Floor Statements

Mr. President, I take this opportunity to honor the life of Tom Graff, a pioneer of the environmental movement. Mr. Graff passed away on November 12, 2009, after a long battle with cancer. He was 65.

Born in Honduras in January 1944, Tom Graff was the son of German Jewish refugees. He spent his childhood in Syracuse, NY, attending Phillips Exeter Academy. He later graduated from Harvard University, Harvard Law School, and the London College of Economics. After graduation, Tom clerked for Federal judge Carl McGowen in Washington, DC, and was a legislative assistant to New York Mayor John Lindsay. In 1970, he moved to California to work for Howard, Prim, Smith, Rice & Downs, a law firm based in San Francisco.

In 1971, Tom founded the California office of the Environmental Defense Fund. From then until 2008 when he retired, Tom served as Environmental Defense Fund's regional director. For more than 37 years, Tom worked tirelessly and passionately as an advocate for the environment. He established a new form of environmental activism based on the idea that economics could, and probably should, play a significant role in environmental policymaking. Tom believed that paying attention to how economic incentives influenced business and personal behavior was critical to bringing about environmental improvements.

Although he was involved with a number of environmental issues, it was Tom's significant contributions to water policy that left an indelible mark in California. From the American River to Mono Lake to the Sacramento-San Joaquin Delta, Tom strove to ensure that water was distributed appropriately, and that the environment got its fair share. Working together with Senator Bill Bradley of New Jersey and Congressman George Miller of Martinez, Tom was a guiding force behind the Central Valley Project Improvement Act of 1991, a milestone in the environmental movement to protect the delta. He helped craft the historic proposal to use water markets and public subsidies that ultimately resolved the controversy around Mono Lake. He also did battle with the East Bay Municipal Utility District when it sought a second source of water from the American River, known for its abundant fall salmon run. Concerned for the health of the river, the Environmental Defense Fund filed suit against EBMUD. Seventeen years later, a landmark decision designated a baseline environmental flow need for the American River that stands to this day as a benchmark in river policy.

Throughout his career, Tom's commitment to conservation and the benefits it brought was evident in the work he did every day. His lifetime of contributions and his stewardship of the environment will not soon be forgotten.

Tom is survived by his wife Sharona Barzilay; his three children Samantha, Benjamin, and Rebecca; and two grandsons Avi and Rafael. I extend my deepest sympathies to his family.

Tom was a true pioneer and advocate for a healthy and sustainable environment, working tirelessly to provide new approaches for managing natural resources. His efforts will continue to shape California's water policies for generations to come.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Motion To Commit

Mr. President, if I might respond.

The plan is, women colleagues will be coming to the floor. As they come, I will yield to them, until Senator Mikulski gets here, and then she will yield the time, if that is all right.

Mr. President, before I start, I want to say to my colleague from Connecticut how much I appreciate his work and the work of Senator Baucus and Senator Reid. What a remarkable moment we have here.

When I go home--and I was home for the holidays--people are urging us to get this done. They know their biggest chance of going into bankruptcy is a health care crisis--62 percent. They know, as my friend Senator Dodd has said almost every day of this debate, every morning 14,000 people lose their health care. They know if we do not intervene with a good bill, their premiums--in my home State, I say to the Senator--will be 41 percent of their income, the average income, by 2016.

Can you imagine? That is unsustainable. For people who say: Why don't we address the economy instead of health care, let me say what happens to my constituents if they have to pay 41 percent of their income for premiums. Even if they have a good job, I say to my friend from Connecticut, they cannot make it. So the status quo is cruel, and it is particularly cruel to women.

Amendment No. 2791

Mr. President, I am proud to support the Mikulski-Harkin- Boxer amendment to improve preventive health coverage for women. The Mikulski amendment addresses this critical issue by requiring that all health plans cover comprehensive women's preventive care and screenings--and cover these recommended services at little or no cost to women. These health care services include annual mammograms for women at age 40, pregnancy and postpartum depression screenings, screenings for domestic violence, annual women's health screenings, and family planning services.

The preventive services covered under this amendment would be determined by the Health Resources and Services Administration to meet the unique preventive health needs of women. HRSA is an agency within the Department of Health and Human Services. HHS Secretary Kathleen Sebelius has already said that ``Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today.'' The Secretary made clear that recommendations by the U.S. Preventive Services Task Force ``do not set federal policy and they don't determine what services are covered by the federal government.''

This is not the first time that experts have disagreed about this issue. I have been in this battle before, with Senator Mikulski, who called a hearing with all of the women Senators in 1994 where I insisted that routine mammograms for women over 40 must be covered. And thank goodness we fought back then, and in 1997 and in 2002 when this issue was raised again and again. Since 1991, the death rate from breast cancer has been reduced by over 20 percent.

According to a 2007 Partnership for Prevention report, 3,700 additional lives would be saved each year if we increased to 90 percent the portion of women age 40 and older who have been screened for breast cancer in the past 2 years. The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their forties. That is why the American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Mammograms are still the most effective and valuable tool for decreasing suffering and death from breast cancer. The Mikulski amendment will ensure women are able to get access to this and other lifesaving preventive services at no cost.

The underlying bill introduced by Senator Reid already requires that preventive services recommended by the U.S. Preventive Services Task Force be covered at little to no cost. These recommendations already include some women's preventive services such as osteoporosis screenings.

But they do not include certain recommendations that many women's health advocates and medical professionals believe are critically important, such as screenings for ovarian cancer--a disease that will claim the lives of nearly 15,000 women this year. We know that when ovarian cancer is diagnosed early, more than 93 percent of women survive longer than 5 years.

Women are often the decisionmakers for their families when it comes to health care. But women too often put the health needs of their family members and their children ahead of their own.

By passing this amendment, we are saving the lives of countless mothers, daughters, grandmothers and sisters who would otherwise forgo preventative health care because of high copays and expensive deductibles.

I would like to share with my colleagues a story from a doctor in my home State of California, William Leininger, that drives home the importance of this amendment:

In my last year of residency, I cared for a mother of two

who had been treated for cervical cancer when she was 23. At

that time, she was covered by her husband's insurance, but it

was an abusive relationship, and she lost her health

insurance when they divorced.

For the next five years, she had no health insurance and

never received follow-up care (which would have revealed that

her cancer had returned). She eventually remarried and

regained health insurance, but by the time she came back to

see me, her cancer had spread.

She had two children from her previous marriage--her

driving motivation during her last rounds of palliative care

was to survive long enough to ensure that her abusive ex-

husband wouldn't gain custody of her kids after her death.

She succeeded. She was 28 when she died.

That is not a story that should be told in the richest nation in the world.

As I said, I am so proud to support the Mikulski-Harkin-Boxer amendment to improve preventive health care coverage for women. Here is why. It is a fact that women are increasingly delaying or skipping altogether preventive health care, and they are doing it because of costs.

I read a statistic done by a nonpartisan group that said about 39 percent of men are delaying going to a physician to check on a problem. But over 50 percent of women are doing that either because they do not have health coverage or they are fearful of the copay. So we could sit here and do nothing--that is the easy thing to do: Scare people, do nothing--or we could step to the plate, save Medicare, which is very important to save, and that is what this bill does. Because we say we are not going to spend money on waste, fraud, and abuse. We are going to spend money on health care for our people.

And to believe that my friends on the other side are the ones who are going to save Medicare? You just have to read history. Senator Dodd explained it; Newt Gingrich saying: Let Medicare wither on the vine; Bob Dole, our friend, who said, at the time of his Presidential campaign: I fought against Medicare. It was a failure.

Well, if you ask our seniors, I think they are the group most pleased with their coverage. It is not perfect, but it is critical, and we save it here. We extend the life of Medicare.

So here we are in a situation where many women are delaying going to the doctor, getting their preventive services, and the Mikulski amendment addresses this critical issue. It requires that all health plans cover comprehensive women's preventive care and screenings, and cover them at little or no cost.

The reason this is so important is--first of all, in the HELP Committee, under Senator Dodd's and Senator Kennedy's leadership, this piece of the package was in the bill because Senator Mikulski and others pushed so hard to get it placed into the bill.

Mr. President, I would ask my friend from Maryland, Senator Mikulski, if I could complete my remarks and then give the floor over to her?

Mr. President, I thank the Senator.

I am so proud to work with Senator Mikulski. I say to the Senator, we worked on this issue over the years. I just asked my staff to go back and look at the first time we teamed up to ensure that women get mammograms at age 40. That was in 1994. Then, again, over the years, every 3 or 4 years, this whole notion would rear its ugly head: Well, women can do without mammography. The question I have is, What is going to replace it? They would keep trying to take away our tools of self- examination and mammography. We know if you look through the years--and Senator Mikulski and I are proud of a lot of the work we do, but this goes right at the top of the list--we know mortality for breast cancer is way down since the early 1990s. It is 20 percent down since the early 1990s. We have had to stand our ground to protect women, to make sure they get those services they need, those lifesaving services, at little or no cost.

I would also say the American Cancer Society continues to recommend annual screening using mammography and clinical breast exams for all women beginning at age 40. There are a lot of other very important tests that are included in the Mikulski amendment--very important tests--to deal with cervical cancer and ovarian cancer, finding the markers so we know how to deal with these deadly diseases. To give up the tools we have, to turn it over to some organization that does not report to the Secretary of HHS, makes no sense.

What my friend has done with her amendment is to make sure the group that decides this is under the jurisdiction of the HHS Secretary. We know the HHS Secretary has already said she wants to make sure women, starting at age 40, get those mammograms.

I am going to close by reading from an article in the March 10, 1994, San Francisco Chronicle. It says:

Joining what became a phalanx of six female Senators

staring down at federal health officials Boxer said she will

insist that routine mammograms and a host of other women's

health needs be part of any new nationwide benefit package.

The article goes on. It is very clear. What I said at the time is:

After all of these years of women being told it is crucial

by age 40 to get a baseline mammogram, now to have this

tremendous confusion hit us is very disturbing.

Well, it was disturbing on March 10, 1994, when I first got involved in this issue. It was disturbing when Senator Snowe, 3 years later, had us pass S. Res. 47 which said this is our only tool. Let's do it. Thank goodness we have now in this body women and men who get the fact that we refuse as women to be stripped of the only tools we have. Making all of these important tests part of this package is going to save lives. It is going to save money. It is going to mean our families can breathe a deep sigh of relief out there.

So I wish to thank Senator Mikulski for her leadership on this issue and to always stand right at her side on this issue of mammography. We also worked on standards for mammography. Remember that one? It was the deregulation fever that hit the Republican side. They wanted to take away the regulations for mammography, roll them back. We fought the fight, and we will continue to fight the fight.

So thank you very much. I strongly support this amendment.

I yield the floor for my friend, Senator Mikulski.

Mr. President, what is the order?

Thank you very much, Mr. President.

I have listened to several of my Republican colleagues and I wish to note that they have the bill in front of them and they are attacking this health care bill, but nowhere on their desks do we see their bill. They have no answers, no solutions.

I can't yield.

They have no solutions at all on an issue that affects every single American.

What we have before us is the Reid bill which I think is an excellent piece of legislation that will make life better for every single American. I will spell that out in the course of my remarks.

We all know change isn't easy. It is easy to come down here and demagog and pound your fists and complain. It is human nature to resist change. But every once in a while a situation cries out for change, and that is the case today with our health care system.

The status quo is not benign. It is hurting our people. I wish to share the story of Nikki White as brought to us in the book ``The Healing of America'' by T.R. Reid. He talks about Nikki in the prologue where he poses it as a moral question: What we do about health care? This is what he writes:

If Nikki White had been a resident of any other rich

country, she would be alive today. Around the time she

graduated from college, Nikki White contracted Lupus. That is

a serious disease, but one that modern medicine knows how to

manage. If this bright, feisty, dazzling young woman had

lived in say, Japan, the world's second richest Nation, or

Germany, the third richest, or Britain, France, Italy, Spain,

Canada, et cetera, the health care systems there would have

given her the standard treatment for Lupus and she could have

lived a normal life span. But Nikki White was a citizen of

the world's richest country--the United States of America.

Once she was sick, she couldn't get health insurance. Like

tens of millions of her fellow Americans, she had too much

money to qualify for health care under welfare, but too

little money to pay for the drugs and the doctors she needed

to stay alive. She spent the last months of her life

frantically writing letters and filling out forms pleading

for help. When she died, Nikki White was 32 years old.

That is a story that should move every one of us, move every one of us to action.

Look, we have spent years studying and analyzing what is working in our health care system and what is not working. What it comes down to is this: Too many of our fellow citizens are suffering because of the broken promises of a health insurance system that abandoned them when they needed it the most. Too many cannot afford health insurance. Too many are getting sick after praying to God that they wouldn't because they knew that sickness could leave them in economic ruin. Praying is not a health care insurance plan.

Americans will spend over $2.5 trillion on health care next year; $2.5 trillion. In all, we spend twice as much per person on health care as other advanced nations. Yet, the United States of America, out great Nation, ranks near the bottom of the 30 leading industrialized nations in basic measures of health, such as infant mortality rate and life expectancy--the bottom of the list. That is where we are. So we spend twice as much and the results are not anywhere near where they should be. It is clear why. Too many people don't have affordable health insurance, and they wait too long before they get the help they need. Or, they are like Nikki and they never get the help they need.

Health care premiums have more than doubled in the last 9 years--more than doubled in the last 9 years--and one respected nonpartisan study says if we fail to act, the average American family will have to spend 45 percent of their income on health insurance premiums alone, and that is by 2016. By 2016, 45 percent of their income, the average family, by 2016, if we do nothing. My friends on the other side stand there with the bill and downgrade what we are doing and never address that issue.

It is time for change. When we know that two-thirds of all bankruptcies are due to a health care crisis, it is time

for change. When we know that every day--every day--another 14,000 Americans lose their health care coverage, that tells me it is time for change.

I know there are many people listening who think the uninsured are not their problem, that it doesn't affect their health care. They are flat wrong. Right now, every one of us with insurance is paying $1,100 a year--each of our families--for those who are uninsured. Why? Because we have to pay for the emergency room services they get when they are rushed into the hospital because they have neglected a health care problem and it is very expensive, and we are paying for it. That tells me it is time for change.

When family after family tells us they paid for insurance for years, but when they had a crisis their insurance company walked away from them--in T.R. Reid's book, we learn about a man who paid all his life for insurance and he got struck by an automobile and he was in the hospital with a terrible situation, and the insurance company knew it was going to cost them a lot. You know what they did? They rescinded his insurance. They told him that he weighed more than he should have, and they walked away from him. Story after story. Good, hard-working people unable to get health insurance, knowing that their future is dark. It is time for a change.

Today, I want to say to America's families: Change is definitely on the way. It won't be easy. It is going to be tough. But all these things I have said are truths. Everybody here has to be moved by that. I believe we will finally bring change. I am hopeful. I am hopeful because of the work of so many of our colleagues and the work of Senator Harry Reid. He has put a bill before us that, as I said, will make life better for every single American. It is called the Patient Protection and Affordable Care Act. First and foremost, if you have health insurance you like, this bill gives you the security of knowing it will be there for you when you need it. And if you don't have health insurance, you will be able to get affordable coverage through a new exchange which includes the public option.

Ultimately, under this bill, we are expanding health care to cover more than 94 percent of the American people, and all the while we are cutting the Federal deficit by an estimated $130 billion over 10 years, because there are real savings and real revenues in this bill to offset the new important programs.

When this bill is signed into law, America's families will see immediate improvements to their health care. They won't have to wait.

For example, right away, when President Obama signs this bill, your insurance company won't be able to kick you off your plan for some made-up reason because they no longer want to cover you. They will no longer be able to cap your coverage. I can't tell my colleagues how many people think they are safe because they had a $500,000 cap on their insurance. They never dreamed they would use it up. But one difficult and terrible illness can use it up, and then they are out of luck. No more rescissions, no more caps.

Parents will be able to keep their children on their health care policy up to the age of 26. Small businesses will have immediate access to tax credits to make covering their employees more affordable. And seniors will have a more generous benefit through their prescription drug coverage. We all hear about that doughnut hole that affects seniors as soon as they need to buy more pharmaceuticals. This will give them another $500 before they reach that point. Those are just a few of the immediate benefits of the Patient Protection and Affordable Care Act.

Here is a sample of other major provisions. This is a very important one. In this bill, no family of four making less than $88,200 a year will have to pay more than 9.8 percent of their income for health insurance premiums. Let me say that again. No family of four making less than $88,200 a year will have to pay more than 9.8 percent of their income for health care premiums. So if you make anything between say the poverty rate all the way up to $88,200, you never have to pay more than 9.8 percent of your income for health care premiums, and if you are on the lower end, it is even less. It goes down to about 2 percent. So it ranges from 2 percent to 9.8 percent at $88,200. That means that more than 62 percent of all of our families will be able to be assured that they will not have to go broke to buy health insurance.

Remember what I said. A respected study has already stated that if we do nothing, by 2016 people will be paying 45 percent of their income on premiums. In this bill, we ensure that our middle class down to our working poor do not have to worry about those kinds of premium increases.

For the rest of our Nation's families who are more affluent, there is the security of knowing that the insurance company reforms in this bill are going to help you. The insurance company can't walk away from you. If you have a preexisting condition, they can't turn you down. If you have a child you want to keep on until age 26, you can. If you are a small business, you will get tax credits to help you pay for your employees. There are many other benefits, including some free prevention coverage that kicks in right away. So no more discrimination against those with a preexisting condition.

By the way, no longer will insurance companies be able to discriminate based on gender. Right now, women in my home State of California are paying almost 40 percent more for the same insurance as men. There is gender discrimination. That will end when this bill becomes law.

In this bill we increase competition, which is perhaps one of the most important things we can do to bring down costs to our families. We have the health care exchange which includes a public option that will compete on a level playing field with insurance companies to keep them honest. In other words, there will be a government option, but there won't be anything different about the government plan in terms of the way it negotiates with the insurance companies.

There has been a lot of shouting from my colleagues about the public option. Why shouldn't the American people have access to a public option?

I ask that question. I don't hear my Republican friends coming down to the floor and saying they are going to give up their public option. More than 90 percent of us have a public option right now--the Federal Employee Health Benefits Program. I don't see one of my colleagues who have been trashing the public option coming to the floor and saying I wish to get rid of mine. Oh, no. They like it. But they don't want it for the rest of the people. I don't understand it.

There are lots of public options we have here. Medicare is a public option, run by the government. I don't hear my Republican friends coming here and saying we should end Medicare. They used to say that. They don't say it anymore. Now they say they depend on it. It is a public option; 45 million Americans are covered by it. Not one of them said get rid of Medicare.

I don't hear any of my Republican friends coming to the floor saying we should get rid of another public option called Medicaid. That is for the poor. It works well. It is tough, and there are problems with it, but it works and it covers 60 million Americans. So you have 45 million Americans in a public option called Medicare, 60 million Americans in a public option called Medicaid.

How about the veterans health care program? I don't hear them pounding the table and saying get rid of the public option for our veterans. I will tell you, maybe they want to, but they would not say it because the veterans would be at their door because that public option covers 7.9 million veterans. Not one of my Republican colleagues say they want to end it.

I don't hear my Republican friends coming to the floor to say we should end our TRICARE program for our military. That is a public option for 9.5 million people. I don't hear them saying stop that public option.

Again, their own health care, brought to them by FEHBP, Federal Employees Health Benefits Program, that is a public option that covers 8 million people, including them, and they don't seem to want to end that. But when it comes to everybody else, they come down here and basically say: a government takeover of health care. False.

The public option is just one option in the exchange. It has to run by the rules of all the other insurance companies. I say if it is good enough for a Republican Member of the Senate and a

Democratic Member of the Senate, a public option ought to be an option for the people whom we represent.

Small business needs help here. I don't know if everybody is aware of this, but small businesses pay as much as 18 percent more for the same health insurance as large businesses. In California, we have seen increased premiums to small businesses that have meant a choice between laying off employees or not providing health insurance at all. More and more of these businesses are dropping health care coverage. If you are in the position where you work for a small business, you don't have health care coverage, and you want to stay there, when this bill goes into effect, you can go into the exchange and then you will have some buying power or your small business can go into the exchange.

This bill will protect our seniors, and it will strengthen Medicare. Medicare is a success story. Before Medicare became law, half our senior citizens went without health insurance. Now, 98 percent of our seniors are covered by Medicare. They believe in the program and they want it to continue. Those of us supporting this bill want to make Medicare stronger, and we do. This bill will ensure a stronger, more sustainable Medicare Program. It lowers prescription drug costs, as I mentioned before. It increases access to preventive services for our seniors, and it extends the solvency of the Medicare Program by 4 to 5 years.

My Republican colleagues are standing here saying that Democrats want to hurt Medicare--by the way, Medicare is a public option. They are saying the Democrats want to hurt Medicare, a public option. Honestly, who could believe that?

In 1964, George H. W. Bush called Medicare ``socialized medicine.''

Newt Gingrich, when he was Speaker of the House, said he wanted to see Medicare ``wither on the vine.''

In 1995, while seeking the Republican nomination for President, Senator Bob Dole bragged that he voted against creating Medicare in 1965. He bragged about it and said: ``I was there fighting the fight, voting against Medicare . . . because we knew it wouldn't work in 1965.''

The Republicans are saying the Democrats want to destroy Medicare in this bill. That is beyond ridiculous. The American people know who is on their side when it comes to protecting Medicare. We didn't just wake up this morning. We know who brought us Medicare.

This bill expands Medicaid. That is for the poor to ensure that the poorest and sickest among us can get into the program. We are going to get those with incomes below 133 percent of the poverty level into the program. That means that more than 1.5 million Californians who are uninsured or are struggling with the cost of health care, that will allow them to be covered.

I thank the majority leader for working with us to ensure that California receives increased Federal support as we expand Medicaid. For the first 3 years of this expansion, the Federal Government will fully cover the cost of expanding Medicaid.

I talked a little bit about prevention. Today, only 4 cents of every $1 we spend on health care is on prevention. Yet more than half our people live with one or more chronic conditions.

Five chronic diseases--heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes--are responsible for more than two-thirds of the deaths in America.

This bill will eliminate copays and deductibles for preventive care so people don't get to that serious illness. Those preventive services go into effect immediately.

That is an overview of the Patient Protection and Affordable Care Act. My friends on the other side have already come out against this bill. They say it is too long, too complex. One of them said it is ``holy war.'' This bill will cause them to fight a ``holy war,'' for some reason. Where is their bill? They don't have one. After all the things we know are wrong with the system--and you don't have to agree with us on everything, but where is your bill?

It seems like my Republican friends care more about playing politics than about protecting our families. That is what it feels like. They seem to care more about bringing down our President than bringing down the cost of health care.

They seem to care more about all that than Tim and Josie Jentes, of Los Angeles, CA. Tim is retired from Raytheon. He gets his health care through his retirement plan. During 2007, the first year of his retirement, their monthly health care premium was $460. During 2008, it rose to $630. In 2009, it rose to $850. That is an 85-percent increase in 2 years for this retiree.

Tim wrote to me and said:

I understand that compared to many we are fortunate to have

good health care and insurance. But we look forward to you,

Senator Boxer, the Senate, and the House . . . addressing the

seemingly unbounded increase in health care cost.

We do it in this bill. People such as Tim will be protected. But my friends across the aisle say: No, we are not going to help Tim.

What about Madeleine Foote of Costa Mesa, California? She turned 25 and lost the health care coverage she had under her parents. She tried to get coverage, but because she is taking medicine, she was denied. They said it was a preexisting condition. They said you can have health care, but you have to have a $3,000 deductible and premiums of $300 a month. She wrote:

As a young person working in a restaurant, repaying student

loans and trying to make it on my own, this is a huge

financial burden. I cannot afford insurance that charges me

so much. . . . For now, I am forced to hope that nothing

extremely bad befalls me.

She is another one who prays not to get sick. That is not a health care plan. My friends on the other side say: No, sorry, we are not going to help you, Madeleine.

I have so many other stories. There is Douglas Ingoldsby, a small business owner in Santa Barbara, CA. He has 11 employees, and soon he will not be able to afford to get them insurance anymore. He asked that I support a public option, and I do. My Republican colleagues are saying: Douglas, no, we are not going to help you. It goes on. The stories go on.

One of the stories is from a doctor, a retired pediatrician in Sacramento, Robert Meagher, who wrote and said that some parents begged him not to write on the form--after he saw a child with asthma, they asked: Please don't write down asthma. Say it was bronchitis. If you write down that my child has asthma, they will have a preexisting condition and when they go out on their own, they cannot get insurance.

Can you imagine a doctor having to face a parent like that? My Republican friends don't want to think about that. They seem to be thinking about politics and the next election.

We all know the bill before us isn't perfect. They should vote to start debate. They can try to make it better. There are many issues I am working on for California. There is the Disproportionate Share Hospital Program. I am working to get better prevention for women.

At the end of the day, this is where we are. Health care coverage for all of America's families has been an elusive goal since Teddy Roosevelt first proposed it nearly a century ago. Our dear friend, Senator Ted Kennedy, whom we miss so much, fought for health care right here on this Senate floor from the moment he arrived in the Senate in 1962 to the moment he died. Today, I am proud to say we are moving closer to fulfilling this promise of health care for all.

Robert Kennedy once said:

Few will have the greatness to bend history itself; but

each of us can work to change a small portion of events, and

in the total of all those acts will be written the history of

this generation.

This is our time. This is our moment. This is the moment for us to come together as a nation and make sure our people never again have to face what Nikki White faced in her last days--filling out forms, praying to God she could get health care, not being able to get it, and dying at age 32. That is immoral. It is not necessary. We can fix it, and we should.

I yield the floor.

Mr. President, I rise today in opposition to amendment No.

2785 to the Caregivers and Veterans Omnibus Health Services Act of 2009.

This is a deeply flawed amendment that may hurt certain veterans of the wars in Iraq and Afghanistan. And for that reason, I must vote against it.

Severely injured or disabled veterans often need someone to care for them in the home. The family members of these veterans often shoulder the burden of this care, which can take a significant financial, psychological and emotional toll. This bill would provide a family member caregiver with health care, counseling, support and a monthly stipend.

But amendment No. 2785 actually seeks to shut certain Iraq and Afghanistan veterans out of this new benefit by mandating that only those who require ``hospitalization, nursing home care, or other residential care'' are eligible.

The Wounded Warrior Project characterized the impact of the amendment as such, stating that it would ``set a much higher bar'' by requiring that the ``veteran be so helpless as to require institutional care if personal care were not available.''

This would potentially shut out veterans suffering from severe mental illness, or those learning to adapt to life at home with blindness or amputations.

The Disabled American Veterans also echoed this concern as a reason for opposing this amendment, writing that the amendment's ``new restrictive eligibility language could actually reduce the number of severely wounded and disabled veterans returning home from the wars in Iraq and Afghanistan eligible for such services.''

For these reasons, I urge my colleagues to defeat this amendment, which is also opposed by the American Legion, the Iraq and Afghanistan Veterans of America and Swords to Plowshares.

It is long past time to pass the underlying bill. This legislation is too important to our veterans to sit in Congress because of the stall tactics of one lone senator.

It includes important health care improvements for women veterans including requiring the Department of Veterans Affairs to train mental health care specialists on how to better treat military sexual trauma. It also implements pilot programs to provide child care to women veterans who require medical care.

In addition, the bill includes two important provisions from bipartisan legislation that I authored with Senator Bond.

The first gives active duty servicemembers access to vet centers, which are community-based counseling centers run by the Department of Veterans Affairs where veterans can receive mental health care services.

The second provision authorizes vet centers to counsel former servicemembers on their rights to present their medical records for review to ensure that the discharge process they underwent was fair. This is particularly important for servicemembers who may have been discharged improperly with a personality disorder and therefore are not entitled to benefits when in fact they suffer from a combat-related condition such as post-traumatic stress disorder.

We owe our veterans an enormous debt of gratitude, and the best possible treatment and care for injuries sustained in service to our country. This bill is an important step toward fulfilling that obligation.

Mr. President, I am honored to remember Lewis Millett--a recipient of the Congressional Medal of Honor, a retired Army colonel and a proud American who passed away on November 14, 2009.

Colonel Millett retired from the U.S. Army after a 31-year career that spanned three wars. He was awarded the Medal of Honor for leading a bayonet charge up a heavily defended hill during the Korean war. In his 31-year career in the Army, that included service in World War II, Korea and Vietnam, Colonel Millett received numerous awards, including the Distinguished Service Cross, the Silver Star, two Legions of Merit, three Bronze Stars, four Purple Hearts, and three Air Medals.

Born December 15, 1920, in Mechanic Falls, ME, Millett grew up in Massachusetts, where he joined the State National Guard. In 1940, with the war in Europe underway, he enlisted in the Army Air Corps. But after President Franklin D. Roosevelt said that no Americans would fight on foreign soil, he deserted the Army and joined the Canadian Army. When he arrived in Europe in 1942, the United States was in the war and he was allowed to transfer back to the U.S. Army.

As a member of the 27th Armored Field Artillery of the 1st Armored Division, Colonel Millett participated in the Allied invasion of North Africa, where he earned a Silver Star after driving a burning halftrack loaded with ammunition away from U.S. troops and jumping out before it exploded. After a year in combat, the Army reviewed his military record and convicted him of desertion. He was fined $52 and sentenced to 3 days hard labor. He was not required to do the hard time, and 2 weeks later he was made a second lieutenant.

After World War II, he returned to civilian status and joined the Maine National Guard. When the Army called for volunteers in 1949, he returned to Active Duty.

He later served in Korea as a company commander and in Vietnam as a military adviser with the intelligence program called Phoenix. Colonel Millett retired from the US Army in 1973.

He is survived by his sons, Lee and Tim, and daughter Elizabeth; a brother, Albert; three sisters, Ellen Larabee, Jean Pepin, and Marion Finnity; and four grandchildren. I extend my heartfelt condolences to them.

The military community, the State of California, and our Nation have lost a proud American and a great warrior.

Mr. President, I am so pleased that today the Senate will pass the fiscal year 2010 Military Construction and Veterans Affairs and Related Agencies Appropriations Act. This legislation provides $133.9 billion in critical funding to ensure that our Nation's veterans have the care and services that they have earned and deserve. Specifically, it includes for the first time advance appropriations for veterans medical services--ensuring that the Department of Veterans Affairs receives funds in a timely and predictable manner. It also provides $45 billion for veterans' health care, including $4.6 billion for mental health treatment and programs.

In addition, the bill includes $23.2 billion for military construction and family housing, including $9.9 million to replace the 144th Squadron's current operations facilities at Fresno-Yosemite International Air National Guard Base. The squadron currently operates across several outdated facilities that are not sufficient for modern day operations. The facility will ultimately be

used to house F-15C Eagle aircraft squadron operations. F-15Cs are expected to arrive at the base in 2012 to replace the aging F-16C fleet. The 144th Fighter Wing provides air defense for California from Oregon to the Mexican border and is vital to the Nation's security.

The Senate voted on a number of amendments to this bill that have important consequences and I want to provide some additional information on two of my votes.

Last night, the Senate rejected a motion to send this bill back to the Appropriations Committee. I joined 68 of my colleagues in voting against this motion because I believe that this is a strong, bipartisan bill. By sending this bill back to committee, we would be unfairly asking our Nation's veterans to wait even longer for care. The men and women who have served our country so honorably should not be forced to wait for critical services.

And today, the Senate voted to reject an amendment that would prohibit the use of funds in this bill to build or make security improvements to a facility in the United States to hold a detainee who is transferred here from Guantanamo Bay. What it would have done is prevent the administration from making vital security improvements to our detention facilities. Ensuring that detention facilities have the highest possible security is critical to our national security and this amendment would have restricted that ability unnecessarily.

Mr. President, I move to reconsider the vote.

Mr. President, I rise today to celebrate the 40th anniversary of an event that is referred to as the ``birthday'' of the Internet.

On October 29, 1969, Dr. Leonard Kleinrock of the University of California, Los Angeles, and his team successfully transmitted the first message to their counterparts at Stanford University, led by Dr. Douglas Engelbart, via a network system that was the predecessor of today's Internet.

I wonder if Drs. Kleinrock and Engelbart ever imagined the full impact and transformative nature of their experiment, not only on California and the United States, but also the world?

From those original tubes between UCLA and Stanford, the Internet has grown into a global network, facilitating important communication, commerce and services around the world. The Internet allows scientists to share research and findings. Consumers can shop almost anywhere in the world via the Internet and have their purchases delivered to their doorstep. Government services, from emergency information to registration of motor vehicles, can be accessed through the Internet.

The Internet has also been an important economic engine for our country, and I am proud that my state of California has been home to many innovators, such as Google and eBay, who transformed ideas into successful multinational businesses.

This anniversary also serves to remind us of the importance of collaborative research efforts between our government and universities, like the UCLA and Stanford. The first network system used by Drs. Kleinrock and Engelbart, called ARPANET, was developed through funding and collaboration between the universities and the Department of Defense.

Today, we must remember that universities and their researchers remain a vital resource in facing and solving the challenges of the future.

I want to close by congratulating the UCLA, Stanford University, and Drs. Kleinrock and Engelbart, for their hard work and contributions to the development of the Internet over the years. Forty years after that first successful message, the Internet continues to transform our lives and the world.

Mr. President, I ask my colleagues to join me in honoring the memory of Dr. Carol Tomlinson-Keasey, a committed educator and administrator and the founding chancellor of University of California, Merced. Dr. Tomlinson-Keasey passed away on October 10th from complications related to breast cancer. She was 66 years old.

Dr. Carol Tomlinson-Keasey was born in Washington, DC, on October 15, 1942. The daughter of an Army officer, she moved around frequently before graduating from a high school in France. Dr. Tomlinson-Keasey received a bachelor's degree in political science from Penn State University, a master's in psychology from Iowa State University, and a Ph.D. in developmental psychology from University of California, Berkeley.

In 1977, Dr. Tomlinson-Keasey became an associate professor of psychology at the University of California, Riverside. During her 15- year tenure at UC Riverside, she earned faculty and

administrative appointments. In 1992, Dr. Tomlinson was named vice provost and professor at University of California, Davis. She was appointed dean of UC Davis College of Letters and Science in 1994 and vice provost for academic planning and personnel in 1995 before lending her considerable talents to the University of California Office of the President in 1997.

Beginning in 1998, Dr. Tomlinson-Keasey assumed a leadership role in the planning and building of University of California, Merced, the first new University of California campus in 40 years. A gifted administrator, Dr. Tomlinson-Keasey fully immersed herself in every aspect of the enormous task of starting a major public university. Whether it was selecting the eventual site of the campus, the recruitment of administrators and faculty members or even choosing the school mascot, Dr. Tomlinson-Keasey worked tirelessly to see that the dream of a University of California campus in the San Joaquin Valley became a reality. In 1999, Dr. Tomlinson-Keasey became the first female founding chancellor of a University of California campus.

UC Merced has been a model of growth and progress since its inception in 2005. Today, the burgeoning campus is a living testament to Dr. Tomlinson-Keasey's hard work, vision, and dedication. Dr. Tomlinson- Keasey has left behind a legacy that has resulted in greater opportunities for future generations of California students, especially those students who are the first in their families to attend college and come from underrepresented ethnic or racial minority groups in the Central Valley. Her family and friends should take great pride and comfort in knowing Dr. Tomlinson-Keasey's accomplishments will continue to positively impact many people in the future.

Dr. Tomlinson-Keasey is survived by her husband Blake Keasey; children, Amber and Kai; three brothers, Alen, Gene and John Tomlinson; and four grandchildren.

I thank Senator Mikulski for her leadership. Everyone in America has a stake in health care reform, even if they are happy with their insurance at the moment. The main reason is that costs are exploding and health care insurance companies are walking away without any penalty. They come up with a reason, and then we all are paying for those who have no insurance and wind up in the emergency room.

Women have even more at stake. Why? Because they are discriminated against by insurance companies, and that must stop, and it will stop when we pass insurance reform.

Now, how are women discriminated against? If they have been victims of domestic violence, that is considered to be a preexisting condition and, therefore, they are told they can't get insurance, and that happens in eight States and the District of Columbia. It is a tragedy, and it will change when we pass health insurance reform.

If a woman is pregnant, only 14 States in America require insurance companies to cover maternity care. Imagine, a country that puts family values first and yet only 14 States will cover maternity. That will change.

Everyone is faced with huge increases in cost, but women 18 to 55 are charged nearly 40 percent more than men for similar coverage in my home State, and that happens in most States, and health reform will stop that.

Because of discrimination, women are at risk under the current system. More than 52 percent of women reported delaying needed care or avoiding it completely because of cost compared to 39 percent of men. Now, 39 percent is terrible, but 52 percent is deplorable. People are walking around sick because they can't afford to go to the doctor. Health insurance reform will stop it. There will be no more gender rating.

Women earn less than men, and that is why it is an impossible situation. In my home State, over the past 9 years, premiums have risen more than four times as fast as earnings. We spend more than twice as much as any other industrialized Nation on health care. You would think we would have greater outcomes, Mr. President, but we rank 29 out of 30 industrialized nations in infant mortality. It isn't surprising, when so many women are not getting prenatal care.

Medicare: More than half of those on Medicare are women. If we do nothing, Medicare goes broke in 2017. So when politicians try to scare our seniors, it is despicable because it is the status quo that is dangerous. When we fix Medicare--and we will in health reform--women will get free preventive care, mammograms, and annual physicals.

So in summary, women, children, and men need us to act on health reform. We must make our voices heard.

I thank my colleagues, my women colleagues, for coming to the floor of the Senate today to wake up this Nation.

Mr. President, I thank the Senator from Wisconsin and the Senator from Vermont for joining me to discuss $350 million in emergency dairy assistance funding included in the fiscal year 2010 Agriculture, Rural Development, and Food and Drug Administration Appropriations Act conference report.

I had a very encouraging meeting with the Secretary of Agriculture where he informed me that he intends to distribute emergency dairy assistance funds included in the conference report in a way that is regionally equitable, and to do so as quickly as possible.

As the author of the amendment to the fiscal year 2010 Agriculture appropriations bill that added $350 million in emergency dairy assistance funds, the Senator from Vermont stated on the floor that ``whether it is Vermont, Wisconsin, California, Colorado--rural America is hurting.''

The Senator from Vermont went on to say that ``I know the people familiar with dairy always say these are great regional fights, the Northeast is fighting the Midwest is fighting the Southeast is fighting the West coast, and every region has its own set of priorities. This is not a regional issue, this is a national issue.''

I ask the Senator from Vermont, was it your intention that emergency assistance be provided to dairy farmers in every region of the country?

I thank the Senator from Vermont. If I may ask the Senator from Wisconsin, as the lead Senate negotiator, can you tell us how the conference committee intended these funds to be used when crafting the final language?

I thank the Senator from Wisconsin for his views and say further that his understanding of the Secretary's goals is correct. I thank my colleagues for joining me to discuss this issue.

Mr. President, I rise to discuss the Water Transfer Facilitation Act of 2009. Senator Feinstein and I have introduced this legislation to facilitate voluntary water transfers within the San Joaquin Valley.

Three years of below-average precipitation have restricted water supplies for much of California. Drought conditions have particularly affected agricultural communities in the San Joaquin Valley.

As a result of these water shortages, more than 500,000 acres of cropland have been fallowed in the San Joaquin Valley, and some cities on the west side of the Valley are facing nearly 40 percent unemployment.

Senator Feinstein and I have worked with Representatives Cardoza and Costa to identify measures to address these water shortages. We included a measure in the Energy and Water appropriations bill allowing voluntary

water transfers between water users on the east and west side of the San Joaquin Valley.

The final provision included in the conference report will allow these transfers for a two-year trial period. We are now seeking to extend this provision permanently and to enable more water users to participate in these transfers.

In addition, our legislation directs the Department of the Interior to use a programmatic approach to environmental review for certain types of water transfers, helping to expedite them.

Finally, it requires the Department of the Interior to prepare a report and recommendations on how to facilitate water transfers throughout California, including between the State and Federal water projects.

These water transfers are an important tool for improving flexibility in managing water supplies, providing a mechanism for getting water to those communities who need it most. Preliminary estimates suggest that this legislation may enable the transfer of as much as 250,000 to 300,000 acre-feet of water per year to communities in need. This will provide a crucial resource to agricultural communities in California that lost 90 percent of their expected water allocations this year.

I look forward to working with my colleagues in the Senate and in the California delegation to advance this important legislation.

Mr. President, I rise to discuss the Water Transfer Facilitation Act of 2009. Senator Feinstein and I have introduced this legislation to facilitate voluntary water transfers within the San Joaquin Valley.

Three years of below-average precipitation have restricted water supplies for much of California. Drought conditions have particularly affected agricultural communities in the San Joaquin Valley.

As a result of these water shortages, more than 500,000 acres of cropland have been fallowed in the San Joaquin Valley, and some cities on the west side of the Valley are facing nearly 40 percent unemployment.

Senator Feinstein and I have worked with Representatives Cardoza and Costa to identify measures to address these water shortages. We included a measure in the Energy and Water appropriations bill allowing voluntary

water transfers between water users on the east and west side of the San Joaquin Valley.

The final provision included in the conference report will allow these transfers for a two-year trial period. We are now seeking to extend this provision permanently and to enable more water users to participate in these transfers.

In addition, our legislation directs the Department of the Interior to use a programmatic approach to environmental review for certain types of water transfers, helping to expedite them.

Finally, it requires the Department of the Interior to prepare a report and recommendations on how to facilitate water transfers throughout California, including between the State and Federal water projects.

These water transfers are an important tool for improving flexibility in managing water supplies, providing a mechanism for getting water to those communities who need it most. Preliminary estimates suggest that this legislation may enable the transfer of as much as 250,000 to 300,000 acre-feet of water per year to communities in need. This will provide a crucial resource to agricultural communities in California that lost 90 percent of their expected water allocations this year.

I look forward to working with my colleagues in the Senate and in the California delegation to advance this important legislation.

Mr. President, I take this opportunity to recognize the 75th anniversary of the East Bay Regional Park District,