Floor Statements

Madam President, first of all, I want to thank the Senator from Oregon for those very passionate comments. We have had the opportunity to join in a number of forums to speak out about the importance of creating jobs in America and of helping those who through no fault of their own have lost their job, and I thank the Senator for his eloquence and passion again this evening.

I come to the floor to also add my voice to what I believe to be an outrageous situation. I say this with all due respect to my friend from Kentucky. We work together on a number of issues, and I look forward to continuing to do that. But on this I believe what is being done is absolutely wrong. It is outrageous.

We are in a situation right now where nearly 135,000 Michigan residents will lose the unemployment assistance they need by the end of this month if we do not take action immediately. That is just in 1 month as to people who have been hit by nothing less than an economic tsunami.

We have a sense of urgency when an earthquake happens, when storms come, and the floods come. Well, to families across this country, the storms have come. They have been here--in our case for years--and we need to have the same sense of urgency as any other disaster would call us, focusing not only on helping people who have lost their job but in creating jobs.

I am proud to be a part of a caucus that has placed jobs at the forefront and a President who, last year, started at the beginning of the year with a jobs bill, a Recovery Act, and moving on, and this year with an entire jobs agenda. But the reality is that until jobs are created, we have millions of people in this country who have played by the rules all their lives, paid their taxes, cared about their families, gave back to their communities, and their only sin is the fact that they have lost their job through no fault of their own.

They are trying to keep a roof over their head, keep food on the table, keep the heat on, trying to make sure their kids have what they need. Most of them are receiving $200 or $300 a week to try to hold it together while they go job training, while they look every day for work. People want to work. This is not about people who do not want to work. People want to work. But we have six people applying for every one job in America.

So while we focus on job creation and partnering with the private sector to make that happen, we have millions of people in America who do not understand how something such as merely extending unemployment benefits could be held up. Last night, the unemployment benefits stopped that process now. This month, people are getting notices, afraid about what is going to happen to themselves and their families.

What we have is a misuse of the rules, in my judgment. What we have is an objection, and it is one for which we have been down here many times. We have the charts now. We have had it happen over 116 times this session, where we have seen objections, bringing to a halt the will of the majority, blocking the democratic process of voting--of simply voting--and being able to solve problems and move things forward.

I received an e-mail from a woman in Livonia, MI, who lost her job last year. She took the opportunity to go back to school to get new job skills to become a registered dietitian. But now, as she is doing that, because of this obstruction, this woman is going to lose the help she needs to allow her to make it and keep a roof over her head while she is turning the corner and gaining new skills to get a new job. The rug is, frankly, being pulled out from under her, and I think that is outrageous.

She is not alone. As I indicated before, we have nearly 135,000 people in Michigan who will lose the help they need under unemployment benefits by the end of this month if we do not act, and act immediately.

I received another e-mail from a woman in Greenbush, MI. She and her husband both worked at the same manufacturing plant. It is a common story in Michigan. They both lost their job. She writes:

We are both seeking work and schooling for new careers. We

have both eceived a letter from the unemployment office that

our benefits will end. We have no other source of income and

we fear we will lose our home.

This is real for millions of people across this country, millions of middle-class families who assume that in a disaster, an economic disaster, their government, the people of the country, will step up to help. That is what unemployment benefits are all about.

It is time to act, it is time to stop blocking democracy. If my friend from

Kentucky has an amendment to offer, offer it, debate it, and vote. But just blocking us from exercising our right to vote is not the American way. The American way is to vote, to act, to make decisions, not to block. We have seen way too much of blocking democracy from our Republican colleagues in these last months and months.

I also want to speak to other provisions in this bill because I find it interesting that within hours of the health care summit last Thursday, the blocking of this bill showed us what the health care plan is by Republicans: cut people off from help with COBRA, cut doctors' benefits. That came within hours of the health care summit. We are now getting calls from people who are concerned about whether their doctor is going to be available.

Are senior citizens under Medicare going to be able to see their same doctor because of the cuts that will happen if we do not act immediately? People who one day lost their job, the next day lost their health care--we have been able to help them through the jobs bill we passed last February to be able to continue their health insurance through work. It is expensive to do under something called COBRA, but we have been able to help them do that by helping to pay on a short- term basis for part of that cost.

So the health care summit happens on Thursday, and hours later there is an objection that will stop health care for hundreds of thousands if not millions of Americans, and stop the ability of doctors to be reimbursed at a fair rate to be able to care for their patients. This is, in my judgment, an absolutely outrageous situation, and it has to stop.

I thank our chairman of the Finance Committee for his work and advocacy and being here on the floor calling for us to vote. I am hopeful people around the country will speak out loudly between tonight and tomorrow and that we will be able to come to the floor and stop what is effectively blocking the democratic process and blocking our ability to vote, to make decisions, and to move forward.

We have millions of Americans who are counting on us to understand what is happening in real people's lives every day--not political games, not all the partisanship, but real people's lives--who are going to get up tomorrow morning and say: OK, what do I do now? How am I going to keep my roof over my head? And how am I going to continue to go to school to get that new skills I need? How am I going to put food on the table for my family? That is what is affecting people across this country.

In addition to the millions of people who have lost their job and are on unemployment, we have millions of others who are one paycheck away from being in the very same situation--people who could be spending in the economy now to be able to help move things forward, who are afraid of what happens next. Part of that fear is not only will they have a job, but what happens if they do not? And what is the message that is sent if we do not make it clear we will be there for them if that happens? Will they be able to continue to have the basics to keep their family going?

I strongly urge we do everything possible. I know we will stop this obstruction, to allow the democratic process to go forward, to allow us to vote, to solve problems, to move this bill forward, and send a very strong message that we understand what is happening to millions of families who have faced a disaster of epic proportions. It is truly as much a disaster as anything else any community has ever felt in terms of losing their jobs and fighting and working to get something.

I thank the Chair.

I appreciate the Senator from Illinois, my friend, in his comments. I guess my question would relate to the State of Michigan because the Senator listed off some very important statistics. I wonder if the Senator is aware that in March, 62,000 people in the great State of Michigan, where we have the highest unemployment rate--we have a 14.6-percent unemployment rate, over 700,000 people right now unemployed, looking for work. These are people trying to keep a roof over their head, trying to keep food on their table, they are trying to hold things together as they are looking for a job. Yet we have 62,000 great people from Michigan who are going to lose their benefits in March. In fact, if this continues--and I know all of us are working very hard to get a year extension of

unemployment benefits. But I am wondering if my friend is aware that by May, 225,000 people in Michigan will be out of their benefits. These are people who are looking for work. We know for every one job available there are six people right now who are fighting to get that job. We have a jobs agenda. We are working very hard to make sure there are more jobs and partnering within the private sector.

But in the meantime, I am wondering if my friend would agree with the fact that this is a disaster, in fact. This is as much a disaster for families as anything else. We do emergency spending for floods and hurricanes and all kinds of disasters. For families, would my friend agree, this is as much of a disaster and warrants as much immediate attention as anything else we do?

Will the Senator yield for a question? I want to ask a question. Would the Senator from Illinois agree that we make choices here every day about what, in fact, we are going to do? And there is no question that the deficit is a huge issue. But I, along with you, have a reaction this evening listening to my friend from Kentucky, who is my friend. We have worked together on a number of different issues.

But to hear that somehow, when there has not been a concern about rising deficits when we were talking about tax benefits for the wealthiest Americans that did not have to be paid for, but now we are talking about those who find themselves, through no fault of their own, without a job, who are trying to hold it together in one of the worst economies certainly of my lifetime, and that somehow we are now--now-- going to worry about balancing the budget and the deficit on the backs of the least of our brothers--I mean, that is really what is being talked about tonight. I find it outrageous that we would be having this kind of discussion.

Would my friend agree that, in fact, there are other choices? In fact, when we have the debate about extending the tax cuts to the wealthiest Americans, I want to hear the same debate and the same objection coming as is coming to people right now who are trying to hold it together for $200 or $300 a week and keep food on their table for their families.

Would my colleague agree?

Mr. President, first, I wish to thank my friend from New Hampshire for her advocacy on health care reform in general, but specifically working together on the areas that affect small business, I very much appreciate, and we are so pleased to have her in the Senate.

I come to the floor to join my colleagues. I know the chair of the Small Business Committee, Senator Landrieu, has been here and others will be here--Senator Lincoln, who has played such a critical role in putting together the small business provisions in the bill.

I am very pleased to have authored one of the provisions in the managers' amendment that will guarantee that small businesses get immediate help starting next year--tax cuts to help them pay for the cost of health insurance. Michigan has close to 200,000 small employers that represent about 96 percent of the employers in our State.

Most folks who think of Michigan think of large employers, large manufacturers. But, in fact, the majority of our employers, as in the majority of each of our States, are small businesses. That is where the majority of the new jobs are being created. We have just 41 percent of our firms that have fewer than 50 employees who actually are able to offer health insurance. So less than half our small businesses are able to offer health insurance, which is why we are focused on small businesses in this reform bill.

The majority of people in this country who don't have insurance are actually working. The majority of us--about 60 percent--have insurance through our employers. We have about another 20 percent or so who receive their insurance through Medicare or Medicaid or the Veterans' Administration or some other public entity and then 15 to 20 percent of the people overall in America who don't have insurance are predominantly small businesses--people working for small businesses or they are self-employed or they are working one, two, or three part-time jobs just to try to hold things together. So that is a major focus of the health care reforms that are in the legislation that is before us.

I am very pleased we have been able to put together a package that has $40 billion in direct tax cuts--$40 billion in direct tax cuts--for small businesses across America to help them afford health insurance going forward, rather than waiting for the new insurance pooling--the exchange--which will provide additional help for small businesses. This help, this tax cut, starts right away. We will see 3.6 million small businesses that could qualify for the tax cuts in this bill that will begin next year.

In my State, that means over 109,000 small businesses that could be helped by the small business tax cuts that will make premiums more affordable. So I am very pleased to be part of a group of Members who came together and worked very hard to focus on the fastest growing part of the economy, which are our small businesses.

I will just share one story, and this was from Crain's Detroit, a highly respected business publication in Michigan. Mark Hodesh, who is the owner of an Ann Arbor home and garden store, said he has seen his health insurance premiums go up more than 300 percent since 1997. In 1996, he paid $132 in health care premiums a month per employee; and this year, regular premium increases have led him to pay upward of $375 per month for each employee. So that is a 300-percent increase. He says:

I have been in small business for 40 years, and my

conclusion is that without health care reform, these

increasing costs will put me out of business.

That is the reality for businesses across this country. I do believe health care reform is directly tied to jobs, whether it is large businesses competing internationally that make a determination to move their facility because of health care costs, whether it is small businesses going out of business or having to decide if they keep people working or pay for health insurance or whether it is the self- employed person out on their own, in their own enterprise--maybe it is local realtor. We know realtors have struggled for years because they haven't been able to buy through a large insurance pool. That is what this reform is all about. That is what this legislation is all about, to help small businesses, people who are working out of their homes, who are self-employed, as well as people who have lost their job and then lost their insurance. That is what this is all about.

When we look at this legislation, according to the Small Business Majority, without health insurance reform that is in this legislation the annual costs of health benefits will more than double in less than a decade. They will more than double. We know, because we have seen the statistics, that when we talk about doubling health care costs for businesses in the next 10 years, it is estimated to equal another 3.5 million jobs.

We cannot afford to lose another 3.5 million jobs because of the doubling of health care costs in America. We are focused on creating more jobs. We need to be laser focused--certainly, I am, coming from Michigan--on creating jobs not losing jobs. According to the economic analysis of the Small Business Majority, health insurance reform could save up to 72 percent of small business jobs otherwise lost to a continuing rise in health care costs. We need those jobs.

Again, health insurance reform is all about saving lives, saving money, saving Medicare, and it is certainly about saving jobs. That is why I am so pleased we have made small businesses a major priority in this legislation--both through $40 billion in tax cuts for small businesses, creating the new insurance pool through which small businesses can get the same kind of deal, have the same kind of clout as a large business today in being able to negotiate with private companies, and other provisions that are in the bill as well.

There are many reasons to support health insurance reform. Standing up for small businesses is certainly at the top of the list.

I yield the floor.

Madam President, as we work toward economic recovery, it is imperative that we act quickly to extend critical tax provisions scheduled to expire this year that promote research and development, spur community development, support the deployment of alternative vehicles and fuels, and provide certainty for businesses and families.

Knowing these tax provisions are in place allows Americans to plan for the upcoming year. The longer we wait to pass this legislation, the more uncertainty we place on businesses during a time when they are starting to recover. Many of these tax provisions encourage investment, the development of new technologies, and business growth, which allow our companies to be competitive in a global marketplace.

Delaying the extension of the research credit could put more than 100,000 jobs and billions of dollars in economic activity and Treasury revenue expected in 2010 in jeopardy, according to estimates from TechAmerica. If the credit is renewed, the association estimates that 120,000 jobs would be generated and/or sustained, there would be an additional $16 billion in additional research and development and other economic activity and $13 billion in Federal tax revenue over the course of 2010. However, for every day that the credit is left expired, there is the potential to lose 331 jobs, $45 million in economic activity, and $37 million in tax revenue.

Another important tax provision set to expire this year allows businesses to write off the expenses of cleaning up brownfields, industrial land that would otherwise continue to be a blight on our communities and harm our environment. In my home State of Michigan, these credits will be needed more than ever to address the brownfields that have been left behind as a result of the restructuring of the automotive industry. Revitalization of these brownfields will be critically important to communities throughout the State and the Midwest.

It is also imperative that we restore the estate tax retroactively to January 1, 2010. I am extremely disappointed that an extension was blocked and that the estate tax will be allowed to expire in 2010. Contrary to Republicans' claims, more heirs of farm and business estates will be hit with a tax increase than if we extended the estate tax at current levels. If the 2009 rules are retroactively applied, then only approximately 6,000 estates would pay the estate tax each year; however, if the estate tax expires, then it is estimated that 61,000 estates could be hit with the capital gains tax. It is critical that we extend the estate tax under the 2009 parameters to protect small businesses and family-owned farms, continue the incentive that the estate tax provides for charitable giving, and provide certainty for the heirs of farm and business estates.

During one of the most challenging economic times our country has faced, dragging our feet on these tax extensions could have a substantial impact on our Nation's businesses and families at a time when we should be doing all we can to help them succeed. I look forward to working with Chairman Baucus and Ranking Member Grassley to retroactively extend expiring tax credits expeditiously when we return next year.

Mr. President, before my friend from Iowa, the distinguished Chair of the HELP Committee, leaves the floor, I thank him for his wonderful leadership and friendship in so many capacities and passion for what we are doing now. We are all here together knowing that in the process of legislating, you don't always get every idea you want. But you come together and you work for something that is good for the American people, and that is what we have done. I thank him very much for all of his leadership.

I wish to take a few moments to talk about how we actually got to this point on a Sunday evening--we are voting at 1 o'clock in the morning--and, frankly, what has been happening all year. I want to take a few minutes to talk about what has happened this entire year, the first year of President Obama's presidency, our first year in the majority, and then to speak a little bit as well about the very important legislation that is in front of us.

I do think it is important that we take a moment to recognize and address a very unfortunate milestone, look back on the year on what we have accomplished in spite of that milestone.

In April, the media celebrated President Obama's first 100 days in office. But here in the Senate, we can measure our progress by something else--not 100 days, but 100 objections from the minority party. Actually, 101 as of yesterday; objections, filibusters, delays, stalling tactics designed to stop us from helping the American people who are hurting in these tough economic times. That is more true in my State than any other place in this country. Our people, the great people of Michigan, have been hurting longer, have been hurting much more deeply than other places in the country because of the major economic transition, as well as the recession in which we are involved.

There is good news because while the Republicans were stalling and wasting time, we were working hard doing what the people of America sent us to do. I want to talk about what we have done in spite of the stalling. But I also want to take a brief moment to explain something hard to explain about Senate rules because people look at us and say: They objected, but why does that matter? Why does that matter?

Mr. President, as you know, when there is an objection, in order to overcome it--and it is called a filibuster--it involves invoking motions called cloture and it takes time. It plain takes time. So 101 times we have not been able to move forward because of an objection or we have had to go through this long process we are involved in right now.

I think it is important to briefly explain it because when Republicans object, as they are now, as they have been on so many occasions, our leader has to file what is called a cloture motion, and then you wait 2 days. You cannot do other business for those 2 days. We have done that over and over, wasting time while people in my State want us to be focused on jobs, on lowering their health care costs, on making sure we are doing the things that matter to them every day. But we stop and we wait 2 days. Then we vote on stopping the filibuster. Then we wait 30 hours, which is what we are doing right now. Then we vote on whether to proceed to the item. There are filibusters again. Then we file a cloture motion on the amendments or the bill. We wait 2 more days. Then we vote on closing a filibuster, and then we wait 30 hours, and then we vote on the amendment, which we will do tonight, and then we have to wait another 30 hours. In this case, another 30 hours.

It does matter when we say there have been 101 objections that have either stopped us or forced this process. It does matter. It matters because it has slowed down the ability to move to get things done.

The good news is that we have gotten things done anyway. We have gotten things done anyway because we are focused and committed to getting things done. We know the American people have waited too long. The last 8 years were about taking us in the wrong direction, with things that did not help most people, that put us in a huge deficit hole, that did not address health care or health care costs or jobs, or policies that made it worse.

We know that even though there have been 101 objections so far this year--and there will be more; there will be more--we are going to get things done for the American people.

It is amazing the stalling actually happened on the very first day of the 111th Congress on January 6 when Republicans objected to moving forward with an important public lands bill, something we had been trying to do for some time to protect and preserve our national parks, forests, and wilderness areas. But we passed that important bill anyway over their objections and three different filibusters, as the chart showed. Three different times we had to wait, wait 2 days, wait 30 hours, wait 2 days, wait 30 hours. But we passed it.

Since then, nearly every single week we have been in session, every single week but 4 out of 41 weeks, we have had to go through this process or have had objections. They have found something to object to or something to filibuster.

As I said, yesterday they objected for the 101st time, this time with a filibuster against providing affordable health insurance for over 30 million Americans. They have misused longstanding Senate rules and traditions to stall everything that might give this President and this Congress a victory.

I think it hurts all of us when the Senate breaks down as it has. Everybody is hurt by that--to stall everything that would help get Americans back to work or that would help 15.4 million Americans who are looking for work, and now to stop us, as I said, from extending health insurance coverage to over 30 million Americans. Their objections are about policy. They are about politics.

Earlier this year, objection 74, they stalled the unemployment bill, and their delaying tactics caused nearly 200,000 Americans to lose their unemployment benefits a couple of months before Christmas. They objected to the bill twice. They filibustered not once but three times before they voted unanimously. They voted unanimously for the bill. Why would you filibuster something three times and then vote for it unanimously? Not because you are concerned about the policy. The only explanation is that Republicans were trying to waste time--time that cost 200,000 Americans their unemployment benefits; the difference between paying the mortgage, keeping the heat on, putting food on the table, and possibly trying to keep health care going with a COBRA payment or in some other fashion.

Objection 4 was the Republican filibuster of the Lilly Ledbetter Fair Pay Act to make sure women get equal pay for equal work. Republicans filibustered and held up that bill, but we pushed forward. We passed it. We passed a very important equal pay for equal work bill in spite of it.

Objection 6 was to the American Recovery and Reinvestment Act which

has been absolutely critical to creating jobs, keeping our economy out of a depression. They filibustered that bill three times as well. But we overcame the objections, passed the Recovery Act, and made critical investments in transportation, in our schools, in our police officers, and in clean energy technology and manufacturing.

And, yes, we are seeing the difference in Michigan right now. Mr. President, $2 billion was part of the Recovery Act. I am pleased to say we have received a large part of that in Michigan to develop new battery technology manufacturing. We have at least six different firms that have announced and begun to develop manufacturing facilities for advanced battery development. Those manufacturing facilities are going to put thousands of people back to work. That was in the Recovery Act that was filibustered three times.

Objection 20 was to Senator Kennedy's Serve America Act, which we passed despite their filibuster, to help young people give back to their country through voluntarism and community service.

Objection 24 was to the Fraud Enforcement Recovery Act which cracked down on predatory lending and abuses by banks and mortgage companies. That bill was held up for nearly a month. But we passed it, giving real relief to millions of American homeowners.

We passed the credit card bill, Republican objection 32.

We passed the Helping Families Save Their Homes Act, Republican objection 33.

We gave the FDA the authority, finally, to regulate tobacco to help keep kids from smoking. That was Republican objection 38.

We passed the Travel Promotion Act which will help stimulate the suffering tourism industry across the country. That was objection 45.

We passed a true funding bill to make sure our soldiers in Iraq and Afghanistan had the support they needed despite having to file cloture to stop a filibuster--objection 47.

We passed the Defense authorization bill that included a pay raise for our troops and other help for our military and their families despite repeated filibusters and objections. And these were objections 54, 56, 57, and 58. Can you imagine? This was a Defense bill.

We passed the veterans health care bill, despite Republican stalling, to help caregivers of disabled veterans, women veterans, rural health improvements for veterans, mental health care for veterans, and support for homeless veterans. This was Republican objection 89.

Objection 98 was another filibuster against those pay raises for our troops just 9 days before Christmas.

Despite all of those objections, 101, we have been doing what we were sent here to do. We have focused on actions to help create jobs and strengthen our economy and focus on the things that families struggle with and care about every day to make people's lives better, not just a few, not just investment bankers on Wall Street, not just the wealthy folks who got the tax cuts in the last 8 years, but middle-class families every day who are trying to figure out: What about them? What about us? That is what we have been focused on.

We passed an extension of the Children's Health Insurance Program to provide health and dental care to nearly 10 million children. We passed legislation to reform government contracting and protect taxpayer dollars. We passed legislation to invest in health care, energy, and education. We passed the cash for clunkers bill, as you know, that I was proud to lead in the Senate that moved over 650,000 fuel-efficient cars off dealer lots and brought thousands of laid-off manufacturing workers back to work.

We passed legislation to support the growth of small businesses and to extend the first-time home buyers tax credit. And now, just a few days before Christmas, we are working to pass this critical, historic health insurance reform legislation. We are committed to getting it done.

Republican colleagues can object 100 times or 1,000 times, but we are not wavering in our commitment to do the right thing. Even though inaccuracies abound, even though misinformation has been said over and over about what this bill would do, we are committed to overcoming what has been the tidal wave of opposition from the special interests who control the status quo, who like it the way it is right now. We are determined to get beyond that and do the right thing for American families. Whether our Republican colleagues work with us or not--and we sincerely hope they do, and we have spent a tremendous amount of time this year reaching out to get bipartisan support--whether they stall or object, our job is to do everything we can to move America forward, and that will continue to be our focus.

As the distinguished Presiding Officer knows because we both sit on the Finance Committee, we have spent months reaching out with committees, with processes to get bipartisan support. But, as my dad used to say, it takes two to tango. It takes both sides to want to work together. Unfortunately, it appears the strategy that was put in place back at the beginning of the year, the very first day of session, with the very first filibuster, was just to stop us from being able to move America forward, to stop this great new President, to stop the majority in the Congress. But we have moved forward despite that.

I think often of what we could do if we hadn't had to deal with 101 filibusters, what we could have done in creating a clean energy bill, which would create more jobs in my great State, or dealing with other critical issues we need to deal with and we will deal with. As we slog through filibuster after filibuster in the coming year, we will do that. But now we have the opportunity in front of us to pass historic health insurance reform that, frankly, people have talked about for 100 years.

This legislation is not perfect, but nothing ever is when you start. It is a great framework, however, for putting in place the value, the principle that every American should be able to have affordable health insurance and that we are going to tackle the explosion of costs that have hit businesses large and small, that have hit taxpayers, and to bring those costs down over time. That is what we are involved in right now, and we are going to get it done.

We could have voted much earlier, rather than keeping our staff here until 1 a.m., and we will vote again after we run the next 30 hours, which will be, I believe, Tuesday morning. We could vote and be done with the final passage at that point. We know where the votes are. We have the votes to pass this. But it appears we will be here until Christmas Eve. Mr. President, I do not mind for myself. I, of course, want to be home with my family, as I know you do. But I think about my brother, who drives for UPS, and I know he will be working on Christmas Eve, as a lot of Americans will be working on Christmas Eve. And if we need to be here until Christmas Eve to do something that will positively affect every American, I am willing to do that. I am willing to do that if that is what we need to do.

Let me take a moment to talk about the bill in front of us. The bill in front of us literally saves lives, saves money, and saves Medicare, and I am very proud that in the managers' amendment, the amendment we will be voting on at 1 a.m. today, we have made it even better.

I am very pleased to have helped to lead a section related to small business tax cuts. Along with our chair of the Small Business Committee, Senator Landrieu, and another strong advocate, Senator Lincoln, we have been working on provisions that will make sure there are small business tax cuts that start immediately--next year--after the bill passes, $40 billion in tax cuts in total to help small businesses afford health insurance for themselves and their workers.

In our amendment, we also provide even tougher insurance reforms.

In the underlying bill, we lay out a whole health care bill of rights. I remember coming here in the year 2000, and the Patients' Bill of Rights was the major thing we were trying to get done. We were in the minority, the Democratic minority, but we were working hard to do that. It was my first opportunity to work with Senator Kennedy. We believed strongly that we needed to take insurance company bureaucrats out of the middle--from between doctors and patients. That is in this bill. Those kinds of reforms are in this bill and only one of many things that are in this bill.

We have toughened it up so that if insurance companies, between now and when the new group insurance pool takes effect, are raising their rates too high, spending too much on profit and administration, then taxpayers, ratepayers, will get a refund. And we hope that will put pressure on them not to continue to raise rates or try to do what the credit card companies have done before the bill takes effect--raise their rates. So we have put new protections in and other protections as well to make sure that the majority--the vast majority--of every dollar a family puts into premiums actually goes for their medical care rather than for profits and administration.

In total, we have $430 billion in tax cuts to create affordability for families and for individuals, to help them afford health insurance. With that, overall, this is a tax reduction--this bill is--for the American people, and it is a reduction for taxpayers because it lowers the deficit in the first 10 years and on into the future.

I am going to take just a moment to give a sense of what is in the bill as it relates to new coverage and the benefits.

We know the majority of us have health insurance already. In Michigan, it is about 60 percent of the people, and in other places it is 50 or 55 percent. But we have what is called an employer-based health insurance system. So we have started from the basis that people should be able to keep what they have, and we have built on that. The majority of people have either employer-based insurance or they have Medicare or Medicaid or veterans services or other public services. So we started from the basis that we want to make current health insurance more secure, more stable. The insurance reforms we are putting in place for those plans that take effect--or new plans after this takes effect--will include the elimination of preexisting conditions, the elimination of what is called rescissions--the ability to drop someone if they have gotten sick--and the elimination of discrimination.

One of the things I was surprised to learn about, in terms of how extensive it is, as we went through this process is that women are paying, on average, 50 percent more than men for the same coverage in the individual insurance market or maybe even less coverage. Because a woman is in her childbearing years or perhaps has been pregnant and may be viewed as having a preexisting condition, some women might not be able to find health insurance.

So those who have insurance today, as they attempt to get new plans, will be able to take advantage of all of the insurance protections--our health care insurance bill of rights--in the bill. And this is very important.

Also, people with insurance today will actually, over time--and it will take some time for this to happen--but as others who do not have insurance now are able to afford health insurance and become able to get health care, there will be fewer people using emergency rooms. There will be fewer people needing other kinds of services that actually end up coming back, in terms of cost, to all of us who have insurance today because when someone walks into the emergency room sicker than they otherwise would be if they had seen a doctor, they get treated, as they should, but then the hospital has to make up the cost, so they put it on people who have insurance today. That is estimated to be about $1,100 in hidden costs for individuals. So we are going to see those kinds of costs come down and other changes and efficiencies and quality that will help people with insurance today. So coupled with the insurance reforms, we will see more stability and more quality for people who have insurance today.

The major area of new coverage is in what is called the insurance exchange. For the 15 to 20 percent of the people who can't find affordable insurance today--and most of them, as our Presiding Officer knows, are small businesses or people who are self-employed or people who have lost their jobs and then lose their insurance--we set up a new group pool, which is a way for people to use the same leverage a big business does or the Federal Government does, just as the insurance policy for Members of Congress uses a pool. Then everyone can choose the insurance coverage they want within that pool and get a better deal. That is what we are setting up in the insurance exchange, with helpful tax cuts for families and for businesses and individuals to help them afford health insurance.

We are also giving a choice to States. For lower income working people, a State may choose to provide a basic health insurance plan rather than people getting a tax cut to go into the exchange. They can set up their own basic health insurance plan and bring down costs as well through the State.

For young workers--and this is one of the things I wish had been around a couple of years ago--we will be allowing parents who have their children on their insurance policies--after the effective date of the act, they will be able to keep their children on their insurance policies until the age of 26. That will give young people a chance to get a start in that first job knowing they have insurance until they are 26. And there are a number of other provisions in the bill for young people as well.

We are making Medicaid a true safety net for low-income people up to 133 percent of poverty. We are truly going to be able to say: If you lose your job, you won't have to lose your insurance. What an important thing to be able to say in terms of taking away that fear of losing your job and having nowhere to turn.

Improving Medicare. We are going to stop what have been overpayments to for-profit insurance companies and put that money back into closing the gap in prescription drug coverage under Medicare. It has been called the doughnut hole. We are going to close that. We are going to provide preventive care for seniors without out-of-pocket costs and lengthen the Medicare trust fund so that it is stronger for a longer period of time.

I am very proud to have worked with Senator Kerry to develop a way to provide support and help for companies that pay for the health insurance of early retirees, to lower their costs so that, in fact, we will be able to help those who have retired, voluntarily or involuntarily, so they will have the insurance they need until they can qualify for Medicare.

Let me close by saying this legislation is very much about saving lives. Forty-five thousand people lose their lives every year because they can't find health insurance they can afford. That is 45,000 families who will have one less person at the dinner table over the holidays because of lack of health insurance. Surely we can do better than that in our great country.

We will be saving money for small businesses, for families, for taxpayers, and bringing down the deficit--beginning to turn those costs downward rather than keeping them going upward in such an uncontrollable way.

Saving Medicare. We will be making sure Medicare is stronger out into the future and that our seniors have more help paying for their prescription drugs and preventative services as well.

When you get through all of it, we know it is hard to change the status quo because those who benefit from the current system don't want it changed.

But we do.

I thank the Presiding Officer.

Mr. President, I wish to thank our distinguished assistant majority leader for being on the floor, for his passion, for his commitment to the issue of health care, affordable health care for every American. I thank him always for his comments.

The bottom line for all of us is, this legislation is about saving lives, saving money, and saving Medicare. I would also say it is about saving jobs.

That is certainly a big focus for me, coming from the State of Michigan. The reality is that this year 45,000 people lost their lives because they couldn't find affordable health insurance. Forty-five thousand families during the holidays will have one less person sharing dinner and exchanging gifts. We can do better than that in this great country. This morning, 14,000 people got up with health insurance and they will go to bed tonight without it and that happens every day, every day, every day. We can do better, and this bill does better than that.

As Senator Durbin indicated, in addition to other provisions in the bill, this amendment would dramatically expand community health centers across the country where people can have the opportunity to go into the neighborhood community health center, see a doctor, see a nurse, and get the care they need--incredibly important.

This bill saves money. It saves money at every level. This bill has over $400 billion in tax cuts for small businesses and families in it. I am very pleased and proud to have been part of an effort with other colleagues, including the chair of the Small Business Committee, Mary Landrieu, and the distinguished Senator from Arkansas, Blanche Lincoln, and other colleagues to strengthen the provisions for small business that are in this amendment. It is very important.

The 35-percent tax credit for small businesses with up to 25 employees will start next year. So right out of the gate, that is something that will be available for small businesses. We also expand on the provisions that would add to the benefits for that particular tax cut. Going forward, the whole point of creating an insurance pool that small businesses can buy into and self-employed individuals can buy into and people without insurance is because, right now, big businesses already provide insurance, for the most part, and they get a good deal because they have enough employees to negotiate a better rate. So health insurance reform, in terms of new coverage, is very much about small businesses.

Most of the people who don't have health insurance work. They don't qualify for Medicaid for low-income individuals. They are not in a big business that has health insurance.

They are working for a small business or maybe they are working one part-time job, two part-time jobs, or three part-time jobs without insurance or maybe they had a job and then lost their job and, like many people in my great State, lost their job on day one and lost their insurance on day two. This is very much tied to small business and filling the gap.

Of the people who have insurance now, about 60 percent of the public will keep what they have. They will benefit from the insurance reforms, so they are getting what they are paying for, and people with preexisting conditions will be able to find insurance that they cannot find today. Those who have public plans, such as Medicare, will be able to continue with a strengthened plan. I want to talk about that in a minute.

For that 15 to 20 percent today who cannot find affordable insurance, that is what this health reform is all about--to make sure small businesses and individuals working out of their homes, their garages-- the next entrepreneur, the next Bill Gates down the road--have the opportunity to find affordable insurance through a large group pool. That is what this is very much about.

I am very pleased to say we have increased the amount of tax cuts for small businesses and tax cuts overall in this bill to help people afford to buy health insurance.

Also, as a part of saving money, we are for taxpayers saving dollars and reducing the deficit over the first 10 years, the second 10 years, and beyond. The Congressional Budget Office now says that during the first 10 years, we will decrease the deficit by $131 billion, not the huge increases that are being talked about on the other side of the aisle, and in the second 10 years, we are looking at up to $1.3 trillion in reduced deficits.

For my large businesses that compete internationally, where we do not have a level playing field right now, in many ways because of health care costs, we are going to be able to bring those costs down. It is absolutely critical for us if we are going to stay competitive and be able to create good-paying middle-class jobs in this country.

We also know we have to stop the insurance company abuses that are occurring today, whether it is dropping people when they get sick because of a technicality, blocking people from getting care, putting on artificial caps, lifetime caps that stop people from getting coverage, or whether they are spending way too much on administrative costs and on profits rather than putting it into medical care. We address all of those issues in this bill, and this amendment strengthens that as well.

We are very much about saving Medicare. We stop overpayments to for- profit insurance companies and put that money back into closing what has been a gap in prescription drug coverage. We add preventive care with no out-of-pocket costs for seniors, and we lengthen the life of the Medicare trust fund.

I have to take just a moment because we have reached a milestone in all of the delaying tactics that have gone on this year, much of it focused on stopping us from passing health care reform that benefits Americans.

We have now reached 101 different Republican objections to moving our country forward as of today. The party of no has blocked us from moving forward 101 times. People oftentimes say: What does that mean? How can they do that?

The rules of the Senate are such that each Member has the ability to object to something going forward. Most of the time, we operate in a way where people agree and we do not object. But if someone objects and you are trying to get something done, you have to go through motions and time clocks and things that become very difficult for people who are following this to understand.

The reality is, if there is an objection, our leader has to do what he has done today. He files a motion to get past a filibuster, we have to wait 2 days, then we vote on stopping the filibuster, then we wait 30 hours, and then we vote on whatever it is--the amendment, the bill, whatever it is we are trying to do. After that, we then move on to the next step. There is an objection again, as there has been on health care, the leader has to file a motion to stop the filibuster, wait 2 days, vote to stop the filibuster, wait 30 hours, and then vote on whatever it is. This goes on and on.

We have seen historic numbers--what I view as an abuse of the process--historic numbers in order to block us not just from health care reform but from funding the troops with the Department of Defense, extending unemployment insurance for unemployed Americans--I can go on and on.

At every step of what we have tried to do this year--and we have done some historic things--every step of the way, we have had to maneuver through an unprecedented effort to block and stall and say no. Mr. President, 101 times now this has happened.

Despite that, we have accomplished many very important things. We are not done. I am not going to be done until we make sure everybody who wants to work has a good job in this

country, and we are all focused on that. We have a tremendous amount to do together to tackle the debt, to make sure we are supporting efforts for good-paying jobs to be created. But this health reform is a critical part of that because it does, in fact, affect costs in this country. It saves lives. We should care about that.

In this amendment, we add additional funds for prenatal care and to support families who want to adopt children with a refundable tax credit. We put in place other items to support women who are pregnant to make sure they have the health care they need so they and their babies can be healthy moving forward.

This saves lives, saves money, saves Medicare. It is the right thing to do, and it is time to get it done. Now is the time to get this done.

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

Madam President, I ask unanimous consent that at 5:30 p.m. today, the majority leader be recognized to make a motion to recess until 12:01 a.m.

Madam President, I ask unanimous consent that at 5:30 p.m. today, the majority leader be recognized to make a motion to recess until 12:01 a.m.

Madam President, I rise to speak about the position we find ourselves in as we come to the end of the year. Despite the incredible successes we have had with the recovery act and equal pay and the Children's Health Insurance Program and so many other areas where we have been focused and working hard to make a difference, every step of the way, as with the current bill, we have been faced with stalling tactics, objections, and filibusters. Now with the very important Department of Defense funding bill, we are in a filibuster again. I had to make the motion I offered because we will have to come in at 1 o'clock in the morning and have a vote to stop a filibuster. That is what this is all about, filibustering a bill that has a pay raise in it for our troops, that has help for military families, that has the funding for the next year--we are in the middle of two wars-- essential funding that is needed to support our military. As our Presiding Officer knows, having been a leader on this as well, we also have placed into this bill provisions that are incredibly important for families, extending unemployment insurance for families across the country who find themselves in a situation not of their making where their job has gone away or they have been laid off because the company can't continue to employ them, maybe because of rising health care costs, which is certainly part of the equation. People are finding themselves in a situation where due to nothing they have done other than be a good citizen, care for their kids and follow the rules, they are without employment. We have this year extended unemployment insurance--and I am so grateful that President Obama has been willing to do this, has helped to lead this in the recovery act and then again as we ended a filibuster, a month-long filibuster in October, brought that to an end in November to extend unemployment insurance. We find ourselves again, because of the unemployment situation, even though we see it getting a little bit better, with a long way to go. We are moving in the right direction, but we have a long way to go. This bill would extend for 2 months unemployment insurance that is critical for families. It would also extend help with health insurance. We are debating the larger health reform bill to create a way for families to be able to afford insurance and for us to bring down costs over the long run for businesses and for families.

This bill in front of us that is being filibustered by the Republicans would extend help for health care, for health insurance, for COBRA payments--a program put in place that made a lot of sense. If you lose your job, you could pay on your own to continue the coverage. But it is incredibly expensive.

So recognizing that, and recognizing how tough it is when you lose your job and you are in a situation--it is either savings or unemployment insurance or both--and you are trying to make the mortgage payment and care for the kids and put food on the table and pay the electric bill and all of the other things, and then to add a several hundred or several thousand dollar payment for COBRA on top of that has not been realistic for families. So we have placed a 65-percent subsidy, to help families get through this tough time, for health insurance. We also have assistance for food for families who, right now, again, have never had to ask for help before in their lives but now have a situation where they cannot put adequate food on the table for their children.

This bill is very important, and what we have in front of us, unfortunately, is another filibuster, another objection--like we have seen all year--to stop us from moving forward to fund our military, to support our troops with a pay raise, to help military families, and then to do a number of other things that are critical to do in the short run until we get into the new year and are able to focus more broadly on these things.

As the Presiding Officer knows, this is not the first time this has happened. We have had from the party of no 98 different objections this year. This is a record, a world's record I think: 98 different times that we have seen them objecting, filibustering, having stalling tactics to moving forward on things that ought to be bipartisan.

These are not Democratic issues when somebody has lost their job or when a small business needs help or needs health insurance they can afford or when a family finds themselves in a situation where they need to be able to have help to continue their health insurance or put food on the table. This is not a Democratic idea or a Republican idea, this is American.

We have Democrats, Republicans, Independents, people who do not have a party, people who are not active politically, people who vote, people who do not vote. They are losing their jobs. They expect us to get it. They expect us to have a sense of urgency around here.

The troops who are serving us right now, who are in tougher times than we will ever face, are not saying what matters is whether you are Democrat or Republican as to whether we fund the troops and fund the Department of Defense and give them a pay raise they have earned and need or to help their families. They are saying: Come on. Come together. Solve problems. Get things done.

But yet, over and over--and we find ourselves tonight where we are going to be stopping a filibuster at 1 o'clock in the morning on a bill to fund the Department of Defense, on a bill that would help families get through the holiday season, keep a roof over their head, pay their heating bills, and keep food on the table.

To dramatize this even more, it is stunning to think about the fact that out of the 40 weeks we have been in session this year--40 weeks-- for 36 of those weeks, we have had filibusters or stalling tactics, objections to amendments or objections to bills being put on the floor. That means only 4 weeks out of the entire year we have been in a situation where the Republicans have not been saying no, have not been stalling on things that are incredibly important.

Even with all of this, by any objective measure, there has been more accomplished this year than in any other time since the Great Depression. We need to be accomplishing more and faster because people have a tremendous sense of urgency about what is happening in their lives right now. So we need to be acting. Think of what we could have gotten done. We have all the things that have gotten done and have been addressed. Think about what we could have gotten done if we did not have 36 weeks of filibusters that we had to deal with and objections we had to deal with.

I hope, as we are going through this new year, there will be a sense that it is time to get things together here and work for the common good and put people back to work and tackle their health care costs and make sure people can afford to have health insurance.

Let me close by sharing a story from Annette from Lake Orion, MI. She says:

After a successful 21-year journalism career, I was laid

off in May when my newspaper closed. I will turn 60 in

October and am a 12-year survivor of breast cancer. My

husband, who is 62, is on my health insurance.

Thankfully, the federal government is helping [us] pay for

our COBRA, which would be more than $800 a month.

Senator, we're not pleading poverty. But it's easy to see

the dilemma of many Americans in our shoes: Risk going

without health insurance, you risk bankruptcy if someone gets

sick. Pay the current price, and watch your life savings,

which were supposed to support you in [your] old age, dwindle

down.

Don't listen to those screaming to maintain the status quo;

it doesn't work for too many Americans.

We have story after story where people are facing an early retirement--not by choice--dipping into retirement savings to try to keep their health care going. Young people, old people need us to act now, and I am urging Congress to act now.

I thank the Chair.

Will the Senator yield for a question?

Mr. President, from the Senator's explanation and from what we have been working on, I want the Senator to clarify two things.

First of all, we could do this conference report today if there were a willingness and, secondly, we have a pay raise for our troops that is coming right before Christmas, the holidays,

help for families, help for those who have lost their jobs and are trying to figure out how they keep their health care going, and help for people who are trying to put food on the table for the holidays; is that correct? I ask the Senator to expand. As I understand it, we could actually get this done today and give people some peace of mind going into the holidays.

Mr. President, I wish to ask another question of the Senator from Illinois. If, in fact, the Senator from Illinois is finding the same thing I am right now--certainly, we have the highest unemployment rate in Michigan--and we are hearing it from all over the country; we are hearing from people that their unemployment benefits are about to expire. They are trying to figure out how they are going to make it through the next few months.

There are particular concerns that if we do not extend it by the end of the year that, in fact, many will have to go out and resign up with a new bureaucracy to continue benefits.

I wonder if the Senator has heard the same kinds of concerns and sense of urgency people have about being able to keep a roof over their head, keep food on the table, and keep their health care going--the same sense of urgency that I know we are feeling from people in Michigan?

If I may conclude, to clarify, we can get this done today. We can create that peace of mind for families going into the holidays, going into Christmas, into the end of the year. We could actually do that today in the next few hours?

Mr. President, I would like to discuss with the chairman of the Financial Services and General Government Appropriations Subcommittee, Senator Durbin, as manager of the Financial Services Subcommittee section of the bill before the Senate, language included in the bill that creates a binding arbitration process for auto dealers associated with General Motors and Chrysler whose contracts were terminated as part of the manufacturers' restructuring efforts this year.

The difficult decisions made during the last year have highlighted the interconnectedness of the industry and have shown the impact that these companies have in every State in the country. I particularly understand how difficult this situation has been for Michigan auto dealers. My father and grandfather ran the Oldsmobile dealership in Clare, MI, where I grew up. My very first job was washing cars on that lot.

Thousands of employees, either directly employed by the companies or through the thousands of dealerships and suppliers, depend on the viability of the auto manufacturers. Without the manufacturers, there is no dealer network, and small businesses across the country would close, adding more devastating job losses as our economy is trying to recover. What we do here must continue to ensure a healthy future for the auto companies as they work towards a profitable future. When negotiating an agreement for arbitration was it the Chairman's intent that the dealers entitled to this arbitration process would only be the dealers that were terminated as a result of the bankruptcy?

The statutory language for the arbitration process provides criteria that will be used to review each case. Is it the Chairman's goal that by considering the economic interest of the public at large the arbitrator should focus on maximizing the return of taxpayer dollars that have been invested in the company?

Additionally, when reviewing the cases, does the statutory language ensure arbitrators take into consideration the stability and protection of the existing dealer network?

I thank the Chairman for these clarifications and for his ongoing efforts to ensure a fair process for all stakeholders as the auto industry continues to restructure.

Mr. President, before my good friend from Iowa leaves the floor, I thank him for his wonderful leadership on the health care reform bill, on the appropriations that he chaired--formerly on Agriculture. It has been a pleasure to partner with him on so many things.

Mr. President, I ask unanimous consent that I be allowed to speak as in morning business for up to 20 minutes.

Mr. President, I want to talk about health care. I have to say that if 20 percent of what was being said by our Republicans friends was true about this bill, I could not vote for it either.

I keep hearing things described that have no relationship to the reality of the bill that I helped to write in the Finance Committee, or my friends helped to write in the HELP Committee or the bill that is on the floor now. I see all kinds of comments that, frankly, concern me because I don't see them reflected in the reality of the legislation in front of us.

I encourage people to take the opportunity to read the bill or the summaries. For the people in Michigan, we have had it up on our Web site, and we have had every bill, as it is introduced and passed, on the Web site, so people will have an opportunity to look at the information available.

I do know this: What we have been hearing from our colleagues is not good enough, when we think about the fact that we had a Congress and a White House for 6 out of the last 8 years that was controlled the by Republican Party and yet nothing was done. Proposals have come forward now about all these things that should be done. But they weren't done when they were in charge. What we saw was a lot of tax cuts for the wealthy people and a lot of no-bid contracts for friends of people in the administration. We saw a lot of things that didn't affect people in my State very positively and didn't help the working people in my great State of Michigan.

But now, as we are trying to move forward and do something for people, for small businesses and large businesses, and bring down costs and provide health care for people, there are all kinds of suggestions about why we should wait and do it over. What I heard in committee and what I am hearing now on the floor, as a proposal--because we don't have a Republican bill in front of us or one that has been offered--is this: Wait, wait, wait. We don't need to do this. That doesn't have to be done right now. There is no sense of urgency. We should wait, wait, wait.

That is what we hear. We hear that business as usual for the insurance companies is OK. Let them decide what is covered--if you can find insurance--and how much it should cost, whether or not they are going to be able to provide a test for you or an operation for you. That is OK. Let the insurance companies continue to be the ones between you and your doctor. That is what we have seen over and over. We saw it in committee. Every time we were trying to lower costs for families and small businesses, they were on the side of helping the insurance companies. They were willing to take tax cuts we put in the bill, and they offered amendment after amendment that would have had higher costs for middle-class families and small businesses, in order to help the insurance industry.

I will share a few stories from people who have become part of our health care people's lobby through my Web site, who have been willing to share stories.

David is from Sutton's Bay, which is a beautiful part of Michigan. We would love to have you come visit. It is a gorgeous part right on the water. David says:

I'm a 61-year-old cancer survivor with diabetes and high

blood pressure. I am self-employed, and lately, uninsured. I

worked all my life to build a stake here in farm country and

almost lost it last fall to foreclosure because of a medical

emergency. This farm is all I have . . . the savings and cash

are gone. I continue to work with no retirement in sight. I

have put everything I had for retirement into my farm.

Please, help me keep it.

I know that David is not saying wait, wait, wait. He wants us to act, and to act now, on something that will be meaningful and makes sense to bring down costs, to give him a chance to find affordable insurance that doesn't bankrupt him and his family.

I want to share also another story from Jeff from Rockford, MI:

It has been over five years since death stared me down. I

was diagnosed with testicular cancer. Losing my job to a

layoff, mortgage to pay, among other things--and my options

were minuscule. I had no insurance then because there was

none that I could afford.

I thank God and the staff at Grand Rapids Spectrum Health

for my life today. Unfortunately, I am still $25,000 in debt

because of lack of coverage.

I served in the Marines from 1984-1988. One of their mottos

is, ``We take care of our own.'' Imagine what this country

would be like if we all thought like that.

Jeff is right. We are in this together and, just as we have dramatically increased our support for our veterans and their health care, we need to make sure we are taking care of our own American families and American businesses.

Wait, wait, wait? I don't think so. I don't think that is what Jeff is asking us to do.

Jennifer from Hollow, MI:

I am married and have one beautiful little girl. But about

6 months ago, my husband's work informed us they would no

longer be able to carry health insurance for their workers.

A very common story, having to choose between keeping people employed and paying for health care.

We could have gone on COBRA but it would have cost double

what we were paying and we couldn't meet that cost.

Mr. President, as you know, we have worked to lower the cost of COBRA, and we hope to be able to continue that lower cost in legislation that will be coming up shortly. But it is still very expensive.

We are lucky because Michigan has a program for children,

so we didn't have to worry about our daughter's coverage.

When we went to look for insurance for my husband and me, the

prices were steep or we were denied because of my preexisting

condition.

That is one of the things we are going to change.

Right now going to the doctor is next to impossible, but to

see a specialist is like asking for the Moon. We know that we

are highly blessed. My husband has a job. That is more than a

lot of people have. We just want affordable health insurance,

and we don't mind paying for it. It just doesn't seem like

too much to ask, does it?

No, Jennifer, it is not too much to ask, and that is what we are all about. We are all about putting together a plan--and that is what is in front of us--that will lower costs, that will save lives, save Medicare, that will focus on making sure each American has a health care bill of rights, has protections they know will allow them to make sure their health insurance will be available if they pay for it; that they cannot get dropped because of a technicality; that if they have a preexisting condition, they can still find affordable insurance; that there will no longer be lifetime caps on insurance policies; that we will allow our young people to stay on mom's or dad's insurance until age 26.

We have a number of changes we are making for people in the insurance exchange, for policies that take effect after the effective date of this act, and it is about making sure people have affordable insurance and they are getting what they are paying for. That is what this is about.

What happens if we do nothing--if we do nothing; if we wait, wait, wait, like the Republicans are saying? Every single day 14,000 Americans lose their health insurance; 14,000 people got up today with health insurance and they will go to bed without it. That happens every single day.

Insurance rates are going to double in the next few years, by 2016. Business costs are going to double. Increased premiums are going to cost us, it is expected, 3.5 million more jobs. I don't know about any of my colleagues, but we cannot afford to lose any more jobs in Michigan. Health care is directly related to jobs and our international competitiveness.

We know incomes of families will be reduced. We know every 5,000 homes will be foreclosed as a result of a health crisis, and 62 percent of the bankruptcies are as a result of a health care crisis.

Wait, like our Republican colleagues say? No, we cannot wait. The families, the people I talked about and read their stories, they cannot wait. Families cannot wait. Businesses cannot wait. Small businesses that cannot find insurance cannot wait. Large businesses that are finding themselves in difficult situations, considering pulling up shop and going to another country because of lower health care costs cannot wait.

People expect us to solve this problem. They expect us to come together and work together, without all the stalling and the objections and the partisan politics. They expect us to come together and solve what is a huge American problem by bringing down costs and creating access to affordable health care where people know that the insurance company will not be the one that is standing between them and their doctor.

This is about saving lives, saving money, saving Medicare. Mr. President, 45,000 people will lose their lives in the coming year. And 45,000 families will have one less chair or an empty chair at the holiday dinners that are coming up because 45,000 people could not find affordable insurance in this country--Americans, in America.

Saving money--this is about making sure small businesses get the tax cuts they need to help them buy insurance, to make sure that families who are buying through the new insurance pool get the tax cuts they need to afford to buy insurance.

This is about making sure large businesses begin to see costs come down over time because when they are providing insurance already, they are not going to pay the extra costs of folks walking into an emergency room uninsured who are treated and then the costs get rolled over on to everybody with insurance.

We as a country are going to save dollars, save money over time for taxpayers and strengthen Medicare to bring down costs.

And, yes, we are going to save Medicare. We are going to lengthen the Medicare trust fund solvency. We are going to make sure overpayments to for-profit insurance companies are reined in so that the majority of seniors do not see their premiums go up under Medicare to pay for those excess profits.

We are going to make sure we are closing that gap in coverage for prescription drugs that has now been called the doughnut hole, where too many seniors or people with disabilities fall into that hole, cannot afford their medicine, and are not able to get the care they need.

We are going to make sure preventive care does not have an extra cost of a copay or deduction because we know it saves money and saves lives. Under Medicare, we are going to make sure that is there as well.

That is what this is about. It is not about waiting. It is not about all the other stuff we have heard that are scare tactics. This is about tackling and solving a problem for the American people that we cannot afford to wait to do any longer.

Coming from Michigan, I have to say everything I do, everything I care about is about saving jobs. We know in addition, we truly are saving jobs. We are saving jobs for our large employers right now that provide insurance, have been doing the right thing for years but have seen their costs go up 10 percent, 20 percent, 30 percent every year and cannot sustain it anymore. They are cutting health care benefits, raising premiums, or laying people off because they cannot afford it.

We know our small employers under our package will save 25 percent. I believe we are going to be doing even more for small businesses.

We have tax credits to help companies, and, as I indicated before, our plan is going to save 3.5 million jobs that would otherwise be lost because of the increased health care costs that cause employees to be let go or companies to move overseas.

We are talking about saving lives, saving money, saving Medicare. We are talking about saving jobs.

What we are not talking about is waiting. We are not talking about stall tactics or politics. We are way beyond that. I understand there is a big strategy to make sure the President of the United States is not successful. There is a big strategy to make sure we are not successful in the Senate. We have seen more filibusters and more objections than ever before. The vast majority of the days we have been in session--I believe it is 39 weeks now--all but 4 of those we have seen filibusters. It has never been done before--filibusters and objections over and over again.

We are committed to getting beyond that and focusing on the reality of what is happening in people's lives. People are waiting for us to step up and to solve this problem and to give them the ability to have access to affordable health insurance for themselves and their families.

We are not proposing something radical. We are proposing that we fill in the gaps for the folks who do not have insurance today, most of whom are in a small business, most of whom are working maybe one, two, three part-time jobs but they are working and they don't have access to health insurance, or they are self-employed, as the gentleman I talked about, David, in Suttons Bay, maybe a farmer, maybe a realtor, maybe the next Bill Gates in their garage coming up with the next great invention. They don't have access to the same big insurance pool that a big business has to bring down costs.

What we are talking about for those folks who are working or have recently been laid off and cannot find insurance is giving them a way, a competitive way to buy insurance from an insurance pool.

I cannot imagine a more important Christmas present to give to American families than the ability to know going forward that when they lose their job, they are not going to lose their health

insurance; that they have an opportunity, a way to get affordable insurance, and that we have come together as a Senate to focus on saving lives, saving money, and saving Medicare.

Mr. President, I yield the floor.

Mr. President, I thank my friend from Rhode Island for the question and for his advocacy and understanding of how we bring down costs and what we should be doing in so many areas for families and for businesses in the country.

I will just say that we have, first of all, attempted to get something done for years. In the last couple of years, reaching out to Republicans in an unprecedented way, our distinguished chairman of the Finance Committee, as everyone knows, went to unparalleled lengths in reaching out and spending months and months putting together a work group of three Democrats and three Republicans to work in good faith to get something done.

We have accepted Republican ideas. I know on the HELP Committee there were many amendments accepted from Republican colleagues. We have continued to reach out and look for ways to work together.

But what we are seeing is a lack of desire to work together and more than just a lack of desire, as the Senator indicated, but simply to attempt to embarrass the President of the United States, to stop him from being successful, and to stop us politically, when the reality is very serious. This is not about a President. We have had 100 years of Presidents trying to do this. This is not a particular Senate. We have had Senates for years that have been trying to do this. This is about when are we going to get beyond all this? When are we going to actually get beyond this and focus on the reality of what is going on in people's lives, what is going on in every small business that is trying to figure out how to pay the bills and hold it together or every manufacturer in my great State that is trying to figure out how they are going to hold it together. At one point, the American people will have every right to say to us: When are you guys going to get beyond this stuff?

The good news is, we have a President who has said now is when we are going to put it behind us and the Senate has said now is the time and we will work in good faith with anyone who wants to work with us. But we will not wait, which is what we are being asked to do--wait until another time, when 45,000 more people will have died next year, when another 5,000 people a day will have lost their homes to foreclosure.

I would like to think there would be a likelihood of that happening, but I can't imagine it. Frankly, and I think unfortunately, they view it in their self-interest, whether it is a business decision, as a radio host, or whether it is a decision of the other party. I appreciate the fact that it is hard to lose elections. We have all been in those situations. I appreciate the fact that folks don't want to be in the minority. Most of us have been in that situation. So I appreciate that. But I think all of us were hoping this year, with two wars, with the deficit we have, with the challenge on health care, with the need to create jobs, and with the financial crisis we are in, that somehow it would be different for a while.

I would ask my colleague if he had the same sense of hope coming in; that this year maybe there would be a moratorium on the partisanship; that we could actually come together in the interest of the country and solve problems before going back to the elections. I would ask my friend if he was as surprised as I was that there was not only no stopping after the election but that the same folks who led things during the election are leading them right here on the floor.

If I might interject with my friend, I have been handed a note that says, in fact, there have been over 150 amendments offered by Republicans, and so our attempts have been ongoing to reach out.

So we have over 300 pages of the bill which contain Republican amendments, and that is fine. There is no ownership in the sense of who has the better ideas. In fact, what I find interesting is the insurance exchange we have in the bill for small businesses--which is at the heart of coverage of small businesses and individuals--has been offered by Republicans and Democrats. I believe distinguished former Senator Bob Dole offered some form of an exchange back during the debate when President Clinton was in office.

So we are not trying to claim a corner on ideas. There are many ideas that have been available and talked about for years. It is a matter of having the will, the commitment to actually do the hard work people expect us to do in order to get this done. I think that is what is so important about this time, when the average family is finding themselves unraveling, with not knowing if their job is going to continue to be available or if there will be a cut in wages. They are paying more out of pocket for everything under the Sun and then worrying if the employer is thinking: Well, you can have your job or your health insurance because the employer can't keep both going.

The fact is, we have lost so many middle-class jobs--and I will spend another time talking about the loss of manufacturing jobs in this country. We have lost a lot of our middle class in terms of good-paying jobs. So people are now saying: Wait a minute, just being the party of no, that is not going to be enough. That is not good enough--just saying no for political reasons. That is not enough. We want to know what you are going to say yes to. We want to know how you are going to work together. We want to know how are you going to actually solve a problem.

When someone such as Joe, from Rockford, MI, says he served in the Marines for 4 years and their motto is: ``We take care of our own,'' my question is: When are we going to come together and take care of our own Americans? I don't mean literally taking care of every person but creating opportunity for people, creating the climate for people to have a job, to have health insurance, to send the kids to college, to be able to afford to keep their lights on, and to be able to know that their country is on their side. That is what this is about. They do not want us to wait more, they want us to move quickly--move quickly on health care and jobs and all the other issues that are so important to their families.

So I thank my friend from Rhode Island for joining me, because there is a sense of urgency that people have, and we need to have that sense of urgency to get things done--to work together and to get things done. Frankly, one of the things our colleagues on the other side of the aisle have successfully done is united our caucus in its determination to not let this kind of stalling and objections and tactics, which are slowing things down, stop us from actually solving a huge problem that has gone too long unsolved for the American people.

I thank the Chair.

Mr. President, I thank the Presiding Officer and the chairman of the committee.

Mr. President, I rise today to speak concerning an amendment on which I am proud to join the Senator from North Dakota, Mr. Byron Dorgan, and other colleagues in an effort to lower the cost of prescription drugs. But I do want to make one comment on Medicare before I do that.

We know our plan, overall, is about saving lives, saving money, and saving Medicare. That is what this is about overall. That is what we are doing in our health care reform proposal for American families. But I do want to mention and stress again this is about saving Medicare. It is about strengthening Medicare and our commitment.

I do have to say, we have been hearing from colleagues, and the distinguished Republican leader has said over and over again that, in fact, cutting Medicare is not what Americans want. Then last night he said here on the floor that expanding Medicare was a plan for financial ruin. So they do not want to cut, they do not want to expand. I am not sure where our colleagues on the other side are in terms of Medicare. But I know where we are. I know we are the party that created Medicare, with President Johnson at the time. We are the party that has continued to promote and to expand and to strengthen Medicare. We are the party that intends to make sure we save Medicare for the future, expanding prescription drug coverage, to be able to close the doughnut hole, to be able to expand the ability of seniors to have preventive care, and to extend the life of the Medicare trust fund, which is critically important.

And to that, I want to speak now to the other two provisions we have as our priorities: saving lives and saving money. The Dorgan-and-others amendment, which I am proud to join Senator Dorgan on, does exactly that. It will save lives and save money. As a Senator from Michigan, I know that very well. We can look across the Detroit River into Windsor and know that the people of Michigan, by going across the bridge, would be able to drop their costs 30, 40, 50 percent.

There is something wrong with the system where Americans are paying so much more than those in other countries for the same drug. The safety provisions are the same. The difference is there have been protections put up at the American border to stop Americans from getting the benefit of having our hospitals, our pharmacies, our schools of medicine, and others who use prescription drugs to be able to bring that back, to do business across the border.

Everybody is always talking about open borders, open trade. Well, this is a trade issue about bringing back FDA-approved prescription drugs across the border to the American side, so Americans have access to lower priced medicines.

It has been about 10 years now since I did my first bus trip to Canada with seniors. I have been doing that for a long time. I have been focused on this issue both in my days in the House of Representatives, where I took the lead on this issue, as well as now working with colleagues in the Senate. It is time to get this right in the context of health care reform because this is about saving lives and saving money.

I want to share one story. I have heard so many over the years from people in Michigan. But here is one recent story of someone who has written to me.

Joe is a 40-year-old father with heart disease. His family says despite his heart condition, he is doing well. He loves to work. His medicines cost over $4,800 a month. Can you imagine that? But his insurance has a family cap of $10,000 a year. In other words, after basically 2 months, he hits the cap, and he has to pay for everything out of pocket.

By going over the bridge to Canada--and we have three bridges: up in the Upper Peninsula, we have a bridge; in Port Huron we have a bridge; and in Detroit we have a bridge, the largest cross-border bridge in terms of volume of goods and services on the northern border--but by simply going across the bridge, Joe would be able to save $2,000 a month.

We should be able to do better for Joe and his family. He could save $2,000--almost half of his cost--by simply buying the same drug, FDA approved, from one side of the bridge instead of the other.

We also know that the cholesterol-lowering drug Lipitor is about 40 percent less, also the ulcer medication Prevacid is about 50 percent less, according to a search on Pharmacy Checker. I have to say that again. This is a trade issue and whether we are going to continue to have trade barriers. Because, for instance, Lipitor is made in Ireland and Pfizer is able to bring that back to America, they can bring it back. But if someone wants to go to Windsor, Canada, right across the bridge, and purchase a lower priced version of the very same drug, Lipitor, and bring it back as an individual or a business or a pharmacy or a hospital, it is illegal. It is illegal. That makes absolutely no sense.

This amendment is about opening the border, allowing our pharmacies, allowing our wholesalers, allowing hospitals--I have gotten calls from medical schools at universities wanting to do business, to lower their cost, with wholesalers in other countries where it is FDA approved, safe to do that. That is what this bill is about.

Right now, we are in a situation where if we do not pass the Pharmaceutical Market Access and Drug Safety Act, which we have introduced on a

bipartisan basis, we are going to continue to have a situation where people such as Joe, a 40-year-old father with heart disease, is going to be paying $4,800 a month out of his own pocket, when we could cut that down. It still would be tremendous, but we could cut that by $2,000 for him, by passing this legislation.

The drug importation bill is supported conceptually. We have been working over time with many different groups such as AARP, the Alliance for Retired Americans, Families USA, and Cato Institute--very different groups philosophically, but they all agree we need more competition, we need to open the border to safe--and I emphasize and underline ``safe''--FDA-approved prescription drugs so we are focused not on what is best for the pharmaceutical industry, the brand-name companies, but what is best for American citizens who are struggling, who see their prices go up 8 percent, 9 percent, 10 percent, 15 percent every year. Families cannot sustain that.

How many of us have stood on this floor and talked about the fact that people are choosing between food and medicine? That is not just rhetoric. It is not rhetoric. It is real. It is real for people right now today. It is getting cold. It is getting very cold. People are deciding: Am I going to keep the heat on or am I going to be able to get my medicine? Am I going to be able to get my food? Am I able to get my medicine? Am I able to pay the rent, the mortgage, or get the medicine I need for my life or for my child's life or for my husband's or wife's ability to continue to live a healthy, successful life?

That is what this is about. We have an easy, straightforward way to increase competition, to bring down prices, with safe, strong safety standards. This is something that makes sense. It will help seniors. It will help people with disabilities who are in the doughnut hole before we get that all closed under Medicare. It will help every family and every individual right now who needs medicine and is paying more and more, higher and higher prices every single year.

I hope we will have a very strong bipartisan vote. This is a very important addition to what we are doing here. This truly will save lives and save money; and that is what we are all about: creating competition to bring prices down so the American people have access to the medicine and to the health care they need and deserve.

Thank you, Mr. President.

Mr. President, I ask unanimous consent that the Committee on Finance be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m., in room 215 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Exports' Place on the Path of Economic Recovery.''

Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on December 9, 2009, at 10 a.m., to hold a hearing entitled ``The New Afghanistan Strategy: The View from the Ground.''

Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m., to hold a hearing entitled ``Strengthening the Transatlantic Economy: Moving Beyond the Crisis.''

Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on December 9, 2009, at 10 a.m., to conduct a hearing entitled ``Five Years After the Intelligence Reform and Terrorism Prevention Act (IRTPA): Stopping Terrorist Travel.''

Mr. President, I ask unanimous consent that the Committee on Indian Affairs be authorized to meet on December 9, 2009, at 9:30 a.m., in room 628 of the Dirksen Senate Office Building.

Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on December 9, 2009, at 10 a.m., in room SH-216 of the Hart Senate Office Building, to conduct a hearing entitled ``Oversight of the Department of Homeland Security.''

Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on December 9, 2009, at 2 p.m., in room SD-226 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Mortgage Fraud, Securities Fraud, and the Financial Meltdown: Prosecuting Those Responsible.''

Mr. President, I ask unanimous consent that the Committee on Veterans' Affairs be authorized to meet during the session of the Senate on December 9, 2009. The Committee will meet in room 418 of the Russell Senate Office Building at 9:30 a.m.

Mr. President, I ask unanimous consent that the Committee on Banking, Housing, and Urban Affairs, Subcommittee on Economic Policy, be authorized to meet during the session of the Senate on December 9, 2009, at 2 p.m., to conduct a hearing entitled ``Weathering the Storm: Creating Jobs in the Recession.''

Mr. President, I ask unanimous consent that the Subcommittee on Science and Space of the Committee on Commerce, Science, and Transportation be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m. in room 253 of the Russell Senate Office Building.

Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs' Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m. to conduct a hearing entitled, ``The Diplomat's Shield: Diplomatic Security in Today's World.''

Mr. President, first, I thank the Senator from California for her passionate advocacy and standing up for all of us, the women of this country. She is a mom, as she said. I, too, am a mom. As hard as it is for me to believe, I am also a grandmother with wonderful 2-year-old Lily and a little grandson Walter, who was born on his daddy's--my son's--birthday in August. Obviously, they are the light of my life, as well.

One of the reasons I feel so passionate about the broader bill on health care reform is that this is about extending coverage to babies so they can be born healthy, and about prenatal care; it is about making sure that in the new insurance exchange we have basic coverage for maternity care. I was shocked to learn that 60 percent of the insurance policies offered right now in the individual market don't offer maternity care as basic care. We happen to think that is incredibly important. We are 29th in the world in the number of babies--below Third World countries--that survive the first year of life. This health care reform bill is about making sure we have healthy babies, healthy moms, and it is about saving lives and moving forward in a way that is positive, expanding coverage, not taking away important coverage for women who, frankly, find themselves in a crisis situation.

That is what we are doing, unfortunately, through the Nelson-Hatch amendment. I have great respect for both of my colleagues who have offered this amendment, and for others who feel deeply about this issue. In the bill that has come before us, I think we respect all sides and keep in place the longstanding ban on Federal funding for abortion services, and no one is objecting to that. No one is trying to change that.

As my friends have said, this is about whether we cross that line into private insurance coverage--whether we say to a woman, to a family: You are going to have to decide whether, when you have a child and you are having a crisis in the third trimester and might need

some kind of crisis abortion services--whether you are going to find yourself in a situation where you are going to need abortion services, and you are going to have to publicly indicate that and buy a rider on insurance because you can't use your own money to buy an insurance policy.

Here is what we know now. We know five States have riders right now-- Idaho, Kentucky, Oklahoma, Missouri, and North Dakota. There is no evidence there are any riders available in the individual market. So even though, technically, they say you can buy additional coverage, it is not offered or available. We are told by the insurance carriers that, in fact, it probably will not be available.

We all know what this is about. This is about effectively banning abortion services coverage in the new insurance exchange we are setting up, which could, in fact, have a broader implication of eliminating the coverage for health plans outside the exchanges. So that is what this is about, which is why it is so important.

Again, we are agreeing on the elimination or banning of Federal funding for abortions, other than extreme crises circumstances. We have done that in Federal law. This is about whether we go on to essentially create a situation where effectively people cannot get that coverage with their own money.

The Center for American Progress noted that because approximately 86 percent of the people who are going to be offered new opportunities for insurance--small businesses, individuals, in the private market--that because 86 percent of them will, in fact, receive some kind of tax credit or tax cut, in fact, again, we are talking about eliminating this option altogether because the majority of people will get some kind of a tax cut during this process.

I think there are also some broader implications around the tax policy. If we are saying that someone can't purchase an insurance policy of their liking if they are getting a tax credit to help with health insurance, the fact is, what about other tax credits? What about other kinds of ways in which people get tax credits or tax cuts today? The implications of this are extremely broad.

I urge a ``no'' vote. Let's keep Federal policy in place that doesn't allow Federal funding for abortion but respects the women of this country.

Madam President, I thank the distinguished Senator from Montana, who has been here morning, noon, and night counteracting falsehoods and scare tactics on the floor and putting forward what is really in this legislation that is so important to millions of people around the country. Everyone benefits, in one way or the other, by either costs coming down or by direct access to more affordable insurance. I thank our distinguished leader from Montana.

We have talked so much about Medicare and Medicare Advantage, but I do have to take a moment to respond to what has been said over and over on the floor. It is very difficult for me--and I know for others around the country--to listen to our friends from the other side of the aisle lamenting that they want to protect Medicare, when it was a Democratic Congress and a Democratic President who created Medicare, over the same objections, by the way. You can take a look at the objections in 1965, the debate: The world was going to come to an end if, in fact, we passed Medicare. Of course, Medicare has become a great American success story for tens of millions of seniors and people with disabilities.

Our friends now talk about how they are going to protect Medicare, at the same time that just a couple weeks ago, on the House side, 80 percent of Republicans voted to do away with Medicare as we know it today and make it a voucher system and put insurance companies back in control.

One of the frustrations for me is to hear the unfortunate negative comments that have been made about a very distinguished organization that represents senior citizens across the

country, the American Association of Retired Persons, that I might add, when we were doing the prescription drug bill, my colleagues on the other side of the aisle used in every single speech because they were supporting them at that time. Now they are supporting our position. They disagree with them. They have said:

Most importantly, the legislation does not reduce any

guaranteed Medicare benefits.

Now we are hearing how horrible they are, which I think is a real disservice to a very important national organization. I think it is important, in the name of truth and in the name of fairness, to look at quotes that have been made about AARP that are different from what we have heard on the floor today and since this debate began.

Our distinguished colleague from Arizona, who sponsored an amendment related to Medicare Advantage and has been on the floor numerous times, including today, disparaging AARP, said at an AARP convention:

I say God bless AARP--

This is the senior Senator from Arizona.

I say God bless AARP for everything they are doing, not

only for the present generations of Americans, but for future

generations. That's your duty, that's your strength, and

that's why I love to see you at every town hall meeting.

The unfortunate thing is now our colleagues on the other side of the aisle don't want to see AARP at every townhall meeting because they are not saying what they want them to say.

I also have to express concern that we had 6 years of our colleagues in full control of the Federal Government--the Presidency, House, and Senate--and we did not get legislation to bring down health care costs or legislation to make sure every American, small business, and family could afford insurance as we are doing today. So it is a little difficult, even though we have come together on other issues on health care, on this particular one it is difficult now to hear all the criticisms that are flying and all the things we should be doing, but they were not brought forward a number of years ago, when they actually were in charge and could have done something about it. That is concerning to me.

This legislation is about saving lives, it is about saving money, and it is about saving Medicare.

I wish to share one story because not too long ago--it seems like a long time since we have been working so diligently this week--it was just Thanksgiving, and families all across America came together to reminisce around the dinner table, to watch football, and share a family meal. Even in tough times we stop, reflect, and give thanks for our many blessings. I know that is true for my family, and I am sure all our families.

This year, there were 45,000 empty place settings at tables across the country for men and women whose lives were cut short because they did not have health insurance. I wish to share one story.

I ask for an additional minute.

One of those place settings was for a young man named Dr. Joe Hines, from Okemos, MI. He was a recent graduate of dental school. He had just completed his residency and had lined up a job in private practice in Detroit. He did not have health insurance. He became ill. He called his mom who urged him to go to a doctor, but he did not have insurance. He waited too long, figuring it would pass and it did not pass. It got worse. He died at age 27.

This legislation is about Joe Hines. It is about his family. It is about every one of the 45,000 families who lost loved ones this year. It is about the 14,000 people who got up this morning--today--on a Saturday, with insurance and will go to bed without it. Saving lives, saving money, saving Medicare, that is what we are fighting to do.

May I ask my friend a question. Do I understand it would be the Senator from New Jersey and then the Senator from Arizona and then myself?

Mr. President, I want to specifically respond to the Senator from Nevada who was talking about the Canadian health care system a little earlier. I appreciate the information, the education. Of course, it has nothing to do with this debate, but it was nice to hear. We now understand a little bit more about the Canadian health care system.

The great news for us is that what we are designing is a uniquely American health care system. I want to walk through the elements.

About 60 percent of the folks of the great State of Michigan get their health insurance through their employer. That will continue. We are told that either their premiums will stay the same or go down, according to the Congressional Budget Office. And we believe many of the efforts in this bill will actually bring costs down.

One of the reasons that costs will come down is those of us with insurance will no longer be paying through the back door for people who use the emergency room who are sicker than they otherwise would be. They use the emergency room and then the costs are shifted on to people with insurance. We know there is about a $1,100 hidden tax we each pay on our premiums to pay for people right now who do not have insurance and use the emergency room inappropriately. Those with insurance now will not see their insurance change in terms of how they relate to their employer and their insurance company, but they will see costs go down because others will actually have insurance and not be using emergency rooms inappropriately.

We also put in place protections for consumers, basically those, as the Senator from Minnesota was talking about, who have a preexisting condition and cannot find insurance now. Or somebody who has insurance. I don't know how many times I have heard from constituents of mine who have paid all their life and said, I don't have a problem, I have insurance, and then somebody gets sick and somebody gets dropped. They get dropped from their insurance because the insurance company does not want to pay for it.

People with insurance now will keep the system they have but will benefit from consumer protections and from gradually seeing costs come down because we are not paying for people who are using other health care services inappropriately.

We have about 80, 85 percent of the public right now who are covered with insurance, either through their employer or through Medicare, the great American success story we have been talking about, or through Medicaid, the VA, and so on. For the 15 to 20 percent of the public we are trying to provide options for affordable insurance, those are mainly people working. A vast majority of the people we are talking about work for a small business, they work part time, they work two part-time jobs, they work three part-time jobs.

I have been hearing from small businesses for years: We wish we had the same clout as big business. We wish we could pool all the small businesses and the individuals, that entrepreneur working out of their garage, that realtor who does not have a pool. Pool us and give us the same clout as big business.

That is what we are doing in this bill. Versions of this have been proposed by the distinguished Senator from Wyoming. I know back during the Clinton years during the debate, Senator Bob Dole proposed something similar. This has been a Democratic idea and a Republican idea for years.

We are calling this an insurance exchange where basically if somebody right now cannot find affordable insurance by going out by themselves in the individual market, they are going to be able to go to a place where companies will bid on the large pool of everybody who does not have affordable insurance now. Just like what we do for the Federal Government, like our insurance plan, our Federal employee insurance plan, which is an insurance exchange, someone will be able to go to a Web site or be able to get information and be able to find out about the private insurance companies that want to offer insurance to them through this insurance pool.

One of the things we are debating is whether there should be a public insurance choice for people. I believe there should be. I believe that in order to provide competition for the for-profit companies, we should have that. But the exchange is set up basically for small businesses and individuals to purchase--and we are told that people will see cheaper rates being able to do that. And to be sure they are able to do that, we are including tax cuts, refundable tax credits for individuals, for small businesses that cannot afford insurance today, to help them afford insurance. That is what the exchange is about. That will affect 15 to 20 percent of the public who do not have insurance today.

We also have in the bill another option where a State could choose to take the tax credits available to people in the exchange and could decide to pool those and do a basic health insurance plan and negotiate with an insurance company to get a better deal for people in their State.

We also have something I wish had been in place a couple of years ago for my own children, and that is, we are going to say to young people that you can stay on your parents' insurance until your 27th birthday. We also have a policy that is more geared to young people within the exchange that will be less cost to them.

Can you imagine all of the young people today, college or not, who come out, get the first job, like my children, no health insurance, who will benefit by saying you can stay on your parents' insurance until your 27th birthday? That is in this bill, and it is very important. Also basically make Medicaid for low-income individuals a safety net so that anyone below 133 percent of poverty can qualify. What that says is--and this is very important to people in my State where we have the highest unemployment rate in the country--if you lose your job, you are not going to lose your insurance. It is a very important right for Americans.

We are improving the Medicare system. We have certainly talked about that for a long time on the floor. A lot of time has been spent on the Medicare Program. We are cutting out overpayments to insurance companies, the for-profit companies right now that are being paid more than they should be and putting that back into the Medicare system to make it stronger for the future, to help pay for prescription drugs and to create more preventive care for seniors.

Then another very important piece I was very proud to coauthor with Senator Kerry relates to early retirees. We have a lot of folks who are retiring early not by choice. They are being told they are going to have to retire early at age 55 or age 58 or 59. They may or may not have insurance. If they do, they are a higher cost for their employer, and if they do not, it is extremely difficult to find affordable insurance for somebody more likely to be using health care at that point.

We have a provision where the Federal Government will partner with a business, with an insurance plan to make sure the costs are lower for the early retiree. It is called reinsurance. But for higher cost procedures or episodes, the Federal Government will come in above a certain level and cover the costs. It is a partnership between the private sector and the Federal Government to make sure early retirees, who are already being hit with a thousand different challenges as a result of early retirement, can afford insurance.

This is a snapshot of what we are doing. Again, the vast majority of people are in private employer-based insurance today. That will not change, other than this will over time bring their costs down and it will give them new protections because if something happens--and it is happening every single day where an employer has to decide, Do I pay the 30 percent increase in premiums or do I keep people employed? If people find themselves in a situation where their employer drops insurance or drops employees as a result of costs, they have another option. They have someplace to go where they cannot today. They can go into the insurance exchange. They can get tax cuts that will help them purchase more affordable insurance from a large group pool as a big business does.

Let me say that bottom line for all of this for us, despite everything that is being said, is that this is about saving lives, it is about saving money, and it is about saving Medicare. Every year we are losing 45,000 Americans who are dying prematurely because they cannot find health insurance and cannot get the health care they need. We have a variety of ways in this bill in which we are saving dollars. We have analysis from the Congressional Budget Office and Joint Tax showing that. And finally, we are saving Medicare for the future.

I yield the floor.

Mr. President, first, I wish to thank our distinguished chairman of the Finance Committee

for debunking what has just been said on the Senate floor by our colleagues on the other side of the aisle, laying out the facts of what is and is not happening with Medicare Advantage. I wish to build on that as well.

I would encourage anyone who is interested to go to the Web site of AARP, one of the organizations we know to be champions for seniors, and take a look at what they say about the myth that health care reform will hurt Medicare. They lay out several things. One is:

None of the health care reform proposals being considered

by Congress would cut Medicare benefits or increase your out-

of-pocket costs for Medicare services.

Then, just this week, in supporting our efforts, they have put out a statement, a letter, and at the end, again, they reiterated:

Most importantly, the legislation does not reduce any

guaranteed Medicare benefits.

I find it interesting that a few years ago our colleagues quoted AARP all the time when we were debating the Medicare prescription drug bill--I would guess that every single one of our Republican colleagues used their support in putting forward their bill--and now they are trying to disparage AARP, which is a very credible organization, because they don't agree with what AARP is saying. But I think the millions of people who belong to AARP will be listening to what they are saying about the fact that we are not, in fact, cutting the guaranteed Medicare benefits.

In addition to that, we have the Alliance for Retired Americans and the National Committee to Preserve Social Security and Medicare all saying they support what we are doing and they have debunked the Republicans' scare tactics point by point.

So what is happening here? The reality is that colleagues on the other side of the aisle, since the inception of Medicare, have been fighting even the existence of Medicare. It was Democrats and a Democratic President in 1965 who passed Medicare over their objections. The same arguments we are hearing today, we heard then. Now everyone sees that Medicare is a great American success story. But we have seen so many efforts.

In the 1990s, when I was a Member of the House, Speaker Gingrich said in his Contract With America in 1994 that they wanted to come in and change Medicare, they couldn't directly do it so they would do it through the back door and let it ``wither on the vine''--those famous words that we heard at that time in terms of trying to privatize Medicare, which is what I believe Medicare Advantage really is.

Then, recently, in the debate on the floor of the House of Representatives, we had 80 percent of the House Republicans support an effort to do away with Medicare at all, as we know it, as a guaranteed benefit. Instead, give vouchers to seniors to buy from private for- profit insurance companies. We know the reality of this. This is about the for-profit insurance industry that right now is receiving overpayments. Whether it is the CBO or MedPAC--any analysis will say they are receiving overpayments right now, and we are trying to ratchet that back.

What is happening? Why should folks care? Of course, taxpayers care about overpayments. We have maybe 15 to 20 percent of seniors right now who are in the Medicare Advantage Program. We have been told by the Budget Office that 80 to 85 percent will see their premiums go up to pay for overpayments to for-profit insurance companies. That is not fair. The vast majority of seniors and people with disabilities would see their premiums go up under Medicare to pay for for-profit insurance companies that try to get a piece of the action under Medicare.

Secondly, we know the Medicare Advantage Program, as the chairman has said, and in reading the report, has actually made the solvency of the Medicare trust fund worse. It is going to run out of money sooner if we don't stop these overpayments. Our legislation, rather than having it run out of money 18 months earlier, will increase the solvency by 5 years. We are committed to increasing and continuing the solvency of the trust fund and protecting Medicare for the future. We believe it is a great American success story. We are proud that Democrats were the ones who created Medicare, with a Democratic President. We are proud that it is Democrats now who are coming forward to be able to make sure we protect Medicare for the future.

What is happening here is that we are seeing a variety of stalling tactics, a variety of efforts on the other side not only to stop us from moving forward on health insurance reform, but efforts time and time again to protect the for-profit insurance companies.

For the record, I want to read to you the list of Medicare benefits everyone receives now, which will continue regardless of this--whether we cut back on some of the profits of the for-profit insurance companies: inpatient hospital care and nurses; doctor office visits; laboratory tests and preventive screenings; skilled nursing; hospice care; home health care; prescription drugs; ambulance services; durable medical equipment, such as wheelchairs; emergency room care; kidney dialysis; outpatient mental health care; occupational physical therapy; imaging, such as x rays, CT scans, and so forth; organ transplants, and a ``welcome to Medicare'' physical.

They are all covered now and will be covered under this legislation. The difference is we are going to take the overpayment to the for- profit insurance companies and put it back into Medicare to reduce the cost of prescription drugs, which has become the infamous doughnut hole, the gap in coverage. We will begin to close that by taking the excess profit for the for-profit companies and putting it back into Medicare. We are going to reduce the premiums seniors pay for drugs and medical care and eliminate copays so that people can get preventive care without a fee, and we are going to strengthen Medicare for the future.

I will wrap up by saying this: This legislation, in total, is about saving lives, about saving money, and about saving Medicare. We admit our goal is not to save the profits of the for-profit insurance companies. We are guilty of that. We are focused on making sure Medicare is strong, vibrant, and solvent for our future generations, as well as our seniors today. By the way, we are going to make sure we are saving lives and money in the process.

I strongly urge us to oppose any effort that is put forward that would be done in the interest of the insurance industry and at the expense of seniors in America. That is what these efforts to commit are all about. I hope we will reject them.

Mr. President, I have an amendment that will be sent to the desk pursuant to the unanimous consent agreement. I now call up my amendment No. 2899.

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

Mr. President, this is a very important amendment to

clarify, once again, that we are not cutting any Medicare benefits. We are not cutting any of the guaranteed Medicare benefits people receive right now. In fact, AARP, which has been saying this on its Web site for months, has released a letter now. It quotes this sentence:

Most importantly, the legislation does not reduce any

guaranteed Medicare benefits.

Not only AARP but the Association for the Protection of Medicare and Social Security, the Alliance for Retired Americans, and other seniors organizations all agree.

What we are talking about is saving Medicare, cutting down on overpayments that have been in place. Right now, 80 to 85 percent of the seniors who get their benefits, their health care, through traditional Medicare are paying more in premiums, according to the Congressional Budget Office, than they otherwise would, because MedPAC estimates we are paying about $12 billion more for people in the private for-profit insurance system right now that is called Medicare Advantage. The majority of seniors are subsidizing high insurance company profits and overpayments. What we have done in this bill is take out the overpayments and, in fact, put in competition, competitive bidding. I thought that was something our colleagues on the other side of the aisle supported--competitive bidding for reimbursements so we are not continuing the overpayments in Medicare Advantage that are causing Medicare to go broke much sooner and causing the majority of seniors to subsidize high insurance company profits.

What we are seeing on the effort, unfortunately, of my friends on the other side of the aisle is an effort to support huge subsidies instead of supporting competitive bidding that is in the bill.

The reality is that the guaranteed benefits--inpatient care, doctor visits, lab tests, preventive screenings, skilled nursing facilities, hospice care, home health care, prescription drugs, ambulance services, durable medical equipment, emergency room care, kidney dialysis, outpatient mental health care, occupational and physical therapy, imaging such as x-ray, EKGs, organ transplants, and the ``Welcome to Medicare'' physical are all covered, as they have been, for all Medicare beneficiaries.

What we are doing is taking overpayments to for-profit insurance companies and putting that back into increased benefits for every senior. That is cutting down on prescription drug costs by closing the doughnut hole and strengthening preventive care. And the most important piece of all: lengthening the solvency of the Medicare trust fund.

I urge the adoption of my amendment at the appropriate time.

Reserving the right to object, I ask that my colleague work with me. We will be happy to talk about how we might address what he is concerned about. Unfortunately, the reality is, the for-profit companies are objecting to competitive bidding. The language my colleague has suggested would include items that have been offered to the in people in for-profit plans such as gym memberships and other things that have been of great concern. Given that, I would have to object.

Mr. President, this amendment is very clear. My amendment states that nothing in this act shall result in the reduction or elimination of any benefits guaranteed by law to participants in Medicare Advantage plans.

Right now, CBO tells us, and we understand from MedPAC that there is $12 billion in overpayments to for-profit insurance companies, which are additional costs that the Medicare recipients pay beyond what is traditional Medicare.

Eighty-five percent of our seniors in Medicare are in traditional Medicare and, right now, we are told that every single senior citizen or person with disability in Medicare pays $90 extra; every couple pays $90 extra to pay for the overpayments to private for-profit insurance companies.

As AARP has said, this legislation does not reduce any guaranteed Medicare benefits. We are asking for competitive bidding--for-profit company competitive bidding--to bring down the overpayments. I ask for support for the amendment.

Mr. President, I ask for the yeas and nays.

Madam President, first, I thank Senator Mikulski for her leadership not only on this important amendment but on so many issues in health care, issues for women across this country. We are honored to call her dean for all of us as it relates to focusing on the issues that are so critical to women and their families.

I thank Senator Reid for making this a priority and making this the first amendment we are offering in this debate.

We all know that often women are the ones making health care decisions for their families as well as themselves. They are more likely to be the person making health insurance choices. Women of childbearing age pay on average 68 percent more for their health care than men do. We have so many instances in which insurance companies are standing between women and their doctors right now in making decisions--decisions not to cover preventive services, such as a mammogram screening or a cervical cancer screening, decisions to call pregnancy a preexisting condition so women cannot get health insurance, decisions not to cover maternity care so that women and their babies can get the care they need so that babies can be successful in life, both prenatal care and postnatal care.

Women of this country have a tremendous stake in health care reform. We pay more now, if we can find coverage at all, and there are too many ways in which insurance companies block women from getting the basic health services they need.

This amendment is critically important to make sure that women are able

to get preventive care services without a deductible and without copays. This amendment recognizes the unique health needs of women. It requires coverage of women's preventive services developed by women's health experts to meet the unique needs of women.

Why do we stress that? We stress that because for years we have struggled in so many areas to make sure that women's health needs were focused on and not just health in general. When we look at research through the National Institutes of Health and what it took to get to a place where research would be done for women on women's subjects or on female mice or rats rather than male subjects to make sure that the differences between men and women were considered in research, we have made important steps in that direction. Again, Senator Mikulski was leading the way as it relates to having a women's health research effort in our country.

This is one more step to make sure we are covering women's preventive services developed by women's health experts for the unique needs of women. That is what this is all about--making sure women have access to preventive services such as cervical cancer screenings, osteoporosis screenings, annual mammograms for women under 50, pregnancy and post partum screenings, domestic violence screenings, and annual checkups for women.

We know more women die of heart disease than actually any other disease. This is something I do not think is widely known. We have even heard that many physicians do not realize the extent to which heart disease is prevalent in women. All of us women have worked together on a women's heart bill and part of that is for screenings. Part of that is to make sure we are screening for heart disease and strokes, the No. 1 killer of women. This would make sure those screenings would be part of health care reform.

I could go on to list all the different prevention items, but I will simply say that when we are talking about women's health and we are talking about women's lives, this is an incredibly important amendment to adopt.

I yield the floor.