Hedge Fund Transparency Act

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, we had a good day on the Children's Health Insurance Program bill yesterday. We considered 10 amendments; we conducted 6 rollcall votes. All in all, I think it was a very productive day because we are very close to finishing and passing the Children's Health Insurance Program--reauthorizing it--so it can be sent to the House. My expectation is the House will then take the Senate bill and send it to the President so we can get it signed very quickly.

This morning, at about 10 a.m., we expect Senator Hatch to come to the floor to offer his amendment regarding the definition of an unborn child. I know Senator Boxer, and perhaps some other Senators, wish to be here to address that issue and speak on that as well.

Last night, Senator Coburn offered two amendments and spoke about another, and we hope to work with him to process those amendments.

For the information of Senators, we are working to set up a series of votes on amendments, perhaps later this morning. A specific time has not been set. My guess is it will be quite late this morning. Frankly, we are working to finish this bill this afternoon. This bill is moving along very quickly, and I urge Senators to bring any remaining amendments they may have to the floor so we can wrap it up.

This is a wonderful program. There aren't very many people who disagree with the Children's Health Insurance Program as enacted by Congress back in 1997. It was wonderful work on the part of Senator Rockefeller, Senator Hatch, Senator Kennedy, and the late Senator John Chafee. They worked very hard.

It is very interesting, there were very serious discussions on the one hand, with many Senators who thought this should be another entitlement program for children; on the other hand, some Senators thought, no, this should not be an entitlement program, it should be a block grant program. That was the compromise; that States get a big chunk of money, to be matched by State payments to provide health insurance for the working poor--for kids of families who are just above the income levels set for Medicaid. It has worked very well. It is very important, and I am very happy, frankly, and proud of the attempt that was begun back in 1997 by the Senators I mentioned.

We had hoped to get this approved a couple years ago, late in 2007, but unfortunately those two efforts were vetoed by President Bush. But here we are today. This is 2009--a new era, a new opportunity--and I think most Senators are quite proud of the efforts we are making to help more kids get better health insurance.

I hope Senator Hatch gets to the floor soon so he can offer his amendment and then we can proceed.

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

Mr. President, last night, Senator Coburn sought to bring up his amendment No. 47. At that time, we asked him to withhold so we might look at the amendment because we neglected to get the Coburn amendment No. 47 until that moment. He spoke on the amendment. We have looked at the amendment. So on behalf of Senator Coburn, I ask unanimous consent that the pending amendments be temporarily laid aside and that Senator Coburn's amendment No. 47 be called up.

Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. President, I suggest the absence of a quorum.

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

Mr. President, a few moments ago the Senator from Mississippi, Senator Wicker, offered an amendment. Basically, it is directed at the so-called August 17, 2007, directive that President Bush promulgated. That directive issued strict guidelines to States regarding Children's Health Insurance Program enrollment, focusing on potential crowdout, and mandated that States adopt more restrictive so- called crowdout policies. Among the policies in that August 17 directive was a requirement that the States prove that at least 95 percent of the children below 200 percent of the poverty level have some coverage before they can enroll higher income children. The amendment offered by the Senator from Mississippi would, in the same vein, prohibit States from receiving the Federal match for individuals under the program above 200 percent of the Federal level unless they enrolled 90 percent of all children under 200 percent.

That is an impossibly high standard, one that cannot be met. Certainly, the 95 percent in the August 17 directive could not be met. That is why that directive was never put into effect.

It is too tight. It would not work. Yesterday, this body voted against an amendment which would set the requirement at 80 percent, and the amendment before us sets the requirement not at 80 percent but a much higher rate; that is, 90 percent. These are impossible standards for States to meet. It is virtually impossible for a State to meet 90 percent. Even mandatory provisions--let's take auto insurance. The takeup rate in States is not 90 percent. Even where it is 90 percent, I think the average is like in the eighties somewhere. This is not mandatory. The CHIP program is not mandatory. It is an optional program for States. It is optional whether a person wants to participate in CHIP or participate in the private market. It is totally optional. So it is impossible for a State to achieve a 90-percent rate. That is a standard which is much too high.

Also, another reason it is so difficult for States to reach a 90- percent rate is because of the economic downturn we are facing. With the downturn we are facing, people are leaving employment, regrettably, they are being laid off, which means they are losing health insurance. The more people who are laid off, the more people lose health insurance, the more difficult it is for a State to show that it is meeting a 90-percent requirement.

That is just a mechanical effect of this amendment. The practical and personal effect is that this is going to hurt kids because the amendment has the effect of denying Federal dollars to States when they cannot meet an impossibly high so-called takeup rate. Therefore, I urge my colleagues to not vote for this amendment. It is not a good idea.

It does try to attempt to address something called crowdout, which has been debated here on the floor for a long time. Frankly, this crowdout debate is missing the mark here. We are not keeping our eye on the ball. The ball really is, how do we get more kids covered under the Children's Health Insurance Program?

For all of the reasons Senators have indicated, my gosh, we want our kids to be healthy. Healthy kids go to school. Healthy kids in school perform better in school. If they perform better in school, they are going to do better when they graduate. We want healthy kids. The more we have healthy kids, the more likely it is we are going to have healthy families and more productive families and be able to address some of the adverse consequences the recession now presents to us.

I yield the floor.

The PRESIDING OFFICER (Mrs. Hagan.) The Senator from Wyoming is recognized.

Mr. President, basically the Bunning amendment is the fourth amendment that would put a cap on eligibility. Yesterday the Senate rejected the Cornyn amendment that would cap it at 200 percent of poverty, a Roberts amendment with a cap of $65,000, and a Murkowski amendment with a cap of 300 percent of poverty. All these amendments, including the Bunning amendment, have the same flaw; that is, they would raise the possibility of kicking kids off the Children's Health Insurance Plan; that is, they are diminishing amendments. They do not add, they subtract. The kids currently on the Children's Health Insurance Plan are taken off. That is not something I think we want to do.

The specific amendment in question here will have that effect. It will basically say that because the States that have been mentioned here essentially get a match rate according to the Children's Health Insurance Plan, that because of the amendment--the amendment says they will get less, they will get the Medicaid match rate, which is less than the Children's Health Insurance Plan; therefore, those kids cannot participate.

Theoretically there could be some participation because the match rate in Medicaid, which I think is around 15 percent lower--in the case of let's say New York or New Jersey--than the Children's Health Insurance Plan match. But still the effect is the same. If this amendment were to go into effect, children currently in, say, New Jersey who receive the Children's Health Insurance Plan match rate will probably get kicked off. A lot will be kicked off the Children's Health Insurance Plan because the match rate is lower, down to the Medicaid rate.

That is not right. The fact is all of these amendments, including the Bunning amendment, are restrictive. It is constrictive. It is a reducing amendment. It pressures to take children off the Children's Health Insurance Plan rather than add children.

People talk about 200 percent of poverty, 300 percent of poverty, et cetera. I think New Jersey is at 350 percent of poverty. One interesting point there is they are at that rate, A, because they asked for it and, B, because President Bush's administration gave a waiver and said, yes, go ahead and do it. President Bush, his administration, and the Republican Secretary of HHS, said, yes, New York, go ahead and do that. That is fine. You should do that.

One can guess why they may have granted that waiver. The reason is because when you talk poverty levels, such as 200 percent of poverty, that is a national figure. It is not a different number for each State, it is what is the national number. New Jersey, I think, has the highest per capita income of any State in the Nation. Clearly, the Federal poverty level which applies to New Jersey probably does not match what the realities are in that State. The realities are if you take a family a little bit above the national median income, a family in that State, in New Jersey, is probably facing the same economic pressures and difficulties--paying for health insurance, providing for the kids and the kids' medical bills--as would the average family in a State where the median income is the same as the national median income. That is probably why New Jersey asked for that waiver and probably why the Republican Secretary of Health and Human Services granted that waiver. But that is where we are. That is history. It makes sense.

The fact is, this amendment says, no, we are going to undo that, even though New Jersey is used to it, even though New Jersey applied for the waiver and lawfully was granted the waiver, we say: No, no, not that anymore. We are going to reduce the match rate you and New Jersey get and it is again going to have the pressure of hurting kids in that State and taking kids off the Children's Health Insurance Plan. That is not the right thing to do.

I therefore respectfully urge Senators to not support this restrictive amendment which does not add kids to the Children's Health Insurance Plan. Rather, it takes kids off the Children's Health Insurance Plan.

Mr. President, I ask unanimous consent that at 3:10 p.m. today, the Senate proceed to a series of votes in relation to the following pending amendments in the order listed: Coburn No. 47, Bunning No. 74, and Hatch No. 80; further, that no amendments be in order to these amendments prior to the votes; that there be 2 minutes of debate equally divided between the votes; and that all votes after the first vote be limited to 10 minutes.

Mr. President, I very much thank the Senator from Illinois for his statement in several respects. One is that he complimented the Senator from Utah. That was the proper thing to do because the Senator from Utah has done a lot and led the way for children's health care. I thank the Senator for making that point very clear. It is true, Senator Hatch has been one of the real leaders in helping to protect kids. He worked a few years ago on the original Children's Health Insurance Program, and he, Senator Rockefeller, and the late Senator John Chafee were several of the prime movers to get children's health insurance passed in 1997.

I would like to say a word or two about the pending amendment offered by my good friend from Iowa, Senator Grassley. He mentioned--and, frankly, some of the speakers have mentioned--a lot about partisanship and seeking bipartisanship, and so forth. We all want to work together. That is clear. Frankly, to be honest, I do not like the word ``partisanship.'' I do not like the word ``bipartisanship'' because that connotes there are two sides trying to force something together. I, rather, think we should--without sounding corny about it--just try to do what is right.

The amendment offered by my friend from Iowa, Senator Grassley, will have the effect of taking about three-quarters of the million children off the Children's Health Insurance Program or, to state it more accurately, if you take the current bill before us, we will add approximately 4 million children to the approximately 6 million children who are currently covered. We are told 10 million kids would be covered under the Children's Health Insurance Program.

Remember, the Children's Health Insurance Program is for low-income kids of the working poor. These are families who are not as poor as those who qualify for Medicaid. It is just the next level up, the working poor. They have had a real tough time making ends meet. The Children's Health Insurance Program is aimed at that group, at the working poor.

Under the legislation before us, not only will the 6 million who currently have children's health insurance coverage receive that care, but 4 million more will be covered under the bill for a total of 10 million.

Cutting to the chase, the bottom line, the effect of the amendment offered by Senator Grassley will be to deny coverage to three-quarters of a million people who otherwise would be covered under the bill or, to state it in very gross terms, if the total under the bill is 10 million covered, that means under the Grassley amendment it would be 9.25 million covered; that is, about 750,000 kids could not be eligible. These are kids who currently in these times need help. These are kids with families where, most likely, the parent is having a hard time finding work or is maybe laid off, really struggling.

We know real wages have not gone up in this country at all in the last decade. Times are tough for a lot of people. They may have lost their house or are losing their house or they may find their rent has gone up even more. There are a lot of reasons people are facing tough economic times. These are the people we want to help.

Now, if these kids in working poor families do not get health insurance, we all know the consequences. One is deferred health care. They are not going to go to a doctor for checkups. They will not get their checkups. One is deferred medication. They do not get their medication. They will get sick more likely.

When they get sick, what happens? Well, if they get real sick, they probably have to go to the emergency room. What happens there? They get emergency care, deferred care. It is expensive care. It is postponed care.

Then what happens? Well, they get the care in the emergency room, but then what is the followup? They will not be seeing a doctor. They will not be seeing a pediatrician. They will not be seeing an internist, somebody who is a primary care doc, a family doc, who could follow up to make sure the child is doing well.

What else happens? Well, the costs in the emergency room are passed on to somebody else. Who are they passed on to? We all know they are passed on to the hospitals, they are passed on to the doctors, who then have to charge their private paying patients more. For those, frankly, who are so concerned about private health insurance--and we all are very much--the net effect of denying children coverage under the Children's Health Insurance Program is not only deferred care, it also means increased premiums for the private health insurance market. That makes it sort of a vicious circle: the higher the premiums go, the harder it is for people, for families to get private health insurance. It is a big problem.

You might ask, who are the 750,000 people the Grassley amendment would deny participation in the Children's Health Insurance Program? Really, his amendment basically strikes the bill on the floor and replaces it with what is called CHIP II. There is a big loss of coverage for perfectly legal immigrants. These are people in our country, frankly, who, for all intents and purposes, are Americans. They stood in line in some country legally to get to the point where they would enter our country. They are going through the process legally. They pay property taxes when they are in America, if they own real property. They, hopefully, pay some income taxes. That means they would have a decent job. They certainly pay sales taxes in this country. These are working people in our country.

They have served in our armed services. I am sure there are some over in Iraq, some in Afghanistan right now. These are perfectly legal folks in our country. The only difference is, they have to wait a little longer to get full citizenship. But they are in line doing all that they need to do under our law to get full citizenship.

They go to public schools in America. Legal immigrants go to school. Those are public programs. So it seems to me, if you have public programs, such as schools and the other public programs like that, then certainly children's health insurance should be fully available to them as well.

But, again, just as a basic reminder, the effect of the Grassley amendment is to deny health insurance to about three-quarters of a million people compared with the underlying bill. I do not think we want to deny coverage to the kids of the working poor who do need health insurance, especially during these very difficult economic times. So, therefore, I urge Senators not to support that amendment.

Mr. President, I wish to address one of the amendments that will be coming up. There is a series of votes at 3:10 this afternoon. That is about 25 minutes from now. The first vote scheduled will be on the Coburn amendment No. 47. That is the amendment that deals with premium assistance.

Essentially, this amendment requires States to substitute premium assistance for the traditional Children's Health Insurance Program and Medicaid for children above the income eligibility determined by a State as of January 1, 2009. Basically what that says is this: If a State decides it wants to cover more children--let's not forget, when this program was enacted in 1997, the decision was that this would be a block grant program to give States the option, first, as to whether they want to participate in the program and also the option to design programs the way they think makes most sense in their States.

In 1997, the debate was should this be an entitlement program, such as Medicaid, where children of the working poor are entitled to get health insurance, as people are entitled to get health care under Medicaid. This Congress made the decision, no, it should not be an entitlement program, it should be a block grant program.

What does that mean? It means Congress, roughly every 5 years, reauthorizes the Children's Health Insurance Program. It provides money for the programs and money is allocated to the States under a formula. Obviously, larger population States would get more dollars than lower population States. But there is a match; that is, the Federal Government will pay a certain percentage for the program and the States pay another percentage. Under the formula, the Federal Government pays a little more than do the States.

Nevertheless, that is what Congress decided in 1997, and this legislation before us basically continues that same approach. It is a State option. States can decide for themselves what children they want to include. They can determine what level of poverty applies.

The Coburn amendment says: OK, let's say some States currently set their eligibility rates for low-income children, let's say, at 175 percent of poverty. That is not unlikely. There are a lot of States that are in that neighborhood. In fact, my State of Montana, until this last year, had 175 percent of poverty. They passed a referendum raising that to 250 percent of poverty.

This legislation says if a State wants to increase its eligibility rate, any increase that is in effect after January 1 of this year means that the State cannot put those children into the Children's Health Insurance Program but, rather, must take the money and apply it to premium assistance.

What does that mean? That means that money has to go to families to buy private health insurance coverage for their children. They cannot go into the program. But that money they get has to buy private health insurance. The fancy term is ``premium assistance.''

The amendment goes further. It says, in addition to that, when you have to buy private health insurance, with premium assistance, you have to wait 6 months. You cannot get it right away. You have to wait 6 months. So there is going to be a period, 6 months, where kids will have no health insurance. Not only are they not covered under the Children's Health Insurance Program, but they cannot get health insurance.

What if somebody gets sick during that 6-month period? They cannot get insurance in the public program. They cannot get private health insurance. They have to wait. Tell me what sense that makes. I cannot understand how that makes any sense at all. The first requirement makes no sense to me. It is wrong, in my view. The second adds insult to injury.

For those reasons, I strongly encourage Members not to support the Coburn amendment. It has a very restrictive effect. It makes it very difficult for kids in working poor families to get health insurance. Let's not forget we are in difficult times. These are recession times. People do not have jobs. Health insurance is very expensive, extremely expensive in the private market. There is discrimination in the individual market. Insurance companies can discriminate against you. If you have a preexisting condition, they can say: no health insurance. If you have a history of medical care, they can say: Sorry, you have been sick too much; we are not going to cover you, and for other reasons.

Let's say a child falls into this category; that is, the State raises eligibility and this child is currently in a family that is 175 percent of poverty, now at 250 percent of poverty. They are still the working poor. That is a very poor family. Let's say that person applies for health insurance because they lost their job. Let's say the insurance company applies normal preexisting rules in the market. Not only can that person not get health insurance in that 6-month period, they may not get it at all.

I strongly urge Members not to support this amendment. The practical effect of this amendment is to significantly discourage health insurance for poor kids, kids belonging to working poor families. I urge the amendment be defeated.

Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. President, there are a lot of amendments around here flying fast and furious. Frankly, we have read them in the past several minutes. I have one amendment in my hand. We received that a few minutes ago. It is hard to go through it quickly. I am not complaining. That is sometimes the way the Senate operates.

As a consequence, I think I overstated, after my staff read the full amendment, the number of kids that the Grassley amendment would cover compared with the underlying bill.

As I mentioned earlier, current law covers about 6 million children. The bill before us would add approximately 4 million more--roughly 10 million. I stated the amendment offered by Senator Grassley from Iowa would have the effect of reducing coverage by about three-quarters of a million people. I said about 750,000 fewer kids would be covered if the Grassley amendment were adopted to this bill.

It looks as if I have overstated that figure. We checked with CBO. On the other hand, we don't know what the right figure is. CBO does not know. While I probably overstated the figure, it is probably less than or fewer than 750,000 kids, but we don't know how much less.

Looking at the bill rationally, analytically, clearly the Grassley substitute will cover fewer kids. Why? Because the Grassley substitute does not allow coverage for legal immigrants who have not waited 5 years. That clearly means there are a lot of kids in that category. Obviously, there are going to be fewer kids covered.

Second, the Grassley amendment uses the formulation in the second vetoed bill in 2007, and that second vetoed bill is more restrictive than the first vetoed bill. If we look at those two different categories, first, legal immigrants, and, second, with the definition of coverage under the second bill, compare the two with the underlying bill and a good number of kids will not be covered.

We do not know exactly how many, but it will be quite a few. We pretty much think it will not be 750,000 fewer, but it is going to be quite a bit fewer.

I apologize to my good friend from Iowa for making that mistake. It was an honest mistake. Things happen fast around here, and that was our first impression looking at the amendment. After we called CBO and studied it further to find the exact number, we realized I was incorrect in the statement I gave. But again, we don't know what the exact number is.

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

Mr. President, I do not see Senator Coburn. I ask unanimous consent that all time be yielded back on that amendment, and I ask for the yeas and nays.

Mr. President, the next amendment is the Bunning amendment. I think under the agreement Senator Bunning is recognized to speak for 1 minute.

The Bunning amendment is the fourth amendment this week that would put a cap on the eligibility of the Children's Health Insurance Program, a cap to prevent kids from entering the program. Yesterday, we rejected a Cornyn amendment with a cap of 200 percent of poverty, a Roberts amendment with a $65,000 cap, and a Murkowski amendment with a conditional cap of 300 percent of poverty. Now the Bunning amendment would set a hard cap at 300 percent of poverty. We should vote this down for the same reasons we voted the others down; that is, because it deprives kids of getting health insurance.

Mr. President, I move to table the Bunning amendment and ask for the yeas and nays on the motion to table.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Amendment No. 80

Madam President, I am aware of only a couple more amendments that require rollcall votes before we go to final passage. I expect we may have a DeMint amendment on tax deductions. I expect that amendment may require a rollcall vote. Second, shortly we will hear from Senator Coburn on his substitute amendment No. 86, and I expect this amendment may also require a rollcall vote. In addition, I hope we can address two amendments by the ranking Republican member, Senator Grassley, and I have some hope that we will be able to address those amendments with voice votes. I am hoping the remaining amendments may only require voice votes. So Senators should be aware that we are getting close to finishing this bill. I am hoping we might be able to vote again in an hour or 90 minutes, but we are closing in.

Madam President, there is no reason we can't make it the pending amendment. But I would like to say, first, very briefly, that I deeply appreciate the remarks by my good friend. I know all of us are trying to get the right numbers, the accurate numbers. It is a search for the truth, and CBO has not given us the right number, so it is hard to know exactly what the effect will be.

It seemed to me, somewhat logically, that the inclusion of legal immigrants would mean probably more people covered, even though some may be covered some other ways. We don't know the number, but that is sort of the effect. Therefore, I say to my colleagues, I think it is better to include more people, more kids, in the Children's Health Insurance Program and not fewer.

With respect to the vote on the last bill, where 55 Members of the Senate supported it, and the Senator's question: If not then, why not now, the answer is because now the underlying bill is a little better. It covers more kids. It is better to cover a few more kids than not to cover a few more kids. So that is why it is not right now where it might have been right then.

Madam President, I ask unanimous consent that we proceed to the Grassley amendment. Notwithstanding the other amendments, I ask that we proceed to the Grassley amendment at this point.

Vote on Amendment No. 83

Mr. President, very simply, I do not agree with this amendment. Why? Because here we are. It is about 5 o'clock. We are on the verge of passing a 4\1/2\ year reauthorization of the Children's Health Insurance Program. We are on the 2-yard line. We are about ready to put this ball across the goal to score a touchdown, to get this passed. This amendment sets us back several yards, quite a few yards. We are on the 2-yard line for a 4\1/2\ year reauthorization. If this is agreed to, we are back to the 50-yard line.

I think it is better to get this bill past the goal line and pass this 4\1/2\ year

legislation. I urge we do not adopt this amendment that sets us back.

Mr. President, I hope not for nothing. This is pretty productive.

Mr. President, I ask unanimous consent that the pending amendments be temporarily laid aside so that the Senator from New Mexico, Mr. Bingaman, can call up an amendment.

Mr. President, I wish to address two pending amendments. The first one I will address is the DeMint amendment which provides for a deduction for health care costs for certain children.

Essentially, the DeMint amendment allows for a deduction for health care costs of children who are not in a Federal program, either Medicaid or the Children's Health Insurance Program, up to $1,500. That is up to the average federally funded program, which I understand is up to $1,500.

On the face of it, that might sound like something people might want to do, to give an extra tax deduction for children's health care expenses. The trouble is, we are here today trying to make sure that the Children's Health Insurance Program works and works better. A lot of effort has gone into this legislation, and there have been a lot of amendments from various Senators trying to improve on the bill.

First, this is not a tax bill. The Tax Code does allow employees who receive health care benefits from their employer to not count that as taxable income. That is true. It is a big provision in the Tax Code today. I think it amounts to roughly $250 billion, $260 billion a year. The employer is able to take the deduction of employer health care expenses, whatever the expenses might be, and there is no limit today in current law. All health care that is provided by the employer is not taxable income to the employee. In fact, when we deal with health care reform, we will have to look at that. We do not want to move away from employer-provided coverage. That is something the American public is used to. They understand it. Companies are used to it. They understand it.

Some have suggested abolishing that tax and basically saying individuals have to find their own insurance, irrespective of employment. I do not think that is a good idea, and I think that is the judgment of the Congress.

Senator DeMint wishes to add a tax provision basically providing the children who are not covered by either the Children's Health Insurance Program or Medicaid, as I understand the amendment, with a deduction for health care expenses up to $1,500 every year. I do not think this is the time and place to be coming up with single rifleshot, arbitrary tax amendments on a nontax bill. These provisions have to be considered together. These tax provisions have to be considered together, certainly in the context of health care reform. We take up various ways to give incentives to people to get health insurance, especially in the private market, in the individual market right now because right now it is very difficult for some people in the individual market to get health insurance. We will probably provide health credits to assist people in the private market.

We also could look to the employer exclusion and see if that can be modified. All this should be addressed in the context of comprehensive health care reform. We need comprehensive health

care reform in this country. We already know how much we pay for health care in this country. We pay twice as much per capita than the next expensive country. We have 46 million Americans not covered by health insurance. It is an abomination. We are the only industrialized country in the world that does not provide a mechanism to provide health insurance for its people. That makes no sense. The United States is slipping, frankly, in a lot of areas. Look at our financial banking system. It is crumbling. In Davos, Switzerland, we have been roundly criticized as a country for letting this happen to us. Of course, the credit markets seized up. It is very complex. The fact is, it has happened and we Americans have let it happen.

We also have to reform our health care system and reform it in a way so Americans can get health care more easily than they can now, make sure they are all covered, improve the costs, and improve our delivery system. Our delivery system is in the dark ages. We in America compensate doctors and hospitals on the basis of volume, not on the basis of quality.

Many of us have ideas. We have to put all this together into comprehensive health reform. I wrote a white paper months ago. I don't mean to pat myself on the back, but most people feel that is the best beginning to get comprehensive health care reform. Others have a lot of ideas to add to it, subtract from it. But it is probably a pretty good foundation of where we have to reform our health care system. That is where we should take up provisions such as the DeMint amendment. That is where we should decide whether it makes sense to change the Tax Code to get better health care, outside of the children's health care program.

This is not an amendment addressed to the Children's Health Insurance Program. This is an amendment that has to do generally with children, irrespective of income of families. This amendment has nothing to do with income of families. It says basically if you are not covered, you get a $1,500 contribution. I guess in some sense the proponents of the amendment could argue this is for upper income people, for moderate income people, for families whose children are not enrolled in the Children's Health Insurance Program. That may be. But that issue must be addressed in the context of comprehensive health care reform. That is the best place. I do not think it makes sense to adopt this kind of amendment. Then somebody else will have an amendment for a tax break here, a tax break there, and who knows what. This should be taken up in comprehensive health care reform or a comprehensive tax bill.

We are going to take up tax legislation later this year. There will be lots of opportunities to address health care in our Tax Code. But this is not the time and place. I urge Senators to resist the siren's song, resist temptation because this is not the road we should go down, not at this time. There is a time and place for everything. There is a time and place for health care tax amendments. This is not the time and place.

Frankly, I think the more we as a Congress are strategic, we plan a little more, we don't just react to the idea of the instant but think things through a little bit more, we will be a lot better off and we will be serving our people better than we are at this moment.

I strongly urge Members to resist this amendment so we can get on to health care reform and tax reform at a later date. I urge Senators not to vote for the DeMint amendment because it, frankly, does not belong on this bill.

Amendment No. 86

On another matter, I wish to speak to the Coburn amendment No. 86. Essentially, this amendment would get rid of the Children's Health Insurance Program, abolish it. That is right, abolish it. This is the same program that had such strong support in America. Republicans have supported it and Democrats have supported it over the decade. It currently serves almost 7 million people, and with the legislation before us, we will boost that to 10 million people. The same CHIP program, the underlying bill, as I said, 10 million people, it works. It worked for 12 years. It is effective. People like it. Why? Because it works. It is a shared partnership between Uncle Sam and the States. It makes no sense to throw this away because it has worked so well.

To be fair, the Senator from Oklahoma wants to not only abolish the program but replace it with a private system. As I understand it--I don't want to put words in his mouth--a private account system. It sounds a lot like Social Security privatization, which is roundly criticized. It is a good thing we didn't adopt that with the shape the stock market is in. People putting savings in a private Social Security account would find they would have lost a lot.

In the meantime, Social Security is strong, it is there, the benefits are there. It is kind of like a defined benefit plan, a defined contribution plan. Seniors can count on it. Social Security is there. It is financed by the payroll tax. The trust fund is in very good shape. The Social Security trust fund is not in jeopardy for, gosh, 30 years from now essentially. Seniors know that Social Security is there.

In the same vein, families, working poor families, families who do not have the same income as others, should rest assure the Children's Health Insurance Program is there. They need that constancy, that predictability. Therefore, I urge Senators not to support the Coburn amendment which essentially abolishes the CHIP program and replaces it with a private system which is precarious at best, certainly given these times.

Mr. President, I have a series of amendments in the nature of technical corrections that I have worked out with the ranking Republican Member, so Senator Grassley and I send these to the desk. I understand they have been cleared all the way around. So I send this package of amendments to the desk, and I ask unanimous consent that they be considered en bloc; that the amendments be agreed to and that the motions to reconsider be laid upon the table.

Mr. President, I ask unanimous consent that at 7:30 p.m. the Senate proceed to votes in relation to the following amendments in the order listed: DeMint No. 85; Coburn No. 86, with 4 minutes equally divided to debate prior to this vote; Coburn No. 50; Coburn No. 49; Bingaman No. 63, as modified; Hutchison amendment--which doesn't have a number, nevertheless the Hutchison amendment.

Further, that no amendments be in order to the amendments prior to the

votes; upon disposition of the amendments listed, that no other amendments be in order to the bill; the bill be read a third time; that there be up to 4 minutes of debate equally divided between the chairman and the ranking member, or their designee, prior to a vote on passage of H.R. 2, the Children's Health Insurance Program Reauthorization bill, as amended; that upon passage, the Senate insist on its amendment; request a conference with the House on the disagreeing votes of the two Houses and that the chair be authorized to appoint conferees on the part of the Senate, with concurrence of the managers and the two leaders; that there be 2 minutes of debate equally divided between the votes; and that all votes after the first vote in the sequence be limited to 10 minutes.

Mr. President, this amendment phases out the Children's Health Insurance Program as we know it. It strikes the underlying bill and phases out the Children's Health Insurance Program over the next 2 years and replaces it with a competitive bidding procedure, somewhat similar to Medicare Part D, where private plans that want to cover kids will submit bids, submit their plans to Uncle Sam for approval. So essentially it totally eliminates the Children's Health Insurance Program over a 2-year period and replaces it with a competitive-bidding process not too dissimilar from Medicare Part D where private plans offer health insurance to participants. I think it is much too much of a radical departure, and I urge its defeat.

Mr. President, I ask for the yeas and nays.

Mr. President, I say to my good friend from Oklahoma, we are prepared to accept the next Coburn amendment. I wonder if the Senator is prepared to yield back the balance of his time so we can accept it. He does. That is great.

We are on the next amendment.

Mr. President, this is yet another way to throw kids out of or off the Children's Health Insurance Program. It is a cap. It is a cap, the effect of which is to deny children coverage. It is similar to several other amendments brought up in the past, where there is sometimes a dollar cap, sometimes a percentage cap, and there are various other ways. This is another one of those caps, and I think it is not right to take kids off the Children's Health Insurance Program rolls. So I urge its defeat.

Mr. President, I think we could voice vote this.

Mr. President, I think the next amendment is the Bingaman amendment No. 63.

Mr. President, we are prepared to vote in favor of the amendment.

I yield the remainder of my time.

Mr. President, I agree with the interpretations of the Senators from Hawaii regarding section 214.

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

Mr. President, I ask unanimous consent to set aside the pending amendment and call up the Hatch amendment No. 80.

Mr. President, I ask unanimous consent that further reading of the amendment be dispensed with.

Mr. President, America's Founders built their case for independence on the foundation of self-evident truths; not party platforms or partisan positions, not opinion polls or intellectual fads but self-evident truths. Our Creator, they said, endows us with inalienable rights, including the right to life. Government, they said, exists to secure those rights. They believed that when America was born, and I still believe that today. I offer this amendment in that same spirit. The conviction about the essential dignity of our fellow human beings motivates the Civil Rights movement here at home and the human rights movement abroad. No matter what our income, race, sex, religion, location or age, we all have our humanity in common.

I came to the Senate with the conviction and tried to act on that conviction ever since by working to protect children's lives and promote children's health. These go hand in hand. That is why I worked so hard with Senator Kennedy and others to originally pass the children's health program and bill. It was kind of a miracle that we were able to get it done over 10 years ago when we did it. It was done in the Finance Committee and became the glue that held both the Republicans and Democrats together on the first balanced budget in over 40 years.

As I said, I came to the Senate with very strong convictions. Again, I have tried to act on those convictions ever since by working to protect children's lives and to promote children's health because I believe they go hand in hand. Elaine and I have 6 children, 23 grandchildren, and 3 great-grandchildren, and we speak for children, grandchildren, great-grandchildren, and beyond, all over America.

I cannot understand those who insist that we establish hundreds of programs to help millions of people by spending billions of dollars but who do not believe the lives of those very same people should be protected.

The Children's Health Insurance Program is about promoting children's health. My amendment does exactly that. A child in the womb is just as alive, just as human as that very same child will be after he or she is born. The CHIP program exists to help States promote children's health. The children who need help might be in a house or an apartment, in a city or out in the country, in a large family or single-parent home, in a crib or in the womb. That just seems to me, well, self-evident.

Since October 2002, a regulation issued by the Department of Health and Human Services has defined a child as anyone from conception to 18 years of age. It may sound a little odd to call someone who can drive, vote, or serve in the military a child, but it is the most natural thing in the world to say that when those very same individuals were in the womb, they were children.

Under this HHS regulation, States have had the option of providing CHIP coverage to children before as well as after birth. My amendment would codify that regulation to continue helping States protect the health of children.

I would point out to my colleagues that so far, 14 States have approved plans to provide CHIP coverage to children before birth. Those States include Arkansas, California, Oregon, Rhode Island, Tennessee, Texas, Washington, and Wisconsin.

I also wish to clarify that my amendment would also provide health coverage to pregnant women. Some have claimed that under this HHS regulation, pregnant women would only get CHIP coverage for conditions specifically related to their pregnancy. I want to assure my colleagues that my amendment will ensure that States have the option of providing services to benefit either the mother or the child or both.

My amendment also clarifies that States may provide mothers with postpartum services for 60 days after they give birth. Mothers have health needs before and after they give birth and their children have health needs before and after they are born. My amendment ensures that the CHIP program continues to meet those very important needs.

I urge my colleagues not to put the health of children at greater risk by sidetracking my amendment with a bogus debate over abortion. This is about children and their health, not abortion.

America itself is built on the foundation of inalienable rights which we receive from God. Government exists to secure those rights. Those rights do include the right to life, and they specifically include the right to life. My life, your life, the life of each of my Senate colleagues did not begin when we were born. Each of us was just as alive, just as human the day before our birth as the day after--or as we are today. Our efforts to promote children's health, including through the CHIP program, flow from that self-evident truth.

My amendment will continue allowing States to promote the health of children and their mothers before as well as after those children are born. I urge all my colleagues to support it.

I yield the floor.

Mr. President, as always, I care for the Senator from California. We are good friends. You know, I hasten to point out that her own State of California has approved unborn child State plans. Look, this amendment by definition has nothing to do with abortion since women who seek help covering their unborn children's health are not women seeking abortion. They are separate, and the Senator should not try to mix them. This is not an issue about abortion. This is an issue about a living, unborn child and her or his mother.

I might add that 14 States have approved unborn child State plans, including the States of Arkansas, California, Illinois, Louisiana, Massachusetts, Minnesota, Michigan, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Washington, and Wisconsin have all approved unborn child State plans.

I agree with the Senator, the bill has worked beautifully, the CHIP bill, for the last 10 years. I know. I wrote every word in it and did so with Senators Kennedy, Rockefeller, Chafee, and others, as a matter of fact. But I don't think anybody doubts that I carried the ball in getting that bill through the Finance Committee and the whole Congress.

I see a one-sided attempt here to change the bill in ways that will make it less effective and not cover as many children as it should. Some argue the legislation already gives States the option to cover pregnant women, so this amendment is not necessary. But the distinct difference between this amendment and what is in the underlying bill is that this amendment allows States to cover children before birth. Children have health needs as much before as after they are born, so legislation to promote children's health ought to cover them. Let me emphasize that this is a State option, not a State requirement.

Some argue this amendment is an attempt to inject, as I think the distinguished Senator from California has argued, the abortion issue into a bipartisan effort to protect children's health through the authorizing of the CHIP program. The truth is exactly the opposite. As I said when introducing my amendment, this has nothing to do with abortion. It has everything to do with promoting children's health, and any reasonable person ought to be concerned about the unborn as much as they are the born and, of course, the mother involved. This amendment takes care of all three.

I feel very strongly about this. I do not think anybody should try to make this an abortion issue--not myself, not the distinguished Senator from California, or anybody else, for that matter. I don't see how anybody can vote against an amendment that protects the life of the unborn child after having read the Constitution about its great desire to protect life, liberty, and the pursuit of happiness. That is what this amendment is all about.

I feel strongly about it. I hope our colleagues will support it, because it would be a great thing to help this bill along. I would feel much better if this was amended. I have to admit, I do not feel good about the approach that has been taken by my colleagues on the other side of the aisle.

The fact is that Senator Grassley and I carried the ball for the last 2 years, working with Senators Reid, Baucus, Rockefeller, Durbin, and others; working with the House, Speaker of the House Pelosi, Rahm Emanuel and others who were there, including Steny Hoyer.

We worked closely together to do CHIPRA I. We got an overwhelming vote in the Senate. On CHIPRA II, we got an overwhelming vote in the Senate, enough to override the President's veto in the Senate. I do not think that would have happened but for the bipartisan effort we put together. We had a solid, strong vote in the House, but not enough to override the President's veto.

Now, I have heard people run down President Bush for his vetoes on CHIP. I think President Bush followed the advice of some very young advisers in the White House who basically gave him bad advice. Had he allowed CHIPRA I or CHIPRA II to go through, we would not be having this awful debate today; we would all be together. The whole Congress would have been together, and this whole effort would have been truly bipartisan. We could have set a bipartisan tone right off the bat, instead of this partisan tone that has been set by bringing up the bill without even talking to the two lead Republicans who in 2007 worked so carefully, honestly, and diligently to try and bring about a bipartisan resolution for a new CHIP bill.

And, by the way, we took a lot of flack in the process from some in the administration and some on our side for supporting the legislation in 2007. We took it. We took it gladly. And our colleagues on the other side saw us take it. They saw us stand firm. They saw Senator Grassley and myself stand on the floor, along with a whole host of others, in a bipartisan way, putting together what would have made CHIP even better for the next certainly 5 years.

This bill only funds the CHIP program for 4\1/2\ years, because if they had gone the extra half year, it would have priced the bill out of the marketplace. But I have to say, we are going to have to come up with that money anyway, and end up going that extra half year. So everybody better understand all that is being done today by my friends on the left, ignoring people, like me and Senator Grassley, who have worked so closely with them--and they have a right to do that. I can live with that, as I vote against their partisan bill.

All I can say is they have a right to do it. But it is the wrong thing to do. It is the wrong way to start off this Congress after the President himself has shown such a propensity to want to work together. I have to say, I was there when the President came and spoke to our caucus last Tuesday. He was impressive. He was friendly. He was making every effort to be bipartisan. But he apparently had not fully examined the stimulus bill that has been passed only in a partisan way by

the House. I would call people's attention to the Wall Street Journal yesterday and their editorial on all the bad things that are in the bill; or Investors Business Daily and their editorial, and how that it is not a stimulus bill at all, but a great big potpourri of long-wanted liberal programs that are not going to stimulate the economy the way they should.

I am not saying there is not any stimulus in the bill, but there is not much compared to the cost of the bill. When you add interest to the bill, it is well over $1 trillion. Of course, you know, they keep interest off because that would make it over $1 trillion. But interest is going to have to be paid regardless.

Now, this particular bill on the floor right now is one where I have a tremendous interest, namely, children and children's health. I am going to continue to take great interest in it.

I want to caution my colleagues on the left that they are making a tremendous mistake here. I think we could have had 95 votes for CHIPRA II or CHIPRA I. That would send a tremendous message that has not been sent around here in a long time.

Now, the CHIP program, so everybody understands, already covers children before birth at the States' option. I read off the States that have made that an option, including the distinguished Senator from California's State.

This is not a new policy. It is already working. This amendment simply continues that policy by codifying the HHS regulation. Women who want their babies need this assistance. Women in California and other States want this. Please do not deny this type of basic humane assistance or help for women and their children with a fake argument about abortion. Let's have an abortion debate on another day. Everybody knows I am pro life. I feel very strongly about that. I will stand up for the pro-life position. But it has nothing to do with what we are debating here today. Let's help children and their mothers now.

Let's codify what a whole raft of States have said we ought to do, including the very important State of California, one-seventh of the whole economy, one-seventh, I should say, in size in the world economy today, and a State I have a lot of regard for.

Fourteen states have gone along with this regulation. And, frankly, I do not see one good argument against protecting unborn children and their mothers who want those children covered through the wonderful child health insurance program. This is a very important set of issues.

I yield the floor.

Mr. President, this is not an injection of abortion into the debate. This is a children's health bill. I was the original author of the one that worked so well for over 10 years. A raft of States have determined that they should take care of the unborn through their CHIP programs. It is not an issue of abortion. In the world view of those who support abortion, the fact is, they don't want to give recognition to the unborn child. That is their right, if they want to feel that way. I think it is ridiculous. It is unspiritual. It is ignoring life itself. But to make that part of this debate is the wrong thing to do. We are trying to protect children.

The distinguished Senator from California said: All women are going to be protected by this bill. That is not true. It is a state option so they are covered only if a State decides to cover low-income, pregnant women. We want to make sure that if the state has the option to not just cover the woman but the unborn child as well. Anybody with brains ought to want to do that and ought to avoid the whole issue of abortion, which I am trying to do by protecting the mother and the unborn child and codifying the 2002 regulation.

Section 111 of the bill says there is a State option to cover low- income pregnant women under CHIP through a State plan amendment. Some States have chosen to do that. But why not recognize the rights of the unborn child? To try and make this into an abortion debate because they just don't believe the unborn child lives is another thing. The point of my amendment is to ensure States continue to have the option in the future to cover unborn children, plain and simple, without any ambiguity. We codify the 2002 regulation into law. Frankly, it is about time we do things like that in a children's health bill. But to make this abortion argument is--I hate to say it--completely wrong.

I am concerned not only with mothers, but I am also concerned about those unborn children who deserve the best health we can give them. My amendment gives the States the right to do that by codifying this important regulation. I know some supporters of abortion rights are afraid this will legitimize the fact that the unborn child is alive and is a human being. That is another argument. I agree that argument is right; that unborn child is alive, it is a living human being inside the mother's womb. The point of when the spirit enters the body is a legitimate question, I suppose, to some. But why would we be afraid to protect the rights of that unborn child? Why would we be afraid to do that? Why are folks so afraid if we legitimize the understanding that this unborn child actually is a living being, that somehow or other it is going to destroy their political world? It isn't going to do that.

This is a children's health bill. I take a tremendous interest in it. I not only want to protect the pregnant woman, I want to protect that unborn child. I don't know of any pregnant woman who wants her child who would not want this type of protection. To make this into a bogus argument is the wrong thing to do.

I yield the floor.

I don't want to continue it all day. I do believe there are some people who want to speak on this side. I will just make one or two comments.

Mr. President, let's not pit mothers against their children. This is not an either/or situation. Let's protect both mothers and their unborn children. In fact, the purpose of this bill is to provide health care coverage to low income, uninsured children. The Senator and I simply disagree. This amendment concerns unborn children and covering them. She seems to think it is about abortion. I don't. Her own State is covering unborn children through the regulation of the prior administration. Thirteen other States are as well.

Mr. President, I think I have made the case. Let me say that I ask unanimous consent that Senator Robert Casey be also listed as a prime cosponsor on this amendment, along with the distinguished Senator from Nebraska, Mr. Nelson.

I feel very blessed to have these two very strong Democrats willing to support a recognition that these unborn kids are human beings, they are human life, and that a child health insurance program bill ought to cover them.

With that, Mr. President, I know Senator Bunning is here and I will yield the floor.

Mr. President, I am a cosponsor of the distinguished Senator's amendment. I am proud of him and very pleased to support his amendment on New York and New Jersey, and I rise in support of that Bunning amendment. He is right. Why on Earth should States be rewarded by getting a higher CHIP match rate for covering kids over 300 percent of the Federal poverty level? That is around $64,000 for a family of four.

Now, when we wrote the CHIP bill in 1997, with Senators Kennedy, Rockefeller, and Chafee, CHIP was created to cover children of the working poor, the only ones left out of the whole financial system--not children from families of four whose income is $77,000 like New Jersey's CHIP program or $88,000 like the CHIP waiver the state of New York has filed. And that does not even count some of the income disregards that may raise the income level to over $100,000. It is ridiculous.

My colleague is right. Senator Bunning is right. These two States should not receive the higher CHIP matching rate. I strongly support my colleague's amendment, and I congratulate him for bringing it to the floor. I hope our colleagues will work to support that amendment because it makes a lot of sense.

Mr. President, I ask unanimous consent that Senator Sessions be added as a cosponsor to the Hatch amendment No. 80.

Mr. President, I support this amendment of the distinguished Senator from Iowa. Essentially, what we are doing is striking the Baucus bill being considered on the floor and replacing it with the CHIPRA II bill that passed overwhelmingly in this body in 2007, enough votes to override a Presidential veto. Not one Democrat voted against this bill. Not one.

But what my good friend, Senator Grassley, and I are offering is a bill that represents a solid bipartisan agreement that we worked out with Senators Rockefeller and Baucus. I do not blame Senator Baucus for the mess we are in right now, or this partisan approach to CHIP, because he represents his side. But I do believe there has been a real lack of effort by some on the Democratic side to work with us after all of the time that we spent trying to make sure we had something that would work in the last Congress.

What we have is a true bipartisan agreement where we were there from start to finish. Senator Grassley and I, Senators Baucus and Rockefeller, and those in the House--we spent hours together, months together, working out the details of this bill. We spent morning, noon, and night for 6 months to get the bill to that point. It was built on a foundation of tough agreements and tough decisions. We were part of the process from the very beginning and stayed with the process until the very end. That resulted in a true bipartisan agreement.

The bill passed overwhelmingly in both the House and the Senate by a veto-proof margin in the Senate. Senator Grassley and I worked our guts out, put our hearts and souls into both CHIPRA I and CHIPRA II. We were proud of our work with Senators Rockefeller and Baucus because that work not only reauthorized the CHIP program for 5 additional years, it covered more low-income uninsured children. It retained the original goal of the original CHIP program, which, by anybody's measure, has worked very well over the prior 10 years.

The bill before us today does not represent that agreement. We talked to our colleagues at the beginning and then we were not included in the discussions that evolved into the CHIP bill recently considered by the Finance Committee and now on the Senate floor. We were not even invited. It seems to me once we were not needed anymore we were more or less thrown by the wayside because our votes were no longer needed.

This is not the way to start off the 111th Congress, especially after the last campaign where our President said he wants to work in a bipartisan way, he wants us to get together, he wants us to be able to work with each other, he wants us to accomplish a great deal for this country.

I think I am known for bipartisan work around here, and I certainly have taken a lot of flack for some of the President's Cabinet people I supported, and supported right off the bat, because they were qualified people. I believe the President should have his

choice as long as they are qualified and not otherwise disqualified.

Well, I am going to support this amendment of Senator Grassley's, which represents the true bipartisan agreement of 2007. Now, let me mention a few of the highlights in CHIPRA II.

The amendment states there will be no Federal CHIP dollars for coverage of children over 300 percent of poverty; that is around, $63,000 for a family of four. Now, to be honest with you, when we did the original CHIP bill, we wanted it to be 200 percent of poverty because those kids were the only ones left out of the health care system, the children of the working poor. We did it so we would have enough money to try and cover all of the kids who really qualified for CHIP. Even with that, we found we were not able to get to all of them. So you can imagine, with the current economic difficulties, we are going to have even more pressure to get to more and more kids. If we start allowing states to cover over 300 percent of poverty, which at least one State does and another is in the process of doing, it is not going to be long until this program becomes a Federal Government boondoggle where everybody will expect money from the Federal Government for health coverage.

This amendment eliminates the earmark to allow New York to cover children up to 400 percent of poverty, $84,800. By the time they use income disregards, some estimate that families could be making over $100,000 a year and still qualify for the CHIP program.

Now what does that do? That takes money from the 6 million kids who are low income and uninsured. It is crazy. Yet that is what this bill allows. Senator Grassley and I had to agree to go to 300 percent, which is over $63,000 for a family of four in 2007. But to now go to 400 percent of poverty, admittedly New York City is an expensive place, but New York's rural areas are not that different from other States, except they are taxed to death in the State of New York. But that should not be the problem of everybody in the country.

This amendment includes the bipartisan crowdout policy that addresses the issue of families giving up private coverage in order to enroll in a public program. Our amendment would require a number of studies on crowdout, would improve data collection on the coverage of low-income children, would require all States to adopt these ``best practices'' to reduce crowdout, and would provide the Secretary with the authority to hold States accountable for covering low-income children.

With regard to crowdout, we did our best to stop it so people would not drop their health insurance that they can afford so their kids would qualify for the CHIP program. That is one of the problems with covering higher income families, because, naturally, if parents find they are going to be better off opting for CHIP coverage as opposed to private health coverage, they are going to crowd-out lower-income children from CHIP coverage. That is what this bill really does.

It is a shame because it means less money and less health coverage for those who are truly needy, those for whom this bill was meant.

If we covered the children of the working poor, the only ones who were formerly left out of the health care system, we could probably do a much better job if we kept it to 200 percent of poverty. But Senator Grassley and I agreed to go to 300 percent of poverty in the interest of a bipartisan agreement even though each of us felt that probably was a mistake.

This amendment does not include the controversial legal immigrant provision allowing States to claim a Federal match for coverage of legal immigrant children and pregnant women.

Look, I started the Republican senatorial Hispanic task force. I brought Hispanic leaders from the country to Washington at least twice a year to help us understand how we could better assist Hispanic people. We brought together Democrats, Independents, and Republicans. I have a long reputation of trying to help Hispanic people.

Under our immigration laws, sponsoring families who brought others to this country legally entered an agreement to take care of those individuals for 5 years. It has worked. The current bill on the floor, the partisan bill, wipes that all out. In the process, how many children who are U.S. citizens are going to be left out because we have expanded this program in ways that will not take care of them?

Sure.

Heavens no.

Certainly not. And as the Senator knows, many States today provide that care to legal immigrants through CHIP or otherwise. And let me emphasize that all expenses are supposed to be provided by the sponsoring families for 5 years. If that was the wrong time or it should have been shortened, I would have worked with the distinguished Senator to do that. But that was the deal. That was the rule. That was what we worked on. That is what we thought would work. That is what we thought was fair.

What I don't want to do is have our own children who are U.S. citizens be without care while we cover those who were supposed to be covered by their sponsor families who brought them to the United States.

Yes, it is true. And they would be covered by CHIP.

What about those who were brought in who are not legal citizens? I am not against helping them.

If I may take my time back, I am not against any children receiving help. A lot of these children get help through our system of health care. But I am talking about a CHIP bill that cannot take care of our current children who are U.S. citizens and now we have included a provision that would allow legal immigrants to be covered before the 5 year waiting period.

I might add, many States today provide coverage to legal immigrant children. Many States do that. I commend them for doing it. But I am worried about having a bill that can get broad bipartisan support that literally first covers our children who are U.S. citizens. This bill does not do that. Let's be honest about it, it doesn't. Today, there are as many as 6 million or more low income, uninsured children who are U.S. citizens who do not have health coverage some of whom could potentially not be covered by CHIP because legal immigrant children will now be covered through CHIP. It is my hope that their family sponsors will take care of them. And if not, these legal immigrant children and pregnant women are still going to be taken care of by the States. I don't know of any pregnant woman who goes to an emergency room and who isn't going to be taken care of.

I think this is a principle that is very important. We should be doing what we can do. But what is more important is that we agreed to not include the legal immigrant provision in CHIPRA II. It overwhelmingly passed, and every Democrat voted for it. Now we come up with a partisan approach that basically undermines that agreement. I am very concerned about it. Frankly, I think Senator Grassley is right in bringing up this amendment.

But don't let anybody fool you. There isn't a child I don't want to help. In fact, the way this bill arose, two families from Provo, UT, came to me. Both husbands worked; both wives worked. Both husbands and wives worked. Neither family, at that time in 1994, earned more than $20,000 combined income a year. Yet they were working poor who wanted to work and not be on the dole, but they couldn't afford insurance for their children, who were

the only kids, the working-poor kids, the only kids left out of the process. So we came up with CHIP to try to resolve that issue. Even with that, we were not able to do everything we wanted to do, but it worked amazingly well. I don't know anybody who denies that fact. I don't know anybody who would dispute me on this statement. I would like to see them try.

The fact is, the bill worked well. Over the last 2 years, in a bipartisan way, we worked to try to solve some of the problems that arose, even with a good working CHIP bill. We worked in good faith. All of a sudden, we find a bill brought up here without any input from us that is a partisan bill, that makes it even more difficult to cover all these kids.

Everybody knows I believe in health care, and I believe we ought to cover everybody. I would like to do it, but I don't want to do it by bankrupting the country or making those who do work have to take care of those who don't. I am a very strong believer in helping those who cannot help themselves but would if they could, but I am not very excited about helping those who can help themselves but won't. Unfortunately, we have a few of those types of people in this country.

What galls me is that I know the President wants to work in a bipartisan way. But the House just acts like, so what, we are just going to do what we want to do. I can understand that type of thinking because they were irritated with some members in the House, even though we ended up with a very strong vote in the House. It just wasn't enough to override the veto. They were irritated with some of those who didn't agree with CHIPRA I or CHIPRA II. But in the Senate, we had, as I recall, 69 votes--more than we needed to override a veto. The reason we did is because it was bipartisan.

I don't know how many people are going to vote for CHIPRA II at this time, but I just remind my colleagues that every Democrat voted for it when it came up. Frankly, even if we didn't get it passed because the House sustained the veto, it was a tremendous victory.

I am not going to spend the rest of my life griping about it. But the fact is, it is a shame that with a President who wants to be bipartisan, the first thing out of the box, the first real bill out of the box happens to be a bill that they know Senator Grassley and I worked hard on, that we carried a lot of water on, that we took a lot of flak for in 2007. Then we find out they are going to do something that is just plain partisan, that isn't going to work as well, and it is going to cost the American people a lot more.

I hope everybody in this body will support Senator Grassley's and my amendment on the CHIPRA II bill. If they don't, personally, I can live with it, but I won't be happy. I think what is going on is not fair, and it is a direct slap in the face to those of us who worked so hard with our friends on the other side. And they are friends. I mean, they are all friends. I care for them. But this is a particularly important bill to me. Right now, it looks as if it is turning into just a partisan exercise.

I yield the floor.

Unanimous-Consent Agreement--Executive Calendar

Will the Senator yield?

I don't think I answered the question as well as I would like to. The question was, Do we want any children of pregnant women, legal immigrant children, not to be helped? Twenty-one States already pay for that. I think most of the others do through emergency rooms. They don't go without health care. But what is happening here is that we are taking what 21 States are actually doing and we are basically just alleviating them from having to do that, that which they are capable of doing and wanted to do, and just taking it over by the Federal Government when, in fact, these problems were solved in a way that was reasonable, with not only families taking care of people they brought into this country for 5 years under their obligation but also because the States would take care of them with State money. I wanted to make that clear. I do appreciate working with my colleagues on the other side, but I am a little disappointed that it has turned out this way.

If the Senator will yield, I thank him for his gracious comments. He knows our friendship means a great deal, and also with the distinguished chairman of the committee. I think he is a very fine man who has done a very good job on this committee. But I am going to have a difficult time supporting this bill without some bipartisan approach that would work a lot better than this is going to work. But I thank the Senator again.

Mr. President, this amendment would codify the 2002 HHS regulation which gives States the option of providing CHIP coverage to children before as well as after birth. Fourteen States have already approved plans to provide CHIP coverage to children before birth: Arkansas, California, Illinois, Louisiana, Maine, Minnesota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Washington, and Wisconsin.

This amendment also allows States to provide health services to the mother for 60 days after the birth of her child. In addition, the amendment also would provide health coverage to pregnant women for issues not relating to the pregnancy. This amendment will continue allowing States to promote the health of children and their mothers before and after birth by codifying the 2002 HHS regulation.

I am happy to have a number of cosponsors on this amendment, including the distinguished Presiding Officer. I urge my colleagues to support this amendment.

Mr. President, for the benefit of my Members, I do not think I will use 10 minutes, but it is always dangerous for me to say that.

(The remarks of Mr. Grassley and Mr. Levin pertaining to the introduction of S. 344 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. President, I rise for the purpose of supporting the Bunning amendment. What I say will have some rebuttal to what the distinguished chairman of the committee has said just.

Medicaid and the Children's Health Insurance Plan were created to cover low-income children. An income of more than $63,000 for a family of four is not low income. I know the Senators from the State of New York and New Jersey will argue that $63,000 is low income in their States. I know they will talk about the cost of living in those States.

As an example, the median home price in Des Moines is greater than that in Binghampton, Buffalo, or Rochester in the State of New York.

The underlying bill says all States can cover above 300 percent of the Federal poverty level. I think that should be limited, as it was in the second bill that was a bipartisan bill passing the Senate in 2007. But if we are going to allow States to cover above 300 percent, all States should be treated equally, and an exception for two States--and I might emphasize only two States--is not fair, and it is not

right. This amendment strikes that exception so all States are treated equally.

I urge support for the Bunning amendment that we will vote on in a little over an hour. I hope Senators coming to the Senate floor will take that into consideration. Treating all States favorably is essential.

Amendment No. 83

(Purpose: To provide H.R. 3963 (CHIPRA II) as a complete substitute)

The amendment I am going to introduce is the exact contents of the bill we call the 2007 bipartisan bill No. 2 because that is the No. 2 bill vetoed by President Bush. This amendment I am offering today, I am doing so with Senator Hatch because he was there with me through all of that discussion in 2007 that brought us to a bipartisan bill.

The amendment is the bill that, 2 years ago, Speaker Pelosi called ``a definite improvement on the first bill,'' meaning the first bill the President vetoed. This amendment I am going to soon lay before the Senate is a bill I believe is the best bipartisan compromise we could put together to cover as many low-income children as possible. This amendment is that 2007 bill that told States they could not cover children above 300 percent of poverty level in the Children's Health Insurance Program. Why do we concentrate so much on that level and not above that level?

In 2007, we thought letting States cover children above the national median income diverted attention from the mission of Medicaid and the Children's Health Insurance Program, which was obvious then and still obvious today; that is, that we ought to be putting the emphasis on low-income children.

The underlying bill allows States to cover children up to any income level and, as I said, includes a special grandfathering exclusion for New York to cover children and families with incomes up to $83,000 per year. The second bipartisan children's health insurance bill--that is the amendment before us or that I will put before us now--returns the focus where it has been since 1997 in the CHIP bill. The emphasis is upon getting low-income children into a plan so they have the health care they need.

This amendment is the bill that includes a policy to address the problem of crowdout that was the subject of an amendment yesterday. It is a policy that is not in the underlying bill, which brings me to the question: What exactly went wrong with the crowdout policies that so many of us voted for in 2007?

Certainly, it is not because the Democrats have put forward a policy that addressed crowdout in a better or more efficient manner. Certainly, it is not because the Democrats have new analyses that crowdout is no longer occurring, especially in the expansion of public programs. When Children's Health Insurance Program dollars go to higher income children who already have private coverage, that money could have gone to low-income children. Make no doubt about it, 4 million new people being covered does not take care of the problem of covering low- income children. There are still going to be millions out there who will not be covered whom we ought to have a focus on.

The second bipartisan children's health insurance bill of 2007 that is now the amendment I am going to lay before the Senate returns the focus to low-income children. Finally, this amendment-to-be is the bill that we voted on in 2007 which did not have the divisive legal immigrant issue in it. The underlying bill today has $1.3 billion of coverage for legal immigrants, more than 100,000 of whom already have private or public coverage, dollars that could have gone to cover more low-income children.

The second bipartisan children's health insurance bill--that is the amendment I am going to lay before the Senate--now returns the focus to low-income children. Now, today in the Senate, there are 43 Democrats and 12 Republicans, of which I am one, who were Members of the Senate in 2007 and voted for this bill that my amendment is going to represent.

Those 43 and 12 Republicans who are still here--that is 55 of us--if we would stand together, we could still do great things. We could show that bipartisan amendments still mean something in the Senate. When the vote count ended, we would probably have more than 70 votes for this amendment. Instead, I know if I call for a vote on this amendment, 43 ayes that were cast in 2007 would become ``no'' votes.

After watching the difficulty those 12 Republicans, including this Republican, faced by voting aye and sticking together because we thought we were doing good policy, watching 43 ayes turn to noes on the very same policy is a bitter pill to swallow.

Mr. President, I ask unanimous consent to set aside the pending amendment and to call up amendment No. 83.

Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. President, I yield the floor.

Madam President, I rise for three or four purposes that I will do in succession.

No. 1, I would like to define bipartisanship for the Senator from North Carolina. No. 2, I want to give a statement in support of the Coburn amendment. No. 3, I would like to bring to final debate my amendment 83, if the majority manager would like to vote on it at that time--and that would be a voice vote--and then I would have my last amendment to introduce, which is amendment No. 71 that I would speak about.

First of all, I think I know something about establishing bipartisanship in the Senate. I was part of a bipartisan proposal 2 years ago that maybe Senator Burr didn't like, but it was very bipartisan. It is kind of an institutional thing, bipartisanship, as far as I practice it in the Senate and as Senator Baucus has practiced it, up until this particular amendment. What you do to get to be bipartisan, you sit across the table from each other, Republican and Democrat--and maybe more than one Republican, maybe more than one Democrat--with expert staff, and you build up a piece of legislation that is eventually put before the committee as a Baucus-Grassley bill or as a Grassley-Baucus bill, depending on who is in the majority. Then what you do is you make up your mind that you are going to be arm in arm defending that through the committee process, through the Senate, through conference, and all the way to the President. And you try to maintain 65 to 70 votes within the Senate. That is the way I define bipartisanship.

It is a little bit like if you and your wife were going to buy a new car for that old jeep that you drive around. If you said it is going to be a family affair, you would be sitting down with your wife and asking: What kind of a car do you want? What color do you want? What accessories do you want? You wouldn't go up to your wife, I hope, and say: Honey, we are going to buy a new car. This is what we are going to buy and it is a mutual decision. You wouldn't do that. You would work with your wife to decide what kind of car you want.

So if you want bipartisanship in the Congress of the United States-- and I am sure that is what our President was talking about during his campaign--you have to work together to get it. But it is not like this issue was handled--or maybe I can speak more accurately about the stimulus issue that will be up next week--where 48 hours or 24 hours before it comes up, Republicans are given a document and are notified that this is what we are going to do.

So I say to the Senator from North Carolina, that is my definition on what bipartisanship is. I don't know whether you agree with it, but at least that is what I have tried to practice, and I think Senator Baucus has basically tried to practice that as well.

Madam President, one of the reasons I said I came to the floor was to speak about the Coburn amendment and to say why I am going to vote for it. This amendment, which has been the product of Senator Coburn's and Senator Burr's speeches a few minutes ago, presents a fundamental choice about how we will go forward with health care reform in this country. Now, I wish to emphasize ``how we will go forward with health care reform,'' which is maybe the next health care issue that is going to be before our Senate.

The underlying bill covers 4 million kids. It leaves 2 million kids without coverage. Why? Well, as CBO has told us so often, if you ask State government to go out and cover kids, as we do in Medicaid and the Children's Health Insurance Program, States need more and more Federal dollars to do so. So let's face it, that is exactly how this bill works. We throw billions of dollars at the States, and the States go out and find kids and pay for their health care. The more money we throw at the States, the more kids they cover. The less money we throw at States, the fewer kids they cover.

The Coburn amendment takes a totally different approach. This amendment generally follows the successful way that the Medicare Part D benefit works. By the way, let me say parenthetically about Medicare Part D, which has been law now for 4 or 5 years, it is about the only Federal program I know about that has come in under budget. I am not talking about just for 1 year, I am talking about the projections CBO made for it at that time for the 10 years into the future. I don't have an exact figure in mind now, but maybe 6 months ago I used a figure that was in the billions of dollars that it was under what we anticipated spending.

So we are talking about a Coburn amendment that follows the pattern of Part D Medicare, which works, and it

is financially a protection for the taxpayers' dollars. If the Federal and State governments work together to create a healthier market, the private sector will be more efficient in covering kids. That is the Part D model. That is the model we have before us in the Coburn amendment. It is the private sector, on the one hand, in that philosophy, versus the public sector on the other hand.

I wish my colleagues had more time to fully develop this with the Congressional Budget Office because the contrast this amendment paints is one we are going to be facing in the health care reform. So I wish to emphasize that the next health care debate we have is going to be health care reform and we ought to have that debate and we ought to bring about the reform that is necessary.

So let's think of that as laying the groundwork for a lot of debate that we are going to have in the upcoming issue of health care reform. Basic questions: Do we want a government-run solution? Is growing our Government bureaucracy in the area of health care the pathway to covering all Americans? Or do we want governments to help the market work better; or possibilities of Government and private partnerships? Do we want to harness the ingenuity that is out there in the private sector in covering all Americans?

Now, I don't answer those questions, but those are questions everybody in this body, and I hope grassroots America, will look at in the coming months. With this vote, I am giving you a partial answer to my approach to these questions.

I would like to go on to, hopefully, what will lead us to a vote on amendment No. 83, I believe is the number of the amendment, but before I do that, I would like to speak about an issue that came up when I was off the floor earlier this afternoon. The chairman of the Senate Finance Committee, my friend, Senator Baucus, characterized the Grassley-Hatch amendment I offered earlier as not covering 750,000 individuals as compared to the underlying bill. This is about my amendment 83.

Now, I understand Senator Baucus later came to the floor to acknowledge that his characterization of the Grassley-Hatch amendment was incorrect and he apologized, and I thank him for that. However, the chairman is still inaccurate, from my point of view, in some characterizations of the Grassley-Hatch amendment, and that is what I wish to go into.

The chairman stated my amendment would cover fewer individuals because it does not include the legal immigrant provision. I would like to draw all my colleagues' attention, but particularly Senator Baucus' attention, to footnote ``f'' on the enrollment table of the Congressional Budget Office production on the underlying bill. Footnote ``f'' states:

The Medicaid and SCHIP figures and the Medicaid SCHIP total

may include some legal immigrant children and pregnant women

who receive health insurance provided through State-funded

programs.

In other words, the so-called new enrollments of legal immigrants are actually individuals who are currently insured with State or local funds. In terms of additional enrollment figures, the chairman notes correctly that we don't have a CBO table. He is correct that we don't know the actual enrollment numbers resulting from the Grassley-Hatch amendment.

I would reiterate what I said earlier. The amendment we are going to be voting on is the same bill that 55 Members of this body--and they are presently Members of this body--voted on and successfully passed by a wide margin in 2007. So I have to ask the question, before we vote on my amendment: If it was good enough then, why isn't it good enough now?

If the majority doesn't want to vote on this now, I will go on to offer my other amendment. Do I ask for the question, Madam President, on amendment No. 83?

Madam President, I would, first of all, like to give my rationale for an amendment I am going to present to the Senate before I actually present it. It will be amendment No. 71, though.

Congress has known for some time that the Children's Health Insurance Program faces expiration March 31 of this year. We all knew Congress would have to act quickly once the new session got underway. The majority had three different options they could have taken in moving forward. First, they could have simply picked up one of the two vetoed bills and quickly passed it. It would have received bipartisan support. I would have preferred the second bill over the first, but I could have probably found a way to support the first bill. Either of those bills would have moved quickly and would have had significant bipartisan support.

The second option the majority could have taken was to do a short- term extension of the Children's Health Insurance Program while we worked on broader health care reform. That is what this amendment does. It is a six-quarter extension of SCHIP through the end of the next fiscal year.

Now, I do understand there is a point of order against this amendment. This amendment actually should have been done on the stimulus bill, where everything and the kitchen sink appears to be going, but that is a debate for next week. It would have been a drop in the bucket on that bill.

If the underlying bill is enacted, it will provide coverage to many people who were previously uninsured--approximately 4 million children--by the year 2013. While I don't want to denigrate the accomplishments of this bill, everyone in this Chamber knows we need to roll up our sleeves and get to work on covering the other 42 million uninsured Americans who will not benefit from this bill--millions of whom are children this bill does not provide coverage for.

I wish to focus on that task. I want us to work in a bipartisan manner to get coverage for all Americans, and everything in that process so far has been bipartisan, but it is something we are going to have to deal with on SCHIP again. So I am willing and ready to do the hard work it is going to take. We could have set aside SCHIP while we focused on that most important task of full-fledged health care reform. Instead, the majority has chosen a third option: to bring up a bill that walks away from the bipartisanship of 2007 and threatens relationships moving forward with broad health care reform. I want to emphasize ``threatens'' because so far everything has been bipartisan in meetings and discussions and everything.

I have made no secret of my disappointment in the changes made in the underlying bill. It is very important that people watching the debate understand how totally unnecessary a

partisan fight is. The majority had bipartisan bills they could have brought up for consideration. I had an amendment earlier that would have replaced the underlying bill with the second of those earlier bills. The majority could have done a simple extension of SCHIP while we worked together on covering 46 million uninsured, not just the 4 million covered by this legislation. That is what this amendment does. It is the last chance for cooler heads to prevail.

It was reported recently that the Speaker of the House said, ``We won the election. We write the bills.'' Seeing the majority take that approach on the Children's Health Insurance Program, an issue that always had broad bipartisan support, does not give me comfort moving forward on health care reform.

I ask unanimous consent to set aside the pending amendment and call up my amendment, No. 71. I do not know how much debate there will be on it, but I have nothing more to say on that amendment.

Mr. President, I wish to emphasize that I do not disagree with what he said, he said it accurately, but here is the point I am trying to make. In just a few months, we are going to be working on health care reform and we are going to be working, within those few months, on how the Children's Health Insurance Program fits in with it. We are going to be going through this exercise once again, so we wasted a lot of time here for nothing.

I yield the floor.

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

Mr. President, in closing today--and I know we have a few votes, but we are about done--I wish to talk about bipartisanship. I believe I have a history of getting bipartisan compromises done. Over the last several years, I have worked to deliver important bipartisan legislation on taxes, trade, and health care. We work together, we make commitments, and we sometimes have to say no to Members of our own party who would put their specific interests ahead of bipartisanship. It is tough at times, but when we work together to produce legislation, we are better off for doing so.

Lately, I have seen a disturbing change in the way bipartisanship appears to be working around the Senate. Last year, on Medicare, we were working together for months--I am talking about for months--on a bipartisan bill to extend a lot of things in Medicare. It was jointly drafted. There were many provisions in the bill I strongly supported. But when we came to an impasse on some of the tough political issues, the majority solved the tough issues the way they wanted them and moved forward. That is not the way I think bipartisanship should work.

Then we have this bill before us today. It is largely the work of Senators Baucus, Hatch, Rockefeller, and myself. It should be a bipartisan piece of legislation, but it is not. In this case, the majority decided to make some very political changes in the bill and presented it to us as a ``take it or leave it'' proposition. Today, I choose to leave it.

Some Senators have tried to argue that this bill is 90 percent the bill we voted in 2007. I wonder that those Senators don't realize how insulting it is to me to hear that. It is an open admission that the majority unilaterally changed 10 percent of the bill and has presented it to me as a take it or leave it; it can still be bipartisan, Chuck Grassley, if you will just do what we tell you to do.

The stimulus bill coming next week is no better. We were presented with a bill and asked if we wanted to sign on to it and call it bipartisan. That approach shouldn't come as a surprise to anybody or much of a surprise at all. As the Speaker said: We won the election, we write the bills. I must admit I appreciate why House Republicans decided yesterday they would not sign off on Speaker Pelosi's version of bipartisanship.

We need to get back to real bipartisanship around here.

I yield the floor.

Mr. President, I suggest the absence of a quorum.

Mr. President, this is where you get the wool pulled over your eyes. Here we are, in the last moments of a very partisan debate, and we have one last vote to abandon further compromises we made in 2007. This one weakens fraud protection.

In that bill 2 years ago, we reached a carefully crafted compromise, balancing access and program integrity. With this amendment, the majority backs away from that compromise further. In 2007, we agreed that an express lane application would require a signature from the applicant acknowledging they were applying for Medicaid or SCHIP. This change eliminates the signature requirement.

It is not technical, it is substantive, and it is going to lead to fraud. We should vote this down because we don't want to promote fraud.

Mr. President, I ask for the yeas and nays.

What do you mean there is not a sufficient second?

Mr. President, people on my side asked for a vote. That is why I am asking for it.

I ask for the yeas and nays.

Mr. President, with great respect for my friend from Utah, I rise to oppose his amendment, not only as a Senator but as a mom and a grandmother. What the Senator is seeking to do essentially is separate the woman from the child she is carrying, separate her from her pregnancy. I think I can speak with authority here. I know my friend is a grandpa and a dad and has a magnificently beautiful family, but I gave birth to two kids. I can assure my friend that when you cover the pregnant woman, you are covering that child from the time that child is a fetus to the time that child is born.

I would just say that it appears to me as if this amendment is a diversionary amendment from this very important bill to expand and improve the health of our children, including the health of our moms who are pregnant, a diversion to a debate about when does life begin-- let's fight about abortion. You know what, we will have many opportunities to have that argument. When we have that argument over Roe v. Wade, I think pro-choice will prevail. But this is not the place to have that argument. This is a place where my friend from Utah and I should walk down this aisle being very happy that under this law that is before us, this bill that is before us, States absolutely can choose to cover a pregnant woman. This is a big step forward, and this is very important.

Again, I think the idea behind this amendment is to divert us from this

very important bill. In my State, it will expand coverage to more than half a million kids and many pregnant women.

The debate over when life begins and all of that is a very philosophical debate. My religion may teach something other than my friend's. I totally respect every view on that subject. I also respect the women of this country and the view they bring through their moral code and their religion and whatever else they bring to the table as human beings. On the day we debate that, I will be out here debating it, but I am not going to get into this debate with my friend today over when life begins. Today is a day where we are going to work on making sure that our children are covered with health insurance and that our pregnant women are covered with health insurance. The good news I bring to the Senate today is that under this bill, pregnant women will be covered by this. This is very important.

Again, to try to separate the woman from the child she is carrying, from the fetus in her womb, is nonsensical. Maybe my friend sees it another way. But when you take care of a pregnant woman, you are taking care of her fetus, you are taking care of her pregnancy, you are working hard to make sure that baby is healthy.

I just became a grandma 3 weeks ago, and my daughter had excellent health care. I want to assure my friends on the other side of the aisle that as she was being treated, so was the child she was carrying, my beautiful grandson.

Let's not take a beautiful bill and start fighting over an issue that has been a philosophical argument forever--what is the point at which life begins? My religion teaches me one thing. My friend's religion may teach him another. Who is right? Who is wrong? All we, as humankind, can do is to give our best effort to figure that out. But in this bill, what we are trying to do is bring health insurance to pregnant women, bring health insurance to our kids. To divert it with this subject is a disservice to the bill that is before us.

I know my friend is passionate on this point. I totally respect him for that. But I hope we will defeat this amendment because it is a diversion. It is a fight about Roe v. Wade. It is a fight about whether a woman has a right to choose, and it does not belong on this bill.

Mr. President, I yield the floor.

Mr. President, my friend from Utah says he wants an honest debate, and then he says, and I am quoting him--not word for word--he says, pregnant women are not covered in this bill. That is a dishonest debate.

States have the option to cover pregnant women, just as under the Bush regulation they have the option to cover the unborn child. Okay? So let's straighten it out.

My colleague has mentioned my State several times. My State was so anxious to cover pregnant women that they did cover them under the unborn child regulation which was put into place by George Bush, because he injected the whole abortion debate into the CHIP program.

What we do is we get away from that. In this bill we talk about covering pregnant women. So for anyone to stand up here and suggest that the only way to cover pregnant women is by codifying George Bush's regulation that, by the way, this Chamber voted down twice--let's be clear.

My colleague says that this is a left-right issue. This is not a left-right issue at all. When my colleagues voted on this a couple of times before, it was bipartisan to reject the Allard amendment, which was to codify the very law that my friend is suggesting we do today. I will predict we will defeat this by a much bigger margin, because of the elections that were just held.

I say again, with all respect, anyone who in their heart wants to cover pregnant women, which means covering the child they are carrying, should be very proud of this bill. Because that is what we do. So to stand up here and say we have to codify George Bush's wording on this, which was ``unborn child,'' saying if we do not pass this amendment, pregnant women and their babies are not covered, this is a straw man or a straw person. Pregnant women are covered. The fetus is covered from the minute that woman goes to the doctor until the minute she gives birth, and through all of those times in between. It is the ability of the States to do it. But we refuse in this bill, and I hope we will continue this, to put forward such a divisive issue and an argument that does not belong on this bill.

If my friend was right, if he stood up here and said, right now pregnant women are not covered, I would go over there and say, well, let's work out some wording to make sure they are covered. But we do not have to do that. They are covered.

What my friend wants is to codify what George Bush put into play, a political decision to inject abortion politics into a children's health bill. I think it is a sad day for the children of this country to be drawn into a debate. And, again, mentioning my State several times, when my State had no choice. If they wanted to cover pregnant women, they had to cover them under this. Guess what. Now they will not have to do it, because this bill corrects the problem.

So I have to say, when my friend says it is a left-right debate, it has nothing do with left-right, and he knows it. In my State, some of the strongest pro-choice constituents are Republicans, and some of the strongest pro-life constituents are Democrats. This is not a left-right issue. It is an issue we all address in our own way using our own logic, our religion, our moral values, and we come to a conclusion.

Do not inject it into this bill. I hope we reject this, because this is now the second abortion-related amendment my Republican friends have offered in as many days. If that is what they think this election was about, I think they are missing something. People want our kids to have health care. They want our families to have health care. They want to solve the economic problems.

Today we learned there are even more jobless claims. Millions of people are unemployed. And we are having our second abortion-related vote. I think if this party, this Grand Old Party does that, I see several colleagues who may say, well, it is your right, it is your privilege, I will debate you. I think we will prevail today.

But if every single bill we bring forward turns into an abortion- related debate, I do not know where my colleagues are coming from. Because let me reiterate, every pregnant woman has the right to have this health care option should their State choose it.

We do not need to change the language and codify a very divisive amendment which was a regulation under George Bush. It should be a new day around here. We should not have to have this division. But I have already heard they may offer more abortion-related amendments on this children's bill.

Who knows what is to come? But you know what, I think my leader, Harry Reid, is right. Let them come at us with these amendments. Let the American people see the priorities, when everyone knows every pregnant woman is eligible for coverage. To now indicate they are not unless my friend's amendment passes is simply, if I could say, an out and out falsehood. It is not true. It is not true.

I have the bill. I will read the section, if my friend needs me to.

I ask unanimous consent to print in the Record the last two votes we had on this very same subject where those trying to inject the abortion issue failed.

Again, I want my colleagues to understand, we are debating a children's health care bill. Happily, I can say every pregnant woman in this country is eligible for health care. It is a wonderful thing. We avoid the divisive language of my friend's amendment which is codifying something George Bush put into place. It was not supported in the Senate. It was not supported twice. I respect his right to offer it as many times as he wants and let the American people see what we are debating. My State wanted so much to cover pregnant women, they said: We will go along with this language. But now they will not have to. They don't have to get engaged in an abortion debate, when you are serving children. I view this, frankly, as a needless debate. If the issue is covering pregnant women and their children, we have taken care of it. If this amendment is about injecting abortion and when life begins, it definitely succeeds.

I hope the Senate will speak loudly and clearly, regardless of how one feels about when life begins because that is not a partisan issue. Everybody comes

to their own conclusion. This is an attempt to inject the abortion debate into a children's health care bill. It is diversionary. It is unnecessary. We should be so proud this bill covers every pregnant woman. It is one of those moments we could walk down the aisle together saying isn't it wonderful because pregnant women will get health care. That will lead to healthier children. We all know that.

I yield the floor.

Mr. President, the reason I want to respond to this, my friend is so eloquent, and he is such a great debater, but I have to bring us back to reality. If you are standing here today because you care about kids and you want to make sure pregnant women get all the health care they need so if there is trouble in the pregnancy, if there is a problem--there are so many miraculous things that can be done, and I have seen some of those in my own family, the things they can do to make sure a child is healthy. If the purpose of my friend, out of his love for his children and all children, which I know he has--if my purpose in supporting this bill is to make sure children are healthy, if that is our purpose, we could be very proud of this bill.

This bill says--and I will reiterate this as long as I have to--every single poor pregnant woman in America today is eligible for health care during her pregnancy, from the first day to the last day. Then, of course, a poor child would continue to get that health care. So anyone else who says that isn't true simply hasn't read the bill.

I ask unanimous consent to print in the Record, so my friend can't say something that is without rebuttal, page 50 of the bill, section 2112, which talks about low-income pregnant women to be covered through a State plan amendment.

Let no one stand and say that unless we support the amendment of the Senator from Utah, a pregnant woman and the child she is carrying will not get coverage. That is false. What my friend wants is to codify George Bush's regulation that he correctly pointed out my State adopted. Why did my State adopt it? They were forced to adopt it if they wanted to cover pregnant women. They had to use that language of the unborn child. This is all about the abortion debate. It has to be. Under this bill I support, every pregnant woman is covered or is eligible for coverage. Under the amendment my friend is offering today, every pregnant woman would be eligible. So it is just about the language. That is the fact.

Let me repeat that. Under the bill, every pregnant poor woman is eligible for coverage. Under the amendment of my friend, every poor pregnant woman is eligible for coverage. What he insists on is that you have to separate the woman from the child she is carrying in order to make a political point about when life begins. This is not the appropriate time to have that debate. Believe me, I look forward to the debate. We have had it on the Senate floor. Tom Harkin had an amendment a couple of times to say that Roe v. Wade ought to be codified. It should not be overturned. We had votes on that. By the way, we did win that vote. But that is not what this is about. This is about making sure every pregnant woman gets coverage. Instead of being happy about it, my friend is agitated about the language and wants to write it in his way so we can then get into a debate about when life begins.

How you would ever separate a pregnant woman from the child she is carrying goes against nature. I have had two kids. I know. It is all about health care to the pregnant woman. When the child is born, it is about health care to the woman and, yes, the baby. My friend can stand here all he wants and say I am the one who is injecting abortion into this debate. I am not the one offering a divisive amendment. I am not the one raising the subject matter of when a fetus is a separate life from the mother. That is for another time. We have work to do. We have people struggling in this country. My friend attacked the stimulus bill.

By the way, that debate is coming as well. But the one area I know we should be able to work together on is making sure our kids are healthy. We should walk down the aisle together being very pleased we have taken care of that in this bill. Believe me, the more people lose their jobs and they can't get another one, the more this program is going to be necessary.

I hope we can have a vote on this in the near future. I guess I would like to ask my friend if he wants to continue this debate. I can stay all day. But I didn't know what his plan was.

I yield the floor at this time and retain my right to respond.

Mr. President, if I might have a moment before Senator Bunning speaks.

Thank you, Mr. President. Because some of the things that are said around here--and, by the way, we will have a whole list of Republicans helping us to defeat this, so I am

not going to name people. But let me say this: To stand up and say we are pitting a woman against her child when we support this bill that makes eligible for coverage every pregnant woman is simply a hurtful and untrue remark, especially to say it to someone who adores her children and her grandkids, and I take great offense. It is the opposite.

This amendment separates a woman from her child because instead of saying you are going to cover a pregnant women, you are saying you are covering the unborn child. And what about the woman? She is not even mentioned. I take offense at that line of attack.

We say when you cover a pregnant woman, you cover her child, you cover that fetus from the moment that woman goes to get health care. What my friend does is separate the woman from her child by saying we are going to give the child health care while the child is in the womb and do not even mention the woman--do not even mention the woman. So who is separating the woman from her child?

Again, it is very clear that this is about the abortion debate. And as many times as my friend says it--and he raises my State again, so let me say again, yes, many States did provide health care under this definition of unborn child. They had no choice because President Bush put a regulation in place, and if my State wanted to help pregnant women, they had no choice but to help them under that particular regulation.

Well, what we are doing today is saying to States: You do not have to get into the abortion debate. If a woman is poor and she is eligible for Medicaid, and she is pregnant, she gets the health care as well as the baby she is carrying.

So do not say that those of us who vote against this amendment are separating women and children. It is the total opposite. For whatever reason, under that old regulation, the child was mentioned and not the woman. That defies science. That defies reality. You treat the woman and the child she is carrying.

So, again, I take offense at this. I do not want to be jumping up every time, but I will if there is something said here that is not true. I have total respect for the other side on the abortion debate-- complete respect for them. And that is what this is about, and they know it. Because if they only cared about the pregnant woman and her child, they are taken care of in this bill.

Mr. President, I thank you very much, and I yield the floor.

Mr. President, the Hatch amendment would codify the divisive Bush regulation that only covers the unborn child but not the mother. In other words, they separate the two. What we do in the underlying bill is we cover both. We cover the pregnant woman and the child she is carrying. There is no reason to have this amendment. Look at page 50 of the bill. It clearly states that prenatal care will be delivered to that pregnant woman. This is about adding abortion to this debate. It doesn't belong in this debate. It is not necessary. We have already voted this down twice. I trust we will vote it down now.

I ask for the yeas and nays on the amendment.

Madam President, I move to reconsider the vote.

Mr. President, I move to reconsider the vote, and I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Amendment No. 86

Madam President, I ask unanimous consent to set aside the pending amendment and call up amendment No. 86.

I ask unanimous consent that the reading of the amendment be dispensed with.

Madam President, the bill we are considering is designed to help low-income kids have coverage and have care. What do we know about the kids who are in those programs and the care they have? Here is one of the things we know: They don't have access to 60 percent of the doctors in this country because the reimbursement rates are so low they won't be seen. That is the first thing. No. 2 is they don't have access to the best drugs because a lot of Medicaid programs and SCHIP won't pay for the best drugs for those children.

I got to thinking about this bill and what it does and what it is intended to do. What is in agreement in the Senate is that we want all of the kids covered. We want every child in this country to be able to have access to quality care with no limitation of their choice of who their doctor is going to be--the one the child and the parent feel the most comfortable with--because we know if that is the case, they are going to be most compliant. So we want them to have the greatest care, and we want every one of them to be able to have access to care.

This bill brings up Government payments under SCHIP to 300 percent of the poverty level--60,000 bucks, essentially. Anybody making, essentially, over that wouldn't be benefited by this bill but everybody under it. It adds $70 billion worth of taxes to the American people to be able to do that. As it does it, it takes 2 million kids who are presently covered by insurance off insurance and gets 2 million out of the 8.9 million or 9.8 million kids who aren't covered today with anything. So we are going to spend $70 billion to get 4 million kids, a little less than 4 million kids covered, of which we are going to absorb the costs that are already being paid by businesses for those kids right now.

By the way, I ask unanimous consent to add Senators McConnell, Enzi, Cornyn, DeMint, Johanns, Kyl, Alexander, Graham, Burr, Chambliss, Thune, and Barrasso as cosponsors of the amendment.

So maybe it is instructive for us to look at what we are doing right now and say: What could we do with that money? Right now, we have 31 million kids in America who don't have private coverage. In other words, we have 31 million out of the 78 million kids who don't get to choose where they want to go, don't get to have the best drugs, don't get the referral to the best centers, don't get the referral to the best doctors because they are on a Government-run program. So 8.9 million kids aren't even covered by any program right now, and not all of those 8.9 million kids are in families who are at 300 percent of the poverty level or less. This is based on 2005 numbers, and we know it is greater now, but these numbers for the number of children are accurate right now. We are spending $67 billion to do that.

What does that mean? That means we are spending $2,160 each to cover 22 million kids. Well, if you divided the 31 million kids who are out there into this number, you would get $2,160 available for every child at 300 percent of the poverty level who is not covered right now by their parents, and that includes Medicaid and SCHIP. So you have $2,160 to work with.

Now, the average price in the individual market in this country is less than $1,200 a year. Some will say: Well, that coverage is not as good. Well, let's make it $1,700, which is $300 more than what our kids cost. Let's make it $1,700, or let's make it $1,800, or let's make it $2,160. What could we buy for $2,160 for every kid at 300 percent of the poverty level or less who is not on the program? What we could buy for all of them is a top-grade policy outside of Government-run programs that would give insurance to 100 percent of the children who don't have insurance and give them 100 percent access to every quality doctor in this country on a competitive basis and give them access to the drugs the Members of Congress' kids have access to and the same doctors to whom the Members of Congress have access.

The important point is, we have a government-run program and the administrative costs and the inefficiencies of it cost more than private insurance, than if we would just go out and buy every one of these guys an FEHPB--Federal Employees Health Benefits Plan--a top- drawer plan. Why would we run it through the Government? Why would we take away choice? Why would we take away access by running it through a government-run program and one that is highly inefficient?

There is another thing we should know. The rate of fraud in private insurance products is about 3 percent. The rate of fraud in Medicaid is 10.4 percent, and in SCHIP it is 14 percent. So because the Government is running the program and we can't run it well and we don't run it well, we are losing about 11 percent or 11 cents out of every dollar that we are trying to get to kids because we can't run efficient or effective programs.

So wouldn't it be smarter, rather than to have all of this gobbledygook government, to make sure that every kid in this country whose parents don't make $60,000, who isn't covered with insurance today, has access to a top-drawer health insurance policy that gives them 100 percent access, gives them 100 percent quality, and gives them 100 percent access to the drugs and the physicians they want? Who is going to argue with that?

As a matter of fact, several of my colleagues are cosponsors of the Healthy Americans Act, and that is exactly what it does. It is going to be very interesting to see if they are cosponsors of this bill but yet don't vote for this for kids. And that is a bipartisan bill. So if it is good enough for all of America and if it is good enough for the Members of Congress and their kids and if it is good enough for Federal employees, why can't we give that to the children of this country who don't have health insurance? Why can't we do that? We can't do it because it doesn't fit into the partisan rancor of Washington.

This is a commonsense proposal that doesn't cost a penny more than what we spent in 2005. And we cover all of the kids, not just 4 million more; we cover 8.9 million more with the same amount of money. All the children have access.

It is not a child's fault if their parents can't afford or don't have a job that gives them access to 100 percent of physicians or access to the best medicines or access to equal care. It is not the child's fault. So if we are going to spend this much of the American taxpayers' money, why don't we get value for it? Why don't we decide we want value for this money?

So if you take all the kids out there--31 million--on what we spent in 2005, you can spend $2,160 on every one of them--every one of them-- and get them a top-drawer health insurance policy. Top drawer. Top of the line. That is almost double what the charge is for an individual policy now. So we could spend almost twice as much to get that same coverage. Why would we

not do that? What is going to keep us from helping all the kids?

I will tell my colleagues the other aspect of it. We are also not going to raise taxes $71 billion if we do this plan. Let me say that again. President Obama said your taxes won't be raised. This bill raises $71 billion--granted, from tobacco products, which I don't have any objection to--but let's save the $71 billion on tobacco products for something else when we can efficiently buy our kids health care and buy them a health insurance policy.

Another key point: As somebody who has cared for Medicaid kids and Medicaid moms, when you have the ``Medicaid'' stamp on your forehead, it is not equivalent care. When we give all these children access to a private insurance policy of their own, it is no longer a Medicaid program, it is their insurance policy. Providers will never know how they got that policy. They will never know if it was an employment- based policy, an individually bought policy, or a policy that comes through SCHIP and Medicaid.

What we do is we take the demeaning qualities and characteristics of having to be dependent through a government program, and we throw that out. So the bias goes out, the discrimination goes out, and the self- esteem goes up.

What will happen if this passes? The first thing that will happen is we will save $70 billion. The second thing that will happen is not 4 million kids--actually, it is a net 2 million kids will get coverage-- 8.9 million kids will get coverage, and we will do it with the same amount of money we spent in 2005. Every child will be covered. There will be a real choice of who is going to be your provider. Right now you get hustled into whoever will take care of you in these programs. Some are great and some are not. Confidence will be restored. There will be increased quality of outcome and increased access to specialists who now today cannot afford to see a Medicaid or SCHIP patient because their overhead is so great.

Finally, $70 billion--I know we are talking about $1 trillion in the stimulus package--doesn't seem like much, but $70 billion is a lot of money. If you look at it, it is about $2,000 per man, woman, and child over the next 5 years that we will save in this country.

If the goal of SCHIP and all the speeches we have heard all week long is to care for kids, to make sure kids have access, to make sure they have care, if that is the goal, then anybody who is not going to vote for this amendment is not secure in saying they want to cover all the kids. This one will.

This substitute allows the Secretary to develop autoenrollment. There is $100 million in this amendment so we can have outreach, trying to get kids coverage. This takes away the negative consequences of applying for Medicaid or applying for SCHIP when your parents cannot afford to get you coverage.

The other thing it does is there is a compensation in terms of making sure we help people who have insurance keep their insurance by compensating to keep them on their employer's insurance, which costs a whole lot less. It costs maybe $200 or $300 a year. But the most important thing it does is it provides liberty and freedom and equal access for every child in this country.

They are going to say this will not work. But notice there is not going to be a point of order filed against this amendment because this amendment does not cost any money. It saves money. It does not cost a penny. It will not cost us and will cover so many more children.

My question to my colleagues, as we wrap up the SCHIP bill, is: Do you want to do it right? Do you want to do it better? Do you want to cover all the kids. Or do you want to play the games of Washington and political gamesmanship and partisanship and say: Yes, I care about the kids, but I couldn't do the right thing, the easy thing, the commonsense thing, the things that are associated with order, priority, and common sense that says: Gosh, we can buy and get better coverage for less money; why wouldn't we do that?

We are going to hear all the reasons. We may not hear any because most of the amendments I offered nobody will debate them. They know they have the votes to defeat them so they will not debate. They will not come out and say why this would not be a good idea.

The American taxpayers ought to think: Here is a great opportunity for us to save a ton of money and do something very good socially: cover innocent children with quality health care that they do not have access to today, with no increase in cost--with no increase in cost. Yet we are going to see a vote where they are going to say no. Then we are going to know if you care about kids and whether you care about access for kids.

I will end my debate at this time and yield to my colleague from North Carolina, Senator Burr.

I ask unanimous consent to add Senator Vitter as a cosponsor.

Mr. President, first, this does not get rid of the system, and it certainly does not privatize it. What it does is it guarantees every child in this country, all 3l million--which is something this bill does not do--all 3l million who don't have an insurance policy today will be insured with a plan equal to what we have for our children.

What it doesn't get rid of is access. They only have access to 40 percent of the physicians now. It gives them access to 100 percent of all the physicians. We are defending a system that, first, is only going to enroll 4 million new kids, is still going to leave 5 million not covered and 2 million of the 4 million they enroll are from those who already have private insurance, and we are going to say we will stick with a system to take care of the ones we have now and we are not going to give real access, and with the not real access comes no choice of a physician because we limited the number of physicians who can participate because of the economics of it.

I will tell you what it does get rid of. It gets rid of $70 billion of taxpayers' money that we are not going to use to cover every one of these kids. Based on the 2005 numbers, we can buy a premium health insurance policy for all 31 million kids--the 8.9 million who do not have any coverage now and the 22 million who are covered in either SCHIP or Medicaid today. We save all the administrative expense. We autoenroll them so we don't have to worry about picking up only 4 million with an additional $70 billion in taxes.

To say this is privatization is a total mischaracterization of it. What it does is it guarantees that all children will not have a Medicaid stamp or SCHIP stamp on their forehead that says: Yes, we are giving you coverage but you can't see all the physicians, you can't get referrals to the best because you have a government-run program.

Not only do we increase access and quality, we save tremendous amounts of money, and it will still be a government-run program because it will be administered by the Secretary in a way that guarantees these kids are autoenrolled. They will have premium health insurance coverage and we still save money, even after that. We are spending $2,160 per kid now based on 2005 numbers, and we will cover every one of these kids and not spend more money than that.

To characterize this as getting rid of coverage is wrong. What it does is greatly create and increase access for children in this country to have the same access that our children have. It saves money and markedly improves quality for those children. Every American child ought to have access, and what we do is take the money we are spending now and spend it more wisely, and create a system where they all have coverage.

I yield the floor.

Mr. President, this amendment really is the amendment that is going to take care of our children. It is going to take the Medicaid stamp and SCHIP stamp off their foreheads. It is going to create access to the finest doctors, not just 40 percent of the doctors as we see in Medicaid and SCHIP. It is going to give the same care to all the children--those at the 300 percent poverty level and under-- that we give to our own kids. It does all that not spending the $70 billion in increased taxes that is in this bill and auto-enrolling children so that we don't just pick up 4 million kids, we pick up all 8.9 million kids who are not insured.

To my colleagues who sponsored the Wyden bill, the Healthy Americans

bill, that is exactly what is in that bill, except we are going to do it for children without increasing costs but increasing the quality, increasing the care, and increasing the outcomes. We are going to truly make children on the same level we are in terms of their access. They are going to get to choose their doctor rather than have their doctor chosen for them. They are going to get a referral to the best rather than to one who will just take them. They are going to get the same thing we get, and they deserve it, and we are not going to spend a penny more than we are spending today.

We don't do away with SCHIP, we don't privatize SCHIP; what we do is say we really care about kids and we are going to give them the same thing we have. At the same time, we are going to save the American taxpayers $70 billion.

I yield my time.

Will the Chair state what the amendment is?

Mr. President, what this amendment does is it says you have 14 percent improper payment rate in SCHIP, we have 10.6 percent improper payment in Medicaid. The average improper payment rate across the rest of the Federal Government on every agency--this amendment says that before New York can go to 400 percent, they have to bring their improper payment rates in line with the rest of the Federal Government. The improper payment rate in New York--New York alone--accounts for 50 percent of the fraud in Medicaid. Fifty percent of that is in New York State alone.

So what this amendment would do is it would delay the improper payment reporting requirements and limit earmark program expansion until the Medicaid and SCHIP improper payment rates match the Federal average of improper payment rates. It is meant to help us get back on track. We just started getting improper payment rates on Medicaid, and they are out of control. We should not be delaying the onset of that, and we should put teeth into it so that where it is bad, we don't expand it and make it worse.

With that, I reserve the remainder of my time.

Mr. President, I ask for the yeas and nays.

I agree. I withdraw my request.