Floor Statements

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Madam President, we had a very early vote, and it brings the health care reform bill obviously one step closer to final passage--at least it looks obvious that is going to happen. Regardless of whether the other side has 60 votes, my friends on the other side still have a problem they want to not have the public concentrate on; that is, that the pending bill still raises taxes on middle-income Americans. The Reid modification did nothing to reverse this fact.

I will take a few moments to illustrate the winners and losers under the bill. We start with a question: If a person is not receiving a subsidy for health insurance under the bill, then how can the person receive a tax cut? This is a relevant question because the White House and the majority leadership continue to proclaim that the bill is a ``net tax cut'' for middle-class Americans. For example, on Wednesday, December 16, a senior White House aide wrote:

The bill being considered represents a substantial net tax

cut for middle income families.

So I think that statement begs more questions. Who do you believe? The

White House, on the one hand, or on the other hand, the nonpartisan independent experts upon whom we on Capitol Hill rely for judgment--the people who are not political, the Joint Committee on Taxation?

This committee tells us that in 2019, a little more than 13 million individual families and single parents would receive the government subsidy for helping people under 400 percent of poverty buy health insurance. The Joint Committee also tells us that the number of tax filers in 2019 will be 176 million people. If people are wondering why we talk about 2019, it is the budget window from now until the end of the 10-year period of time that we call a ``budget window.'' That means out of--comparing this 13 million to the 176 million taxpayers, 13 million people receiving the subsidy and 176 million tax filers--that means out of that 176 million individuals, families, and single parents, only 13 million of them would receive a government subsidy for health insurance. That is only 7 percent of the tax filers. It is pretty important to understand that only 7 percent of Americans will benefit from the subsidy for health insurance.

We have a pie chart so people can see exactly what I am talking about. This says 176 million taxpayers, with 13 million receiving the subsidy. This means 163 million families, individuals, and single parents--or 93 percent of all taxpayers--will receive no government benefit under the Reid bill. What does that mean? It means there is a small beneficiary class under the Reid bill--7 percent. Thirteen million people will receive benefits under the Reid bill. A very large nonbeneficiary class--93 percent--will not benefit.

This nonbeneficiary class is 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. This group would not have a tax benefit to offset the new tax liability. That means these Americans will be worse off under the Reid bill.

It is legitimate to ask, for these 93 percent of the people, what happened to their net tax cut? What they will see instead is a net tax increase. Based on the Joint Committee's data, in 2019 42 million individuals, families, and single parents with incomes 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.

If we were to identify those Americans who are not eligible to receive the tax credit and those whose taxes go up before they see some type of tax reduction from the subsidy, this number will climb to 73 million Americans. The first bar on the chart illustrates what we have already established but looks at Americans earning less than $200,000. Right here, 13 million families and single parents and individuals would receive the subsidy.

The middle bar on the chart shows the net tax increase number of 42 million Americans under $200,000-a-year income. Finally, when we identify those Americans who get no benefit under this bill, and those Americans who see a tax increase, we find that there are 73 million individuals, families, and single parents under the $200,000 category. That is this group.

I want to close by referring to a final chart that illustrates the winners and losers under the Reid bill. What we see 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--8 percent of Americans, if you look at those earning less than $200,000.

There is another much larger group of Americans who are seeing their taxes go up. This group is not benefiting from the government subsidy, this group on the chart. There is another group of taxpayers who are generally unaffected, this 82 million here. The Joint Committee on Taxation tells us this group may be affected by tax increases that are not included in this study, like the cap on flexible savings accounts and the individual mandate tax that people are going to pay if they don't buy health insurance.

The bottom line is this: My friends on the other side of the aisle, first, cannot say that all taxpayers receive a tax cut; two, they cannot say the Reid bill does not raise taxes on middle-income Americans because we have the professionals who are nonpolitical at the Joint Committee telling us differently. No one can dispute that data.

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

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

Madam President, my friends on the other side of the aisle continue to argue that the Reid bill eliminates the so-called hidden tax. They argue that this would reduce the cost of health care. For example, on Wednesday, December 16, a senior White House aide wrote:

Even if you believe that some of the tax on insurance

companies is passed along, it would be more than outweighed

by the benefits middle-class families would get from reducing

the hidden tax they currently pay for the uninsured.

I don't believe the fees on health insurance companies will be passed through to the policyholders. I think it is just idiotic not to think they would not be passed through.

I want to flatout state I know they are going to be passed through. My authority for this is the Congressional Budget Office and the Joint Committee on Taxation telling us that fact. The CBO and the Joint Committee on Taxation told us that these fees will actually increase health insurance premiums. Premiums will go up because the companies are paying increased taxes under this bill. For insurance premiums to go up, under a title of a bill that encompasses health care reform, that is going in the wrong direction. Also, for argument's sake, let's assume my Democratic colleagues are correct and this so-called hidden tax that results from uncompensated care equals $1,000. The pending health care reform bill still leaves a large number of Americans uninsured. Specifically, the Reid bill leaves 23 million out of 54 million without health insurance at the end of this budget window, 2019. So, at best, the Democrats' reform cuts the hidden tax in half-- in this case, to about $500 a family.

To add insult to injury, however, the bill adds new hidden taxes. These taxes are the fees imposed on health insurance. CBO and the Joint Committee on Taxation--two respected organizations--say this will increase costs. If you check the report, no one can dispute that. These fees go into effect in 2011--still 3 years before any of the major reforms under the pending bill kick in.

That means this hidden tax will increase premiums in 2011, 2012, and 2013. That is before there is any government assistance for health insurance being provided to families that need it. The new hidden tax is also created as a result of the Medicaid expansion on the one hand, and Medicare cuts on the other hand, a major cost shift in health care derived from government programs--Medicare and Medicaid--which reimburse providers at rates roughly 20 percent to 40 percent lower than private providers.

President Obama understands that paying doctors below market rates leads to cost shift. This is what he said at a townhall meeting on health care reform:

If they are only collecting 80 cents on the dollar, they

have to make that up someplace else, and they end up getting

it from people who have private insurance.

The Medicare and Medicaid cost shift will be increased significantly under the pending health care reform bill. According to the CBO estimate, Medicaid will be increased by more than 40 percent, from 35 million to 50 million people. Additionally, the bill includes almost $\1/2\ trillion in Medicare cuts that will result in lower payments to providers.

Increasing the current Medicare and Medicaid cost shift as a result of the Democrats' health reforms would add even more costs to a family's health insurance policy. The easier cost shift to address would be the $1,700 cost shift from defensive medicine. The Democrats do not address the cost shift from defensive medicine which former CMS Director Mark McClellan has estimated adds $1,700 in additional cost per average family.

Addressing this reform alone could save more than covering all of the uninsured in America.

So, you see, my friends on the other side say their bill will eliminate the so-called hidden tax. My friends seem to come up short on that one. Also, they add new hidden taxes that will burden middle-class Americans.

I think in the present situation, the legislation before us and the language used by debaters on the other side, they should be transparent when they are talking about getting rid of the hidden tax. The pending health care reform bill makes things from these three perspectives work.

Madam President, I will be happy to yield the floor for a minute for the purpose of a colloquy with Senator Baucus on another subject.

Madam President, I would like to add to what Senator Baucus said by speaking positively on this issue and to remind my colleagues who maybe have been watching in the last 3 weeks and have seen Senator Baucus and I on opposite sides of the issue of health care reform--it is uncharacteristic for us to have different points of view on legislation. In the 10 years he and I have been leaders of the Finance Committee, most of the issues coming out of our committee have been very bipartisan. What he just talked about and what I am going to respond to is one of those issues.

I agree with Chairman Baucus that we should retroactively extend the expiring tax provisions as soon as possible after Congress reconvenes in 2010.

As chairman of the Finance Committee in 2005, I worked with then- Ranking Member Baucus, and we authored the biodiesel tax credit.

The biodiesel tax credit is a tax credit that is needed to be extended before the end of the year to prevent the U.S. biodiesel market from grinding to a halt on January 1, 2010. This tax credit differs from other tax provisions in that the price of biodiesel will be $1 higher on January 1, 2010, as a result of the tax credit not being extended before that date. That means people will simply buy petroleum diesel rather than biodiesel come January 1, 2010.

I point out that support in Congress for extending the biodiesel tax credit, I think, has been and still is robust, bipartisan, and bicameral, and that it has not been extended prior to January 1, 2010, due solely to issues unrelated to the merits of the biodiesel tax credit.

I want everybody to know that I agree with Chairman Baucus that the expiration of these tax provisions creates uncertainty and complexity in the tax law. I also agree that the taxpayers need notice that these tax provisions will be in place so they can plan their personal and business affairs to fully and efficiently use the intended tax incentives.

In addition, extending the tax provisions as early as possible in 2010, as we intend to do, will minimize the administrative problems created for the Internal Revenue Service.

I look forward to working with Chairman Baucus to retroactively extend these provisions as soon as possible when the Senate reconvenes in 2010.

Madam President, I suggest the absence of a quorum.

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

Madam President, there was a report released recently by the Chief Actuary, Rick Foster. I hope this report will once and for all put an end to any serious consideration of the CLASS Act. The CLASS Act is going to be in the bill, if this bill passes Congress. But it should not be in it, and we should have had a long discussion on this provision because it is simply fiscally unsustainable.

The information the Chief Actuary's letter provides is ample evidence of why the CLASS part of this bill cannot work. Quoting from page 13 of the Chief Actuary's letter:

We estimate that an initial average premium level of about

$240 per month would be required to adequately fund CLASS

program costs for this level of enrollment, antiselection,

and premium inadequacy for students and low income

participants.

So who would enroll in the CLASS program? An American making 300 percent of poverty has a gross income of $32,490. If the CLASS premium is, as the Chief Actuary predicts, $240 per month--that is $2,880 per year--and an individual at 300 percent of poverty would have to commit 8.9 percent of their income to join the program. That is simply not possible, nor is it plausible to argue that young, healthy persons will commit almost 9 percent of their income to long-term care insurance policy.

The people who will enroll then are those who have real expectations of using the long-term care benefit. People who join the CLASS program with the expectation of needing the benefit become the Bernie Madoffs of the CLASS Act Ponzi scheme.

An individual becomes eligible for the CLASS program after paying premiums for just 5 years. If a person pays premiums of $2,880 per year for 5 years, they would have paid a total of $14,400 in premiums for that program. That person can then begin collecting a benefit of $1,500 per month. In 10 months, the person will have recouped their 5 years' worth of premiums.

This simple explanation should make it crystal clear why the CLASS Act is a fiscal disaster waiting to happen, not based on our determination but based on the determination of the Chief Actuary. The premium will be too expensive to entice young, healthy people to participate. The benefit payout is very enticing for people who know they will need the benefit. Healthy people do not participate; sicker people will. This adverse selection problem will send the program into the classic insurance death spiral.

The Chief Actuary concluded on page 14 of his report with this one sentence:

There is a very serious risk that the problem of adverse

selection would make the CLASS program unsustainable.

If the CLASS Act becomes law, the Federal taxpayers are at very serious risk of paying a price to clean up the fiscal disaster when the CLASS Act fails.

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

Madam President, My Friend, Senator Casey, just a few moments ago repeated the frequent claim made by members on the other side of the aisle that the health care bill provides a $40 billion net tax cut.

As I demonstrated in a speech earlier today, this claim is inaccurate and does nothing to address the fact that millions of middle-class Americans will see a tax increase.

I have consistently given my Democratic friends credit for providing a significant benefit to help people buy insurance.

This beneficiary class, however, is small.

At the same time there are 78 million individuals, families, and single parents who will see a tax increase.

Seventy-three million of them are below $200,000.

It is only because the subsidy for this small group is so large--and refundable--that there is a net tax benefit.

For example, the average subsidy is close to $8,000. Around 13.2 million individuals and families receive this subsidy.

But the data also shows that there is a group of 73 million middle- class Americans who will pay on average $710 more in taxes.

My Democratic colleagues want to say that since the cost of providing an average tax benefit of $8,000 to 13.2 million individuals and families is greater than the revenue raised by raising the taxes on 73 million individuals and families by $710 there is a net tax decrease.

The truth is individuals who are seeing a tax increase are not actually benefiting from the very large subsidy. This is because, in general, this group isn't even eligible for the subsidy.

It comes back to this: a small group of Americans benefit under this bill. Another group of Americans pay higher taxes. These Americans include middle-income individuals and families.

Mr. President, the biodiesel tax credit will expire on December 31, 2009. I am speaking today to set the record straight about why the biodiesel tax credit will not be extended before the end of the year.

Some have suggested that Republicans are to blame for not getting the biodiesel tax credit extended before the end of the year. This is simply inaccurate.

The bottom line is that the Senate Democratic leadership decided they were going to attach the tax extender package to a controversial estate tax bill in an attempt to get moderate Democrats and Republicans to vote for an estate tax bill that does not provide sufficient estate tax relief.

If the Senate Democratic leadership had not chosen to hold the tax extender package hostage in an attempt to force moderate Democrats and Republicans to vote for an estate tax bill that lacks support, the tax extender package would have easily passed separately.

The tax extenders bill could have passed as a stand-alone bill easily at any time during this whole year. In fact, the Senate Democratic leadership could simply bring up a noncontroversial version of the tax extenders bill and pass it by unanimous consent like we have done in the past. We wouldn't even need to be talking about the tax extenders package in relation to the Department of Defense funding bill.

However, because the Senate Democratic leadership failed to act on the tax extenders package this entire year, one of the only legislative vehicles left to pass the tax extenders package was the Department of Defense funding bill.

Instead of just adding to the Defense bill a noncontroversial tax extenders package that both Republicans and Democrats could agree on, the Senate Democratic leadership instead decided that they would also try to attach the controversial estate tax bill and a controversial increase in the debt limit.

They could have instead just included a noncontroversial tax extenders package with the Defense bill, and it would have easily passed. Again, they did not do this because they wanted to use the tax extenders package as leverage to get moderate Democrats and Republicans to vote for an estate tax bill that lacks support.

It is also worth noting that there are 60 Senators that caucus with the Democrats, so they can pass anything if they vote together. It rings hollow to place the blame on Republicans for failing to enact the tax extenders package before the end of the year when the Democrats hold a supermajority of 60 Senators, an overwhelming majority in the House, and the Presidency.

The House, waiting until the last month of the year, finally passed a tax extenders bill. However, the House usually passes an extenders bill prior to the last month of the year.

For example, in 2008 the House passed a tax extenders bill on September 26, 2008, and in 2007 the House passed a tax extenders bill on November 9, 2007. This year, the House passed an extenders bill that they knew the Senate would not accept. And then they left town for the year. This is called a dump and run.

The House dumped a tax extenders bill that they knew the Senate would not agree to, and left town before the Senate could have any chance to negotiate a tax extenders bill that both the House and Senate could agree to.

The House also had a choice to make regarding whether they wanted to pass a tax extenders bill this year by simply attaching a noncontroversial version of the tax extenders bill, which both the House and Senate could agree on, to the House Department of Defense bill, without attaching either the controversial estate tax bill or the increase of the debt limit on the Defense bill. However, the House chose not to do so.

Therefore, this should set the record straight. The Democratic leadership in the House and the Senate, and not Republicans, are responsible for the failure to pass a tax extenders bill before the end of this year.

This failure has very serious consequences to the U.S. biodiesel industry, which will grind to a halt as of January 1, 2010. I remind my colleagues of the economic challenges faced by this industry. In 2008, the biodiesel industry supported more than 52,000 green jobs.

Because of the downturn in the economy, the biodiesel industry has already lost 29,000 green jobs in 2009. The industry is poised to lose another 23,000 jobs if nothing is done on the tax incentive or regulatory delays at the Environmental Protection Agency.

So where are these jobs? Some might think they are all in the Midwest, but they are not. These green jobs are in 44 of the 50 States. I would like to list the 13 largest biodiesel-producing States in the country.

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 1 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.

So workers in 44 States will be negatively affected by the inaction of this Congress to extend the tax credit.

You don't have to take my word for it. On November 25, I received a letter from the Iowa Renewable Fuels Association.

The letter outlined the economic and job ramifications of allowing the tax credit to expire, even if it is a short-term expiration. I would like to read directly from that letter.

It states in part:

Simply put, if the biodiesel tax incentive is allowed to

expire--even for a brief period of time--the Iowa biodiesel

industry will cease production and many plants will likely

not reopen under current ownership.

If the biodiesel tax incentive expires, biodiesel blends

will be priced out of the marketplace and our customers--the

oil companies--will stop purchasing biodiesel. In reality, we

already cannot book any first quarter sales for next year.

No retroactive action on the tax credit sometime next year

will undo the harm caused by the lost sales and shuttered

plants over the holidays.

Quite frankly, the biodiesel industry is facing shutdowns

that would certainly lead to a much longer--and unpaid--

Christmas break than anticipated for the hundreds of workers

at Iowa biodiesel plants.

But there are long-term impacts potentially even more far-

reaching. After more than a year of mainly breakeven or

negative margins, most of Iowa's biodiesel plants simply do

not have the cash reserves to withstand even a two or three

month shutdown.

So, even if the biodiesel blenders' tax credit is

retroactively enacted, several of Iowa's biodiesel plants are

unlikely to reopen under the current local-ownership. Please

do not let the Iowa-owned biodiesel industry disappear on

your watch.

I would ask unanimous consent that the entire letter from the Iowa Renewable Fuels Association to which I referred be printed in the Record.

The dire situation reflected in this letter applies to all 173 biodiesel plants around the country. The expiration of this tax credit on December 31, 2009, will affect all 23,000 workers in this green energy sector.

It is unfortunate that we have to be faced with the loss of 23,000 green jobs because of inaction on the extension of the biodiesel tax credit. I hope this explanation makes clear who is responsible for this terrible situation.

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

Mr. President, I would call to the attention of the leadership of the majority party that I have a unanimous consent request I wish to make. I am going to be visiting with my colleagues about the issue of taxes on medical devices, so my unanimous consent is in regard to that. I hope people would observe that if there is an effort to block this motion I am going to make, I think it is an endorsement of the tax on medical devices such as the Berlin heart and hundreds of others that children across this country rely on.

With that in mind, I ask unanimous consent to set aside the pending amendment in order to offer my motion to commit.

Mr. President, it is disappointing for those of us on this side of the aisle to not be permitted to offer an amendment or motion that is as important as this, so I will go ahead with my remarks.

This is another major problem in the Reid bill. Of the many taxes in this bill, I am especially worried about the excise tax on medical devices. Medical device technology is responsible for saving many lives and extending the overall life expectancy of people in the United States.

In the United States, over 6,000 companies are in the business of developing lifesaving medical products. The majority of these companies are very small businesses. Small business we tend to measure around here as being those with less than 500 employees. So what will happen when the Reid amendment imposes a tax hike of $20 billion on these innovative medical devices? I think that is something we ought to consider if we are considering the quality of life in America and quality health care to preserve that life and extend life expectancy.

During the markup of the Finance Committee bill, I asked the question to the nonpartisan Congressional Budget Office and the nonpartisan Joint Committee on Taxation--and let me emphasize the word ``nonpartisan'' because these folks are professionals. So both of these organizations, the Congressional Budget Office and the Joint Committee on Taxation, said these excise taxes will be passed on to consumers in the form of higher prices and higher insurance premiums.

Also, I wish to emphasize on this chart a statement of the Chief Actuary of the HHS. The Congressional Budget Office, the Joint Committee on Taxation, and the Chief Actuary all say the tax gets passed on to consumers. Who are the consumers of these devices? Who is going to bear the cost of the new medical device excise tax? Well, it is quite a burden, so I am going to share some real-life stories here.

I will start by telling the story of the Tillman family, a family who would bear the burden of this new medical device tax. At only 5 months old, Tiana Tillman had her life saved by a medical device. This story has received a lot of attention because Tiana's father is a professional football player for the Chicago Bears. However, lifesaving stories such as this happen all across the country regularly.

When Charles Tillman reported to training camp in 2008, it wasn't long before his coach told him that his 5-month-old daughter Tiana had been rushed to the hospital. When Charles got to the hospital, Tiana's heart rate was over 200 beats per minute. That doctor told Charles and his wife Jackie that Tiana may not make it through the night. Tiana survived that night, and after a series of tests, she was diagnosed with cardio myopathy, an enlarged heart that is unable to function properly. Her condition was critical, and without a heart transplant she would not survive. But finding pediatric donors is very difficult and many children do not survive the long wait time, so Tiana was immediately put on an ECMO, a device that would help the function of the heart while Tiana waited for a transplant.

However, ECMO is an old device that has many shortcomings. Infants can only survive on ECMO for about 3 weeks, much shorter than the average wait for a donor heart. ECMO also requires that the patient take a paralytic medication which prevents a patient from moving and at the same time that obviously weakens the body.

The Tillmans waited for one of two outcomes: Either Tiana would receive a transplant or she would die waiting on ECMO.

But then the doctors told them about a new pediatric medical device called the Berlin heart. The Berlin heart is an external device that performs the function of the heart and lungs. It is designed for a long-term support to keep infants and young children alive for up to 421 days while they wait for the donor heart--obviously a lot longer than the 3 weeks on ECMO. So the Tillmans decided to move forward with the Berlin heart.

After 13 days of being on ECMO without any movement, Tiana underwent surgery to connect the Berlin heart. So we have pictures here that show what this is like. These two photos are of Tiana with the Berlin heart. You can see that this device is run by a laptop at the foot of the hospital bed. It pumps the blood through her body, a job that her heart could not perform on its own.

Unlike ECMO, the Berlin heart and its long-term support capabilities allowed the Tillmans some peace of mind while they waited for that donor. The doctor said that the Berlin heart

helped Tiana regain her strength because she was off the paralytic medication and was finally able to move. Not long after Tiana was connected to the Berlin heart, a donor was found and Tiana underwent an 8-hour transplant surgery. The risky surgery was a success. Usually it takes some time for the new heart to start working, but doctors said that due to Tiana's strength, her new heart started working immediately.

I wish to talk about the tax on devices such as this.

This picture shows Tiana today holding a football. That is Tiana today, and we shouldn't be surprised about her love for football, considering her father is a professional football player. She enjoys playing on her swing set and watching her dad play football.

There are many people responsible for the successful effort to save Tiana's life, but without the Berlin heart to keep her alive and help her to gain strength, they may not have had that opportunity.

What does this legislation have to do with this story about Tiana? Well, the Reid bill would increase costs for families such as the Tillmans. In fact, the Reid bill would tax every pediatric medical device.

Pediatric devices aren't the only devices affected by the tax on medical devices in the Reid bill. The Reid bill also taxes one of the most important modern technologies: automatic external defibrillators. The defibrillator is used to save people from sudden cardiac arrest, and that is the leading cause of death in this country. Each year, nearly 325,000 people die from sudden cardiac arrest. That is nearly 1,000 deaths a day. Sudden cardiac arrest occurs when the heart's electrical system malfunctions and the heart stops beating abruptly and without warning. When this happens, the heart is no longer able to pump blood to the rest of the body, and for about 95 percent of the victims, death occurs. Once cardiac arrest occurs, the clock starts ticking and the victim's proximity to a defibrillator could mean the difference between living and dying. As many as 30 to 50 percent of the victims could survive if such a device is used within 5 minutes of sudden cardiac arrest.

Here we have the story then of Mari Ann Wearda. Mari Ann is a constituent of the county I have lived my entire 76 years in, Butler County, IA. She is also a survivor of a sudden cardiac arrest, thanks to the prompt response of the Hampton Police Department and the availability of a defibrillator.

On July 26, 2002, Mari Ann pulled up to a stoplight in Hampton, IA. Without any warning, Mari Ann experienced sudden cardiac arrest. As she slumped over the steering wheel, her car drifted across the road, climbed the curb, knocked over a sign, and came to rest against a tree. She was only minutes away from brain damage and death. At 11:38 a.m. the police station dispatched Officer Chad Elness, who arrived at the scene 2 minutes later, at 11:40. When Officer Elness arrived, Mari Ann was as blue as his uniform, according to his own report.

Officer Elness attached the defibrillator to Mari Ann and pushed the button, sending 200 joules of electricity through her heart. That was one of the two shocks that Mari Ann required. Between the shocks, the defibrillator prompted officer Elness to perform CPR. Twice he almost lost Mari Ann. But by 11:50 a.m., Mari Ann had a pulse and her color was improving. At 11:52, just 11 minutes after the defibrillator was turned on, it had saved her life and was turned off.

Mari Ann then was taken by helicopter to Mercy Hospital, Mason City, IA, where she received care. One week later--just one week later--she was back home with no permanent damage.

Defibrillators are only effective if they are used within minutes of cardiac arrest, which means that in order to save more lives, there needs to be more of these devices. But do you know what this bill would do about all that? It would increase the cost, meaning there would then be fewer defibrillators.

We understand the laws of economics. If we increase a price, we get less of it. If we lower a price, we get more of it. So we are going to increase the price of these devices. That would make it more difficult for police departments, schools, libraries, churches, and other public places to purchase defibrillators, or for an individual to have one. If you have to be within 5 minutes of their use, you can understand why they have to be in every police department, school, library, church, and a lot of other places. Right now, only one-third of police departments are equipped with defibrillators. However, Mari Ann was lucky that the Hampton Police Department had already purchased the device.

Increasing the cost of defibrillators will make it more difficult for communities to make this lifesaving investment. We already have 62-- 62--defibrillator stations throughout the Capitol and the three Senate office buildings. So you and I are protected, but we are going to put a tax on them for the people in the rest of the country. It seems as though around here we have one set of morals and ethics for Capitol Hill and another set of morals and ethics for the rest of the country. Congress clearly understands why having so many of these devices, the importance of them and having them on hand to protect us and to protect our staffs and the million visitors who come to the Capitol.

I made a motion that was objected to, so I cannot go through with that motion. My motion would have stopped this new Federal tax from increasing the cost of defibrillators and hurting the chances of placing the devices where they need to be--hopefully, within 5 minutes of people who need them. It is a disappointment my colleagues on the other side of the aisle would not allow that motion to go through.

It is a sad state of affairs when the majority is not only blocking the offering of the motions and amendments that will improve the bill but also trying to ram through a bill before the American people even know what is in it.

Yesterday, we heard things about Republicans having not offered amendments. There are 214 Republican amendments at the desk. One would think we would have a chance to offer more than a dozen or so--I doubt it is even a dozen at this point--on a bill that is going to restructure one-sixth of the economy.

I yield the floor.

Mr. President, how much time remains?

I would think one of the things we would have seen from the majority at this point is a list of what the last two Senators were talking about, all the earmarks that are in this bill, because I asked for a parliamentary inquiry yesterday--I am not going to ask that again--but, as we said yesterday, rule XLIV was adopted as part of a major ethics and reform legislation, adopted in 2007. It was part of the Honest Leadership and Open Government Act. The Democratic leadership made it the first bill to be introduced when they took the majority in 2007, taking control of Congress for the first time for a long period of time. This bill passed by unanimous consent.

When rule XLIV was passed, the theory behind it was that we ought to have total transparency on earmarks. It applies to floor amendments such as the pending Reid bill. It requires the sponsor of the amendment to provide a list of earmarks in that amendment.

Earmarks are provisions that provide limited tax benefits. Those words, ``limited tax benefits,'' are words out of the rule. Another substitute language for limited tax benefits is ``congressionally- directed spending items'' or ``earmarks,'' as they are generally referred to by the public at large.

Given what a priority the new rule passed in 2007 was given and the importance of it, one would expect that the majority leader would be making every effort to comply with it. One would think he would be wanting to set a good example in complying with the rule and disclosing these earmarks. In order to assure transparency of these very narrow provisions, such as what Senator Johanns just referred to, to get the votes of specific Members of the majority party who probably would not have voted for this bill, you would think that ought to be made public. That is what rule XLIV is about. Of course, that burden under that rule is on the sponsor to provide the list.

Once again, I am going to ask the Democratic leadership to comply with the Honest Leadership and Open Government Act.

I object. I don't know what this is all about. Has this been cleared with our side?

I withdraw my objection.

Mr. President, one longstanding priority of mine has been to improve Medicare payments for hospitals known as tweeners. They tend to have too many beds, so they can't qualify as critical access hospitals, but they do not have sufficient volume to operate viably under Medicare's prospective payment systems. There are a number of these tweener hospitals in Iowa.

Working closely with the Iowa Hospital Association and individual Iowa hospitals over the years, I introduced, last Congress, the Rural Hospital Assistance Act of 2008, S. 3300, which would improve the low- volume adjustment for hospitals under Medicare's hospital inpatient prospective payment system. This improvement would enable tweener hospitals to benefit from this adjustment.

In fact, the low volume adjustment provision in the Finance Committee's health reform bill, S. 1796, and the Reid substitute to H.R. 3590 is the language that I crafted. This language was crafted with the intention of benefiting all Iowa tweener hospitals. I was assured by the Iowa Hospital Association that this language would do so, and they supported it.

Unfortunately, after the Finance Committee markup of S. 1796, I learned from the Iowa Hospital Association that the language they originally supported would not benefit all Iowa tweener hospitals. I was informed that several Iowa tweener hospitals had Medicare discharges in excess of the maximum in the provision, which was 1,500.

In an attempt to make sure that all Iowa tweener hospitals benefit from this provision, I filed an amendment that would increase the maximum number of Medicare discharges from 1,500 to 1,600. This amendment was also offset. My staff was successful in working with the majority staff to include my amendment in the manager's amendment to the Reid substitute.

Mr. President, we have all been waiting for many weeks while the Democratic leadership worked behind closed doors, out of public view, to write this new health care reform bill, and this process, of course, is very much contrary to what the President promised during the campaign--that negotiations on the health care reform bill would even be on C-SPAN so everybody in the country could see it. So now a very secretly put together bill is out for our consideration with just a few days to consider it.

Last week, they were considering expanding Medicare to people between 55 and 64 years of age--also, increasing Medicare to cover people up to 150 percent of poverty--and thirdly, having a government-run plan run by the Office of Personnel Management.

Now we have something entirely different. We have the Reid amendment, and it is chock full of special deals. It does nothing to fix the fatal flaws in the 2,074-page bill we started with, and now we have a bill that is probably 400 pages longer than 2,074 pages.

What kind of changes does this new amendment make to the original Reid amendment? Well, one tax disappears--it was a tax on cosmetic surgery--and in its place we have a new tax, a tax on tanning bed services. The dial on the Medicare payroll tax is turned up. So the first-time marriage penalty in a Medicare tax--one that hits about half the two-earner couples--is enhanced. Well over 1 million couples get to look forward to that tax hit--can you believe it?--just for being married. So the old marriage penalty is back. The dial on the insurance fee is also turned up in the back end of the bill.

But with respect to a few favored insurance companies, the fee is turned off. The very limited small business tax credit is expanded-- over $\1/2\ trillion in new taxes, according to the official congressional scorekeepers. What kind of tax changes stay the same? Basically, the managers' amendment in the underlying Reid amendment still imposes new taxes--new taxes on everything from tanning beds to insurance companies to wages to heart valves to drugs and even more.

Contrary to what has been said on the Senate floor this very day, the tax burden still rests on many middle-class folks. As has been said, there is a sizable subsidy that 12 million tax-filing families and individuals receive. We do not dispute that. But what the other side does not want to acknowledge is this: There are 42 million tax-filing, middle-class families and individuals who will pay higher taxes under this 2,000-plus page bill. For every middle-class, tax-filing family who receives an insurance subsidy, three middle-class families will pay higher taxes.

I ask unanimous consent to have printed in the Record a copy of a corrected version of an article from Congressional Daily, dated December 18, of this year.

This new compromise does not fix any of the core problems in this original 2,074-page Reid bill. It is still that long of a bill. It is still a $2.5 trillion massive bill as far as costs are concerned. The Reid amendment actually adds 400 more pages.

These closed-door negotiations did not produce a better product. Quite the opposite. It still taxes middle-class families, seniors, and veterans. Millions of people still will not be able to keep what they have, as the President promised in the last campaign. A lot of people who were hoping to pay less as a result of the word ``reform'' will still end up paying more.

I am not just talking about the young and the healthy. It still imposes higher premiums for prescription drug coverage on seniors and the disabled. It still permanently cuts all annual Medicare provider payment updates based on productivity gains outside of health care. These cuts still go into effect, even if it means providers will get a negative payment update, and these permanent cuts still threaten Medicare access to care.

The bill still cuts $120 billion from Medicare Advantage, cuts that will reduce Medicare benefits for 11 million beneficiaries, contrary to what the President told us in his speech in September--that nobody is going to get cut in Medicare. This bill still creates a new body of unelected officials with broad authority to make further cuts in Medicare beyond the $40-some billion that are in this bill.

This bill still unwisely makes the board permanent. This bill still requires this board to continue making even more cuts in Medicare and to do that forever into the future.

The damage this group of unelected people could do to Medicare is unknown, but we certainly do know how impossible it will be to undo any damage that unelected board does, if Congress decides we ought to undo it. That is because whatever cuts they make we have to offset, and stirring up that money is very difficult for offsets.

This bill passes a $26 billion unfunded mandate on to the States because the Reid amendment even made this problem worse by adding $1 billion to that unfunded mandate for States under Medicaid. These increased costs will cause States to raise taxes, maybe cut education, maybe cut transportation, and maybe cut law enforcement. But it is still money the States have to dig up.

This bill still has the CLASS Act in it, even though the administration's own Health and Human Services Chief Actuary says it runs the risk--a great risk--of being unsustainable.

It still has a special carve-out for committee and leadership staff from having to use the health insurance exchanges. This is a cute move on the part of somebody in these closed-door offices. I got an amendment through the Senate Finance Committee on a unanimous basis that, if the people of this country have to use the exchange, employees and Congressmen on Capitol Hill ought to use it. But, no; when you get to the secrecy behind doors, just the Congressmen and their permanent staffs but not the thousands of people who serve on leadership staff or committee staff, they still got the deal they have today. So they are not going to know what the American people are going through by using the exchange.

This bill still has special deals for brand-name drug makers that will reduce access to generic drugs, making drug costs even higher for everyone. What this process has shown is that there is a clear and significant philosophical difference between this side of the aisle versus that side of the aisle. Those differences are still there, and the lines between us on this specific piece of legislation become brighter still, even though maybe on 90 percent of the legislation going before this body, there is bipartisan cooperation. But on this one, restructuring one-sixth of the economy, health care being a life- or-death issue for 306 million Americans, this is different from anything this body has tried before. On something such as this, maybe there is a legitimate reason for having differences.

Republicans tried to reduce the overall cost. They said no. They increased the spending in the bill. Republicans tried to reduce the pervasive role of government. They said no, and they increased the role of government. Republicans tried to make it harder for illegal immigrants to get benefits. They said no, and that still has not been fixed. Republicans tried to guarantee that Federal funding for abortions would not be allowed under this bill. That has been the Federal policy since 1976. That has even had bipartisan support ever since the Hyde amendment was put in place that year. But they said no. They wouldn't agree to apply that policy. That still has not been fixed. Republicans tried to allow alternatives to the individual mandate and the harsh penalties associated with it. They said no. They have subjected even more people to the mandate, and they have raised penalties. Republicans tried to raise medical malpractice reform. They said no. Real lawsuit reform is still not in this bill.

We have watched while the other side has expanded government coverage. Since this process began, the other side has been working hard to move millions of people from private coverage to government- subsidized coverage. The bill creates new government programs that cover families making close to $100,000 a year. When we hear about that in rural America, in the Midwest part of the United States, they think we have gone bananas in this body by subsidizing families making $100,000.

At the end of the day, after raising billions in new taxes, cutting about $\1/2\ trillion from Medicare, imposing stiff new penalties for people who don't buy insurance and increasing costs for those who do, still 23 million people will not have health insurance. I don't think this is what the American people had in mind when we promised to fix health care.

The Reid bill imposes a $2.5 trillion tab on Americans. It kills jobs with taxes and fees that go into effect 4 years before the benefits of the bill take hold. It kills jobs with that employer mandate. It imposes $\1/2\ trillion in higher taxes on premiums, on medical devices, on prescription drugs, and yet more. It jeopardizes access to care with massive Medicare cuts. It imposes higher costs. It raises premiums. It bends the cost curve in the wrong way because people would expect you to bend inflation down, but this bill takes it up. This is not what people have in mind when they think about health care reform.

We have been hearing repeatedly from the majority whip from Illinois that the Republican side has offered only four amendments. I found this to be rather astonishing. The majority whip should know, because they are filed at the desk, that Republicans have put forth 214 amendments. In addition to striking some of the bad ideas in the Reid bill, these amendments also contain Republican proposals that are

improvements over the Reid bill. But in this rush to get it done, the majority has decided they don't want to consider any more of the 440 amendments filed at the desk.

Let's be clear. We keep them so people can have access to them anytime they want to, the 440 amendments that have been filed, that we are accused of not offering any suggestions or improvements. Right here in these three binders, any one of the amendments you want, it is there.

Since this happens to be the case, I would like to take them up on their interest in considering additional amendments. The majority leader and my friend, the Senator from Montana, have both said they want this bill to fill the doughnut hole in the Medicare Part D Program. I share my colleagues' desire to provide even more protection than seniors get under Medicare. I filed an amendment that is in this binder, amendment No. 3182, that would use the savings from medical liability reform, which happens to be about the second or third thing that always comes up at my town meetings that the people in this country feel we ought to be working on if we are going to make real the word ``reform.'' It would put that $50 billion into savings toward eliminating the doughnut hole. The amendment puts the needs of 27 million seniors ahead of the needs of trial lawyers. I can't speak for my colleagues, but that seems like a pretty easy decision.

To my good friend from Montana, I only have one unanimous consent request. I ask unanimous consent to set aside the pending amendment in order to offer amendment No. 3182, which is at the desk.

I find it disappointing that we would miss the opportunity to forgo $50 billion in savings that could make prescription drugs more affordable for 27 million seniors. Even though my friend has just said they are filling the doughnut hole, I would quickly say it is being filled in a way that the big pharmaceutical companies are going to make sure they are selling prescription drugs, prescribed drugs, for a long period of time and not have the savings that ought to come from using generics to a greater extent. This $50 billion--actually $54 billion--that CBO says we would save with medical malpractice reform would be a better way of filling that doughnut hole.

I have a parliamentary inquiry of the Chair.

I want to make a parliamentary inquiry about the pending managers' amendment. My inquiry will be whether the pending amendment, which everyone agrees is critical to the health care reform legislation before us, complies with Senate rule XLIV.

Senate rule XLIV was adopted as part of major ethics and government reform legislation. It was passed in 2007. Its title was the ``Honest Leadership and Open Government Act.'' The Democratic leadership made it the first bill introduced when they took over the majority in 2007. It enjoyed broad bipartisan support. I wish the reform had been tougher. The part of the legislation that became Senate rule XLIV dealt with the transparency of earmarks. They are technically defined as ``limited tax benefits'' and ``congressionally directed spending items.''

Rule XLIV applies to floor amendments such as the pending managers' amendment. Rule XLIV requires the sponsor of the amendment--in this case, Senator Reid--to provide a list of these narrow provisions. Senator Reid has not provided the list. We received the several- hundred-page amendment yesterday morning. Republican staff have performed a preliminary review. That review finds that some items might--I repeat, might--be limited tax benefits. There are press reports about narrowly crafted exceptions to the insurance fee.

I ask unanimous consent to have printed in the Record a copy of the Dow Jones article dated December 19, 2009.

Likewise, single State Medicaid provisions might be determined to be congressionally directed spending items. Under rule XLIV, the determinations are not made by the minority staff.

In order to ensure transparency of narrow provisions, the burden is on the sponsor to provide the list.

This is my parliamentary inquiry: Does rule XLIV of the Standing Rules of the Senate require that if a Senator proposes an amendment containing congressionally directed spending or a limited tax benefit, that the sponsor of those provisions and the names of the Senators requesting them be printed in the Record?

Has the majority leader provided a list of these special

deals and of the Members requesting them for the Record as required by the Senate rules?

So what is the situation as far as the rule being provided, as long as the Senate has not been made aware of this?

I yield the floor.

Mr. President, I ask unanimous consent to speak as in morning business for 10 minutes.

Mr. President, I rise on the issue of jobs and 10 percent unemployment and to tell my fellow Senators what we can do to preserve maybe 25,000 jobs in an industry that, by the end of the month, will be otherwise shut down because Congress is not taking action. The main point of my remarks is, if we don't extend the biodiesel tax credit by the end of the month, these jobs will be lost.

My point is 23,000 jobs will be lost. In fact, right now, on December 17, companies are making plans to shut down these operations by the end of the year.

Everybody knows our unemployment rate is 10 percent. Everybody knows the President has spent a great deal of time, over the last 2 or 3 weeks, talking about creating jobs and getting us out of the recession. But we have to remember that for those without work, this is not just a recession, it is a depression.

We all agree we should take whatever action is necessary to jump- start our economy and get people back to work. President Obama and Vice President Biden have been talking for months about the need to create green jobs. Well, green jobs, purple jobs, whatever kind of jobs, jobs are jobs. I don't object to the creation of green jobs. In fact, what I am talking about is some of these green jobs.

President Obama has held three public events in recent days to highlight his concern about the economy and the need to create jobs. Yesterday, the administration apparently announced billions more in tax credits for renewable energy and energy conservation efforts. I will bet when I look at that list I am going to support most of those because I believe a national energy policy involves capturing whatever we can of petroleum and fossil fuels we have available for a short period of time because we are never going to get rid of them in the short term. We need conservation, and we need renewable and alternative energy. Those three things make a comprehensive energy program. Obviously, if I am for that comprehensive energy program, I am for renewable energy and alternative energy.

It seems as if nearly everyone, in fact, in the administration is touting the benefits of green jobs and a clean energy economy and I am doing that right now myself. It is astonishing, though, with all this talk about green jobs and clean energy that this Congress right now seems to be heading for the holidays while thousands of green energy workers will receive pink slips and furloughs.

On December 31 of this year, the current biodiesel tax credit will expire. The biodiesel tax credit provides a $1-per-gallon credit for biodiesel made from soybean oil and yellow grease and animal fats. The tax credit is essential in maintaining the competitiveness of this clean-burning, domestically produced green fuel and the jobs that are connected with it.

The tax credit exists for a commonsense reason and something we have been using for a long period of time: to offset the higher cost of producing biodiesel--or I could just as well insert the word ``ethanol''--compared to petroleum diesel. Without the tax credit, petroleum marketers will be unwilling to purchase the more expensive biodiesel and demand will vanish. From this standpoint of the tax credit, I hope everybody remembers that whether it is wind, ethanol, solar, biodiesel, biomass, or geothermal, it takes tax credits to get these programs off the ground. Right now, wind energy is a big industry in my State, not only from the production standpoint but from the standpoint of manufacturing of components because, in 1992, I got a wind energy tax credit passed; otherwise, we would not have wind energy and everybody touts wind energy today. It is a little bit like the very infant biodiesel industry we have. One might not think biofuels are an infant industry because ethanol has been around for 30 years, but biodiesel is about where ethanol was 30 years ago. So we want to help move this industry along so eventually it can stand on its own legs. That is the motive behind all these tax credits, to get an infant industry started and then they stand on their own.

In 2008, getting back to the jobs in this industry, biodiesel supported 51,000 green jobs. Because of the downturn in the economy and the credit crisis, the biodiesel industry has already shed 29,000 green jobs. So now what about the rest of those jobs? That is what my remarks are all about, and that is what getting the tax credit renewed before the end of the year is all about. Because the industry is currently operating at just around 15 percent of capacity. Without an extension of the tax credit, all U.S. biodiesel production will grind to a halt. Plants will be shuttered and workers will be let go.

No one should be surprised by the upcoming expiration of this tax credit. It was extended most recently in October 2008. So we have known for 14 months; hence, nobody should be surprised that it would need to be extended by the end of this year.

The Senate has been in session nearly continuously for months. Earlier this year, Senator Cantwell and I introduced a bill to extend the tax credit for 5 years and change it to a production tax credit. There is no excuse for inaction on this credit. The Democratic leadership is content to leave without doing the necessary work on extenders, believing they can extend the tax provisions retroactively sometime early next year. Retroactivity does work a lot of times on tax extenders that are not extended at the end of the year and extended to be made retroactive. But retroactivity in the case of the biodiesel market doesn't help bring it from grinding to a halt on January 1, 2010, because without the incentive, the biodiesel will cost much more than petroleum diesel.

While the House and Senate dither, thousands will lose their jobs, but demand for dirty, imported petroleum diesel, however, will continue. Investments in the domestic renewable fuels industry will lose value and possibly disappear--quite to the contrary of what I said in my remarks of yesterday, the President announcing various tax credits. So this one has been on the books. All it has to be is reauthorized.

It is too bad that among all the talk of green jobs and the clean energy economy, Congress is unable to pass a simple extension of an existing tax credit. Once again, the actions of the majority do not match their words. For all the talk, they will have failed all those in the biodiesel industry working today to reduce our dependence upon foreign oil if we leave without extending this critical tax credit before the end of the year.

I yield the floor.

Mr. President, the Senator is absolutely right. Let me emphasize it this way. I was on a radio program in Iowa yesterday, where a lady called me, and I had been saying, as the Senator has just said, that you have to wait until 2014 for this program to go into effect. She said: You are telling me you are going to pass this bill right now, but we have to wait until 2014 until we get any benefit from it? She didn't talk about the taxes, as the

Senator is, but the taxes go into effect. Another smokescreen is, you have 10 years of tax increases, fee increases, and the program is 6 years long, but the taxes are 10 years long. So it is nice for the CBO to say: Yes, this is balanced and maybe even has a surplus in it. But over the long term, this program does not cost just $848 billion. I hope I answered your question.

Mr. President, we have two key votes this afternoon on drug reimportation. These votes mean that today is the day we can show the American people whether we can pass drug importation or whether the Senate will give it lipservice and nothing else.

We have heard on the Senate floor the concerns that some have about drug importation and whether it can be safe. Everyone who knows me knows I care deeply about drug safety. The fact is, an unsafe situation is what we have today. Today consumers are ordering drugs over the Internet from who knows where, and the FDA does not have the resources, in fact, to do much of anything about it. The fact is, legislation to legalize importation would not only help to lower the cost of prescription drugs for all Americans but also should shut down the unregulated importation of drugs from foreign pharmacies, the situation we have today. The Dorgan amendment, in fact, would improve drug safety, not threaten it. It would open trade to lower cost drugs.

In 2004, my staff was briefed about an investigation that the Permanent Subcommittee on Investigations of the Senate Governmental Affairs Committee conducted. That subcommittee conducted this investigation into what we would call going on right now, current drug importation. They found about 40,000 parcels containing prescription drugs come through the JFK mail facility every single day of the year, 40,000 packages each day.

Now the JFK airport houses the largest international mail branch in the United States, but even then that is the tip of the iceberg. According to this subcommittee, each day 30,000 packages of drugs enter the U.S. through Miami, 20,000 enter through Chicago. That is another 50,000 more packages each and every day.

What is worse, about 28 percent of the drugs coming in are controlled substances. So we have a situation where we need the basic approach in this amendment to assure that imported drugs are safe. That is what the Dorgan amendment is all about, to give FDA the ability to verify the drug pedigree back to the manufacturer, to require FDA to inspect frequently, and to require fees to give the FDA the resources to do that.

The bottom line is, the Dorgan amendment gives the FDA the authority and the resources it needs to implement drug importation safely.

Certainly, the President knows that a great way to hold drug companies accountable is to allow safe, legal drug importation. I would like to quote this President not when he was a candidate for President but a candidate for the Senate. This is what President Obama said then:

I urge my opponent to stop siding with the drug

manufacturers and put aside his opposition to the

reimportation of lower priced prescription drugs.

Now we are hearing about the secret deal with big PhRMA. That was revised just this week to solidify support with PhRMA's allies for killing this very important Dorgan amendment. The drug companies will stop at nothing to keep the United States closed to other markets in order to charge higher prices.

With the Dorgan amendment, we are working to get the job done. What we need is to make sure Americans have even greater, more affordable access to wonder drugs by further opening the doors to competition in the global pharmaceutical industry.

Americans are waiting. Too often this thing has been stymied, and it looks like there is another chance to stymie it. Only I am surprised. Most of the time in the past that I have been for the importation of drugs, it was my colleagues over here who were trying to stymie it. But now it looks as though it is the other side. We ought to

have a vast majority for this amendment. I would be surprised. It would be a crime, if we didn't.

I yield the floor.

Reserving the right to object, Mr. President. You can't do that to us because we only have 8\1/2\ minutes left on our side.

We only have 8\1/2\ minutes.

This is typical of the comity of the Senate. I thank my good friend for doing that. I have a little different view on some of the things he said about taxes here. I respect him giving me some time because we don't have time on this side. It is nice, his doing that.

Republicans and Democrats are working off of the same data provided by the Joint Committee on Taxation. For some reason my friends on the other side of the aisle seem to want to read this data selectively, so I wish to look at this data. I want to stress this data is from the nonpartisan Joint Committee on Taxation. They are experts. They are nonpolitical people who tell it like it is.

My friends on the other side are correct in one thing: This bill provides a tax benefit to a small group of Americans. You can see right here that this benefit is to the people here where the minus sign is in front of the numbers. These numbers are in white.

As I pointed out previously, when you see a negative number on this chart, the Joint Committee on Taxation is telling us these people are receiving a tax benefit. This income category--the income categories where you see these negative numbers begin at zero and stretch to $50,000 for individuals and $75,000 for families. That will be $50,000 to $75,000. I give my Democratic friends credit for being right on this part of the data. But I want to show you where I disagree with them and their choosing to overlook other parts of the data, the data I will soon refer to here on this chart.

When we see negative numbers on this chart, as I have said, the Joint Committee on Taxation is telling us that there is a tax benefit. So, conversely, where there are positive numbers--this will be an example of positive numbers--the Joint Committee on Taxation is telling us these taxpayers are seeing a tax increase. Those numbers I have already pointed to begin at $50,000 for an individual and go up to $200,000 for an individual.

When we see a positive number, then, it is the reverse. The Joint Committee on Taxation is telling us these taxpayers are in fact seeing tax increases. So if we see positive numbers for individuals making more than $50,000 and we see positive numbers for families making more than $75,000, it is just this simple: We know these people's taxes are going to go up.

The Joint Committee on Taxation is telling us that taxes for these individuals, once again, for a third time, will go up under this 2,074- page Reid bill.

These individuals and families are making less than $200,000. What is significant about less than $200,000 is that this violates what the President promised in his campaign, that individuals who are middle class, under $200,000, are not going to see one dime of tax increase.

To come to any different conclusion is saying that the data on this chart--and of course the professionals at the Joint Committee on Taxation--both are wrong. To come to any different conclusion is saying the chart produced by the Joint Committee on Taxation is wrong.

I yield the floor.

Mr. President, yesterday afternoon, a few of my friends on the other side made some assertions about congressional history, fiscal policy, and the role of bipartisan tax relief for the period of 2001-2006. The speakers were the distinguished junior Senators from Vermont, Ohio, and Minnesota. They are all passionate Members. They are articulate voices of the progressive, as they term it, or very liberal wing, as those of us on this side term it, portion of the Senate Democratic Caucus.

I respect the passion they bring to their views. But, as one of them has said frequently in his early months of Senate service, we are entitled to our opinions, but not entitled to our own facts. I couldn't agree more with that notion. In order to insure an intellectually honest standard of debate, both sides need to correct the record when they feel the other side has misstated the facts. It is in that spirit that I respond today.

I won't take this time to debate the merits of the surtax that they propose as a substitute revenue raiser in this bill. That can wait till we debate their amendment. I am going to focus on their assertions about recent fiscal history and the role of bipartisan tax relief.

Before I address the revisionist fiscal history we heard, I would like to set the record straight on congressional history.

It was said yesterday afternoon that there were 8 years of a George W. Bush administration and Republican Congress. If the Members making these assertions would go back and check the records of the Senate, they would find that during that 8-year period Republicans controlled the Senate when it was evenly divided for a little over 5 months. For almost half the month of January 2001, Democrats held the majority because outgoing Vice President Gore broke ties. For the balance of the period from January 20, 2001, through June 6, 2001, the Senate was evenly divided, but Republicans held because of Vice President Cheney's tie breaking vote.

On June 6, 2001, the Democrats regained the majority when Senator Jeffords, previously a Republican, began caucusing with Senate Democrats. For the balance of 2001, 2002, and in early 2003, Democrats held the majority.

For two Congresses, half of President Bush's term, Republicans held a majority. For the last 2 years of the George W. Bush Presidency, Democrats controlled both Houses of Congress.

When you add it up, with the exception of a little over 4 months when the Senate was equally divided, Democrats controlled the Senate for about half the period of the George W. Bush administration.

When you hear some of our friends on the other side debate recent fiscal history, these basic facts regarding political power and accountability are obscured. Perhaps it is their opinion that Democrats were not exercising majority power during that period, but the fact is that Democrats controlled the Senate for almost half the period of the George W. bush administration.

Now let's turn to the fiscal history assertions from my friends on the other side. The revisionist history basically boils down to two conclusions:

1. That all of the bipartisan tax relief enacted during that period was skewed to the top 1 percent or top two-tenths of 1 percent of taxpayers; and

2. That all of the ``bad'' fiscal history of this decade to date is attributable to the bipartisan tax relief plans.

Not surprisingly, nearly all of the revisionists who spoke generally oppose tax relief and support tax increases. The same crew generally support spending increases and oppose spending cuts.

On the first point, two of the three speakers from the other side voted for the conference report for fiscal year 2010 budget resolution. The third speaker was not a Member of this body at that time the conference report was adopted. I am not aware, however, of his opposition to that budget which was drawn up by the Senate Democratic Caucus.

That budget was similar to President Obama's first budget. A core portion of that budget, much ballyhooed by the Democratic leadership, was an extension of the major portion of the bipartisan tax relief enacted during the period of 2001-2006. As a matter of fact, roughly 80 percent of the revenue loss from that legislation, much criticized by the three speakers yesterday afternoon, is contained in the budget that two of them voted for. Eighty percent is usually a pretty fair endorsement of any policy. Again, I have not heard the third speaker, the junior Senator from Minnesota, indicate that he doesn't support the tax relief included in the Democratic budget. Perhaps I missed something. In addition, the three speakers need to pay attention to analyses from the nonpartisan Joint Committee on Taxation.

If they did examine those analyses, they would find that, in terms of the burden of taxation, the 2001 legislation redistributed the burden from lower income taxpayers to higher income taxpayers.

Now, I turn to the second fiscal revisionist history point. That point is that all of the ``bad'' fiscal history of this decade to date is attributable to the bipartisan tax relief plans.

In the debate so far, many on this side have pointed out some key, undeniable facts. We agree with the President on one key fact. The President inherited a big deficit and a lot of debt.

The antirecessionary spending, together with lower tax receipts, and the TARP activities has set a fiscal table of a deficit of $1.2 trillion. That was on the President's desk when he took over the Oval Office on January 20, 2009. That is the highest deficit, as a percentage of the economy, in Post World War II history.

Not a pretty fiscal picture. And, as predicted several months ago, that fiscal picture got a lot uglier with the $787 billion stimulus bill. So for the folks who saw that bill as an opportunity to ``recover'' America with government taking a larger share of the economy over the long term, I say congratulations.

For those who voted for the stimulus bill, including two of the three speakers to which I refer, they put us on the path to a bigger role for the government. Over a trillion dollars of new deficit spending was hidden in that bill. The Congressional Budget Office concluded that the permanent fiscal impact of that bill totaled over $2.5 trillion over 10 years. It caused some of the extra red ink. Supporters of that bill need to own up to the fiscal course they charted.

Now, to be sure, after the other side pushed through the stimulus bill and the second half of the $700 billion of TARP money, CBO reestimated the baseline. A portion of this new red ink, upfront, is due to that reestimate.

The bottom line, however, is that reestimate occurred several weeks after the President and robust Democratic majorities took over the government. Decisions were made and the fiscal consequences followed.

Some on the other side who raises this point about the March CBO reestimate. That is fine. But, if they were to be consistent and intellectually honest, then they would have to acknowledge the CBO reestimate that occurred in 2001 after President Bush took office. The surplus went south because of economic conditions. The $5.6 trillion number so often quoted by those on the other side was illusory.

The three members should go back and take a look at what CBO said at the time. According to CBO, for the first relevant fiscal year, the tax cut represented barely 14 percent of the total change in the budget. For instance, for the same period, increased appropriations outranked the tax cut by $6 billion. So, spending above baseline, together with lower projected revenues, accounted for 86 percent of the change in the budget picture. Let me repeat that. Bipartisan tax relief was a minimal, 14-percent factor, in the change in the budget situation.

Over the long term, the tax cut was projected to account for 45 percent of the change in the budget picture. Stated another way, the 10-year surplus declined from $5.6 trillion to $1.6 trillion. Of that $4.0 trillion change, the tax cut represented about $1.7 trillion of the decline.

Let's take a look at the fiscal history before the financial meltdown hit. That conclusion is, again, in this decade, all fiscal problems are attributable to the widespread tax relief enacted in 2001, 2003, 2004, and 2006.

In 2001, President Bush came into office. He inherited an economy that was careening downhill. Investment started to go flat in 2000. The tech-fueled stock market bubble was bursting. Then came the economic shocks of the 9/11 terrorist attacks.

Add in the corporate scandals to that economic environment. And it is true, as fiscal year 2001 came to close, the projected surplus turned to a deficit. I referred to the net effects of some of these unforeseen events on the projected $5.6 trillion surplus.

Now, yesterday afternoon's three speakers may so oppose bipartisan tax relief that they want to attribute all fiscal problems to the tax relief. The official scorekeepers show the facts to be different.

Those on this side of the aisle have a different view than the revisionists. In just the right time, the 2001 tax relief plan started to kick in. The fiscal facts show as the tax relief hits its full force in 2003, the deficits grew smaller. They grew smaller in amount. They grew smaller as a percentage of the economy. This pattern continued up through 2007.

If my comments were meant to be partisan shots, I could say this favorable fiscal path from 2003 to 2007 was the only period, aside from 6 months in 2001, where Republicans controlled the White House and the Congress.

But, unlike the fiscal history revisionists, I am not trying to make any partisan points. I am just trying to get to the fiscal facts.

So, let's get the fiscal history right.

In this decade, deficits went down after the tax relief plans were put in full effect. Deficits did start to trend back up after the financial meltdown hit. I doubt the fiscal history revisionists who spoke yesterday would say that bipartisan tax relief was the cause of the financial meltdown. So, aside from that unrelated bad macroeconomic development, the trend line showed revenues on the way back up.

But that is the past. We need to make sure we understand it. But what is most important is the future. People in our States send us here to deal with future policy. This budget debate should not be about Democrats flogging Republicans and vice-versa. The people don't send us here to flog one another, like partisan cartoon cut-out characters, over past policies. They don't send us here to endlessly point fingers of blame. Now, let's focus on the fiscal consequences of the budget that is before the Senate.

President Obama rightly focused us on the future with his eloquence during the campaign. I'd like to take a quote from the President's nomination acceptance speech:

We need a President who can face the threats of the future,

not grasping at the ideas of the past.

President Obama was right.

We need a President, and I would add Congressmen and Senators, who can face the threats of the future. The legislation before us, as currently written, poses considerable threats to our fiscal future. It is too important to dodge. It is a bill that restructures one-sixth of the economy. It affects all of us and, more importantly, all of our constituents.

Grasping at ideas of the past or playing the partisan blame game will not deal with the threats to our fiscal future. Let's face the honest fiscal facts. Let's not revise fiscal history as we start this critical debate about the fiscal choices ahead of us. The people who send us here have a right to expect nothing less of us.

Mr. President, the Senator from Illinois is still on the Senate floor. Last week, I pointed out the plans that Republicans have introduced right here. The only way the Senator from Illinois can have an out is he was cute--he was cute--in modifying it, that it has not been scored by the Congressional Budget Office. But here is the fact on what the Congressional Budget Office can do and not do.

They were busy since May with the Senate health bill, getting it scored. They were busy working with us in the Group of 6 to try to get a bipartisan bill scored. Since October 2 until now, they have been working with the Senate leader full time to score everything they have had a chance to put out.

So I do not want anybody listening around the country to think Republicans do not have alternatives to what is being offered. But the only thing he can say is: They do not have a plan that has been scored. But we have plans, and if they went to hire more help in the Congressional Budget Office, we will get them scored.

Mr. President, I rise for the sake of the 50 States in the United States today because in this 2,074-page bill is a massive budget burden for every 1 of the 50 States--or maybe I better say for almost all of the 50 States--because of the expansion of Medicaid. I am talking about Medicaid, a Federal-State program. I am not talking about Medicare, a totally Federal program.

If this bill becomes law, the Congressional Budget Office estimates by the year 2019, 54 million nonelderly, nondisabled Americans will be locked into Medicaid. Now, there is a very important word I want to emphasize--``locked''--because with these additional people in Medicaid, they will not have any choice. Medicaid is the only place to get their health care, where a lot of other people will have choices under what we call the exchange.

So let me say it another way. I say they are locked in because this bill does not allow Americans with incomes below 133 percent of the Federal poverty level to get tax credits like most other Americans who are not below 133 percent of the Federal poverty level in a subsidy that comes through the exchange.

Mr. President, 54 million Americans will be locked into a program-- and this is where we get back to the States--that the 50 States cannot afford. We are not being honest with ourselves or our constituents or the people who will depend on the safety net if we try to argue that States can fund their share of this massive expansion.

Medicaid, as I said, is a Federal-State partnership, probably about 43 years old. The Federal Government pays for, on average, 57 percent of the cost of Medicaid. So, on average, States pay about 43 percent of the program, and the States administer the program.

In my State of Iowa, that division would be about 68 percent coming from the Federal Government, 32 percent the taxpayers of Iowa pay for.

To describe Medicaid's financial situation as fragile would be an understatement. Earlier this year, Congress voted to provide States an additional $87 billion to prevent States from drastically cutting back their program. That is $87 billion out of the $787 billion stimulus bill.

When we were considering that bill, the Government Accountability Office made it clear to us that States were in crisis. Every day you read about States being in crisis--budget crisis. The Government Accountability Office models predicted that State spending will grow faster than State revenues for at least the next 10 years. So here is the warning the Government Accountability Office has provided to those of us in Congress:

Since most state and local governments are required to

balance their operating budgets, the declining fiscal

conditions shown in our simulations suggest that, without

intervention, these governments would need to make

substantial policy changes to avoid growing fiscal

imbalances.

The State fiscal situation has not improved in the months since the Government Accountability Office report.

Now, let's go to the National Governors Association. They published a report recently entitled, ``The State Fiscal Situation; The Lost Decade.'' In this report, the Nation's Governors portray a bleak picture of State finances. Their report highlights the situation with State revenues and the economic situation. Their report notes:

The recent economic downturn started in December 2007 and

likely ended in August or September 2009, making it one of

the deepest and longest since the Great Depression.

State revenues are not likely to rebound until the years 2014 or 2015. States will continue to have to finance retiree pensions, as they wait for this rebound. The National Governors Association's conclusion is, obviously, a somber one. Their report goes on to say:

The bottom line is that states will continue to struggle

over the next decade because of the combination of the length

and depth of this economic downturn and the projected slow

recovery. Even after states begin to see the light, they will

face the ``over-hang'' of unmet needs accumulated during the

downturn.

Meaning the recent recession.

The report continues:

The fact is that the biggest impact on states is the one to

two years after the recession is over. With states having

entered the recession in 2008, revenue shortfalls persisting

into 2014 and a need to backfill deferred investments into

core state functions, it will take states nearly a decade to

fully emerge from the current recession.

Here we have the National Association of State Budget Officers, from a December 2009 fiscal report about the terrible position States are in right now, even without loading them down with the additional burden that is going to come through Medicaid expansion in this 2,074-page bill. Quoting from the National Association of State Budget Officers:

States are currently facing one of the worst, if not the

worst, fiscal periods since the Great Depression.

You see that quote behind me, as shown on that chart.

Under current conditions, States will face significant challenges if they are to meet their current Medicaid obligations--emphasis upon ``current''--without the addition of these millions of people being put on Medicaid because of the expansion in this 2,074-page bill.

States are also going to have to make substantial policy changes to meet their budget obligations just currently the way the situation is.

Will States cut their Medicaid Programs to cut costs? Right now, as a condition of the $87 billion in stimulus funds, States cannot cut because that is a requirement of the stimulus package. Under this bill, they will not be able to touch their Medicaid Programs until 2014, the year they are forced, then, to massively expand their programs.

So what will States do to make their budgets work? Will they cut roads and bridges? Will they cut education? Will they cut back on law enforcement and prisons? Will the States raise taxes?

I cannot say what 50 different States will do for certain. But States are going to have to make significant changes. Right now, in my State of Iowa, my Democratic Governor, Chet Culver, is trying the best he can to work out of a $565 million hole of which he has spending cuts in State government that is intended to address the shortfall in the current budget year. A shortfall of more than $1 billion is forecast in my State for the budget year that begins July 1 of next year. That is a major problem for our State legislators meeting in January. This isn't just Iowa. Forty-three States have been forced to cut spending in 2009. It is not just about the raw numbers, it is about the people served by the program.

A few days ago I had a group of constituents in my office asking for support for a children's mental health program. They told heart- wrenching stories about the challenges they face as parents in providing care for their children. Their children bravely recounted the struggles they have faced and are overcoming as they battle mental illness.

They benefit from a combined Federal-State program to provide them critical support services that aren't covered in Medicaid. The State dollars that go into that program are going to be severely jeopardized when this bill takes effect and the States are going to have to assume a larger share because of our forcing them to expand Medicare coverage.

It is going to hurt these children I referred to. Right now, Iowa is looking at the possibility of closing two State mental health facilities. In fact, the Des Moines Register recently editorialized that out of four, we only ought to keep one open.

On December 4, Iowa State courts were closed as workers there were furloughed without pay in an effort to close the budget gap. States are struggling to keep up essential services. Senators here will add a giant new unfunded mandate to States and hide behind the rhetoric of State responsibility.

It is very disappointing to have people who claim to be champions of the poor and the needy turn a blind eye to the obvious impact of their actions in this bill on State budgets and on the people served by those States. Yet, in the face of the evidence, the Democrats are proposing a bill that forces States to expand their Medicaid Programs.

This bill proposes that every State cover every American up to 133 percent of poverty. This is a massive expansion of the welfare state. It is the largest expansion of Medicaid in the 43-year history of the program. It will add another 15 million people to the Medicaid rolls. It will increase Federal Medicaid spending by $374 billion. It also will increase State spending by $25 billion.

Which States will be affected? Every State here that is colored in red on this chart will be affected by this mandate. States are in their most dire fiscal situation since the Great Depression and the Democrats want to slap all of these States in red with a huge unfunded mandate.

The majority obviously believes Medicaid expansion is the right way to increase coverage. The majority is willfully ignoring facts. States already can't afford the programs, and this bill requires States to expand their programs and make them pay more for the privilege of doing so.

That is not the only cost being shifted to the States. The insurer tax in this bill hits Medicaid managed care plans. Those managed care plans run on an extremely narrow margin. The tax on them is simply going to be passed on to the States. The decision made in the back rooms of the majority leader's office to keep all of the additional Medicaid drug rebate dollars for the Federal Government will hurt States.

I know some people will try to argue that you can't take something from the States they never had, but for years States have been negotiating supplemental rebates with drug companies. Those will most certainly go away. As more and more people get added to the fraying safety net, that safety net will not be able to hold up. That safety net is going to fall apart. This is a bill that will crash the safety net. If this bill is signed into law, it is only a matter of time before Congress is forced to come back and restructure the policies in this bill and spend tens of billions of dollars more to keep the safety net from failing completely.

Providing extra dollars to the States is going to become an annual rite in the Congress. It will very quickly become the so-called doctors fix or the SGR problem of Medicaid. The Governors know this as well. I wish to quote some.

I will start with Nevada Governor Jim Gibbons:

Under the Reid plan, a mandatory expansion of the Nevada

Medicaid program would add more than 41,000 people to the

program's rolls in 2014, expanding Nevada's Medicaid

enrollment by nearly 60 percent by 2019. Overall, the Reid

plan will cost Nevada taxpayers more than $613 million in

State General Fund dollars between 2014 and 2019. In addition

to imposing this massive tax burden, the bill also removes

existing state options, essentially federalizing this

program.

Then a quote from North Dakota's Governor John Hoeven:

We, along with the National Governors Association, urge

extreme caution in moving forward with any plan that would

commit the states, without their express participation and

consent, to obligations that may financially bind them for

decades into the future.

I will close with two of my favorite Governor quotes, and both of these are Democrats. The governor of Tennessee says this:

There won't be new prisons built during that period. There

won't be much in the way of capital improvements in the state

during that period. So it's very scary for governors to be

saying as soon as the revenues get back there, the federal

government is going to come in and say here's how you're

going to spend your new money.

Governor Brian Schweitzer of Montana, describing Medicaid, says:

One of the least effective programs in terms of health care

in the history of this country is something called Medicaid.

About 20 percent of America is on a Medicaid program and they

would like to shift it and grow it to somewhere around 25 or

30 percent.

A quote from Governor Schweitzer goes on:

Now Medicaid is a system that isn't working, almost

everyone agrees. But what Congress intends to do is increase

the number [of people] on Medicaid so they could do it on the

cheap. It is not working for anybody.

The Democrats in Congress are committing well more than $1 trillion of taxpayer dollars to health care reform.

It is not our money, it is the taxpayers' money. It is our responsibility to make sure it is spent wisely. In Medicaid, with a massive expansion and a de facto tax increase on the States, this is clearly not the case. In other words, the money is not spent wisely.

Mr. President, how much time do I have?

In a minute and a half, I would simply bring to the attention of all of the Members of the Senate the fact that between now and December 30 of this year, besides working on this health care bill, we have these things that have to be done:

The debt ceiling has to be increased.

We have to pass the Defense appropriations bill.

We have to decide what is going to happen with the death tax. The estate tax is going to end at the end of this year. Next year, there is not going to be any estate tax. I don't think anybody wants that situation to happen because it is only going to happen for 1 year, so we need to do something on estate tax.

The highway bill needs to be reauthorized or extended.

The PATRIOT Act has to be extended because at least three parts of it expire, and if they are not reinstituted, a lot of the work of the FBI tracking terrorists is going to be impossible.

We have several tax provisions--73, to be exact--that are extended from time to time. They need to be extended.

Doctors are going to take a 23-percent cut in their reimbursement under Medicare if we don't do something about it.

The Federal Aviation Administration needs to be reauthorized, and maybe the Satellite Home Viewers Act needs to be reauthorized, all between now and the end of the year.

This bill doesn't take effect until 2014, so we ought to be getting off of this health care bill and get some of these things done that need to be done before the end of the year.

I yield the floor.

No, I am finished. I thank the Senator.

Mr. President, we keep hearing about all the tax cuts that are in this 2,074-page bill. Earlier today, I heard the distinguished senior Senator from Illinois say this, after Senator Kyl was done speaking, and I am reading from the transcript.

First, this bill has $441 billion in tax cuts in the first

10 years for average people trying to pay their health

insurance premiums. I don't know if the Senator from

Arizona--

There he means Senator Kyl--

thinks that is a good idea or not. He has never spoken to

that at least that I have heard. I think it is a good idea.

If you are making less than $80,000 a year, I want to make

sure you have insurance, and this bill wants to make sure we

give you a helping hand. It is a tax cut.

First of all, when you have a tax credit or subsidy for buying insurance, the Joint Committee on Taxation describes 73 percent of that as outlays, 27 percent as tax reductions. So to call $441 billion a tax cut is completely contrary to the way scorekeepers for the Congress keep track of things.

The second thing I noticed, in talking about helping people earning $80,000 a year or so--and I heard another Senator speak frankly about tax increases for people at $75,000--is that there seems to be an effort to define down what the middle class is, from the way the President of the United States described it during his campaign-- individuals under $200,000 and families under $250,000 being the middle class.

Well, I wish to go into some detail about this because I have had an opportunity to speak on this point and I think other Members have as well and somehow we don't seem to get through to our friends on the other side of the aisle who have consistently stated that the Reid bill, according to the Joint Committee on Taxation, is a net tax cut-- and emphasis upon the word ``net.''

Yesterday, this chart was used to illustrate this point--a chart the other side was using to illustrate that point. This chart I am referring to has multiple bars with dollar figures. For example, in 2019 we see here a figure of $40.8 billion net tax cut. My Democratic friends said this number came from the Joint Committee on Taxation. Unfortunately, the chart my friends were using at that time is not entirely clear on how they came up with this net tax cut, so that is what I want to bring to the attention of my colleagues. It was quite natural for most to wonder how that number came about, so they said: Show me the data.

To clear up any confusion, here is the Joint Committee on Taxation table the Democrats relied on to claim that the Reid bill results in a net tax cut. Do you see here this negative figure of $40,786 million? Of course, negative, that minus mark there. My friends on the other side, unfortunately, do not explain what is going on. Instead, it appears the other side simply made an assertion that they hope many of us, and those in the media, would believe. I am not going to let my friends on the other side of the aisle get away with this because the entire story is not being told. So let me take a moment to explain.

First, in simplest terms, where you see the negative number on this chart, the Joint Committee on Taxation is telling us there is some type of tax benefit going to the taxpayers. For example, families making between $50,000 and $75,000 you can see have a negative $10,489 number in their column. This means the Joint Committee on Taxation is telling us that this income category is receiving $10.4 billion in tax benefits. But I need to have you listen more closely because when we see a negative number on this chart, the Joint Committee tells us there is a tax benefit. So, conversely, where we see positive numbers, in these areas here, where you see positive numbers, the Joint Committee on Taxation is telling us these taxpayers are seeing a tax increase.

I have actually enlarged those numbers of tax returns and the dollar amounts where there is a positive number for individuals and families-- once again, right in here. These positive numbers indicate a tax increase.

My friends have said that all tax returns on this chart are receiving a net tax cut. If this were so, why are there not negative numbers next to all the dollars on this chart? Because not everyone on this chart is receiving a tax cut, despite what has been said, including just within the last hour. Quite to the contrary, a number of taxpayers are clearly seeing a tax increase. This group of taxpayers is middle-income taxpayers.

I didn't come down to the floor to say my friends on the other side are wrong. After all, you can see the negative numbers quite frequently on the chart. After all, you see this negative number, $40,800 million. What I am doing is clarifying that my friends on the other side cannot spread this $40.8 billion tax cut across all of the affected taxpayers on this chart and then say all have received a tax cut. Why? Because this chart produced by the Joint Committee on Taxation shows that taxes go up for individuals making more than $50,000 and families making more than $75,000. It is right here on these yellow figures. Numbers do not lie.

Of course, people who inhabit the Joint Committee on Taxation are professional people who do not have a political agenda, and they tell it like it is. That is what they are hired for. That is why there are the same people around whether you have a Democratic or Republican majority in the Congress.

I would like to give you my read on what the Joint Committee on Taxation is saying here with these figures.

First, there is a group of low- and middle-income taxpayers who clearly benefit under the government subsidy for health insurance. This group, however, is relatively small.

There is another, much larger group of middle-income taxpayers who are seeing their taxes go up for one or a combination of the following tax increases: the high-cost plan tax, the medical expense deduction limitation, and the Medicare payroll tax increase. In general, this group is not benefiting from the government subsidy. After all, how can taxpayers see a tax cut if they are not even eligible for a subsidy?

Also, there is an additional group of taxpayers who would be affected by other tax increase provisions in the Reid bill that the Joint Committee on

Taxation could not distribute as other things in the bill are distributed on this chart. These undistributed tax increases include things such as putting a cap on the flexible savings accounts. There has never been a cap. So when you cap it at $2,500 and people cannot put in more than $2,500 under this 2074-page bill, that is a tax increase for those people who had higher expenses and wanted to put that money in a flexible savings account.

Then also there is a tax that is not accounted for here on cosmetic surgery. My friend from Idaho, Senator Crapo, whose amendment is pending before the Senate, recently received a letter from the Joint Committee on Taxation stating that this additional group exists and many in this group make less than $250,000 a year.

My friends on the other side of the aisle cannot, No. 1, say that all taxpayers receive a tax cut and, No. 2, say that middle-income Americans will not see a tax increase under the Reid bill as promised by the President in the last campaign.

I yield the floor.

Madam President, I understand that maybe I will have my speech interrupted by a unanimous consent request from the leadership, so if that happens, I ask that my remarks be continuous throughout the Record.

There has been a lot of talk over the past few days about Senator Reid's so-called compromise. Although he said he has broad agreement, I have yet to see any specific details. In fact, it sounds as though Members of his very own caucus, the Democratic caucus, aren't aware of these details either.

I find it quite hard to understand how there can be ``broad agreement'' on something when they don't know what is in it. Of course, I hope we will see details very soon. An issue such as health care reform affecting 306 million Americans and restructuring one-sixth of our economy is something that should not be done in secret. And when the so-called compromises come out, I would expect we would have the same 72 hours on the Internet for the public and the 99 Members of this body other than the leader to review them in the totally transparent way we have always been promised, and as this 2,074-page bill has been transparent, as well as all of the amendments. Because this is one of the biggest and most important pieces of legislation I have worked on in all of my years in the Congress. So I hope Senator Reid is not planning to keep the details of his compromise under wraps and then ask us to vote on it. This piece of legislation is going to touch the lives of every single American, from the cradle to the grave, so we owe it to our constituents to make sure we have sufficient time to study any changes to the underlying bill. We all need to remember that it is their money, the taxpayers' money, that is being spent on this bill, not ours.

As I have said, so far, Senator Reid is keeping this ``broad agreement'' under wraps. So today I can only talk about what I have heard from my colleagues or read in the newspaper, and who knows whether what the newspaper or our colleagues are surmising what this compromise might be actually is.

I have heard the majority leader is planning to expand the already unsustainable Medicare Program. The idea has been met with, of course, strong opposition, as we would expect from hospitals, doctors, and other health care providers, particularly from rural America, because expanding Medicare to people ages 55 to 64 and paying Medicare rates is going to make it even more difficult for our hospitals to survive because the Federal Government only reimburses 80 percent of costs.

Today, with people over 65, with the government not paying more than 80 percent, it can be offset by private sector charges by the hospitals to a greater amount to make it up. But if you load another tens of millions of people on Medicare--and it is just about broke anyway--you can see that this deficit of our hospitals is going to be greater and it is going to be even more difficult to make up because there will be fewer private-paying people to make up the deficit.

I said the hospital, doctors, and health care providers are bringing strong opposition to this idea of expanding the Medicare Program because they fear that the largest expansion of Medicaid in history and an expansion of Medicare to people age 55 to 64 will drive providers out of business. And then what, of course, does that do for our seniors? It makes it even harder for low-income Americans under Medicaid and seniors under Medicare to have access to care. What are the promises of the Federal Government in Medicare worth if you don't have doctors to provide the services to the seniors when they get sick?

I have already spoken over the last few days about why I agree with these providers and why I oppose that part of Senator Reid's so-called compromise. Of course, now we have the administration's own Chief Actuary confirming that the Medicare cuts already in this bill--in other words, the 2,074-page bill, without even considering the so- called Reid compromise, which we don't know what it is--the Chief Actuary confirmed that the Medicare cuts already in the bill are so severe that providers might, even now, end their participation in the program, even before you add on all the people who are 55 to 64. If the compromise expands Medicare even further, then this is going to make this problem even worse.

I also find it curious that some would even consider this a compromise. For instance, Speaker Pelosi could not convince House Democrats to support a government-run plan paying Medicare rates, but that is exactly what Senator Reid's compromise is proposing, I have been told. That doesn't sound like much of a compromise to me.

In fact, let me quote another Congressman, Anthony Weiner of New York, who doesn't see it as a compromise either. In fact, he sees it as a big step toward their ultimate goal of a single-payer health plan where government is going to run everything. And you will have one choice: the government plan. You won't have choices the way we have in America today.

Congressman Weiner said this:

This exchange would perhaps get us on the path to a single-

payer model.

I don't see this as a compromise to a government-run plan. In fact, in some ways, it is worse because this could harm seniors' access to care starting not down the road but on day one.

I don't want to spend too much time today talking about Medicare expansion. I think I have made my feelings on this idea pretty clear. Instead, I would like to focus on another aspect of the supposed new Reid compromise we are hearing about.

This is what we are hearing about--that the newest Reid proposal would have the Office of Personnel Management operate a national health insurance plan. This may sound pretty harmless at first glance, especially since Senator Reid has refused to release any details, but there are some very big problems with a proposal like having the Office of Personnel Management take over.

Around here, we use the term ``OPM'' for the Office of Personnel Management. It is the office in charge of the Federal Government's 2 million-person workforce. One could consider OPM as the human resource agency or department for all of the Federal Government, dealing with everything from salaries to the operation of the Federal Employees Health Benefits Program, which I think is the reason Senator Reid thinks this agency would be well equipped to run the largest insurance company in the country.

Unfortunately, a former Director of OPM disagrees. He was asked about giving new responsibilities to the Office of Personnel Management. This former Director, Linda Springer, said this:

I flatout think that OPM doesn't have the capacity to do

this type of role.

Federal employees have also expressed concern. People in this body-- particularly the other party--ought to be listening to the National Treasury Employees Union or the National Active and Retired Federal Employees Association. They have come out in opposition to this proposal of OPM running a national health insurance company.

In a Washington Post story highlighting union opposition, the author writes that unions raise these concerns:

. . . legitimate concerns about expanding the size and

scope of OPM beyond its capacity.

So there are already concerns from a former Director and more than 5 million Federal workers and retirees and dependents that OPM is not equipped to handle this new responsibility. That alone should make any Member pause before signing on to this so-called broad agreement.

I also think it is important that Members are aware of some of the challenges the Office of Personnel Management faces with its current responsibility, without loading it down with a lot more, because being the human resources department for the Federal Government is, obviously, no easy task. In fact, I would imagine it is a pretty thankless job that entails a lot of long hours.

Please don't misconstrue my comments as an attack on OPM, its Director, or any of its employees. They do the best job they can under difficult circumstances. But they are going to have real problems if Senator Reid's compromise does include a government-run insurance plan operated by OPM. If he is going to come out of nowhere with a new proposal to hastily hand the American health insurance system over to this government agency, I think it is important for the American people to know what they are getting into.

We need to be asking some hard questions. Is this expansion of the Federal Government necessary? We are about to vote to raise the debt ceiling by $1.8 trillion because the national credit card has maxed out. Some Members of the Senate seem intent upon increasing the size of the Federal Government even more.

There is a second question beyond the generic one of, can you afford to expand the Federal Government role and expenditures. It is, should the OPM, a government agency, be handed the key to the largest health insurance plan in the entire country? I don't know that the current OPM Director--and I would imagine he is a very nice person, and since I don't know him, I don't want him to take offense to what I say. But I think it is fair to point out that his position, just prior to taking over at OPM, was running the National Zoo. Does this really mean we should put him in charge of the national health insurance plan?

The Office of Personnel Management has been consistently criticized for being out of date and being inefficient on everything from processing national security projects to administering Federal benefits. We have all heard about the massive backlog in people waiting for Social Security disability benefits. Some 833,000 Americans are currently on a waiting list to see if they qualify for government disability benefits, and some Members blame OPM for this backlog.

I am going to put a chart up here from a person whom I trust in the House of Representatives, Representative Earl Pomeroy. I think he does very excellent work. He heard about this backlog. He made some comments about OPM. Congressman Pomeroy is a Democrat from North Dakota and a member of the very powerful House Ways and Means Committee. He said:

The Office of Personnel Management is fiddling around,

years go by before they can even get around to all the things

they have to get around to. . . .

This seems to reinforce what the government unions and the former Director have expressed about OPM's ability to handle this new responsibility.

I want to continue to quote Congressman Pomeroy:

People are being hurt, some of the most vulnerable people

in this country are being hurt every day because of

bureaucratic bungling at OPM. . . .

Senator Reid hasn't provided enough details, but Congressman Pomeroy's comments certainly raise concerns.

Undermining the availability of disability benefits is bad enough, but do my colleagues want to also be responsible for setting up an unworkable system that leaves hundreds of thousands of Americans on the waiting list for their health care benefits?

Government agencies, whether it is the Office of Personnel Management or some other agency, do not have an impeccable track record. As President Reagan often said, the nine most terrifying words in the English language are ``I'm from the government and I'm here to help.'' Think of a health care system with the responsiveness of Hurricane Katrina or think of the efficiency of the Internal Revenue Service or the customer service at the department of motor vehicles. That doesn't sound like a recipe for real health reform to me.

The OPM has also taken considerable criticism for its handling of retiree benefits. The agency's own 2008 financial report stated:

[The Office of Personnel Management] had increased

difficulty keeping up with retirement claims and had a

decrease in the number of customers satisfied with their

services.

That is coming directly from the agency, saying how it is coming up short responding to the needs of the American people, and particularly government employees, and that is before we are talking about adding a new government health insurance program to the responsibilities of OPM.

The Hill newspaper wrote this last week:

Watchdogs maintain the program is riddled with

inefficiencies that ultimately cost both the agency and the

Federal Government money.

So I think there are legitimate concerns about whether this Federal agency is even equipped to take on the additional responsibilities of a whole new government countrywide program that is obviously a massive undertaking.

I also wonder why this proposal is even necessary. The bill already sets up government-run exchanges that would offer a choice of competing for-profit or not-for-profit plans. My colleagues on the other side of the aisle have compared this system to the Federal Employees Health Benefits Program. This bill already has provisions that encourage national health plans. This leads me to ask the question: Why does this bill need another layer of bureaucracy to create a national plan run by a government agency?

Some have suggested this is just another backdoor attempt to end up with a government-run plan. Another detail that has been reported supports this claim. We have been told that if not enough not-for- profit plans agree to contract with the Office of Personnel Management or if they do not meet certain affordability standards, the Office of Personnel Management will have the authority to establish its own government-run plan.

With some of the other provisions that are in this bill, this trigger approach seems to be rigged. There are at least two reasons why this is the case. First, the bill undermines any ability to avoid the first government plan trigger to make health coverage more affordable. The bill puts in place a bunch of new regulatory reforms, a bunch of fees, and a lot of taxes that will drive up premiums, making it impossible for health plans to meet new affordability requirements.

Again, you are going to say you question this Senator's judgment saying that. Do not take my word for it. The nonpartisan Congressional Budget Office, a group of professionals who do not care about politics, predicts premiums will be 10 to 13 percent more expensive as a result of this bill.

Then, of course, we have the second government plan trigger which gives the Office of Personnel Management the authority to create a government-run plan if not enough not-for-profit national plans contract with OPM.

Senator Reid failed to mention in announcing his broad agreement that there is not one national plan in existence today, for-profit or not- for-profit--not one national plan--that is offered in all 50 States. It does not exist.

Once again, it sounds to me like this so-called trigger is being rigged to shoot. I can only assume this backdoor attempt to shoehorn in a government-run plan at the last minute happens to be an act of desperation. Senator Reid and his colleagues have seen the facts. You have heard them from our distinguished Republican leader. According

to a CNN poll from December 2 and 3, 61 percent of Americans oppose this 2,074-page bill. At a time when the Democratic leadership is pushing a $1.8 trillion increase in the debt limit, we learn from the White House's own Actuary that this $2.5 trillion bill, this 2,074-page bill bends the cost curve up by increasing health care spending. If you go back to day one of this year, when we first started talking about health care reform, one of the overriding goals was to bend that cost curve down. After 11 months of activity, we have a bill with that cost curve going up--not one of the major goals we set out to do 11 months ago.

This bill is also under pressure from opposition by the National Federation of Independent Business, speaking for the small businesses of America, the ones that do 70 percent of the net hiring. It is also opposed by the National Association of Manufacturers, the Chamber of Commerce, the National Retail Federation, and almost every other business group across the country.

Because of this last-minute, desperate attempt to appease the far left, this rumored new compromise now is being opposed by hospitals, doctors, and other health care providers. These people were on board through most of these 11 months promising their support, and now they see it going in the wrong direction.

With all those factors, I do not see how anyone, let alone 60 Senators, can vote for this bill, this last-minute, desperate attempt to expand Medicare and hand over private health insurance systems over to a Federal agency, the Office of Personnel Management. This step, if it materializes, has made a bad bill even worse.

I have another part of the bill to which I wish to speak. We have this 2,074-page bill before us, and I wish to refer to just a few words on page 2,034, way at the tail end of the bill, in section 9012 of the Reid bill. It only takes up eight lines, but it could have a major impact on millions of retirees and even on the entire U.S. economy.

Listen to this. The AFL-CIO, the Americans Benefits Council, and the Business Roundtable have all joined in opposition to this provision, section 9012. How often do we have the AFL-CIO, the American Benefits Council, and the Business Roundtable--that roundtable is the big corporations in America--joining in opposition to anything? But they are in opposition to section 9012 of the bill.

This would prohibit businesses from fully deducting a subsidy they receive to maintain retiree drug coverage. The Medicare Modernization Act of 2003 created this subsidy to encourage businesses to keep offering retiree drug coverage once the Part D benefit was established because back in 2003, our goal in passing the prescription drug bill for seniors was not to disturb people who already had drug coverage and they liked what they had and they wanted to keep it. We did not want these big corporations dumping these people off into something with which they were unfamiliar. So we helped to encourage companies and save the taxpayers money. I will refer to those specific dollar figures in a minute.

In Federal tax policy, it is very unusual to provide a deduction for a business expense, such as retiree health costs, if that expense is subsidized by a Federal program. But in this case, the conferees decided to provide this unusual tax treatment for compelling health policy purposes, some to which I have already referred.

If people are satisfied with what they have, we should not pass a bill pushing people out of a plan they like. But it was also to save taxpayers' dollars because the rationale was, it was cheaper to pay a $600 subsidy than to have these people forced out of their corporate plan and then to have the taxpayers pay an average of $1,100 that it will cost if the retiree joined the Part D government plan.

You know what. After 6 years, so far it has worked. Millions of seniors have been able to keep their retiree coverage as a result of this subsidy, and the Part D Program continues to come in under budget and also to receive high marks from our senior citizens.

But the provision tucked away in this 2,074-page bill on page 2034 could change all that and, in fact, have severe consequences and, let me say, unintended consequences not just on those retirees but for the entire U.S. economy.

In an effort to pay for this massive expansion of a government-run health plan, the Reid bill proposes to eliminate the tax deductibility of this provision. This could cause employers all across the country to drop retiree coverage. This will not only break the President's promise by preventing millions of seniors from keeping what they have--remember that promise during the campaign--it will also cause the costs of the Part D Program to go up.

In addition, accounting rules for retiree benefits require that the businesses that do keep offering plans, offering these benefits, will have to report the total revised cost on the day the bill becomes law.

We have an op-ed written in the Wall Street Journal about this point. This could cause businesses to post billions of dollars in losses and significantly impact an already struggling economy.

Is this something we want to do when we still have 10-percent unemployment? I think the majority ought to give second thought to that.

A letter sent on December 11 from the chief financial officers of some of the largest employers in the country stated:

The impact of the proposed Medicare Part D changes would be

felt throughout the overall U.S. economy as corporate

entities and investors would be forced to react.

Another letter signed by the AFL-CIO stated this provision would ``unnecessarily destabilize employer-sponsored benefits for millions of retirees.''

Once again, how often do we get these large corporations and the AFL- CIO singing off the same song sheet?

This simple provision tucked away on page 2034 is just one more in a long list of policies that could have serious unintended consequences for American businesses and retirees.

At this point, it appears the majority is so determined to get a bill at any cost that they will put in place bad policies and promises to somehow clean up the mess later on. That is not the way to write legislation. That is not what the American people were hoping for when they were told Congress was going to fix the health care system. This provision is just one more reason we need to scrap this product and go back to the drawing board.

In finishing, I will say what I have probably said two or three times before. We are trying to fix the health care system, health care reform. The word ``reform'' implies all of that. If you were having a coffee klatch in rural New York or rural Iowa this very morning and one of us Senators dropped in on it and they started asking us about a bill because they were already talking about health care reform and any one of us told them it would increase taxes, it would increase health insurance premiums, that it would not do anything about decreasing inflation of health care--in other words, costs are going to go up yet--and we are going to take $464 billion out of Medicare, a program that is already in distress, to set up a whole new government program, you know what. Every one of those people around the table would say: That doesn't sound like health care reform to me. Let's not denigrate the word ``reform.''

I ask unanimous consent to have printed in the Record a letter from the AFL-CIO.

I yield the floor.

Mr. President, on September 21, 2009, I announced my intention to object to proceeding to the nomination of Alan D. Solomont to be the Ambassador to Spain because of the incomplete responses that the Corporation for National and Community Service, CNCS, had provided to my document requests regarding the removal of its Inspector General, Gerald Walpin. Mr. Solomont was the chairman of the board of CNCS at the time that my requests went unanswered, and he began the process that led to Mr. Walpin's removal by contacting the White House Counsel's Office on May 20, 2009.

Since September 21, the White House produced approximately 1,900 additional pages of previously withheld documents. During that time, my staff conducted a series of negotiations with CNCS and the White House Counsel's Office over the hundreds of pages of remaining documents that were being withheld or had been redacted. As a result of these negotiations, this week the White House authorized and CNCS provided: 1. descriptions of the information redacted from several CNCS documents, 2. 37-previously produced documents with substantive redactions removed, and 3. 370 pages of previously withheld documents. In addition, the White House made Mr. Solomont available for a follow- up interview on December 8, 2009, so that he could be questioned about new information that had been learned from these documents and other sources since his initial interview on July 15, 2009.

In order to obtain this additional information, I agreed to no longer object to proceeding to Mr. Solomont's nomination if the White House took these steps. I have kept my word and informed leadership that I no longer intend to object. However, I remain concerned about the accuracy and completeness of Mr. Solomont's answers to questions during both his July 15 and December 8, 2009 interviews. I understand Congressman Issa of the House Committee on Oversight and Government Reform shares those concerns and has sent a letter to Mr. Solomont to that effect.

Although CNCS has produced a total of approximately 3,000 pages of material responsive to my request, the record should also be clear that the White House continues to withhold 46 documents, on grounds of deliberative process and attorney work product privileges. The White House did not provide a detailed log of the documents being withheld despite my requests. I will continue to seek answers to the remaining questions in this matter.