Floor Statements

Madam President, I strongly urge that the Violence Against Women Act come up on the floor so we can look at the issues and debate them in an open and public forum. If people have amendments to either add or subtract from the bill or improve the bill, let's do it because this is a compelling situation.

I have been here since we passed the first bill in 1994. The original architect of it was Senator Joe Biden, who is now our Vice President. Why did we do it? It is a compelling need. One in four women will be the victim of domestic violence; 16 million children are exposed to domestic violence each year; 23 million will be a victim of physical or sexual violence--20,000 in my State of Maryland.

Since we created the legislation in 1994, the national hotline has received over 1 million calls when women felt they were in danger. So those 1 million people had a chance of being rescued. Who has the biggest request for passing the Violence Against Women Act? It is not only the women of America; it is also local police. One out of four police officers killed in the line of duty is responding to domestic violence calls. When they go to a home, they have a checklist to determine how dangerous the situation is. Is it simply a spat or a dispute or are they in a danger zone?

We debate big issues--war and peace, the deficit, and all these are important--but we have to remember our communities and our families. I think if someone is beaten and abused, they should be able to turn to their government to either be rescued and to put them on a safe path and also to have those very important programs early on to do prevention and intervention. We fund this bill. I stand ready to support the passage of the bill and putting the money in the checkbook to support it.

I will leave time now for other Senators. I will yield the floor, but I will not yield on this issue.

Mr. President, I come to the floor today to fight for a paper company in western Maryland called Luke Mill. I am fighting for the jobs it creates in western Maryland, and I am fighting to make sure its workers have a government on their side.

I have worked with the leadership at Luke Mill for decades. It is one of the last large employers in western Maryland. These jobs provide good wages and good benefits for Maryland workers and their families. When it was owned by the Luke family, I was in frequent contact with John Luke about challenges the company was facing. We talked about ways the Federal Government could help his business and where it should just stay out of the way.

When unfair trade practices of China were threatening the viability of Luke Mill and the jobs of its workers, I was on the side of Luke Mill. I contacted the Department of Commerce and represented Luke Mill before the International Trade Commission to make sure China and other countries had to play by the rules in trade. As a result, we saved the jobs of American workers who were threatened by an uneven trade playing field.

When the management at Luke Mill called me about EPA's Boiler MACT rule, I took their concerns to the highest levels of EPA. Luke Mill told me that the regulations were too expensive to implement companies needed more time to comply and EPA needed to use accurate data to set emissions standards.

I heard these concerns and took them directly to EPA Administrator Lisa Jackson. Here is what we accomplished: No. 1, EPA produced more targeted emissions limits under the regulation; No. 2, EPA reduced the cost of compliance for businesses by 50 percent; and No. 3, companies could have as much as 4 years to comply.

EPA's compromise rule is not perfect, but it is significantly better than the first draft. From the day I heard about EPA's Boiler MACT rule, my priorities have been the same. I am fighting to protect the jobs in western Maryland, and I am working with EPA to reach a compromise that gives flexibility to businesses to comply without abandoning my environmental principles. But I also will not abandon western Maryland or the jobs that depend on Luke Mill's viability.

I will continue to fight for American jobs and the viability of American business.

I yield the floor.

Thank you very much, Mr. President.

Mr. President, what is the parliamentary situation?

Mr. President, I ask unanimous consent to extend the time on the Democratic side for 15 minutes.

Thank you very much. I want to thank my colleagues who have spoken on this amendment, particularly those who oppose the amendment.

I come to the floor today with sadness in my heart. I come because over the weekend one of our Maryland National Guards was killed in Afghanistan. He was one of two men working in a building in which he was attacked by someone he trusted at the Interior Service, and it appears that he was assassinated. I talked to his widow. We are sad. We are sad that somebody who went to defend freedom was killed in such a terrible way.

I am sad because last night I spoke to a dear friend of mine whose husband is very ill from the ravages of brain cancer, and we remembered so many good times we had together, but those good times don't seem possible in the future. I want so much for her to be with her husband and not think about the consequences of costs and so on.

Last night we learned that our very dear friend and colleague, Senator Olympia Snowe, is going to retire not because she is tired but because she is sick and tired of the partisanship. Senator Snowe is not tired. She is sick and tired of the partisanship. And you know what. So am I.

We have a highway bill here. We have an unemployment problem. We could solve America's problems and get it rolling again, and if we pass the highway bill--with the appropriate debate on amendments germane to the bill--we could do it. So I am really sad.

I am sad that I have to come to the floor to debate an amendment that has no relevance to the highway bill. And I am sad because we are so tied up in partisan politics and scoring political points that we don't look at how we can get our troops out of Afghanistan. How can we make sure we have a budget that can fund the cure for cancer and at the same time make sure any

family hit by that dreaded C word doesn't go bankrupt during care?

I am devastated that a dear friend and extraordinary public servant is so fed up with how toxic we have become that she chooses not to run for office again. So I want to be serious, and therefore you need to know I am really sad about this, but I also am frustrated about this. So I want to talk about this Blunt amendment because we have heard nothing but mythology, smokescreens, and politics masquerading as morality all day long.

Let me tell you what the Blunt amendment is not. It is not about religious organizations providing health care and the government saying what the benefits should be. It is not about affiliated religious organizations and the government saying what the service is to be. This amendment is about nonreligious insurance companies and nonreligious employers. It is about secular insurance companies and it is about secular employers. The Blunt amendment allows that any--any--health insurer or employer can deny coverage for any health service they choose based on something called religious beliefs and moral convictions.

Now, there is a body of knowledge that defines religious beliefs, but what is a moral conviction? That is not doctrine. That is a person's personal opinion. A moral conviction, no matter how heartfelt, no matter how sincere, no matter how fully based upon ethical principles, is still a person's personal opinion. So we are going to allow the personal opinions of insurance companies and the personal opinions of employers to determine what health care a person gets. What happened to doctors? What happened to the definition of essential health care? So this is not about religious freedom; this is not about religious liberty because it is not even about religious institutions. So let's get real clear on this Blunt amendment.

This amendment is politics masquerading as morality. Make no mistake. The politics is rooted in wanting to derail and dismember the Affordable Care Act and our preventive health care amendment.

So what the Blunt amendment does, as I said, is allow any insurer or any employer to deny coverage based on religious beliefs or moral convictions. Well, what that essentially means is this: Let's look at examples. If an employer has a conviction, a personal opinion, against smoking, they can refuse to cover treatment for lung cancer or emphysema. If an employer has a personal opinion that they call a moral conviction that doesn't approve of drinking alcohol, they can refuse to cover any program for alcohol treatment or substance abuse.

Let's say there is an employer who doesn't believe in divorce and they say: I will not cover health care for anybody who is divorced because I have a moral conviction against that. Suppose a person says-- there are some schools of thought that say: I have a moral conviction that a woman can only see a woman doctor, and I will not cover anything where she is seen by a male physician. Where are we heading? These are not ridiculous examples. It puts the personal opinion of employers and insurers over the practice of medicine.

This is outrageous. This is vague. It is going to end up with all kinds of lawsuits--let's speak about lawsuits. While some have been pounding their chests talking about religious freedom and the Constitution, what is also in the Blunt amendment is this whole idea that gives employers access to Federal courts if they believe they can't exercise the amendment. This is a new lawyers full employment bill.

I am shocked because the other party is always trashing lawyers. They are always trashing the trial lawyers associations. Now they have created a whole new right--or an opportunity--for Federal court action, clogging the courts on this particular issue.

This is why Americans are so fed up. They want us to focus on health care. They want us to focus on how to lead better lives.

Let me talk about how we got here in the first place. Do my colleagues remember why we had health reform legislation? I remember because it still exists: 42 million Americans are uninsured; 42 million Americans are uninsured for health care.

This is the fifth anniversary of a little boy in Prince George's County who died because he could not have access to dental care. His infection was so bad, so severe, and there was nobody to see him. His mother was too poor to be able to pay for it. That little boy, in the shadow of the Capitol of the United States, died.

Now, that is why we work for the Affordable Care Act. People can call it ObamaCare. I don't care what people call it. I call it an opportunity for the American people to get what a great democratic society should provide.

Then, we not only looked at what was uninsured, we also looked at the issues around women. Senator Stabenow held a hearing, and I held a hearing, and guess what we found. Women pay more for their health insurance than men of equal age and equal health status. Nobody said that is a social justice issue. Well, I have a moral conviction about that. I have a really deeply felt moral conviction that if you are a woman, you shouldn't be discriminated against by your insurance company.

We also found that women were denied health care because of preexisting conditions. We found that in eight States, if a person was a victim of domestic violence, they were doubly abused--not only by their spouse, but they couldn't get insurance coverage because they said the cost of physical and mental health care would be too much. Well, I had a moral conviction. I had a moral conviction that if you are a victim of domestic violence, you shouldn't be denied health care. I had a real strong moral conviction about that.

Then, during my hearing, I heard a bone-chilling story. It wasn't just me; it was all who attended. There was a woman who testified that she had a medically mandated C-section. Then she was told by her insurance company, in writing, that she had to get sterilized in order to receive health insurance. The insurance company was mandating sterilization for her to get coverage. I nearly went off my chair.

At that hearing there was a representative of the insurance company. They had no moral reaction to that. They had no moral reaction to that. I had a reaction. I had a really big one. That is why we got the amendments we did, where you could not deny health care on the basis of preexisting conditions. So I have a lot of moral convictions about this: that in the United States of America no child should die because of the absence of health care; no woman should be discriminated against in the health care system; and, at the same time, a person needs to be able to have the opportunity to get the services their doctor says they need.

The other thing on our agenda was to not only save lives, but to save money, and we knew that prevention was the way to go. I came to the floor and offered the preventive health amendment. It was a great day. Many women spoke for it. It was primarily oriented toward women, but it was going to cover men as well. It was going to make sure that early detection and early screening would save lives. We spoke about the necessity for mammograms. We spoke about the necessity for screening for diabetes and heart disease and the kinds of things that, if detected early, could save lives. That bipartisan amendment passed.

Then, after it was passed, and after the bill passed, the Secretary of Health and Human Services said: Preventive benefits should be defined not by politicians and not by a bureaucrat at HHS but by the medical community. So she requested the Institute of Medicine to define the preventive health care benefit. The preventive benefits we are talking about that Senator Blunt says an employer doesn't have to provide came from the Institute of Medicine. It didn't come from the Congress. It didn't come from bureaucracy at HHS. It came from a learned, prestigious society that we turn to--the Institute of Medicine. This is what they said are the essential preventive services that would save lives as well as save money.

So this is where this came from. Now, some are on the floor saying: If you have a moral conviction against what the Institute of Medicine says is an essential benefit, you could go ahead and do it. Again, we are not talking about religious institutions who are employers; we are not talking about religious-affiliated institutions; we are talking about nonreligious institutions.

Ordinarily I would call this amendment folly, but this is a masquerade. I think it is just one more excuse to opt out of the Affordable Care Act. It is one more excuse to opt out of ObamaCare. They want to opt out, but I think it is a cop-out, and we have to stop masquerading that this is about morality or the first amendment or someone's religious beliefs.

So I hope we defeat this Blunt amendment. Most of all, I wish we could get back to talking about the serious issues affecting the American people. I am going to bring those troops home. I sure want to find that cure for cancer and help come up with the resources so we can do it. I am going to be sure that no little boy ever goes through what Deamonte Driver and his family had to suffer.

Let's defeat the Blunt amendment. Let's get back to the highway bill. Let's get America rolling--and how about let's start functioning as an institution that focuses on civility and finding the sensible center that America has been known for in other years when we had the ability to govern.

I yield the floor.

Oh, I sure did, and it was deja vu all over again, I say to my colleague from California, because it was like the Anita Hill hearings. The Senator remembers what happened there.

During that time, there was not one woman on the Judiciary Committee.

This is not new. The discrimination against women has been around a long time. I consider discrimination against women one of the great social justice issues, whether you are a secular humanist or you have core beliefs in an organized religion.

I found not only the picture appalling, but I want to reiterate what we have been saying here: There is a systematic war against women. We do not get equal pay for equal work. We are often devalued in the workplace. We worry more about parking lot slots for our cars than childcare slots for our children. Then, when it comes to health care, what was so great about the preventive amendment was, first of all, we talked not only about family planning, where women could have the children they knew they could care for, but we talked about prenatal care. We talked about making sure our children had the opportunity for viability and survivability at birth.

So, yes, it was both a picture of us not being included, but it shows we need to be able to fight to be heard. The issue is, women's voices are not being heard, and I am saying today the voices of women are being heard and the voices of good men who support us. I am telling you--not you, Senator Boxer, but I am saying out loud--if this Blunt amendment passes, I believe the voices of women will be heard. They will be heard on the Internet. They will be heard in streets and communities. Most of all, they will be heard in the voting booth.

Mr. President, I come to the floor today both volcanic and flabbergasted. I am volcanic that this bill is not fully paid for and that we are using permanent solutions to solve temporary problems. And, I am flabbergasted that Republicans are more willing to protect billionaires than keep our economy rolling and provide a safety net for those going through tough times.

We are asked to make an impossible choice. I want to continue the payroll tax holiday. I want to continue unemployment insurance. And I want to stop a pay cut to doctors that care for the injured and infirm. But I will be darned if I agree to pay for it by cutting payments to hospitals that serve the poor and by asking civil servants to take it on the chin when billionaires do not have to contribute a dime.

Republicans say they want to cut spending. They say they are serious about reducing the deficit. But the only thing they are serious about is protecting the pampered and prosperous. I will give you an example. Continuing the payroll tax holiday costs about $100 billion. I want to pay for it by cutting tax breaks for billionaires, tax breaks for oil companies, and tax breaks for big agriculture. But Republicans do not want to pay for it at all. The so-called party of fiscal discipline wants to add $100 billion to the deficit before asking billionaires to pay more. Some people might call that hypocrisy. I call it a sham.

This bill would block a 27% pay cut to doctors that care for the injured and infirm. I support that but I would like to see a long-term fix to this payment problem and not just a 10-month patch. To pay for this temporary fix, the bill cuts $10 billion to hospitals that provide care to the poor and Medicare patients. We ask doctors and hospitals to care for the most vulnerable and then we say we would not pay the bill.

The bill also cuts funds for health prevention activities. Republicans like to call it a ``slush fund.'' Since when did efforts to combat our Nation's highest cost disease and conditions like diabetes, Alzheimer's and heart disease become a ``slush fund''? The bill also cuts laboratory services that diagnose illness. We are cutting the ``good-guy'' institutions to protect the checkbooks of the wealthy.

The bill also sticks it to civil servants who are already operating under a 2-year pay freeze. Congress has already balanced the budget on their backs and saved $60 billion over 10 years by freezing their pay. Instead of asking billionaires to sacrifice once it asks more than 2 million middle class civil servants to pay more again. It leaves the

hedge fund managers alone and takes from the GS 5 earning $30,000 a year and the GS 7 earning $40,000.

Across the country there are 2 million civil servants who work for 300 million Americans every day with honesty, integrity and competency. They keep our food safe, our environment clean, our communities protected and our democracy stable. They are at our borders and airports protecting our safety and at Social Security offices helping seniors get their benefits. They are Nobel Prize winners, they create private sector opportunities and they are the economic engine of Maryland. Despite all of this, civil servants have been the target of unending attacks. They have been downsized, furloughed and shut down. They are enduring pay freezes and broken promises on retirement security. Every great democracy needs a civil service. We have one but we can not keep it if we keep up this toxic environment for our civil servants.

I support a payroll tax holiday. I support extending Unemployment Insurance and I support a long-term doc fix. But these items must be paid for. We cannot let corporations and the wealthy walk away again when the middle class gets stuck with the bill.

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

Madam President, now what is the pending business?

Madam President, I wish to claim 10 minutes to speak on behalf of a bill which I hope will return to the Senate today, which is the surface transportation reauthorization bill. I hope we take it up. I hope we actually vote on it, and I hope there are not a lot of extraneous amendments that are not relevant to getting America moving again, creating jobs that result in public safety, a better environment, and people actually working. What I like about the surface transportation reauthorization bill is that, in effect, this could be the only vehicle we have that is a version of the infrastructure bank, a topic on which I know the Presiding Officer has worked assiduously.

We need an infrastructure bank. We need to have jobs in construction to build highways, byways, subways, and we can do it, but it looks as though it will be difficult to do. In the meantime, we have a regular order bill, the surface transportation reauthorization bill. This is the bill that Congress reauthorizes every couple of years to do construction on highways, byways, and beltways, and at the same time in the very important area of mass transit, something the gentlelady from New York knows is important since she has one of the busiest subways in America. We have a busy subway called the Metro, and I am going to talk about that in a minute.

Right now we must pass this long-term transportation bill to put people back to work, repair our aging roads and bridges and tunnels, keep the public safe, and lower our carbon footprint. This is a bipartisan bill, and it is

actually paid for and meets a sense of a frugal government but smart spending. It is time to show the American people that we can govern, that we can actually pass legislation in a regular order, conducting ourselves with civility as we debate our amendments.

We have to keep America rolling. This is a jobs bill. One of the best ways to put people to work is through infrastructure projects. It builds America and builds our economy. This bill will contribute to saving over 1.8 million jobs and actually creates new jobs in construction, in the supply chain, and in design and engineering, and all the vendors it supports.

In my own home State we estimate that 10,000 jobs will be created if we pass this bill. I cannot speak about this in a more firm and insistent way. When I met with the building trades guys, it was a bleak conversation with the unemployment rate in construction still sky-high. This bill will jump-start the economy. All the people who analyze this type of data say that for every dollar we spend on infrastructure construction, we get $2 in economic output back into our economy through the multiplier effect.

Let's do an inventory of why this is a compelling need. We know we have a high unemployment rate and that we are running big debts and we are running deficits. One of the ways to reduce the debt and the deficit is to have people working where they are paying revenue in to the government. We also have an infrastructure deficit. Do you know that right now 700,000 bridges are structurally deficient? That is not a fact, that is a danger zone. Fifty percent of our roads are in need of serious repair. More than 4 million people travel over these bridges every day. This would address that kind of problem.

Then there is this whole issue of, again, roads, highways, byways, and beltways. There is also the issue of mass transit. One of the parts of the bill I am most proud of is creating Federal safety standards for the metro systems nationwide.

On June 22, 2009, there was a terrible accident in the national capital region. Nine people were killed and 50 more injured in a terrible metro transit accident when a red line train struck another train. The woman who was the conductor on that train tried valiantly to save her passengers. She died as a result. Well, we went to the funerals, we listened to the people, and we always say: We will never forget, but we do. Well, I didn't forget and the Maryland delegation didn't forget. Ben Cardin didn't forget, Chris Van Hollen didn't forget, and Donna Edwards didn't forget. We worked very hard in creating legislation. The first thing we did was listen to the National Transportation Safety Board that gave us recommendations and said there was not only a failure of Metro being fit for duty, but all of the transit systems in America face this kind of risk where there is a failure of technology, the failure of cars to be crash resistant, the failure to have exit doors, and the failure to have a black box.

When you look at the Congress, we are the failure. Give us an F because we have safety standards for how you open a bottle cap but not how you open a subway car in a disaster. So it wasn't Senator Barb making up safety rules on her own; we went and listened to the National Transit Safety Board. I put in legislation to give the Federal Transit Administration the authority to establish and enforce national safety standards for Metro. We had aggressive oversight hearings. Metro leadership initially was dragging its axles, but I wouldn't take no for an answer. We shook up the management, we shook up the board, and now I want to shake up the Congress.

I want to thank Senator Bob Menendez. He had a parallel bill. I want to thank Tim Johnson, the chair of the committee. They have taken my ideas and have actually done a version of their own, and working together we have come up with a great solution that has bipartisan support. This checklist for change that I insisted on would replace the oldest cars in the fleet. It would develop real-time automatic controls so that technology would have redundancy in it. It would develop a training and certificate program so that the personnel not only know how to operate their cars but what to do in the danger zones. Runaway cars make a great movie. Denzel Washington did that one, but I don't want to see another movie where there is another transit system that went through the horrific accident here in the national capital region.

In this checklist for change legislation, working again with Senator Menendez, my colleague Senator Cardin, whom I cannot give enough credit to, our new bill gives the Transportation Secretary, Mr. LaHood, authority to establish and enforce safety standards, and allows Federal funding for these safety improvements. I am pleased that this was inculcated.

The story goes one step farther, and this is an example. Last year, through the appropriations, I was able to get funding, working with Senator Murray, to be able to replace the Metro cars, the ones that are old, dated, and cannot withstand all the problems I just enumerated.

I am going to tell you the rest of the story as if Paul Harvey were on the floor. A couple of weeks ago during one of our work weeks when we were visiting our constituents, I went to a place called Knorr Brakes in Carroll County, which was once very rural. Knorr Brakes actually makes the brakes for these Metro cars and makes the brakes for Amtrak and makes the brakes for many transit systems in the United States of America. Because of the improvements at Metro, they have been able to hire more people.

I wish you could have walked that factory floor with me. It is not your grandfather's factory floor, which was often dark and dangerous. It is clean, uses the best of engineering, a few robots, engineers, with skilled blue-collar workers who are machinists who are working on this very specialized equipment. These brakes have to work, and they are the best in the world. Workers in Maryland are the best in the world. Yes, they are part of a German holding company, so we are ready to be global, and at the same time they are fixing not only Washington's Metro but they are working on transit systems.

My whole point is smart funding in the area of infrastructure and in transportation safety creates American jobs. Every time we modernize our transit fleet, we are building railroad cars in the United States of America. Many of those brakes that will go on that car will be made in Maryland by Maryland workers, competing with other American companies. And you know what. That is what it is all about. That is smart funding that creates safety and creates jobs.

I want to thank the Banking Committee for including this, and I also want to thank all three committees: Banking, Environment, and Public Works, under the leadership of Senator Boxer and Senator Inhofe, Senator Baucus, Senator Grassley, Senator Tim Johnson, and my colleague from Alabama, Senator Shelby.

This could be a great day. This could be a great day or a great week. But, yes, while we are working on the payroll tax and its temporary holiday, the real thing we could get done this week is to pass this legislation. America will be safer, our economy will grow, and it will be a win-win situation.

Madam President, I want to thank you for your kind attention. I want to thank all my colleagues who worked on a bipartisan basis. We actually listened to each other. I had a set of ideas. Others had as well. Some had flashing lights about costs, we went back and forth, and that is the subject of negotiation, and we were able to do it. I think we have come up with a great bill for surface transportation. We have come up with a great bill for transit safety, and I am going to be happy to vote for it. Let's get Congress rolling so we can get our economy rolling.

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

Madam President, what is the parliamentary situation?

Madam President, I claim 10 minutes of the Democratic majority time. I come to the floor to speak about women's health. I come to speak about the issue of prevention, and I want everybody to fundamentally remember what we debated and what we did in the health care bill.

For the first time in a long time, our Nation is talking about women's health. Am I glad to hear that. It has mostly been happening on the morning talk shows and on the front pages of our newspapers. But, unfortunately, too much of the conversation isn't about women's health; it is politics disguised as women's health.

What should we be talking about when it comes to women? We should be talking about the top killers of women: cancer--that dread ``C'' word-- including breast cancer, cervical cancer, lung cancer. They are the highest killers of women: lung cancer, cervical cancer, and breast cancer. Then there are the silent killers of women: undetected diabetes as well as the consequences of heart and vascular disease. What did we talk about in the health care bill to deal with these issues? We talked about the fact that we needed preventive services, that we believed in early detection, that we believed in screening for early detection so we could identify those consequences that would negatively impact women in terms of their health care.

One of the things we know is that many women don't have health insurance at all. Seventeen million are uninsured. Women are most likely to neglect their treatment because of cost. Women of childbearing age are also even more at risk because they are performing jobs that tend to be starting out and they don't pay for health insurance.

We tackled a lot of this in the health care bill. I am so proud that one of the first things we did was end general discrimination in health care--the punitive practices of insurance companies discriminating against women by charging more for women of the same age and the same health status as men. But we came together, united, and passed it as part of the affordable health care act, and we ended gender discrimination.

Then we saw that simply being a woman meant being treated as a preexisting condition. I held a hearing about this that was bone- chilling, when we listened to how women were discriminated against and aspects that had happened to them were viewed as a preexisting condition. In eight States if a woman was a victim of domestic violence, she could not get health insurance.

In another bone-chilling story, which was breathtaking, a woman testified at our hearing that because she had a C-Section, her insurance company told her they would drop her from their insurance plan unless she got sterilized. That was in the hearing. She had a letter from her insurance company. We were aghast on both sides of the aisle, regardless of how one feels about some of these reproductive issues. Nobody felt that should happen in America. So the people on the committee, led by myself, said: We can't have that. So we have ended discrimination against women getting health care on the basis of preexisting conditions.

We wanted to go further, and one of the issues we looked at was that of prevention. This is a subject of great debate. The very first amendment on the Senate floor during the health care debate was one to add preventive health care benefits. I offered an amendment, and the Senator from Alaska, Ms. Murkowski, offered a counteramendment. Her amendment was terrific. She had every preventive service that I would have ever loved. CBO, though, scored it at something such as $50 million. The CBO's score sunk the Murkowski amendment, but the Mikulski amendment prevailed, in which we said we will leave it to the Institute of Medicine to determine what would be some of these amendments for women.

So guess what we have. In our preventive health amendment, which is now the subject of such debate, such controversy and, unfortunately, such misinformation, our amendment said this: First of all, if a woman is over 50, she gets a free yearly mammogram, one of our highest risks. Second, if a woman is over 40, she gets an annual well woman preventive care visit. This then goes to the screenings that then go to the highest risk for the highest diseases we have.

We have early detection and early screening. For young women who are pregnant, we guarantee they can be screened for diabetes, but also in our prevention amendment we provided for maternity services. We provide for maternity services so these women can get proper prenatal care. Working with their doctor, we can ensure the health of the mother and survivability and the ability to carry her pregnancy to term. We looked out for those maternity benefits.

IOM also said that as part of prevention we should add contraceptive coverage. That was a recommendation not of Senator Barb and not of Senator Jeanne Shaheen; this was a recommendation of the Institute of Medicine. Why do they say that? First of all, there are over 15 or 20 percent of women who need to take birth control in order to deal with the medical issues associated with their menstrual cycles. This isn't the place to go into the biology of being a woman, but for many this is where people long before--young women and adolescents who were not sexually active were experiencing some significant hormonal problems. So it is not always about being sexually active.

So this whole thing about the preventive amendment being all about birth control is so exaggerated, so overblown, so out of context with what we wanted to do. I am shocked and--I am just shocked.

We looked at our bill, in addition to my amendment, and we included preventive services for men and women, those services that affect both sexes, including colorectal screening for adults over 50. That also includes prostate screening for men. We have diabetes and high blood pressure screening. There is also the ability to do alcohol misuse screening which, in many instances, is an undetected and silent killer not only of lives but of families.

So one of our major thrusts was prevention. We won maternity benefits so a mother can be safe and well herself and be able to carry her pregnancy to term in a way that ensures the health of both the mother and the child, when the child is born. The fact that we had these other screenings, including mammograms, prostate cancer, diabetes--

the things that are killers of us all--some of these will close the health disparity gap because so many African-American men face terrible problems with high blood pressure that leads to the terrible consequences of stroke. Diabetes is rampant in our country but particularly rampant among people of color. So that is what we were doing.

I find it troubling that instead of focusing on our preventive health services, we are focusing on birth control. Birth control was never the focus of health care reform. It was a recommendation to be included in the benefit that came from the Institute of Medicine.

There is another bit of confusion out there about mandating churches to do something against their will. I wish to draw a distinction between what the bill does and mandating the provision of service and providing insurance coverage. The bill does include insurance coverage. But there is no place in the bill that mandates a religious organization provide something against their principle in providing a service. So if you are St. Mary's Hospital, you do not have to give out birth control in your women's health clinic. If you are Notre Dame University or Georgetown University or a Catholic women's college, you do not have to give out birth control in your student health clinic.

What the Obama-Sebelius regulations say is that there has to be insurance coverage available, particularly to those who are non- Catholic. For all of us who go to these wonderful institutes and have benefited from their services, they are nondiscriminatory. One does not have to be Catholic to teach at a Catholic college. One does not have to be Catholic to work at a Catholic hospital. One does not have to be Catholic. So these institutions hire people of a variety of religious preferences.

I don't want to get into a debate on the first amendment, but I do welcome a debate on what the health care bill did and what it intended.

The health care bill, I felt, was one of the greatest social justice initiatives I have participated in in the Senate. It was going to work and organize in an effective way to make sure we were on the road that every American had access to affordable care. Then we removed the barriers that were not only financial but often these discriminatory practices, these punitive practices that often were directed against women and preexisting conditions or in gender discrimination and the way they set their prices.

The best care is preventive care, and one of the tools well known in the public health field is these screenings tests that we worked to provide, and we turned to the eminent and distinguished people in learned societies, in this case the Institute of Medicine, to tell us not based on politics but to tell us based on science what the benefits should be, and they added contraceptive coverage.

That is the history. I hope it clears up the misinformation. But we did work to move our citizens to greater health care and remove the financial and other societal barriers to getting health care in our society, with a fantastic emphasis on prevention. We have gotten off to the wrong debate and the wrong discussion. Let's get back to talking about how we improve the health care of women and how we can keep moving on our preventive aspects that not only help women but help the men who so love us and support us, and we want to return the favor by making sure they get their screenings too.

I yield the floor.

Mr. President, I support a clean extension of the FAA bill. But I cannot support the conference report that's before the Senate today because it includes a radical provision to undermine our rail and airline workers' right to organize.

The FAA bill is a jobs bill that keeps air safety employees and construction workers at airports on the job. According to the U.S. Department of Transportation, every dollar spent on transportation isn't just an investment in concrete and steel, it is an investment in our workers that creates jobs. Reauthorizing this bill keeps thousands of Federal employees and tens of thousands of construction workers on the job and not worrying about whether they will receive a paycheck.

A reauthorization of the FAA bill means 4 years of stability. It will modernize and upgrade our air traffic control system. And it will provide billions in investments to improve our airports with new runways, aprons, lighting, and land purchases. A clean FAA bill saves jobs, protects the flying public, and stimulates our economy.

But this FAA bill comes with a poison pill labor provision that was added in Conference. I cannot vote for such a radical provision that makes it more difficult for rail and airline workers to organize and sets a dangerous precedent of opening the Railway Labor Act up for hostile anti-worker amendments on unrelated must-do transportation bills.

This is just another example in a persistent pattern of attacking workers' rights. The Republicans have made it clear that the price of their support for a much-needed investment in our air infrastructure is to undermine our workers' right to organize and decide whether they want to be represented by a union.

During the Senate's debate of the FAA bill last year, the Republicans tried to strip hardworking Transportation Security Administration workers of their collective bargaining rights.

Last summer, the FAA shut down for 2 weeks because the House Republicans insisted on a provision to make it harder for rail and airline workers to form unions. Now, we are days away from the expiration of the latest of 23 short-term extensions to the FAA bill, and the conference report includes another attack on workers' rights. The Republicans need to get off of it with labor, and get on with the business of creating jobs.

Unions play a vital role in ensuring safe and fair working conditions. We encourage the right to organize around the world. We need to encourage it on our own FAA bill.

Our rail and airline workers are hard at work every day protecting Americans. They keep us safe and secure as we travel. In return, they deserve a decent wage and safe working conditions. They deserve to have their right to organize and negotiate protected. And they deserve our thanks and respect.

I support a reauthorization of the FAA bill, but I am not prepared to trade away our workers' rights to get it done. I cannot support this conference report.

Mr. President, I am proud to introduce the Spending Reductions Through Innovations in Therapies Agenda Act with my good friends and colleagues, Senators Collins, Kerry, Blumenthal, and Warner. This is a bi-partisan and bi-cameral bill that I have worked on with Representatives Markey and Smith and community organizations and leaders such as George and Trish Vradenburg's U.S. Against Alzheimer's. This legislation will help us sprint to the finish line by getting innovative therapies from bench to bedside more quickly for chronic diseases like Alzheimer's. It spurs innovation in advanced research and drug, device, and diagnostics development for chronic health conditions that are leading causes of death as well as the most costly to taxpayers and families.

The act puts the focus where it needs to be. It tackles the health problems we are challenged with today and will be faced with in the future if there is inaction. We must conquer these complex health conditions and plug the drain that draws money from our nation's economy and patients, families, and taxpayers checkbooks.

It is been over 10 years since a new Alzheimer's drug entered the U.S. market. Eleven industry sponsored clinical trials have failed in recent years. It takes 10 to 15 years to develop a drug and get the FDA gold seal of approval. Each drug that successfully enters the market, costs over $1 billion to develop. This is because of the high failure rates in the ``Valley of Death.''

Currently, 5 million Americans have Alzheimer's and 15 million Americans are caring for a loved one with Alzheimer's. There are no drugs on the market today to delay-onset, prevent, or cure Alzheimer's. Medicare spending for Alzheimer's patients is 3 times higher than Medicare patients without Alzheimer's. Medicaid spending for Alzheimer's patients age 65 and older is 9 times higher. This is unsustainable. Families are left bewildered, bereft, and broke.

I know what this is like. My own dear father was one of the 5 million Americans with Alzheimer's. I remember when I would go to visit him. It didn't matter that I was a United States Senator or the Senator who represents the National Institutes of Health. It didn't matter that I could get Nobel Prize winners on the phone. The information that would have made his life easier just wasn't there. My family and I knew about the long goodbye. We lived the 36-hour day. It was devastating for him, heart-breaking to my mother, and heart-wrenching for my sisters and me. What was difficult was not only the disease but that we also felt powerless. All we could do was make my father comfortable. There was no cure. There was no safety net for our family.

I vowed to do everything I could. Not just to support research and development in Alzheimer's but also to create a safety net for families. I know it is gut-wrenching to wonder how you'll be able to care for a parent. I have always believed Honor thy mother and father' is a good commandment to live by and a good policy to govern by. We need innovative strategies like the SPRINT program to make sure your brain span lasts your life span.

SPRINT speeds the development of drugs and therapies to combat the most deadly and costly chronic diseases. It compresses the product development timeline and increases the volume of drugs in the development pipeline so that priority is given to the most promising drugs. This bill expedites the Food and Drug Administration review process. It helps get more drugs out of the labs and into patient's hands more quickly.

This act establishes a new program--the SPRINT Program. SPRINT will develop new therapies to reduce federal health care spending on chronic health conditions like Alzheimer's, diabetes, heart disease and cancer that are the leading causes of death identified by the Centers for Disease Control and Prevention. In fact, some researchers are already working hard to see if diabetes or heart diseases are associated with Alzheimer's. I have seen first-hand that many Alzheimer's patients have multiple chronic conditions.

SPRINT directs the Secretary of Health and Human Services to work collaboratively with non-profit investors to identify public and private organizations with expertise in developing therapies for these conditions like a biotech company or an academic health center such as University of Maryland or Johns Hopkins. Prize payments, contracts, grants, or cooperative agreements will be awarded to accelerate development of therapies that have potential to prevent or diagnose, delay onset or cure, and aid recovery or improve health outcomes for Alzheimer's disease and other high-cost conditions.

This bill is built on a public-private partnership. We will make a $50 million Federal investment and leverage private capital by raising $2 in private investment for every Federal dollar to combat this problem together. For this small investment we will get huge returns in lives saved and new cures. By making a small investment today we will save billions in future health care spending and long-term care costs. Alzheimer's Association estimates that Alzheimer's alone costs our federal health programs, Medicare and Medicaid, over $183 billion annually.

SPRINT is a job creator. Manufacturers in Maryland and other states are on the frontier of discovering new drugs and biologics. By helping patients find new treatments we can also make targeted investments in our innovation economy. Biotech companies are an economic engine in Maryland's economy. SPRINT helps America remain number one in biomedical innovation and job creation.

I have a saying, ``each of us can make a difference and together we can make change''. I will keep fighting for a cure for Alzheimer's. I will keep fighting to support our innovative industries in their quest for new therapies and treatments that will help patients globally and create jobs domestically. And I will keep fighting to help families living with Alzheimer's. We are working together because a Congress that works together works the best. We will get this done. Some people want to go to Mars but I want to be in the United States of America when they say ``we found a cure for Alzheimer's.''

Mr. President, I am proud to introduce the Spending Reductions Through Innovations in Therapies Agenda Act with my good friends and colleagues, Senators Collins, Kerry, Blumenthal, and Warner. This is a bi-partisan and bi-cameral bill that I have worked on with Representatives Markey and Smith and community organizations and leaders such as George and Trish Vradenburg's U.S. Against Alzheimer's. This legislation will help us sprint to the finish line by getting innovative therapies from bench to bedside more quickly for chronic diseases like Alzheimer's. It spurs innovation in advanced research and drug, device, and diagnostics development for chronic health conditions that are leading causes of death as well as the most costly to taxpayers and families.

The act puts the focus where it needs to be. It tackles the health problems we are challenged with today and will be faced with in the future if there is inaction. We must conquer these complex health conditions and plug the drain that draws money from our nation's economy and patients, families, and taxpayers checkbooks.

It is been over 10 years since a new Alzheimer's drug entered the U.S. market. Eleven industry sponsored clinical trials have failed in recent years. It takes 10 to 15 years to develop a drug and get the FDA gold seal of approval. Each drug that successfully enters the market, costs over $1 billion to develop. This is because of the high failure rates in the ``Valley of Death.''

Currently, 5 million Americans have Alzheimer's and 15 million Americans are caring for a loved one with Alzheimer's. There are no drugs on the market today to delay-onset, prevent, or cure Alzheimer's. Medicare spending for Alzheimer's patients is 3 times higher than Medicare patients without Alzheimer's. Medicaid spending for Alzheimer's patients age 65 and older is 9 times higher. This is unsustainable. Families are left bewildered, bereft, and broke.

I know what this is like. My own dear father was one of the 5 million Americans with Alzheimer's. I remember when I would go to visit him. It didn't matter that I was a United States Senator or the Senator who represents the National Institutes of Health. It didn't matter that I could get Nobel Prize winners on the phone. The information that would have made his life easier just wasn't there. My family and I knew about the long goodbye. We lived the 36-hour day. It was devastating for him, heart-breaking to my mother, and heart-wrenching for my sisters and me. What was difficult was not only the disease but that we also felt powerless. All we could do was make my father comfortable. There was no cure. There was no safety net for our family.

I vowed to do everything I could. Not just to support research and development in Alzheimer's but also to create a safety net for families. I know it is gut-wrenching to wonder how you'll be able to care for a parent. I have always believed Honor thy mother and father' is a good commandment to live by and a good policy to govern by. We need innovative strategies like the SPRINT program to make sure your brain span lasts your life span.

SPRINT speeds the development of drugs and therapies to combat the most deadly and costly chronic diseases. It compresses the product development timeline and increases the volume of drugs in the development pipeline so that priority is given to the most promising drugs. This bill expedites the Food and Drug Administration review process. It helps get more drugs out of the labs and into patient's hands more quickly.

This act establishes a new program--the SPRINT Program. SPRINT will develop new therapies to reduce federal health care spending on chronic health conditions like Alzheimer's, diabetes, heart disease and cancer that are the leading causes of death identified by the Centers for Disease Control and Prevention. In fact, some researchers are already working hard to see if diabetes or heart diseases are associated with Alzheimer's. I have seen first-hand that many Alzheimer's patients have multiple chronic conditions.

SPRINT directs the Secretary of Health and Human Services to work collaboratively with non-profit investors to identify public and private organizations with expertise in developing therapies for these conditions like a biotech company or an academic health center such as University of Maryland or Johns Hopkins. Prize payments, contracts, grants, or cooperative agreements will be awarded to accelerate development of therapies that have potential to prevent or diagnose, delay onset or cure, and aid recovery or improve health outcomes for Alzheimer's disease and other high-cost conditions.

This bill is built on a public-private partnership. We will make a $50 million Federal investment and leverage private capital by raising $2 in private investment for every Federal dollar to combat this problem together. For this small investment we will get huge returns in lives saved and new cures. By making a small investment today we will save billions in future health care spending and long-term care costs. Alzheimer's Association estimates that Alzheimer's alone costs our federal health programs, Medicare and Medicaid, over $183 billion annually.

SPRINT is a job creator. Manufacturers in Maryland and other states are on the frontier of discovering new drugs and biologics. By helping patients find new treatments we can also make targeted investments in our innovation economy. Biotech companies are an economic engine in Maryland's economy. SPRINT helps America remain number one in biomedical innovation and job creation.

I have a saying, ``each of us can make a difference and together we can make change''. I will keep fighting for a cure for Alzheimer's. I will keep fighting to support our innovative industries in their quest for new therapies and treatments that will help patients globally and create jobs domestically. And I will keep fighting to help families living with Alzheimer's. We are working together because a Congress that works together works the best. We will get this done. Some people want to go to Mars but I want to be in the United States of America when they say ``we found a cure for Alzheimer's.''

Mr. President, Senator Kirk and I have introduced the Visa Waiver Program Enhanced Security and Reform Act.

This is a piece of legislation near to my heart. For those who have known me, they have known I have fought long and hard for Poland to become free and independent. I think about the dark days of martial law in Poland, when we worked to support the solidarity movement in Poland and remove the yoke of communism. And after Poland emerged from the Iron Curtain, I worked with many of my colleagues to secure Polish democracy and bring them into NATO, securing their future in Western Institutions.

This legislation would help provide Poland a path to entry into the visa waiver program. It would eliminate the need for Polish citizens to obtain a visa to travel to America. As the granddaughter of a woman who came to America from Poland over 100 years ago, it would warm my heart to know a grandmother from Gdansk would no longer need a visa to visit her grandchildren in Baltimore.

This legislation does much more than just strengthen our relationship with Poland. It is a jobs bill. The visa waiver program makes America open for business for more tourists from allied countries. This can have a profound impact. South Korea entered the VWP in early 2009. In 2010, there was an increase of 49 percent in arrivals to the United States from South Korea, which created $789 million in new spending and supported 4,800 new jobs.

If Poland becomes eligible for the visa waiver program and has a similar increase in visitors, it would create $181 million in new spending and 1,500 new jobs. It's good for business and good for the economy.

Finally, it would strengthen America's national security by improving how we protect our borders. To participate in the visa waiver program, countries must agree to stronger passport controls, border security, and cooperation with American law enforcement--making it harder for terrorists to use these countries as entry points to the United States.

This legislation reinforces the program as an important component of national security by placing member countries on probation if any of the VWP requirements are not met and requiring a country's removal if it does not fulfill its requirements within two years.

The legislation also reinstates the Secretary of Homeland Security's Waiver Authority and a new cap on visa refusal rates will be set at no more than 10 percent, allowing the Secretary to recognize those nations that have met U.S. concerns on passport security, law enforcement cooperation, and border security. By admitting countries that have greater security standards for their travelers, the State Department can focus its limited consular resources on higher risk nations.

Poland has long been a friend to the United States, sending two of its finest heroes, Kosciusko and Pulaski, to fight in the Revolutionary War for America's freedom. In recent years, Poland has stood besides the United States in the aftermath of September 11, sending troops to fight alongside Americans in Iraq and Afghanistan.

Poland has overcome a melancholy history to become a vibrant and growing democracy. This legislation helps cement that relationship while improving America's security and creating new jobs. I look forward to working with my colleagues to secure its passage.

Mr. President, I yield back all the time on the Republican side.

Mr. President, I rise to oppose the balanced budget amendment proposals before us today. I support a balanced budget. But I cannot support these proposals.

All year, we have been discussing and debating how to have a more frugal government. But while we are trying to be frugal, how can we also meet our responsibilities to national defense and maintain our social contract? To achieve that we have to put politics and partisanship aside, and work together to find the sensible center. And the balanced budget amendment does not allow for that.

I am for cuts. But our approach must be balanced like a three legged stool with responsible discretionary and military spending cuts; revenue; and reform that strengthens Medicare and Medicaid. The balanced budget amendment does not allow for that.

Before we adopt a balanced budget amendment, we should know exactly what it is that we are doing. We need to know just how these programs are going to be affected. What cuts are going to be taken. How deep. What programs. And most importantly what the consequences will be to the health, safety, and security of the American people.

How would a balanced budget amendment affect seniors? It attacks economic security for senior citizens through cuts to Social Security and Medicare. It breaks the social contract.

Under the Republican plan, it cuts spending to 1965 levels before Medicare existed and when the average Social Security benefit was about $1,200 a year. That was 46 years ago, when making $8,000 a year was considered a fantastic salary. Would you want to go back and make $8,000 a year? I do not think so. I do not think we want to go back to that. Do we really want to go back to not having Medicare? Sure we need to reform and refresh Medicare, but do we want to end Medicare? I don't think so.

How would a balanced budget amendment affect our ability to respond to natural disasters, when the 24-hour news coverage is over and people return to their regularly scheduled programs? States that are hit by disasters are just beginning the recovery process and depend on their Federal partners. Times of disaster are not for making choices between one State or another. Government must be there. We are all in this together. Just one snowstorm, wildfire, or devastating flood away from our own crisis. But the balanced budget amendment would force these terrible choices.

What about funding for America's veterans in order to be able to meet their acute care, provide primary care connected to service-connected disabilities, and long-term care for those who bear the permanent wounds of war? What about funding for disability pensions for veterans? The balanced budget amendment makes funding for American's veterans with service-connected disabilities vulnerable to mandatory budget cuts.

How will a balanced budget amendment affect the next generation? It denies educational opportunity to young people and an opportunity structure to working families. The balanced budget amendment puts funding for Head Start, Pell Grants, and funding that helps schools comply with Title IX funding for job training on the chopping block. I believe we must keep the doors of opportunity open, not slam them shut.

How will a balanced budget amendment affect our Federal workers and everyone who depends on their work? The State of Maryland is home to some of the flagship agencies of the Federal Government and 130,000 hardworking Federal employees live in Maryland. Agents at the Federal Bureau of Investigation work to protect our safety. Employees at the Social Security Administration provide actuarial information on how to keep it solvent and make sure the checks are out there on time. At NASA's Goddard Space Flight Center, they are scanning the universe for the secrets to life here on Earth. The mandatory budget cuts of the balanced budget amendment will require arbitrary cuts to the Federal workforce without certainty that the agencies will be capable of doing their job. These kinds of cuts are dangerous and harmful to the public.

The Founders did not include a provision requiring a balanced budget at all times. They did not include a provision limiting the size of government to an arbitrary percent of the size of our economy. Instead, in our Constitution, the Founders said that Congress would have the power to borrow on the credit of the United States and the responsibility to provide for the general welfare of the country.

Providing for the general welfare of the country means keeping the promise of our social contract to our seniors and our veterans. It means keeping the ladder of opportunity available to the next generation. And it means responding to natural disasters and maintaining a safe and secure homeland.

Make no mistake. We must balance the budget. But we must do it based on principles that preserve economic security for senior citizens, that provide opportunity for young people, and that ensure opportunity for working families.

I cannot and will not support any legislation that abandons these principles. Therefore, I will vote against this legislation.

Mr. President, Mr. Gross has worked with Cuban communities for many years. In 2009, he was working with USAID to assist Cuba's Jewish community by improving their access to the Internet. As a former social worker who has worked for 25 years in international development, he has a long record of helping people around the world to improve their lives.

He was arrested and held without charge for 14 months and later sentenced to 15 years for crimes against the state.

Mr. Gross is in failing health. He has lost 100 pounds and suffers from arthritis. He is being held in harsh conditions on trumped-up charges.

His family in Maryland has had very limited contact with him. They, too, have faced health challenges and are facing significant financial hardships.

I was hopeful that America and Cuba could move closer together--in trade, in community connections, and for individual families who have been separated. I thought these links would help open up Cuba, improve human rights, and enable their country to move toward democracy. Yet the case of Mr. Gross shows that Cuba is not serious about moving forward--for its own people or for its relations with the United States.

If Cuba wants to improve relations with the United States, they need to release Mr. Gross now. I will not support easing restrictions or sanctions on Cuba until Mr. Gross is allowed to come home to Maryland. I thank my colleagues for joining me in standing up for Alan Gross and urge the Government of Cuba to release him immediately.

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