Floor Statements

Mr. President, I ask unanimous consent that the Senate proceed to a period for the transaction of morning business, with Senators permitted to speak for up to 10 minutes each.

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

That is correct, 2 minutes.

Madam President, what is the parliamentary situation? What is pending?

I thank the Chair.

Madam President, on another subject, I wish to say I am very distressed that the other side objected to a request by the majority leader to pass legislation offered by himself, by myself, and Senators Reed and Shaheen to extend unemployment insurance benefits.

Our country faces very high unemployment rates nationwide. In some States, it is much worse than other States. It is only fair. It is the right thing to do for the U.S. Government to recognize those folks who don't have jobs--to help tide themselves over until they get a job-- with extension of unemployment insurance benefits.

I think for every job that is available in the United States today there are about six applicants. There are too many people unemployed-- people seeking jobs who cannot get jobs. So the right thing to do, as we come out of this great recession, is to recognize those who are unemployed and help them tide things over to make sure they are compensated.

The legislation we have introduced does that with 14 additional weeks for all States, and also would provide additional weeks for the hardest hit States--6 weeks of additional benefits for those States hardest hit, those States with the highest rates of unemployment. This unemployment rate we are facing is going to continue. It is not just a short-term phenomenon. There are estimates that we will see rates up to 9.8 percent through most of even next year.

I am very disheartened myself, but more so for the folks who are going to be denied benefits by the action taken by the Republican side to object to extending benefits to those folks who are in need of them. I am hopeful at a later point in time--very soon in fact; hopefully by next week--the other side will see fit to let this legislation pass because it is sorely needed. I urge my colleagues to vote for it when it does come up next week.

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Madam President, the Congressional Budget Office has issued its report on the Finance Committee legislation. That bill was sent over to the Congressional Budget Office a couple days ago. The report is quite promising. The report is good news.

Our balanced approach in the Finance Committee to health reform has paid off once again. Today, the Congressional Budget Office confirmed that America's Healthy Future Act--that is the legislation in the Finance Committee--remains fully paid for and reduces the Federal deficit. In fact, it reduces the deficit by $81 billion in the first 10 years.

CBO also says in its report that the legislation continues to reduce the deficit in the second 10 years; that is, it bends the cost curve in the second 10 years as well.

More important, it improves and expands health care coverage for tens of millions of American families. That is done by raising the coverage rate of 83 percent to 94 percent. In fact, that might be a slight increase from what we earlier anticipated in the committee bill.

This legislation, I believe, is a smart investment on the Federal balance sheet. It is an even smarter investment for American families, businesses, and our economy. Health reform will modernize the health care system for America for the 21st century. It is about time we got to that point.

The bill also reduces inefficiencies and focuses on quality and ensures we are getting the best bang for our health care buck.

Health care reform should be fiscally responsible as it expands and improves coverage. CBO confirms the legislation does that.

I am very pleased with that report. It will help us move toward the next steps in merging the bill with the HELP Committee bill.

Madam President, I yield the floor.

Madam President, unless the Senate acts soon, millions of seniors and disabled individuals will face sharply higher Medicare premiums next year. In this great recession, we

must act quickly to ensure we do not allow a formulated quirk to punish our seniors on fixed incomes in our financially strapped States.

Many seniors have their Medicare Part B premiums deducted from their monthly Social Security checks. Normally, the Social Security cost-of- living adjustment is greater than the increase in the Part B premium for that year. As a result, the beneficiaries' monthly checks in the new year are greater than their monthly checks were in the last year. But next year there is not likely to be an upward cost-of-living adjustment in Social Security checks. When that happens, most Medicare beneficiaries are held harmless against reductions in their Social Security checks. The Part B premium is reduced so that their monthly Social Security checks in the new year are not less than they were in the prior year.

However, 27 percent of Medicare enrollees do not benefit from hold harmless. The absence of a cost-of-living adjustment will expose these seniors to big premium increases next year. Under current law, these enrollees not only have to pay their own premiums, but they must make up the premiums by the 73 percent of beneficiaries we hold harmless. These 27 percent of Medicare recipients will be forced to shoulder the full load of next year's premium increases. This will mean an increase in premiums up from $96 to $120 a month next year. Who are these recipients? They include low-income beneficiaries who participate in both Medicare and Medicaid. They include new enrollees in Medicare Part B. They also include Medicare Part B enrollees who don't receive Social Security, such as some Federal retirees. They include higher income enrollees who already pay higher premiums.

This burden will hit Medicare beneficiaries hard, but financially strapped States will also feel the effect because State Medicaid Programs pick up the cost of Part B premiums for Medicare beneficiaries who are also eligible for Medicaid. The premium hike would also hit State budgets because of that reason. States all across the Nation are facing huge deficits and difficult choices, and we should not allow this quirk in the law to add to their burden.

The Medicare Premium Fairness Act would correct this. It would ensure that these 27 percent of Medicare beneficiaries would not have to shoulder any additional burden. No Medicare Part B enrollee would face a higher premium next year over this year. The bill would provide security to seniors on fixed incomes. To prevent Federal cost shift to States, the bill would pay for and would tap into the Medicare Improvement Fund, which was created to solve problems such as this.

Inaction on this bill is not an option for seniors and States, and I hope the bill will have broad bipartisan support.

Madam President, I ask unanimous consent that the Finance Committee be discharged from further consideration of H.R. 3631, the Medicare Premium Fairness Act, and the Senate proceed to its immediate consideration; further, that the bill be read a third time and passed, and the motion to reconsider be laid upon the table, with no intervening action or debate.

None.

Madam President, I regret that the Senator from Oklahoma feels constrained to object. I will continue to work to see that Medicare beneficiaries are not unfairly harmed. I must also say that this is not for the Ross Perots of the world. There are due eligibles-- there are many people who are very poor who will be harmed unless this legislation is passed. I might also say that this bill is paid for, despite the implications to the contrary. It is paid for with funds already set aside at an earlier date in the Medicare Improvement Fund-- a fund that was set up for just such purposes. So despite the implications about the future children and grandchildren, the fact is, this is already paid for in funds previously set aside.

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

Madam President, Hippocrates once said: ``A wise man should consider that health is the greatest of human blessings.''

Every day we see the real-world consequences for Americans who have been deprived of that blessing. A Harvard study found that every year in America, lack of health coverage leads to 45,000 deaths. People without health insurance have a 40 percent higher risk of death than those with private health insurance. No one should die because they cannot afford health care.

Every 30 seconds another American files for bankruptcy after a serious health problem--every 30 seconds. Every year, about 1.5 million families lose their homes to foreclosure. Why? Because of unaffordable medical costs. No one should go bankrupt because they get sick. A Kaiser Family Foundation survey found that health care coverage for the average family now costs more than $13,000 a year. If current trends continue, by the year 2019, 10 years from now, the average family plan will cost more than $30,000 a year.

No one should have to live in fear of financial ruin from crushing insurance premiums. Americans are looking for commonsense solutions to these problems. Americans want a balanced plan that takes the best ideas from both sides. Americans want their leaders to work together to craft a health care package that will get 60 votes it needs to pass.

The Congressional Budget Office has just given us their analysis of legislation we put together in the Finance Committee and it shows that our bill reduces the deficit by $81 billion over 10 years. That is a reduction in the Federal deficit of $81 billion. CBO also says the legislation out of the Finance Committee continues to reduce the deficit in the outyears; that is, the years after 10 years, the second 10 years, and the legislation increases coverage from 83 percent to 94 percent, so 94 percent of Americans will have health insurance.

For 2 years now, that is exactly what we have been doing in the Finance Committee--working to get that result. Over the last 2 years, the Finance Committee has held 20 hearings on health care reform. Last June we held a health care summit at the Library of Congress. The committee held three roundtable discussions with experts on each side of the area, especially on the three major areas of reform. We held roundtables on how health care is delivered, on coverage--that is insurance coverage--and on how to pay for health care. In connection with each roundtable--we had experts around the table, asked lots of questions, the experts just balanced--experts were not chosen for a certain point of view but just to get the facts. The committee put out a detailed option paper after those roundtables and we then held three walk-throughs to hash out those options--walk-throughs to see what might make sense after those walk-throughs.

Six members of the Finance Committee--three Republicans and three Democrats--then had meetings. They held 31 meetings to try to come to a consensus. We held exhaustive meetings and met for more than 61 hours. We went the extra mile.

I might say if a fly on the wall were to watch those six meet, three Republicans and three Democrats, I think Americans would be very proud. This was hard work. It was not ideologically driven. It was based on the facts. We asked questions of experts, actuaries were objective--of the Congressional Budget Office, the Joint Committee on Tax--a very solid effort to try to find out how the various parts would be put together in a balanced and fair way.

I can say the Finance Committee has held the most open and exhaustive consideration of this health care proposal. I put out the starting point and posted it on the Web on September 16. That was nearly a week before we started our markups, a full week notice before we started our markup.

In a first for the committee, we posted every amendment, all 564 of them, on the Web. We had never done that before, all posted, all available to the world. The committee has held a thorough markup, and I know the present occupant of the chair can attest to that. When the committee reconvenes to report the bill, the committee will have met for 8 days. Many of those were long days, often running past 10 o'clock at night. In fact, last Thursday we worked until 2 o'clock in the morning. It has been more than 22 years since the Finance Committee met for 8 days on a single bill. In the committee's consideration, Senators offered and the committee considered about 135 amendments. The committee conducted 79 rollcall votes and the committee adopted 41 amendments.

The result is a balanced, commonsense plan that takes the best ideas from both sides. It is a plan that essentially implements President Obama's vision to improve America's health care and it is a plan designed to get the 60 votes it needs to pass. We have just received from the Congressional Budget Office the numbers that we need to have to proceed to the next step. The CBO says we reduce the deficit by $81 billion in the first 10 years and the legislation that will be reported out of the committee soon will reduce the deficit further in the next 10 years, and it increases coverage to 94 percent.

I am confident that after Senators have had a opportunity to review the CBO numbers the Finance Committee will report the bill. Then we on the Finance Committee expect to work together with the HELP Committee to meld our two bills together. Our colleagues on the HELP Committee have done some wonderful things, especially in the area of prevention, workforce, and quality. We look forward to bringing together the best of both bills.

Then the majority leader will offer the combined bill as an amendment on the floor and I expect we will have a full and vigorous debate here in the Senate. I am proud of our work.

All Americans should have access to affordable, quality health care coverage. Our bill would raise the share of Americans with insurance coverage from about 83 percent currently to 94 percent, and our bill would deliver coverage to millions through new insurance exchanges and to millions more through Medicaid--that is the Finance Committee bill I am discussing.

Our bill would dramatically increase prevention and wellness, will begin shifting health care delivery to the quality of care provided-- not the quantity of services rendered but the quality of care provided. It is so important. This is transformative. This is game changing. When we look back several years from now we are going to see this is probably one of the more important items in this legislation because it will begin American health care to focus on where it should be, on quality and teamwork and the patient, more than today, where it is focused on quantity under the fee-for-service system. This is clearly the major, most important part, I think, when we look back at this bill 5, 6, 8, 10 years from now.

The bill also will lower prescription drug costs dramatically for seniors--no small point.

Our bill would reform the insurance market. It would protect those with preexisting conditions. It would prevent insurance companies from discriminating and capping coverage. And it would require insurance companies to renew policies as long as policyholders pay their premiums. No longer would insurance companies be able to drop coverage when people get sick. These reforms would give Americans real savings.

Under the Finance Committee bill, everyone making less than 133 percent of poverty would receive health coverage through Medicaid. Our plan will provide tax credits to help low-and middle-income families buy private insurance coverage. These tax credits would mean that our bill would deliver tax cuts for those whom it affects. Overall taxes would go down for people affected by this bill. These tax credits would help make insurance more affordable.

Some have made some pretty outrageous claims about our bill. Some folks frankly have said some whoppers. Let me take a few minutes to bust some of those myths.

Myth No. 1. Some say our bill cuts benefits for seniors. That is false. Nobody cares more about maintaining Medicare than I do. Medicare benefits will not be reduced under our bill. Seniors will get the same level of benefits they receive today. In fact, seniors have a lot to gain from health care reform by lower prescription drug costs

and more free preventive care such as mammograms and colonoscopies. Plus our bill takes the long view to help preserve the life of the Medicare Program. Our bill puts the Medicare Program on sounder financial footing. Our bill will remove from a system that pays for volume to one that pays for value. It would improve Medicare solvency by reforming the way Medicare delivers health care.

Don't just take my word for it. Don't just take President Obama's word for it. Go to the AARP Web site and see what they say. AARP is probably one of the greatest advocates for seniors. This is what AARP says:

Myth: Health care reform will hurt Medicare.

Fact: None of the health care reform proposals being

considered by Congress would cut Medicare benefits or

increase your out-of-pocket costs for Medicare services.

That is the conclusion of AARP in their letter to seniors.

Myth No. 2. Some say our bill will lead to rationing because we encourage comparative research. That, too, is false. The Institute of Medicine--MedPAC, that is the bipartisan group, nonpartisan group that advises Congress on Medicare payments--and former CMS administrators have all recommended that Congress invest in research to compare what works and what doesn't work in medicine. Groups such as the American Medical Association and the American Health Association support this idea.

Our bill would set up a nonprofit institute to provide for this ``comparative effectiveness research.'' The goal is better evidence, unbiased information that doctors and patients can use to make better health care decisions. Comparative effectiveness research is about giving doctors and patients the best information available on what works so they can decide, the doctors can decide in consultation with their patients, as to what procedure, what drug, makes most sense and what doesn't.

If one treatment works far better than another, then doctors and patients have a right to know. That is what our bill tries to do, it tries to foster the kind of commonsense research that can get better information in the hands of doctors and patients.

Nothing in our bill would ration care--nothing. The new institute could not make coverage decisions or issue medical guidelines. And our bill would prevent the HHS Secretary from using the research to ration care in any way. The Secretary could never use the evidence to discriminate against individuals based on age, disability, terminal illness, or their preferences between length of life and quality of life.

Calling this rationing only supports a delivery system that is pro- waste and antipatient education. That is what opponents will end up doing. That is the effect of it. That is not the type of care people deserve. They deserve the information that comparative effectiveness research produces to help them make informed health care decisions.

Myth No. 3. Some say our bill will cause premiums to go up. That, too, is false. There are a lot of things in our bill that would cause premiums to go down. Our bill would cut out fraud, waste, and abuse in our health care system. That is going to help. Our bill would spread insurance risk through a much broader population, including younger, healthier people. That would clearly help. And our bill would help to eliminate the cost of uncompensated care, which results in more than $1,000 in additional premium costs each year for American families. The effects of open competition in our new insurance exchange should bring premiums down as well.

CBO has said there are a lot of factors in whether premiums go up or down and, frankly, they punted on a lot of those factors. But in the one part of premium costs about which they did make a projection, CBO said that premiums would go down. In a September 22 letter CBO said:

CBO currently estimates that about 23 percent of premiums

for policies that are purchased in nongroup market under

current law go toward administrative costs and overhead.

About 23 percent of premiums for policies goes toward administrative costs and overhead. CBO goes on to say:

Under the proposal, that share would be reduced to 4 or 5

percentage points.

So if 23 percent of costs are administrative overhead under the legislation the committee reported out, that should be reduced by 4 or 5 percentage points. That is lower costs, administrative costs, which should result in lower premiums.

Myth No. 4. Some say you will not be able to keep your insurance. That, too, is false. Nothing in our bill would take people's insurance away from them. No one would be forced into a particular plan. This is the central feature of the way we have gone about health care reform. We have not tried to change the employer-based system, a system Americans know and understand. We improve upon it, make it work a lot better. We have not tried to fix something that is not broken. We have an employer-based system and it is very important we improve upon it, not eliminate it.

Some who do not share our best interests assert that cuts to Medicare Advantage will cause some plans no longer to be offered. We do bring the government's subsidies to Medicare Advantage more in line with the government's own commitment to Medicare, but our bill would not cut benefits under Medicare Advantage. Rather, it would cut out waste in the system to ensure that Medicare is sustainable for years to come.

Even after the cost of marketing and delivering benefits and after making a profit, insurance companies are paid about 14 percent more, on average, under Medicare Advantage than under traditional Medicare. Insurance companies pad their pocket with those subsidies. Our bill would end those subsidies for insurance companies.

If insurance plans want to pass cuts along to seniors instead of reducing their huge profits, that is up to them. In a competitive market, it will be hard for plans that do that to keep their customers.

Yes, under our bill Medicare Advantage plans will have to compete in the free market. But that has been true of insurance companies generally for as long as there has been insurance. It is true that we in our bill do not guarantee that the government will keep each and every insurance company in business. We should not and we do not, in our bill, guarantee that each and every insurance plan will continue to be offered. Those are business decisions. Those are decisions for the private sector. And that is where we leave it.

It is absurd to say that people will not be able to keep their insurance because the government is going to trim back wasteful subsidies. That is a pretty absurd statement.

Myth No. 5. Some stated our bill will raise taxes. That is false. In fact, our bill is a tax cut. Our bill will cut taxes for millions of Americans. When fully phased in, our bill will cut taxes by tens of billions of dollars every year. Let me restate that. When fully phased in, our bill will cut taxes by tens of billions of dollars every year. And millions of Americans will be able to use those tax cuts to buy health insurance coverage.

Myth No. 6. Some say that a high-cost premium excise tax will raise taxes on working families. That too is false. The bill levies the high- cost premium excise tax on the insurance companies. It will put downward pressure on insurance company profits. And it will put pressure on insurance companies to offer more efficient insurance plans.

In fact, the Joint Committee on Taxation tells us that much of the revenue that the high-cost premium excise tax brings in is because employers will give workers raises. People will avoid insurance plans with high-cost premiums, and as a result employers will raise workers' salaries with the money they save. That is what the Joint Committee on Taxation predicts will happen. That is what they say over and over again in publicly given testimony.

Finally, the biggest myth of all, myth No. 7. Some say our bill is a government takeover of health care. That is so false. We have built our plan on the exchange marketplace that allows choice among private health insurance company products, choice among private health insurance products.

People will be able to choose their own plan. They can choose their own plans among private options. Our bill does not include a public option. We did not include an employer mandate.

And we pay for every cent. This is a uniquely American solution. We are not Canada. We are not Britain. We are America. This is a balance. We have a tradition of balance between public and private. This legislation accomplished that.

We do not buy into government-only solutions in America, but we do believe in rules of the road. Our bill provides a balanced solution. And CBO says we do so in a balanced way.

Soon it will come down to the Senate. My colleagues, this will be our opportunity to make history. Think of it. Our actions here will determine whether we will extend the blessings of better health care to more Americans.

Ours is a balanced plan that can pass the Senate. Our bill should win the support of Republicans and Democrats alike. Now the choice is up to Senators.

Hippocrates said that ``health is the greatest of human blessings.'' But too many Americans are being deprived of that blessing. Let us enact this balanced, commonsense plan to improve health care. Let us reform the health care system to control costs and premiums. And let us extend the blessings of health care coverage to all Americans.

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

The PRESIDING OFFICER (Mr. Nelson of Florida.) The clerk will call the roll.

Mr. President, I am very honored by all the comments of the majority leader, who is a good friend; Senator McConnell; my good friend Jon Tester; and the Senator from Iowa, Mr. Grassley. I am also honored to have served in this body.

Everyone here cares a lot about public service and about people. We are all here because we care. I very much appreciate working with all of you. There are a lot of characters here, different personalities. The bottom line is that everybody is here for their State and the Nation.

I feel as if I am the luckiest guy in the world. I think this is the best job one could have. I have 900,000 of the world's greatest bosses, the people of Montana. They are terrific and wonderful. I am just a hired hand working for them.

Combined with all of you and all the staff here, you are all people here who care about our great country. I thank you very much. I could not be more touched and appreciative. Thank you.

(Applause.)

Amendment No. 2580

Mr. President, NCADE is a missile defense concept that uses a modified AIM-9X seeker launched from an aircraft to intercept a boosting missile target. I am aware that the Missile Defense Agency has conducted several tests of this system and it continues to show progress. I believe it is important that the Missile Defense Agency continue to develop this technology. Short- and medium-range ballistic missiles pose a significant threat to the United States, our Armed Forces, and our allies around the world. Could the chairman clarify that the Missile Defense Agency could use funds provided in this bill for the continued development of NCADE, consistent with the budget request?

I thank the chairman. This is very important work for our national security and we are pleased that some of it is being done in Montana.

Mr. President, following the passing of President John F. Kennedy, Senator Mike Mansfield said: ``He gave us of his love that we, too, in turn, might give.''

These words ring true today as we remember the life of our late colleague, Senator Ted Kennedy.

So much of this country's history in the past half century can be attributed to this one man. But Ted Kennedy was also a modest man, and he would not have put it that way.

Speaking almost 30 years ago at the 1980 Democratic National Convention, he quoted Tennyson:

I am a part of all that I have met . . .

Tho much is taken, much abides.

That which we are,

we are one equal temper of heroic hearts

Strong in will

To strive, to see, to find

and not to yield.

In the more than 46 years that Senator Kennedy served this body, he did not yield and, in turn, he affected each and every American.

During his career in the Senate, Senator Kennedy authored thousands of bills, and hundreds of them became law. From championing civil rights to advocating equal opportunity and higher education, to fighting for access to affordable health care for all Americans, Senator Kennedy's work has quite simply improved the quality of life for millions of Americans. Over the past 2 weeks we have heard many speak of his accomplishments.

It didn't take long for me to realize when I came to this body, and more and more as each year passed, that Ted Kennedy was probably the greatest legislator in modern American political history. The guy was amazing, absolutely amazing; an inspiration for me personally to try to be a very good legislator. Many people have also said that. I am not the only one who has recognized his talents and that he is probably the best legislator in modern American political history.

Let me just say why that was true for me. First of all, it was the passion of his convictions. His moral compass was set so true: for the average person, the little guy, the person who didn't have representation, health care, the poor, civil rights. He just believed so passionately, so steadfastly. His moral compass was just so firmly set. There is no question of what Ted Kennedy was and what he believed in, and it made him alive. It was his dream to fulfill the lives of the people he worked so hard for.

All of us remember Ted Kennedy working so hard to fulfill his dreams. From his desk over here, he would stand up and he would thunder, red- faced. He would get so involved, so passionate, speaking so loudly, almost shouting what he believed in. You couldn't help but know that here was a guy who believed what he said and, by gosh, let's listen to him. He also had terrific staff. Ted Kennedy's staff had him so well prepared. All of these briefing books--I will never forget the briefing books Ted took, and he read them. He studied them. He was so well prepared. Along with his passion was his preparation, and his staff just helped him prepare because they were all one team. They were working so closely together for the causes they believed in.

I also was impressed and found him to be such a great legislator because after the speeches he believed in so thoroughly and passionately, he would sit down with you and start to negotiate, try to work out an agreement, try to work out some solution that made sense for him and made sense for you if you happened to be on the other side. It was amazing to sit and watch him work, a different demeanor, a different temperament. He would sit there and cajole, talk, tell jokes, all in good spirit, all in an attempt to try to get to the solution.

On the one hand he would be here in the Chamber and he would be thundering, but in the conference room he would be saying: OK, let's figure out how to do this. How do we get this done? It was amazing. It was such a lesson to learn just watching him legislate.

I think he is also one of the best legislators in modern American political history because he had such a light touch. He really cared individually for people, not just groups but individually. We have heard references to a book he gave Senator Byrd, a poetry book, and how Senator Kennedy would bring his dogs over to Senator Byrd's office; and listening to Senator Chambliss, how Senator Kennedy made sure he knew when Senator Chambliss's grandchildren would be here so the grandchildren could see his dogs. He loved his dogs and he had that very light touch.

I remember not too long ago--and Senator Byrd referred to it--I think it was Senator Byrd's 67th wedding anniversary, and Senator Kennedy had the foresight and the caring to send 67 roses to Robert Byrd and Erma Byrd. It was one of the things he just did, as well as all the letters he wrote, the handwritten letters he wrote.

Here is this wonderful guy who probably never used a BlackBerry; didn't know what they were. We know what they were. We use them. He wrote notes, hundreds of notes, thousands of handwritten notes, tens of thousands of handwritten notes. It was incredible. He would write a note to anybody at any time--just a light touch--on their birthday or call them on their birthday or call somebody who was in the hospital. He would just do that, more than any other Senator here I can think of, and I would venture to say probably more than most Senators combined. He was just that way.

Let me give one small example. Several years ago, in my hometown of Helena, MT, I was at a meeting and came back late at night after the meeting, and my mother said: Max, Ted Kennedy called.

Really?

Yes, Mom said. Well, I told him you were out, but we had a nice chat, Ted Kennedy and I.

What did you talk about?

We talked about the Miles City bucking horse sale. It is an event in Montana that comes up every year. Ted came and rode a horse at the Miles City bucking horse sale back in 1960.

A few days later I was back on the floor of the Senate, and I walked up to Ted and I said: Ted, I understand you talked to my mother.

Oh, he said. Sometimes on the telephone you are talking to somebody, you can tell who the person is. Your mother, she is such a wonderful person, so gracious, on and on talking about my mother and the conversation the two of them had.

They had never met before. My mother is a staunch Republican, and here is Ted Kennedy.

So I went back home a few days later, and I told my mother, I said: Mom, Ted was sure impressed with the telephone call you had.

Oh, gee, that is great. That is wonderful.

My mom wrote Ted a note thanking him for being so--for praising her so much to me, her son, just a few days earlier.

Well, the next thing I knew, my mother and Ted were pen pals. Ted

wrote a letter back to my mother, and they were back and forth and back and forth. I would be at a committee hearing someplace and Ted would say: Hey, Max, look. Here is the letter I am writing your mother. Just out of the blue. Basically, they were just reminiscing about Montana and again about the bucking horse sale, which is another reason Ted was such a great guy.

He lived life so fully. He just loved life. He embraced life in all of the ways that life is available to a man. He was just wonderful that way.

Back in 1960 when his brother was running for President, Ted was assigned the Western States in the 1960 Presidential campaign. So Ted was out in Montana, and they went to a Democratic gathering. There wasn't anybody there, so he went to the Miles City bucking horse sale. We in Miles City, MT, have this bucking event. We take these horses off the prairie and buck them. You bid on the horses and, obviously, the best bucking horses get the highest bid and go off with the rodeo operators and they use them.

Anyway, the long and the short of it is, Ted was there and he went to the bucking horse sale and got in the booth because he wanted to speak on behalf of his brother. The announcer said: Well, young man, if you want to speak, first you have to ride a horse.

Ted said: Why not.

So Ted got on a horse and there is this wonderful photo of Ted at the Miles City bucking horse sale in Montana that somebody took. So there is Ted on his bronco. I don't think he made the full 8 seconds, but he sure had a great time on that horse.

The long and short of it is, he is a great man for so many reasons, and we love Ted for all he was. Again, I think he was the greatest legislator I think, in modern American political history.

I am touched by what a family man he was. As the years went by, after his brothers were tragically lost and all that happened in the Kennedy family, Ted was a rock to others in the family. He experienced so much and he went through so much tragedy and it has built so much character.

Ted was more than a Senate icon who fought for causes, more than a voice for the Commonwealth of Massachusetts. As I mentioned, he was a loving son, brother, husband, father, uncle, grandfather, and friend. Working with him for the past 30 years is one of the greatest honors I have had as a Senator.

Ted, as far as I am concerned, we are going to take up your last great cause, health care reform. We are, in the Senate, doing all we can to get it passed. I, personally, pledge every ounce of energy at my command to help get health care reform passed for all the American people and for Ted Kennedy.

He was a wonderful man, and he will be sorely missed. I don't think there is going to be another man or woman in the Senate who will be a giant such as Ted Kennedy. He was that great a guy.

I yield the floor.

Mr. President, Representative John Randolph, chairman of the House Ways and Means Committee in the early 1800s, said, ``We all know our duty better than we discharge it.''

U.S. Customs and Border Protection, or CBP, and Immigration and Customs Enforcement, or ICE, have two vital duties. They must protect our national security by ensuring that threats to that security do not cross our borders, and they must protect our economic security by ensuring that legitimate trade does cross our borders, smoothly and quickly. I have no doubt that CBP and ICE know these duties. But they must do a better job of discharging their trade duties.

Senator Grassley and I introduced a bill that would require the agencies to do just that. The Customs Facilitation and Trade Enforcement Reauthorization Act of 2009 would direct CBP and ICE to make customs facilitation and trade enforcement a priority again, and it would provide the agencies with the tools and resources that they need to fully discharge those duties.

These agencies know that high-level officials must focus on their trade duties. The bill would help the agencies discharge those duties by creating new high-level positions at CBP devoted exclusively to trade. The bill would assign new trade facilitation and enforcement duties to the highest level official at ICE.

The agencies know that they must facilitate and expedite legitimate trade across our borders. The bill would help the agencies to discharge those duties by providing trade facilitation benefits, such as faster customs clearance, to importers with a history of complying with U.S. customs and trade laws. The bill would also require the Secretary of Homeland Security to identify and provide trade facilitation benefits to importers that provide additional security information. The bill would provide funding for automated programs that would help CBP process imports more quickly.

The agencies know that they must enforce U.S. trade, intellectual property, and health and safety laws at our borders. The bill would help the agencies to discharge those duties by giving CBP new tools to identify goods that are most likely to violate these laws. It would give CBP the means to prevent those goods from crossing our borders. It would require ICE to do more to prevent the importation of goods made with forced, convict, or indentured labor.

The agencies know that they must listen to Congress and the business community when taking significant actions that affect America's competitiveness. The bill would help the agencies to discharge that duty by requiring CBP to engage in robust consultation before taking such steps.

The agencies know that they must serve rural border areas, such as those in my home State of Montana. The bill would help the agencies to discharge that duty by creating a pilot program to establish 24-hour ports along these border areas, ensuring that legitimate trade can flow quickly through these areas.

So let's come together to reauthorize CBP and ICE. Let's give these agencies the tools and resources they need to facilitate and enforce international trade. And let's help CBP and ICE to discharge these duties that are so essential to our economic security.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Amendment No. 2303

Mr. President, I urge the Senate to pass by unanimous consent the WIPA and PABSS Reauthorization Act of 2009--H.R. 3325-- which was passed recently by the House of Representatives. The bill will extend, for 1 year, two programs that provide important assistance for Social Security and supplemental security income, SSI, disability beneficiaries who would like to return to work.

Both of these programs were included in the Ticket to Work and Work Incentives Improvement Act of 1999, which passed Congress with bipartisan support. Under the Work Incentives Planning and Assistance, WIPA, program, the Social Security Administration, SSA, funds community-based organizations to provide personalized assistance to Social Security and SSI disability beneficiaries who want to work, by helping these beneficiaries understand SSA's complex work incentive policies and the effect that working will have on their benefits. This program can help to reduce the fears many beneficiaries have about attempting to return to work.

Under the Protection and Advocacy for Beneficiaries of Social Security, PABSS, Program, SSA awards grants to protection and advocacy systems to provide legal advocacy services that beneficiaries need to secure, maintain, or regain employment. The PABSS Program also provides beneficiaries with information and advice about obtaining vocational rehabilitation and employment services.

The Finance Committee and other committees in Congress have received testimony from disability advocates and other stakeholders about the importance of these programs to increasing employment among disability beneficiaries.

The Social Security Administration is currently authorized to spend $23 million annually from its administrative budget to fund the WIPA Program, and $7 million annually to fund the PABSS Program. However, the authorization for both programs expires on September 30, 2009.

This bill will extend the WIPA and PABSS Programs for 1 year, with no changes, while the relevant committees in Congress consider a longer term reauthorization. This 1-year extension will ensure that these programs can continue to provide disability beneficiaries with the assistance they need to return to work.

I thank my colleagues for their support for temporarily extending these important programs.

Mr. President, it is with great honor that I rise to express my support for the nomination of Judge Sonia Sotomayor to be an Associate Justice of the U.S. Supreme Court.

In the Federalist Papers, explaining our great Constitution and the role of the judiciary, Alexander Hamilton quoted Montesquieu to say:

There is no liberty, if the power of judging be not

separated from the legislative and executive power.

We Americans should take a moment to recognize that few other nations in the world possess such a strong emphasis on individual rights and liberties--something we cherish greatly. Too often we take it for granted. We can, in large part, point to this Nation's independent judiciary as the reason for this emphasis on individual rights and liberties. Sure, they are enshrined in the Constitution, but the independent judiciary, framed in the Constitution, helps make all that possible. Justice Sandra Day O'Connor stated, for example:

The Framers of the Constitution were so clear in the

Federalist Papers and elsewhere that they felt an independent

judiciary was critical to the success of the nation.

Our Founding Fathers were wise in setting up three separate branches of government, including a strong and independent judiciary. The pinnacle of this system and its independence is the U.S. Supreme Court, the highest Court in the land.

Our Constitution embodies this independence in the separation of powers and checks and balances throughout this great document. This is the case in the structure of appointing our Supreme Court Justices. The Constitution provides of the President, for example, that:

He shall nominate, and by and with the advice and consent

of the Senate, shall . . . appoint judges of the Supreme

Court.

Let me repeat, the Constitution says: the President ``shall nominate, and by and with the advice and consent of the Senate, shall appoint . . . judges of the Supreme Court.''

The Senate's role is of utmost importance in defending the independence of the Supreme Court. The Senate's active advice and consent role in the confirmation of Supreme Court Justices helps to ensure that nominees have the support of a broad political consensus.

Of the many responsibilities the Constitution grants to the Senate, few are more critical than the Senate's role in the confirmation process for Supreme Court Justice nominees.

I take--and I know each of us in the Senate does--this constitutional responsibility very seriously. Throughout my time in the Senate, I have established three criteria I use to examine nominees. These three criteria are: professional competency, personal integrity, and a view of important issues within the mainstream of contemporary judicial thought. Those are the three. They are the criteria I use. I have analyzed past Supreme Court nominees using these three criteria, including Chief Justice Roberts and Justice Alito. I will review my criteria.

First, professional competency. The Supreme Court must not be the testing ground for the development of a jurist's basic values. We do not have time for that. A Justice cannot learn on the job, nor should she require further training. The stakes are simply too high. She must be professionally competent on day one.

Second, personal integrity. Nominees to our Nation's highest Court must be of the highest caliber.

And, third, the nominee should fall within the mainstream of contemporary judicial thought. The next Justice must possess the requisite judicial philosophy to be entrusted with the Court's sweeping constitutional powers.

I believe that in the case of Judge Sonia Sotomayor, the answer to all three questions is a resounding ``yes.''

Judge Sotomayor is the embodiment of the American dream--rising from a Bronx public housing project to a place among the judicial elite. She attended Princeton, where she graduated among the top of her class, and she was editor of the Law Journal at Yale Law School.

Judge Sotomayor's work history is diverse and rich with experience. Judge Sotomayor began her legal career as assistant district attorney for New York County in 1979. She then worked as a litigator at Pavia & Harcourt, a small firm in Manhattan, where she handled commercial cases.

Judge Sotomayor's 17 years on the bench, first as a district court judge, then on the second circuit, have yielded an enormous yet consistent body of work. Her opinions show thorough and thoughtful analysis, an eye for detail, and, in her own words, fidelity to the law.

I have no doubt that Judge Sotomayor has the professional competency that the American people require of Supreme Court Justices.

Judge Sotomayor's life experiences also convey the personal integrity essential to a Supreme Court Justice. She has given back her time, energy, and expertise to the community that helped shape who she is. She has worked hard throughout her career, inspiring students across the country to pursue study of the law.

For her service, Judge Sotomayor has received many honorary degrees-- many--countless awards, and accolades from her colleagues, clerks, and the academic community. Judge Sotomayor has also made personal sacrifices. She recognizes the personal sacrifices she must make in order to serve as a Justice on the Supreme Court.

My third criteria--that is, a nominee who falls within the mainstream of contemporary judicial thought--is met, again, by reviewing Judge Sotomayor's lengthy judicial record. Some of my colleagues want to paint her as a judicial activist with leftwing leanings.

In fact, in constitutional cases that came before the second circuit, Judge Sotomayor voted with the majority 98 percent of the time--hardly a leftwing activist. In the rare cases where she held a government action unconstitutional, the decision was so clear that it was unanimous. Judges appointed by Republican Presidents have agreed with Judge Sotomayor 90 percent of the time--hardly a leftwing activist.

This is not the actions of an activist judge. In fact, this is a judge who can be relied on to produce a decision that most people can agree with.

I strongly believe Judge Sotomayor has met the three criteria I view essential to a Supreme Court Justice, and this was even more evident during her confirmation hearing.

Over the 4 days of hearings on the nomination of Judge Sotomayor, what did we see? We saw a composed, intelligent, and thoughtful judge, someone committed to the law, and one with a rich life story and expansive judicial experience, whose perspective will enrich the judgments of the U.S. Supreme Court.

In closing, I congratulate our President. I congratulate President Obama on his historic nomination. I am confident Judge Sotomayor will make an outstanding Justice on the U.S. Supreme Court.

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

Mr. President, I ask unanimous consent that the following individuals on my staff be granted the privilege of the floor during consideration of the confirmation of Judge Sotomayor: Caitlin Coan, Emily Yeska, Andrew Dusek, Dan Huffman, Raphael Graybill, Philip Feldman, Josh Gardner, and Maureen Weiland.

I ask unanimous consent that Laura Safdie, Aaron Guile, and Kathleen Roberts, law clerks on Senator Leahy's Judiciary Committee staff, be granted the privilege of the floor for the remainder of the debate on the nomination of Judge Sotomayor.

Mr. President, today I recognize one of the most dedicated members of my staff, Janis Lazda. Janis joined the Senate Finance Committee in 2005 to work on international trade matters, and today he leaves us to become senior policy adviser to the Deputy U.S. Trade Representative. USTR's gain truly is our loss.

For the past 5 years, Janis has demonstrated a quiet intelligence, unquestionable loyalty, and an unwavering commitment to the great State of Montana and this great country. He has worked hard to keep U.S. relations with Asia strong during these challenging economic times, and focused on improving America's competitiveness around the globe. He has spearheaded policies to increase U.S. exports to the world, and brainstormed ways to make international institutions more meaningful.

He has performed all of these tasks diligently and with careful thought. And he has put the needs of Montanans and the American people first. Janis has witnessed the majestic mountains of Missoula, the bucolic beauty of the Big Hole Valley, and the memorable music of Molt. He met with hard-working people in all of these areas, and across Montana, to hear their thoughts and understand their needs. And he used these experiences to ensure that the policies crafted in Washington are meaningful for folks across America.

Janis has been a sound and knowledgeable adviser. His experience and analysis have been critical to many of the trade policies formulated by the Finance Committee. I thank Janis for his hard work, and wish him well as he takes the next step to what I am sure will be a brilliant future.

Mr. President, I have been extremely concerned about the problems lease-in/lease-out and sale-in/lease-out transactions cause our tax system for years. I have made clear before that gaming the system at the taxpayers' expense is simply unacceptable. In 2004, Senator Grassley and I successfully shut down the loophole that allowed losses from these deductions, but the current economic crisis has created new problems. I applaud the work of Senator Menendez to address these issues, and I support his efforts to resolve this problem.

Mr. President, today I join my colleague Senator Tester in recognizing and paying tribute to MG Thomas F. Deppe, Vice Commander of Air Force Space Command, and his wife Eileen for their lifetime of service and unfaltering dedication to the U.S. Air Force and our great Nation.

As both an airman and leader, spanning 42 years of military service, General Deppe's contributions to our Nation's strategic deterrence and space

missions were critical to the warfighter, global economy and safety of our families. General Deppe's leadership was an essential element in winning the Cold War and vital to Air Force Space Command's support of combat operations around the world to include Operations Enduring Freedom, Iraqi Freedom, the global war on terrorism and overseas contingency operations.

General Deppe began his illustrious Air Force career by graduating from Basic Military Training School in 1967. In September of 1967, General Deppe was introduced to the Air Force through missile instrumentation electronics technical training. This training led to a series of aircraft munitions assignments and rounded out his enlisted service with an Air Force recruiting position, achieving the enlisted rank of technical sergeant. In 1977, General Deppe received his commission through the Officer Training School. This led him to his first assignment in Montana at Malmstrom Air Force Base. General Deppe's Air Force journey as an officer would take Eileen and him through a series of wing, air staff and joint assignments relating to strategic and tactical missile and space systems. He operated the ground-launched cruise missile in Europe and later served as the commander of the 351st Organizational Missile Maintenance Squadron in Missouri at Whiteman Air Force Base. Additionally, he commanded the 90th Logistics Group at Francis E. Warren Air Force Base, WY, and the 341st Space Wing in Montana. While assigned to the National Military Command Center, he directed actions during the early days of Operation Iraqi Freedom and the Space Shuttle Columbia recovery effort.

Mr. President, last year, America spent $2.4 trillion on health care. That is 1/6 of our economy. Yet we ranked last among major industrialized nations in the Commonwealth Fund's National Scorecard on Health System Performance, which ranks the number of deaths that could be prevented before age 75 through effective health care.

Some analysts estimate that as much as 30 percent of our spending is for ineffective, redundant, or inappropriate care. That's care that does nothing to improve the health of Americans.

Our system also leaves nearly 50 million Americans without health coverage and 25 million more with inadequate coverage. Most bankruptcies and foreclosures in America are related to medical costs.

Our system needs reform.

Today, along with Senator Conrad, the Chairman of the Budget Committee, I am proud to introduce a bill that would improve health care in America by helping doctors and patients to make better, more- informed health care decisions.

This legislation would increase the chances that Americans receive the right care. This bill would provide for research that can help physicians and patients know more about what works best in medicine, and what does not.

Some patients, receive medical treatments that work well. Some patients receive treatments that do not. In many cases, doctors simply don't have enough reliable evidence to decide which treatments are best for which patients.

Rapid innovation and advancements in medicine have led to an ever- changing array of new and sometimes expensive technologies. The age of personalized medicine and genetic engineering will provide even more choices for patients and their physicians. Indeed, both patients and physicians can face great difficulty in choosing among treatment options.

Patients and physicians need more credible information about how treatments for a specific condition compare to each other. Today, the vast majority of medical information shows how treatments work compared to placebos. Most medical information does not show how treatments work compared to each other.

For example, men with prostate cancer have a choice among 3 common treatments surgery, radiation, and chemotherapy. Each approach yields different outcomes in terms of survival, ability to return to work, and other measures of quality of life.

Comparative effectiveness research would compare each approach in a systematic way. That way, doctors and patients would have more information about how options work, and for whom. The bill that I introduce today would do just that.

This bill would facilitate comparisons across a broad spectrum of health care interventions and health care strategies that are used to prevent, treat, diagnose and manage health conditions. By evaluating and comparing what works best, patients and providers can make more informed decisions about care.

More specifically, this bill would create a nonprofit institute that would be responsible for setting national health care research priorities. The institute, called the Patient-Centered Outcomes Research Institute, would be a private

entity. It would be governed by a multi-stakeholder, public-private sector Board of Governors. It would not be an agency of the Federal Government.

Keeping the Institute a private, nonprofit entity would shelter it from potential political influence from both the executive and legislative branches of Government. The independence and expertise of the Institute would result in more credible and more useful research for Americans.

The Institute would set national priorities for comparative effectiveness research and facilitate studies that would help to answer the most pressing questions about what works, and what doesn't.

The Institute would have the authority to contract with experienced Federal agencies--such as the National Institutes of Health and the Agency for Health Care Research and Quality, or with private researchers--to carry out the actual research. The Institute would also be responsible for disseminating the findings of the research in ways that make sense to both patients and providers.

The Institute's work would not happen behind closed doors. The bill would provide opportunities for public input and scientific review of the integrity of the research being conducted. The Institute's meetings would be accessible to the public, and open forums would help to solicit and obtain input on the Institute's activities and agenda. Also, public comment periods would be made available to discuss research findings.

The Institute's work would benefit all Americans who receive health care. So both public and private payers would fund the Institute. After an initial investment from general revenues, the Institute would be funded by an all-payer system, drawing from both public and private sources.

Comparative effectiveness research would not be the ultimate decision maker. Instead, it would provide an additional tool to improve health quality. The Institute would be a health care resource, a scientific entity, a source of knowledge, and a provider of information.

According to the Institute of Medicine, this research would provide better evidence--objective information--so that doctors and patients could make better decisions.

If we are truly to reform our health care system, then we must get more evidence into the hands of the people making medical decisions. This research is not only about reducing health care costs. It is focused on addressing significant gaps in knowledge.

It is not just the academics and economists who agree. Patient advocates like the National Breast Cancer Coalition, provider groups like the American Medical Association, and consumer groups like AARP can see the benefits of this research quite clearly. They have all extended their support.

The American Recovery and Reinvestment Act made a significant investment towards this type of research. But that was just a first step. We must ensure that this research will be sustained in the years to come.

From cars to toasters, Americans are able to readily view and evaluate information about the quality and effectiveness of so many of the items that they buy. It seems only logical that they should have information on what works and what does not when it comes to their health, especially with one in every 6 of this country's dollars leing spent on health care.

It is time for Americans and their doctors to be wield the world's most advanced science, so that the most personal health care decisions, like so many of the other decisions we make, are made with access to the best available information.

I urge my colleagues to support this common-sense measure.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.