Floor Statements

Mr. President, following leader remarks, the Senate will resume consideration of the health care reform legislation. The first 3 hours will be for debate only. That time will be equally divided and controlled between the two leaders or their designees and controlled in 45-minute alternating blocks of time. The majority will control the first block. We anticipate reaching an agreement to have a series of votes beginning at 2:30 this afternoon. Senators will be notified as soon as possible with regard to when the votes will actually occur.

Mr. President, yesterday, Friday, 14,000 people lost their health insurance in America. Today, Saturday, another 14,000 people will lose their health insurance, and Sunday and Monday and Tuesday and on and on. Every day, 14,000 people lose their health insurance in America. The American people don't get weekends off from this injustice. Bankruptcy doesn't keep bankers' hours. They do not go away just because it is Sunday or Saturday. The pain is still there. So our work continues this weekend. It will continue until we give this Nation's citizens a health insurance system that works for them.

Tens of millions of Americans, those with coverage and those without coverage, know all too well right now that the system is broken. They do not need academic studies or congressional investigations or politicians' speeches to tell them health care is in critical condition. Every day they live with it, and every day some even die with it or because of it.

Next year is just around the corner. It is just weeks away. In the new year, a whole lot more Americans are about to learn just how broken our system is. You see, last year one of America's largest private insurance companies made about $1 billion. In fact, it was more than $1 billion. Its chairman and chief executive officer took home $100 million himself. But this health care company isn't going to make enough this year, by their estimation. The healthy profit of this health insurance company, by their standards, is not healthy enough because its executives

have decided that the profit they are making--and remember, more than $1 billion, with the boss taking home more than $100 million--isn't enough. So this multibillion-dollar company found a clever way to make more money next year. How? Raising rates.

As one might expect with the insurance industry, being as callous as it is, those higher premiums are going to be too expensive for many. Some analysts say that as many as 650,000 people insured by this company will no longer be insured by the company. They will have to find other insurance or go without. Now, 650,000 is more than the entire population of North Dakota, more than the population of Vermont, and more than the population of Wyoming. It is more than the entire populations of Baltimore and Boston and Denver and Seattle. How many people is this one company going to drop? You could count every man, woman, and child in Las Vegas and still have 100,000 people left over. Las Vegas is as big as Boston, Baltimore, Denver, and Seattle. But here is the worst part: That shocking estimate comes directly from the president of the company himself--the man who made more than $100 million last year. That means the company devised this strategy, crunched the numbers, and saw how many American families it was going to hurt. Then the bosses shrugged their shoulders and decided to go ahead anyway.

We would hardly stand idly by as a country if every citizen of one of our States was left out in the cold. And that is, in fact, what we have here. We would never consider doing nothing if every resident of one of our biggest cities was, in fact, hung out to dry, but that is the equivalent of what just one company is doing--just one of the countless health insurance companies that care about nothing except profits.

Others may suggest the system is just fine the way it is. We on this side of the Senate do not believe that.

Why are they able to do this? Well, one reason they are able to do it is they are not subject to the antitrust laws. They can conspire to fix prices, as we have indicated, and there are no civil or criminal penalties.

Some may suggest the system is fine just the way it is. We don't believe that.

Just this summer, the junior Senator from South Carolina said what we need to do is ``get out of the way and allow the market to work.'' Well, the market sure worked fine for this insurance company. It is working fine right now. The problem is, it doesn't work for the American people, only for the big shots of these insurance companies.

Just last week, my distinguished counterpart, the Republican leader, said the health care crisis is ``manufactured.'' Those were his words: The health care crisis is ``manufactured.'' In one sense, he is right. It has been manufactured by the greedy insurance companies, just like the one I mentioned earlier, companies that claim to be in the business of helping people stay healthy when they are actually in the business of making as much money as they can. They raise families' rates on a whim, deny coverage because someone has a preexisting condition or they are a woman or they are too old, with concern for nothing but their own executives' personal bank accounts.

The question before the Senate is, How many more of our own citizens will we sentence to such a fate? How much longer will we look the other way while our neighbors suffer right in front of us? How much more are we going to charge those fortunate enough to have insurance in order to cover the many who don't? Right now, every individual who has insurance pays at least $1,000 a year more because of the uninsured going to emergency rooms all over the country. I ask my colleagues, How much longer will we enable the insurance companies to deny health care to the sick? How much longer will we let those companies force thousands upon thousands of Americans into bankruptcy while they rake millions of dollars of cash into their pockets? That is the reality.

Opponents of progress have tried to drown out this truth with distortions, distractions, and dishonesty. But, as John Adams observed a long time ago, facts are stubborn things.

Here is one of the most startling facts: Last year, 750,000 people filed for bankruptcy. Seventy percent of those who filed for bankruptcy did so because of medical expenses, and 62 percent of those who filed because of medical expenses had insurance. What a sad commentary. In the year World War II ended, President Harry Truman warned that many of us were vulnerable to what he called ``the economic effects of sickness.'' In the 64 years since, it has only gotten worse.

Here are some facts--facts about what our legislation will do: The legislation before this body will make sure every American--nearly every American, at least 97\1/2\ percent--will be covered with insurance. It will not only protect those seniors on Medicare, it will make it stronger. It will make sure more than 30 million Americans who don't have health insurance now will soon have it. It will not add a dime to our deficit. In fact, in the next 10 years it will reduce it by $130 billion and over the next 20 years by almost $\3/4\ trillion.

We are even making this bill stronger than when it was introduced, this bill here. For example, because we have added Senator Mikulski's amendment to the legislation, women can now get the mammograms, checkups, and other preventive tests they need in order to stay healthy, at no cost. We made it better by reaffirming our commitment to seniors who rely on Medicare and Medicare Advantage, guaranteeing they will always get the care they need and the quality of life they deserve. We made it better by ensuring that the money dedicated to the health care of America's seniors and people with disabilities should be used only for those precise payments. And today, we will continue to make it better with an amendment by Senator Lincoln of Arkansas that stops irresponsible tax breaks for millionaire health insurance executives and starts to use companies' revenues to strengthen Medicare.

The fact is, our bill will, in short, save lives, save money, and save Medicare. It will make it possible for each and every American to afford to live a healthy life. We can't afford not to do this.

Will the Chair now announce the business before the Senate.

Mr. President, following leader remarks, the Senate will resume consideration of the health care bill. The time until 11:30 a.m. is equally divided and controlled between the leaders or their designees. The majority will control the first half and the Republicans the second half.

We have a number of votes we are going to try to arrange this afternoon. We will let all Senators know as soon as we have this worked out, but there will be some votes today and tomorrow.

Mr. President, the amendment process continues to crawl forward, and this historic health reform bill continues to evolve and improve. This is a good bill. It saves lives, saves money, and saves Medicare. It makes health insurance more affordable, makes health insurance companies more accountable, and makes our economy stronger. The Democrats know we can make it even better. This is happening because of the dedicated hard work from throughout the Democratic caucus--from veteran Senators and newer Senators, by the hands of men and women from diverse parts of the country and good public servants from all points of the political spectrum.

Senator Mikulski of Maryland, who for decades has been a champion for women's health, made it better by making sure women can get the mammograms, the checkups and preventive care they need to stay healthy and get them at no cost.

Senator Bennet of Colorado, who has served skillfully in this body for less than a year, made it better by reaffirming our commitment to Medicare. He made it better by ensuring seniors get the care they need and the quality of life they deserve.

That positive trend will continue today. Senator Whitehouse of Rhode Island, who came to Congress with a class of Senators elected with a strong mandate to change the way Washington works, has proposed an amendment based on common sense and accountability. It says the money dedicated to the health care of American seniors and of people with disabilities should be used only for those precise purposes.

Unfortunately, Senate Republicans are less interested in solving problems than they are in creating them. The day before this floor debate began, the assistant Republican leader--the junior Senator from Arizona--said: ``There is no way to fix this bill.'' Of course, that is absolutely totally wrong.

All Senators know there is a reliable way to improve legislation--to improve this bill. It has been in use for 220 years. It is called the legislative process. It is called doing our job.

As this bill continues to improve, I, once again, remind my colleagues not to lose sight of the bigger picture. As we delve into the details and debate the fine print, let us not forget why we are here. Our goal remains the same it was the day we began this debate many months ago. It remains the same as it was a year and a half ago, when Senate Finance Committee chairman Max Baucus first held a series of hearings that led to the legislation that is now before us.

Our goal remains the same as it was last November when the American people called in a loud and clear voice for change. It remains the same as it did 31 years ago, when Senator Ted Kennedy called it shameful that ``in our unbelievably rich land, the quality of health care available to many of our people is unbelievably poor, and the cost is unbelievably high.''

It remains the same as it did the day President Truman sounded a call to action to ensure that American families are protected from what he called ``the economic effects of sickness.'' That was more than 64 years ago, and more than half of today's Senators weren't even born then. That constant goal has been and remains this: We must make it possible for every American--each and every American--to afford to live a healthy life.

Each moment in this fight is historic. No bill to put health care decisions in the hands of the people has ever come this far. But the most historic days of the journey lie ahead. We can only seize that opportunity if this debate is about facts, not about fear.

I remind my colleagues that if we are to truly help the American people and the American economy, if we are to sincerely do the work our neighbors sent us to do, if we are to leave our children and grandchildren a better inheritance than a deep deficit and a broken health care system--if we are to do any of these things--we must work together and not against each other. We must work as partners, not as partisans.

This is not the first time I have asked my Republican friends to think of the real families across this Nation who face real problems-- families with real diseases, real sicknesses, real medical bills, and real fears. It is not the first time I have warned that America has no place for those who hope for failure.

This is not the first time I have extended my hand across the aisle and asked my Republican friends to abandon their shortsighted strategy to bring the Senate to a screeching halt; for example, issuing an informational guide on how to stop and slow things. That doesn't work. We need a strategy that says we can win because that will mean the American people do not lose.

So I hope that, for the first time, we will have people of good will on the Republican side of this Chamber who will walk over and say: Let's work together to get some things done. I have had a couple good conversations the last few days with some of my colleagues on the other side of the aisle. I hope we can move forward. This is a bill that doesn't look at a person who is sick or hurt or afraid as being a Democrat or a Republican or an Independent. They are Americans. They are from Virginia, Montana, Nevada and from all over America and they are people who are calling upon us to do the right thing.

Mr. President, I would say through the Chair to my distinguished colleague, the senior Senator from Kentucky, that we are going to come in at 10 in the morning. At this time, it appears Senator Lincoln will be offering an amendment, and I would hope we can be ready at that time to have whatever the minority wants to do in regard to that amendment. Then we are going to have an amendment offered by the Republicans. I would hope that we can dispose of those two amendments tomorrow, maybe in the early afternoon--maybe 2:30 or 3 o'clock start voting on them.

In the afternoon. I think we will need some debate in the morning.

Then Sunday morning, at the request of the Republican leader, we are not going to come in until noon, or thereabouts.

There is an event in Washington that a number of Senators are obligated to go to that is in the evening, so we will get everybody out of here by 6, 6:30 that night, at the latest.

I would also say, Mr. President, through the Chair to my friend, that we Democrats are going to have a caucus--tentatively scheduled to have one Sunday afternoon.

Madam President, following leader remarks, the Senate will resume consideration of H.R. 3590, the health reform legislation. There will be up to 10 minutes, equally divided, between the managers of the bill. The remaining time until 11:45 a.m. will be divided and controlled equally between Senator Mikulski and the minority leader or their designees.

At 11:45 a.m., this morning, the Senate will proceed to a series of two rollcall votes. The first vote will be in relation to the Mikulski amendment, No. 2791, as modified, to be followed by a vote on the Murkowski amendment, No. 2836.

Following those votes, the time until 2:45 p.m. will be equally divided and controlled between Senators Baucus and McCain or their designees. At 2:45 p.m., the Senate will proceed to vote in relation to the Bennet of Colorado amendment, No. 2826, to be followed by a vote in relation to the McCain motion to commit.

All four votes today will be subject to a 60-vote affirmative threshold for adoption.

I would be happy to yield.

Of course. I think it very likely we wouldn't come in until noon, or somewhere around noon on Sunday.

I would indicate to my friend it appears that the next opportunity for amendment will be when we complete this. It is my understanding Senator Ben Nelson is ready, he has an amendment, and I think we have given it to your staff. This may be one where it is sponsored by people on your side also, and then we will wait to see what your next amendment will be.

We will show those to each other before that happens.

Madam President, we in this Chamber, a lot of times, talk as if no one is listening to what we are saying, as though we are talking to ourselves. But that is not true. The American people are listening and they are watching. That is good. But this morning I have good news and I have some bad news. The good news is, Senate Republicans finally--finally, at long last--have put a detailed plan down on paper. The bad news is, it is not as we had hoped--a plan to make health insurance more affordable, it is not one that makes health insurance companies more accountable, and it is certainly not a plan to reverse rapidly rising health care costs and draw down our deficit, such as the plan that has been submitted to the Senate and is now before the Senate by the Democrats.

Again, the plan we had hoped to receive from the Republicans would be to

make insurance more affordable, it would be one to make health insurance companies more accountable, and it would be a plan to reverse the rapidly rising health care costs and draw down our deficit. But, no, the Republican plan we have waited weeks and months to see doesn't do any of those things. In fact, it is not even about health care at all, even though it is on the health care bill, this plan they have outlined. The first and only plan Senate Republicans bothered to draft is an instructional manual on how to bring the Senate to a screeching halt. We knew that was happening anyway, but they had the audacity to put it in writing.

Madam President, I ask unanimous consent to have printed in the Record the letter I will be referring to.

Madam President, here are some of the highlights of the Republican plan laid out in the letter I referred to:

Tips on how to force the full reading of all amendments--long amendments, short amendments.

I have no objection to transparency. That is important. Every Senator should know what he or she is voting on, but let's be truly transparent. We all know that those who would ask for such readings have no intention of sitting in this Chamber, listening to the Senate clerks. Any suggestion otherwise is simply disingenuous.

This document explains how to manipulate points of order. Yes, that is what I said, manipulate points of order--a complex but important part of the legislative process. Yet these Senators have no intention of examining the procedures of the Senate or any constitutional rules.

The document says it in plain language. The whole purpose of the document, dated the day before yesterday--December 1--a ``Dear Republican colleague'' letter, is to set forth how to slow things down, as if they needed more help to slow things down. Ninety-one times this year they have already done that. But on this bill--this bill that affects every person in America--to put in writing that they are going to do everything they can to stop this, to delay this, is beyond something that I think the American people can comprehend.

The document says in plain language that is their intention. It even condones using this tactic ``without cause.'' Do this without any reason. Just do it. The rules allow it, so go ahead and do it. It stalls things. This letter admits, in no uncertain terms, that the goal of this tactic is to delay. I didn't make up the word. It is in here. It is as clear as day.

But there is more in this plan. It also advises Senators on how to ``extend consideration of a measure,'' which motions ``may be filibustered,'' and when Senators might ``offer an unlimited number of motions.''

Well, as we see in the press, today, anyway, this has caused outrage. It is a catalogue of obstructions--a catalogue of instructions to obstruct. But what disappoints me most about this is what isn't here. Nowhere in this Republican plan is a strategy to lower premiums; not a single word about how to make sure more of our citizens can afford to stay healthy; can't even find one idea for stopping insurance companies from denying health care to the sick. You see, my Republican friends have been so busy coming up with games and gambits, with ways to distort and delay, with scare tactics and stalling tactics, that they haven't left time to come up with solutions to one of the most profound crises in the history of our country. The Senate might be interested to learn that the architect behind this blueprint is none other than the former chair of the Budget Committee, the senior Senator from New Hampshire. It is worth noting that this Senator--who, more than any other, often speaks publicly about how to properly use citizens' tax dollars--has now signed his name to a plan with the explicit goal of wasting the taxpayers' time and money.

Less than 2 weeks ago, the author of this document, along with every single one of his fellow Republicans--every one--voted against even letting the Senate debate this bill. He didn't even want to give the American people the opportunity to watch this debate take place--to discuss and defend his position. Now he expects us to believe his only motive is making sure the minority party's voice can be heard.

No one believes that because it couldn't be any further from what the Founders had in mind. They didn't write this esteemed body's rules so we could stare at the hands of the clock--which are right up here--as they rotate around each other without end. So let's not pretend the Republican strategy is anything different than what it is. After all, Republicans certainly aren't trying to hide it.

When I see these kinds of political games, I think of many cases in Nevada and around the country, but, in particular, I think of a woman from Las Vegas named Alysia. She wrote me a letter when the health care debate was getting underway. She is in her early twenties. I don't know if she is a Democrat, an Independent, or a Republican. It doesn't matter. She was born with a kidney disease, a bad kidney disease. She has suffered with it every day of her life, and these days she desperately needs surgery. But she is not going to get surgery.

Similar to so many in Nevada and across the Nation, Alysia recently lost her job. With her job lost, she lost her insurance and her health care. So Alysia went out and tried to buy a new plan to help her afford her care. No one will give her insurance. She can't find a job to get group insurance.

What did the insurance companies tell her--plural? That her kidney disorder is a preexisting condition, and because of that policy of the insurance industry, which is reprehensible, they refuse to cover her. They refuse to cover this young woman at the exact moment she needs it the most. She then tried to go get some help from Medicaid. What did she hear in response? She doesn't qualify because she isn't pregnant, she doesn't have children, and they say she doesn't have a disability.

So how can you take a woman such as Alysia out of your mind? I think she is probably following this debate. It means a lot more to her, this debate, than a legislative exercise or a political objective. She will pick up the newspaper this morning, turn on the news, or go online to read about what is happening in the Senate. Why? Because it affects her health--her pain and suffering. She probably remembers her grade school textbook teaching her that this is the world's greatest deliberative body and she is eager to find out about how those deliberations are going. She is eager to learn what we are going to do with a system that makes it impossible for her to get health care.

Who knows, she might even be watching C-SPAN as we speak. Can you imagine being Alysia and going through all that she has gone through, counting on your leaders to right the wrongs that we know exist, and this is what she finds--a Senator writing a letter on how to guide avoiding the tough decisions that will affect her life and maybe even save her life.

It is not hard to imagine. We all know you don't have to have a bad health history, such as Alysia's, to tell a similar story of your own. You may have had an accident in your early days. You may have diabetes. It doesn't matter. You don't need kidney disease for insurance companies to take away your health insurance. As it stands now, they can deny you coverage because of high cholesterol, because you have allergies or maybe you have had minor surgery or maybe because you are a woman. Maybe your mom had breast cancer. These are all reasons they use to deny coverage.

We all know that, much like our Republican colleagues, insurance companies will use any excuse in the book to just say no.

For many good people in Nevada and throughout the Nation, it is a painful, terrible reality. That is one of the many problems our good bill fixes.

The American people see transparent tricks like this--it is a shameful scheme--for what they are. The American people could not be impressed. They are not impressed. I can't decide which should disappoint the American citizens more, that the Senate Republicans are happily wasting time or that they are so eager to admit it. But here is one thing I do know, this is no way to govern, no way to legislate, this is no way to lead, and especially no way to lead our country, our constituents,

back to health. The bill before the Senate saves lives, saves money, and saves Medicare.

Exhibit 1

U.S. Senate,

Washington, DC, December 1, 2009.

Dear Republican Colleague: As we embark on Senate debate of

Majority Leader Reid's massive $2.5 trillion health care

reform legislation, it is critical that Republican senators

have a solid understanding of the minority's rights in the

Senate.

I think that we can all agree that the Democrats' bill is

the wrong choice for our nation. It will impact one-sixth of

our economy, vastly grow the government, and pile tremendous

debt on future generations. We are at an important crossroads

both for the economy and for the health care system.

Therefore, it is imperative that our voices are heard during

this debate.

We, the minority party, must use the tools we have under

Senate rules to insist on a full, complete and fully informed

debate on the health care legislation--as well as all

legislation--coming before the Senate. As laid out in the

attached document, we have certain rights before measures are

considered on the floor as well as certain rights during the

actual consideration of measures. Every Republican senator

should be familiar with the scope of these rights, which

serve to protect our ability to speak on behalf of the

millions of Americans who depend on us to be their voice

during this historic debate.

I hope you find the attached information helpful. If you

have any questions, please contact my communications office.

Sincerely,

Judd Gregg.

Foundation for the Minority Party's Rights in the Senate (Fall 2009)

The Senate rules are designed to give a minority of

Senators the right to insist on a full, complete, and fully

informed debate on all measures and issues coming before the

Senate. This cornerstone of protection can only be abrogated

if 60 or more Senators vote to take these rights away from

the minority.

I. Rights Available to Minority Before Measures are

Considered on Floor (These rights are normally waived by

Unanimous Consent (UC) when time is short, but any

Senator can object to the waiver.)

New Legislative Day--An adjournment of the Senate, as

opposed to a recess, is required to trigger a new legislative

day. A new legislative day starts with the morning hour, a 2-

hour period with a number of required procedures. During part

of the ``morning hour'' any Senator may make non-debatable

motions to proceed to items on the Senate calendar.

One Day and Two Day Rules--The 1-day rule requires that

measures must lie over one ``legislative day'' before they

can be considered. All bills have to lie over one day,

whether they were introduced by an individual Senator (rule

XIV) or reported by a committee (rule XVII). The 2-day rule

requires that IF a committee chooses to file a written

report, that committee report MUST contain a CBO cost

estimate, a regulatory impact statement, and detail what

changes the measure makes to current law (or provide a

statement why any of these cannot be done), and that report

must be available at least 2 calendar days before a bill can

be considered on the Senate floor. Senators may block a

measure's consideration by raising a point of order if it

does not meet one of these requirements.

``Hard'' Quorum Calls--Senate operates on a presumptive

quorum of 51 senators and quorum calls are routinely

dispensed with by unanimous consent. If UC is not granted to

dispose of a routine quorum call, then the roll must continue

to be called. If a quorum is not present, the only motions

the leadership may make are to adjourn, to recess under a

previous order, or time-consuming motions to establish a

quorum that include requesting, requiring, and then arresting

Senators to compel their presence in the Senate chamber.

II. Rights Available to Minority During Consideration of

Measures in Senate (Many of these rights are regularly

waived by Unanimous Consent.)

Motions to Proceed to Measures--with the exception of

Conference Reports and Budget Resolutions, most such motions

are fully debatable and 60 votes for cloture is needed to cut

off extended debate.

Reading of Amendments and Conference Reports in Entirety--

In most circumstances, the reading of the full text of

amendments may only be dispensed with by unanimous consent.

Any Senator may object to dispensing with the reading. If, as

is often the case when the Senate begins consideration of a

House-passed vehicle, the Majority Leader offers a full-text

substitute amendment, the reading of that full-text

substitute amendment can only be waived by unanimous consent.

A member may only request the reading of a conference report

if it is not available in printed form (100 copies available

in the Senate chamber).

Senate Points of Order--A Senator may make a point of order

at any point he or she believes that a Senate procedure is

being violated, with or without cause. After the presiding

officer rules, any Senator who disagrees with such ruling may

appeal the ruling of the chair--that appeal is fully

debatable. Some points of order, such as those raised on

Constitutional grounds, are not ruled on by the presiding

officer and the question is put to the Senate, then the point

of order itself is fully debatable. The Senate may dispose of

a point of order or an appeal by tabling it; however, delay

is created by the two roll call votes in connection with each

tabling motion (motion to table and motion to reconsider that

vote).

Budget Points of Order--Many legislative proposals (bills,

amendments, and conference reports) are subject to a point of

order under the Budget Act or budget resolution, most of

which can only be waived by 60 votes. If budget points of

order lie against a measure, any Senator may raise them, and

a measure cannot be passed or disposed of unless the points

of order that are raised are waived. (See http:// budget.senate.gov/republican/pressarchive/PointsofOrder.pdf )

Amendment Process

Amendment Tree Process and/or Filibuster by Amendment--

until cloture is invoked, Senators may offer an unlimited

number of amendments--germane or non-germane--on any subject.

This is the fullest expression of a ``full, complete, and

informed'' debate on a measure. It has been necessary under

past Democrat majorities to use the rules governing the

amendment process aggressively to ensure that minority

Senators get votes on their amendment as originally written

(unchanged by the Majority Democrats.)

Substitute Amendments--UC is routinely requested to treat

substitute amendments as original text for purposes of

further amendment, which makes it easier for the majority to

offer 2nd degree amendments to gut 1st degree amendments by

the minority. The minority could protect their amendments by

objecting to such UC's.

Divisible Amendments--amendments are divisible upon demand

by any Senator if they contain two or more parts that can

stand independently of one another. This can be used to fight

efforts to block the minority from offering all of their

amendments, because a single amendment could be drafted,

offered at a point when such an amendment is in order, and

then divided into multiple component parts for separate

consideration and votes. Demanding division of amendments can

also be used to extend consideration of a measure. Amendments

to strike and insert text cannot be divided.

Motions to Recommit Bills to Committee With or Without

Instructions--A Senator may make a motion to recommit a bill

to the committee with or without instructions to the

Committee to report it back to the Senate with certain

changes or additions. Such instructions are amendable.

AFTER PASSAGE Going to Conference, Motions to Instruct Conferees,

Matters Out of Scope of Conference

Going to Conference--The Senate must pass 3 separate

motions to go to conference: (1) a motion to insist on its

amendments or disagree with the House amendments; (2) a

motion to request/agree to a conference; and (3) a motion to

authorize the Chair to appoint conferees. The Senate

routinely does this by UC, but if a Senator objects the

Senate must debate each step and all 3 motions may be

filibustered (requiring a cloture vote to end debate).

Motion to Instruct Conferees--Once the Senate adopts the

first two motions, Senators may offer an unlimited number of

motions to instruct the Senate's conferees. The motions to

instruct are amendable--and divisible upon demand--by

Senators if they contain more than one separate and distinct

instruction.

Conference Reports, Out of Scope Motions--In addition to

demanding a copy of the conference report to be on every

Senator's desk and raising Budget points of order against it,

Senators may also raise a point of order that it contains

matter not related to the matters originally submitted to the

conference by either chamber. If the Chair sustains the point

or order, the provision(s) is stricken from the conference

agreement, and the House would then have to approve the

measure absent the stricken provision (even if the House had

already acted on the conference report). The scope point of

order can be waived by 60 Senators.

Availability of Conference Report Language. The conference

report must be publicly available on a website 48 hours in

advance prior to the vote on passage.

Mr. President, I ask unanimous consent that the Senate be in a period of debate only between now and 4:30. It is my understanding there has been an agreement that at 4:30 we will all go to the classified room in the Visitor Center to listen to what the administration has to say about Iraq and Afghanistan. I haven't had a chance to clear this with the Republican leader, but for the next hour we will remain in a period of debate only and come back and offer the amendment after we finish with the classified briefing.

We have not yet had agreement to recess at 4:30. I ask unanimous consent that we recess from 4:30 until 5:30 for a classified briefing.

Mr. President, I rise today to recognize the work of Jeffery D. Rupert, who served as executive assistant to the U.S. Capitol Police Board from August 2003 to December 2009.

Pursuant to Public Law 108-7, section 1014(c) Congress established the position to act as a central point for communications and enhance the Police Board's work. In his capacity as the first executive assistant to the board, Mr. Rupert built the job from the ground up, developing policies, initiating procedures, and establishing an archival system which will serve as a historic chronicle of board security decisions.

Mr. Rupert contributed greatly to the safety and security of the Capitol Complex during his tenure, which included board support for two Presidential inaugurations, two dozen joint sessions of Congress, and other major special events and demonstrations.

Additionally, Mr. Rupert's regular daily duties enhanced the overall effectiveness and efficiency of the board's oversight activities. Whether he was coordinating a meeting or writing legal analysis, Mr. Rupert paid great attention to detail.

His more than 6 years of work were critical in supporting preparations for potential terrorist attacks and included a vast span of expertise in law enforcement, safety, and security issues. He served the USCP and the Capitol Police Board honorably in the aftermath of the ricin attacks.

Mr. Rupert served as a liaison with other congressional and executive branch entities to include the Department of Homeland Security, the Federal Bureau of Investigation, the Central Intelligence Agency, the Department of Defense, and many other agencies. As a liaison, Mr. Rupert provided information concerning national level issues including continuity of government and continuity of operations for the U.S. Congress. His personal and professional contacts ensured seamless sharing of vital intelligence, and the Capitol community was well served during his stewardship.

I understand Jeff has accepted a high-ranking position at the Pentagon. On behalf of the entire Senate, I wish Jeff the very best in his future endeavors and offer him heartfelt thanks for his service to Congress and the American people.

Mr. President, following leader remarks, the Senate will resume consideration of the health care reform legislation. It will be for debate only until 11:30 a.m., with alternating blocks of time. The first 30 minutes will be under the control of the Republicans; the majority will control the next 30 minutes.

The Senate will recess from 11:30 a.m. until 12:30 p.m. today. Following the recess, the Senate will resume consideration of the health care legislation. I am hopeful we can have some votes this afternoon. We have been unable to work that out with the minority and so we will see what the afternoon brings.

Mr. President, this historic health care reform bill before us is strong, and it is a strong head start in the right direction toward urgently needed change. But similar to nearly every bill to come before the Senate, it stands to benefit from the constructive input of all Senators. This good bill will be even better when this body debates it, refines it, and improves it.

I am pleased we have begun the amendment process. I hope we will soon be able to begin voting on those amendments--the ones drafted and sponsored by both Republicans and Democrats. But as we delve into the details and give the individual parts of this bill the considerable thought and attention they deserve, let's not forget the big picture.

So as we begin the third day of debate on this bill, let's remember what it does: First, we are making it more affordable for every American to live a healthy life. Second, we are doing it in a way that is fiscally responsible and in a way that will help our economy recover.

This bill does not add a dime to the deficit--quite the opposite. In fact, we will cut it by $130 billion in the first 10 years and as much as $\3/4\ trillion in the next 10 years. We do this by keeping costs down. This critical piece of legislation will cost less than $85 billion a year over the next decade--well under President Obama's goal. It will make sure every American can afford quality health care. We will make sure that more than 30 million Americans who don't have health care today will soon have it. It will not only protect Medicare, but it will make it stronger. In short, this legislation saves lives, saves money, and saves Medicare.

The Congressional Budget Office and respected economists outside Washington have studied it, and they agree. The bill will do what we set out to do at the beginning of this Congress: It will lower costs and increase value so all Americans can afford quality health care, not just a few.

The experts have crunched the numbers, and they have come back with positive reviews. It will help parents afford to take care of their children and help bosses provide coverage for their workers. It creates more choices and more competition in the health care market. It will protect everyone against insurance company abuses, and for all the changes, in areas where our health care system does work, it keeps it the way it is.

I am very happy with the way Democratic Senators have stood for these

principles and those who have defended them against hollow attacks from the other side. One after another, Republicans have come to the floor with disingenuous claims.

For example, they have talked about health care premiums, overlooking the fact that those costs will go down for the vast majority of Americans--in fact, 93 percent. They have talked about the deficit, ignoring the fact that health care reform will do more to lower the deficit than any other measure has in years--remember, over 20 years, almost $\3/4\ trillion. They have tried to scare seniors, saying you are going to die soon, as an example, closing their eyes to the fact that we strengthen Medicare and cut waste, fraud, and abuse from the program. They have tried to scare women, closing their ears to the fact that we will make it easier than ever for women to get the preventive screenings they need, and that is a gross understatement. They claim to speak for the American people but neglect to mention that, for the last year, a majority of the Americans have consistently said it is more important than ever to nurse our health care system back to health.

What is the most consistent Republican attack on this bill? They carefully count the number of pages in this legislation but completely discount the number of people it helps. Can anyone think of a more superficial way to measure the worth of a bill than how many pages it is printed on? As far as I can tell, the only threat that poses is more paper cuts, perhaps.

Those who want to keep the broken system the way it is throw everything they can at the wall, but nothing has stuck. Incredibly, my distinguished counterpart, the Republican leader, last week, called the health care crisis manufactured, in spite of the fact that 750,000 people filed for bankruptcy last year--70 percent of them because of health care costs. In one sense, my Republican counterpart is right--it was manufactured. This health care crisis has been manufactured by the greedy insurance companies that raise families' rates on a whim and deny health care to the sick.

Remember, the health care industry is exempt from the antitrust laws. They can conspire to fix prices with no civil or criminal penalties. No other business is like that, except baseball. This crisis was manufactured by leaders who enabled them, who empowered them, and who sat idly by while the problem grew worse and worse, until it finally collapsed into a crisis.

My Republican friends have been so busy coming up with distortions that they have forgotten to come up with solutions. They seem more concerned with scaring the American people than helping them. This barrage of baseless accusations underscores how desperate some are to distract the American people from the real debate and from the fact they have no vision for fixing our health care system, which is broken.

Yes, correcting the record has taken a long time. That is OK. We will continue to do so as long as necessary. Democrats are more than willing to defend this good bill. After all, it is not hard to do. As Mark Twain, a great Nevadan, said: ``If you tell the truth, you don't have to remember anything.''

I wish to note that I especially appreciate the assistant leader, my friend of decades, Senator Durbin, for his brilliant statements on the floor during the last several weeks on this health care issue. I so admire his spunk, his intelligence, and his ability to deliver a message.

Mr. President, following the remarks of the two leaders, the Senate will resume consideration of H.R. 3590, the health care reform legislation. That will be until 11:30 a.m., for debate only. The Republicans will control the first 30 minutes, the majority will control the next 30 minutes. Any remaining time will be equally divided and controlled between the two leaders or their designees, with Senators permitted to speak for up to 10 minutes each.

At 11:30 a.m., the Senate will turn to executive session to debate the nomination of Jacqueline Nguyen to be a U.S. District Judge for the Central District of California. The vote on confirmation of that nomination will occur at 12 noon today. That will be the first vote today.

The Senate will recess from 12:30 to 2:15 p.m., to allow for our weekly caucus luncheons. Following the recess, the Senate will resume consideration of the health care reform legislation. Additional votes are expected this afternoon in relation to the health care legislation.

Mr. President, here are two truths about the historic health care reform bill that is now before this body. First, it will save money, it will save lives, and it will save Medicare. Again, the legislation before this body will save lives, money, and Medicare.

While this is a pretty good start toward that, the second fact is, there is always room for improvement for this bill. Of course, that is what the legislative process is all about. Senator Barbara Mikulski of Maryland has offered an amendment that does both. Her proposal would improve this bill by making sure women get, at no cost, the preventive screenings they need to stay healthy. These are important screenings that can catch potential problems as early as possible and that will save lives and save money.

Health care premiums rise higher and higher every year. The insurance industry this year has already raised insurance rates an average of 10 percent--an average. Of course, this is far faster than incomes in this country, and that is an understatement. As this happens, more and more women are simply skipping the important preventive care they need. Why? They are skipping screenings for cervical cancer, they are skipping screenings for breast cancer, they are skipping screenings for pregnancy. They are even skipping annual checkups and doctor visits that could flag serious problems, such as postpartum depression and domestic violence.

Why is this happening? Do women simply care less about their well- being? Of course not. Are diseases on the decline? Quite to the contrary. The only reason women are putting off going to the doctor is because, in our broken health care system, it simply costs too much to stay healthy.

Senator Mikulski's amendment also makes clear that the decision of whether and when to get a mammogram

should be made by a patient and a doctor. It shouldn't be made by an insurance company, by Members of Congress or by someone you have never met. No matter what independent task forces recommend and no matter what some Republican Senators falsely claim, this legislation--the one before this body--offers free preventive services to millions of women who are being discriminated against by their insurance companies, and this amendment before this body makes that absolutely clear.

Senator Mikulski has long been someone who has been a leader and has looked out for women's health. Years ago, she worked with me on a problem women have; 90 percent of the people who have a disease called interstitial cystitis are women. I discovered that when three women came to visit me in Las Vegas. It was a disease that was ignored. People thought it was psychosomatic. Working with Senator Mikulski, we had the National Institutes of Health set up a protocol. Now 40 percent of those people, who previously were thought to be psychosomatic and who suffered with symptoms they described as shoving slivers of glass up and down their bladder, are symptom free--not 100 percent but 40 percent. It is easier to diagnose now.

Senator Mikulski has also worked hard to have the National Institutes of Health set up a division for women's health problems. So she is a leader in this area, has been for a long time, and with this amendment she does it once again.

I am sorry to see Republicans deliberately confuse the facts about women's health, particularly as they relate to mammograms. It shows how desperate some of them are to distract the American people from the real debate and from the fact they have no vision for fixing our health care system, which is so broken.

I am even more sorry to say it is part of a larger trend. In recent days, they have been distorting the data from the Congressional Budget Office, an independent agency Republicans in the past have praised. What are they complaining about now, the Republicans? They are complaining about two of this Nation's top priorities: reforming our health care insurance system and helping our economy recover.

First, on health care. The Congressional Budget Office said yesterday the majority of American families who buy insurance in the new marketplace we will create--what we call health insurance exchanges-- will see their premiums go down. They will go down by as much as 60 percent. Out of 100 percent of the American people, 93 percent will have a drop in their insurance premiums with this legislation--93 percent.

CBO's experts aren't the first to recognize these benefits. Massachusetts Institute of Technology's Jonathan Gruber, who is one of the most respected economists in the world, said in today's Washington Post:

Here's a bill that reduces the deficit, covers 30 million

people and has the promise of lowering premiums in the long

run.

Pretty good statement. That means millions of Americans who today cannot afford coverage or whose medical bills drive them to financial ruin. Remember what I said yesterday as this debate began. Last year, 750,000 people in America filed for bankruptcy. Almost 70 percent of the bankruptcy filings were because of health care costs. But of those people who filed for bankruptcy because of health care costs, 62 percent of them had health insurance. Does that speak about a system that is in trouble? Of course it does.

So I repeat: This bill will mean millions of Americans who today cannot afford coverage or whose medical bills drive them to financial ruin will be able to afford to stay healthy. It means, if we don't reform health care, millions more will find themselves in bankruptcy, bad health or worse.

Second, on economic recovery. The Congressional Budget Office said yesterday the extraordinary steps we took to bring our economy back from the brink have created and saved hundreds of thousands of jobs. I will direct my comments to the American people but also to the brave Republicans who joined with us to make this possible--Senators Snowe and Collins. I want them to know that what they did helped us get that legislation passed and, according to the Congressional Budget Office, saved hundreds of thousands of jobs. The CBO said yesterday the extraordinary steps we took to bring our economy back from the brink have created or saved hundreds of thousands of jobs. Its estimate reaches as high as 1.6 million jobs, each one a direct result of our economic recovery plan. Pretty good. The same report also said our country's gross domestic product has gone up by as much as 3.2 percentage points higher than it would have if we hadn't acted.

Let us not do what our colleagues on the other side of the aisle are doing--betting on failure. This country is coming out of a hole that was dug by this administration for some 8 years. The facts are that what we did on a bipartisan basis in January and February has brought this country out of an economic hole. We still have a ways to go, no question about it. But we created 1.6 million jobs and increased the gross national product by as much as 3.2 percentage points. Pretty good. These facts tell us the same thing: Not acting is not an option.

Some of my Republican colleagues prefer to close their eyes and ears to this reality. They prefer to play politics than to do what is right and what is necessary. They are content to say no, instead of offering constructive alternatives and a way to lead our country and our constituents back to health.

At the beginning of this second day of debate, I say: Come along and work with us to improve this legislation. Try to improve it the way Senator Mikulski looked at it and said: This legislation can be improved. We want to work with the minority. We want to have legislation that is bipartisan. We don't want to do this alone. We need the Republicans' help, and I hope they will join with us. It would certainly look better. Let's stop berating this legislation before this body. If they do not like it, try to do something to make it better.

As we know, this legislation saves lives, it saves money, it saves Medicare, and it brings down insurance premiums. That is a pretty good deal. And it brings down the debt. It saves $130 billion over the next 10 years and, after that, $650 billion. Not bad. So the numbers they keep talking about are out of--I don't know where they come from. We, as a body, have used the Congressional Budget Office for 50 years. It is bipartisan. That is the way it should be. We should start talking real numbers, not fake numbers.

Mr. President, I appreciate the statement of the chairman of the Finance Committee. It is one of the most well-reasoned statements we have had. And rightfully so. No one worked harder on this matter than Senator Baucus. I appreciate his dedication, hard work, and the way he handles that Finance Committee.

Mr. President, I ask unanimous consent that the time until 2:15 p.m. tomorrow, Wednesday, December 2, be for debate with respect to the pending Mikulski amendment and the McCain motion to commit; that during this period, Senator Reid or his designee be recognized to offer an amendment as a side-by-side to the McCain motion, and Senator Murkowski or her designee be recognized to offer an amendment as a side-by-side to the Mikulski amendment; that the debate time be divided equally among the four principals listed above; that no other amendments or motions to commit be in order during the pendency of these amendments and motion; that at 2:15 p.m. tomorrow, the Senate proceed to vote in relation to the above noted in the following order; that prior to each vote there be 2 minutes of debate equally divided and controlled in the usual form, and after the first vote, the remaining votes in the sequence be 10 minutes in duration; further, that all amendments and motion provided under this consent require an affirmative 60-vote threshold for adoption, and that if those included in the agreement do not achieve that threshold, then the amendments and motion be withdrawn:

Mikulski amendment No. 2791; Murkowski amendment regarding preventive care; Reid or designee amendment regarding Medicare; McCain motion to commit regarding Medicare.

Mr. President, before I put this to a final consent request, let me say, we have been trying to get some votes today. It would be very good if we could move this bill along, have some votes tomorrow afternoon. We would have four votes. We have two amendments pending. This, in fact, would dispose of those amendments.

Mr. President, I suggest the absence of a quorum.

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