Floor Statements

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Madam President, I ask unanimous consent to speak for up to 15 minutes.

Madam President, I rise today to speak in support of the Thune amendment, which I cosponsored. It would put the brakes on the TARP train wreck.

TARP was originally conceived to purchase toxic assets from banks in order to clean up their balance sheets and provide them the capability and liquidity to begin lending again. At the time, Federal Reserve Chairman Ben Bernanke said that we were facing the most severe financial crisis in the post-World War II era. President Bush stated that the unprecedented challenges of such a financial crisis required unprecedented response and, without action, the American people would face massive job losses, significant erosion in the value of retirement accounts and home values, and a lack of credit availability. Treasury Secretary Hank Paulson said that unless Congress took action, the financial system of our Nation and the world would collapse in short order.

My constituents said at the time that they could not get loans to keep their businesses up and running. Something needed to be done. Secretary Paulson proposed an emergency plan to authorize as much as $700 billion to purchase toxic assets, such as devalued mortgage securities, from the financial institutions holding them. It was stated that the plan would restore consumer confidence in the economy as the Treasury would show faith in our financial system by purchasing these assets and managing them while the market stabilized, and selling them later. The proceeds from the sale of these assets would then go to pay down our national debt.

In response, Congress proposed the Emergency Economic Stabilization Act, which created the Troubled Asset Relief Program, called TARP, and authorized $350 billion not $700 billion in Federal assistance.

The Republican and Democratic Governors Associations wrote jointly to ask Congress to act immediately on the legislation to provide economic security to the financial system and stabilize the crisis. Congress did act in overwhelming majorities.

Almost immediately, however, the Treasury Department deviated from the intent of the program and design they told Congress they would pursue. It did not purchase toxic assets as planned. Instead, the Treasury used TARP funds to take equity stakes in over 300 of our Nation's financial institutions. The program was further expanded to nonfinancial companies, pouring billions of dollars into AIG, GM, and Chrysler. When the administration asked for the second tranche of $350 billion, I said no, and so did many of my colleagues.

We have especially seen the misuse of TARP in capital repayments to the Treasury. Since the program began, the Treasury has received over $165 billion in paybacks, with interest. Under the Stabilization Act, proceeds from these paybacks were meant to be used to pay down our national debt. That was a key condition to its approval.

In a hearing last November, before the Banking Committee, of which I am a member, I spoke with the Assistant Secretary of the Treasury, Herb Allison, regarding the State of the TARP program 1 year later. Secretary Allison told us that these repaid funds ``go directly into the general account of the U.S. Treasury to reduce the Treasury's funding need''--to reduce our debt. Yet, when I asked him to confirm that the money repaid was no longer part of the total authorization of $700 billion, Secretary Allison said that when TARP funds are repaid, headroom is created within the program to provide additional commitments to maintain the $700 billion funding level. Thus, as the Treasury puts repaid funds back into one pot, it reaches into another for more--basically recycling the $700 billion. This is not what was promised. It is not what was passed. It is not what was envisioned. I most certainly never voted to authorize a revolving fund to remain in our economy indefinitely. I didn't even vote for $350 billion of this $700 billion that is now becoming a revolving fund.

According to the most recent TARP report from the Office of Financial Stability, approximately $545 billion in TARP funds has been committed. Repayments through TARP were over $165 billion. This leaves roughly, with the amount of the $545 billion which has been committed, about $374 billion being paid out with roughly $319 billion of unobligated TARP funds, or TARP authority.

The recent report issued by the Congressional Oversight Panel for TARP stated that although TARP authority ends October 3, 2010, any funds committed by that date but not yet spent can still be spent under TARP past this deadline. This could create an indefinite time period for expenditures through TARP.

The amendment offered by Senator Thune, me, and many others would allow us to truly put an end to TARP expansions, and it would put an end to it immediately. It would show taxpayers that Congress finally gets it, and that we are serious about reducing our Nation's skyrocketing debt. This would indeed be the first step in putting our financial house in order.

Today, we can begin the process of lowering this huge debt that our country, which just in the last year, has increased exponentially. We are looking at a bill that would increase our debt to $14 trillion. If we pass the amendment before us today, we can cut that back instead of adding to the debt. That is what we ought to do.

While we are at it, we need to stop the spending binge we are on. We need to stop the stimulus package, whatever is not authorized, because that, too, will add to our debt. We need to recommit to cut taxes. We need to say our financial house must get in order. It is time to reauthorize the tax cuts that were put into place that caused our financial stability after 9/11. It is the tax cuts that caused our financial stability. It is lowering the capital gains rate, lowering the dividends rate of taxation. This is what would open our markets and open our ability for businesses to hire people. It would restore consumer confidence. What about the death tax that will come back in full force next year? People don't know how to plan their giving to their children or giving to their employees and their businesses because they don't know what Congress is going to do. If there is anything Congress ought to do, it is stabilize our tax system and make the tax cuts permanent. We need to lower the capital gains and dividends rate permanently. These are funds that have already been taxed. They were taxed when they were earned. They should not be taxed for savings--dividends and capital gains are savings. That is how people plan for their future.

We need to recommit today to reorder our financial priorities. We need to get our financial house in order. That means cutting down on the debt, not adding to it. It means cutting spending, and it means making our tax cuts permanent. Capital gains and dividends rates should be lowered permanently so that our stock market would be permanently stabilized. And we should lower the rate for everyone because the people who can hire others will be paying at the highest rates when the rates go up. That includes schedule C corporations. We need to lower capital gains rates. We need to lower the burden on businesses. We need to lower the burden on families. We need to help people, not hurt people, who are trying to plan for their financial retirement.

Today, we have a chance to take the first step by saying that TARP is going to end, that we are not going to expand something that was authorized for an emergency purpose. This emergency purpose should be a commitment of Congress. We should not allow the expansion of TARP. We can take the first step by voting for the Thune amendment of which I am a cosponsor. We need to start the process today, and we can say to the American people that Congress is finally listening.

Many on my side of the aisle have been making these points day after day. We were here almost every day in December, Saturdays and Sundays included, trying to make the point that people don't want a government takeover of their health care system. Now I think we have a clear message from the people of Massachusetts that they don't like this either. The exit polling showed that 48 percent of them voted to keep this health care bill from going forward. The rest of them voted to say: Stop all of this takeover by government of so much of our lives-- whether it is the cap and trade that will raise energy and fuel costs or whether it is letting the tax cuts lapse, which would give us more money for our own families to spend as we wish, not as government wishes; it is to stop the growth of big government; it is to stop the ending of the death tax for all intents and purposes so that we can pass on to our children the fruits of our labor.

Most of all, we have a chance today to say we are not going to raise the cap on our debt limit and we are not going to $14 trillion, which is now above 17 percent of our gross domestic product. It is our debt burden. This is not healthy.

The people of Massachusetts said: Get your house in order, Congress; get your house in order, Mr. President.

Let's do it. We can take the step today to do it. It is time for Congress to hear the American people and act, to hear their cry that we must get our house in order for the future of every American and every American's child and every American's grandchild. That is what we owe them. I hope we will take the first step with the Thune amendment and then the rejection of

the resolution to raise the debt ceiling. Then we can lower taxes permanently, and then we can take to the American people a new agenda that will really create jobs because the jobs will be in the private sector, not the government sector.

Madam President, I yield the floor.

Mr. President, I will be taking the leader time on our side. How much time is there?

I thank the Chair.

Mr. President, today we are taking another step toward passing a bill that has not seen the light of day for very long. It is a bill that is going to change health care policy in this country forever if it is finally coming to enactment. It will take effect in 2014. The reason we are talking about this bill and trying to let people know what is in it is because we hope there is still a chance this bill will not become law.

This bill was drafted behind closed doors without Republican input. The votes are 60 to 40. Sixty Democrats and 40 Republicans make up the Senate, and that is what is providing cloture on this bill.

This bill increases taxes by over $\1/2\ trillion over a 10-year period--that is over $500 billion--and $\1/2\ trillion in cuts to Medicare. This is a time when we should not be increasing taxes. Small businesses are burdened already. This adds to their burden. Families are trying to make ends meet. They are trying to pay their mortgage so they will not be thrown out of their homes. They are trying to pay their bills. They are trying to find jobs in the highest level of unemployment in our country since World War II, and we are going to heap taxes and burdens on them starting as early as next year--in 2 weeks. This is not a time to raise taxes. We don't need a tax burden increase, we don't need Medicare cuts, and we do need health care reform that would lower the cost of health care. This is going to do the opposite. We are going to increase taxes and lower the service for Medicare in our country.

I remember reading some of the history and the anecdotes about the vote on the constitutional amendment to allow women the right to vote. There was a Congressman from Tennessee who was wavering. He said what finally made up his mind--and he was the Congressman who made the difference--was that his mother wrote him a letter and said: Vote for ratification.

What is going to be said about this bill that changes health care policy for every American? What is going to be written about how the votes were brought together to have a bill that would tax our American people $\1/2\ trillion and take Medicare as the pay-for for this program is that there will be essential protection for seniors in Florida and New York to prevent them from suffering the cuts to Medicare Advantage but no other State. Insurance companies in only two States, Nebraska and Michigan, are exempt from the taxes that will take effect on insurance companies, raising the premiums for every insured person in this country. Changes to the language restricting physician ownership of medical facilities appear only to benefit a single medical center in Nebraska, and additional Federal payments to Louisiana, Massachusetts, Nebraska, and Vermont to expand Medicaid will cost taxpayers in every other State in America over $1 billion. This is part of the deal that was brokered to make sure 60 votes would pass this bill. The people of Nebraska will never pay a dime for Medicaid increases, whereas my State of Texas will carry a new burden of over $9 billion, and every other State in America will eventually take the burden of the Medicaid increases but not Nebraska, not ever. Even the Governor of Nebraska has said he does not think that is fair.

So I think we can do better. We can do better in this country than having the history of the overhaul of our health care system that is going to affect the quality of life and the tax burden on every American. I think we should have a better history.

So I am asking my colleagues to think about this vote. We could change one vote, one person who says: I don't

want the Senate to do something this way. I want the Senate to rise to the level that we know has been the tradition of this Senate for all of the years of our Republic, and that is that we would have an open, transparent process; that we would have bipartisan input; that a Republican amendment--one might have passed; that what we offer is what we promised the American people: lower costs in health care----

--and a way for people to have more affordable access.

We still have a chance. That is why we are here today. And I hope we can turn away from this process and share the light of day with our colleagues and with America.

Thank you, Mr. President. I yield the floor.

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

Mr. President, are we now in a period where we go back and forth without limit?

Mr. President, I ask to be notified after 5 minutes, after

which Senator Vitter is going to speak.

Mr. President, we have talked a lot about what is in this bill, the massive tax increases, the massive cuts in Medicare. But there is another issue I think, looking down the road, we are going to need to pursue. We have talked about how groundbreaking this bill is. In fact, the majority calls it historic, and it is historic. We believe it is historic in the bad precedents it is setting, both in process and in substance. I think some of these precedents are going to be tested under the Constitution of the United States.

I wish to start by talking about a couple of those. No. 1, in the effort to get the last vote, clearly there were deals made. There were deals that affect individual States and even one that affects two insurance companies that will have a different treatment from all the other insurance companies in America. It is said there will be two Nebraska insurance companies that will not have to pay the tax increases of the insurance companies that will be levied on all the other health insurance companies. This is an issue that must be raised under the Constitution, the equal protection clause of the Constitution. To take a set of companies in an industry, competitors-- and we value the free market system and the free enterprise system--to pluck out two competitors and say: You will be treated differently because we need your vote to pass this bill should be tested under the Constitution of the United States.

It is my hope some insurance company that has standing to bring this suit will be able to test this precedent. It is a very bad precedent, and it is certainly bad policy to start passing laws that distinguish some parts of an industry versus other parts of an industry that would be treated in a different way. I hope we will do that.

No. 2, I believe there is a 10th amendment issue. Here is my concern. Many States, including my State of Texas, have self-insurance plans for State employees. States with large numbers of State employees find that self-insurance is a better way to go than private insurance programs. In this bill, every insurance company that plans to increase its premiums must get approval from the Department of Health and Human Services first.

Now, my State of Texas, with its self-insurance plan, then, has to go to the Secretary of Health and Human Services to ask permission to increase the premiums on their State self-insured insurance plan. That is a violation of the 10th amendment, as I see it.

I am very concerned that a State that has State employees who accept a self-insurance plan would then be able to be told by the Federal Government that they cannot increase their premiums to cover the cost and keep the sound system that they have in place.

Now, other States have self-insurance plans, so I believe they would also be very affected by this, and I believe there will be a standing for a State with this type of plan to be able to challenge this part of this bill and, hopefully, bring it down if it is a violation of the 10th amendment.

I want to talk about another area that I think is a stretch in this bill; that is, apparently the individual mandate is being justified by the commerce clause of our Constitution. Now, the commerce clause basically says no State may impede interstate commerce. You may say, out in America: I don't see the connection. I am going to be mandated to buy health insurance or be fined if I don't because States cannot impede interstate commerce?

Well, I would agree with people out there that seems like a disconnect because, apparently, using the commerce clause, the majority is saying the Federal Government has the right to manage insurance, and that a requirement of an individual mandate is part of the Federal capability to manage insurance in this country, and you cannot impede that right by the Federal Government because you cannot impede interstate commerce.

I think this whole individual mandate issue is going to be a center for discussion, debate, and opposition to the bill that is clearly moving down a track that we are trying to stop, but that train is moving. I think we are going to have to talk about the individual mandate. People are saying to me: How can the Federal Government tell me I have to buy insurance? I think they have a point.

You have to buy automobile insurance because, but that comes with the right to drive. So you get the right, licensed by the State, to drive your car, and in exchange for that a State may require that you have collision insurance on your automobile, and many States do. But when you say you have to buy an insurance policy, I think that crosses a line where a person has a right to say: I am not going to buy insurance if I guarantee that I am not going to be a burden to the Federal Government or to the State government or to any other taxpayer. I think you should have that right, but that is not the way this bill is written.

The bill is a Federal mandate that every person in America has to have health insurance or be fined if they do not. So at least if we were going to write such a provision, to keep the right of an individual not to have a mandate under the commerce clause of the Constitution, at least you ought to say that a person would have to sign something that says: I will give you a promissory note if I do not choose to buy insurance. But that is not the way this bill is written.

So I think this, along with the State mandate on Medicaid--which, again, I think is an equal protection issue, and maybe that is a stretch--but that one State will not have to ever pay the State's share of the increase in Medicaid that is in this bill but the other 49 States in America will is certainly a violation of our responsibility to treat all States equally or to have formulas that have some ability to say there is a standard that has been set that should prevail. But not in this bill.

My State of Texas will have almost a $10 billion increase in its State's share of Medicaid because of the expansion in this bill. But there are States that are exempted from the increases and one State that is exempted forever because of a deal made to get that 60th vote to pass this bill.

I think people are looking at this issue in America today and saying: What has gotten into the people in Congress who are voting for this bill?

So, Mr. President----

Mr. President, thank you for the notification.

I think there are issues now that will be raised going forward in the future, and there is still time for one Senator in the 60 to change the vote. Therefore, I hope one will hear from his or her constituents enough that that person will say: It is time to slow this bill down. I am going to change my vote so people can see all the effects that we have not talked about yet, and let's do this right.

We can lower the cost of health care, we can provide more access to more people to have health care coverage, which should be the goal of this legislation, this massive reform of a health care system that is working for many and has provided the best quality of health care in the world. We have a chance to keep it by slowing this bill down. That is why we are fighting. That is why we are still here talking 3 days before Christmas. We want to stop this bill and do it right. Doing it right is more important than doing it fast, and I think the American people believe that too.

Thank you, Mr. President. I yield the floor.

Mr. President, may I ask, is it 10 minutes--what is the procedural position as of now?

I thank the Chair.

Mr. President, for weeks we have been debating legislation that will dramatically and permanently reform our health care industry. It will impact the life of every American, and it will add to our growing national debt.

On Saturday, the majority leader filed an amendment increasing the size of this bill. Early this morning at 1 a.m., we had a vote to proceed to the revised bill that makes a mockery of transparency and public policy. Yet even though the majority took the opportunity to amend the bill, it is clear the concerns of the American people were not heard by my friends on the other side of the aisle.

I was astounded to see this revised bill still contains $\1/2\ trillion in new taxes, $\1/2\ trillion in Medicare cuts and mandates and penalties on individuals and businesses throughout our country at a time when businesses are struggling, unemployment is up, and families are trying to make ends meet.

I wish to talk about the taxes. The revised bill has an additional $25 billion in taxes than the bill as introduced. We have been hearing for weeks about families who are struggling to pay their mortgage, struggling to find a job, struggling to pay their utility bills. Yet what do we find in this new bill? More taxes and more mandates.

The American people overwhelmingly oppose this bill, and just when we thought the final product could not get any worse, it does.

Under the revised bill, the taxes collected from individuals who cannot afford health insurance has been raised from $8 billion to $15 billion--almost double. Why? Because the penalty for not purchasing insurance has become more severe. If you cannot afford insurance, the tax is either $750 or 2 percent of your taxable income, whichever is higher.

There are still taxes that begin next month, less than 2 weeks from now.

Less than 2 weeks from now in this bill, $22 billion in taxes on prescription drug companies will start, and the public can expect to see higher prices for medicines.

In 2011, we see $60 billion in taxes on insurance companies except for companies in two particular States. That does not seem fair. Fortunately, the Constitution's equal protection clause may have something to say about this gross situation. This will not stand the test of the Constitution, I hope, because the deals that have been made to get votes from specific Senators cannot be considered equal protection under the law.

If it does stand and the taxes start in 2011, people who have insurance are going to pay higher premiums--even higher than what has been projected already.

In 2011, we also see the taxes on medical device manufacturers. So the public can expect to see higher prices for devices--thermometers, blood sugar machines, canes, walkers--the things people need to stay healthy. That is another $19 billion in taxes.

Then there is another round of taxes in 2013: $149 billion in taxes on high-benefit plans; a 40-percent excise tax on the amount by which premiums exceed $8,500 for individuals and $23,000 for families; $87 billion collected from a Medicare payroll tax. This tax is actually $33 billion higher than in the prior bill. Individuals earning more than $200,000 and couples earning more than $250,000 are now assessed at a tax rate of 2.35 percent for a new Medicare payroll tax rather than 1.45 percent. So if you are a couple earning $125,000 each, you have another tax increase, in addition to possibly a tax on not having insurance or a high-benefit plan.

Also, $15 billion will be collected by raising the threshold for the medical deduction. To receive the medical deduction, you must now spend 10 percent of your income on medical expenses rather than 7.5 percent. This tax will impact those who have high medical costs or are suffering from a catastrophic or chronic illness.

This bill taxes those who have insurance and those who do not. All these taxes are collected. All the taxes I have mentioned will be collected before there would be the option that is the purpose of this bill. Whatever the insurance option becomes, it takes effect in 2014. All the taxes I have mentioned start before 2014.

Senator Thune and I had a motion that would have sent this bill back to the committee and required that everything in this bill start at the same time. So if the program starts in 2014, the taxes would start in 2014. Under our motion, not one dime in taxes would be paid before Americans are offered the insurance option in the bill. The motion was defeated. Now the Democrats have revised their bill and the taxes collected are even higher than the previous bill.

But do not forget the penalties to businesses that cannot afford to offer health insurance to their employees. A tax of $750 per employee is assessed. This at a time when unemployment has reached double digits. We should be encouraging employers to hire new workers. Yet this bill imposes $28 billion in new taxes on employers.

What will these taxes do to small businesses which create 70 percent of the new jobs in our country? In a letter sent to the majority leader, the Small Business Coalition for Affordable Health Care stated:

With its new taxes, mandates, growth in government programs

and overall price tag, the Patient Protection and Affordable

Care Act--

The bill we are discussing--

costs too much and delivers too little. . . . Any potential

savings from those reforms are more than outweighed by the

new taxes, new mandates and expensive new government programs

included in this bill.

That letter is signed, in addition to the Small Business Coalition, by associations such as the Farm Bureau, Associated Builders and Contractors, Associated General Contractors of America, the National Association of Homebuilders, the National Association of Manufacturers, the National Automobile Dealers Association, the National Retail Federation, and more.

The National Federation of Independent Business, which is the voice of small business, sent a letter expressing their strong concerns over this bill. It says:

The current bill does not do enough to reduce costs for

small business owners and their employees. Despite the

inclusion of insurance market reforms in the small-group and

individual marketplaces, the savings that may materialize are

too small for too few and the increase in premium costs are

too great for too many.

That is the tax situation. How about the $\1/2\ trillion in Medicare cuts? They are still there. They were in the first bill, and they are there now.

There are $120 billion in cuts to Medicare Advantage, which we know reduces choices for seniors. In my State of Texas, over 500,000 currently enrolled enjoy the benefits of Medicare Advantage. That is in my State alone. Millions across the country like Medicare Advantage, but many seniors, without a doubt, are going to lose this option.

Oddly enough, once again, one of the points in the new bill is, there was an opt-out for certain States on Medicare Advantage cuts. So some States are going to have the Medicare Advantage cuts while other States will not.

The individual fixes for certain States, presumably to get the votes of certain Senators, do not pass the test of transparency. If you put it in the nicest way, it does not pass the test for fairness, for due process and equal treatment under the law, and it certainly does not pass the test for what is the right way for us to pass comprehensive reform legislation.

The other health care cuts in Medicare would be $186 billion in cuts to nursing homes, home health care, and hospice providers.

Then there are the cuts to hospitals, approximately $135 billion in cuts to hospitals. The Texas Hospital Association has estimated that hospitals in my State will suffer almost $10 billion in reduced payments.

I have a letter from the Texas Hospital Association that outlines their concerns with these cuts and this bill and they are very concerned. Here is one of the quotes from their letter. The Texas Hospital Association says:

With a significant reduction in payments, hospitals may be

forced to reduce medical services. [H]ospitals . . . may be

forced to close or merge with another hospital, or severely

reduce the services they provide to their community.

Essential services, such as maternity care, emergency

services, medical-surgical services or wellness programs may

be reduced or entirely eliminated.

I have talked with so many hospital administrators and people on hospital boards, and they are very concerned about the cuts in this bill because most of them are on very thin margins. They are struggling, especially in our rural areas. They are very worried there are going to be shutdowns of hospitals throughout our State and certainly our country.

Our aging population is growing, so cutting payments to providers who treat those patients, whether it is in hospitals or health care providers, does not seem to be a way to reform Medicare.

Cuts in Medicare, and especially the payments for treating low-income seniors, will disproportionately impact rural hospitals which are the safety net for health care outside the metropolitan areas. The Texas Organization of Rural and Community Hospitals, which represents 150 rural hospitals in Texas, said in a letter:

We also fear the Medicare cuts as proposed could

disproportionately hurt rural hospitals which are the health

care safety net for more than 2 million rural Texans. Because

of lower financial margins and higher percentage of Medicare

patients, rural hospitals will be impacted more than urban

hospitals by any reductions in reimbursement. These proposed

Medicare cuts could have a devastating effect . . . which

could lead to curtailing of certain services. And the closure

of some of these Texas hospitals is a very real possibility.

. . .

How could anyone support a reform bill that will result in seniors having to drive 30, 60, 90 miles and more to get the care they need-- care that was accessible in their own community before this bill took effect?

Mr. President, what we have is a bill heavy with tax hikes, Medicare cuts, and government intrusion. This bill is being forced through Congress the week of Christmas because everyone knows this is not the reform that Americans want. The polls are showing that. We all know polls can have margins of error, and maybe they are not completely accurate, but the trend in the polls is clear: It has gone from people thinking that health care reform is a good thing and supporting it, in the majority, to going down now to the point where the trend is clear the

American people now do not support this bill, they would rather have nothing, according to the latest polls, and have Congress start all over and do what they hoped it would do, and that is bring down the cost of health care not have this be a big government increase in debt, cuts to Medicare, and increases on taxes to small business and families, especially at this time in our country's economic period.

My Republican colleagues and I have tried to offer fiscally responsible alternatives to reform, allowing small businesses to pool together, increase the size of their risk pools, which will bring premiums down. If you have an exchange it would be fine unless you have so many mandates, such as we see in this bill, that are going to cause the prices to stay up and even go higher because of all the taxes on the underlying companies that are providing the health care.

Creating an online marketplace free from mandates and government interference where the public can easily compare and select insurance plans would be a Republican proposal, something that I think would be a point at which we could start having health care reform that would be truly effective for America, if you didn't have the mandates that would drive up the cost.

Offering tax credits to individuals and families who purchase insurance on their own, that is a bill that we have put forward. Five thousand dollars per family would cut the cost and make it affordable without any government intervention that would be necessary.

Of course, medical malpractice reform could take $54 billion out of the cost of health care by stopping the frivolous lawsuits, or at least limiting them. Yet Republicans were really not at the table. The bill was written in a room, with no transparency, no C-SPAN cameras, and no Republicans. We did not have input into this bill. That is why it is a partisan bill. That is why the vote last night--or this morning at 1 a.m.--was completely, 100 percent partisan. Why would a Republican vote for a bill that goes against every principle we have--higher taxes, higher mandates, and cuts in Medicare--and in which we had not one amendment pass? We offered amendments, but there were hundreds of amendments left on the table that we were closed out of offering because of the rush to pass this bill before Christmas.

Mr. President, Americans asked for reform; they deserve it. This bill is not the reform Americans hoped to get from a Congress that should have acted responsibly but did not.

Mr. President, I yield the floor.

Mr. President, I will be using some of the leader's time, and if the leader decides to step in, all he has to do is signal.

I wish to, first of all, say how much I appreciate the leader, Senator McConnell, the Republican leader for the heroic efforts he has made in the last few weeks to try to assure that the American people know what is in the bill that will be put before us very soon. Now, I say put before us very soon because we don't know what the substitute bill is that has been worked on for the last few days. We haven't seen it yet. I think that brings up an important point.

I am hoping the distinguished majority leader, who is also on the floor, will allow America, as well as Senators certainly, to see the managers' amendment which includes all of the changes in the bill that is before us before we are forced to vote on this monumental piece of legislation.

When I am talking to my constituents back home, my friends, the people who just come up to me on an airplane, they say: What are you doing? Why is this being rushed through when it is one-sixth of our economy, when it is quality of life for every American, when we are talking about jobs in the private sector that will be sacrificed for a big government takeover, more government jobs, fewer private sector jobs. People are saying: What are you doing?

When I was talking about the taxes that are going to take effect in 2 weeks, before the bill takes effect 4 years from now, people were surprised. Even very informed people who read all the major newspapers, they said: What? The taxes are going to take effect 4 years before the bill takes effect? I mean, what are you all doing? Has Congress ever done that before?

I couldn't remember a time when Congress would pass taxes for 4 years, purporting to put together a new program, and then all of a sudden, after 4 years, the program would start but the taxes have accumulated, and it is going to be $75 billion that will have accumulated before any implementation of the bill that is before us.

So I have heard the criticism on the floor that Republicans are trying to slow this down, that they are trying to stop this bill. It is very important that this health care bill be slowed down so that not only the Senate but the people of America can look at this and determine how it affects them personally, so they can look at what the proposed options are going to be. They can look at the taxes. They can look at the mandates. They can look at the small business requirements that could actually cost jobs.

Now, one might say: Well, if it costs a few jobs, maybe there is a greater good. We are in the toughest recession we have been in since the 1940s, since World War II. We are in the toughest recession we have been in, and here we are maybe stopping job increases or maybe adding to the unemployment figures which are the highest in 40 years in our country.

So I know the American people are saying: Why? Why push this through? Why push it through so fast when we are talking about maybe losing jobs in an economic downturn, when people are already hurting. Even the people who are employed are afraid that maybe they are going to be laid off because times seem to be getting tougher out there. We hear that the buying season, the Christmas season, is not going as well as retailers have come to expect to try to make their yearly requirements to make their profits.

What does that mean? If we do not make those profits, then people are not buying and people are not going to be hired and maybe people are going to be laid off.

I do not think this is the time to be talking about losing jobs, something that is going to increase the burden and the mandate and the taxes on our business.

I hope we can have a bill that will be bipartisan that we can all support.

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

Mr. President, I rise today to speak about the health care bill that is pending. The Department of Defense bill is also pending. It is the business we have on the floor today. I have no doubt that at the appropriate time there will be a vote in support of funding our troops. I know that may come on Saturday after the time for debate has run out.

I want to talk about the health care issue because it is the reason we have been here for really most of the last month--voting every Friday, Saturday, and Sunday--is to talk about the health care bill, debate the health care bill, ensure the American people know what is in this health care bill, and ensure people start looking at the effect it is going to have on their businesses and their families. I can't think of anything we have ever voted on in this body since I have been here that will affect people's lives in such a personal way.

I have tried to look at what is good in the bill, and then I look at what I don't like in the bill, and I have to say the scale is very heavily tilted toward what I don't like.

In fact, I had a tele-townhall meeting, which is a new capability we have to talk to people. It is a wonderful way to be able to reach out in your State to people who are interested in asking questions and actually call them and let them ask their question. At all times during the tele-townhall I had last night, there were over 6,000 people who were in and out of that tele-townhall meeting. I was very pleased because every single question was a real question, a real person. One man who called is on kidney dialysis treatments. He has very high drug costs and high expenses. Then we had people on Medicare asking how the cuts in Medicare would affect their treatment and their care. Then we had small businesspeople who are scared to death of having more burdens, more taxes, and more mandates on their small businesses. Some were almost screaming into the phone: But don't people realize how hard it is to make ends meet right now for small business? Don't you all realize we are trying to stay afloat while we are in one of the worst recessions of our lifetime?

Of course, I assured them I do understand that. That is why I am trying to amend this bill, trying to change it, trying to encourage my colleagues on the other side of the aisle that we should really start over and try to have a health care reform bill that does three basic things.

We want a bill that actually lowers the cost of health care. Right now, the bill before us will increase the cost of health care. The cost of the bill that is before us today, if you start with when the bill takes effect, which is 2014, and you go 10 years out, you are looking at $2.5 trillion in costs.

We have a debt of $12 trillion in America right now. Those numbers are staggering. We used to be worried about $12 billion, $15 billion, and $100 billion; now we are talking about trillions of dollars. We are talking about $12 trillion in debt right now. The idea that we would put $2.5 trillion more in this health care bill, which mandates taxes, to offset some of it, to businesses, employers, and families, is unthinkable. It is unthinkable in good times, but in the bad times we have now, it is absolutely unthinkable. Here we are now talking about this bill that will increase the debt and increase taxes and mandates.

In talking with the people of Texas, I did a little poll on the tele- townhall. I said: Register in, punch 1 for yes, 2 for no, and 3 for undecided. I asked: Do you support the bill that is before us today? If you say yes, press 1; no, press 2. Eighty-one percent instantly started registering against this bill.

I was listening to my colleague, Senator Barrasso of Wyoming. He also had a tele-townhall meeting for Wyoming. Many Senators are doing this now. He had a couple of thousand people on the call. Ninety-three percent who registered on the poll were against this bill. My colleague from Nebraska, Senator Johanns, said the polls in Nebraska are overwhelmingly against this bill.

People are listening to the debate, reading the newspapers, getting every bit of information they can, listening to the tele-townhall conference calls, they are asking their questions, and in unprecedented numbers they are registering their interest and their overwhelming rejection of this bill.

I talked about what is in this bill and what we could have. Instead of $100 billion in new taxes, which would start next month, we could step back and say we are not going to put new taxes on businesses and families and companies before the bill even takes effect. In fact, Senator Thune and I had a motion that was rejected on the floor. It was tabled yesterday afternoon. It would have done exactly that. Very simply, if the bill is going to pass, at least don't start the taxes until there is some program available that is as a result of the bill. It is very simple and clear. That was our motion, and it was tabled, with only 41 Senators saying yes, so we lost the motion.

It is of great concern to us that the tax increases in this bill start next month--we will have over $100 billion in new taxes starting next month--and that the 40-percent excise tax on premium health care coverage policies takes effect in 2013 but the bill doesn't take effect until 2014.

That is the bill we are debating today, which an overwhelming number of American people are rejecting. They don't want taxes, mandates, and they don't want the government to step between them and their doctors. They want the physician-patient relationship that is the hallmark of American health care. It is what makes us different from most other countries in the world--that we don't have government standing in the way and most of our private plans don't say: No, you can't have this treatment because you are too old or you are not fit enough, or having the government say: Here is who is qualified for this procedure. That is not the health care we have known in America.

We are for health care reform that lowers the cost of health care in our country, and more people will have affordable options. There is a part of this bill that could provide that. It doesn't mean a government takeover. We don't need a government takeover. That is why you have all the taxes and mandates, because it will cost so much that taxes and mandates are the way the majority is putting forward to pay for this expensive government takeover.

Why not have the health care exchange without all the mandates so there would be a free market on the exchange with no cost that would allow people to have choices? The insurance companies would come forward and there would be high-deductible plans for people who wanted high-deductible plans, and there would be low-deductible plans that would be more expensive, but some people would prefer to have that. You could make your choices among the plans that would be put on an exchange that would be open, transparent, and competitive. You would have bigger risk pools and, therefore, lower premiums would be the result.

Talking about what Republicans wish to see in health care reform and asking the majority if we could stop going through every weekend with one vote on Friday, one vote on Saturday, one vote on Sunday so that we are not able to do anything with our families during this holiday season, instead why don't we step back and say we will come back after Christmas or whenever the majority wishes to come back and say: Let's sit down in a bipartisan way, and let's have three principles in a health care reform bill. No. 1, we would lower the cost with the exchange, bigger risk pools, lower costs. No. 2, how about tax credits for every individual or family who would buy their own policies because they don't have access through an employer or if they are going to go on this exchange that would not cost anything, they would be able to have a tax credit to buy their own health care coverage. That would increase the number of people insured in our country, much larger than we are looking at today with a big government-run plan, which is said to increase the number of insured 31 million, but leave 24 million uninsured. We could get 31 million with the free market working.

No. 3, what about medical malpractice reform? We could take $54 billion out of the cost of health care by having frivolous lawsuits curbed with some kind of reasonable limits on damages or attorneys fees that would allow

people to get some compensation for a transgression, but not something that is going to raise the cost of premiums so high for doctors and hospitals that they have to order more medical tests and that raises the cost of health care across the board.

Those would be the principles we could support. Let's start again after Christmastime and do a rational proposal that the American people would accept.

I yield the floor.

Mr. President, parliamentary inquiry.

Mr. President, I was under the impression there would be a 30-minute allocation for colloquy for our side. I am not sure when we start that process.

How many?

I thank the Senator from Oklahoma. I think it is very important that before we start talking about passing a bill or having a cloture on a bill--I think the Senator from Oklahoma is making the main point. I think the Senator from Oklahoma was making a very good point that I was hoping to work with him on and that is: Where are we now? The Republicans have put forward reform alternatives for our health care system that are not a government takeover and are not going to be $\1/2\ trillion in taxes and are not going to be $\1/2\ trillion in Medicare cuts.

The Republican proposals would do what health care reform should do-- they would lower cost. They would increase risk pools so that small business would be able to offer health care coverage for their employees. They would have medical malpractice reform so we would be able to lower the cost of frivolous lawsuits, cutting over $50 billion out of the costs of health care, making it more accessible for more people. They would give tax credits for individuals who would buy their own health care coverage to offset that cost.

None of that would be a big government takeover of health care. That is what we have been trying to put forward here. But we have not had a seat at the table. We have not had the capability to say what our proposals would be because we have not even seen the proposed new bill yet. We have been talking about the tax increases that are going to burden small business at a very hard time for this country's economy and we have also been talking about $\1/2\ trillion in Medicare cuts, which I think has caused many senior citizens to say: Wait a minute, I don't want my Medicare options cut. I don't want Medicare Advantage to be virtually taken away.

That is why we are here today, because the pending business before the Senate is the Hutchison-Thune motion to recommit this bill to do a simple thing. It is to say that you will not start collecting the taxes until the program is in place. It is very simple. It is the American sense of fair play, and that is that you do not start collecting taxes before you have a program that you might want to buy into. That is what the Hutchison-Thune motion to recommit does. It is very simple. It is a matter of fair play. I even question whether we have the right to pass taxes for 4 years before you would ever see a program put in place.

We are going to try to do what is right by this body. That is to say, the $100 billion in new taxes that will start next month--3 weeks from now--will not start until there is a program put in place. Because right now $100 billion in new taxes starts next month but there is no program that anyone can sign up for that will supposedly make it easier to get health care coverage in this country until 2014, 4 years away.

I ask my colleague, the distinguished ranking member of the Finance Committee, if he believes all these new taxes would be fair to start before we could ever see a program--not 1 year from now, not 2, not 3 but 4 years from now. I ask the distinguished ranking member of the Finance Committee if he believes it would be fair for us to start the taxes in 3 weeks and then not start the program for 4 years. Does that seem like a fair concept?

You did. It is interesting because you say maybe it is going to be break even. How is it going to break even? I ask my colleague from South Dakota, who is a cosponsor of this motion: How is it going to break even? With $\1/2\ trillion in Medicare cuts, $\1/2\ trillion in tax increases, is that the way we ought to be saying to the American people we will reform health care? Have we lost the purpose of the bill, to make health care more affordable and accessible to the American people? I ask my colleague, the Senator from South Dakota, who has worked on this issue for a long time, is that the concept of break even?

Mr. President, the 2 physicians out of the 100 Members of Senate are here this morning. They have talked for a long time about the quality of care. They are the two who have the credibility on this. I would like to ask the Senator from Wyoming, Dr. Barrasso, to talk about what is going to happen to the quality of health care when you have $\1/2\ trillion in Medicare cuts, which we have discussed, and the bill we are discussing today and the motion Senator Thune and I are offering, that is going to put a higher cost on every prescription drug, every piece of medical equipment. Perhaps you would expand on what kind of medical equipment is needed for people to have the quality of life we have in our country today and then the insurance companies, which are, of course, going to raise the premium of every person who already has coverage.

I ask the Senator from Wyoming, Dr. Barrasso, in your experience, how is this going to affect the quality of health care?

That is a very important question. Here we are going to start collecting the taxes for 4 years before the program is put in place. The distinguished Senator from Oklahoma, the other physician in this body, knows we have had promises from the Federal Government before. But I can't remember a time when we started collecting a tax for a purpose that would be 4 years away. What on Earth could people expect to actually be there when the program kicks in?

The program is going to have to be implemented. It is going to have to be brought up to speed. I am sure there will be changes. What would you think your patients whom you still care for in Oklahoma or the ones, in the experience you have had, how do you think people are going to react to having higher costs in all these areas of health care for 4 years, even a tax on the high-income plans, not high-income people having those plans but high coverage that a union member might have that will start being taxed in 2013, 1 year before the program takes effect?

How do you think that is going to affect the quality of health care people can expect and the cost to them out-of-pocket when there would be nothing even on the drawing boards for 4 years?

I ask the Senator from Oklahoma, you are saying that a schoolteacher is probably not making $200,000 or more?

Yet we were promised there would be no taxes, no harm to people making under $200,000. Remind me if there is a teacher in Oklahoma--because I know there is not one in Texas--making over $200,000.

That is exactly what the Senator from South Dakota and I are trying to do. We are trying to make sure Americans will not-- will not--pay taxes and increased prices on prescription drugs, on coverage we do have, the policies we do have, and the equipment that is so necessary for health care services.

Senator Thune and I want to do what is basic fairness and very simple; that is, to say the program starts and the taxes start at the same time. That is a tradition we have had in this country for years. We do not tax people 4 years from having any kind of program in place that they could choose from that might benefit them. We do not do that. That is not the American way, and it is certainly not anything we have done before.

What in the world would people expect to happen in 4 years? What if this plan is changed? What if the people rise up and say: We don't want this plan, and they say: No way, and they would have been paying higher premiums and higher health care costs already. It is a downpayment where you are not sure what the end is going to be.

It is like buying a house and saying: Now, in 4 years we are going to give you the key to the house, we are going to give you the key to the house that you bought 4 years from now. Oh, maybe there will be a change in condition, but you are going to get it. Maybe it will be damaged. Maybe it will be worn. Maybe it will have a fire that starts in part of it. But you will get those keys and then something will be there for you. We promise you. We are from the government, and we are going to promise you that.

That is not good enough. That is not what we owe the American people. And it is not health care reform.

I would just ask my colleague from South Dakota, who is the cosponsor of this motion, if he agrees that as a matter of simple fairness, openness, and transparency to the American people, health care reform should not mean 4 years of taxes before any program is put in place.

I thank the Senator from South Dakota.

Just to recap, the amount that would actually be collected before any program is put in place would be $73 billion--already collected. That will include, as the Senator from Oklahoma mentioned, schoolteachers from Oklahoma who are considered to have these high-benefit plans, a schoolteacher making $50,000, $60,000 a year with a high-benefit plan. And do you know what the tax is on that high-benefit plan? Do you know what the tax is on that Oklahoma schoolteacher? A 40-percent excise tax--40 percent.

Mr. President, I thank the Senator, and I would just say I hope we get a bipartisan vote on this motion. I hope we get a bipartisan vote to say the one thing we ought to do, if nothing else, is be fair to the American people. You do not pay taxes until the program is up and going.

Thank you, Mr. President.

Madam President, I thank the majority leader for allowing me to speak because I am very concerned about a precedent that has been set on the floor in this last vote.

When the Senator from Vermont withdrew his amendment and started talking, my motion to commit was the measure pending on the floor. I did not have notice--which is the normal procedure here--to be able to talk on my motion. We had no idea there would be a motion to table my motion before I had a chance to close.

Here is my point. The measure that was tabled, the Hutchison-Thune motion, would have assured the American people that there would not be 4 years of tax collection before any kind of program would be put forward under the health care reform package. I thought it was very important that Senator Thune and I be able to close on that. That is a concept we have always had in the Senate--that a program starts when it starts. That means if taxes are included, the taxes will start when the program starts. That is not the case in the underlying bill. The underlying health care reform bill has 4 years of taxes. There will be taxes on insurance companies that will surely raise the premium of every insurance policy in America. There are taxes on prescription drug companies, so that prescription drug prices will surely go up. There are taxes on medical device companies, so the prices on health care equipment will also go up. How much are we talking about? We are talking about $100 billion in taxes that will start in 3 weeks--in January of 2010. Again, we are looking at taxes that will start in 3 weeks, next month, which will accumulate up to $73 billion before a program is implemented that will give anyone a choice of an affordable health care option.

That is the motion that was tabled 10 minutes ago. I want to make sure everyone knows I never had a chance to close on the motion. Senator Thune didn't have a chance to close, because it was a motion made that could not be objected to. That is not the way things have operated here in the past, and I think it is time we bring back the traditions of the Senate, where we have time that we agree to, everybody has their say, and then we go forward.

I am very concerned about that process. I hope it is not setting precedent because I think we can resurrect health care reform if we have a bipartisan health care effort. If we have an effort that will bring down the costs, that will increase the risk pools so that an employer will be able to afford to offer employees health care coverage, bring down the costs of health care with medical malpractice reform that would save $54 billion in the system, we can do things without a government takeover of health care. But the bill that is before us has $\1/2\ trillion in Medicare cuts--Medicare cuts, $\1/2\ trillion--and $\1/2\ trillion in new taxes--taxes on businesses that offer not enough coverage, businesses that offer too much coverage, a 40-percent excise tax on policies that give what is called Cadillac coverage, the high benefit plans. So if you have a good insurance policy, you have a 40-percent tax on top of the premium you pay. And if you have too little coverage, you also get taxed. You are whipsawed in this bill.

I think the small business people of this country know what this bill is about because that is the comment we are getting. They are the people calling into our offices. They are the people I see on the airplanes as I go back and forth to try to make sure we are covering the bases on this bill and trying to let the American people know what is in it.

I am concerned about the precedent that was set, but more than that, I am concerned that the American people must know that if this bill passes as it is on the floor today, the taxes will take effect in 3 weeks, that insurance premiums will surely go up, prescription drugs will surely go up, prices on medical equipment will surely go up, and there will not be an affordable insurance plan for people to choose to take for 4 years. It is like buying a house and having the mortgage company hand you the keys and say: Come back in 4 years, and we will let you unlock the door.

I don't think that is transparency, and it is certainly not health care reform. I hope there is still a chance that we can bring this body to a bipartisan effort that will allow lower premiums, more health care options for the people of this country but, most important, that will keep the quality of health care, the choices we have in health care that Americans have come to expect and not start going on the road to a single-payer system because in the end, that is what the bill before us will lead to. It will be a single-payer system. It will take choices out. It will take quality out.

It will add taxes and burdens on our small businesses at a time when they need to be able to hire people to get our economy going and to get that jobless rate down. We need them to employ people. We need to encourage our employers to employ people. They cannot do it if we put more taxes and burdens on them, which is what the bill before us does.

I thank the majority leader for allowing me to speak since I did not have a chance to speak before my motion was tabled. I hope the American people

are listening because we have a chance to do this right. The bill on the floor today is not that bill.

I yield the floor.

If I may respond to the Senator from Idaho. I was thinking, when the Senator from Tennessee was talking, about the luxury taxes and how everyone thought that felt so good to have a tax against luxury boats. And who suffered? The workers. Then there was the catastrophic Medicare coverage which resulted in a tax on seniors who had that coverage. Seniors erupted, and that was repealed. Then that is followed on by what the Senator from Nevada talks about--the Cadillac plan, which is the high-end plan of coverage.

I thought, maybe Congress has learned something. Maybe the Democrats are on to something. They have listened to the history of all of these good-sounding taxes on rich people or people who buy expensive things. As the Senator from Nevada has pointed out, they have now learned they probably ought to go ahead and tax both ends instead of just the high end because in this bill, you have a tax on the high-end plans. You have a tax on employers who provide too much coverage. Oh, but we also tax the people who do not have any coverage. If it is too small, you get taxed, and if it is too big, you get taxed. It seems that maybe the Democrats learned the wrong lesson. It is not that you tax just the rich or the people who buy expensive things, it is that you tax both ends to make sure you get every little drop of taxpayer dollars.

I think we have shown on this floor from the endless hours of debate that everyone in America is going to be taxed because the taxes that take effect in 3 weeks' time under this bill, January of 2010--the major tax increase takes place, and that is the tax increase on prescription drugs; on insurance companies that are going to have to raise their premiums; the drug costs are going to go up; and medical equipment, which is essential for seniors, especially for everyone who needs some form of equipment, the equipment manufacturers are going to have a tax. Mr. President, $100 billion in new taxes starts next January, 3 weeks from now. Every person in America is going to pay taxes in the form of higher prices starting in 3 weeks.

The Senator from South Dakota and I are sponsoring legislation because the next question will be: Oh, my goodness, if we are going to be taxed in 3 weeks, surely we are going to have some sort of benefit offered in 3 weeks, some sort of low-cost health plan or option. Three weeks, surely. Oh, no, we are not going to have any of the plan that would offer options to people--not in 2010, not in 2011, no, not in 2012, not in 2013, but 2014.

So all these higher prices are going to start kicking in in January, and then we are going to have the Cadillac plan that the Senator from Nevada mentioned in 2013, all being paid before one supposed benefit would be available. If this is not a bait-and-switch, I have never seen one.

The Senator from South Dakota and I are going to offer the next amendment after the ones that are in the

tranche right now to very simply say: Whatever the bill is in the end, there will be no taxes until there is a plan. Not one dime of taxes could take effect until there is actually some sort of plan available that would, hopefully, give some sort of benefit to people, which is what is being promised.

I ask the Senator from South Dakota if that is his understanding, that we would at least draw a line. Whereas Senator Crapo's motion, which I support and I know everyone on the floor talking this morning supports, is to say there will be no taxes to anyone who makes under $200,000. But even if there are taxes in the end, they will not take effect until there is some sort of plan available for people that is going to help Americans who do not have coverage and for whom we are not able to lower the cost, which is what the Republicans are trying to do. At least we would set that deadline.

I ask the Senator from South Dakota what he has been hearing about this bill.

Mr. President I have a motion at the desk, and I ask that it be brought forward.

Mr. President, this is a motion that Senator Thune and I are putting forward. It is a very simple motion. A lot of people don't realize that the taxes in the bill we are discussing actually start in about 3 weeks. They start in January of 2010. The effect of the bill, whatever the proposals are going to be in the bill, whatever programs are available, will not come into play until 2014. The taxes will start this next year, and they will be paid for 4 years before any of the programs the bill is supposed to put forward will be there. The motion Senator Thune and I put forward merely says that taxes start being collected when the bill is implemented. So whatever programs are being offered to the people, whatever insurance programs, whatever kinds of benefits there might be in the bill would start at the same time as the taxes start. So you are not going to be paying taxes before you have any options that you would be able to take in this bill.

It is simple. It is clear. We believe that if you pay taxes for 4 years before you see any of the programs in this bill, the American people can't be sure there will ever be a program, because there will be intervening Congresses and intervening Presidential elections that will occur before this bill is designed to start in 2014. We have congressional elections in 2010. We have a Presidential election plus congressional elections in 2012. And 2 years following that, 2014, is when this bill will be implemented.

I hope everyone will look at this motion and support the amendment we are putting forward. It is a motion to commit the bill to fix this issue, that America should not be looking at higher drug prices, higher medical device prices, and higher costs of insurance, all of which are the first taxes that will take effect.

Let's walk through it. Starting next year in January, 3 weeks from today, there will be $22 billion in taxes on prescription drug manufacturers that will start. The price of prescription drugs, aspirin, anything that people take will go up because the drug manufacturers are going to start paying a tax. There is $19 billion in taxes on medical device manufacturers. So medical devices we use, hearing aids, things we use to treat ailments will be taxed to the tune of $19 billion next January. There is $60 billion on insurance companies starting next month. That is about $100 billion in taxes that start in about 3 weeks. So the insurance companies have probably already priced in the negotiations that they are having now with people about their insurance premiums. I am sure they realize that they are going to have to be locked in for a year or two or three and, therefore, these rises in insurance premiums are probably part of this bill we are dealing with right now. And $60 billion will be passed on to every person who has health care coverage right now.

Here we are, health care reform that is supposed to bring down the price of health care so that more people can afford it. And what is the first thing we do? It is not to offer a plan. It is not to offer any kind of program that would help people who are struggling right now because they don't have insurance. It is certainly not going to help people struggling to pay their prescription drug prices. We are going to raise the price by taxing the manufacturers of drugs, of medical devices, and the companies that are giving insurance today.

It is time that we talk about the high taxes in this bill. What we are going to talk about in the Hutchison-Thune proposal, the motion to commit, is to say at the very least, the least we can do is not ask people to pay taxes for 4 years when you are going to have three intervening congressional elections before this bill takes effect. Things could change mightily. All these taxes that are going to go into place might never bring forward the proposals that are in the underlying bill.

In 2013, 1 year before the bill is to take effect, the taxes on high benefit plans go into effect. What is a high benefit plan? A high benefit plan is one that is a good plan. Many unions have these, and many people who work for

big corporations have everything paid for. They have all of the employer regular, in the order that most companies do, payments, but they also allow in these plans to have most of the deductibles also paid for. They are very good plans. This bill will excise for those plans $149 billion, cut it right out and have an excise tax on those good plans, $149 billion. That starts in 2013. That is 1 year before the bill takes effect.

In 2013, 1 year before there is any new plan put forward, those who have very good coverage--whether it be someone who works for a big company or whether it is a union member--will start getting a 40- percent tax on that benefit. So all of the things that have been negotiated are going to have a big 40-percent tax. That starts in 2013.

In addition, in 2013, 1 year before the bill takes effect, there is a limitation put on itemized deductions for medical expenses. Today, if you spend more than 7.5 percent of your income on medical expenses, you get to deduct everything over that. So if you have a catastrophic accident or you have a very expensive disease to treat or you are in a clinical trial--something that is expensive--if you go above 7.5 percent of your income, you can deduct that. In 2013, under the bill that is before us, you would have to spend 10 percent of your income before you could deduct those expenses. That is another $15 billion that will be collected in taxes that are not collected today.

The new Medicare payroll tax, which impacts individuals who earn over $200,000 or couples who earn $125,000 each, would take effect in 2013. That is $54 billion in taxes.

These are all the taxes that take effect before the bill does, before there is any plan offered. You would have the tax that starts next month on insurance companies, pharmaceutical companies, and medical device companies. Then, in 2013, you would have a tax on high-benefit plans, a 40-percent tax on that plan. Then, in 2013, the itemized deductions will not be allowed until you have paid 10 percent of your salary in medical expenses. Then there is the Medicare payroll tax, which is going to impact individuals. All of this is before there is a program in place.

In 2014, when the bill does come forward so there are plans to be offered to people, then you start the mandates on employers and the taxes if people are not covered. So you have $28 billion in taxes on employers that start in 2014. These are the employers who cannot afford to give health care to their employees or they do not give the right kind of health care to their employees, so it is not the right percentage, and if it is not the right percentage, then the employer pays a fee of $750 to $3,000 per employee. That is their fine.

Then there is the tax on individuals who do not have health insurance, and that is $750 per adult.

My colleague from South Dakota and I will certainly want to spend more time talking about this and hope very much that our colleagues will also. I do not think this is what the American people thought they would be getting in health care reform. Of course, what we would hope the American people would get in health care reform would be lower cost options that do not require a big government plan. They would not require big taxes. They would not require big fees. If we had a lowering of the cost, by allowing small businesses to have bigger risk pools, that would not cost anything. It would allow bigger risk pools that would provide lower premiums and employers would be able to offer more to their employees.

Most employers want to offer health care to their employees. It is just a matter of the expense. The bill we are debating now is going to put more expenses and burdens on employers, at the time when we are asking them to hire more people to get us out of this recession.

Everywhere I go in Texas, when I am on an airplane, when I am in a store, a grocery store--I have not been able to do any Christmas shopping, I must admit, so I have not been in a department store, but nevertheless I do go to the grocery store--everyone who I am talking to is saying: I can't afford this. What are you all doing? And I am saying, of course: Well, we are trying to stop this because we agree with you that small businesspeople cannot afford this.

I was a small businessperson. I know how hard it is because we do not have the margins of big business, and it is very hard to make ends meet when you have all the mandates and the taxes, and when you are trying to increase your business and hire people, which is what we want them to do. You cannot do it if you are burdened with more and more expenses, as this bill will do.

What Senator Thune and I are doing is making a motion to commit this bill back with instructions, to come back with the changes that will assure that when the implementation of this bill starts, that will trigger whatever programs are in the bill at the same time as whatever taxes and fees are going to be in this bill.

I would hope there would be fewer taxes and fees. But whatever your view is on that issue, it is a matter of simple fairness that you would not start the taxes before you start the implementation of the program. It would be like saying: I want to buy a house, and the realtor says: Well, fine, you can start paying for the house right now, and in 4 years you will be able to move in. The house might be stricken by lightning. It might fall apart. It might blow up. It might have a fire. And that is exactly what could happen in this bill.

This bill may not make it for 4 years, when people see what is in it. There will be elections, and I cannot imagine we would establish a policy of taxing people for 4 years, raising costs, leading down this path that will eventually go to a public plan that will end up doing what was originally introduced in the bill; and that is, to end up with one public plan. It will take a little longer the way the bill is being reconfigured, but it is going to end up in the same place, unless we can stop it by showing people that the mandates and the taxes are not good for our economy and they are not good for the health care system we know in this country.

We have choices in this country. We have the ability to decide who our doctor is and what insurance coverage we want, whether we want a high deductible or a low deductible. That is not a choice that should be taxed. We should not have someone tell us what procedures we can have. We should have the option of deciding that for ourselves with our doctors. That is what we want in health care reform. But that is not what is in the bill before us.

I hope we can discuss the Hutchison-Thune motion to commit. We are going to work to try to make sure everyone knows we want fairness in this bill and that people know what is in it. I hope we will get whatever the new version of the bill is very soon so we will have a chance to see if maybe there are some changes that are being made. But in the bill before us, the taxes start next month, and the bill is implemented in 2014. On its face, that is fundamentally unfair. I hope our motion is adopted so we can change it.

Mr. President, I yield the floor.

Mr. President, as I understand it, we are now in the 30-minute timeframe for the Republicans; is that correct?

Mr. President, I ask unanimous consent that we be allowed to have a colloquy so we can go back and forth.

I thank the Acting President pro tempore.

Mr. President, I think the Republican leader just stated the case for why it is so important that we have the votes and that we go back to the drawing board on this bill. Americans are looking at the fine print of this bill. They are seeing $\1/2\ trillion in taxes.

Just this week, the President has had a jobs summit because we are all concerned about jobs. My goodness, since the President took the oath of office, more than 3.5 million Americans have lost their jobs-- 300,000 Texans--our budget has tripled to $1.4 trillion, and the Federal debt as a portion of the U.S. economy has risen to its highest level since World War II. So we are very concerned about these taxes. In fact, the small businesses of our country have said: No, do not do this to us.

The NFIB, which is the National Federation of Independent Business, sent a letter just this week saying:

When evaluating healthcare reform options, small business

owners ask themselves two specific questions. First, will the

bill lower insurance costs? Second, will the bill increase

the overall cost of doing business?

Well, the answer to the first question is clearly no because the business taxes start on January 1, 2010--3 weeks or so from now--and going forward, the mandates and taxes in 2014 to small business are egregious. It could be $750 per employee or it could be $3,000 per employee if you do not have exactly the right mix of health care coverage for your employees. Well, at $3,000 per employee, small businesses are telling me: I am out of here. We are just going to let people go to the government option because we cannot afford that.

So the answer to question No. 2 in the NFIB letter--which is, ``Will the bill increase the overall cost of doing business?''--is, well, of course it will, at a time when we are seeing the numbers of people employed go down.

We are in a financial crisis in this country. People are jobless. We are in a holiday season. People are very stressed, and here we have a health care bill being rushed through, without amendments being able to come forward with a real chance for passing them. The cost of business is going to go up, which means more people are going to be laid off.

Now, I want to ask my friend, the Senator from South Dakota, a question because he and I are teaming up on an amendment. If we are going to have taxes increase in 3 weeks, you would say: Oh, OK, well taxes are going to start in 3 weeks, so, then, where is the package I signed up for that is going to lower my health care costs? So I would ask the Senator from South Dakota, when do the programs that are supposed to lower health care costs take effect?

So I would ask the Senator from South Dakota--because it is our amendment, the Hutchison-Thune amendment--and surely the American people, who would look at the debate, would say: We are missing something. This cannot be right. We can't have taxes that are increasing our premiums, increasing our prescription drug costs, increasing our medical devices we must have for our health care for 4 years. Did he say that right? Did he say we would be paying those higher costs for 4 years before there is any option available to allow more people to have health care coverage?

Mr. President, I am glad you mentioned the Farm Bureau because my constituents in the Farm Bureau, 400,000 members of the Texas Farm Bureau, have contacted me repeatedly about how bad this will be for the farmers, the small businesses they own, and the few people they employ. Maybe they have five employees. This will be a killer for them.

To reinforce the letter that the Senator from South Dakota read from the Small Business Coalition for Affordable Health Care, they say in the letter:

If this bill is enacted, the small business community will

be forced to divert resources away from hiring and expansion,

the very investments our country so desperately needs as it

continues to struggle in a faltering economy with double-

digit unemployment.

Then they go on to talk about what those costs are going to be: a small business health insurance tax; an employer mandate that encourages job cuts, not job creation; and the temporary small business tax credit falls short.

I am glad they mentioned this temporary small business tax credit because I have heard them say on the other side of the aisle: But there is a tax credit for small business that will alleviate the pain.

Well, that credit is for employers with fewer than 25 employees with average annual wages of less than $40,000. Very few small businesses are going to be able to qualify for this tax credit. That is a very strict standard. The average annual wages of less than $40,000 are going to be very difficult. However, if they qualify, the credit is temporary. The credit is temporary. It is not a permanent credit that helps people who would be able to qualify for this credit. So, in effect, this is not a tax credit at all, and certainly when it goes away it will help no one.

I ask unanimous consent to have printed in the Record the letter from the Small Business Coalition for Affordable Healthcare.

Mr. President, I am from a State that has big cities, but the vast majority of my State is rural, as is Wyoming and as is South Dakota. I see my employers, my small business owners, which are the largest bulk of the employers in my State, every day. I talk to them or I see them. Unfortunately, we are in Washington every day right now, 7 days a week, but when I am home I see them and when I am here and talking to them on the phone, or they are visiting me, I talk to them and they are aghast. They are aghast that Congress would actually be putting more strain on small business at a time when we know the jobless rate is the highest since World War II and people are trying to do their part to increase our economy and they can't do it with more taxes, more mandates, more burdens. So it is time we look at the tax burden and do something about it.

The Senator from South Dakota and I are trying to do something about it. We are saying, at the very least we should not allow this bill to go forward when the taxes start next month--January 2010--because none of the programming gets up and running until 2014. So we are going to have the mandates and the business taxes and we are going to have the program that is supposed to alleviate the health care crisis in our country in 2014. Shouldn't we start all of the taxes in 2014 rather than asking people to pay for 4 years the taxes that will increase insurance premiums, increase prescription drug costs, and increase medical equipment costs--$100 billion in new taxes on those items-- shouldn't we at least put it off until the supposed program comes into place. Because in 4 years, with any luck in America, we won't have these programs start.

There is hope for America that we can stop this program by 2014 as people learn what is in it and protest enough that the Members of Congress who are elected in 2010, elected in 2012, will say: No, we now know that this would be a disaster for our country. There is hope.

I would ask the Senator from Wyoming, when people start learning about the Medicare cuts about which you have spoken so eloquently, and the taxes on the small businesses in your State and all of our States, do you think that perhaps not putting these taxes in place is a good policy, because maybe we can still stop this when people find out what is in it, when it is supposed to take effect 4 years from now?

Mr. President, I ask unanimous consent that until the Democrats take over, we may continue to talk.

Mr. President, to continue with the Senator from South Dakota, I am glad he made the point because we are very much hoping our amendment will be in the order when we start voting on the health care amendments.

The amendment is so clear; it is very simple. I have it here. For Washington, it is half a page. That is something everyone will be able to appreciate--the motion to commit with instructions:

Senator Hutchison and Senator Thune move to commit the bill

to the Committee on Finance with instructions to report back

to the Senate with changes to align the effective dates of

all taxes, fees, and tax increases levied by such bill so

that no such tax, fee, or increase takes effect until such

time as the major insurance coverage provisions of the bill,

including the insurance exchanges, have begun.

The committee is further instructed to maintain the deficit

neutrality of the bill over the 10-year budget window.

That is what was promised. This was going to be deficit neutral. It is not deficit neutral. The cost of this bill is $2.5 trillion over the 10-year period when it starts, in 2014 until 2023. It is $2.5 trillion. The ``offset''--I put that in quotes because the offsets are $500 billion in tax cuts to Medicare, which will lower the ability of hospitals to stay in business and treat Medicare patients and doctors to be able to treat Medicare patients.

So the quality of Medicare is going to go down. Medicare Advantage will be severely restricted. So you have $500 billion in cuts to Medicare, and then you have $500 billion in tax increases and mandates. That is a total of $1 trillion in offsets in a bill that costs $2.5 trillion.

What the Senator from South Dakota and I are trying to do is let's keep our word. Let's keep our word and do two things that the American people should expect: No. 1, that we would not start the taxes until the program takes effect; No. 2, that it would be deficit neutral.

By my math, I ask the Senator from South Dakota, it looks to me like we are $1.5 trillion into the deficit, and we are already at a debt ceiling that is higher than we have had as a percentage of our GDP since World War II. So it is a $12 trillion debt ceiling we are hitting right now, and we are talking about a $1.5 trillion deficit in the bill we are being asked to vote for.

I ask the Senator from South Dakota, who is my cosponsor on this very important amendment, don't we owe the American people the transparency, as well as the policy, that we would eliminate the deficit and we would stop these disastrous taxes from taking effect, so maybe we would have a chance to change this product going forward in the next 4 years so the American people will not be saddled with these expenses, taxes, and mandates?

I am sorry to interrupt my friend. I ask unanimous consent that he have 1 minute to finish, after which the floor would go to the majority.

I thank the Senator from Arizona. I am pleased our leader is standing strong to say nothing should take precedence over our handling of this bill and making sure it is done right. That is what the Republicans are trying to do, to make sure this is done right. We talked about the Medicare expansion that is in the purported bill that we have not seen yet but that Democrats appear to be putting forward. We have also been spending the week talking about $\1/2\ trillion in cuts to Medicare. Now we are talking about possibly expanding Medicare at the same time we are cutting $\1/2\ trillion out of the care Medicare patients would get.

I have an amendment. It would stop the $135 billion in cuts in the underlying bill to hospitals, cutting hospital reimbursements for Medicare patients. That is my amendment. Now we are talking about possibly expanding Medicare. The American Hospital Association put out an alarm, an action alert. It says:

Medicare pays hospitals 91 cents for every dollar of care

provided. Medicaid pays just 88 cents for each dollar of care

provided.

Medicaid, which may also be expanded, and the cuts in Medicare, which we are talking about possibly expanding, would go forward. Which means what? The hospital association knows what. ``What'' is rural hospitals that care for Medicare patients are going to go under. What kind of services can be provided if there is no hospital in the whole county that can provide care to these senior citizens? I ask the Senator from Arizona, who has been such a leader on this, we are going to cut $135 billion out of Medicare coverage for hospitals. We are going to now talk about expanding the coverage of more Medicare patients, which will mean we will cut more from the hospitals than is even envisioned in the underlying bill. Help me understand this, Senator. How would you suggest that passes the commonsense test?

Is the Senator saying that whether you were at the top of your class, such as the Senator from Oklahoma or the Senator from Tennessee or the Senator from South Dakota, or the bottom of your class, as the Senator from Arizona has admitted he held down the fort, regardless of where you are on the quotient of where you stood in your class, you know what the bottom line is.

Mr. President, I ask unanimous consent that we be able to go into a colloquy for the next half hour.

Mr. President, I rise today to talk about the taxes that are in this bill--taxes that are imposed in 3 weeks--not 3 weeks from 6 months from now, not 3 weeks from 2014, but 3 weeks from now, January 1, 2010. Three weeks from now, on January 1, 2010, we are going to see the taxes in this bill start.

I know people are saying: Wait a minute. This bill doesn't take effect until 2014. That is what we have been talking about. It is what we have been hearing. But, no, the tax part starts in 3 weeks--January of 2010.

I have partnered with Senator Thune, who has been working on this problem, and Senator Grassley and Senator Hatch and many others who will be speaking today.

I see my colleagues from Florida, Nebraska, Wyoming, as well as my colleague, Senator Crapo, from Idaho, all of whom--Senator Crapo, of course, is waiting for a vote on his amendment, which would stop the taxes on everyone who makes $200,000 or less.

We are talking about the taxes because it is such a huge issue. Here is what is going to happen with the taxes in the bill that start in 3 weeks. Americans will pay more in insurance premiums. Americans will pay more in prescription drugs. Americans will pay more for medical equipment. Let's walk through those taxes.

In a few weeks, in January of 2010, this will begin: $22 billion in taxes on prescription drug manufacturers; $19 billion in taxes on medical device manufacturers; $60 billion in taxes on insurance companies. That is around $100 billion, which starts in 3 weeks. Then, in 2013, the taxes on high-benefit plans take effect. That is $150 billion in taxes. So for every union member who has a good plan that gives them the benefits they have negotiated for over the years, those taxes come in at 40 percent of the benefits. That starts in 2013.

You are still saying: Wait a minute. I thought the bill started in 2014--and that is right. But the taxes start in 3 weeks, and they keep right on going. In 2013, the high-benefit plans start getting a 40- percent excise tax.

Mr. President, when the $100 billion in taxes start in 3 weeks on drug manufacturers, medical device manufacturers, and insurance companies, what happens? Premiums go up immediately, prescription drug prices go up immediately, and the medical devices--hearing aids and things people need for medical treatments--go up immediately.

We have been talking about health care reform and the need for it, and the need to make history. Yet the reform we are going to see go into effect right away is huge tax increases. I am here with many colleagues, who are so concerned about this for their constituents.

I ask the Senator from Wyoming, who is one of the two physicians in the Senate--he has been so active in this area. When the taxes go up on our insurance premiums, our prescription drugs, and our medical equipment, I ask the Senator from Wyoming, as a physician, what does he think is going to happen to the cost of health care.

The President said, in his address to the joint session of Congress, that this bill had to come in at a cost of no more than $900 billion. So the CBO scored the bill at $847 billion. But the Senator from Wyoming has brought up a point that is because they started scoring the bill in 2010, but the services in the bill don't start until 2014.

If you take the years from 2010 to 2019, it probably comes in at $847 billion. But if you start when the spending starts and go to 2023, the cost is $2.5 trillion.

I just ask the Senator from Nebraska if his constituents are hearing of this $2.5 trillion cost, with one-quarter of it coming from Medicare cuts and about one-quarter of it in new taxes that start next week. What does the Senator from Nebraska say about this?

I thank the Senator from Nebraska. I think having been a former Governor, his view is especially important. What we have heard through the grapevine--we haven't seen any new proposals, but we heard there is going to be an expansion of Medicare and an expansion of Medicaid. Medicaid, in particular, is going

to be very costly to States because they have a matching requirement for Medicaid. Many Governors are concerned about that.

I know the former Governor of Nebraska, in his background, realizes that is one of the biggest issues in a State's budget.

I know the Senator from Florida also has experience with being in a Governor's office, being a chief of staff for a Governor. He has been very active, especially because the population of Florida has a very high rate of senior citizens. The cuts in Medicare in the bill are huge. He is on the Senate floor. I am just wondering, when we are looking at the cuts in Medicare and the huge taxes, how that will impact the State of Florida, and how he thinks we are going to have to deal with that.

I am very pleased that the Senator from South Dakota talked about what we are trying to do because it is very simple. It is very simple. The Hutchison-Thune motion to commit says, if we do nothing else, if we do nothing else in this bill, we have to be fair and transparent with the American people; that is, we do not start the taxes, we do not start the increases in premiums, increases in prescription drug benefits, increases in medical devices until at least there is an implementation of this insurance program that we hear is going to be offered to the American people. We have not seen it, but we are told that there is going to be an insurance program that Americans can sign up for, but they are going to be paying higher taxes and premiums and costs in health care for 4 years before they ever see it. All we are saying is, let's send this bill back to committee and fix that.

It does not--as the Senator from Nebraska said earlier--pass the smell test. It does not pass the smell test in Nebraska, Wyoming, Florida, Idaho, South Dakota, or Texas. To tax people for 4 years, to raise their costs until they basically are going to say, Give me an alternative, and the alternative is, guess what: A big government takeover of our health care system. That is like saying: I am from the Federal Government, and I am here to help you. We have heard that before.

I do not think the American people will in any way believe that this bill is fair or honest with them if we start the taxes 22 days from now, as the Senator from South Dakota has pointed out, but they do not see a program. They are going to go online and say: Oh, my premiums are going up, my prescription drugs are going up; my goodness, where is the insurance program they have been talking about? They are going to go online, but, hey, there is no program.

How can we go home--I ask any of the Senators who would like to add their perspective on this--how are you going to go home and tell your constituents that your taxes start in 22 days, and maybe in 4 years, roughly, maybe you are going to see a program, and we are from the Federal Government, and we are here to help you?

How much time is left on our side?

Let me give the last 5 seconds to the Senator from South Dakota.

Reserving the right to object, I ask the Senator from Florida, it is 10 minutes and going back and forth. It is not 30 minutes allocated per side; is that correct?

How much time remains on our side?

I thank the Chair.

Mr. President, we have been talking about the Crapo motion and the new taxes that are in this bill. There are so many new taxes that it is going to increase the cost of health care to every individual who has health insurance. It will also tax the people who don't have health insurance. It will tax the people who have too much health insurance. The taxes in this bill are almost mind-boggling.

Yesterday we talked about the cuts in Medicare. But we are also talking now about the $\1/2\ trillion in tax increases, $500 billion of tax increases. What Senator Crapo's motion will do is to say that we want to go back to the promise made by the President that no one who makes under $200,000 or a couple who makes under $250,000 would have any tax increases. It recommits the bill and takes out everything that would tax individuals at that level because the promise was made to the American people.

Senator Crapo's motion would certainly benefit those who have high- benefit plans which are going to have a 40-percent excise tax in this bill. If your plan is considered high benefit and you make under $200,000 a year or you are a couple making under $250,000 a year, you should not have to pay, because your benefits are better than the government has said they should be.

We would help the union member, for instance, because the unions do have high-benefit plans. We would help those union members who are making under $200,000 a year, if they are single, to make sure that they are not going to pay a tax for having too much coverage. Then there are the individuals who have no coverage or too little coverage who are going to have to pay an individual tax in this bill of $750. Surely if someone can't afford to have health insurance, we should not be taxing them. The Crapo motion will assure that when this goes back to the committee, someone would not be subject to the individual mandated tax, if they make under $200,000 a year, which they surely probably do, or if they have a high-benefit plan and they make under that amount. It is trying to say that promise that the President made would be kept.

I also wish to talk about another issue in this bill. One would think that the bill takes effect in 2014, so the taxes would take effect in 2014 as well, that everything will come together and start in 2014. That is what one would think, but they would be wrong. That is not the case. In fact, the biggest part of the taxes in this bill will take effect next month, less than 1 month from now. The taxes that are going to increase the cost of health care premiums, prescription drugs, equipment that you would use for medical care--the taxes start next month. The bill imposes taxes for 4 years before any person would be able to sign up for any of the plans that are going to be available, presumably, under this bill.

Let's walk through this: $22 billion in taxes on prescription drug manufacturers would start next month; $19 billion in taxes on medical device manufacturers, next month; $60 billion in taxes on insurance companies across the board, next month. What is going to happen? Of course, the cost of all of those items will go up. Americans will start next month paying more in insurance premiums. Americans will pay more for their prescription drugs and more for their medical devices because those taxes start next month for supposed programs that are going to start in 2014. Well, maybe you would think the benefits would start coming in 2011, 2012, 2013. Not at all. Nothing starts in benefits or programs until 2014.

But there are more taxes that come before 2014. In 2013, taxes on high-benefit plans take effect: $149 billion. This will affect union members, surely people making under $200,000. They will be affected starting in 2013, but any benefits from this bill would take effect a whole year later.

The limit on itemized deductions for medical expenses is also changed. Under this bill, you would have to spend 10 percent of your income on medical expenses before you could take a deduction. This is for people who have a terrible accident or a debilitating high-cost disease, such as a cancer treatment, maybe a clinical trial. So present law is 7.5 percent of your income, and you can start deducting these expenses. But with the new bill, starting in 2013, you have to go to the 10-percent threshold before you can have those deductions. So that would be another $15 billion in taxes to individuals.

Finally, in 2014, after 4 years of taxes and increases in premiums and medical devices and prescription drugs, then you would start seeing the rest of the bill take effect. In 2014, you still have more taxes. Mr. President, $28 billion in employer taxes will start in 2014. These are for employers who cannot afford to meet the threshold of what they will have to cover for their employees. Or individuals who cannot afford health care will have $8 billion in taxes. That starts in 2014.

I am working with Senator Thune. There will be a Hutchison-Thune motion to commit this bill that will say the taxes start when the implementation of the bill starts. I think that is a matter of fairness. We want to commit the bill and say: Everything should start at once. How can we tax people for 4 years, raise their prices on insurance premiums, raise their prices on drugs, raise their prices on medical devices when they get none of the opportunities that would be in this bill until 2014?

I am going to be working with Senator Thune, Senator Grassley, and Senator Hatch to try to make the corrections in this bill that will present transparency and fairness to the public about what these taxes are and when they start, then, when the implementation of the program starts.

It is so important we have the ability to say to the American people, if this bill passes: You are not going to be taxed, your prices are not going to go up, your premiums are not going to go up--any more than they already have, caused by the increased taxes in this bill--at least until the bill is implemented. We are going to try to do that in the bill for the American people very soon. I am very much looking forward to talking about this issue.

I talked to someone last night who heard us starting to talk about the taxes in this bill, and they were astounded.

They were astounded.

We are going to try to give relief to the American people and have a bill that will truly not have the taxes and mandates that are there now that start 4 years before the bill is implemented.

Mr. President, I yield the floor.

Madam President, I rise today to talk about another amendment that is pending, the Nelson-Hatch-Casey amendment. This is an amendment that I think has been discussed in the last day as well. That is the amendment that would assure that no Federal funds are spent for abortion. That was unclear. It is unclear in the underlying bill. I think it is very important we talk about it, that we make sure it is very clear exactly what the Nelson-Hatch-Casey amendment does; and that is, it would bar Federal funding for abortion, which is basically applying the Hyde amendment to the programs under this health care bill.

Since the Hyde amendment was first passed in 1977, the Senate has had to vote on this issue many times, probably just about every year, and I have consistently voted to prohibit Federal funding for abortions, as I know my colleague and friend from Utah has done, as well as the Democratic sponsors of this amendment.

Yet it seems that some Members were on the floor last night misconstruing exactly what the Nelson-Hatch-Casey amendment does. Specifically, their claim was that the Hyde language only bars direct funding for elective abortions while the Nelson-Hatch-Casey amendment bars funding of an entire benefits package that includes elective abortions and therefore is unprecedented.

I wish to ask the distinguished Senator from Utah, what exactly did the Hyde language say? Let's clarify what Hyde was, so we can then determine if your amendment is the same.

So Federal funds are prohibited from being used in abortions in that particular bill.

What about programs such as CHIP, that was created in the Balanced Budget Act? And in 2009, it was reauthorized by Congress and signed by the President earlier this year. What about the CHIP program?

I would assume you do know what is in that bill. What about the Federal Employees Health Benefits Plan, what does it say?

Well, isn't that the same as the language in the Nelson-Hatch-Casey amendment?

So based on what you have said, this is not new Federal abortion policy. The Hyde amendment currently applies to the plans discussed, including the plans that Members of Congress have. And the abortion protections for all of the Federal health programs all say exactly the same thing.

The amendment we are going to vote on that is the Nelson-Hatch-Casey amendment would preserve the three-decades-long precedent--that is what your amendment does--and that we must pass it if we are going to guarantee that the bill that is on the floor is properly amended so it is the same as our 30 years of abortion Federal policy in this country?

I thank the Senator for the explanation. I thank the Senator from Utah because I do think it is important people know. There has been a lot of questions raised about the bill and whether it would be a foot in the door for changing a policy that has been the law of our country, and accepted as such. Whether it was a Democratic- controlled Congress or a Republican-controlled Congress, I think everyone has agreed this Hyde amendment language has protected Federal taxpayers who might have a very firm conviction against abortion so they would not have to be subsidizing this procedure.

I will.

Madam President, we have spent the last few days highlighting how this health care reform bill is paid for by cutting benefits to seniors, jeopardizing their access to care. Almost $500 billion will be cut from the Medicare Program.

But this bill also imposes $\1/2\ trillion in new taxes. These are taxes that hit every American and virtually every health care business or related business in the country.

During an economic downturn, this approach is counterintuitive. These taxes will discourage investment and hiring. We are in one of the worst economic downturns in the history of our country. We do not need to tell anybody that. We are all feeling it. We know people who are suffering right now.

I look at what has been done in the past when we have had economic downturns, and I look at President Kennedy, President Reagan, President Bush. They lowered taxes. What happened? The economy was spurred. Lower taxes have proven to spur the economy. Yet in this bill we see $\1/2\ trillion in new taxes on families and small businesses.

Let's walk through some of these taxes.

Employer taxes. Madam President, $28 billion in new taxes is imposed on businesses that do not provide health insurance to their employees. To avoid the tax, an employer has to provide the right kind of insurance--insurance that the Federal Government approves. It is going to be a certain percentage and have certain coverage requirements. Employers who do not provide the right kind of insurance could see a penalty as high as $3,000 per employee.

We should be encouraging people to hire in this kind of environment. That should be job No. 1: creating jobs.

Yet imposing taxes and fines are what is in this bill, and that is not going to encourage hiring; it is going to discourage hiring. That is economics 101.

Individual taxes: There are $8 billion in taxes for those who don't purchase insurance on their own. The tax is $750 per person. Again, because you are insured today does not mean you will avoid the tax. You must have the right kind of insurance--insurance that the Federal Government approves and says is the right amount of insurance.

How about the taxes on high-benefit plans? There are $149 billion in taxes on health insurance plans that the Federal Government says are too robust. These high-benefit plans--Cadillac plans some call them-- would be subject to a 40-percent excise tax. To make it worse, the tax is not indexed, so it is a new AMT, a new alternative minimum tax that everyone says was not supposed to encroach on lower income people, but, in fact, it has because it is not indexed for inflation.

So here we are. In this bill, you get taxed if you don't provide enough benefits and you get taxed if you provide too many benefits. So this is beginning to sound like government-run health care to me, and I can only imagine how the unions feel because they are the ones that have these high-benefit plans and here they are under fire because they have too much coverage.

Medicare payroll tax: This is the new payroll tax that is imposed on individuals making more than $200,000 and couples making more than $250,000. That tax raises another $54 billion. This additional payroll tax is a marriage penalty. It is not indexed to inflation, meaning it is another AMT in the making because today, that may sound high-- $200,000 and $250,000--but it is a huge marriage penalty, and it could begin then to go down in numbers so that more and more people are affected.

This body voted unanimously during the budget debate--unanimously-- that a point of order would be made against legislation that would impose a marriage penalty in the budget. So we have voted unanimously that a budget point of order would stand if there is a marriage penalty in the budget. So now here we are a few months later, and the majority is not only retreating from the opposition to the marriage penalty, but we now have for the first time in our Tax Code--or will when this bill passes--a payroll tax marriage penalty. How on Earth can we do that?

I am going to fight this marriage penalty, and I hope the Senate will vote against this concept. It is a new precedent that could be set in other areas that would say if you are married, you are going to get fewer benefits than if you are single. That is not a precedent we ought to be setting.

Then there is the medical deduction cap. There is a change in our Tax Code that would limit the itemized deduction for medical expenses. We have always had one that said if your medical expenses go above 7.5 percent of your income, that you would be able to deduct anything above that. This bill increases that threshold to 10 percent so that if you are going to get deductions--and this is going to affect people who have catastrophic accidents, really, really high medical bills, debilitating health conditions, or very, very expensive medicine--if you go above 7.5 percent today, you would be able to deduct. But in this bill, it is going to be 10 percent of your income before the government is going to allow you to deduct these added expenses.

Then there is the drug, device, and insurance company taxes: $60 billion in taxes assessed to insurance companies, $22 billion to prescription drug manufacturers, and $20 billion on medical device manufacturers. The experts have said, all of the economists have said these taxes will be paid by the public. Of course they are going to be passed on: higher premiums for every insurance policy that is already there, and higher prices for medications and medical equipment.

So medications you take for diabetes or heart disease, medications or medical devices that you need to fight cancer would all become more expensive because every one of them would have a higher cost because the company is going to pay an added fee just for producing these medicines and equipment.

So many people today are struggling with their medical bills. They are struggling to fill prescriptions. Why aren't we bringing costs down? Isn't medical cost part of the reason for reform because the costs are going up? Wasn't the point of reform to bring the costs down so more people would have affordable options for health care coverage? What happened to that? All of these taxes on individuals and businesses are going to drive prices and costs up.

In closing, the bill before us imposes $\1/2\ trillion in new taxes at a time when unemployment is soaring and our economy is struggling. We have $\1/2\ trillion in cuts to Medicare which is going to severely hurt our senior citizens and their access to health care, and then $\1/ 2\ trillion in tax increases, taxing marriage, taxing Tylenol, taxing high-benefit plans, taxing low-benefit plans, taxes if you offer employee health care coverage, and taxes if you offer not quite enough. This is a tax-and-spend bill.

Republicans have repeatedly put forward ideas that would reform our health system, bring the costs down without burdening our employers with more taxes that would keep them from helping our economy by hiring more people; ideas that would increase competition and transparency and ensure access to affordable care.

So I hope while our colleagues are meeting to try to get their 60 votes--which we know they are--that maybe they might consider bringing everybody into this process and listening to other ideas that would not be a government takeover of our health care system; that would not be more government mandates, more taxes, cuts from Medicare services. This is a recipe for disaster for our country, and I hope it is not too late for the Democratic majority to say: OK, let's get together and try to put together a bipartisan plan that will not hurt the quality of health care that Americans have known and expected in our country, one that will bring costs down and make health care more affordable, one that will give carrots to our employers not sticks that will switch them if they don't have the right kind of coverage or the government-approved coverage or the right percentage of coverage.

We can do better and I hope we will.

Thank you, Madam President. I yield the floor.