Floor Statements

Mr. President, before I begin, I congratulate Senator Dodd for all of the extremely hard work he has done on Wall Street reform. We are certainly pleased that we are at this point in time.

Mr. President, I come to the Senate floor this afternoon to

discuss two nominees for the Fourth Circuit Court of Appeals--Judges Jim Wynn and Albert Diaz.

When I came to the Senate, I had high hopes of increasing the number of North Carolinians on the court. North Carolina is the fastest growing and largest State served by the Fourth Circuit. Yet only 1 of the 15 seats is filled by the abundant talent from our State, and over the past century North Carolina has had fewer total judges on the court than any other State.

Furthermore, there have been inexcusable vacancies on this court throughout history. Given that the U.S. Supreme Court only reviews 1 percent of the cases it receives, the Fourth Circuit is the last stop for almost all Federal cases in the region. We must bring this court back to its full strength. Since 1990, when this court was granted 15 seats, it has never had 15 active judges.

Judge Wynn brings decades of judicial experience to the bench. He has served on the North Carolina Court of Appeals since 1990 and had a brief tenure on the State supreme court. He has been the chair of the bar association's Judges Advisory Committee on Ethics.

Additionally, Judge Wynn has served on Active and Reserve Duty in the Navy for 30 years and was a certified military trial judge. He has been honored for his extraordinary service several times, including three Meritorious Service Medals.

Judge Diaz has served since 2005 as one of North Carolina's three business court judges. Prior to that, Judge Diaz was a judge on the State superior court for nearly 4 years.

As a business court judge, Judge Diaz has handled complex business cases. He started as a lawyer in the U.S. Marine Corps, was an appellate counsel in the Navy's Office of the Judge Advocate General and has been a judge in the Marine Corps Reserves.

Judge Diaz also has extensive experience in business litigation and has served on the State Judicial Council which advises the State supreme court's chief justice on ways to improve the courts. He is a graduate of New York University Law School, with a graduate degree in business from Boston University and undergraduate degree in business from the University of Pennsylvania.

I note that both judges have received unanimous ratings of well qualified from the American Bar Association.

Additionally, both men's confirmation to this Federal bench will be historically significant, as Judge Diaz will be the first Latin American on the Fourth Circuit and Judge Wynn will be the fourth African American to ever serve on this bench.

These fine men have the support of both myself and my colleague from North Carolina, Senator Burr. Editorials and newspapers throughout North Carolina have praised these nominations and have urged their swift confirmation. The Charlotte Observer said Judges Wynn and Diaz are ``widely regarded as intelligent, ethical judges who have won respect for their judicial and military careers. They are the kind of judges the federal bench needs . . . Their quality is so unquestioned that only partisanship could stall their nominations.''

Unfortunately, I worry that is what is happening. Both Judge Wynn and Judge Diaz were approved by the Senate Judiciary Committee on January 28--Judge Diaz unanimously and Judge Wynn with only one dissenting vote. But for over 5 months now, the nominations have languished on the calendar. It is past time that these two fine judges be confirmed to the Fourth Circuit.

Mr. President, as in executive session, I ask unanimous consent that at a time to be determined by the majority leader, following consultation with the Republican leader, the Senate proceed to executive session and consider en bloc the following nominations on the Executive Calendar: Calendar No. 656, Albert Diaz, to be a U.S. Circuit Judge for the Fourth Circuit, and Calendar No. 657, James Wynn, to be a U.S. Circuit Judge for the Fourth Circuit; that the nominations be debated concurrently for up to 3 hours, with the time equally divided and controlled between Senators Leahy and Sessions or their designees; that upon the use or yielding back of time, the Senate proceed to vote on confirmation of the nominations in the order listed; that upon confirmation, the motions to reconsider be considered made and laid upon the table en bloc, the President be immediately notified of the Senate's action, and the Senate resume legislative session.

Mr. President, it is disappointing that we cannot get consent for these judges. Senator Richard Burr and I together introduced these two individuals at the Judiciary Committee hearing. I will say that I remain committed to working with my colleagues on both sides of the aisle, as well as any Senator who has concerns over either judge, to working toward a reasonable solution that would allow an up- or-down vote on Judges Wynn and Diaz.

Mr. President, I yield the floor.

Mr. President, today, I am proud to introduce the Medication Therapy Management, MTM, Expanded Benefits Act of 2010, with my colleague from Minnesota, Senator Franken.

A recent analysis conducted by the New England Healthcare Institute estimates that the overall cost of medication nonadherence is as much as $290 billion per year. According to a recent article published in the New England Journal of Medicine, over $100 billion is spent annually on avoidable hospitalizations because patients do not take their medications correctly.

Not only does nonadherence cost our system billions of dollars, nonadherence to medication regimens also affects the quality of life for seniors and may lead to early death. The elderly typically take many more prescription medicines than the general population and therefore are at greater risk for problems associated with improper use of medications. For example, the same New England Journal of Medicine article I just reference found that better adherence to antihypertensive treatment alone could prevent 89,000 premature deaths in the U.S. annually.

With as much as one half of all patients in the U.S. not following their doctors' orders regarding their medications, medication therapy management could help reduce some of the wasted health care costs in our system.

North Carolina has implemented some very successful MTM programs.

The Asheville Project, which focuses on diabetes, asthma, and cardiovascular disease, has seen improved health outcomes and significant savings among city employees since it began in 1997. For example, in the Asheville Project's diabetes MTM Project, they have seen a decrease in medical costs of between $1,622 to $3,356 per patient per year; a decrease in insurance claims of $2,704 per patient in year 1 and a $6,502 decrease in year 5; a 50 percent decrease in use of sick days; and increased productivity gains estimated at $18,000 annually.

In 2007, the North Carolina Health and Wellness Trust Fund Commission launched an innovative statewide program, Checkmeds NC, to provide MTM services to North Carolina seniors. During the program's first year, more than 15,000 North Carolina seniors and 285 pharmacists participated. The seniors bring all of their prescriptions, over-the- counter medicines, vitamins and supplements to the pharmacy to be thoroughly reviewed in a one-on-one session. The pharmacist follows up and educates the patient about his or her medication regimen. The program saved an estimated $10 million, and countless health problems were avoided.

During consideration of health care reform, I was pleased to have successfully secured language in the bill that built off these North Carolina models and implemented MTM nationally for seniors suffering from two or more chronic conditions.

The bill I am introducing today takes MTM one step further. Specifically, this bill would expand MTM eligibility to seniors with any chronic condition that accounts for high spending in our health care system, such as heart failure and diabetes. Currently, only 12.9 percent of Part D beneficiaries are eligible under the MTM criteria for multiple chronic conditions. However, of those, more than 85 percent have chosen to participate in the benefit. Clearly this program is very popular and widely utilized by those who are already eligible. By expanding eligibility to more seniors, MTM will certainly result in Medicare savings.

The bill also ensures access to MTM for seniors at a pharmacy or with a qualified health care provider of their choice.

To ensure pharmacists and health care providers are able to provide MTM to seniors, this bill ensures they are appropriately reimbursed for their time and service. This provision will permit pharmacies and other health care providers to spend considerable time and resources evaluating a person's drug routine and educating them on proper usage-- all critical components of a successful MTM program.

Finally, this bill would establish standards for data collection to evaluate and improve the Part D MTM benefit.

The value of MTM is widely known and discussed. I am proud that North Carolina is a leader in this arena. Expansion of MTM to more seniors will no doubt improve their overall health, while at the same time reducing waste in our health care system.

I urge my colleagues to support this bill.

Mr. President, today, I am proud to introduce the Medication Therapy Management, MTM, Expanded Benefits Act of 2010, with my colleague from Minnesota, Senator Franken.

A recent analysis conducted by the New England Healthcare Institute estimates that the overall cost of medication nonadherence is as much as $290 billion per year. According to a recent article published in the New England Journal of Medicine, over $100 billion is spent annually on avoidable hospitalizations because patients do not take their medications correctly.

Not only does nonadherence cost our system billions of dollars, nonadherence to medication regimens also affects the quality of life for seniors and may lead to early death. The elderly typically take many more prescription medicines than the general population and therefore are at greater risk for problems associated with improper use of medications. For example, the same New England Journal of Medicine article I just reference found that better adherence to antihypertensive treatment alone could prevent 89,000 premature deaths in the U.S. annually.

With as much as one half of all patients in the U.S. not following their doctors' orders regarding their medications, medication therapy management could help reduce some of the wasted health care costs in our system.

North Carolina has implemented some very successful MTM programs.

The Asheville Project, which focuses on diabetes, asthma, and cardiovascular disease, has seen improved health outcomes and significant savings among city employees since it began in 1997. For example, in the Asheville Project's diabetes MTM Project, they have seen a decrease in medical costs of between $1,622 to $3,356 per patient per year; a decrease in insurance claims of $2,704 per patient in year 1 and a $6,502 decrease in year 5; a 50 percent decrease in use of sick days; and increased productivity gains estimated at $18,000 annually.

In 2007, the North Carolina Health and Wellness Trust Fund Commission launched an innovative statewide program, Checkmeds NC, to provide MTM services to North Carolina seniors. During the program's first year, more than 15,000 North Carolina seniors and 285 pharmacists participated. The seniors bring all of their prescriptions, over-the- counter medicines, vitamins and supplements to the pharmacy to be thoroughly reviewed in a one-on-one session. The pharmacist follows up and educates the patient about his or her medication regimen. The program saved an estimated $10 million, and countless health problems were avoided.

During consideration of health care reform, I was pleased to have successfully secured language in the bill that built off these North Carolina models and implemented MTM nationally for seniors suffering from two or more chronic conditions.

The bill I am introducing today takes MTM one step further. Specifically, this bill would expand MTM eligibility to seniors with any chronic condition that accounts for high spending in our health care system, such as heart failure and diabetes. Currently, only 12.9 percent of Part D beneficiaries are eligible under the MTM criteria for multiple chronic conditions. However, of those, more than 85 percent have chosen to participate in the benefit. Clearly this program is very popular and widely utilized by those who are already eligible. By expanding eligibility to more seniors, MTM will certainly result in Medicare savings.

The bill also ensures access to MTM for seniors at a pharmacy or with a qualified health care provider of their choice.

To ensure pharmacists and health care providers are able to provide MTM to seniors, this bill ensures they are appropriately reimbursed for their time and service. This provision will permit pharmacies and other health care providers to spend considerable time and resources evaluating a person's drug routine and educating them on proper usage-- all critical components of a successful MTM program.

Finally, this bill would establish standards for data collection to evaluate and improve the Part D MTM benefit.

The value of MTM is widely known and discussed. I am proud that North Carolina is a leader in this arena. Expansion of MTM to more seniors will no doubt improve their overall health, while at the same time reducing waste in our health care system.

I urge my colleagues to support this bill.

Mr. President, today, I am proud to introduce an important piece of legislation to spur job growth across America. The American Manufacturing Efficiency and Retraining Investment Collaboration Achievement Works Act also known as the AMERICA Works Act is part of the solution to the Nation's unemployment problem.

With the national unemployment rate at 9.7 percent, and at 10.8 percent in my home state of North Carolina, we need to do everything we can to reinvigorate the American workforce.

The United States needs a strong technical workforce. Our country is facing a widening skills gap between older workers with advanced technical skills who will be retiring in the next few years, and the younger workers who have not yet received adequate training to replace them. The benefits of industry-recognized credentials are widely known, but too often those credentials do not count toward educational requirements, do not match the needs of local employers, or require too much time to earn just one credential. Ultimately, the system ends up breaking down, to the detriment of instructors, employers, and employees.

The AMERICA Works Act would give priority to Federal job training programs that provide an industry-recognized and nationally-portable credential. The legislation encourages national industries to come together and agree upon common standards, defining the skill sets needed in employees. Once industries have agreed upon standards, they can work with educational institutions to turn the standards into workable curriculums with tiered or stackable credentials. Ultimately, local workforce boards can help workers seeking training and employment opportunity by directing them toward job training programs that have priority under existing Federal programs.

The AMERICA Works Act would require certain Federal job training and career development education programs to give priority to programs that provide an industry-recognized and nationally-portable credential. This credentialing system starts out with basic competencies that prepare individuals for the workplace. Once basic competencies are completed, individuals can work toward high performance technical competencies and then progress further to highly skilled technical and management competencies. The credentialing levels are stackable, allowing workers flexibility along their career tracks. Stackable credentials provide straight forward paths, with clear entry and exit points, for workers to advance their careers and attain high quality jobs.

In North Carolina, we have an advanced manufacturing skills program at Forsyth Technical Community College in Winston-Salem. Forsyth Technical Community College is participating in the National Association of Manufacturers Endorsed Skills Certification System, which offers credit programs toward nationally-recognized, stackable credentials. Currently, they have 207 students enrolled in their programs. Forsyth Technical has already collaborated with State and local businesses to begin the process of incorporating their credentials into job descriptions. They believe that introducing graduates with skill certifications into the local workforce will help improve the hiring process, and these nationally-recognized credentials will increase employment opportunities.

The AMERICA Works Act will benefit business. When businesses clearly identify skills they need in their employees, educational institutions can tailor programs to teach those skills and workers will be better suited to meet their needs--starting on day one.

This legislation will benefit workers. Stackable credentials benefit workers by offering several on-ramps and off-ramps to a two-year technical degree: workers in training can exit the system having earned a basic, industry-recognized credential that qualifies them for employment, but without having completed the full two-year technical degree, and they can easily re-enter the system later to move up within their field and work toward the more advanced degree.

The AMERICA Works Act will benefit educational programs. Local educational institutes want to provide their students with the most useful skills possible. Open lines of communication between businesses, workforce boards and workers will better enable them to do just that.

This legislation will benefit local economies. Local workforce boards will have the chance to determine which skills training programs are most valuable for their region, today and into the future. Local areas with well-trained workforces can more effectively lure new businesses. While this bill mentions manufacturing, it would benefit any industry that meets the criteria established in the legislation.

I want to do everything I can to create jobs and make sure our workers have the skills needed to help our businesses grow and thrive. By incentivizing companies to work with educational institutes and develop industry-recognized, nationally-portable,

and stackable credentialing curricula, we can ensure that we have the best businesses, with the best workers, trained at the best institutes.

I urge my other colleagues to join me in supporting this important bill to enhance employment opportunity for hardworking Americans.

Mr. President, today, I am proud to introduce an important piece of legislation to spur job growth across America. The American Manufacturing Efficiency and Retraining Investment Collaboration Achievement Works Act also known as the AMERICA Works Act is part of the solution to the Nation's unemployment problem.

With the national unemployment rate at 9.7 percent, and at 10.8 percent in my home state of North Carolina, we need to do everything we can to reinvigorate the American workforce.

The United States needs a strong technical workforce. Our country is facing a widening skills gap between older workers with advanced technical skills who will be retiring in the next few years, and the younger workers who have not yet received adequate training to replace them. The benefits of industry-recognized credentials are widely known, but too often those credentials do not count toward educational requirements, do not match the needs of local employers, or require too much time to earn just one credential. Ultimately, the system ends up breaking down, to the detriment of instructors, employers, and employees.

The AMERICA Works Act would give priority to Federal job training programs that provide an industry-recognized and nationally-portable credential. The legislation encourages national industries to come together and agree upon common standards, defining the skill sets needed in employees. Once industries have agreed upon standards, they can work with educational institutions to turn the standards into workable curriculums with tiered or stackable credentials. Ultimately, local workforce boards can help workers seeking training and employment opportunity by directing them toward job training programs that have priority under existing Federal programs.

The AMERICA Works Act would require certain Federal job training and career development education programs to give priority to programs that provide an industry-recognized and nationally-portable credential. This credentialing system starts out with basic competencies that prepare individuals for the workplace. Once basic competencies are completed, individuals can work toward high performance technical competencies and then progress further to highly skilled technical and management competencies. The credentialing levels are stackable, allowing workers flexibility along their career tracks. Stackable credentials provide straight forward paths, with clear entry and exit points, for workers to advance their careers and attain high quality jobs.

In North Carolina, we have an advanced manufacturing skills program at Forsyth Technical Community College in Winston-Salem. Forsyth Technical Community College is participating in the National Association of Manufacturers Endorsed Skills Certification System, which offers credit programs toward nationally-recognized, stackable credentials. Currently, they have 207 students enrolled in their programs. Forsyth Technical has already collaborated with State and local businesses to begin the process of incorporating their credentials into job descriptions. They believe that introducing graduates with skill certifications into the local workforce will help improve the hiring process, and these nationally-recognized credentials will increase employment opportunities.

The AMERICA Works Act will benefit business. When businesses clearly identify skills they need in their employees, educational institutions can tailor programs to teach those skills and workers will be better suited to meet their needs--starting on day one.

This legislation will benefit workers. Stackable credentials benefit workers by offering several on-ramps and off-ramps to a two-year technical degree: workers in training can exit the system having earned a basic, industry-recognized credential that qualifies them for employment, but without having completed the full two-year technical degree, and they can easily re-enter the system later to move up within their field and work toward the more advanced degree.

The AMERICA Works Act will benefit educational programs. Local educational institutes want to provide their students with the most useful skills possible. Open lines of communication between businesses, workforce boards and workers will better enable them to do just that.

This legislation will benefit local economies. Local workforce boards will have the chance to determine which skills training programs are most valuable for their region, today and into the future. Local areas with well-trained workforces can more effectively lure new businesses. While this bill mentions manufacturing, it would benefit any industry that meets the criteria established in the legislation.

I want to do everything I can to create jobs and make sure our workers have the skills needed to help our businesses grow and thrive. By incentivizing companies to work with educational institutes and develop industry-recognized, nationally-portable,

and stackable credentialing curricula, we can ensure that we have the best businesses, with the best workers, trained at the best institutes.

I urge my other colleagues to join me in supporting this important bill to enhance employment opportunity for hardworking Americans.

Mr. President, today I am proud to introduce the Birth Defects Prevention, Risk Reduction, and Awareness Act. This bill would ensure that women of childbearing age and health care professionals have access to clinical and evidence based information about the risks and benefits of drug, chemical, and nutritional exposures during pregnancy and while a woman is breastfeeding.

Women who are pregnant or breastfeeding and taking medication for chronic diseases such as asthma, hypertension, and epilepsy often have questions about the risks and benefits. Most pregnant women, as we witnessed last year, really want to know what the science indicates on whether they should get vaccinated against H1N1 or the seasonal flu.

Oftentimes, women will seek answers to these important questions from an established pregnancy and breastfeeding information service. In fact, each year over 70,000 women and health care providers contact these information services across the country. These information services provide valuable information that empowers women. In fact, one study indicated that 78 percent of women who were considering terminating otherwise wanted pregnancies due to fears about exposing their fetus to a medication changed their mind after receiving appropriate counseling from a teratology information service.

It is not just women who use these services; health care providers, including physicians and pharmacists, also utilize these pregnancy and breastfeeding information services. A 2009 study found that over 90 percent of physicians who use these services indicated that the service provides high quality information that has a significant impact on clinical care.

In North Carolina, we have the North Carolina Pregnancy Exposure Riskline, run out of Mission Health System in Asheville. The North Carolina Pregnancy Exposure Riskline fields calls from a variety of constituents, including health care providers, pregnant

women, preconception women, potential adoptive parents, and others. Each year, trained genetic counselors answer questions from over 300 callers, who want information on the impact of maternal exposures during pregnancy and while breastfeeding.

The North Carolina Pregnancy Exposure Riskline provides detailed, factual information to callers on the current available data, and makes referrals to pregnancy registries that are continuing to gather information so that researchers and health care providers can have the best information for future women. If needed and requested, counselors will refer women to pregnancy resources such as substances treatment facilities or the NC Family Health Resource line, which has led North Carolina in information campaigns on the benefits of folic acid and ``Back to Sleep.''

The North Carolina Pregnancy Exposure Riskline also supports the North Carolina Teratology Information Specialists program to provide outreach and education about fetal alcohol syndrome.

Although this is an invaluable service for many women, physicians, and other health care providers, pregnancy and breastfeeding information services across the country have been forced to close due to insufficient funding.

The bill I am introducing today would require the Secretary of Health and Human Services, through the Centers for Disease Control and Prevention, to implement a birth defects prevention and public awareness grant program. Specifically, CDC would initiate a national media campaign to increase awareness among health care providers and at risk populations about pregnancy and breast feeding information services. Experienced organizations would be eligible to apply for grants: to provide information; and to conduct surveillance and research of pregnancy exposures that may cause birth defects, prematurity or other adverse pregnancy outcomes, and maternal exposures that may cause harm to a breast-fed infant.

I am so pleased that the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, the March of Dimes, the Organization of Teratology Information Specialists, and the American Academy of Asthma & Immunology are in support of this worthwhile bill.

I urge my other colleagues to join me in supporting this important bill to provide valuable information about maternal exposures during pregnancy and while breastfeeding.

Mr. President, I rise in support of the motion to instruct offered by my colleague from Texas, Senator Hutchison. I thank the Senator from Texas for her leadership on this issue of importance to members of the military in our States and across the country. Section 619 of the Restoring American Financial Stability Act of 2010 bans certain activities not only at depository institutions but also at bank affiliates, including insurance affiliates. In doing so, section 619 inadvertently jeopardizes access to the important financial resources offered by diversified financial institutions to service men and women and their families. Section 619 bans proprietary trading, but proprietary trading by insurance entities is significantly different than the risk that comes with banks' proprietary trading. Insurance companies use premiums to trade funds, not the consumer deposits that this provision targets. Insurance trades are generally low risk and focus on long-term payment of claims and are already heavily regulated by State insurance regulators.

Servicemembers and their families rely on the ability of diversified financial service firms to provide both insurance and banking services under one roof. I am concerned that section 619 may force military members to change their current financial service providers and possibly subject the service men and women to unnecessary cost and burdens. That is why Senator Hutchison and I have worked for several weeks to correct this oversight, and why I introduced amendment 3799 with Senators Hutchison, Carper, Cornyn, Begich, Webb, Burr, and Isakson. Amendment 3799 was a narrow change that addressed the issue. To my knowledge, it was not opposed by anyone. While amendment 3799 was not voted on, Senator Hutchison's motion to instruct provides clear guidance to the conferees to ensure that proprietary trading restrictions do not prevent insurance company affiliates of depository institutions from engaging in such trading as part of the ordinary business of insurance.

It is critical that we adopt this motion so that diversified financial institutions may continue to provide low-cost and convenient access to diversified financial services for those sacrificing in service to our country. I urge my colleagues to vote yes on this motion.

I yield the floor.

Mr. President, I rise in support of the motion to instruct offered by my colleague from Texas, Senator Hutchison. I thank the Senator from Texas for her leadership on this issue of importance to members of the military in our States and across the country. Section 619 of the Restoring American Financial Stability Act of 2010 bans certain activities not only at depository institutions but also at bank affiliates, including insurance affiliates. In doing so, section 619 inadvertently jeopardizes access to the important financial resources offered by diversified financial institutions to service men and women and their families. Section 619 bans proprietary trading, but proprietary trading by insurance entities is significantly different than the risk that comes with banks' proprietary trading. Insurance companies use premiums to trade funds, not the consumer deposits that this provision targets. Insurance trades are generally low risk and focus on long-term payment of claims and are already heavily regulated by State insurance regulators.

Servicemembers and their families rely on the ability of diversified financial service firms to provide both insurance and banking services under one roof. I am concerned that section 619 may force military members to change their current financial service providers and possibly subject the service men and women to unnecessary cost and burdens. That is why Senator Hutchison and I have worked for several weeks to correct this oversight, and why I introduced amendment 3799 with Senators Hutchison, Carper, Cornyn, Begich, Webb, Burr, and Isakson. Amendment 3799 was a narrow change that addressed the issue. To my knowledge, it was not opposed by anyone. While amendment 3799 was not voted on, Senator Hutchison's motion to instruct provides clear guidance to the conferees to ensure that proprietary trading restrictions do not prevent insurance company affiliates of depository institutions from engaging in such trading as part of the ordinary business of insurance.

It is critical that we adopt this motion so that diversified financial institutions may continue to provide low-cost and convenient access to diversified financial services for those sacrificing in service to our country. I urge my colleagues to vote yes on this motion.

I yield the floor.

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

I ask unanimous consent to speak on amendment No. 3744.

Mr. President, payday lending institutions prey on people who find themselves in need of quick cash often for things like a necessary car repair or a medical problem. The lenders charge astronomical interest rates and expect immediate repayment.

By marketing payday loans as short-term advances, predatory lenders gouge borrowers into a cycle of debt. With repayment due in just days, interest rates that reach 400 percent, and because repayments are due in full, borrowers are often forced to take out new loans to repay the old loan.

The lenders themselves recognize that the loans are not for borrowers who intend to use them repeatedly. For example, one lender notes on its website that, ``Since a payday advance is a short-term solution to an immediate need, it is not intended for repeated use in carrying an individual from payday to payday. When an immediate need arises, we're here to help. But a payday advance is not a long-term solution for ongoing budget management. Repeated or frequent use can create serious financial hardship.''

But the statistics do not add up. Over 60 percent of payday loans go to borrowers with 12 or more transactions per year and 24 percent of payday loans go to borrowers with 21 or more transactions per year.

This startling statistic illustrates just how devastating this problem can be for families.

Take the story of Sandra Harris from Wilmington, NC. She had a job at Head Start and always paid her bills on time. When her husband lost his job, Sandra got a $200 payday loan to pay the couple's car insurance. When she went to repay the loan, she was told she could renew. Sandra ultimately found herself indebted to six different payday lenders, paid some $8,000 in fees.

Now, the payday lending industry will argue that they provide a valuable service. I would simply point out that, whether or not you believe that to be true, my amendment does not prohibit payday loans.

In fact, it allows up to six payday loans to the same borrower. If your business model relies on your ability to rope borrowers into rolling these loans over again and again, even though you are charging 400 percent per loan, I would have some serious questions about your business model.

By reining in payday lenders, we will protect consumers from racking up endless, long-term debt that can ultimately cause a family to declare bankruptcy.

This amendment protects consumers by ensuring that short-term cash advances remain short-term.

It has three parts to accomplish this goal:

First, it limits rollovers by prohibiting creditors from issuing new payday loans to borrowers with six loans in the previous 12 months or 90 days aggregate indebtedness.

Second, it would require lenders to give borrowers the option to repay their loan over a longer time period. Creditors would need to offer an extended repayment plan for borrowers who are unable to meet repayment obligations.

Finally, the bill gives the Federal Reserve Board the authority to require licensing and bonding of payday lenders.

Leading consumer advocates such as the Center for Responsible Lending strongly support this legislation.

This is a commonsense amendment, it will help protect Main Street borrowers from predatory lenders, and I would urge all of my colleagues to join me in supporting it.

I ask unanimous consent to have printed in the Record the following letter of support from Michael Calhoun, the president of the Center for Responsible Lending.

I will yield to the Senator.

The Senator from Illinois is certainly correct. I believe, instead of anywhere near a 400-percent rate, there are limitations of 36 percent. The Senator is correct.

The Senator is exactly right. This amendment allows, if a family does need to have a short-term advance, for a short-term advance, renewable six times. They can have six of them within a 1-year period of time. If at that point they cannot repay it, the institution has to give them a longer repayment schedule.

We are not saying these loans cannot be given. But that recurring debt over and over and over again is what should be stopped by limiting it to six a year.

Mr. President, I ask unanimous consent that the pending

amendment be laid aside, and that I be allowed to call up amendment No. 3744.

Mr. President, I yield the floor.

Madam President, I, too, am disappointed that my colleagues on the other side of the aisle have decided against even debating Wall Street reform legislation in the Senate. It has been almost 2 years since our financial system stood on the brink of absolute catastrophe. The meltdown on Wall Street has wreaked havoc on Main Street across America. Millions of Americans lost their homes, their jobs, their retirement savings. Taxpayers were asked to fund a massive bailout of Wall Street.

Here we are, a full 2 years later, trying to debate a bill that will establish new rules of the road, create a more stable financial system, and ensure the American taxpayer will not be asked to bail out Wall Street banks again. I am sorry to say my colleagues today voted to stand up for Wall Street instead of standing up for all the people on Main Street who lost their job and their entire life savings.

They voted against the seniors who saw their 401(k)s instantly eaten away by the reckless games Wall Street was playing with their hard- earned money.

In my State, this recession, the worst since the Great Depression, has meant that currently half a million North Carolinians are out of work. In many families, both the husband and wife are out of a job. They are worried how they will put food on the table for their families.

Democrats have been working in good faith for many months on a bill to hold Wall Street accountable for gambling with the money of North Carolinians and people across the country. I know Chairman Dodd has been working with Republicans on the Banking Committee for the last year and a half. The time has come to have this debate on the floor of the Senate. Wall Street reform means ending taxpayer-funded bailouts. It also means establishing new standards for the complicated financial products that contributed to this economic downturn.

The purpose of this bill is to ensure the recent financial meltdown never happens again and that we protect seniors who lost retirement savings and small business owners who got caught up in the credit freeze and the countless Americans who lost their job. It means protection for consumers from irresponsible banking practices and greater certainty for bankers. Banks need to be able to understand what the ground rules will be so they can focus on the business of banking. North Carolina is a leader in the banking industry. Both our State's banks and banking customers will benefit from responsible financial reforms.

The proposed legislation also creates an office of financial literacy that will develop initiatives intended to educate and empower consumers to make informed financial decisions. Our students today need the tools to understand financial products and how to manage debt, including mortgages, student loans, and credit cards.

I hope my colleagues will listen to the American people on this issue. It is imperative we pass commonsense Wall Street reform so American taxpayers will never again have to shoulder the cost of a financial crisis.

Madam President, I yield my time.

Mr. President, there are two judicial nominees on the calendar from North Carolina who I believe would be confirmed by this body overwhelmingly. Judges Jim Wynn and Al Diaz, nominees for the Fourth Circuit Court of Appeals, were both approved by the Senate Judiciary Committee in January. Judge Diaz had the vote of every single member of the committee, and just one Senator opposed Judge Wynn.

The reality of this situation, though, is that North Carolina has been waiting for one of these judges since 1994. That is 1994. Since then, there has been only one judge from North Carolina on the 15-judge panel of the Fourth Circuit Court of Appeals, even though North Carolina is the largest and fastest growing of the five States in the Fourth Circuit. Partisan bickering has continually blocked qualified North Carolinians from confirmation since the court's establishment back in 1891.

But in consultation with both me and Senator Burr, the President has appointed two highly qualified, experienced, and fairminded North Carolina judges: Al Diaz and Jim Wynn. Judge Diaz, of Charlotte, a Business Court judge, handles extremely complex business cases. Before that, he was a State superior court judge. Judge Wynn, of Cary, is a 19-year veteran of the North Carolina Court of Appeals and formerly served on the North Carolina Supreme Court. The American Bar Association has given them both its highest possible rating. They both have served our country in the military. They have the support of Democrats and Republicans, including my North Carolina Senate colleague, Senator Richard Burr. They have no real opposition that I am aware of.

Finally, we have not one but two qualified and bipartisan choices to serve North Carolina and our country on the Fourth Circuit. I am hopeful that we are close to confirming these two outstanding nominees for the Fourth Circuit. I will continue working with my colleagues to ensure they are confirmed as swiftly as possible.

I yield the floor.

Mr. President, I thank the Senator from Virginia for helping us come together to talk about this issue because it is of critical importance.

In North Carolina, we have two justices for the Fourth Circuit Court coming before this body. They were heard in the Judiciary Committee back in January. They are ready to go. However, once again, the individual who is to vet justices has not been heard, Chris Schroeder. We need to bring him up. Although both of these individuals, Judge Wynn and Judge Diaz, have come out of the Judiciary Committee, they are waiting to come up for a vote. They are behind in the queue from all the other district court judges who have not come forward. I will say that my colleague, Republican Senator Burr, is in total agreement with both of these nominees. We need to bring them forward for a vote. The interesting fact is that one of these positions has been open since 1994. Talk about justice delayed is justice denied. It is high time this body had an opportunity to vote to put forward Judge Diaz and Judge Wynn to represent our State on the Fourth Circuit Court of Appeals.

Mr. President, I rise today to speak in support of the education provisions in H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010.

Over 40 years ago, Congress passed the Higher Education Act of 1965 with the conviction that no qualified student should be denied the opportunity to attend college simply because of the cost. Who knew that today, in the year 2010, this concern would still ring true? The passage of this legislation will provide greater access to higher education for thousands of American students.

The Health Care and Education Affordability Reconciliation Act represents the single largest investment in college affordability in history. From increasing the maximum Pell grant for low-income students to eliminating excessive subsidies for banks, this bill makes significant improvements to Federal student loan programs. Also, as students and their families look to Federal loans to pay for their post-secondary education, this legislation will allow non-profit student loan servicers in states like mine to continue servicing student loans.

This legislation provides funding for the college access challenge grant program, a program created in the College Cost Reduction and Access Act of 2007. This program was designed to assist states working in partnership with organizations with expertise in improving access to college. These guarantee agencies ensure that students have access to high-quality, affordable higher education. In my home State, the College Foundation of North Carolina serves as our State guarantee agency and plays a critical role in providing students and families with financial literacy, debt management, and loan counseling information.

I fully support the intent of the access and completion challenge grants included in this legislation. They will allow State guarantee agencies to continue the important work that they do. The College Foundation of North Carolina has done extraordinary work in this regard and, as a result, has had a default rate consistently below the national average for the past several years. As a strong advocate for financial literacy education, I can think of nothing more important than ensuring that students and families are armed with the tools they need to understand the dynamics of their student loans.

In North Carolina, we have 58 community colleges and 10 historically Black colleges and universities. The students at these institutions of higher education stand to benefit greatly from the passage of this legislation. A $2.55 billion investment over the next 10 years for Minority Serving Institutions, and more specifically Historically Black Colleges and Universities, is unprecedented. While HBCUs only make up 3 percent of all colleges and universities across the country, they graduate 40 percent of African-Americans with degrees in science, technology, engineering and mathematics, 50 percent of African-American teachers, and 40 percent of African-American health professionals. Community colleges play an instrumental role in our education and workforce systems by providing postsecondary education and job training. We need to keep our community colleges open and thriving. I can't think of a better investment as we encourage people to get the training and skills necessary to get back to work.

Making the commitment to create greater access to higher education, and ensuring that our students have the tools that they need to complete their postsecondary education is at the core of the education provisions in the Health Care and Education Affordability Reconciliation Act, and I am proud to support this legislation.

I thank Senator Warner. I too appreciate the time for us to come down here and talk about the need for health care reform. The bill that was signed into law yesterday is getting us on that track.

The new and historic law, combined with the bill we are now considering in the Senate, is going to reform our health care system to reduce costs and improve patient care for those families in North Carolina and in Virginia and families across America.

In 1996, the average premium in North Carolina for a family of four was $6,000. Today it is $12,000. It is projected, in 2016, to be 24,000. People cannot afford that. That is why we need to have change.

After decades of working to fix a broken health care system, this law controls exploding costs, increases access to health care, and reduces our long-term deficit, which I know we are very concerned about, by as much as $1.2 trillion over the next 20 years.

But in addition to containing costs, health care reform will improve access and quality of health care for millions of Americans. Right now, in North Carolina, we have 1.7 million people without insurance. They will now have access to a family doctor.

This bill provides immediate benefits to small businesses, middle- class families, and seniors in North Carolina. The small business owners whom I talk to want to provide coverage for their employees, but the costs are prohibitive.

This month, I received an e-mail from a small chiropractic practice in eastern North Carolina that had to drop its health plan for its employees because the rates doubled over the last 2 years. But starting today, 112,000 North Carolinian small businesses will be eligible for tax credits to provide health care to their employees.

Within the next 6 months, hard-working, middle-class families will be able to add their children up to the age of 26 on their health care plans. This will benefit about 870,000 young adults in my State.

This year, insurance companies will no longer be able to deny coverage to a child for a preexisting condition, such as asthma or diabetes. And it means insurance companies will no longer be able to drop your coverage because you get sick or because you file too many claims.

In North Carolina, 1.4 million seniors will receive preventive services with no additional costs, and 250,000 seniors will have their drug costs in the doughnut hole immediately reduced and eventually eliminated.

I am proud of these immediate benefits and our efforts to reform the health care system over the long term. The health care reform effort would not have been possible without the work of tenacious Capitol Hill staffers. I personally want to thank two incredible health care staffers on my team, Michelle Adams and Tracy Zvenyach, who worked countless hours for reform in our country.

Mr. President, today I rise in support of a bill that builds upon the health care reform legislation that was signed into law yesterday.

The new--and historic--law combined with the bill the Senate is now considering, will reform our health care system to reduce costs and improve patient care for North Carolina families and families across America.

In 1996, the average family premium was $6,000. Today it is $12,000. Without health care reform, premiums would skyrocket to $24,000 by 2016--or half of the average North Carolina family income.

Without reform, health care costs were projected to reach 20 percent of GDP, or $4.3 trillion, by 2017. This trajectory was simply unsustainable.

After decades of working to fix a broken health care system, President Obama yesterday signed into law a reform bill that controls exploding costs, increases access to health care and reduces our long- term deficit by as much as $1.2 trillion within 20 years.

By passing this bill, we will reduce the deficit, for a total savings of $143 billion by 2019.

In addition to containing costs, health care reform will improve access and quality of health care for millions of Americans. 1.7 million North Carolinians without insurance will now have access to a family doctor.

It will provide immediate benefits to small businesses, middle class families, and seniors in North Carolina.

While small businesses make up 98 percent of North Carolina's private sector employers, in 2008, only 38 percent offered health insurance.

Small business owners I talk to want to provide coverage for their employees, but costs are prohibitive. This month, I received an e-mail from a small chiropractic practice in eastern North Carolina that had to drop its health insurance plan for employees because rates were doubled over 2 years. Most of the practice's employees are young women under 30.

But starting today, 112,000 North Carolina small businesses will be eligible for tax credits to provide health care to employees.

Within the next 6 months, hard-working, middle-class families will be able to add their children up to age 26 onto their health plans. This will benefit about 877,000 young adults in North Carolina.

This year, insurance companies will no longer be able to deny coverage to a child for a preexisting condition, like asthma or diabetes.

Health care reform means people can access preventive care without being saddled with copays or deductibles. This includes well-child visits and seasonal flu immunizations.

I recently heard a story about a North Carolinian who, as a junior in college, had terrible stomachaches. But he could not afford a colonoscopy. He learned of his colon cancer too late for the doctors to save him. Health care reform means this young man would have had a chance.

Health care reform means people with chronic illnesses will no longer have to fear losing their insurance because of an arbitrary, insurance company-set lifetime cap.

And it means insurance companies will no longer be able to drop your coverage because you get sick or file too many claims.

Seniors also will see immediate benefits. In North Carolina, 1.4 million seniors will receive preventive services with no additional costs, and 247,000 seniors will have their drug costs in the ``donut hole'' immediately reduced and eventually eliminated.

I am proud of these immediate benefits and our efforts to reform the health care system for the long term.

This reform effort contains provisions that I have championed since coming to the Senate. In the United States, 23 million adults and children suffer from diabetes, and in North Carolina, diabetes costs our State $5.3 billion per year in medical interventions, lost productivity, and premature mortality.

Given these dire numbers, I added to the health care reform bill the second

piece of legislation I introduced as a U.S. Senator--The Catalyst to Better Diabetes Care Act. The Senator from Texas, Mr. Cornyn, cosponsored the bill last July. It creates a national and State-by- State level diabetes report card to track progress at beating the disease. It also requires the promotion of physician education on properly completing birth and death certificates, and requires that recommendations be made on appropriate levels of diabetes medical education that should be completed prior to medical licensing and board certification.

I also worked with the Senior Senator from Colorado, Mr. Udall, to add a section to health care reform to improve access to health care in rural areas. The section we added will help medical schools establish programs designed to increase the number of graduates who practice in rural areas. It will give schools resources to recruit students from rural areas who have an interest in practicing medicine in their communities, and it provides for additional training in pediatrics, emergency medicine, obstetrics and behavioral health.

I also want to take this opportunity to discuss how the bill the Senate is currently considering will help make college affordable for our families.

One of the most significant provisions for our students in this legislation is the over $2.5 billion investment over the next 10 years in historically Black colleges and universities.

There are 10 outstanding HBCUs in North Carolina. HBCUs graduate 40 percent of African Americans with degrees in science, technology, engineering and mathematics; 50 percent of African-American teachers; and 40 percent of African-American health professionals.

North Carolina A&T, an HBCU in my hometown of Greensboro, graduates more African Americans with PhDs in engineering than any other school in the country.

This is a milestone week for the State of North Carolina. I am working with my colleagues to send this bill to the President's desk to further reduce costs for North Carolina's families and small businesses.

This health care reform effort would not have been possible without the work of some tenacious Capitol Hill staff, and I want to personally thank my two incredible health care staffers, Michelle Adams and Tracy Zvenyach, who worked countless hours for reform in our country.