Floor Statements

Mr. President, today I am pleased to introduce the Community Health Center Capital Investment Act. I also thank my colleague, Senator Thad Cochran of Mississippi, for joining me in sponsoring this critical legislation. Health centers in both our states are committed to serving more people, and our legislation will give them a little help to do just that.

One of our most important investments in our health-care system is

funding the Community Health Center program. According to the National Association of Community Health Centers, health centers provide comprehensive primary and preventive care to over 16 million people-- including nearly 7 million uninsured--each year in more than 6,000 urban and rural communities.

One of my initial pledges when I first ran for the Senate was to increase the number of community health centers in Michigan. Since I became a Senator, there are new 15 community health centers or access points in Michigan. I am also so pleased to have had the support of so many of my colleagues in increasing funding for community health center grants. This year, 64 Senators signed the Stabenow-Bond funding request, and we were pleased that the Senate Labor-HHS-Education Appropriations bill will provide an additional $250 million increase for community health centers. This increased funding will help reach nearly 2 million people next year.

But even as we provide assistance to community health centers for operations, we cannot forget their capital needs such as renovating older buildings, purchasing new equipment, and investing in health information technology. But in general, without specific authorization in Federal law, health centers cannot use current grant dollars for construction, modernization, or expansion of facilities.

According to NACHC, one out of three health centers currently operates in buildings that are 30 years old or older. The average cost of a facility project is estimated to be $2.3 million. Many centers borrow funds for these purposes at rates that could be, and should be, lower.

Kim Sibilsky, the executive director of the Michigan Primary Care Association, wrote me: ``The majority of Michigan's 34 community Health Center organizations were founded in the middle and late 1970s, and many of their 160 community-based sites are located in facilities that require renovation to meet the changing health care needs of their communities. More readily available renovation dollars will assist Michigan Health Centers in improving access to quality health care for Michigan residents.''

One simple solution would be granting access for community health centers to use the facility assistance programs at the Department of Housing and Urban Development. If health centers were able to access HUD's loan guarantee and mortgage insurance program through the Title XI Small Medical Group Facilities Program, they would have an important tool with which to address facility concerns.

The legislation we are introducing today is a small clarification to the Title XI Program to ensure that health centers can obtain mortgage insurance under the program. But this small change will have a huge reward for our safety-net providers. It will allow them to lower the interest rate on the money they borrow, and therefore lower the cost of the project for the center. This savings will be translated directly to increased patient care.

I ask unanimous consent that the letter of support be printed in the Record.

Mr. President, first of all, I commend my colleague from Missouri for her wonderful comments as it relates to health care. Also, as to the bill in front of us, I thank the distinguished Senator from Iowa for his passionate commitment to the right things as it relates to the values and priorities for our families: health care, education, and focusing on things that really matter to families every day.

I specifically come to the floor, though, because we just saw a vote in the House of Representatives that was just completed regarding the children's

health care legislation. Unfortunately, it fell short of the override we need to have happen in order to be able to provide health insurance for 10 million children in America--10 million children of working families who are working very hard. They don't want to be on public assistance and Medicaid so that their children can get coverage; they want to work. They are working, but they are not in a position to be able to afford private health care coverage and they don't have it at work. So we are, through the children's health care program, rewarding work and rewarding the families of America who want to make sure their children have health insurance.

It is my understanding that there was just a vote that fell short. There were 273 colleagues in the House of Representatives--and I commend every one of them.

All of those who have worked so hard on both sides of the aisle in the House and the Senate should be commended again. Certainly, our leader, Senator Reid, the Speaker, Senator Baucus, Senator Grassley, Senator Rockefeller, Senator Hatch--all of our bipartisan colleagues should be thanked for their efforts one more time.

I come to the floor to say that we are not done. We are not done. The people of this country are appalled at the lack of understanding of what average families are going through today. This President will be shortly asking us to approve another $200 billion for the war in Iraq-- that will be paid for by our children, by the way, because it is not paid for; it goes on the national deficit, so our children and grandchildren will be paying for it--but says no to a program that is fully paid for, that invests $7 billion a year in making sure the children of America have health insurance. Seven billion dollars versus $200 billion, on top of another half a trillion dollars that has already been spent, on a war the American people want to stop as it is currently constituted. They want to change that mission and focus on things that will certainly keep us safer.

So I come to the floor to, first of all, commend everyone who has been involved to this point. I am very proud to be a member of the Finance Committee, where we worked very hard to put together a bipartisan agreement. But we are not done. This is a mainstream program supported by the broadest possible coalition you could have, from the business community and the large pharmaceutical companies to Families USA and to organized labor and child advocates and health care organizations. This is mainstream. This is the broadest possible coalition. Unfortunately, I regret to say it has been defeated by misinformation presented by folks who think that if they repeat long enough that somehow this covers people making $83,000 a year or repeat long enough that illegal immigrants are covered, that it somehow makes it true. Now, as the distinguished Chair knows, even in looking at the issue of documented or undocumented immigrants, even those who are here legally were asked to--were basically put in a position not to be able to receive children's health care help.

So to be able to address all of this misinformation that is out there, there is a real issue about that which needs to be fixed. So we have seen lack of information, misinformation, and more that has gone on with this proposal. In the short term, it seems to have worked, but it will not work in the long run because the reality is this is the right thing to do. It was passed 10 years ago by a Democratic President and a Republican Congress. I remember that debate. I was in the House of Representatives at the time in 1997. This was a positive step forward to support families working hard every day, trying to make sure they can put food on the table, pay the mortgage, buy the school clothes, and then have children's health care, have health care for their children, maybe be able to take them to the dentist so they don't end up with an abscessed tooth and the outrageous situation that happened with a child who died whom we all read about in the paper.

This is about moral values, priorities. When this President now comes to us asking for another $200 billion for a war that is not paid for, that is putting brave American men and women in the middle of a civil war in Iraq every day, I want to have him answer the question: Why?

Why, Mr. President, is it all right to add $200 billion more to the debt and ask our children and grandchildren to pay for it, yet you are not willing to stand with the children of America, 10 million children in America who are counting on us to be able to make sure they can get basic health care? There is something fundamentally wrong with this.

I urge colleagues to join with us. We are not going to stop until this is addressed because it is the right thing to do from a moral standpoint, and from a fiscal standpoint it is the right thing to do.

When children can't go to the doctor, their family can only use the emergency room or the child gets sicker than they otherwise would because they only have the emergency room to go to. They can't go to a doctor. The hospital pays, and then who picks up the tab? Every business that has health insurance. So from a practical economic standpoint, it makes sense. Certainly from a moral standpoint, it makes sense.

I think this is one of the proudest moments we have had in the Senate, of people of diverse backgrounds and philosophies coming together, putting the ideology at the door, and saying: You know what, this is about children. I don't know how many times I heard the chairman of the Finance Committee, the distinguished chairman, say: This is about the kids. Just keep focused on the kids. And because we did that in this Chamber, we came up with something we can all be very proud of.

The American people want to know that we reward work in this country and that we understand that families who are desperately concerned about health care for their children ought to be able to have a right to be able to purchase an affordable policy that will allow them to have their children get the health care they need.

So I appreciate our distinguished chairman of the Appropriations subcommittee allowing me to speak. I am deeply disappointed, along with people all across America, at the vote that just happened. But we are not done. Ten million children and their families are counting on us, and we are not going to stop until they have the health care they need.

I yield the floor.

Mr. President, I rise to engage in a colloquy with the distinguished senior Senator from Michigan and the distinguished chairman and ranking member of the Labor-HHS Appropriations Subcommittee. As this body debates this spending bill, I would like to start by thanking Senator Harkin, Senator Specter and the other members of the Senate Committee on Appropriations for supporting the Workforce Investment Act in this bill. The Workforce Investment Act is a critical program for workers across the country in need of training and education benefits.

WIA brings essential resources to my home State of Michigan, where hundreds of workers are ready and willing to begin job-training programs that make them more employable for high wage, quality jobs. The House-passed Labor-HHS spending bill includes a $335 million rescission of WIA funds as proposed by the administration. This potential cut would devastate the various efforts in place to reinvigorate Michigan's economy and workforce right at the time when our Governor is making great strides towards the goal of doubling the number of workers trained for high-demand jobs in the State.

In Michigan, we are using WIA dollars to create scholarships for workers who want to attend State colleges, we are counseling workers on skill development and the importance of furthering their education, and we are performing skill assessments that help workers decide what level of training they should pursue. All of these services need to be available to workers in my State.

Michigan workers have been hit hard by layoffs and I am proud that the committee has decided to support workers in my State and in all States with the resources and benefits that they need so that they can continue to support their families. I hope to see this body continue to work towards full restitution of these funds in a final bill. It is the right thing to do for our Nation's workforce system.

I thank the distinguished chairman and ranking member of the subcommittee.

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

Before the distinguished Senator from Massachusetts

leaves the floor, I thank him for his leadership in so many areas but none more important than advocating for health care and for the children of this country. As he has said numerous times, we are spending $330 million a day in Iraq and we have come together in a bipartisan way to say children should be receiving $19 million for health care; $19 million for children's health care in the United States for working families versus $330 million for Iraq.

I thank the Senator from Massachusetts for his voice. There is no one stronger or more passionate or more effective on this issue.

Also, before speaking further about health care, I thank our leaders on this very important appropriations bill in front of us, our Commerce-Justice-Science bill which Senator Mikulski has led so effectively, along with her ranking member, Senator Shelby. When we talk about changing the direction of the priorities of this country, this particular appropriations bill does that. Under the leadership of the chairwoman, we are investing in community policing, we are beefing up the FBI, we are dealing with drug enforcement, we are doing those things to keep our communities safe every day. I am very proud to support her efforts in changing the direction of this country, to focus, among other things, on keeping Americans safe and investing in science and research and opportunities for jobs for the future.

Health Care Reform

I particularly come to the floor today to speak about affordable, accessible health care--quality health care for Americans. Access to affordable health care is one of the most critical issues facing families of America, facing businesses of America. There is not a meeting I go to--whether it is with seniors, with families, with those advocating for children, with small businesses, big businesses--the No. 1 issue folks want to talk about is the skyrocketing cost of health care, health insurance premiums going up, and the difficulty in getting health insurance. They want us to come together, our Federal Government, our Congress, our President, and find a solution to something that is a national crisis.

Health care should not be a commodity. It should not be just an issue. It is a public issue, a public service, a public health issue. We are all paying the price for not having addressed this sooner.

According to a recent study by ``Families USA,'' approximately 90 million Americans have gone without health insurance for all or part of the last 2 years. These numbers are even higher than we had thought. Certainly in my home State of Michigan, where we are seeing the middle- class families across Michigan being squeezed on all sides--folks who have worked in manufacturing and continue to work in manufacturing, the industries that created the middle class of this country--they find themselves being squeezed, being asked to take less pay in order to continue to have health care for themselves and their families; more and more people falling into the category of those losing their jobs, therefore losing their health insurance. What is most amazing and important for us to understand, of the 90 million people who have not been able to get health insurance for all or part of the last 2 years, 70 percent of them are working full time.

This is a crisis and it is not acceptable in the greatest country in the world. To add insult to injury, we in America pay twice as much of our GDP for health care as any other industrialized country. We are paying twice as much, and 90 million people in the last 2 years were without health insurance for part or all of that time. This has to change. It is long past needing to change. This has to change soon.

That is why I am so pleased to be joining a bipartisan group of Senators in making a commitment to universal health coverage. I am very proud to be cosponsoring the Healthy Americans Act, which has been championed by Ron Wyden, my friend and colleague from Oregon, and his partner, Senator Bennett from Utah. It is important that we tackle this issue in a bipartisan way so both parties, so all of us, are invested in making the changes we need to make the health care system work for everybody, for all Americans--for our businesses, for our families, individuals, small towns, big cities. We have to get a handle on this. I am so appreciative of the focus and the leadership Senator Wyden is providing, in bringing all of us together to do that.

There is a sense of urgency that is needed and we are coming together to provide that sense of urgency, to say we hear it from those around the country and we are rolling up our sleeves and getting to work. This legislation is a good place for us to start, for us to develop a real solution to the health care crisis. The bill's main goal is making sure each American gets health insurance that is equal at least to what every Member of Congress gets. I would think as employees of the American people, the employer should be asking for nothing less.

It creates a strong insurance regulatory system that protects families against discrimination based on preexisting conditions. This is absolutely critical. If we are talking about a universal system that is privately administered, then you cannot have insurance companies cherry picking, covering only certain people, saying if you have some kind of a preexisting condition, you cannot get insurance. That is not going to work and this bill changes that.

It is critical that there be accountability and oversight and the regulation that is needed to make sure everyone can afford to get the insurance they need for themselves and their families. This is the goal all of us as Members of the Senate should be behind. I do understand this is a work in progress. I come to this bill with important improvements that I believe need to be done in order for me to ultimately support a final bill. As the process moves forward, it is important that certain critical improvements be made, such as people who currently have good insurance plans and want to keep them should be able to do so. We should not do anything to undermine employer- sponsored health insurance for those who choose to keep it.

Second, and this is so important, we are seeing with so many people in Michigan now, and others in the auto industry, any voluntary employee benefit association, or so-called VEBA, that results from a collective bargaining agreement must get the same tax treatment they do under current law.

Three, I believe there should be a choice of a public plan for health insurance, such as Medicare, to compete with private sector plans. When we are talking about a choice of private plans or keeping what you have, we should also add to that a public choice, so people have real competition and real choice. That is something I am advocating for.

I mentioned earlier that we need to make sure whatever is done involves the best possible consumer protections; that whatever we are doing in terms of private sector insurance, they should need to take allcomers. They should not be able to pick and choose who gets insurance based on preexisting conditions. There are other important regulatory mechanisms that need to be in place.

Finally, it is critical that there be a real safety net for low- income families who are now on Medicaid or similar programs. I strongly believe we cannot keep the status quo when it comes to health care. We cannot do it anymore. We cannot do it. It is affecting every part of our economy.

Rapidly growing health care costs are literally costing us jobs in America. When we look at good-paying manufacturing jobs in this country, I invite you to come to Michigan and talk to people who have worked hard all their lives, who have built a good life for their family, who are now, because of health care costs, losing their jobs.

American businesses are at a serious disadvantage in competing with businesses around the world that do not have to pay the same costs for health care. Our workers are being asked to take pay cuts in order to keep their coverage. Too many Americans find themselves without basic health insurance in the greatest country in the world. Shame on us. It is time to get this right.

It is past time for every American to have access to the health care they need and deserve. Let me say as part of that, we have shown what we can do as a Senate, in a bipartisan way, when we

come together and we have a focus on the goal of covering children and working families with health insurance.

Despite the President's veto, which is, to me, unexplainable, given the overwhelming need and support of American families, and even from business and labor, and health care providers coming together on a bipartisan basis here, it is mind boggling to me that the President would veto that bill. We have shown what we can do together.

I am so pleased to be working with my colleagues on the other side of the aisle, as well as with Senator Wyden, certainly Senator Bennett, but I want to particularly say I am proud to be coming to this process and this legislation at the same time as my good friend, Senator Chuck Grassley, who has shown such courage. He and Senator Hatch are heroes in terms of advocating for children's health care and showing the courage to stand up to their President. It is not an easy thing to do. But to stand up and tell the truth, to debunk what has been said as inaccurate, it is something that truly everyone in this Chamber and around the country respects and admires.

Coming to this legislation with Senator Grassley is also something that is important to me. I believe in addition to making sure that 10 million children have health insurance they need, it is time to then take the next step--universal health care for every person in America. I believe health care should be a right in the United States of America, not a privilege.

It is time to get this done. I am hopeful this legislation will serve as a starting point for Democrats and Republicans to accomplish what the vast majority of Americans want: to be able to afford good health insurance for themselves and their families.

I yield the floor.

Mr. President, I commend the leadership of Senator Mikulski in ensuring appropriate funding for the many critical activities under the auspices of the Commerce, Justice, and Science spending bill.

I also commend my colleagues, Senators Whitehouse and Kennedy, for their leadership in the critically important arena of health information technology, IT. Without their diligent work, the promises of health IT to reduce costs and improve quality of care would be very distant indeed.

Even with their dedication and that of many other colleagues, we have our work set out for us as we seek to accelerate the adoption of health IT. The Democratic steering committee heard yesterday from leaders on all aspects of health information technology--representing consumers, health care providers, business, insurers, labor, and others. All share an appreciation for what health IT can do to manage costs and ensure that patients get the care they need, at the right time, and in the best setting.

Yet they also expressed a shared sense of the need for Federal leadership and legislation to remove barriers to the adoption of health IT. These barriers include a misalignment of incentives and inadequate funding, the lack of standards adoption, and privacy and security concerns. Some of these barriers are large and will take all of us working together to find solutions. I am committed to doing so and look forward to working with my colleagues this Congress toward that goal.

There are also some barriers that should be easy to remove, and we must do so this year. One of those is the current U.S. Drug Enforcement Administration, DEA, prohibition on the electronic transmission of prescriptions for controlled substances, schedules II-V.

We know that e-prescribing saves lives, prevents injury, improves patient care outcomes, is more efficient, and saves health care dollars. One amazing statistic: According to the Center for Information Technology Leadership, CITL, e-prescribing systems with a network connection to pharmacy and advanced decision support capabilities can help avoid more than 2 million adverse drug events, ADEs, annually-- 130,000 of which are life-threatening.

It is important to note that some of the most dangerous drug interactions can occur with and between controlled substances. Preventing them from being processed electronically also prevents a physician's ability to do a computer drug interaction check to avoid what could be a fatal interaction.

Additionally, although the schedule II-V drugs account for only 12 to 15 percent of all prescriptions, the prohibition affects a much larger percentage of prescriptions for a very simple reason: of the relatively small number of physicians who have tried to move to electronic prescribing, some are giving it up entirely because they are prohibited from using it for all drugs. Physicians need to be able to use one means to write all prescriptions. If they must shift from electronic to paper depending on the patient or depending on which drug a particular patient needs, the confusion and extra time become too large a barrier to electronic prescribing. The result is a return to paper prescribing, and increased costs, increased errors, and worse health outcomes.

The prohibition on e-prescribing of controlled substances not only has a ripple effect in that it deters e-prescribing of all medicines, but it may deter adoption of electronic medical records in general. Electronic prescribing is the first step to adoption of full electronic medical records; if doctors can't efficiently adopt the process of writing prescriptions electronically, they are less likely to adopt electronic medical records.

The widespread adoption of electronic medical records could save up to $100 billion annually. Given the fact that health care will soon consume 20 percent of our country's gross domestic

product, and yet we have 47 million uninsured Americans and the highest infant mortality and lowest life expectancy of any other industrialized nation, we must do whatever we can to encourage adoption of electronic prescribing and electronic medical records, not keep in place policies that deter adoption.

I understand and appreciate that the DEA has a very important law enforcement function and needs to have the tools to enforce the laws and prosecute law breakers. However, electronic prescribing is not a barrier to that. The systems that have been used for years to transmit prescriptions electronically are secure and auditable. In fact, electronic prescribing will not only help enforcement but will create new opportunities to prevent abuse of controlled substances. Existing e-prescribing processes are actually more secure than written prescriptions. Banking transactions have been conducted for years electronically, and authorities have been able to prosecute people who misuse the technology. I am confident we can do the same with respect to any misuse regarding controlled substances.

I know that the DEA has acknowledged that e-prescribing offers many benefits and has considered ways to allow the electronic transmission of controlled substance prescriptions. And I know that DEA and Health and Human Services held a public meeting last year to begin to address this issue. That was a great first step, but progress has been very slow and now we need to solve this problem in a way that realizes the benefits of health IT, is secure, scalable within the industry, and that protects the DEA's interests.

One relatively easy fix may be to simply amend the Controlled Substances Act to permit electronic prescribing. There may be other ways to address the problem, and I am open to discussing those. What is critical is that we find a way to allow e-prescribing for all medications soon--every day we delay, the cost in dollars and lives grows. We need incentives to encourage adoption of e-prescribing, not roadblocks to adoption. Increased use of electronic prescribing will increase patient compliance, improve health outcomes, reduce medication errors, and reduce health care costs.

It is my sense that DEA should not invest additional resources in pursuing plans to allow e-prescribing of controlled substances through measures that are unnecessarily high in cost and complexity.

I join my colleagues in urging DEA to quickly adopt rules allowing electronic prescribing of controlled substances that rely on the high level of security built into the existing e-prescribing infrastructure and are deemed workable by all stakeholders.

Absent a timely adoption of such DEA rules, I look forward to working with my colleagues to find a solution to the prohibition on electronic prescribing of certain medicines this year.

Mr. President, I see the chairman of the Committee on Health, Education, Labor, and Pensions is here, and I would appreciate his comments on this issue.

Will the Senator yield for a question?

I rise with a brief question. I wish to say we would not be at this point, we would not have this bipartisan majority without the work of the Senator from Montana and Senators Grassley, Hatch, and Rockefeller. The chairman has been the person who reminds us every day that it is about the children.

Isn't it true that we do, in fact, believe we have wonderful bipartisan support, enough to override a Presidential veto here and in the House of Representatives?

Madam President, I would ask for a moment before making that final decision to talk to the chairman about an amendment. It is the amendment you have in front of you, but I came down to speak to the chairman about that. So I wonder if we might take a moment to consider the Sessions amendment and allow me to have just a moment before that decision is made.

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

Mr. President, I ask unanimous consent to speak and to have that time allocated toward the majority time in morning business.

Mr. President, a colleague and friend of mine on the other side of the aisle spoke a few minutes ago about the budget process. I come today to specifically talk about children's health care, but I think it is important to respond to what was said as it relates to the budget process and adopting a budget by October 1.

I was thinking as he was speaking, I have been here now--this is my seventh year, my seventh budget process. We have never met the October 1 deadline--never. In fact, I am not sure I remember having done it in the House when I was there for 4 years, either. We all know it is a nice political argument to make on the floor of the Senate, but it has no credibility because the reality is the October 1 deadline is something that is difficult to meet and we usually work through the fall on the budget. Everybody knows that.

What I think is significant, though, is the fact that if we are going to hold to that test as the test of responsible leadership, 6 of the last 7 years the Republican majority was in charge and 6 times they did not meet an October 1 deadline. In fact, last year, they never got a budget passed at all--at all. We came in as the new majority and had to pick up the pieces and figure out how to keep the Government going for the last half of the year. So I find it disingenuous--and I would say this to my friend if he were here--to come to the floor and make great political speeches and great theater. The reality is we all on both sides of the aisle know that the appropriators are working together now, coming to the floor on a bipartisan basis, to do what we do every single year--every single year in October and November and, unfortunately, at times into December.

But what I am very proud of is the fact that our leader, Senator Reid, and our leadership in our caucus take very seriously our responsibilities on the budget; not only putting a budget in place, but a budget with the right values, the right priorities. We are changing the priorities on behalf of the people of this country. We are changing the priorities as they relate to funding the troops and pay raises and making sure our troops have what they need. We are changing the priorities. We will be dealing with a bill later this week as it relates to the Commerce, Justice, and State appropriations where we are going to stop the cuts the President has made in law enforcement, in the COPS program, in the FBI, and in juvenile justice and drug enforcement. We will work to reinstate that and refocus us on those things that keep our communities safe, keep America safe.

I am very proud of that. I am very proud of the priorities we have been putting in place as relates to this budget. On top of that, we are not digging a bigger hole as it relates to the deficit of this country, because we have returned to a policy that was in place under the former administration, under President Clinton, that simply says if you are going to spend dollars, you have to pay for it. You either have to cut some place in order to increase another or you have to raise revenue. It is a basic principle. It ought to be a no-brainer. But that has been suspended in the last 6 years, creating the largest deficits in the history of the country.

I am happy to come to the floor and talk about budgets and process, and I am very proud of the direction we are going in.

I am also very proud of what we have done as it relates to another absolutely critical priority, and that is children's health care. We have a health care system for low-income individuals called Medicaid. If you work, two parents or a mom may be working two jobs, maybe three minimum-wage jobs to try to make sure she pays the bills and has a roof over her children's heads and food on the table, chances are she is a low-income working parent, or a couple working together, a dad working for his children. Chances are health care is going to be too expensive--just too expensive to buy in the individual market if you don't have it through the place where you work.

Ten years ago this Congress came together in a bipartisan way under a different President to say: We want to help families who are working hard every single day, who care about their children and who are doing everything they can to do the right thing--the values we should be supporting in this country, of hard work, family, and caring about our kids.

We want to help them by putting in place a children's insurance program so that at least the children of low-income working families are able to get the health care they need. It has been a huge success. We have overwhelming support from Governors, Republicans and Democrats, and State legislatures. In fact, this is the ultimate in strange bedfellows. We have the U.S. Chamber and the business community, the labor community, health care providers, children's advocates, and consumer advocates; we have the broadest possible group of Americans with the broadest possible interests that have come together to work with us to be able to design an extension of children's health care and, in fact, to be able to include additional children who qualify under that program for working families. We passed that on a huge bipartisan vote in this Senate--enough to override a Presidential veto. The House of Representatives passed it with a very large bipartisan vote.

Today, the President, we assume, will be getting this bill. There is only one thing standing between 10 million children getting health insurance in this country, the parents of 10 million children being able to sleep a little easier tonight--there is only one thing standing between that happening and those families and that is the signature of the President of the United States.

So I am here today, as colleagues on both sides of the aisle have done, to thank our leadership--Senator Reid and the bipartisan leadership of Senator Max Baucus, Senator Grassley, Senator Orrin Hatch, and Senator Rockefeller. They have done a magnificent job of doing what we are supposed to do: bring people's diverse interests together, develop a true compromise, and get things done.

I urge this President to look deep inside his heart, take a few moments to talk to some of these families before he puts his veto on this bill. This is one of the most significant things we will do in this Congress. It is one of the most significant moments for this President. He asked us, again, to fund a war that is not paid for. For 41 days of funding of that war, we could pay for 10 million children getting health insurance over the next 5 years. This is about values and priorities. It always has been.

In my home State, I can tell you we have 90,000 children and parents--families who are waiting and hoping and praying that this President will join with all of us in doing the right thing. Too many families are struggling. Health care is skyrocketing. These same families are being squeezed on all sides. Gas prices going up, health care costs are going up, they have challenges in keeping their mortgages, and what will happen to their jobs? Will they be shipped overseas? Will they get a pay cut? What is happening in terms of preparing to send their children to college? Middle-class families are being squeezed on all sides.

For a group of parents who are working very hard but don't have health insurance through their job, this Congress has done the right thing by passing a children's health care bill that will say at least your children will be able to get the health insurance they need and deserve.

When this President was at the Republican convention in 2004 accepting his nomination for reelection for his second term, President Bush said:

In the new term, we will lead an aggressive effort to

enroll millions of poor children who are eligible but not

signed up for Government health insurance programs. We will

not allow a lack of attention, or information, to stand

between these children and the health care they need.

Since that time, President Bush sent to us a budget that, in fact, as he funded it, would eliminate well over a million children who currently receive

health care under the Children's Health Care Program. We have rejected that, and we have turned to see how the program was working and found there were millions more children eligible for this very same program as the economy gets tougher and tougher for families, but the funding wasn't there to make sure those children receive children's health care as well. So we worked together, and we are now including an additional 4 million children whose families are working but have not been able to get health insurance. That, all together, equals 10 million children under the legislation we passed.

There is nothing more important we could do than to guarantee that children get a healthy start in life--whether it is the general practitioner they need to see, the dentist or whether they need mental health help. We have said the children of this country are a priority for our majority, for the Senate, for the House of Representatives.

I simply ask today at this critical moment: President Bush, please join us and sign this bill.

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

Will my colleague yield for a question?

First, I thank the Senator for his comments on the floor of the Senate, debunking what has been inaccurate statements that have been made and also for laying out the realities of what is true about this proposal. I think the Senator has done it in a wonderful way. I appreciate the Senator's willingness to stand up and talk about what is real, important, and the fact that this is such a strong bipartisan bill.

I wonder if the Senator might comment on the fact that aren't we talking about working families, low-income working families, trying every day to keep things together for their family, and they want to know that the children have health care? Isn't that what this is all about?

I also wish to thank Senators Specter and Casey for raising this issue. We have worked together to ensure the continuation of 508 while we work to ensure that Medicare reimbursement more adequately reflects our hospitals' true costs. Section 508 funding has provided crucial assistance to a number of hospitals in my State, although I note that there are still inequities in the reimbursement system that must be corrected.

Mr. President, on behalf of the leader, I ask unanimous consent that the time for morning business be extended to 11:45 a.m. today under the same conditions and limitations as previously ordered.

Mr. President, I rise today to speak about a very important and very positive issue we are going to be addressing and sending to the President this week; that is, the reauthorization of the children's health care program. This is really a historic, bipartisan effort that has been put together, and it is something we have done together for all of our families and children across America.

We urgently need to pass this bill in its final form and send it to the President of the United States. I know the House of Representatives is doing that today, and it will then come to us. There is no question that it is one of the most important things we will do this year, not only guaranteeing that some 6 million children who currently receive this children's health care program will be able to continue to get health care, but we will be expanding upwards of another 4 million children who will be able to have the health care they need and deserve.

I wish to particularly thank leaders on the Finance Committee, including Senator Baucus, Senator Grassley, Senator Rockefeller, and Senator Hatch, for working together in such a wonderful way that has given us the opportunity in the Senate to come together, with the original vote on the bill being 68 Members of the Senate--68 Members of the Senate. In addition to that, we are so thrilled to have Senator Johnson back with us so that his vote will be added as well to this very important program.

I also thank our leader, Senator Harry Reid, for making this a top priority and for personally engaging in the negotiations that took place to be able to get us to the point where we have something on which we can move forward in the House and the Senate in a bipartisan way.

This really builds on the bipartisan spirit that created the whole program in 1997. I was in the U.S. House of Representatives representing mid-Michigan at the time and felt that as we put this program together then, it was an incredibly important statement of our values and our priorities. We are talking about working families, moms and dads who go to work every day to maybe one, two, or three jobs who are trying to hold things together and desperately want to make sure their children have the health care they need. That is what this legislation is all about. That is what this program is all about.

Among many good things that have been placed into this bipartisan legislation, I am very proud to say that it makes important improvements in dental care and in mental health care for children. It looks at quality issues and health information technology. I am very pleased that language which I authored concerning creating an electronic medical record for children, a pediatric electronic medical record, is in this legislation so that we can bring children's information together around immunizations and other kinds of health care needs in one place so we can more effectively have them treated and have doctors and hospitals knowing what, in fact, a child's medical record is. I am also very pleased about another piece of the legislation I worked on in relation to school-based health centers and the importance of recognizing them as part of a continuum of care for children.

This bill really does represent a very successful public sector and private sector partnership that helps our families and makes sure more children, children of working families, are able to get health care in this country. In my State of Michigan, a private insurer runs what we call the MIChild Program. Last year, nearly one-third of the children in Michigan relied on either Healthy Kids through Medicaid for low- income children or MIChild, which represents working families, for health care coverage. About three-quarters of the children have at least one working parent. I must say that oftentimes that is mom--mom trying to, again, work one job or two jobs or three jobs, desperately concerned about her children, needing to put food on the table, needing to buy them school clothes, needing to get them what they need to be able to survive and function every day, and knowing that when they desperately need to go to the dentist, they are able to get a dental checkup, or to be able to get basic kinds of health care.

I know too many people who tell me they go to bed at night saying: Please, God, don't let the kids get sick. This program in Michigan, MIChild, and this program which we are now coming together on a bipartisan basis to expand says to those parents: Somebody is hearing you; that we as a country and as a Congress care about the children of this country and making sure they have their health care needs met.

It is so important to stress that this is not a program for wealthy families, for rich kids. We have heard so much misinformation about what this program is all about. In Michigan, a family of four cannot make over $40,000 to qualify for MIChild. This is, again, a family of four. If there are two working parents, working just barely above poverty level, this allows them to be able to get the health insurance they need for their children.

The Saginaw-based Center for Civil Justice shared a story with me about a young mother named Christie whose husband was laid off and the family income dropped to less than $2,000 a month for a family of five--less than $24,000 a year for a family of five. Nearly half of that goes to rent and utilities, like most families. The children's health care program in Michigan, MIChild, has helped their three children, who are 4 years old, 3 years old, and 8 months. Thankfully, they have been able to--in Michigan, we have had a dental benefit, which is something we are going to provide through this bill. Without that, Christie's children would not have what they need.

Recently, one of the children needed to have their tonsils removed. I remember those days with my children. It would not have been able to be done--it could have turned into a much more serious situation for that child--if it was not for the children's health care program. It makes a difference in children's lives every day.

Another mom, Pam, is a full-time preschool teacher and mother. Her monthly premiums of $384 per month, or over $4,500 per year, would have taken up a fifth of her pay if she was trying to pay through a private individual plan.

But through MICild, she was able to get the specialized care she needed for her daughter, who suffers from a rare seizure disorder. She would not have been able to care for her daughter if it were not for the children's health care program.

Like Pam, most working families simply cannot afford traditional health insurance and make ends meet--to be able to pay rent, utilities, a mortgage payment, or purchase food and school clothes, and, on top of that, find an individual policy that is affordable in the private market. According to the Commonwealth Fund, nearly three-quarters of people living below 200 percent of the poverty line found it very difficult or impossible to find affordable coverage in the individual market. Premiums for individual market coverage for families with incomes between 100 percent of poverty and 199 percent of poverty-- which is what we are talking about and what we have in Michigan--on average, one-quarter of the family's total income--25 percent--would be premiums for health care in the private market. Faced with these costs, many families just don't have the coverage because they cannot afford to do it and at the same time put food on the table. The situation is even worse for families with chronic conditions, such as asthma or juvenile diabetes. If they were able to purchase coverage in the individual market, costs would be much higher.

The children's health program, it is important to note, is not just for kids in cities, it is not just an urban program. This program helps all children regardless of where they live. In fact, according to the Carsey Institute, they found that there were more children in rural areas who were benefiting from the Children's Health Insurance Program than in urban areas--32 percent of rural children versus 26 percent of urban children. So this really is something that touches every single part of the country, every single part of our States, and families all throughout America who are working hard every day and counting on us to help them to be able to get the children's health care they need.

We are taking a huge step forward for our Nation's uninsured children, the vast majority of whom--78 percent--live in working families. Seventy-eight percent live in a home where mom and/or dad is working, but they are not making enough to be able to afford private premiums in the private individual market. Because the importance of the children's health care program is so critical for so many families, I urge my colleagues not to listen to inaccurate statements or negative attacks but to join together, as we have done, in a wonderful bipartisan effort in the Senate to send a very strong message to this President that we come together on behalf of the children and the working families of America to put our values and priorities in the right place. That is what we are talking about here. This is about choices, about values, about priorities.

This bill is totally in line with what President Bush proposed at the 2004 Republican Convention. He said at that time:

In a new term, we will lead an aggressive effort to enroll

millions of poor children who are eligible but not signed up

for Government health insurance programs. We will not allow a

lack of attention, or information, to stand between these

children and the health care they need.

Well, Mr. President, this bipartisan compromise, this bipartisan victory which has been put together in the Congress is an aggressive effort to enroll millions of poor children into a successful public- private partnership. This bill before us is a chance to make a real difference in the lives of millions of children--millions of children who, without us and the children's health care program, will not have that chance.

We need to do the right thing. Every day, as we wait, children are growing; they don't wait for us. They keep on growing whether we are debating, whether we are in committee meetings. Regardless of what we are doing, the children of America keep on growing. They keep on having needs--dental or broad health care needs or mental health needs. It is time to do the right thing. We have it within our grasp. A tremendous amount of hard work has gone into this. Let's remember the bipartisan spirit that created this great program in 1997. Let's remember that the Children's Health Insurance Program is truly a great American success story for which we can all take credit. We can join together in taking credit for it.

Let's pass this bill and, most importantly, let's together urge the President of the United States to do the right thing on behalf of the children of America.

Mr. President, I yield the floor.

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

Mr. President, I know we are in the middle of working on a very important bill, but I do wish to take a moment to respond to a press conference the President just held where he spoke about his intent to veto the bipartisan children's health care bill we will be sending to him.

It is very important we indicate that just because the President has a bully pulpit does not mean he is accurate or right. It does not matter how much spin they want to put on this situation, the reality is the President of the United States gave us a budget earlier this year-- and the Budget Committee looked at this very carefully--this President proposed a budget that would cut, according to CBO, 1.6 million children from health care, current children. So when I hear the President at a press conference talking about the fact that he wants to make sure children are covered with health insurance, actions speak louder than words.

The President asked us to put forward a budget that would cut 1.6 million children of working families who currently have health insurance from their health care. We rejected that request. We looked at the fact that there are from 6 to 7 million children who currently qualify to receive children's health insurance. Again, these are working families, folks who do not qualify for low-income help. They are moms and dads working one, two, maybe three minimum wage jobs, who are desperately concerned that at least their children have the health care they need.

I am very proud the Senate came together and in a true bipartisan effort developed a health care program, an expansion that will not only make sure every child who currently has health insurance will keep that health care, but that 4 million more children will be able to have health care in this country. Their moms and dads will not have to go to bed at night praying: Please don't let the kids get sick.

Sixty-eight Members of this Senate, not counting the fact that Senator Johnson who is now back with us would make that 69 Members, voted together in true bipartisanship to say that one of the basic values of this country is to make sure the children of working families have the opportunity to get the health care they need. It is pretty basic. This is a matter of values and priorities.

Later today, in a few moments, I am going to be joining with Families USA to announce their new study that says that 90 million Americans sometime in the last 2 years did not have health insurance. One out of three Americans sometime in the last 2 years did not have health insurance. This is a national tragedy. And for us not to at least focus on children, at least say our value as Americans is to make sure that children of low-income working families get the basic health care they need, to me is something I find incredibly important and appalling, quite frankly, that the President of the United States says on the one hand he will veto a bipartisan bill to expand health care coverage to children of working families and then have--I hate to say what I was going to say--the amazing position to come to us shortly and to ask somewhere up to another $200 billion for the war in Iraq that the majority of Americans want to see changed.

I would be happy to.

Well, my distinguished colleague is absolutely correct, and I thank him for his comments.

This is truly a question of values and priorities. That is what we are about in this business, in this Chamber, when we make decisions. The President has said the wealthiest among us are much more important than moms and dads, most of whom, by the way, are making much less than what we are talking about or the numbers the White House has put out. Those families ought to be able to, at a minimum, know that their children have health insurance when they get sick.

But what adds insult to injury, I believe, for the American people, is to know that on top of that--on top of tax priorities for the wealthy versus families and their health care--is the fact that on the one hand we have put together something that is responsible, bipartisan, and fully paid for within the budget, and yet the President is going to be sending us a request for anywhere from $150 billion to $200 billion more for a war in Iraq that the American people want to change, a policy that is not supported by the majority of Americans. To add insult to injury, none of it is paid for. It will go directly on to the national debt.

So this is a question of values and priorities. It doesn't matter, again as I said when I began, how much the President wants to spin it. We all know he has a very big megaphone, a very big bully pulpit. But that doesn't mean he is right. The spin machine cannot outweigh what is going on here in terms of American families. We have something that we have done together on a bipartisan basis. We should all be very proud of it. A basic for every single one of our families is the ability to know they can care for their children and they will have the health care they need.

Far too many families today don't get help because they do not have a low enough income. They are working and putting it together. Maybe it is a single mom, maybe it is a single dad, maybe it is mom and dad. They are putting together the income in a way where they can pay all the increased costs that everybody is having to deal with--the gas prices that are going up and the possibility of losing jobs. Certainly in my State wages are going down, and health care costs going up--all of the things that are squeezing our working families. But we are saying, you know what, one of the things we can do together, and we have already done it here and we are going to be sending it to the President, is to allow for 4 million more children to get the health care they need for those moms and dads who are working but not making enough to be able to pay for health insurance.

We, as a country, ought to be able to say we at least want the children to receive the health insurance they need. Health care, in my opinion, should be a

right for the greatest country in the world, not a privilege. Too many things have been given to the privileged in this country while working families are trying hard every day to make ends meet.

So I wish to thank all our colleagues who have worked so hard on this legislation. It is something we can all be very proud of, and I ask the President to take another look. This body together, 68 Members who voted, were not playing politics. We were coming together in a bipartisan way to be able to give more children, American children, the ability to get their health care needs taken care of. It is time we had the President join with us in the right set of priorities for American families.

I yield the floor.

Mr. President, I first thank my friend and colleague from Wisconsin for his foresight and his leadership on this very critical issue, the most critical issue facing our country.

I rise today to support the Feingold amendment, as I have in the past. The American people want us to stop this direction we are going in and to, in fact, bring our military home so they can be effectively refocused, to redeploy to address the real threats that are facing America.

We all heard during the Armed Services hearing the distinguished Senator from Virginia, Mr. Warner, ask what I think is the most important question to General Petraeus. After General Petraeus had laid out the strategy and what was happening on the surge, Senator Warner asked him: General, are we safer? Is America safer? He then first began to answer that question by talking about the fact that he was proceeding on the mission that had been given to him.

Then he was asked again, and I believe it was the third time he was asked by the Senator. He was asked: Is America safer? The general said: I don't know.

Three-quarters of a trillion dollars spent, lives lost--thousands of lives, hundreds of thousands of Iraqis and innocent civilians--and the answer is: I don't know. I think the American people do know.

I think the American people understand that when we are directing our forces--our brave men and women, the best trained, the most highly recognized and effective troops in the world--when we are placing them in the middle of a civil war in Iraq, and then we turn on our television sets and we see the man who has the organization that attacked us and killed over 3,000 Americans on American soil speaking to us through a video, commenting on American politics and what is happening here in the Senate, they are appalled. People understand we should be addressing ourselves to the people who attacked us and the real threats we have. We know where they are, at least close to where they are. We know the region, and we need to redeploy our troops to address the threats that have, in fact, been serious for America--not the middle of a civil war, but the people who attacked us, and those now who have joined them in their cause.

My husband is a veteran of the Air Force and the Air National Guard; 14 years. He reminds me all the time that our men and women in uniform are doing their duty to complete the mission that is laid out for them in a democratic society by their civilian leaders, by their President, by their Congress. They look to us, they are counting on us to make sure it is the right one, to give them what they need, but to also give them a strategy that makes sense. They are counting on us to ask tough questions, to probe. They are there putting their lives on the line every single day. Their families are at home sacrificing every single day, and they are counting on us to get this right.

As one of the people who voted no on going into this war in Iraq, I now join with colleagues in saying: Enough is enough. This has to change. There are real threats. We need to refocus and redeploy in the name of safety for Americans. But we need to make sure we are ending this civil war participation we have put our soldiers into. The Feingold amendment does this. It brings our troops home and refocuses them, redeploys them, as we should, in a way that will truly focus on the ways to keep us safe for the future, so that

when the next general is testifying before the Armed Services Committee and that general is asked: Is America safer, we can join together and say yes.