Floor Statements

Mr. President, I voted against waving a budget point of order to the Murray/Kerry amendment on the grounds that it is not paid for and contained terrible welfare and Medicare policies.

The Congress cannot keep spending money it does not have. It is unconscionable to put forth an amendment that is not being paid for at a time of exploding deficits to an underlying bill that already has another $104 billion not paid for.

In addition to adding to the deficit during a fiscal crisis, the underlying Murray/Kerry amendment perpetuates flawed welfare policies that undermine key principles of welfare reform.

The Murray/Kerry amendment perpetuates the fund established in the stimulus bill that, for the first time since the landmark 1996 welfare reform act, rewards States for increasing their welfare caseload and does not require these additional eligible adults to participate in work, education or training activities.

This in turn adds to the current deplorable situation where, according to the latest data we have from the Department of Health and Human Services, the U.S. average for eligible adults receiving welfare doing nothing is 56 percent.

That is right--on average 56 percent of adults receiving welfare are engaged in zero hours of work, training or education activity. Some States have over 70 percent of eligible adults doing nothing.

That is zero hours of job search. Zero hours of education. Zero hours of substance abuse treatment. Zero hours of job training. Zero hours of subsidized work activities.

I bet if you asked the American people--how many adults on welfare should be doing something to qualify for their welfare check--I bet the answer would be: all of them!

I bet if the American people knew that the majority of adults on welfare were doing nothing, they would be as stunned and appalled as I am.

We need to do better by these families. Allowing them to languish in the soul crushing, deep and persistent poverty of welfare is a travesty. The Murray/Kerry amendment does nothing to address the issue that the majority of adults on welfare are not doing anything to get themselves out of poverty.

That makes no sense, Mr. President, and I cannot support it.

Finally, in addition to the misguided welfare policies, I also had reservations about the use of ``intelligent assignment'' in Part D to pay for this amendment. I fully support efforts to make sure vulnerable populations are in the lowest cost plan that meets their personal health care needs and look forward to continuing to work on this issue in the future. But the Centers for Medicare and Medicaid Services, CMS, and MedPAC commissioners have raised concerns that ``intelligent assignment'' could lead to increased disruption, higher costs and little overall improvement for beneficiaries.

Therefore, I opposed waving the Budget Act that would have allowed the Murray/Kerry amendment to undermine welfare policy, advance misguided Medicare policy and increase the deficit.

Mr. President, I want to resolve a dispute that arose on the floor earlier this morning.

There were differing opinions on whether the Senate-passed health care reform bill cuts taxes or raises taxes.

During the month-long floor debate on health care reform--ending with a final vote on Christmas Eve--I took to the floor on five occasions to address this question.

Let me top-line it for my Senate colleagues and my friends in the media.

According to the Joint Committee on Taxation, only about 7 percent of Americans would actually receive the government subsidy for health insurance under the Senate-passed health care reform bill.

The remaining 93 percent of Americans would not be eligible for a tax benefit under the bill.

How can a person receive a tax cut if they do not receive a tax benefit?

Here is another powerful statistic that every policymaker needs to know: While only about 7 percent of Americans under $200,000 would actually receive the subsidy for health insurance, 25 percent of Americans under $200,000 would see their taxes go up.

This is even after taking into account the government subsidy.

This means that for every one middle class family that would receive the government subsidy, three middle class families would pay higher taxes.

Again, this is all according to the Joint Committee on Taxation, the nonpartisan experts.

Now, let's get to specifics. JCT tells us that in 2019 a little more than 13 million individuals, families, and single parents would receive the government subsidy for health insurance.

JCT also tells us that the total number of tax filers in 2019 would be 176 million.

That means that out of 176 million individuals, families, and single parents only 13 million of them would receive a government subsidy for health insurance.

That is only about 7 percent of tax filers.

Let me repeat that. Only about 7 percent of Americans will benefit from the subsidy for health insurance.

I have a pie chart here so my friends can see.

You can see here, out of 176 million tax returns, around 13 million of them get the government subsidy for health insurance.

This means that 163 million individuals, families, and single parents or 93 percent of all tax returns receive no tax benefit under the Reid bill.

So what does this mean?

It means that there is a small beneficiary class under the Reid bill--about 7 percent of Americans.

And a very large nonbeneficiary class--93 percent of Americans.

Is this nonbeneficiary class affected in other ways?

Yes. While one group of Americans in this class would be unaffected-- another group of Americans will see their taxes go up.

And this group won't have a tax benefit to offset their new tax liability.

That means that these Americans will be worse off under the Reid bill. What happened to their ``net tax cut''?

What they will see instead is a net tax increase.

JCT data backs up this claim.

Specifically, based on JCT data, in 2019, 42 million individuals, families, and single parents with income under $200,000 will see their taxes go up.

This is even after taking into account the subsidy for health insurance.

Again, this is on a net basis.

Now, if we were to identify (1) those Americans who are not eligible to receive the tax credit and (2) those whose taxes go up before they see some type of tax reduction from the subsidy, this number climbs to 73 million.

I have a chart here that illustrates this: The first bar illustrates what we have already established, but looks at Americans earning less than $200,000. Here, 13 million individuals, families, and single parents would receive the subsidy.

The middle bar shows the net tax increase number of 42 million Americans under $200,000.

Finally, when we identify those Americans who get no benefit under the bill--and those Americans who see a tax increase--we find there are 73 million individuals, families, and single parents under $200,000 in this category.

I want to close by referring to a final chart that illustrates the winners and losers under the Reid bill.

What we see here is that there is a group of Americans who clearly benefit under the bill from the government subsidy for health insurance.

This group, however, is relatively small--about 7 percent of Americans.

There is another much larger group of Americans who are seeing their taxes go up. This group is not benefiting from the government subsidy.

Also, there is another group of taxpayers who are generally unaffected.

But, JCT tells us that this group may be affected by other tax increases like the cap on FSAs or the individual mandate penalty tax.

The bottom-line is this. My Democratic friends (1) cannot say that all taxpayers receive a tax cut and (2) cannot say that the Reid bill does not raise taxes on middle-income Americans.

JCT tells us differently.

No one can dispute the data.

vote explanation

Mr. President, are we now on the pending legislation?

I ask unanimous consent--and I think this has been cleared with the other side--that the pending amendment be set aside for the purpose of my offering an amendment and giving short debate on my amendment.

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

Mr. President, a couple of days ago I stated that I had worked in early February to put together a bipartisan package with my colleague, Finance Committee Chairman Baucus, to address some time- sensitive matters that needed to be considered. So I find it surprising we are taking up a package this week that, as was last week's exercise, is still a partisan product belonging to the Senate Democratic leadership. We are not taking up the bipartisan package I put together with Finance Committee Chairman Baucus.

The Senate Democratic leadership arbitrarily 2 weeks ago decided to replace the Baucus-Grassley bipartisan bill with one that is dramatically different. That partisan package is almost three times the size and significantly greater in cost than the bipartisan bill Senator Baucus and I announced on February 11. It is unfortunate that the Democratic leadership failed to ensure that these critically needed Medicare provisions were extended at the end of last year, and then they failed to extend the provisions that had expired in 2009 for over 2 months.

So, today, this present situation I just described brings me to the offering of this amendment. This amendment would ensure that Medicare provisions are fully offset, and my amendment would also extend the physicians update through the end of this year. The words ``physician update'' are directly related to the formula used to determine Medicare payments to physicians. On February 28, the extension expired and physician payments were scheduled to be cut by 22 percent under the existing formula, except just recently that was extended so that doesn't actually happen. But this on-again, off-again situation that doctors are put in

ought to end, and this amendment I offer will make sure that doesn't happen through all of 2010.

I wish to make very clear this isn't just for doctors, even though it affects just doctor payment. These provisions are also essential to the health and well-being of every Medicare beneficiary. This is the fiscally responsible way to extend them. We ought to pay for them.

These Medicare provisions have been routinely supported by both sides, fully offset, and passed repeatedly in recent years. Now, of course, it is March 3. Medicare beneficiaries around the country are suffering from the Democratic leader's decision to abandon the Baucus- Grassley bipartisan package my colleagues and I had worked out weeks ago.

First, there is the urgently needed physician payment update, and sometimes around this town we refer to this as the doctors fix for short, to fix the formula, to bring the formula up to date so those 22- percent cuts don't go into effect. There was a doctors fix at the end of last year through a 2-month extension that expired, as I said, on February 28. So as of March 1, physicians and nurses and other health care professionals were subject to these severe cuts of 22 percent. Then, because we get a lot of calls--and my office got these calls as well--from doctors concerned about how they are going to keep their offices open, we now have a 30-day extension passed last night so these physician payments that would have been a 22-percent cut now, for 3 days, won't take place until, unless we act, the end of March. That is not a very good way to do business if you have to worry about a doctor, particularly in rural America, keeping their offices open and paying their help, so we ought to do it on a more consistent basis instead of running month to month.

These cuts to physician payments cannot be allowed to occur, and as damaging as these would be to beneficiary access to care anywhere, these cuts are even more disastrous for access to care in rural America such as in Iowa where Medicare reimbursement is already at least 30 percent lower than in other areas.

I am appalled that seniors' access to physicians and needed medical care has been handled this way because of political games that are being played by the majority leadership. Should these cuts remain in place, they will have a truly devastating effect on the ability of seniors to find doctors who take Medicare patients. Many beneficiaries have already been affected by Medicare provisions that the Senate Democratic leadership allowed to expire even last December.

One of the most urgent situations involves limitations that Medicare places on the amount of certain kinds of treatments for beneficiaries. Medicare places annual limits on the amount of outpatient physical therapy, speech language pathology therapy, and occupational therapy that a beneficiary can receive. In other words, the government is saying, regardless of how much health care you need in these areas of therapy, you can only get up to so much dollar amount.

Well, laws that have lapsed have allowed special cases to be taken care of contrary to what the law specifically says on dollar limit. In 2005, the law was changed to provide an exception process to these therapy caps for situations when additional therapy is medically needed, and that needed protection for beneficiaries then expired when the doctors fix expired on December 31. Medicare beneficiaries who have suffered strokes or serious debilitating injuries such as a hip fracture have significant rehabilitation needs.

So we are in this situation of extending this doctor fix from month to month. Situations where patients need this rehabilitation have already exceeded the caps for 2010.

Those with the greatest need for therapy will be the hardest hit. Here, again, with the 30-day extension bill having passed last night, this problem has been only temporarily fixed. This is another case where Congress is playing political games with Medicare. These should have been taken care of at the end of last year, and they could have already been resolved if the Senate had taken up the original Baucus- Grassley bill instead of replacing it with a cutback, partisan piece of legislation that the Senate handled last year or, one might say, being handled right now with this legislation now on the floor of the Senate to which my amendment is being added.

Other essential provisions we need to be looking at for extension are additional payments for mental health services. This benefits Medicare beneficiaries in need of mental health counseling, as well as veterans suffering from post-traumatic stress and other disorders since TRICARE is based on Medicare rates.

Another issue concerns additional payments for ambulance services that many ambulance providers need to keep their doors open. Those provisions also expired at the end of last year, but they were not extended in the 30-day bill voted on last night.

Another important issue affects community pharmacies. Pharmacies that have not gone through the accreditation process will soon be forced to turn away Medicare beneficiaries. A provision in my amendment would ensure that beneficiaries who need vital medical supplies, such as diabetic test strips, canes, nebulizers, and wound care products, can continue to have access to these products through their community pharmacy.

Many eligible professionals, such as physicians, nurse practitioners, physical therapists, and others, have been specifically exempted from this accreditation requirement. This provision would also exempt community pharmacies under certain conditions.

A number of other expired provisions are extended in this package. They include improved payments for hospitals, especially rural hospitals, that rely on these provisions just to keep their doors open. Like many others, these problems are not fixed in the simple 30-day bill passed last night. These problems remain.

The impact of a hospital shutting its doors would be especially hard on rural and underserved areas where hospitals offer the only access to health care.

We need to pass this critically needed and fiscally responsible amendment now. I urge my colleagues to support it. That is what I have to say on my amendment.

I would like to take a couple minutes to respond to a couple issues that Senator Durbin brought up. I am not here to refute anything he said but to give an addendum to what he said on a couple points.

One is the use of reconciliation and the opposition that I think is pretty unified on this side of the aisle that the name of the game should not be changed. He did not say anything inaccurate. But when it comes to reconciliation on a massive 2,700-page bill that we call health care reform--that is a partisan bill--the same bill that passed Christmas Eve in this body, never has reconciliation been used to reorganize one-sixth of the entire economy. In other words, about $2.5 trillion out of a $14 trillion economy is being reorganized by that health care reform bill.

I say to Senator Durbin, that is quite a bit different than using reconciliation for a tax bill or for a Medicare reform bill or to save money on certain entitlement programs. It is like peanuts compared to a massive restructuring of one-sixth of the economy. That is why we say reconciliation should not be used.

A second point for not using reconciliation is the fact that this bill has been turned down by the vast majority of the American people. There is overwhelming opposition to this 2,700-page bill, albeit not overwhelming opposition to the issue: Is the present health care system adequate and should it be changed. I think a slight portion of the American people would say yes, and I think most of the 100 Senators would say yes to that. But for this 2,700-page bill, 70 percent of the American people have said it needs to be started over again with a clean sheet of paper.

Then on the issue he brought up of extending Medicare for 10 years, that is true if you use the double accounting in the bill. The Congressional Budget Office has stated that it is using double accounting. That is not the way you can intellectually count money twice. The Congressional Budget Office, in a paper I read to the President at the summit last week, claims it is double accounting. That is not the way to do business.

You can extend the viability of any program by a lot if you are going to count money twice, but you cannot do

that. Some of the problems with the 2,700-page bill, the American people understand. That is why they rejected it. That is why we say reconciliation should not be used, and that is why we say we should start over and do things incrementally.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, first, I ask unanimous consent to add Senators Bond and Bennett as cosponsors.

Mr. President, my amendment extends critically needed Medicare provisions for all of 2010, not just part of it. It replaces the provisions that are not fully offset with fully offset provisions, and it adds an additional 3 months for the physician update through the end of 2010. This amendment draws additional funds from the Medicare improvement fund to ensure these provisions are fully offset.

My friend from Montana said that is not the place to take the money from, but his substitute amendment takes money from the very same fund. I take a little bit more, yes, but I don't think a few billion in funding needed here will make much of a difference when it comes to the $2.5 trillion cost of health care reform, as was suggested earlier. So I don't see that as a valid argument for not paying for these Medicare provisions.

Going back to the situation at hand, the 30-day extension that passed last night only prevents payment cuts until the end of March. Physicians and Medicare beneficiaries need to have certainty and be ensured access to care. This is the fiscally responsible way to pay for these important Medicare provisions.

We need to pass this very essential amendment now, so I urge my colleagues to support it.

Mr. President, do I have some time?

Good. I am glad I have 26 seconds. His amendment takes $8 billion away from the Medicare improvement fund, mine takes $10 billion away.

Mr. President, in October of 2008, the Social Security Administration, SSA, announced that beneficiaries would receive a 5.8- percent COLA in 2009, the biggest increase since 1982.

This increase was primarily due to record high energy prices. Energy prices have since declined resulting in a 2.1-percent year-over-year decline in the consumer price index, CPI, as determined by the Bureau of Labor Statistics.

Because current law precludes a negative COLA, the SSA announced this past October that there will be no COLA in 2010.

It was also announced that there will be no increase in Medicare Part B premiums for current beneficiaries, except for those with incomes greater than $85,000--single--and $170,000--married.

I understand the concerns about Medicare Part D and Medigap premiums. Unlike Part B premiums--which cannot go up when there is no COLA--these other premiums are not subject to such a restriction.

However, beneficiaries have other options to reduce these premiums. For example, there may be a competing drug plan with lower premiums. I always encourage people to reevaluate their coverage on an annual basis to see if there is another plan that offers the benefits they need at a lower price. Or, there may be a Medicare Advantage plan that covers both prescription drugs and provides coverage similar to a Medigap plan for a lower premium.

As an aside, senior citizens at my town hall meetings frequently ask about congressional COLAs. I remind them that Congress did not receive a COLA this year either. I have consistently voted against automatic COLAs for Congress.

However, I recognize the financial need of many seniors who rely on Social Security. A $250 check would be roughly equal to a 2 percent COLA for the average beneficiary.

Congress enacted the automatic COLA in 1972 in order to provide an objective, nonpartisan way to determine benefit adjustments. The annual COLA has been based on the CPI calculations of the Bureau of Labor Statistics ever since.

Any decision to change, or override, the current process needs to be carefully vetted. History shows Congress has often played partisan politics with Social Security without regard to the solvency of the program or the burden placed on future taxpayers.

I understand the desire to send $250 checks to current Social Security beneficiaries to compensate for the lack of a COLA. But, we are also facing an annual budget deficit in excess of $1 trillion for the second year in a row.

We cannot continue to add to our deficit without any regard to the consequences.

The Sanders amendment fails to include an acceptable way of offsetting the $13 billion cost of this proposal.

The amendment offered by Senator Burr would offset the cost by reducing unspent stimulus funds.

Last year, CBO scored the stimulus bill at $787 billion. But earlier this year CBO revised its estimate to $862 billion.

CBO estimates that we have already spent $200 billion in 2009 and we will spend $400 billion in 2010. That leaves more than $250 billion for future years.

This amendment would simply reduce the unspent balance by $13 billion.

It has been suggested by some on the other side of the aisle that we should not use stimulus money to pay for other things.

They insist the stimulus money is needed to create jobs. Given the fact we have lost nearly 4 million private sector jobs since last year, I doubt the stimulus money has created any net new jobs. But for those who choose to believe government spending can create more jobs than it destroys, CBO says payments that can be made quickly are more effective than those that take a long time.

By that standard, using less effective stimulus dollars to pay for more effective stimulus dollars is the best alternative.

I urge my colleagues to support this amendment which is fully paid for, and reject the amendment of my colleague from Vermont that needlessly increases the deficit.

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

I yield myself such time as I might consume. Maybe I better ask, are we under a time agreement?

Mr. President, today, the Senate starts debate on expiring tax and health provisions, for people outside Washington. Around here, those tax provisions are generally referred to with the word ``extenders.'' But before I discuss the bill before us, I would like to make a couple points on the process, before I get into the substance of the substitute before the Senate. What I find surprising is, we are taking up a package that, similar to last week's exercise, absolutely belongs to the Senate Democratic leadership; that is to say, we are not taking up a bipartisan package that I put together with my friend, Finance Committee Chairman Baucus.

To be sure, some of the structure reflects the agreement I have with Senator Baucus, but this package is almost three times the size of the package we agreed upon. Virtually all the additional cost is due to proposals I would not have agreed to in representing the people of Iowa or the Republican conference.

I was under the impression the Senate Democratic leadership was genuine in its desire to work on a bipartisan basis, but clearly I was mistaken. Although the Senate Democratic leadership was highly involved in the development of that original bipartisan bill, they arbitrarily decided to replace it with a bill that skews toward their liberal wing. So my first comment to my colleagues, also to the media and to the entire Nation, is: Don't let this package be mislabeled as the Baucus- Grassley package. It is not the package my friend, Chairman Baucus, and I negotiated. Again, the package before the Senate dramatically differs in cost, balance, and dramatically is different in intent from the Baucus-Grassley compromise announced on February 12.

My second preliminary comment goes to the way in which these expiring tax provisions have been described by many on the other side, including those in the Democratic leadership. If you roll the videotape back a week or so, you would hear a lot of disparaging comments about these routine, bipartisan extenders. From my perspective, those comments were made in an effort to sully the bipartisan agreement reached by Chairman Baucus and this Senator. If you take a look at newspaper accounts of a week or so ago, you come away with the impression that the tax extenders are partisan work of Republicans and only for Republican interests. A representative sample comes from one report which describes the bipartisan bill as:

. . . an extension of soon-to-expire tax breaks that are

highly beneficial to major corporations, known as tax

extenders, as well as other corporate giveaways that had been

designed to win GOP support.

The Washington Post included this attribution to the Senate Democratic leadership in an article last week:

"We're pretty close,'' [the majority leader] said Friday

during a television appearance in Nevada, adding that he

thought, `fat cats' would have benefited too much from the

larger Baucus-Grassley bill.''

That quote happens to be from the majority leader.

The portrait that was painted by certain members of the majority and was echoed without critical examination--and in some press reports was outright inaccurate. For one thing, the tax extenders included provisions such as deductions for qualified tuition and related expenses and also the deduction for certain expenses for elementary and secondary schoolteachers. If you are going to college or if you are a grade school teacher, the Senate Democratic leadership apparently views you as a fat cat. If your house was destroyed in a recent natural disaster and you still need any of the temporary disaster relief provisions contained in the extenders package, too bad because helping you would amount to a corporate giveaway in the eyes of some. Such distortion of the extenders--some of them have been on the books for a long period of time; some of them passing this body by consensus-- belittles helping some people who have needs.

Again, I wish to say the tax extenders have been routinely passed repeatedly because they are bipartisan and, frankly, very popular. Democrats have consistently voted in favor of extending these tax provisions. Let me tell you what House Speaker Nancy Pelosi released recently, a very strong statement when the House passed these very same tax extenders at the end of last year saying this was ``good for business, good for homeowners, and good for our community.''

That was December of 2009, not very long ago.

In 2006, the then Democratic leader released a blistering statement ``after Bush Republicans in the Senate blocked passage of critical tax extenders American families and businesses are paying the price because this Do Nothing Republican Congress refuses to extend important tax breaks.''

Recent bipartisan votes in the Senate extending bipartisan tax provisions had come in the Emergency Economic Stabilization Act of 2008 and the Tax Relief and Health Care Act of 2006. By the way, that passed the Senate by unanimous consent. Then we had the Working Family Tax Relief Act of 2004, which originally passed the Senate by voice vote, although the conference report only received 92 votes in favor and a whopping 3 against it.

Let me give what the nonpartisan Congressional Research Service has to say about the history of these extenders which are now before us, which should have been passed in December. They have been consistently widely supported because they mention the Tax Relief Extension Act of 1999, which passed the Senate by unanimous consent and one vote against it on the conference report. One Member on the other side said:

Our side isn't sure that the Republicans are real

interested in developing good policy and to move forward

together. Instead, they are more inclined to play rope-a-dope

again. My own view is, let's test them.

So we are testing each other when we are talking about merely reimposing some policy that has been on the books for a long period of time and just happens to sunset, to force some review by Congress.

We had another Member of this large 59-vote majority exclaim:

It looks more like a tax bill than a jobs bill to me. What

the Democratic caucus is going to put on the floor is

something that's more focused on job creation than tax

breaks.

Reading these comments, I found myself obviously scratching my head. The only explanation for this behavior is, certain Senators decided last week it serves a deeply partisan goal to slander what had been for several years bipartisan and popular tax provisions benefiting many different people.

The Washington Post article I quoted from earlier includes a statement from a Democratic Senate leadership aide saying that ``no decisions have been made, but anyone expecting us immediately to go back to a bill that includes tax extenders will be sorely disappointed.''

You can imagine that, today, a little over a week after these comments, I scratch my head, once again. We have before us the expiring tax and health provisions that were disparaged just a short time ago. Have they morphed from corporate tax pork? Have they suddenly reacquired their bipartisan character? Are these time-sensitive items, now expired for more than 2 months, suddenly jobs related?

We are beginning another debate, a jobs bill debate. So I wanted to focus on the economy, small business, and jobs after giving you that partisanship that should not have existed a week ago, to explain that it existed and not much has changed since then, but all of a sudden there is some idea of being bipartisan.

So we are going to talk about the substance of this bill. We all agree our Nation is currently facing challenging economic times. While there have been some signs of improvement such as the recent growth in our gross domestic product, job losses continue to mount and many hard- working Americans are struggling to make ends meet.

According to the Bureau of Labor Statistics, over 8 million jobs have been lost since our economy officially slipped into recession in December 2007. The unemployment rate is currently 9.7 percent, which is simply an unacceptable level. The lack of job creation continues despite aggressive action taken at the Federal level in order to stabilize the economy.

This includes the enactment of TARP and the $800 billion stimulus bill. However, these bills were all missing a critical ingredient for spurring job creation, and that was substantial tax relief targeted to small business.

Everybody knows small business is where the jobs are created in America; 70 percent of the net new jobs. In October 2008, Congress enacted the Troubled Asset Relief Program that we all call TARP around here, T-A-R-P. That was a $700 billion financial bailout bill that we were told had to be enacted immediately in order to deal with the so- called toxic assets to keep credit from drying up, which would have choked off the lifeblood of the American economy.

What we actually got--because we sure did not take out these toxic assets. So what we actually got was direct infusion of cash into the largest Wall Street banks, which was 180 degrees different than what we were told by Treasury before that bill was voted on, and the purpose of that bill as well. Later came the bailout of General Motors and Chrysler using TARP money after the Senate had just voted not to bail out GM and Chrysler.

This inconsistent policy by Treasury created uncertainty in the financial markets and the business community. Moreover, exorbitant bonuses were paid to executives and the management of firms that would have been out of a job if not for Congress and Treasury and the Federal Reserve intervening.

How effective was the bailout in improving the credit markets? In October 2009, the Government Accountability Office released a report reviewing TARP's first-year performance. The GAO report found credit had improved based on certain market indicators. However, they were not able to determine how much, if any, was attributed to TARP as compared to general market forces or other Federal action.

While it is unclear the extent credit has been freed up as a result of TARP, it is clear who has reaped the benefits of those programs. This past year, many financial firms, including Goldman Sachs, JPMorgan Chase, and others who received TARP funds, posted record or near-record profits.

While Wall Street executives have clearly benefitted form TARP, small businesses and their employers have not been that fortunate. Small businesses continue to struggle to obtain credit in order to expand their operations, purchase inventories, and even make payroll. The so- called stimulus bill, enacted almost solely by an overwhelming Democratic majority in Congress last February, has not spurred job creation either.

This massive $800 billion spending bill was hastily rushed to the floor of the Senate with little time to deliberate its merit. Lawrence Summers, the Director of President Obama's National Economic Council, said:

The test for the stimulus is whether it is timely,

targeted, and temporary.

This stimulus bill hit the trifecta. It has failed in all three. Through a report issued in January 2009 by the current Chair of President Obama's Council of Economic Advisors, Christine Roemer, the administration predicted that the stimulus would save or create 3 million jobs. We were told by the Obama administration that if the bill was not passed quickly we would experience unemployment of 9 percent.

At this point we have a chart. The middle line, where it says 9 percent, the White House projected unemployment at 9 percent with no stimulus. However, we were also told by the Obama administration that if the stimulus bill passed, unemployment would not go over 8 percent, and that would be the bottom line.

Well, the bill was passed. But what did we get for $800 billion of debt before interest that was laid at the feet of our children and our grandchildren? The unemployment rate jumped from 7.7 percent in January right before the stimulus was enacted, to a high of 10.1 percent in October.

While unemployment recently dipped slightly to 9.7 percent--you can see that is the red line at the top--this was not due to job creation but because millions of individuals have literally given up looking for work and obviously do not show up in the unemployment statistics.

The Obama administration also stated that ``more than 90 percent of the jobs created are likely to be in the private sector.''

In all, 3.3 million jobs have been lost since the stimulus bill was enacted. That is 3.3 million compared to the 3.7 million the President said. Of course, 3.2 million of those jobs were in the private sector.

In summary, the Obama administration was terribly inaccurate regarding its stimulus jobs projection. At the time the stimulus bill was passed, I raised concerns that the bill was not targeted enough at small businesses and job creation. However, my point of view lost out and less than one-half of 1 percent of the bill included tax relief for small business.

The money in the stimulus bill gave tax credits to people who buy electric plug-in golf carts or to pay for rattle-snake husbandry in Oregon, among other ill-advised provisions, which would have been better allocated to small business tax relief, the place where employment starts. Since the stimulus, small businesses have been bearing the brunt of job losses in our economy. However, the words of those on the other side regarding the importance of small business job creation do not match their action when looking at the paltry amount of small business tax relief being provided.

Again, in the jobs bill, or stimulus bill, or whatever you want to call it that passed the Senate last week, there was only one provision directed solely to small business tax relief. That was a provision I supported which increased expensing of equipment purchased by small businesses. But it is a very small provision. It only gave small businesses what they have already been getting for the last couple of years, just extending it; in other words, just extending that figure. That provision was only $35 million out of $62 billion, the $15 billion that everyone talks about, plus the $47 billion for the highway trust fund that is typically not mentioned.

Last year, I introduced S. 1381, the Small Business Tax Relief Act. My bill would double the amount of equipment that small businesses could expense and would make those higher levels permanent instead of just for 1 year, as the Reid bill did.

In my negotiations on the jobs bill, I sought to include provisions for my small business tax relief bill. But there was no agreement to put small business tax relief provisions for my bill in the bipartisan compromise that we reached. Instead, we were asked to defer those provisions to a future tax bill.

According to ADP, national employment data from January 2009 through January 2010, small businesses with fewer than 500 employees saw employment decline by 2.67 million jobs, while large businesses with 500 or more employees saw employment decline by 694,000.

While I am sure many of us disagree about the effectiveness of the financial bailout and stimulus spending in getting our economy back on track, I know for sure that we all agree there has been a lack of job creation and too many people continue to be unemployed. Because the stimulus bill has so clearly failed in what it was supposed to do, which was to create jobs, and the administration and the congressional Democratic leadership are running away from the word ``stimulus'' faster than the Triple Crown winning horse Secretariat. Everything proposed now is called a ``jobs bill'' even if it includes proposals that were always labeled ``stimulus'' in the past.

Only 6 percent of Americans believe the stimulus bill created jobs. That is less than the 7 percent of Americans who believe that Elvis is still alive. Last week, the Senate passed a bill that included provisions designed to increase hiring. This includes a payroll tax holiday for businesses that hire unemployed workers and a tax credit for the retention of newly hired individuals throughout all of 2010.

The payroll tax holiday part of this proposal is likely to spark some modest hiring at businesses at the margins among those who have seen some improvement in their business but are on the fence about whether to hire somebody now or wait a while. However, many businesses continue to struggle and will not hire new employees just because it is the stated policy goal of Congress.

Before a business can hire a new employee, they need to know that new employee will generate additional revenue that exceeds the cost of the employee. The latest survey of the Small Business Economic Trends--and that is produced by the National Federation of Independent Businesses, or NFIB, as we know it--shows that many small businesses may not be in a place that they can afford to hire new employees even with the provisions of that bill passing the Senate last week called the Payroll Tax Holiday.

I have a chart from the National Federation of Independent Businesses to which I now want to refer. That chart has selected components from the Small Business Optimism Index. While many components of this index improved slightly from December, it is clear that small businesses continue to struggle. You will see from the chart a net negative 1 percent of owners who plan to create new jobs in the next 3 months. You will see on the chart a net positive of only 1 percent of business owners expect the economy to improve. Only 4 percent of business owners said it was a good time to expand, and a net negative 42 percent of owners reported higher earnings.

This last component is especially important for businesses when it comes to hiring new employees. If earnings are declining, there is little a payroll holiday will do to spark hiring since businesses need to know that the revenue generated by the additional employees will exceed the cost, not just today but in the future.

Before I go on to this NFIB survey, at the grassroots of my State, I had the opportunity the previous weekend to spend part of a Friday and part of a Sunday afternoon in what is called the Des Moines Home and Garden Show which has probably been around for 30 years or so, that one weekend a year. On the Saturday in between, I had an opportunity to attend a like show called the Home Improvement Show in Waterloo. You walk around and talk to vendors, small business people. You kind of look at what do they expect Congress to do about creating jobs. I never got anything positive about something we might do, but I got a lot of ideas that they want us to do that said: You have to give us some certainty.

Do you know what they quoted. They quoted the big tax increase coming up at the end of this year as some of that uncertainty. They quoted the cap-and-trade tax that possibly could pass the Senate. Then they quoted the potential cost to small business because of the health care reform bill. They said: Take all of those potential things out of the picture, and we will start hiring. But it is the uncertainty that is out there of what Congress is going to do to us that is keeping us from hiring people.

I want to go back to the NFIB survey. When businesses are asked what the single most important problem facing their business is, the answer is lack of sales. That is in addition to the uncertainty I related. But this is closely

followed by what I did say, taxes, and then government regulation, and redtape. I am glad my colleagues on the other side have recognized that true job creation comes through the private sector and have thus sought hiring incentives through payroll tax relief.

However, this minor tax relief is a drop in the bucket considering the challenges small businesses face due to the economy and proposed increased taxes and redtape included in the President's budget. Whether we are speaking about cap and trade that will drastically increase energy costs, health care reform that would mandate small businesses offer health benefits that will increase the cost of labor, or the call for tax increases on so-called wealthy taxpayers earning over $200,000 that will largely fall on the backs of small businesses, if our intention is to increase long-term employment, the last thing we should be doing at this time of economic uncertainty is to increase taxes and place additional burdens on those who are responsible for creating 70 percent of the jobs in our economy; namely, small business.

Providing small businesses a payroll tax holiday while intending to impose increased taxes, regulations, and mandates amounts to throwing them a few peanuts while taking away their supper. In recent months, I have spoken at length about the impact of tax increases set to kick in 10 months from today. I have examined the impact of these tax increases on small businesses. I think Members ought to take a closer look at it before we actually enact big tax hikes.

The President and my colleagues on the other side of the aisle have proposed increasing the two marginal tax rates from 33 and 35 percent to 36 and 39.6 percent, respectively; increasing the tax rates on capital gains and dividends to 20 percent, fully reinstating the personal exemption phaseout for those making over $200,000, and fully reinstating the limitation on itemized deductions for those making more than $200,000.

With these two provisions fully reinstated, the individuals in the top two rates could see their marginal tax rates increase over 15 percent or more. My colleagues on the other side of the aisle respond that these proposals will only hit ``wealthy individuals'' and only a small percentage of small businesses fall into this category. I have been trying to tell them for 3 or 4 years that what they want to talk about, the small percentage of small businesses falling into that category--I will not convince them, because I don't know what they are reading--is wrong. Because small business is going to be hit very definitely by these increases. What my colleagues fail to understand is that the small businesses that fit into this group are not static but consist of different businesses over time that go in and out of the top two tax brackets depending on the market.

Data from the Joint Committee on Taxation, which is a nonpartisan official congressional scorekeeper on tax issues, shows that 44 percent of the flowthrough business income will be hit with the increase in the top two tax rates proposed by the President. This hits small businesses particularly hard since most small businesses are organized as flowthrough entities. It will increase taxes on single small business owners who make more than $200,000 per year, even if they plow all of their income back into their small business to keep paying their workers and hire additional workers. Increasing taxes on this group punishes their success and limits their ability to reinvest in their company. It prevents them from putting away funds for tough economic times to keep their business afloat.

Government is currently creating a climate of uncertainty where the private sector does not know what we will do next, what taxes will be raised, and what regulatory barriers will be put in their way. We can start to put some certainty back into the business world by declaring we will not increase taxes on businesses 1 dime, by making the 2001 and 2003 bipartisan tax measures permanent.

Let me be clear: Businesses do not want to be certain that the government is going to raise their taxes and make them go up through more redtape. They want to be certain that it is not going to happen. Until then, many will simply sit on the sidelines and not hire more workers, as I reported from my weekend before last at a couple affairs in the State of Iowa.

Moreover, we can directly provide targeted relief to small businesses. Last June, I proposed legislation to do that. I introduced the Small Business Tax Relief Act to lower taxes on job-creating small businesses. Since the Democratic leadership barred any amendments last week, I am hopeful we will debate and vote on an amendment offered by Senator Thune. Many provisions in my bill are contained in the Thune bill. My bill contains a number of provisions that will leave more money in the hands of small businesses so they can hire more, continue to pay the salaries of their current employees, and make additional investments. This includes allowing flowthrough small businesses, partnerships, S corporations, LLCs, and sole partnerships to deduct 20 percent of their income, effectively reducing their taxes by 20 percent. My bill also includes tax relief for small business owners from the unfair alternative minimum tax. It takes general business credits, such as the employer-provided childcare credit, out of the alternative minimum tax. This would allow a mom-and-pop retail store that provides childcare for its employees to get the same tax relief a Fortune 500 company gets when it provides childcare for its employees.

My bill would also allow more than nearly 2 million small C corporations to benefit from the lower tax rates for the smallest C corporations. There are so many small C corporations because they were formed as C corporations before other entities such as LLCs became more widely used.

Among other provisions, my bill would also lower the potential tax burden on small C corporations that convert to S corporations.

The NFIB has written a letter supporting my small business tax relief bill, stating:

To get the small business economy moving again, small

businesses need the tools and incentives to expand and grow

their businesses. S. 1381 provides the kind of tools and

incentives that small business needs.

I want to talk about an opportunity for true bipartisanship that was killed by the Democratic leadership. The same day Chairman Baucus and I released a bipartisan bill that contained significant compromises, behind closed doors the Democratic leadership cherry-picked four provisions out of the larger bill Chairman Baucus and I agreed to. Those provisions had been agreed to in a meeting of senior Members of the other side only while Chairman Baucus and I were negotiating. I was extremely disappointed to see the Democratic leadership blow up the bipartisan deal Chairman Baucus and I reached. To pour a little salt into the wound, the Democratic leadership then prohibited any Senator on either side of the aisle from even offering an amendment to improve a bill that he hijacked. One of the four provisions the Democratic leaders cherry-picked is Build America Bonds. If it had been just me drafting the bill, I wouldn't have included this provision. However, for the sake of bipartisanship and compromise in the context of a much larger bill, I reluctantly agreed that putting this provision in the bill would not cause the overall bill to lose my support. Build America Bonds is a very rich spending program disguised as tax cuts. Bloomberg reported that large Wall Street investment banks have been charging 37 percent higher underwriting fees on Build America Bonds deals than on other deals. Therefore, American taxpayers appear to be funding huge underwriting fees for large Wall Street investment banks as part of the Build America Bonds program.

Democratic leadership has said the Build America Bonds program is about creating jobs. I wanted to know whether it is about lining the pockets of Wall Street executives. So last week I asked the Goldman Sachs CEO a number of questions about these much larger underwriting fees subsidized by American taxpayers. I expect to have that discussion shortly.

Turning back to the bill being debated this week, the Thune amendment, which incorporates many of the provisions from my small business tax relief bill, provides substantial small business tax relief and should be adopted.

In this bill, I hope we can all work toward improving our economy, not through more government but by letting the engine of job creation, meaning small business, keep more of its

own money in the form of substantial small business tax relief.

I yield the floor.

Mr. President, in 1997 then-Senator Biden and I sponsored legislation to create the Drug Free Communities, DFC, grant program. At the time, I believed, as I still do today, that one of the most effective ways the Federal Government can prevent drug abuse from flourishing is by supporting local community efforts to identify, prevent and eradicate the sources of abuse. Since the passage of the Drug Free Communities Act, hundreds of community anti-drug coalitions have received Federal grants to further their efforts to halt the spread of drug abuse in their communities.

Despite the successes of the DFC program, drug abuse continues to challenge our communities. More often than not, a community can rise up to meet this challenge head on and confront the abuse before it spreads. However, drug abuse is one challenge that can emerge in rapid fashion. In difficult economic times when States and communities struggle to stay within their budgets without eliminating vital services, it is important that community anti-drug coalitions do not suffer from a lack of resources. This is why I am pleased to join my colleague, Senator Leahy, in introducing the Drug Free Communities Enhancement Act, DFCEA, of 2010.

This legislation builds off the successful DFC grant program by allowing community coalitions to form a strategy that best fits their community to confront a sudden or emerging drug threat without Federal interference. The DFCEA authorizes $5 million to the Office of National Drug Control Policy to award supplemental grants of up to $75,000 to current and past DFC grantees to address an emerging drug issue or crisis. The grantee would be eligible to receive these supplemental grants for up to a 4 year period if they document, using local data, rates of drug abuse higher than the national average.

In my home State of Iowa, communities face unique challenges in confronting drug abuse. In Polk County, the home of the State capitol of Des Moines, 37 percent of 11th graders admitted to using marijuana in the 2008 Iowa Youth Survey. This is significantly higher than the statewide average of 27 percent from the same survey. This number is also 4 percent higher than the national average according to the 2009 Monitoring the Future survey of 12th graders. In Black Hawk County, the home of Waterloo and Cedar Falls, 8 percent of 11th graders admitted to using over-the-counter cold medicines to get high according to the Iowa Youth Survey. This is higher than the 6 percent of the Nation's 12th graders who admitted to cold medicine abuse in the Monitoring the Future survey. Communities like these would benefit under the DFCEA, because they would

be able to apply for a supplemental grant to put a strategy into action to reduce these use rates.

Community coalitions represent the front lines in the fight against drug abuse. The DFCEA will help to ensure that community coalitions will remain strong and vibrant no matter the economic or drug trend situation in the community. Drug abuse flourishes when the problem is ignored. If we are to overcome the challenges of drug abuse we must stand untied in the effort. I urge my colleagues to join us as we continue this fight to keep our communities drug free.

Madam President, I yield myself such time as I may consume. I rise to address the jobs issue and the bill before the Senate. Part of it is to show to my fellow Senators and the American people that the Democratic leadership has a different view on this bill before us that is a partisan bill, particularly in regard to the absence of tax extenders being in that bill, compared to what they have over several of the recent years, which was very supportive of these tax provisions that are left out of this bill. I will explain it this way.

Although the Senate Democratic leader was highly involved in the development of the bipartisan bill, he arbitrarily decided to replace it with a bill now being jammed through the Senate. From the start, this was something Senator Baucus and I were working on with both leaders of the Senate. Somehow, that didn't seem to work in the end, as we thought it was working very well as we were moving along. As much as I was surprised by the Democratic leader's disregard for bipartisanship, I am even more surprised by the explanation given by him and his people who speak for him.

Perhaps the most significant change between the bipartisan package Chairman Baucus and I helped put together and the package we voted to move to is the package of expired tax provisions has been removed. These expired tax provisions are the ones I referred to as tax extenders. These generally very popular and certainly bipartisan tax extender provisions have, in fact, been extended several times over the past few years. What is surprising is that hyperpartisan members of the majority have suddenly somehow decided tax extenders are what they refer to as ``partisan pork for Republicans.'' A representative sample comes from one report which describes the bipartisan bill as ``an extension of soon-to-expire tax breaks that are highly beneficial to major corporations, known as tax extenders, as well as other corporate giveaways that have been designed to win GOP support.'' Like this is something that only Republicans have ever been for or it is just for major corporations.

There is another quote in the Washington Post which includes this attribution to the Senate Democratic leadership:

``We're pretty close,'' [the majority leader] said Friday

during a television appearance in Nevada, adding that he

thought ``fat cats'' would have benefitted too much from the

larger Baucus-Grassley bill.

Understand, Senator Baucus is a Democrat, I am a Republican. The portrait being painted, then, by certain members of the majority, echoed without critical examination by people in our press, is wildly inaccurate. For one thing, the tax extenders include provisions such as the deduction for qualified tuition for college and related expenses and also the deduction for certain expenses for elementary and secondary schoolteachers. That ended December 31. It is going to mean tax increases for these families if we don't reinstitute it. If you are going to college or if you are a grade school teacher, the Senate Democratic leadership thinks you are a fat cat, so you are on your own. If your house was destroyed in a recent natural disaster and you still need any of the temporary disaster relief provisions contained in this extenders package, too bad, because helping you would amount to corporate giveaways in the eyes of some around here.

The bipartisan package that was shelved included an extension of unemployment insurance and also a COBRA health insurance extension. Do these provisions benefit corporate fat cats? The answer is obviously no. Therefore, the common, ordinary person, Main Street America, smalltown America or big city America, the working people of this country, that is who will benefit from those provisions that are left out of this bill.

The tax extenders have also been routinely passed and repeatedly passed because, in fact, they are and have been bipartisan and have been very popular and have been very beneficial to the economy. Democrats have consistently voted in favor of extending these tax provisions. Let me as an example refer to House Speaker Nancy Pelosi, who released a very strong statement upon the House package of tax extenders in December 2009. Just 6 weeks ago, the other body passed these tax extenders. This is what the leader of the Democratic Party in the House had to say in December 2009, not very long ago: that it is ``good for business, good for homeowners, and good for our communities.''

In 2006, the then-Democratic leader released a blistering statement:

After Bush Republicans in the Senate blocked passage of

critical tax extenders [because] American families and

businesses are paying the price because this Do Nothing

Republican Congress refuses to extend important tax breaks.

Recent bipartisan votes in the Senate on extending expiring tax provisions have come in the Emergency Economic Stabilization Act of 2008, the Tax Relief and Health Care Act of 2006, which passed the Senate by unanimous vote, and the Working Families Tax Relief Act of 2004, which was originally passed in the Senate by a simple voice vote,

although the conference report received 92 votes in favor and a whopping 3 against. That doesn't sound, to me, like these tax extenders are just for GOP corporate fat cats.

According to the nonpartisan Congressional Research Service, extension of several of these provisions goes back even further, including the Tax Relief Extension Act of 1999, which passed the Senate by unanimous consent and lost just one Senator voting against it coming out of conference.

Why have Democrats in the last few weeks or maybe in just the last few days turned against the extenders, particularly considering it passed overwhelmingly in the House of Representatives with Democratic support? The only explanation to this behavior is that certain Senators have decided it serves deeply partisan goals to slander what have been, for several years, very bipartisan and very popular tax provisions benefiting many different people.

Yesterday's Washington Post article, from which I quoted, includes a statement from a Democratic leadership aide saying that:

No decisions have been made, but anyone expecting us

immediately to go back to a bill that includes tax extenders

will be sorely disappointed.

Having put their heads into the sand, this Chamber's leaders seem intent on keeping them there, based on that previous quote. The bill, as currently written, would allow employers of illegal workers to benefit from the payroll tax holiday. For sure, we should correct that mistake with an amendment. But under this parliamentary setup, you can only offer an amendment if not a single Senator objects to setting aside the existing business and replacing it with a new idea. The leadership's posture on this bill now prohibits this correction of giving illegal workers the benefit of a payroll tax holiday or the employer that employs them. Either the Democratic leaders are playing partisan politics with tax extenders or they don't understand the worth of the provisions to the economy as a whole and, most importantly, job retention and job creation.

I wish to speak about a very specific industry where 23,000 jobs are at risk and, in some instances, people actually without a job since December 31 because the biodiesel tax credit has been allowed to expire on December 31. That is one of the many tax extenders.

These workers are not GOP corporate fat cats, and in case anybody thinks biodiesel--because it is connected to agriculture--is related just to Iowans, let me make it very clear that these green jobs are in 44 of the 50 States, with thousands of people unemployed.

There are 24 facilities in Texas, 15 in my State of Iowa, 6 in Illinois, 6 in Missouri, and 4 facilities in Washington State. Ohio has 11 facilities, there are 5 facilities in Indiana, 3 each in Mississippi and South Carolina, 7 in Pennsylvania, and 4 in Arkansas. New Jersey has 2 facilities, there is 1 facility in North Dakota. Only 6 States out of 50 do not have some biodiesel production layoffs because Congress did not act by December 31 of last year.

You know what. We just had to stay in session on Christmas Eve-- because we had not met on Christmas Eve since 1895--to pass a health care reform bill that does not take effect until 2014.

Think of that. Let people in the biodiesel industry be laid off because Congress cannot act because we had to work on a bill that does not take effect until the year 2014.

So we need to turn away from talk about GOP corporate fat cats. We have to start thinking about those teachers having income tax provisions to be able to deduct expenses they have for their classrooms. We ought to think about these biodiesel workers being laid off. We ought to be thinking about the people who are harmed by the floods and have an extension of the temporary tax relief for them and quit bad-mouthing popular bipartisan proposals that we need to pass and should have passed yet last year, as the House of Representatives did. So we need to get back to work on a bipartisan package that was in the works until the Democratic leadership dramatically changed directions and went partisan.

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

Mr. President, as I stated earlier today, I had worked to put together a bipartisan package with my colleague, Finance Committee Chairman Baucus, to address some time-sensitive matters that need to be considered.

I was under the impression that the Senate Democratic leadership genuinely wanted to work on a bipartisan basis but, unfortunately, I was mistaken.

Although the majority leader was deeply involved in the development of our bipartisan bill, as soon as it was released he announced that he would not take it up, and he arbitrarily decided to replace it with a bill he plans to jam through the Senate.

I addressed my concerns earlier about the removal of the tax extender provisions.

Now I want to discuss another significant change between the bipartisan package Chairman Baucus and I put together and the Senate Democratic leadership's bill that we will be voting on this week.

A package of expired and expiring Medicare health provisions has been removed without any explanation. These bipartisan provisions are essential to the health and well-being of Medicare beneficiaries. They have been routinely supported by both sides and passed repeatedly in recent years.

So where does that leave us? We are now less than a week away from the end of February, and Medicare beneficiaries around the country will suffer from the Senate Democratic leader's decision to remove these provisions without any explanation. Medicare beneficiaries should not be held hostage to whatever partisan goals the Senate Democratic leadership envisions.

To make matters worse, they have decided to ``fill the tree,'' as the procedure is called, so there will be no opportunity to offer these essential health provisions known as ``Medicare extenders'' as amendments to his bill.

The decision to abandon a bipartisan approach is especially ironic considering the fact that later this week President Obama is hosting a bipartisan meeting with Senators and Members of the House to discuss health care reform.

It is too early to tell if that meeting will lead to a true bipartisan effort to address health care reform issues, at least in some areas where there is broad agreement on both sides. But I commend the President for his bipartisan outreach and invitation to meet and discuss these important issues. It is an approach that the Senate Democratic leadership abandoned last year.

Apparently, political games have become more important than ensuring that critical legislation is passed to protect Medicare beneficiaries' access to health care.

Many individuals, in fact, are already in jeopardy of suffering adverse consequences to their health because of the failure by the Senate Democratic leadership to ensure that these critically needed Medicare provisions would be enacted by the end of last year. These are the same provisions that had broad, bipartisan support when they were considered by the Finance Committee and included in the health care bill the committee reported last fall.

I am going to review some of these provisions and the impact they have on Medicare beneficiaries and their access to health care.

First, there is the need for a physician payment update, what we commonly refer to as the ``SGR'' or the ``doc fix.'' A 2-month extension that was passed in December is scheduled to expire on February 28, just 5 days from now. Unless a physician update is enacted by March 1, physicians, nurses, and other health care practitioners will experience severe payment cuts of 21 percent as of that date.

These payment cuts would be even more disastrous for physicians in rural States, such as Iowa, where Medicare reimbursement is already about 30 percent lower than in other areas. But payment cuts of this magnitude will severely impact physicians and health care practitioners throughout the country, and they will significantly threaten beneficiary access to care.

Should these cuts occur and continue for any length of time, they will have a truly disastrous effect on the ability of seniors to find, or keep, physicians who take Medicare patients.

I am appalled that Medicare beneficiaries' access to physicians and other needed medical care is being jeopardized because of the political games that are being played by the Senate Democratic leadership.

Let's look at beneficiaries who are already being affected by other Medicare provisions that should have been extended, as they have been in the past, but that were allowed to expire at the end of last year.

One of the most pressing is an extension of the exceptions process for therapy caps. The law puts annual payment limits or financial caps on therapy services. There are annual dollar limits on outpatient physical therapy and speech-language pathology therapy combined and on occupational therapy.

While the law provided for an exceptions process to these caps when additional therapy was medically necessary, that provision expired at the end of 2009. Medicare beneficiaries who have suffered strokes or serious debilitating injuries, such as a hip fracture,

have significant rehabilitation needs. Some of these beneficiaries have already exceeded their therapy limits for 2010.

Since the exceptions process that would have allowed these patients to receive more needed therapy has expired, beneficiaries with the greatest need for therapy will be the hardest hit. Congress must address this issue immediately.

A second issue of major concern is the need for additional payment for mental health services. A provision that expired at the end of last year provided an additional 5-percent payment for Medicare mental health services provided by psychologists and mental health counselors. This provision has been key to improving access to mental health care services for veterans and other military personnel suffering from post- traumatic stress and other disorders since TRICARE coverage is based on Medicare rates.

Significant shortages of mental health personnel have made it exceedingly difficult for Medicare beneficiaries and some of our military returning from overseas to find this critically needed help. The expiration of this provision has made it even more difficult for them to obtain these services. Congress needs to act immediately to help Medicare beneficiaries and members of the Armed Forces in need of mental health services.

A third issue concerns additional payments for ambulance services that are routinely extended, year after year. Many ambulance providers need them to survive. But those provisions also expired at the end of last year.

Another provision would ensure that Medicare beneficiaries can continue to get vital medical supplies such as diabetic test strips, canes, nebulizers, and wound care products from their local community pharmacies.

Under current law, suppliers of durable medical equipment, prosthetics, orthotics, and other supplies must get accredited to prove they comply with quality standards. Many eligible professionals, such as physicians, nurse practitioners, physical therapists, and others are specifically exempted from this requirement. This provision would exempt pharmacies from being accredited under certain circumstances. Pharmacies must have been enrolled as a Medicare supplier with a provider number for at least 2 years, have DME billings that are less than 5 percent of their total sales, be in good standing with Medicare, and meet other criteria.

Medicare beneficiaries living in rural and underserved areas are particularly at risk of losing access to these critical medical products. This provision is essential to ensure they do not.

There are also a number of expired provisions in this package that improve payment for hospitals, especially rural hospitals. These hospitals rely on these provisions to keep their doors open.

The impact of a hospital shutting its doors would be especially hard on rural and underserved areas where hospitals are the only point of access for health care.

Our country is facing record unemployment and Americans are struggling to make ends meet. The failure to extend these essential Medicare provisions immediately will make access to health care or needed medical services simply unavailable for many beneficiaries. The impact will be even worse for those in rural areas already facing health care access problems.

These examples show some of the damage that failing to extend these Medicare provisions will do to our seniors' health care.

We need to get back to work on the bipartisan package that was in the works until the Senate Democratic leadership's dramatic change in direction.

Medicare beneficiaries are counting on us to work together and get this done.

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

Mr. President, the Senate is about to engage in a cloture vote on the Senate Democratic leadership's third stimulus bill. What I find surprising is that what we are about to vote on indisputably and absolutely belongs to the majority leader. That is to say we are not going to vote on a bipartisan package that I put together with Finance Committee Chairman Baucus. I was under the impression that the Senate Democratic leadership was genuine in its desire to work on a bipartisan basis, but clearly I was mistaken. Although the Senate Democratic leader was highly involved in the development of a bipartisan bill, he arbitrarily decided to replace it with a bill he hopes to jam through the Senate.

As much as I was surprised by the Senate Democratic leader's disregard for bipartisanship, I am even more surprised by the explanations given by him and his cohorts.

Perhaps the most significant change between the bipartisan package Chairman Baucus and I helped put together and the package we will be voting to move to is that a package of expired tax provisions has been removed. Normally referred to as extenders, these generally very popular and certainly bipartisan provisions have been extended several times over the past few years.

What is surprising is that hyperpartisan members of the majority have suddenly decided that the tax extenders are partisan pork for Republicans. A representative sample comes from one report, which describes the bipartisan bill as ``an extension of soon-to-expire tax breaks that are highly beneficial to major corporations, known as tax extenders, as well as other corporate giveaways that had been designed to win GOP support.'' Just today the Washington Post includes this attribution to the Senate Democratic Leadership. From the Post:

``We're pretty close,'' {the majority leader} said Friday

during a television appearance in Nevada, adding that he

thought ``fat cats'' would have benefitted too much from the

larger Baucus-Grassley bill.

The portrait being painted by certain members of the majority, echoed without critical examination in some press reports, is wildly inaccurate. For one thing, the tax extenders include provisions such as the deduction for qualified tuition and related expenses and also the deduction for certain expenses of elementary and secondary school teachers. If you are going to school or if you are a grade school teacher, the Senate Democratic leadership thinks you are a fat cat so you are on your own. If your house was destroyed in a recent natural disaster and you still need any of the temporary disaster relief provisions contained in the extenders package, too bad, because helping you would amount to a corporate giveaway in the eyes of some.

The tax extenders have been routinely passed repeatedly because they are bipartisan and very popular. Democrats have consistently voted in favor of extending these tax provisions.

House Speaker Nancy Pelosi released a very strong statement upon House passage of tax extenders in December of 2009, saying this was, ``good

for businesses, good for homeowners, and good for our communities.'' December of 2009 was not very long ago. In 2006, the then-Democratic leader released a blistering statement: ``After Bush Republicans in the Senate blocked passage of critical tax extenders, . . . American families and businesses are paying the price because this Do Nothing Republican Congress refuses to extend important tax breaks.'' I ask unanimous consent that both of these statements be printed in the Record in their entirety.

Recent bipartisan votes in the Senate on extending expiring tax provisions have come in the Emergency Economic Stabilization Act of 2008; the Tax Relief and Health Care Act of 2006, which passed the Senate by unanimous consent; and the Working Families Tax Relief Act of 2004, which originally passed the Senate by voice vote although the conference report received 92 votes in favor and a whopping 3 against. According to the nonpartisan Congressional Research Service, extension of several of these provisions go back even further, including the Tax Relief Extension Act of 1999, which again passed the Senate by unanimous consent but lost one vote on the conference report.

Blinded and dazed by the power of their now not-so-super majority, certain Democrats have in the last few weeks turned against the extenders. One Democrat said:

Our side isn't sure that the Republicans are real

interested in developing good policy and to move forward

together. Instead, they are more inclined to play rope-a-dope

again. My own view is, let's test them.

Another member of this large 59-vote majority exclaimed:

It looks more like a tax bill than a jobs bill to me. What

the Democratic Caucus is going to put on the floor is

something that's more focused on job creation than on tax

breaks.

The only explanation for this behavior is that certain Senators have decided that it serves a deeply partisan goal to slander what have been for several years bipartisan and popular tax provisions benefitting many different people.

Today's Washington Post article I quoted from earlier includes a statement from a Senate Democratic leadership aide saying:

No decisions have been made, but anyone expecting us

immediately to go back to a bill that includes tax extenders

will be sorely disappointed.

Having put their heads into the sand, this chamber's Democratic leaders seem intent on keeping them there. I appeal to all of you to vote against the Democratic Leadership's effort today to jam the Senate. A vote for the Senate Democratic Leadership's cloture motion is a vote to foreclose an opportunity to improve the bill. It also is a vote to forbid any corrections to mistakes in the bill. And there is a significant mistake in the Senate Democratic Leadership's bill. The bill as currently written would allow employers of illegal workers to benefit from the payroll tax holiday. We should correct that mistake with an amendment.

The Senate Democratic Leadership's posture prohibits this correction.

Either the Democratic leaders are playing partisan politics with tax extenders, or they don't understand the worth of the provisions to the economy, including job retention and creation. The biodiesel industry alone says 23,000 jobs are at risk due to the biodiesel tax credit being allowed to expire. Those workers are not fat cats.

And in case anyone thinks biodiesel is something only Iowans worry about, these green jobs are in 44 of the 50 states. There are 24 facilities in Texas. There are 15 facilities in Iowa. There are 6 facilities in Illinois and 6 in Missouri. There are 4 facilities in Washington. Ohio has 11 facilities. There are 5 facilities in Indiana. There are 3 facilities each in Mississippi and South Carolina. There are 7 facilities in Pennsylvania and 4 in Arkansas. New Jersey has 2 facilities.

There is one facility in North Dakota. Only 6 of the 50 States do not have some biodiesel production. They are Alaska, Delaware, Maine, New Hampshire, Vermont, and Wyoming. The other 44 States have some biodiesel presence. I have an article from the Erie, PA, newspaper, describing the struggles of a local biodiesel plant.

So we need to turn away from talk of fat cats. We need to get back to work on the bipartisan package that was in the works until the Senate Democratic Leadership's dramatic change in direction. Many people who are not fat cats or a part of large corporations are counting on these provisions being extended, and they are counting on their elected representatives to work together, as we were doing, to get the job done.

I ask unanimous consent the article be printed in the Record.

Madam President, I stand before you today with a somber task. I extend my most sincere gratitude to fallen soldier, CAPT Daniel Whitten, and his family. Captain Whitten was a decorated officer who served valiantly with Company C, 1st Battalion, 508th Parachute Infantry Regiment, 4th Brigade Combat Team, 82nd Airborne Division out of Fort Bragg, NC, before he was killed by an improvised explosive device in the Zabul province, Afghanistan, on February 2, 2010.

When people described CAPT Daniel Whitten, comments such as, ``always doing the right thing,'' ``stood by his values,'' ``true to his family and himself,'' ``trusted his character'' were common responses. It is a true testament to the character of Captain Whitten that those who knew him held him in such high regard.

Captain Whitten is a graduate of Johnston High School, class of 1999, and the U.S. Military Academy at West Point, class of 2004. He was a very motivated individual, always striving to be the best he could be. The men who served under him had only good things to say about him. People who knew him said that he was the exact type of person they would want defending this country.

My deepest sympathies go out to Captain Whitten's wife Starr, his mother Jill, his father Dan, and his sister CAPT Sarah Whitten who is currently serving her country in Afghanistan. It is men like CAPT Daniel Whitten who guarantee our Nation's security and our people's liberty. We all owe Captain Whitten and his family our profound gratitude for their tremendous sacrifice. I ask that they be in your thoughts and prayers, as they are in mine.

Mr. President, I cannot support this pay-go amendment because it would continue the double-standard that exists between taxes and spending. Under current law, more than a dozen mandatory programs will expire over the next 10 years. Extending these programs will cost nearly $1 trillion according to CBO. But, unlike tax cuts that expire during these same years, pay-go does not apply to the cost of extending these mandatory programs. This double standard is unacceptable.

Mr. President, I want to express my concern about the nomination of Ben Bernanke as Chairman of the Federal Reserve Board and explain why I will vote against him when the Senate has the opportunity this week.

I know many of my colleagues will support Mr. Bernanke because he was a cocaptain of the U.S. economic recovery efforts in the last year and a half. Appointed by President Bush, Mr. Bernanke undoubtedly has a difficult job. Our Nation has been jolted by greed, corruption, fraud, and excessive risk-taking that led to the largest taxpayer bailout in history. Mr. Bernanke was holding the reigns, along with officials in the Department of the Treasury, but steered us into an out-of-control spending frenzy with very little oversight by the American people.

Ben Bernanke has been wrong about the economy. He was wrong about the subprime lending meltdown. He was apparently blind to the pitfalls of credit default swaps. He misled the American public about the purpose and intent of the Troubled Asset Relief Program. He recklessly spent billions of dollars on a few renegade financial firms, picking winners and losers on Wall Street and justified these actions by saying Main Street would be saved. Then, he stonewalled Congress from learning about how the billions of dollars were spent. Ben Bernanke also opposed transparency almost every step of the way.

Let me address these issues more in depth.

Whenever the Chairman of the Federal Reserve opines about the economy, he understands that his words can be misunderstood or taken out of context and thus have an unintended impact on the market and day-to-day trading. However, Ben Bernanke has been saying that our economy has been strong since the beginning of the decline. His analysis of the situation and predictions for our future economic growth were far off.

Let's take the housing problems, for example. In 2006, Fed Chairman Bernanke believed that the housing market had been strong but could cool slightly. He said, ``Our expectation is that the decline in activity or the slowing in activity will be moderate, that house prices will probably continue to rise, but not at the pace that they had been rising. So we expect the housing market to cool, but not to change very sharply.'' He didn't think the housing market would blow up, nor did he believe that the weakness in the market would spill over to other sectors of the economy. He was dead wrong.

He was wrong about unemployment. Most recently, in May of 2009 and in front of the Joint Economic Committee, Fed Chairman Bernanke said: ``Currently, we don't think [the unemployment rate] will get to 10 percent.'' In November the unemployment rate hit 10.2 percent.

We can go back to February 2006. As President Bush's Chairman of the Council of Economic Advisers, Mr. Bernanke was responsible for drafting the Economic Report of the President which claimed the following: ``The economy has shifted from recovery to sustained expansion. . . . The U.S. economy continues to be well positioned for long-term growth.'' In this report, Bernanke projected the unemployment rate to be 5 percent from 2008 through 2011.

Even in 2007, the Fed Chairman believed that the labor market would stay healthy and incomes would continue to rise. In February of that year, he said that ``the business sector remains in excellent financial condition.'' Later in July of 2007, Mr. Bernanke said, ``Employment should continue to expand. . . . The global economy continues to be strong. . . . financial markets have remained supportive of economic growth.''

Then came the Bear Stearns debacle. Bear Stearns led the charge in the securitization market. Because they had placed significant resources in mortgage-backed securities, the company was on the verge of collapse. In March of 2008, the Federal Reserve Bank of New York attempted to save the company through an emergency loan, but failed and moved to force a sale to JPMorgan Chase.

Three months later, Fed Chairman Bernanke still did not acknowledge the pending economic crisis. In fact, in June, he said, ``The risk that the economy has entered a substantial downturn appears to have diminished over the past month or so.'' He couldn't have been more wrong. The economy melted down, and the Fed and Department of the Treasury had to come to the rescue of several failing firms.

The Federal Reserve Chairman only warned Congress about the financial crisis when it was too late. Under his leadership, the Federal Reserve took very little action to control the root causes that led us to economic storm we have all had to endure. Instead, they urged Congress and the American people to swallow a plan that was ill conceived and risked making the situation worse.

So another reason I cannot support his renomination as Chairman of the Board is because of the disastrous implementation of the Troubled Asset Relief Program, also known as TARP.

Chairman Bernanke came to Congress with former Treasury Secretary Paulson, selling a proposal that would direct taxpayer money to purchase ``toxic assets.'' The proposal would have allowed the Federal Government to take bad assets off the books of troubled firms to keep credit flowing. We were told that the situation was dire. We were told that the Fed and the Treasury Department had a plan in place. We were told that taxpayers may even come out ahead. We were told to trust them.

It wasn't long after the Emergency Economic Stability Act was passed in October 2008 that the Fed and the Treasury reversed course. Without input from Congress, they took the authority they were given and went their own way. Chairman Bernanke was doling out funds for Bear Stearns and AIG while the Treasury was doling out funds to firms that were destined for failure.

Today, the Troubled Assets Relief Program has been used as a slush fund to bail out firms on Wall Street and troubled automakers. Taxpayer money has been enabling these companies to continue in their misguided ways. Corporate jets were being used to lobby Congress for billions of dollars, and CEOs resisted proposals to slim down the fat pockets of their cronies. The American people were misled, and Ben Bernanke should share responsibility for that.

But, it wasn't just the Troubled Asset Relief Program that was used to funnel taxpayer money to failing firms. Chairman Bernanke led the Fed on a spending spree, using a blank check to unilaterally direct money to AIG, Fannie Mae, and Freddie Mac.

Chairman Bernanke was AWOL as the Federal Reserve funneled billions of taxpayer dollars to AIG knowing that the money would go directly out the back door to AIG counterparties like Goldman Sachs and foreign banks. AIG's payment of 100 cents on the dollar for the counterparty securities meant Goldman actually received more than some other counterparties, because Goldman's securities had a market value of 40 cents on the dollar while UBS Bank's securities, for example, were worth 71 cents on the dollar.

Chairman Bernanke was absent from the critical ``haircut'' negotiations with the AIG counterparties, in stark contrast to the TARP Capital Purchase Program negotiations weeks earlier. As a consequence, no reductions in counterparty payments were obtained for the American taxpayer. These negotiations failed despite the fact that some of the foreign counterparties offered to reopen negotiations. The Federal Reserve failed to capitalize on this opportunity and investment bankers were paid in full.

The AIG bailout was designed by the Fed in a manner that funneled billions of dollars directly to the counterparties. No other outcome was possible.

The effect was a ``backdoor bailout'' regardless of the Fed's now- stated intent merely to improve AIG's liquidity in order to avoid a collapse.

Reasonable people can disagree about whether Chairman Bernanke made the right decisions. Aside from the problems I have already outlined, I have serious reservations about voting for him again given his resistance to transparency. For example, we have seen very little cooperation from the Federal Reserve to ensure that the Government Accountability Office, GAO, has independent audit authority.

Last March, the GAO testified before the Finance Committee that the Federal Reserve was resisting its efforts to conduct oversight of the response to the financial crisis by citing provisions of law that were intended to maintain the independence of monetary policy.

Such restrictions could be defended when the Federal Reserve focused only on monetary policy. However, since the financial crisis, the Federal Reserve has routinely exercised extraordinary emergency powers to subsidize financial firms far above the levels Congress is willing to authorize through legislation. The Federal Reserve took on enormous amounts of risk in complicated and unprecedented ways. That risk is ultimately borne by the American taxpayer. Congress authorized $700 billion in funds under TARP. However, the total projected assistance in various initiatives by the Federal Reserve could be up to $3.4 trillion by GAO estimates.

Therefore, I introduced an amendment in May of last year that would have guaranteed GAO the authority to audit all of the extraordinary emergency assistance from the Federal Reserve. Regrettably, due to objections from the Federal Reserve, my amendment had to be watered- down to ensure that GAO received at least some of the additional authorities it needed.

Although I would have preferred to make all of the Fed's emergency actions under section 13(3) subject to GAO audit, I agreed to limit my amendment to Fed actions aimed at specific companies like Bear Stearns and AIG. However, broader, more comprehensive oversight authority over the Federal Reserve is needed to ensure the kind of transparency and accountability the American people expect. Unfortunately, when the opportunity to embrace that sort of oversight was presented, the Federal Reserve hid behind concerns about the independence of monetary policy to maintain the secrecy of its operations.

Another example of the Federal Reserve resisting attempts to shine light on their actions surrounds the ``back-door bailout'' of Goldman Sachs and major foreign banks through the aid to AIG. The Federal Reserve initially refused to disclose the identity of the banks to whom AIG paid out the vast majority of its Federal assistance. Federal Reserve lawyers even opposed AIG disclosing details of its transactions in public filings required by the Securities and Exchange Commission. The Federal Reserve argued that disclosing the identity of these counterparties who engaged in exotic, risky transactions with AIG would destabilize AIG, would harm the private business interests of the counterparties, and could affect the stability of the markets as a whole. However, following significant public and Congressional pressure, the identities of the counterparties were released, and we learned that French bank Society General and Goldman Sachs were among the largest beneficiaries of the Federal bailout of AIG. None of the horrible consequences the Federal Reserve used to oppose basic transparency came to pass. The sky did not fall.

The Special Inspector General for TARP has launched an investigation into whether there was misconduct at the Federal Reserve in regard to the Fed's role in the failure of AIG to disclose billions of dollars in counterparty payments to the SEC last year. And just this week, the Special Inspector General announced that it is investigating the Federal Reserve for withholding documents from the Special Inspector General in connection with his audit in November 2009 of the AIG counterparty payments. The Special Inspector General learned that they did not receive all of the documents they requested from the Federal Reserve when they saw the documents produced last week under subpoena to the House Committee on Oversight and Government Reform for the Committee's January 27, 2010, hearing. This sort of stonewalling by the Federal Reserve is outrageous and cannot be tolerated.

So, I have had to ask myself, Is Ben Bernanke the man to lead us forward?

Chairman Bernanke didn't see the financial crisis coming. He never expected our unemployment to reach 10 percent. He didn't foresee the subprime housing market affecting the broader economy. He didn't expect complicated financial instruments like credit default swaps to pose a risk to the economy, even though they were considered by some to be ``financial weapons of mass destruction.'' In fact, Chairman Bernanke insisted only well-informed and intelligent minds were using such instruments and that government supervision wasn't necessary.

This lack of foresight makes me wonder if he is ready to lead our economy down the path to a sustainable recovery.

I am afraid Ben Bernanke thinks everything is under control. He steered our economy out of danger. But we still have a long road ahead of us. The Fed has to unwind its massive balance sheet. It has to remove the excess funds that were created to paper-over the financial sectors' unacknowledged losses without stoking the flames of inflation.

We need a Fed Chairman that is committed to a strong dollar and low inflation. We need a Fed Chairman that is committed to transparency.

I am afraid Ben Bernanke had a seat at the table during the development of our current economic and financial crisis. He has failed to learn its lessons. He has promoted a policy of easy money, inflating our way from a stock market bubble to a housing bubble. He neither predicted nor prepared for the inevitable results. Moreover, he seems determined to repeat the mistakes of the past.

For these reasons, I cannot support his nomination by President Obama to serve a second term as Chairman of the Fed.

Mr. President, in 2009 the Medicare, Medicaid and CHIP programs accounted for over $800 billion of the $2.3 trillion spent on health care in the U.S. Together, these programs constitute around 35 percent of national health spending. With so much taxpayer money at stake, it is no surprise that all this spending brings crooks, scam artists and even organized crime out of the woodwork.

Low estimates are that fraudsters steal $60 billion from the Medicare and Medicaid programs every year. As Federal health care spending continues to skyrocket, so will the dollars lost to fraud, waste and abuse.

This is a crime against not only the taxpayer, but against each and every beneficiary who depends on these programs for their health care. The examples of fraud are all around us. In a 60 Minutes segment late last year, we saw a medical supply company that billed Medicare $2 million last July--despite being empty and having apparently no staff.

One man interviewed said he was waking up every day making $20,000- $40,000. Every single day. He said it was like winning the lottery, and you and me and every taxpayer were footing the bill. He was running a fake medical supply company that didn't actually sell any medical equipment to anyone. He says he stole at least $20 million from Medicare. He said it was, ``real easy.''

This must change.

I don't think Members on either side of the aisle dispute this. Back when health care reform was a bipartisan endeavor, I developed a set of legislative proposals with Senator Baucus to combat fraud, waste and abuse. These proposals are in the bill that the Finance Committee reported as well as the health care reform bill that the Senate passed late last year. And these provisions did not draw opposition from either side of the aisle. Tackling fraud, waste and abuse in health care is one of the areas where there is widespread agreement.

That is why I am here today to introduce the Strengthening Program Integrity and Accountability in Health Care Act. This legislation includes the critical measures that I developed on a bipartisan basis. This bill also includes legislation and amendments I have subsequently introduced to strengthen these proposals to address fraud, waste and abuse.

They are designed to deter, detect and prevent those that would steal from Federal health care programs, to assist those tasked with catching these criminals, and to protect taxpayer dollars. These commonsense changes will go a long way in helping to make sure Medicare, Medicaid and CHIP dollars are going to bona fide providers, instead of fraudsters set on scamming the system.

This legislation would make it harder for fraudsters to enroll in Federal health programs as providers and bilk the system. This includes requiring meaningful screening of health care providers and suppliers. Additional tools would also be provided to prevent fraud, waste and abuse including enhanced oversight measures, disclosure requirements, authority to impose enrollment moratoriums and requirements for developing compliance programs.

This bill would impose additional requirements on providers and suppliers to ensure that bona fide providers are billing Federal health programs for bona fide items and services. This includes providing documentation or performing a face-to-face evaluation before certifying a beneficiary's eligibility for an item or service.

It would also improve Federal monitoring for fraud, waste and abuse by requiring better data sharing and data

access across the Federal government. Government agencies would be able to share information with each other in an effort to identify crooks in the system promptly. It would also create a national clearinghouse of information so we can better detect and prevent and thereby deter medical identity theft. Again, this is about the Federal Government sharing information it already has in ways that protect the Taxpayer and work against those defrauding the system and hopefully deter those who are thinking about stealing from you.

The legislation takes several steps to end the current ``pay and chase'' model of Federal health care spending. It takes the commonsense approach of allowing the government to withhold taxpayer dollars from those under investigation for health care fraud.

It would change Federal laws that require Medicare to pay providers quickly, regardless of the risk of fraud, waste, or abuse. Under current law, the government is required to make payment for a ``clean'' claim within 14 to 30 days before interest accrues on the claim. That is not enough time for the limited number of Medicare auditors to determine if the claim is legitimate before the payment has to be made. The result is that this ``prompt payment rule'' requires that Medicare pay fraudsters first, and ask questions later.

This requirement doesn't make any sense. This bill would give the Secretary of Health and Human Services the authority to ask questions first and then and only then to make the payment if the health care provider and the payment for services check out. The Secretary would also be required to suspend payments pending the investigation of credible allegations of fraud against the provider or supplier.

This legislation would also increase funding for those fighting health care fraud. Study after study has shown that every dollar spent fighting health care fraud is repaid multiple times over in funds recovered and fraud prevented. This is a good investment for the taxpayer and bad news for health care fraudsters.

This bill would provide powerful disincentives for those that would rob the taxpayer through health care fraud. It would better arm those fighting fraud with tools to catch and prosecute fraudsters. It also would make the consequences for committing health care fraud more meaningful by increasing civil monetary penalties and expanding the types of acts and omissions that would be subject to civil monetary penalties and exclusion from Federal health programs.

This legislation would also strengthen the government's most powerful tool for preventing and recovering taxpayer dollars lost to fraud, the False Claims Act. It also ensures that courageous whistleblowers that come forward to speak up against fraud and file False Claims Act cases are protected from retaliation by their employers.

These changes would go a long way to deter those who would defraud our health care programs. It also would provide greater protections to the taxpayer. In these difficult economic times, we have got to do everything we can to protect taxpayer dollars and the resources of health care programs on which so many Americans depend.

Mr. President, in 2009 the Medicare, Medicaid and CHIP programs accounted for over $800 billion of the $2.3 trillion spent on health care in the U.S. Together, these programs constitute around 35 percent of national health spending. With so much taxpayer money at stake, it is no surprise that all this spending brings crooks, scam artists and even organized crime out of the woodwork.

Low estimates are that fraudsters steal $60 billion from the Medicare and Medicaid programs every year. As Federal health care spending continues to skyrocket, so will the dollars lost to fraud, waste and abuse.

This is a crime against not only the taxpayer, but against each and every beneficiary who depends on these programs for their health care. The examples of fraud are all around us. In a 60 Minutes segment late last year, we saw a medical supply company that billed Medicare $2 million last July--despite being empty and having apparently no staff.

One man interviewed said he was waking up every day making $20,000- $40,000. Every single day. He said it was like winning the lottery, and you and me and every taxpayer were footing the bill. He was running a fake medical supply company that didn't actually sell any medical equipment to anyone. He says he stole at least $20 million from Medicare. He said it was, ``real easy.''

This must change.

I don't think Members on either side of the aisle dispute this. Back when health care reform was a bipartisan endeavor, I developed a set of legislative proposals with Senator Baucus to combat fraud, waste and abuse. These proposals are in the bill that the Finance Committee reported as well as the health care reform bill that the Senate passed late last year. And these provisions did not draw opposition from either side of the aisle. Tackling fraud, waste and abuse in health care is one of the areas where there is widespread agreement.

That is why I am here today to introduce the Strengthening Program Integrity and Accountability in Health Care Act. This legislation includes the critical measures that I developed on a bipartisan basis. This bill also includes legislation and amendments I have subsequently introduced to strengthen these proposals to address fraud, waste and abuse.

They are designed to deter, detect and prevent those that would steal from Federal health care programs, to assist those tasked with catching these criminals, and to protect taxpayer dollars. These commonsense changes will go a long way in helping to make sure Medicare, Medicaid and CHIP dollars are going to bona fide providers, instead of fraudsters set on scamming the system.

This legislation would make it harder for fraudsters to enroll in Federal health programs as providers and bilk the system. This includes requiring meaningful screening of health care providers and suppliers. Additional tools would also be provided to prevent fraud, waste and abuse including enhanced oversight measures, disclosure requirements, authority to impose enrollment moratoriums and requirements for developing compliance programs.

This bill would impose additional requirements on providers and suppliers to ensure that bona fide providers are billing Federal health programs for bona fide items and services. This includes providing documentation or performing a face-to-face evaluation before certifying a beneficiary's eligibility for an item or service.

It would also improve Federal monitoring for fraud, waste and abuse by requiring better data sharing and data

access across the Federal government. Government agencies would be able to share information with each other in an effort to identify crooks in the system promptly. It would also create a national clearinghouse of information so we can better detect and prevent and thereby deter medical identity theft. Again, this is about the Federal Government sharing information it already has in ways that protect the Taxpayer and work against those defrauding the system and hopefully deter those who are thinking about stealing from you.

The legislation takes several steps to end the current ``pay and chase'' model of Federal health care spending. It takes the commonsense approach of allowing the government to withhold taxpayer dollars from those under investigation for health care fraud.

It would change Federal laws that require Medicare to pay providers quickly, regardless of the risk of fraud, waste, or abuse. Under current law, the government is required to make payment for a ``clean'' claim within 14 to 30 days before interest accrues on the claim. That is not enough time for the limited number of Medicare auditors to determine if the claim is legitimate before the payment has to be made. The result is that this ``prompt payment rule'' requires that Medicare pay fraudsters first, and ask questions later.

This requirement doesn't make any sense. This bill would give the Secretary of Health and Human Services the authority to ask questions first and then and only then to make the payment if the health care provider and the payment for services check out. The Secretary would also be required to suspend payments pending the investigation of credible allegations of fraud against the provider or supplier.

This legislation would also increase funding for those fighting health care fraud. Study after study has shown that every dollar spent fighting health care fraud is repaid multiple times over in funds recovered and fraud prevented. This is a good investment for the taxpayer and bad news for health care fraudsters.

This bill would provide powerful disincentives for those that would rob the taxpayer through health care fraud. It would better arm those fighting fraud with tools to catch and prosecute fraudsters. It also would make the consequences for committing health care fraud more meaningful by increasing civil monetary penalties and expanding the types of acts and omissions that would be subject to civil monetary penalties and exclusion from Federal health programs.

This legislation would also strengthen the government's most powerful tool for preventing and recovering taxpayer dollars lost to fraud, the False Claims Act. It also ensures that courageous whistleblowers that come forward to speak up against fraud and file False Claims Act cases are protected from retaliation by their employers.

These changes would go a long way to deter those who would defraud our health care programs. It also would provide greater protections to the taxpayer. In these difficult economic times, we have got to do everything we can to protect taxpayer dollars and the resources of health care programs on which so many Americans depend.

Mr. President, I think most of the people watching this debate, studying how Congress works and how the Federal Government works, know there is a statutory limit on the amount of debt that can be issued by the Federal Government. If the public does not know this, they are constantly reminded of it because, from time to time, we pass legislation that does what this legislation does, increase the borrowing capacity of the Federal Government.

Right now this legal limit stands at $12.394 trillion, and it applies to money borrowed from Federal investors such as banks and pension funds, as well as money borrowed from government programs such as Social Security and Medicare. Yes, we ought to admit that a lot of the Federal debt is owned by various foreign governments as well. I think the latest I saw, in the case of China maybe investing and holding about 8 percent of all the Federal debt

and then you have other countries as well.

This determination is made when the Secretary of Treasury goes to the market and says: We want to borrow X number of dollars, and people bid on it. Obviously, we take it for the lowest interest rate we can get, whatever individuals or pension fund or foreign entity might want to take our debt for that interest. That happens throughout the year.

The decision to increase the debt limit is never an easy one. In recent years, I have reluctantly supported increases in the debt limit on the grounds that Congress must pay its bills. That is quite obvious. Some countries--such as Argentina--decided, from time to time, they did not want to pay their debt, and they are paying the piper for making those unwarranted public decisions in those countries. We do not want to be in that shape.

But Congress sometimes, and too often, has been very irresponsible. I am going to get into some of this current irresponsibility but, at the same time, I do not wish to say some other political party is entirely responsible, over a period of decades, for irresponsible spending. But I think it has reached a new height recently. Because of that, I will be voting no.

Sometimes deficits are unavoidable. People know about wars. The No. 1 responsibility of the Federal Government is to provide for the national defense, the protection of Americans or a threat to our security. We meet that threat. If that requires borrowing to do it, to protect the United States, we consider that justified.

But you cannot plan for wars. You can plan for peace by having a strong national defense. So war is one reason, recession is another. Natural disasters are another example. All of these can result in lower taxes and higher spending, which produces bigger deficits that add to our Federal debt.

But sometimes deficits can be avoided. Since the beginning of 2009, the majority in Congress has approved a $787 billion stimulus bill, a $408 billion supplemental appropriations bill, an additional $350 billion for the financial bailout, and, most recently, an Omnibus appropriations bill that increased Federal spending by 12 percent over the previous year's levels.

In my recent 21-county tour of southeast Iowa, I discussed the most recent example as an example of how spending recently has gotten entirely beyond the commonsense view that Midwesterners look at spending by government. I pointed out how 1 year ago today, the new President was sworn in. The previous President was under a budget that was established for a 5-month period of time. That last budget under Bush had spending at a 3-percent increase. But just as soon as the new majority came into power with a new President, that 3-percent increase was not enough for the remaining 7 months, it was jacked up to 9 percent and then, for the year we are in, the 12 percent I just spoke about.

I think you have to adopt a principle of spending that has increases in expenditures related to the economic growth of the tax policies that provide revenue to the Federal Government. That doesn't have to be on a year-to-year basis, but over a long period we ought to have that balance. In other words, without increasing tax rates, with economic growth of the tax base, more money will come in to the Federal Treasury under the same tax rates.

Well, that growth in Federal income coming in makes it possible to appropriate more money, but there ought to be some relationship between the amount of money coming in and the expenditures made by the Congress.

The bills I just referred to--the stimulus bill, the Omnibus appropriations bill, and others--I voted against every one of those on the grounds that we could not afford them. The fact that we are here this week facing yet another vote to increase the debt limit proves that is true. Many of my colleagues, particularly on the other side of the aisle, insist that it is not their fault. They continue to blame previous administrations for all fiscal problems.

I want to make it clear that we in the Republican Party got kicked out of the majority in 2006 because we lost fiscal integrity. I hope we are reestablishing that, and I hope that in the process of reestablishing that we can convince the people who had doubts about Republicans that we can regain their trust.

More recently, as I indicated, it seems a great deal of the current debt problem is related to irresponsible spending that has taken place near term.

What do they target us with when they want to blame us for the deficit? They criticize the 2001 and 2003 tax cuts which they insist were excessive and unfair. Such criticism overlooks several facts. First, these were not Republican tax cuts. They passed both the House and Senate with bipartisan support. Second, Federal revenue quickly returned to the historical average following these tax cuts, so they were not excessive relative to the government's historic claim on revenue.

I suppose you can take any period of time you want, but in the post- President Kennedy period of time, it seems to me the average take of the economy that has come through the Federal Government in the way of taxes has been about 18 to 19 percent. Even including the tax cuts of 2001 and 2003, those cannot be considered excessive relative to the government's historic claim on revenue; in other words, what the government takes as opposed to what they leave in the pockets of taxpayers in the United States.

It is very important to remember that our Tax Code is not fully indexed to inflation and economic growth. Thus, every year without a tax cut results in a small but not insignificant tax increase or more revenue coming into the Federal Treasury without our actually changing rates. Indeed, without the 2001 and 2003 tax cuts, Federal revenue would have risen well above that historic average of 18 to 19 percent. In fact, when we passed those tax cuts, it was very near 21 percent.

Third, critics insist that the 2001 and 2003 tax cuts unfairly benefitted the wealthy. Again, critics are wrong. I quote the Congressional Budget Office. Around here, we don't question the Congressional Budget Office. Maybe you want to. But if you want to question them, it takes 60 votes to override their determination of something, if there is a budget point of order.

According to the Congressional Budget Office, the bottom 90 percent of households pays the smallest share of Federal taxes in nearly 30 years while the top 10 percent pays the largest share. When taxes are measured as a share of income, the bottom 90 percent of households pays the lowest effective rates in nearly 30 years while the top 10 percent pays their historic average.

You can say it many times, but it never sinks in because people have their own ideas of how to show populism, and it is to always hit the wealthy of America. From that standpoint, you have to understand that percentage of top income earners, if you compare what they are paying into the Federal Treasury now with what they were paying in even during the Reagan years, you will find it is a much higher percentage right at this point.

In regard to what I just said about historical averages, President Obama's budget and the budget resolution adopted by the Democratic majority in Congress last year both called for the continuation of 70 to 80 percent of the 2001 and 2003 tax cuts. So you can bad-mouth those tax bills all you want, but the new President, the new majority wants to maintain about 70 to 80 percent of them. So some of it isn't so bad, but you never hear that. It is all about the 2001 tax cuts being everything for the wealthy.

If these tax cuts were so excessive and so unfair then, why does the majority party support so many of those tax cuts right this very day?

The desire to blame our current predicament on the previous administration also overlooks two other facts. First, the Democrats controlled the majority of the Senate during half of the previous administration, including its final 2 years. I think it is disingenuous for them to deny any responsibility for where we are today.

Second, when the new administration took office in 2009, it sent up a budget that proposed to increase the debt three times faster than the previous administration. You know where that takes us to from the 40- year average? I talked about the 40-year average of the proportion of the GNP that is coming into the Federal Treasury as far as

taxes are concerned at 18 to 19 percent. Take a 40-year average on what the percentage of the national debt is to gross national product. It is about 40 percent. This is going to be reaching 80 to 90 percent under this budget that was sent here in the previous year.

The majority party essentially approved most of that very same budget. So they have now signaled the intention to continue to increase the national debt at a record pace.

Finally, let me say a word about the health care bill adopted by the Senate. Rather than taking an incremental approach and waiting for the results to see what works and what doesn't work, the majority wants to raise taxes and cut Medicare to pay for a brand new health care entitlement program. If they use all of the tax hikes, and all of the Medicare cuts they can support to pay for more spending, how will they ever reduce the deficit? At what point will those who want to blame our current predicament on previous administrations take responsibility for actions that are taking place now?

This week we have an opportunity to do that. I am glad we have a long period of time to discuss the debt limit but connect it with a lot of policies that seem to be out of proportion to problems that we previously had. If they want to continue to vote for more deficit spending, it seems to me they should vote to raise the debt limit or take actions that would reduce the need for such a dramatic increase in the debt limit.

I yield the floor.

Mr. President, I would like to take a moment to honor a remarkable Iowan, Raymond Paul Pritchard, a native of Bondurant, IA. He is a distinguished World War II Air Force veteran and a civil servant of 29 years.

Following graduation from Bondurant High School in 1937, Mr. Pritchard went to work for Standard Oil Company. In 1941, Mr. Pritchard joined the Army Air Corp and served his country valiantly for the entirety of World War II. As an engineer and top turret gunner in the 384th Bomber Group, Mr. Pritchard was involved in numerous missions in the hostile skies of Europe, including several bombing runs over Germany and Czechoslovakia that were critical to the war effort.

Upon returning from World War II, Mr. Pritchard became a U.S. Postal Service worker. Mr. Pritchard retired in 1974, following 29 years of public service.

Mr. Pritchard and his wife Helen have three children, along with seven grandchildren, and five great-grandchildren. He is a member of Christ United Methodist Church, American Legion Post 374, and a 50-year member of Pioneer Lodge No. 22.

Mr. Raymond Paul Pritchard is a truly remarkable Iowan and American, who exemplifies great military and civilian service to his country.