use the money each year that it received, I think I would have a terrible time trying to object to this bill. I hope we do not play that kind of numbers game, we don't get that parochial on bills around here.

Another bill I have been working on is the Older Americans Act, and it has a formula in it. Again, there are States that lose under that bill. But there are people who have been willing to work out a formula like we did on this. We must have run about 300 different programs trying to come up with something as equitable as possible. We even put in the 3 years hold harmless for people who were being grossly overpaid.

I think we have come up with as reasonable a bill as we possibly can. We need to get it passed, and we need to get it passed by September 30 so the penalties don't kick into effect for those States that have a big penalty coming up and that are desperately in need of making sure they get enough money to take care of the cases they presently have.

I have one more answer that I need to do.

I will yield for some other questions as soon as I finish answering this question.

There aren't 14 States that would lose money unless the new bill doesn't pass. There are only five States that will lose money under the new bill, the bill we are trying to get passed by unanimous consent--the bill that we are at least trying to be able to bring up by unanimous consent. We tried a number of different ways. There are just five States that are involved in losing money. Of those five, three have said we have to be fair. Two have said we don't care whether we are fair or not.

Mr. President, I don't have that number. Like I say, we ran about 300 different iterations of different formulas. I will get the Senator that number.

But there is 3 years hold harmless in this. You are talking about 5 years hold harmless. Hold harmless means

that the dollars don't follow the person, that the State gets the money even if they have run out of people with HIV/AIDS, and if there are decreasing numbers of them they should not continue to get those dollars. What you are asking is we continue to give those dollars even if we run out of people. All we are trying to do with this bill is make sure the dollars follow the person. You get more people, you get more money. You get less people, you get less money. It is take care of the people.

It is not an economic development bill.

Mr. President, I thank the Senator from Alabama for his kind comments and even more so for his passion and understanding on this issue. I thank the others who have spoken.

We had given those who are objecting to the Senate completing this bill an hour to state their case; no one showed up. We were pretty sure of that based on the fact they had one of the Members who is not running for office to be the one to object. They sent someone from a State that actually gains by having the bill completed. That tells something about how willing they are to defend the position they have on this bill.

This bill is critical to people all over the United States. There are HIV/AIDS families in every single State asking Congress to pass this bill and to pass it immediately.

Thirteen States, on September 30, will have huge losses in revenue. We are getting more calls, naturally.

This is not just a bill. This is not just policy. This is life and death to people across this country

We have heard people are on waiting lists that cannot get drugs because the money does not follow the person. The money goes to the States that had the money before. This bill readjusts that so the people who need the drugs get the drugs. It sounds like an American principle to me.

As I mentioned before, there are other bills we work on where we are changing the formula. I have been very fortunate the people working with those bills have said, yes, we have to be fair. We always transition into these things. This is no exception. Three years of hold-harmless. That means they get the same amount of money whether they deserve it or not for 3 years, while they count again to see if they have more or less people affected.

standards conversion

The 2000 reauthorization stated that States need to have CDC accepted HIV data as early as 2005 but not later than 2007. Therefore, States have already had seven years to make this change.

Under the bipartisan, bicameral product, California and Pennsylvania will have 4 more years to make the change. Thus, you both will have had over a decade to convert your systems. However, in fiscal year 2011, only CDC standards for HIV cases will be used for the funding formula.

According to a February 2006 report by the GAO, Pennsylvania would lose $9 million and California would lose $18.5 million in 1 year. With this bill that allows those States to still count the people that matter while the systems are transitioning, Pennsylvania would instead gain $4.8 million and California would gain $15.4 million.

CDC has offered to provide assistance to States throughout the process. In fact, I recently confirmed today that CDC has already offered California technical assistance--up to six staff for up to 6 months--to help them make this change. Further, given some confusion about that technical assistance, I have asked CDC to send a letter to California, restating that they would provide that assistance.

Mr. President, Senator Hatch was the chairman of this committee when the original Ryan White HIV/AIDS treatment bill went through. He is the one that selected the name of Ryan White. He has an explanation of how that came about and the differences this bill has made and the urgency with which this needs to be done right now.

I am very distressed. I have had a lot of success on other bills we are trying to get through. People have been willing to listen to reason and understand the urgency of a lot of the issues, particularly in the health area, but also in the education, labor, and pensions area.

As a committee, we work on these things across the aisle and across the building. As a result, we have had 12 bills signed by the President. Of those 12 bills, we have only spent about 2 hours total in the Senate debating them because we work across the aisle and across the building. We work on important issues. We solve the parts we can and we bring them here. This is one of those where we thought we had the parts solved that we could. There are a lot of moving parts to a lot of these things. We work to get as much consensus as we can, but occasionally we reach a sticking point like this.

I am really disappointed we have reached a sticking point like this where people are going to die. If, by tomorrow, we have not passed this bill and in case we go longer than tomorrow, I am going to ask the leader to file cloture on this bill so we can see if five Senators can hold up a Senate bill.

If we leave tomorrow or the next day, it won't ripen yet, but it can ripen as soon as we can get back. We can spend the time debating it, and those States that are losing money on September 30, while they will not be able to retrieve all the money they will lose, they will have some breathing room for the future.

I am desperate. I usually do not have to do that sort of thing. I am willing to do it on this bill. I am very distressed. Usually we are able to get agreement. We went a long ways toward giving concessions to those States.

In all fairness, if you do not have the cases, you really should not have the money tomorrow, let alone 3 more years. We have tried to be reasonable. We have tried to help out States. We have run a bunch of formulas to make it as fair as we possibly could and to protect the States as much as we can, but it is time to be fair to the people with HIV/AIDS and to be fair to the families of people with HIV/AIDS.

I ask unanimous consent that a Washington Post article be printed in the Record.

I have a unanimous consent that has been agreed to by the majority and minority leader. I yield back all time on the Defense appropriations conference report.