Floor Statements

Mr. President, today I recognize Boone and Newton Counties, in my home State of Arkansas, for their efforts to create communities where children and their families have access to healthy, affordable foods and safe places to play and exercise. These counties, through the North Arkansas Partnership for Health Education, NAPHE, recently received a $360,000 grant from the Robert Wood Johnson Foundation's ``Healthy Kids: Healthy Communities'' program.

The funding will help local officials and organizations create policies that encourage active lifestyles for children and healthier eating habits for all residents in Boone and Newton Counties. The project will create a walking path to connect the south side of Lake Harrison to the schools and grocery stores to the north and will develop a system to deliver healthy foods to underserved neighborhoods and more remote parts of the counties.

According to Rick Hinterthuer, NAPHE executive director, ``our community model is extremely efficient and effective. If we can do it in Harrison, it can be done in other places. We reach our community best through the Home Town Health Coalitions of Boone and Newton Counties.''

I have had the pleasure of visiting the Boone County Hometown Health Improvement Coalition. The program is a model for the rest of the country and illustrates how a community can leverage its resources to address community health issues through local, State, regional and national partnerships.

As chairman of the Senate Committee on Agriculture, Nutrition and Forestry, I have fought to include funding to provide meals to needy children during summer months, to secure grants for States to modernize their school lunch delivery systems, to improve health outcomes for infants participating in the WIC Program, and to promote the health of young children in early childhood settings.

I salute the good work going on in Harrison and North Arkansas to help keep our youngest citizens healthy.

Mr. President, today I congratulate the Brandon Bauman Family for being named the 2009 Northern Arkansas County Farm Family. The recognition comes in honor of the Baumans' efficiency of production, conservation of energy and resources, leadership in agriculture and community affairs, home and farm improvement, and home and farm management.

Brandon and his wife Amy have two daughters, Caroline and Abigail. They farm 2,200 acres with rice, soybeans, wheat, and oats. I was pleased to help recognize the Baumans earlier this month during the 70th Annual Stuttgart Chamber of Commerce Membership Meeting and Banquet in Stuttgart.

As a seventh-generation Arkansan and farmer's daughter, and as chairman of the Senate Agriculture Committee, I understand firsthand and appreciate the hard work and contributions of our farm families. Agriculture is the backbone of Arkansas's economy, creating more than 270,000 jobs in the state and providing $9.1 billion in wages and salaries. In total, agriculture contributes roughly $15.9 billion to the Arkansas economy each year.

Our farm families are critical to our Nation's economic stability. Agriculture leads all U.S. product groupings with the largest trade surplus at $23 billion in fiscal year 2009, almost triple the next largest category of transportation products. We must work to continue the farm family tradition, so families such as the Baumans are able to maintain their livelihoods and continue to help provide the safe, abundant, and affordable food supply that feeds our own country and the world and that is essential to our own economic stability.

I salute the Baumans and all Arkansas farm families for their hard work and dedication.

Mr. President, today I congratulate Norma Strabala as ``Citizen of the Year'' and Debbie Ahrens as ``Volunteer of the Year'' for Stuttgart, AR.

I was pleased to be on-hand as Norma and Debbie were recognized earlier this month during the 70th Annual Stuttgart Chamber of Commerce Membership Meeting and Banquet in Stuttgart. I have felt a long kinship to Stuttgart, one of our delta communities not far from and very similar to my hometown of Helena. Stuttgart always feels like home, and I am grateful for the friendships I have made there. As members of a community with such a great spirit of volunteerism and caring, Norma and Debbie should be particularly proud of their recognitions.

According to those who know her best, Norma always strives to help other people through her attitude and actions. She has consistently worked to establish programs that help those less fortunate. She was a key figure in coordinating volunteer efforts during and after the 2008 tornado and 2009 straight-line winds that damaged much of the city, and during each holiday season.

Similarly, Debbie is known throughout Stuttgart for her volunteer efforts. Through the years, she has been active on many local Chamber of Commerce committees and is a deserving recipient of the designation of ``Volunteer of the Year.''

We should all embrace the spirit of service and volunteerism on display by these deserving individuals. I send my heartfelt congratulations to both Norma and Debbie.

Mr. President, today I would like to congratulate Wynne Intermediate School, in Wynne, AR, on achieving the designation as a ``Program of the Month'' from the national ``Reading Is Fundamental,'' or ``RIF,'' program for the month of December 2009. RIF prepares and motivates children to read by delivering free books and literacy resources to children and families who need them most.

Located in the Arkansas Delta, not far from where I attended public school myself, the Wynne Intermediate School RIF program serves 462 children in the 4th and 5th grades. For the past 16 years, Wynne Intermediate School has held engaging motivational activities for both students and parents. With the closest bookstore 50 miles away, families depend on the RIF program to enjoy reading together.

I believe that education is the key to success for our young people. The knowledge and training that students receive today are the tools that carry them for the rest of their lives.

That is why I am so proud to help recognize Kaley Boeckmann, RIF coordinator, and the entire faculty and staff at Wynne Intermediate School for their dedication in helping increase opportunities for students to read and learn. Through their leadership and good example, countless students have been motivated to expand their horizons through the written word.

Most important, I would also like to congratulate all of the students in Wynne who have discovered the joy of reading. I encourage them to make the most of their education and opportunities.

I would like to engage my colleague, the distinguished Senate Finance Committee chairman, in a short colloquy regarding the Medicaid pharmacy reimbursement provisions in the Senate health care reform bill.

I thank my colleague and agree with him. That is why I ask him the purpose behind the language in the bill that would establish the Federal upper limit for generics at no less than 175 percent of the weighted-average average manufacturer price. I know this amount is less than the chairman originally proposed in the Medicaid Fair Drug Payment Act from last Congress, which I cosponsored. However, in what cases would it be the intent of the intent of the chairman that the Federal upper limit would be set at more than 175 percent? I am particularly concerned about my small independent pharmacies in Arkansas that fill a significant number of Medicaid prescriptions. Would it be the intent to set a higher rate for these pharmacies? Would it be the intent to set a higher rate for generics that might be in short supply or for which there are availability problems to encourage more manufacturers to make them?

I thank the chairman for his insights into this provision and his work on behalf of our Nation's community pharmacies.

Madam President, the Committee on Agriculture, Nutrition and Forestry has amended and adopted subcommittees for the 111th Congress. On behalf of myself and Senator Chambliss, I ask unanimous consent that a copy of the subcommittees be printed in the Record.

Yes.

Mr. President, thank you. And I appreciate the courtesies of my colleague from Oregon for allowing me to speak now.

I rise today to talk a little bit about the health care concerns, particularly, in our small businesses. I first wish to compliment and thank my colleagues, particularly Senator Landrieu, who is chairman of the Small Business Committee, as well as Senator Snowe, with whom I have worked for years on the plight of the small businesses in our States and across the country--their need to be able to really access the kinds of competition and choice that allow them to make good decisions and spend their health care dollars more wisely and being able to do what they all want to do in small business, and that is to be able to cover their employees, to make sure their employees and their employees' families are covered with reasonable and meaningful health insurance that actually covers what they need but is at an affordable price. So I thank those women, as well as Senator Stabenow, who I know has also been working on these issues.

But I really come to the floor today to highlight the challenges Arkansas small business owners face in providing quality, affordable health care for themselves, their families, and their employees under the current system and to look at what we can do to improve what their challenges are, what it is they face.

Small businesses are our No. 1 source of jobs in Arkansas, and they are truly the economic engines of our local economies, but they are also the economic engines of our national economy, not to mention learning laboratories for great ideas that will allow us in this great Nation to be truly competitive in the 21st century.

Arkansas's nearly 250,000 small business and self-employed individuals make significant contributions to our State's economy and generated $7.2 billion in 2008. Small employers account for 97 percent of the employers in our State, and I would daresay nationally it is somewhere at that same level.

Addressing the needs of small businesses is absolutely critical to any health insurance reform legislation we bring forward.

As I mentioned before, Senator Snowe and I have worked together for many years to try to address these concerns, talking with small businesses and their advocacy groups to try to figure out what it is we can provide them, just as we provide ourselves as Federal employees the ability to access health insurance that has been negotiated, where people have come together, pooled the resources of all of our risks as Federal employees--all 8 million of us--to really get a better deal in the marketplace.

We want to be able to allow small businesses to do the same, to come together nationwide, pool themselves in their State exchanges, and be able to really take advantage of sharing their assets and their risks in the health insurance marketplace and get the best possible product they can.

Those small businesses that are able to afford health care coverage for their employees in today's world continue to experience skyrocketing costs, jeopardizing our States' and our Nation's competitive edge, both among themselves nationwide domestically but also internationally. We find that our small businesses are finding themselves more and more in the situation of having to be competitive globally to be able to do the business they do and to create the jobs they need to create.

Yesterday, I spoke with a radio station owner from Wynne, AR, in Cross County, who said high costs have threatened his ability to be able to provide coverage for his employees. Or, worse, skyrocketing costs are forcing business owners to consider giving up their businesses altogether, like the small business owner from Malvern, AR, who wrote me that he was giving up his 17-year-old business because he can no longer afford his rising health care insurance premiums. His wife and

his daughter each have a preexisting medical condition, and he feels pressured to find a new job that provides affordable employer-sponsored coverage for his family.

I heard from another small business owner in Mena who told me that at the age of 65, he continued to keep himself on his own small business's health insurance plan in order to ensure that he could maintain providing health insurance to his employees, many with whom he grew up. They were friends of his from grade school or church and community services and other places where he had built lifelong relationships, not only as an employer and an employee but as part of a community. Being able to maintain providing that to them was so critical to him that he was willing to ante up.

I have heard from small business owners from all across my State who desperately want to offer health care coverage for their employees, but it is simply not cost productive. The fact is, so many people think small businesses just want to opt out, that they don't want to provide health insurance, but they do. They do because it is important to them as a part of that community to do something for their employees who also happen to be their friends and neighbors. They also want to make sure their business is the best it can be, and in order to do that they have to compete for those skilled workers. Getting the best workers means providing good benefits, with health care being at the top of that list.

Another Arkansan asked me to please include the self-employed in my efforts to secure affordable health care. There are many small businesses with only one employee, and health care under this scenario is extremely expensive. They are put in an individual market where they are rated against themselves in many instances and not given the benefit of what we enjoy as Federal employees; that is, pooling ourselves together, adding our assets and our risks together so that we can mitigate that risk among all 8 million Federal employees.

These are just a few of the stories I have heard from Arkansans, and that is why in every Congress since 2004, I have introduced legislation to help small business owners afford health coverage for themselves, their employees, and their families. Several of my provisions are already included in the health insurance reform bill currently before the Senate, including the tax credit to help small businesses afford coverage, and we want to improve upon that. Also included are insurance exchanges through which consumers can compare insurance plans side by side so that they will be able to choose the option that is best for them, allowing their employees to see what is available to them and making sure that they are having access to all the options of the marketplace. There are reforms that force insurance companies to change the way they do business by limiting what an insurer can charge based on age and by banning the practices of denying coverage based on preexisting conditions or increasing rates when customers all of a sudden get sick.

We look at our small businesses and, yes, there are a lot of young entrepreneurs, but a lot of our small businesses are those individuals in that category above 55. These are people who, unfortunately, are starting to see chronic disease challenges in their life as they age. Unfortunately, they become an issue, or certainly their coverage becomes an issue when we talk about preexisting conditions. So it is critical that we make sure we change the way insurers do business as usual today and make sure they are playing fair with the small business entities out there.

Just one more of my efforts is something on which we worked with Senator Snowe and Senator Durbin, which is to allow that there would be national private insurers, as there are today, but allowing them to sell multistate plans nationwide, to be able to sell their plans in all 50 States. It would be with a strong Federal administrator who would be able to negotiate for quality and affordable coverage. Some of this has emerged as another potential part of the framework for national health insurance reform that can help us achieve our goals of more choices and more affordability for consumers, particularly those in the small business marketplace.

So I wish to thank the Presiding Officer for the opportunity to share with my colleagues and certainly those Americans out there who are the ingenuity and the engine of our economy. I know my colleague from Oregon has talked so much about choice and competition. It is so important, more important than ever in that small business marketplace and in that individual marketplace, as well as providing exchanges and the ability for national insurers, private insurers to be able to provide these types of products across all 50 States. Also, a multistate plan gives our small businesses and our self-employed, our individual marketplace, our independent contractors, such as our realtors and others, the ability to have access to greater choice, greater competition in that marketplace, and, therefore, a better product--greater, more meaningful coverage at a more reasonable cost, and that is what we want to see. More importantly, that is what our small businesses want to see.

So I thank the Presiding Officer, and I yield the floor to my colleague from Oregon and my colleague from Indiana, and the Senator from Maine as well, whom I know will have a great addition to this conversation. Thank you.

Mr. President, today I join many of my fellow Arkansans in recognizing and thanking Terry Sherwood with the Southwest Arkansas Planning and Development District for his 40 years of work with this agency and to wish him all the best in his retirement.

Since the Southwest Arkansas Planning and Development District was organized and began operation in 1967, it has served local governments by working as an indispensable partner to identify and implement State and Federal programs. Through Terry's hard work and leadership with the Southwest Arkansas Planning and Development District, communities throughout southwest Arkansas have been positively impacted and their lasting results are a testament to his dedication and vision and will be felt for decades to come.

Not only has Terry admirably served in his chosen career, but he has also offered his talents and expertise to a variety of local, state and national organizations. Terry has served as past President and board member of the National Association of Development Organizations, chairman of the Arkansas I-69 Association and vice-president of Arkansas Good Roads, board member of the Council of Peers and Southwest Regional Economic Development Association, chairman of the Association of Delta Development Districts, member of the Arkansas Highway and Transportation Public Participation's Committee, and a member of the Arkansas Association of Development Organizations. Terry's efforts have enhanced the lives of the citizens of our state. I am thankful for his work and his friendship and wish him a productive retirement.

I am proud to represent Terry in the U.S. Senate and pleased to have this opportunity today to publicly thank him for his contributions to the State of Arkansas and the people he touched.

Mr. President, I think it is so important we look at the choice we will be making when we vote on this amendment in a few minutes. It is very simple. When health insurance reform becomes law, health insurance companies will receive millions of new customers purchasing their product for the first time.

My amendment is intended to encourage those insurance companies to put the additional premium dollars they will be bringing in with the volume of new customers back toward lowering their rates and making more affordable coverage for consumers, not putting it in their own pocketbooks.

Where health insurers spent more than 90 cents of every dollar on patient care in the early 1990s, that number has decreased dramatically to just over 80 cents for every dollar in 2007, and even more so in recent years.

According to testimony delivered in the Senate Commerce Committee earlier this year, this trend has translated into a difference of several billion dollars in favor of insurance company shareholders and executives at the expense of health care providers and their patients.

I think it is so important we understand what it is. This amendment does not dictate what insurance companies can pay their executives. They have the complete ability to pay what they choose. It is not a salary cap. But it does limit the American taxpayers' subsidization of outrageous pay and, instead, devotes those resources to protecting Medicare.

A vote for this amendment is a vote in support of strengthening the Medicare trust fund. A vote against this amendment is a vote in support of having the IRS write a check of $650 million to the health insurance companies to subsidize the multimillion-dollar salaries they are paying their executives.

So I urge my colleagues to support this effort on behalf of the American taxpayer and our seniors and to vote in favor of our amendment.

Mr. President, I am proud to join in this debate on an issue that is absolutely critical to all Arkansans and all Americans. I compliment Chairman Baucus because, as we talk about this issue in terms of health care reform, clearly, our delivery system in health care is broken. We have the best hospitals and doctors, research and technologies in the world. Yet our delivery system is broken. For the last 24 months, the Senate Finance Committee has held hearings and roundtables, summits, all kinds of different deliberative efforts working in partnership with associations that represent providers, advocacy groups on behalf of patients, anybody who would come to the table to talk about how we reform this system and make it better for the constituents we serve, the patients who are the ultimate recipients of the health care system. I applaud him and the work we have done.

To anyone who says we are jumping in here and moving too fast, I have tremendous respect for the minority leader from Kentucky. My husband trained at Kentucky, did his subspecialty there. His admiration for one of those he trained with is a good friend of Senator McConnell's. But the minority leader's comment that we are saying to our constituents, sit down and shut up, again, like the comment from the Senator from Tennessee that we are throwing seniors under the bus, we are in a body that is here to be respectful of one another, respectful of our differences, our different approaches, how we come to the ideas we have of how we solve these questions.

The Senator from Massachusetts brings up a great point. Where are the suggestions from the other side of how we solve this? Come to the table. Are they going to come to the table with ideas of how we do something other than just going with the status quo? Clearly, Americans understand that we are not throwing them under the bus. We are trying to figure out how we preserve a Medicare Program that is going to be bankrupt in 2017. How do we make the difference in the delivery system so we bring down those long-term costs in health care, so that we can actually preserve the programs

that work and that are so meaningful to people in their lives. As we come to this debate, I hope we will continue the age-old attitude in the Senate of being respectful for one another's views and one another's efforts in trying to bring about something that will make sense and that will be helpful, not throwing people under the bus, not telling constituents to sit down and shut up, but actually working hard to come up with some solutions.

Senator McCain was trying to call an awful lot of people in Arkansas. My mother was one of those whom he tried to get in touch with to tell them that something is wrong up here and that we are not doing what we need to do. I certainly visit with my mom an awful lot. I hear about her experiences and the concerns she has about Medicare, which is a system that is great for her, and I am proud I live in a country that provides her with that kind of care. She does believe very strongly in some of the things she has seen in her Medicare bill, inefficiencies that could be changed, ways that we could make it a better program. I hope we will all come to the table here with good ideas and ways that we can make a difference.

I notice that there was an effort or certainly a concern about wanting to add people to my amendment. I would welcome Republicans, if they wish to offer their own amendment to include other entities, if they wish to do that. I have worked on my amendment, and I like my amendment the way it is. I think it focuses on an industry with the sole purpose to provide health insurance. Their sole purpose is to provide health insurance. If they want to add other people----

I will continue visiting for a moment, and then I will let the Senator take time on his part. I am directing it solely to those businesses whose only purpose is to provide health insurance for the people of this country.

I refer as an example to an article that came out yesterday. It references basically one of our large national insurance companies working hard, at least I hope they are, to do what is right. I see that they are going to be dumping 600,000-plus customers because they don't think their profits are big enough. Yet I look at the record, and I believe their CEO actually, in 2008, made over $24 million. If they can pay their top executive $24 million last year but they are going to complain that their profits are not big enough, that they have to dump patients, I would ask my colleagues, where do we go to correct this imbalance, if it is not to a very plausible amendment? My amendment does not restrict what industries, corporations can provide or give their executives in pay. It says we are not going to subsidize that with tax dollars. The very American taxpayers they are dumping are the ones who are subsidizing those incredible executive pay amounts.

I have to say to my friends over there, those over there who are defending the status quo on behalf of the health insurance companies and their executives who are receiving these multimillion dollar compensation packages, it took nine of them at one time, so it is a tough lift to be able to defend these executive compensations for insurance company executives; otherwise, nine of them wouldn't have been down here trying to shift the conversation to something else.

The American people do understand that is out of balance. Here we are with an opportunity to provide these insurance companies even more customers. We just simply want to be reassured that we are not, through taxpayers' dollars, subsidizing these enormous executive compensation amounts and, more importantly, that the savings that come from that are going to go into the Medicare trust fund to shore it up.

I appreciate everyone's debate and their efforts to come to the floor today and talk about a critical issue. I remind my colleagues, current law allows all businesses to deduct up to $1 million annually per executive as a business expense. That is a million dollar tax break per executive per company that is subsidized by the taxpayers. There are multiple more ways they can obviously provide greater compensation, and there are lots of loopholes in there that allow them to get tax subsidies for more compensation for their executives. My amendment would limit this amount to $400,000, the very amount the highest public official in this land gets paid, the President, a $400,000 salary for those health insurance companies that will profit as a result of the health insurance reform.

Our objective is to get more people insured. Working diligently through all of these technicalities, trying to get more people insured, we are creating a new marketplace for them with more consumers, a tremendous amount. This is only in regard to health insurance companies. It doesn't dictate what a business can pay an employee. It does limit the taxpayer subsidies for compensation. This is a fair policy. It is aimed at encouraging health insurance companies to put premium dollars toward lower rates and more affordable coverage, not into their pocketbooks. They are complaining about profits. Yet they are still paying these executives a tremendous amount of money. To be sure, there is evidence these companies need the encouragement to do the right thing for consumers. Where health insurers spent more than 90 cents per every dollar on patient care in the early 1990s, that number has decreased to just over 80 cents per dollar. For every dollar they spend, only 80 cents of it goes back into their efforts to provide coverage for consumers. That is in 2007. Those are the numbers we have.

According to testimony delivered to the Senate Commerce Committee earlier this year, this trend has translated into a difference of several billion dollars in favor of insurance company shareholders and executives at the expense of health care providers and their patients. It is imperative that we do what we can to reverse that trend, particularly now when millions more Americans will be purchasing their health insurance coverage as a result of this health reform package. Taxpayers are footing the bill for this subsidy, and we must take steps to deter the health insurance companies from further enhancing their profit margins at the expense of the American people.

We had a lot of Senators who came to the floor this morning on the Republican side to defend the status quo on behalf of the health insurance companies and their executives who are receiving these multimillion dollar compensation packages. Maybe they don't understand that under current law, the American people are already footing the bill for this tax windfall for health insurance executive pay. As we move forward, it is going to be a greater benefit to those executives and the ability for these insurance companies to be able to do that. We want to keep those insurance companies in business. We want to make sure they are there as providers. It is just a disconnect when they say they have to cut 600,000 of their insured under the current system because their profits aren't high enough. Yet they are paying their top executive a $24 billion compensation package that is subsidized by the taxpayers.

I hope we will work together to figure out what is the right place to be here, if what we want to do is to make sure we are reforming health care, that we are asking everybody to come to the table and make an effort in putting ourselves back on track. Ultimately, we want that quality of life that a new, reformed health insurance and health care delivery system can provide. We also want to make sure we strengthen our economy. Making sure we make good use of every medical dollar, that we are getting the biggest bang for that buck is a critical part of putting our economy back on track.

The assumption on the other side has basically been based on the current and broken marketplace where insurance companies really do bully their customers and monopolize choices. I don't know about their phones, but I hear a lot on my phones and from my constituents that they can't get insurance.

They have a neighbor--a hard-working woman who is a single mom--who cannot get insurance because of a preexisting condition. I have others who have had insurance, and then when they did become ill, they got dropped.

So our hope is we look at this in the context not of the broken marketplace that exists today but of what we are trying to create, and that is, a more robust marketplace, and one that makes sense both for insurance companies and for consumers as well.

With insurance market reforms we plan to implement, along with more consumer choices through the exchange, these insurance companies are going to have to work to keep up with the business they have and to be able to be there for future customers. That is a healthy marketplace. I do not think I will get any disagreement from my colleagues on the other side that competition and choice is the way to go in the marketplace. That is who we are as Americans. It is to let those who have that entrepreneurial spirit--who want to get in the marketplace and provide a product at a reasonable cost--to be an active part of the marketplace. That is what we are trying to encourage in this legislation.

So the amendment I am offering today would set the deduction cap at the same level as the highest paid government official, and that is the President. It is estimated to save approximately $650 million over 10 years, and will place these savings in the Medicare trust fund to further strengthen the solvency of that fund and protect our seniors.

We want desperately to make sure we protect our seniors. We know that in many instances there are Medicare Programs out there, unfortunately, that are oversubsidized, which means those who are in regular Medicare Programs are having to pay for the outrageous subsidies in these other Medicare Programs. We want to make sure we bring them to balance and create a better system for everybody out there. That means bringing down long-term costs. It means making sure we are protecting Medicare for all seniors. It means we do it in a deficit-neutral way, which we have done in this bill and the other bills we worked on in the Finance Committee. It means we work to put our best foot forward and bringing about partnerships between States and the Federal Government, as well as with providers who understand this delivery system is broken as well.

So in closing, the choice on this vote is very simple: either you support these revenues being placed in the Medicare trust fund or you support having the IRS write a check and sending it to health insurance companies to subsidize the multimillion-dollar salaries they are paying in their taxes.

I urge my colleagues to support this effort on behalf of the American taxpayer and on behalf of our seniors, and to vote in favor of this amendment that I feel has been structured in a very fair way.

Mr. President, I yield to the Senator from Montana.

Mr. President, I call up amendment No. 2905.

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

I yield the floor.

Mr. President, with a mother who is covered by Medicare, I remain committed to protecting seniors' access to Medicare, just as I have throughout my public service, which is exactly why I am opposed to the McCain motion to commit. Mr. McCain's purpose is not to protect Medicare but to frighten our Nation's seniors so that they too will oppose health care reform. I have noted that he has taken his scare tactics to a new level by recording his voice for an automated phone call into my State claiming to seniors that these Medicare savings are going to cut their benefits. He urges them to call me. I believe the seniors in my State know me better than that. They know that I have worked my entire career in this body to protect Medicare.

I have cosponsored the Bennet amendment as an extra safeguard to ensure our seniors that this bill does not cut the guaranteed Medicare benefits that they receive today and that any savings generated from making the Medicare Program more efficient will go back into improvements to the program.

If we do nothing, the Medicare Program will be broke in just 8 years. This bill restores the program's solvency beyond 2022. It will reduce premiums and copays for seniors; ensure seniors can keep their own doctors; cut the billions of dollars of waste, fraud, and abuse that occur annually; provide new prevention and wellness benefits for seniors; lower their prescription drug costs; and help them to stay in their own homes rather than going to nursing homes if that is what they wish to do.

So what about the $500 billion in Medicare cuts Republicans say seniors should be worried about? Well, what they are not saying is that part of the reason Medicare is insolvent is the fact that private insurers under the Medicare Advantage Program are overpaid by 14 percent on average. A typical couple pays $90 more per year in Part B premiums to pay for Medicare Advantage overpayments, even if they are not enrolled in these plans. This bill curbs those overpayments, saving over $118 billion, by for the first time requiring competitive bidding of Medicare Advantage plans against one another. Furthermore, Medicare and Medicaid subsidies to hospitals that help them cover the cost of the uninsured will be reduced since hospitals will have less need for them once millions more Americans have health insurance. That is another $43 billion. Provision after provision is specifically designed to ensure greater value in Medicare, all while the Republicans are using fear tactics to score political points.

I have heard from many seniors in Arkansas, recently, and over the years, about their satisfaction with Medicare. It is not a perfect program, and as a Senator it is my job to ensure that Congress continue to improve upon the program as needed so that it can continue to meet the needs of our Nation's seniors. Rightly so, seniors in my State are concerned about the misinformation spreading that we will cut their benefits and allow bureaucrats to ration their care. Organizations such as AARP, the Alliance for Retired Americans, and the National Committee to Preserve Social Security and Medicare have stood up to say enough with the misinformation campaign. Today I add my voice to that chorus.

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

Madam President, I have asked for this time today not only to address my colleagues in this body but to speak directly to my constituents at home in Arkansas. After many months of debate on health care, we are nearing yet another important step in a very deliberative process. Today we are voting on whether to continue to discuss how to improve health care in America or to stop the debate.

I personally have carried the mantle to improve health care for Arkansas throughout my public service, like many of my colleagues and so many others as well who have worked hard on this issue. Over the last several decades the advance of medical technology and our Nation's changing demographics have placed new demands on our health care system that it is not designed to meet.

Our vote later this evening is not the first step toward making the necessary adjustments in health care, nor will it be the last, without a doubt. The Finance Committee on which I serve and which is led so ably by my good friend from Montana, Chairman Baucus, has produced what I still describe as the most responsible approach to health insurance reform. We deliberated for more than 22 months, incorporating recommendations from experts all across our great Nation and proved, through our bill, that America can achieve unprecedented health insurance reforms that expand coverage, reduce cost, and provide stability for those with existing coverage.

We accomplished these goals without posing long-term risk for taxpayers. It was not a perfect bill. We never see perfect bills around here, quite frankly, but I can honestly say I will fight hard so our final product will more closely resemble the commonsense, deficit- reducing plan we produced in the Senate Finance Committee.

At times like this I think it is very important for each of us to remember the very reasons we began this debate. Small businesses and working families are reaching the breaking point financially because of the relentless rise in health care costs. Nationally, our economic recovery will only be slowed by the inflationary cost of health care. Taxpayers and the insured are already bearing the cost of medical treatment for the uninsured at the most expensive point of delivery, in our emergency rooms. Health care in America today is a model that waits until people get sick rather than focusing on the wellness, prevention, and good management of illness that keeps people out of the hospital and from having the most costly care needs.

Our current health care system wastes money and is so inefficient that the United States spends more than twice as much per person while insuring a smaller portion of our population than the average spending in 29 other industrialized nations. There simply are not enough health insurance options available to most Americans today when in at least 17 States, including my home State of Arkansas, only one insurance company controls more than half the insurance market, and in at least 22 States still only two carriers control half or more of the market.

Patients and doctors are routinely making treatment decisions with little or no objective information about which treatments are more effective. American capitalism is based on choice and competition because when these elements are present, consumers can most always find the best value for their money. That is not true in health care. So by creating health insurance exchanges through which small businesses and individuals can choose from a menu of private plans, we can enhance cost transparency, create head-to-head competition, and allow market forces to reduce prices.

These are facts. These are facts, and whether we are Republicans or Democrats or independent, I believe we can agree on most all of them. I know the great majority of Arkansans believe these facts and want to see us accomplish these reasonable goals.

For months now, groups from outside my State have assigned various motives to my deliberations on health care and tried to define the meaning of my vote. According to the last tally, there has been more than $3.3 million worth of media ads that have been purchased in my home State of Arkansas by groups from outside of our State--certainly none by me--and most with my name in the ad. Still, I have continued to approach this issue as I always do. These outside groups seem to think this is all about my reelection. I simply don't think they know me very well.

I am focused on my opportunity to influence the final version of health care legislation in a way that most helps my State. That is why the people of Arkansas sent me here. They sent me here because they know I am going to work hard to do the best job possible and to do the right thing; to stand my ground on my principles.

I have avoided the extremist claims from the left and from the right and tried to pull the commonsense solutions from among all the policy options so that we get health care reform that benefits Arkansans and all Americans. That is our job in this body, to represent our States in this unbelievably historic body, the Senate.

The truth is, this issue is very complex. There is no easy fix, and it is imperative that we build on what is already working for health care in America and not turn away from the problems we face. We keep building until we can truly say one day that all American citizens will have access to quality and affordable health care. In order to improve upon and build upon what we already have, I do not support the creation of a so-called robust, government-administered public plan.

I believe we should work to make sure we do not expose American taxpayers and the Treasury to long-term risks that could occur over future government bailouts of a public plan. Rather than create an entirely new government-run health plan to compete with private insurers, I support health insurance reform that focuses on changing the rules of our existing employer-based private health insurance system. I believe we should change the current rules that permit insurance companies to bully their customers and cherry-pick healthy patients, so we can force them to compete with each other.

My first loyalties are with the people of Arkansas--not insurance companies, the health care industry, or my political party. In fact, I authored an amendment during consideration of legislation in the Senate Finance Committee which limits taxpayers' subsidies for health insurance companies that pay their top executives millions in salaries. Responsible health insurance reform should ensure that insurance executives are not receiving a personal windfall, and that companies they work for are not receiving excessive tax breaks while at the same time profiting from government requirements on consumers to buy insurance.

The reason we are having this vote is because our Republican colleagues object to beginning debate and consideration of amendments on health care legislation. Although I do not agree with everything in this bill, I have concluded that I believe it is more important that we begin this debate to improve our Nation's health care system for all Americans rather than simply dropping the issue and walk away. That is not what people sent us here to do.

Attempts by the National Republican Party and other conservative groups to portray this as a vote for or against this particular health care reform bill are untrue and deliberately misleading. The vote tonight will mark the beginning of consideration of this bill by the full Senate, not the end. Republicans have sought to revive their political party by opposing any real solution to our Nation's health care crisis. In fact, this vote for or against a procedure that allows us to begin debate on health care reform is nothing more and nothing less. Put simply, those who vote yes on this vote believe our Nation's health care system needs reforming, and they are ready to have an honest and open debate in the Senate about how to best achieve that reform.

I am not afraid of that debate, nor am I afraid of coming before this body to say what I believe is the most important thing we can do to reform health care. I hope none of us are. Our country needs us too desperately now to be making good decisions and moving forward.

I will not allow my decision on this vote to be dictated by pressure from my political opponents, nor the liberal interest groups from outside Arkansas that threaten me with their money and their political opposition; the multitudes of e-mails and ads we have received, unbelievable types of threats about what they are going to do and how they are going to behave. The fact is, I am serious about changing our health care system, as most Arkansans and most Americans are. I am not with those who seek to avoid the debate, nor with those who use political attacks to achieve their narrow goals. I will vote in support of cloture on the motion to proceed to this bill.

But let me be perfectly clear. I am opposed to a new government- administered health care plan as a part of comprehensive health insurance reform, and I will not vote in favor of the proposal that has been introduced by Leader Reid as written. I, along with others, expect to have legitimate opportunities to influence the health care reform legislation that is voted on by the Senate later this year or early next year. I am also aware there will be additional procedural votes to move this process forward that will require 60 votes prior to conclusion of the floor debate. I have already alerted the leader and my colleagues that I am prepared to vote against moving to the next stage of consideration as long as a government-run public option is included. The public option, as a part of health insurance reform, has attracted far more attention than it deserves. While cost projections show that it may reduce costs somewhat, those projections don't take into account who pays if it fails to live up to expectations. If, in fact, premiums don't cover the cost of the public plan, it is taxpayers in this country who are faced with the burden of bailing it out.

Our colleagues cannot ignore the growth in the Federal Government since the year 2000. I can assure you that the American people have not ignored it. According to the American Institute for Economic Research, government spending grew by 55 percent under President Bush. As he was leaving office, government launched a massive bailout of Wall Street. Then it was the domestic auto manufacturing industry that needed taxpayer funds to survive. And finally, in order to revive a dying economy, it took a government economic recovery package to save or create hundreds of thousands of jobs. We can argue about the necessity of these unprecedented steps, but we need not argue about the impression they have made on the American people. We should be stopping the growth of government, not expanding it more. Without the public option, we could still force private insurance plans that participate in the exchanges to provide standard benefit packages that are easy to compare and more fairly priced. We will be bringing millions of new customers to the exchanges so insurers should be motivated to lower prices and be competitive.

I have pledged to dialog with Leader Reid regarding my concerns that remain about this bill. I look forward to continuing that dialog on improvements that I believe are necessary in order to meet the challenge. I will be asking my colleagues to consider these additional important changes I believe will improve our chances for real health insurance reform and that can also enjoy the support of most Arkansans and most Americans.

Some of these include that the legislation remain deficit neutral, now and in the future, and curbs future cost, that it protects Medicare beneficiaries for seniors and extends solvency of the Medicare Program, that it improves accessibility and affordability of health insurance for employees and owners of small businesses and the self-employed through access to health insurance exchanges and tax credits, that it enhance choice and competition of health insurance plans for small businesses and individuals without the inclusion of a government-run public option, and that it build our Nation's health care workforce and ensure continued access to quality health care providers, especially in rural America.

Today I know I will ultimately be held accountable by my constituents in Arkansas for all of my votes on health care, not the National Republican Senatorial Committee, not by other groups from outside my State that continue to engage in a conversation they have begun. I know my decision to support the upcoming cloture vote on the motion to proceed is not my last nor only chance to have an impact on health care reform.

I am optimistic and encouraged about the step we are preparing to take in the Senate, to amend and craft a bill that will improve access to quality, affordable coverage options for the residents and businesses of my State who desperately need relief, a bill that improves the quality and efficiency with which we deliver health care, all without adding to our Nation's deficit and while lowering the cost of health care over the long term. I am committed to using every power of my office to achieve success on this issue by enacting meaningful reforms that will benefit the people of Arkansas and our Nation.

I have spent the last several months in a passionate dialog with my constituents about health care reform. It was not only in townhall meetings where I heard from Arkansans. I had hundreds of conversations with many of them in groups and one-on-one conversations. They may not be in agreement about solutions, but I can assure my colleagues that each Arkansan I speak to expects us to roll up our sleeves and get this right. We can. Following the vote tonight, the bill that will be laid before us will not be the only possible solution. I know my decision to support cloture on the motion to proceed is not my last or only chance to have an impact on overall health care reform. My strongest hope is that each of us can lay political fortunes aside and make the tough, commonsense choices our constituents expect of us, whether you are a Democrat or Republican, and look at what we face and the challenges of our Nation. Make sure that as we are working toward an end result, that each of us is working as hard as we can to come up with a pragmatic solution that our constituents expect of us. We may not get this opportunity again in our lifetime.

Today I am thinking about the Arkansas working family who can't pay their mortgage because of their sick child's medical bills. I am thinking of the Arkansas small business owner who told me that more than 20 percent of the cost of running his business now goes to health insurance for him and his workers. I am thinking about the 450,000 Arkansans who have no health insurance. I am not thinking about my reelection, the legacy of a President, or whether Democrats or Republicans are going to claim victory in winning the debate. I hope all of my colleagues join me in looking forward to working with the leader and all of our colleagues in the days and weeks ahead as we strive to solve a problem whose solution is long overdue.

I yield the floor.

I thank the chairman very much for that important clarification which will provide more certainty for our constituents who wish to purchase a manufactured home.

Mr. President, today I am joined with my colleague, Senator Pryor, to recognize the Aerojet-General Corporation's Camden, AR, production facility. The Camden facility recently achieved the milestone shipment of its 5,000th MK 104 dual thrust rocket motor to Raytheon Missile Systems and the U.S. Navy. Aerojet is a world- recognized aerospace and defense leader principally serving the missile, space propulsion and armaments markets. This most significant milestone will be commemorated with a celebration ceremony held in Camden, AR, on Wednesday, October 28, 2009.

The MK 104 dual thrust rocket motor provides the main propulsion for the standard missile 2 (SM-2), the U.S. Navy's primary surface-to-air air defense weapon. SM-2 is an integral part of the AEGIS weapon system aboard Ticonderoga-class cruisers and Arleigh Burke-class destroyers. The MK 104 dual thrust rocket motor also is the second stage propulsion for the Navy's newest defensive weapon, the standard missile 6 extended range active missile, SM-6, which will provide extended range anti-air warfare capability over both sea and land. The MK 104 also is utilized on the standard missile 3, SM-3, for aegis ballistic missile defense, BMD, from the sea missions.

Aerojet has manufactured the MK 104 dual thrust rocket motor since 1987 at its Camden facility. The Standard Missile family of products, which also includes the MK 72 booster and MK 125 warhead, are noteworthy elements of Aerojet's industry-leading tactical propulsion portfolio produced in Camden.

On the occasion of this milestone, Senator Pryor and I are proud to join together and lend our voices to congratulate and honor the nearly 600 Aerojet workers in Camden, AR, on a job well-done. You have served our State and our Nation admirably for more than 20 years.