Floor Statements

Madam President, I rise to speak about the urgent need for health care reform. I wish to thank both the Finance and HELP Committees for the enormous amount of effort they are both putting into this monumental task.

When it comes to health care, if you talk with Coloradans, they will point you in the right direction. They want us to end double-digit premium increases on the middle class and small businesses. They want us to leave alone the parts of the system that are not broken. They agree that all Americans should have access to affordable and secure health care coverage.

But they are skeptical that Washington can get this done without breaking the bank. They want us to find a way to pay for these reforms now and not just pass on the cost to the next generation in the form of increased deficits and debt.

That is a tall order, but it is the right one and simple common sense. We will be tempted throughout this process to settle for half- fixes and easier political victories that help a few people but do not deliver real reform for all families. We have to work hard across party lines and avoid these temptations.

Showing resolve means not giving in to the usual political posturing that has characterized the debate on health care for 30 years and has gotten us nowhere. Failing to act responsibly now will result in yet another lost decade of soaring health care costs for families and small businesses.

Working families with good health insurance are now spending over $3,700 of their own annual income just on premiums, drug copays, and other out-of-pocket costs. The amount a family has to pay before health insurance coverage kicks in has gone up by over 30 percent in the last 2 years alone.

Even the amount all of us pay to cover the uninsured as a part of our health care premium--a hidden tax on every family in the country who has health insurance--has increased to over $1,000 a year. This hidden tax will only continue to increase for all families if we keep walking down this path.

Our top priority must be to stop this ever-increasing spiral of health care costs that create such a struggle for families and small businesses. But we do not have the luxury of spending recklessly to accomplish these goals.

I agree with the President that reforming the health care system is the most pressing fiscal challenge our Nation faces right now. That is right, fiscal challenge.

Fail to reduce costs and health reform will not work. Fail to pass meaningful reform and we will face a worsening fiscal mess. Americans spend over $2 trillion on health care each year. Yet premiums continue to skyrocket, and our coverage is not keeping up with what we are paying for it.

Coloradans know this is a bad deal, and it is getting worse every day we do not act.

We do not have to look very hard for enormous cost savings. The potential savings in Medicare and Medicaid are right in front of us. We must look at inefficiencies and perverse incentives in the system and address those first. Medicare's payment incentives spur doctors and nurses to recommend procedures instead of spending more quality time with patients.

We can empower medical professionals to do the best job possible by fixing this incentive structure. It starts with Medicare. If we want a culture change in health care, we must start with our largest health care spending program, Medicare.

If nothing changes in the next 8 years, the cost of health insurance for families covered by their employer will rise by 124 percent. The average annual cost to cover a family will increase from $11,000 to $25,000.

As you can see, increases in the growth of health care costs have rapidly outpaced increases in family income. Median income has risen by $11,300 in the last decade, and it is projected to increase by $10,600 in the next decade. Income growth will stay relatively stable.

Let's look at the growth of health care costs in this same time. In the last decade, health care insurance to cover a family rose by $5,400, and now the cost of health insurance for a family will increase by $14,000 in this next decade. This rapid increase in growth is clearly unsustainable.

What you can see from this chart is that median income, in real dollars--the increase--remains essentially flat over these decades. From 1996 to 2006, the growth was $11,300. From 2006 to 2016, we see $10,600. But look at the growth in median health care premium costs at the same time: $5,400 over the first period; $14,000 over the second period. It is clearly unsustainable.

We have just come out of a decade when median family income in the United States, in real dollars, actually declined by $300, and over the course of this same time, health care costs went up by 80 percent and the cost of higher education went up by 60 percent. These are not ``nice to haves.'' These are essential things if our middle class is to remain intact and we are to preserve the American dream for the next generation of Americans.

Our revenues as consumers have been far outstripped by the costs of that which is essential to all of us, and it is one of the reasons we find ourselves in the fiscal mess we are in. Because in order to finance that gap, we piled on credit card debt, we had home mortgage loans we could not afford--all to try to finance this gap. It is unsustainable. It has been a house of cards, and we are dealing with the consequences now.

Already, some Coloradans are seeing cutbacks on the benefits in their coverage, and some businesses are no longer able to afford coverage for their workers. Faced with these unchecked increases, health coverage becomes a luxury few families and small businesses can afford. Many people are cutting back on other essentials, visiting the doctor less frequently, even when they know they need care.

We must meet this economic challenge head on. The first goal is fixing health care. But we cannot forget the second goal. It is just as important: fiscal responsibility. A more efficient health care system can save taxpayers money in the long run.

A study from the White House Council of Economic Advisers shows that smart reform will slow the rapid rise in health care costs by a percent and a half or more. Slowing health care costs by just a percent and a half will have a significant impact on our Federal budget.

If we were to look at how much we will save by reforming our health care, economists have shown us our Federal deficit will decrease. By 2040, we would have saved enough money to reduce our Federal budget deficit by 6 percent from health care cost savings alone.

Just this point and a half would increase the income of the average family in this country by $2,600 in the next decade, growing our economy and improving our ability to get a handle on the deficit. Colorado families will use $2,600 to make purchases, put away for college tuition and retirement, and obtain new employment skills to improve their earning potential. Part of fiscal responsibility is empowering middle-class families. The current health care system is holding them back.

If nothing changes, employers will see about a 10-percent increase in their health care costs next year. Businesses are straining to pay salaries already and remain competitive because health care costs are so high. Every day, they are making tough decisions about what kind of benefits they can afford to offer and whether they can even offer health coverage at all.

Coloradan Jean Butler is the clerk and treasurer for the small town of Blanca in Costilla County. The town has about 400 people and employs 6 people in its government. Two of those town employees, the town police officer and the head of maintenance--who oversees roads, water, and sewer--get health benefits provided with their employment.

The town pays the full premium for the two employees, though they do have to pay some out-of-pocket costs. The cost of maintaining a plan that covers just these two employees has become an increased burden on the small town. The coverage has been in place for about 10 years and has increased in cost almost every single year.

Jeannie said the town budgets for a significant increase every year, with the hope it has budgeted enough. In 2008, the increase was 25 percent; the year before, it was 15 percent--40 percent in 2 years. No other town expense requires such a big year-to-year increase. Most others are budgeted to increase with the inflation rate.

The current plan with San Luis Valley HMO costs the town $804 a month and the employees $750 in out-of-pocket expenses. But that plan is no longer available. Jean said that similar plans from other providers would increase the cost premium anywhere from 33 percent to 235 percent. Even with the smallest cost increase, the total annual cost to the town will be close to $12,000.

Jeannie said--Jeannie told me her official name is Jean but that I could call her Jeannie; and she said everybody else does--Jeannie said:

My [town] board now has to decide whether to accept the

higher rates, reduce the coverage, require the employee to

pay a much larger share of the premium, or try something

else. It is not an easy decision.

Jeannie may have summed up the problem we face as well as anyone. She pointed out that:

They should call it sick care not health care because the

insurance companies do not pay to keep anyone healthy.

Because Jeannie cannot find another plan, hard decisions are being made about employees. We cannot continue down this path when we know health care costs are overwhelming businesses and working families.

Ann Brown and her husband Gordon run New Vista Image, a large-format digital design and printing company in Golden. The business has nine employees and provides health care benefits, covering 60 percent of each employee's premium but not that of their dependents.

Ann said she is happy with the choices available in Colorado for different types of plans, and she believes in the employer-provided benefits model. She and her husband built in the cost of health care when they began their business because she knew it would help attract the best employees.

Ann said she understands how important a healthy workforce is and supports wellness programs, so employees can prevent major medical conditions. Whenever she brings someone in, she knows the first question asked will be: Do you have a health care plan?

Nevertheless, the business has been forced to offer less and less coverage in order to keep premiums within its budget. Health care is one of the biggest ticket items they worry about. Ann said that in recent years, the percent cost increase over the previous year has been in the double digits. As a result, they have had to offer less coverage, with higher deductibles and more out-of-pocket costs.

The plan's deductible has gone from $1,500 to $3,000, and Ann said it is likely the next step they will have to take is a $5,000 deductible. She knows how hard those out-of-pocket costs can be for employees to absorb. A few years ago, when an employee was facing a serious health condition, the business covered the deductible so the employee would not be saddled with the medical bills.

``I would do it again,'' Ann said, although she knows higher deductibles mean a less generous plan to offer to her employees and less of a competitive edge for the business overall.

Teresa Trujillo of Pueblo, CO, has employer-based coverage. For 7 years, Teresa saved up money to buy a home, and then learned she had breast cancer. After 14 months of treatment, the money ran out and Teresa had to take a loan out to finish paying for the rest of her treatment.

For Teresa, her health insurance coverage only took her so far. While she has been cancer-free for 4 years, she constantly worries that her cancer will come back, and with it, the huge financial strain it would bring. All she wants is health care she can count on.

These are people who have done everything right, played by the rules, looked out for their fellow employees and fellow citizens. Our health care system is failing them. People should not have to wait until they get sick to learn their health insurance will not cover the cost of their treatments. Families should not have to watch their loved ones go through sickness and also deal with the anxiety of paying for medical bills that are increasingly becoming completely unaffordable.

We know health care reform will not be easy. As the President has said, if it were easy, we would have done it a long time ago. But for these Coloradans--for their families and for their businesses--the system must change. For our Nation's long-term prosperity, the system must change. We cannot burden future generations with responsibility for the reform we need today. If we make the hard choices, we will create a better health care system, a better economy, and a better future for our children and our grandchildren.

I thank my colleagues for listening this morning.

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

Mr. President, I rise today to introduce a bill with Senators Brown of Ohio and Casey of Pennsylvania called the Enhancing Child Health with Automatic Enrollment for School Meals Act. We wrote this legislation because too many kids across this country are not getting the free school meals their families are qualified to receive. As members of the Agriculture Committee's subcommittee on Nutrition, Senators Brown, Casey and I share an interest in eradicating childhood hunger and increasing the efficiency of the National School Lunch and Breakfast programs.

Our bill builds on the foundation laid during the 2004 child nutrition reauthorization which included a mandatory phase-in of an automatic enrollment process called `direct certification.' Our bill stipulates that schools, districts, and states must directly certify at least 95 percent of children who can be enrolled in the national school lunch and breakfast programs using this method. The intent of this provision is to modernize the enrollment process by reducing reliance on paper applications and to improve access to school meal programs by ensuring kids who should be receiving free school meals actually receive them.

Because we want to reward achievement and encourage improvements to the school meal enrollment process, our bill includes performance awards for the five states which make the best use of direct certification and for the five states which show the most improvement from one school year to the next. Additionally, our bill requires states which are unable to meet the 95 percent standard to submit a report to Congress and the U.S. Department of Agriculture that identifies the challenges prohibiting effective use of direct certification and maps out a plan for improvement.

As former Superintendent of Denver Public Schools I cannot stress enough the importance of reducing red tape and administrative costs in schools. We cannot expect our children to focus on fractions when their stomachs are growling nor can we expect teachers, principals and school administrators to prepare our children to be tomorrow's leaders if they are spending their time filling out paperwork. That's why modernizing the National School Lunch and Breakfast programs is one of my top priorities for the child nutrition reauthorization this Fall and that is why I am introducing this bill today.

Two additional provisions in the bill would eliminate paperwork and improve the existing system of determining whether or not kids qualify for free meals. The first is a clarification that sending a letter in the mail to a child's household letting them know they are eligible for free school meals is not an acceptable means of direct certification. A child who can be enrolled for free school meals automatically should be enrolled without any action on behalf of the child's household. We make this clarification because a vast number of paper notifications sent to families are not returned and, therefore, kids miss out on meals they should receive.

The second is a request for a study from the U.S. Department of Education that would help determine how data the Department of Education is currently collecting is being used currently and could be used in the future to ensure all kids who should receive free school meals are provided those meals.

Initially, Senators Brown, Casey and I were working on ways to expand access to free school meals independently, but now we are working collaboratively. Meeting President Obama's goal of ending childhood hunger by 2015 will require all hands on deck. Last week Senator Casey, along with Senator Specter and myself, introduced the Paperless Enrollment for School Meals Act to make it easier for schools and districts to serve free meals to all children. The bill we are introducing today is yet another installment in the ongoing dialog with Chairman Harkin, members of the Agriculture Committee and the USDA in preparation for reauthorizing child nutrition and WIC programs in the coming months.

In Colorado and around the nation there is a renewed call for common sense measures to improve existing programs and provide assistance to those who need them most during these tough economic times. I encourage all Senators to do right by our children and support this legislation and the principles of the National School Lunch and Breakfast Programs Senators Brown, Casey and I have outlined.

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

Mr. President, I rise today to introduce a bill with Senators Brown of Ohio and Casey of Pennsylvania called the Enhancing Child Health with Automatic Enrollment for School Meals Act. We wrote this legislation because too many kids across this country are not getting the free school meals their families are qualified to receive. As members of the Agriculture Committee's subcommittee on Nutrition, Senators Brown, Casey and I share an interest in eradicating childhood hunger and increasing the efficiency of the National School Lunch and Breakfast programs.

Our bill builds on the foundation laid during the 2004 child nutrition reauthorization which included a mandatory phase-in of an automatic enrollment process called `direct certification.' Our bill stipulates that schools, districts, and states must directly certify at least 95 percent of children who can be enrolled in the national school lunch and breakfast programs using this method. The intent of this provision is to modernize the enrollment process by reducing reliance on paper applications and to improve access to school meal programs by ensuring kids who should be receiving free school meals actually receive them.

Because we want to reward achievement and encourage improvements to the school meal enrollment process, our bill includes performance awards for the five states which make the best use of direct certification and for the five states which show the most improvement from one school year to the next. Additionally, our bill requires states which are unable to meet the 95 percent standard to submit a report to Congress and the U.S. Department of Agriculture that identifies the challenges prohibiting effective use of direct certification and maps out a plan for improvement.

As former Superintendent of Denver Public Schools I cannot stress enough the importance of reducing red tape and administrative costs in schools. We cannot expect our children to focus on fractions when their stomachs are growling nor can we expect teachers, principals and school administrators to prepare our children to be tomorrow's leaders if they are spending their time filling out paperwork. That's why modernizing the National School Lunch and Breakfast programs is one of my top priorities for the child nutrition reauthorization this Fall and that is why I am introducing this bill today.

Two additional provisions in the bill would eliminate paperwork and improve the existing system of determining whether or not kids qualify for free meals. The first is a clarification that sending a letter in the mail to a child's household letting them know they are eligible for free school meals is not an acceptable means of direct certification. A child who can be enrolled for free school meals automatically should be enrolled without any action on behalf of the child's household. We make this clarification because a vast number of paper notifications sent to families are not returned and, therefore, kids miss out on meals they should receive.

The second is a request for a study from the U.S. Department of Education that would help determine how data the Department of Education is currently collecting is being used currently and could be used in the future to ensure all kids who should receive free school meals are provided those meals.

Initially, Senators Brown, Casey and I were working on ways to expand access to free school meals independently, but now we are working collaboratively. Meeting President Obama's goal of ending childhood hunger by 2015 will require all hands on deck. Last week Senator Casey, along with Senator Specter and myself, introduced the Paperless Enrollment for School Meals Act to make it easier for schools and districts to serve free meals to all children. The bill we are introducing today is yet another installment in the ongoing dialog with Chairman Harkin, members of the Agriculture Committee and the USDA in preparation for reauthorizing child nutrition and WIC programs in the coming months.

In Colorado and around the nation there is a renewed call for common sense measures to improve existing programs and provide assistance to those who need them most during these tough economic times. I encourage all Senators to do right by our children and support this legislation and the principles of the National School Lunch and Breakfast Programs Senators Brown, Casey and I have outlined.

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

Madam President, I rise today to discuss the urgent need for health care reform. The people of Colorado, and the American people, have waited for too long for Washington to act.

We should begin with a basic principle: if you have coverage and you like it, you can keep it. We will not take that choice away from you.

But even as we keep what works, we must confront the challenges of soaring health care costs and the lack of access to affordable, quality health care. The status quo is unacceptable. Every day, families in Colorado and across America face rising premiums. Their plans offer fewer benefits. They are denied coverage because of preexisting conditions.

And until we fix the health care system, we will not be able to fix the fiscal mess in which we find ourselves.

Since 1970, the share of health care as a part of the GDP has gone from 7 percent to 17 percent. The United States spends over $2 trillion in health care costs, including over $400 billion on Medicare. President Obama has said the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. He is right.

In Colorado, we have not waited on Washington. We have made real progress in showing how you can provide high quality health care at a lower cost. Last week, the New Yorker magazine published an article titled ``The Cost Conundrum'' that highlights the important work that has been done in Mesa County, CO. Over 30 years ago this community serving 120,000 people came together, doctors, nurses, and the nonprofit health insurance company. They agreed upon a system that paid doctors and nurses for seeing patients and producing better quality care. They realized that problems and costs go down when care is more patient-focused.

In Mesa County, the city of Grand Junction implemented an integrated health care system that provides follow-up care with patients. This follow-up care has helped lower hospital readmissions rates in Grand Junction to just 3 percent. Compare that to the 20 percent rate nationwide, and it is clear that our rural community on the Western Slope of Colorado is onto something groundbreaking.

High readmission rates are a large problem for our seniors. Nearly one in five Medicare patients who leave a hospital will be readmitted within the following month, and more than three-quarters of these readmissions are preventable. Rehospitalization costs Medicare over $17 billion annually.

It is painful for patients and families to be caught up in these cycles of treatment. All too often, care is fragmented; you go from the doctor, to the hospital, to a nursing home, back to the hospital and then back to the doctor again. Patients are given medication instructions as they are leaving the hospital, many times after coming off of strong medications. They do not know whom to call, and they are not sure what to ask their primary care doctor.

The solution, both our Denver and Mesa County health communities have found, is to provide patients leaving the hospital with a ``coach.'' This coach is a trained health professional connecting home and the hospital. This coach teaches patients how to manage their health on their own.

Our Denver health community created a model based on this idea called the Care Transitions Intervention. Their work is the basis for the Medicare Care Transitions Act of 2009, a bill I introduced to implement this model on the national level. This legislation recognizes that patient care should not begin in a doctor's office and end at the hospital doors. Investing in coaching and transitional care now can head off huge costs down the road. It has the advantage of being both preventive and responsive.

Take 67-year-old Bill Schoens, from Littleton, CO, who recently suffered a heart attack. Before he was released from the hospital, registered nurse Becky Cline was assigned as his Transitions Coach. She made sure that he understood the medications that his doctors prescribed and everything else he needed to do to get healthy. Bill even pointed out, ``When you are in the emergency room, you are all drugged up and can barely remember what to do. Confusion starts to set in.''

Becky went through each step Bill needed to follow when he left the hospital. Becky evaluated Bill's ability to follow doctor's orders in his environment and helped him maintain his own Personal Health Record. With her help, when Bill visited the doctor, he did not have to remember everything that happened since he left the hospital; it was all in the book.

Bill said, ``When people are in front of their doctor, their blood pressure goes sky high and they forget what they need to ask.'' He said he found the help and guidance he received from his Transitions Coach ``invaluable and life-saving.''

We need patient-centered coordinated care, care that views nurses, doctors and family members not as isolated caregivers, but as partners on a team whose ultimate goal is to make sure patients get the guidance and care they need. Hospitals are not the problem, primary care physicians are not the problem, and nurses are not the problem. Our fragmented delivery system of care is the problem.

This bill also makes sure that we are teaching patients to manage their own conditions at home.

Sixty-nine-year-old Frank Yanni of Denver, CO, had surgery for a staph infection of the spinal cord. After leaving the hospital, he noticed that the pain he was experiencing weeks after surgery was getting worse. Having been ``coached,'' he identified the problem and knew to insist on visiting his doctor immediately. A hospital test showed that Mr. Yanni required a second surgery. His coach said that, ``Had he let that go for even another week, he could have ended up in the ICU, septic and horribly sick.''

Our Colorado transition of care model, reflected in our legislation, gives health care systems the choice of whether to create this program. But it allows existing patient-centered transitional care programs like the one in Mesa County, CO, to continue on.

We want communities and providers to think and work together to reduce readmission rates, reduce costs and provide better coordinated care to our patients. Other systems should look at Colorado and the systems in 24 States that have already begun to follow this model.

As we begin to emerge from the economic downturn, we must call upon existing health care professionals from all walks of life--nurses, nurse practitioners, social workers, long-term care, and community health workers--to serve as transitional coaches.

Colorado nurses like Becky Cline have found that focusing on transitional care has leveraged their skills,

empowering them to take a more active role with patients. They are able to work with both patients and family caregivers. For too long, family caregivers have been ``silent partners.'' Some 50 million Americans provide care for a chronically ill, disabled or aged loved one. This bill recognizes their importance, connecting them with a coach who can teach them how to properly coordinate at-home care.

This bill is only a small part of the solution to the complex challenges of our fragmented health care system. The problems of rising costs and limited access affect people from all walks of life.

Skip Guarini of Parker, CO, is a self-employed private consultant and retired U.S. Marine. After years of regular doctors' visits, Skip's dentist discovered a lump on his thyroid during a routine exam that had gone undetected by his physician despite 10 previous exams.

Skip underwent a CT/MRI scan, ultrasound, and biopsy, all of which were inconclusive. A second series of tests 6 months later revealed that the lump had grown, and Skip underwent surgery. During the surgery, doctors found cancer. Skip was then sent to an endocrinologist who ordered more tests. All tests came back negative. A second full body scan revealed no sign of cancer anywhere in Skip's body.

All these exams and screenings cost Skip $122,000.

Since then, Skip has maintained perfect health, but he cannot obtain private insurance because of the thyroid surgery. He now relies on COBRA and is paying a monthly premium of $1,300. This coverage is set to expire in less than 1 year, at which point Skip will have no insurance.

Hollis Berendt is a small business owner in Greeley, CO. She is covered through her husband's employer, which is ``a luxury many other small business owners don't have,'' she said.

After graduating from Colorado State University in 2004, their daughter Abby found a job with a large company in New York City. She was told she could not get health care coverage until she had been working for the company 1 year. At 10 months of employment, she was diagnosed with an ovarian tumor that would require surgery. The expenses were too much for Abby, so her parents had to take out a second mortgage to pay her medical bills.

Hollis shared that ``this experience brought to light, all too clearly, how close we all are to losing everything due to a health issue.''

The current system is hurting our small business people and their employees. Take Bob Montoya of Pueblo, CO, who runs Cedar Ridge Landscape in Pueblo with his brother Ron. They are torn between providing health care coverage for employees and keeping the business afloat.

Last year, the business paid out $36,000 for a health care plan to cover Bob and Ron's families and one other employee. The other 12 employees and their families do not get coverage through their work. Bob said, ``As business owners, we want to do right by the people who work for us, but if all our employees opted into our health care plan and paid their 50 percent, we would be forced out of business.''

He said it is an ``impossible situation'' for him and his employees.

Like too many small business owners, Bob can not find good health care coverage at a cost he can afford.

He said, ``The longer it takes to pass comprehensive health care reform, the more jobs will be lost as small businesses shut their doors due to rising costs.''

These Coloradans speak for countless others across the nation. All they ask for is a health care system that works for them, a health care system that does not crush them with unreasonable costs, and a health care system that does not deny them coverage just because they have pre-existing conditions. I am hopeful.

I am hopeful that we can keep what works in our system and fix what is broken. I am hopeful that this Congress, working with our President, will finally deliver on the promise of health care reform. The people of Colorado deserve it. The American people deserve it.

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

The PRESIDING OFFICER (Mr. Kaufman.) The clerk will call the roll.

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

Mr. President, I ask unanimous consent to set aside the pending amendments so that I may call up my amendment No. 1167.

Mr. President, my amendment ensures that active-duty soldiers do not lose family benefits, nutrition benefits that they have come to count on. It is wrong that a combat family would actually loose WIC benefits and child nutrition benefits just because the military loved one gets called up.

I thank my colleagues Senators Johanns and Casey for their support of this amendment. I appreciate the great work of the chairman on this important piece of legislation.

I urge, at the appropriate time, adoption of the amendment.

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

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

Mr. President, l rise today to congratulate Chairman Dodd and Senator Shelby for developing the legislation we have before us. Pass this bill, and we will be able to go home and tell our constituents with confidence that the Credit CARD Act of 2009 is a groundbreaking consumer protection achievement. I am pleased that, as a member of the Banking Committee, I was able to vote for the bill in committee and help pave the way for floor consideration this week.

In my travels around Colorado, I have been struck by stories of unfair, undeserved credit card practices, hitting consumers at exactly the hardest time. Melissa Mosley of Durango, CO, told me about how tough economic times forced her to use several credit cards for purchasing supplies and day-to-day expenses for her small business. After a stretch of making minimum payments, Melissa's interest rates suddenly rose, one even reaching 32 percent. The company is refusing to negotiate, making it even more difficult for Melissa and her husband to make ends meet.

And in Cedaredge, Joy Beason is a small business owner who runs a small herbal products business. Last fall, Joy's interest rates tripled from 7.9 percent to 23 percent without notification of any kind. The high interest rates prevent her from paying down more of the principal on the card, leaving her in an endless cycle of debt.

And there's Garrett Mumma of Pueblo whose interest rate on his credit card doubled from 7.9 percent to 13.65 percent despite his solid history of payment. In a letter to me, Garrett wrote, ``I only want what's fair. I want the credit card companies to honor their original agreements and not to gouge the American people when they are already suffering so much from the present economic crisis.''

These struggles paint an unacceptable picture. We need to rein in abusive practices and create a new set of rules that works for Colorado consumers.

According to a Pew Safe Credit Cards Project study, 87 percent of cards allowed the issuer to impose automatic penalty interest rate increases on all balances, even if the account is not 30 days or more past due. And 93 percent of cards allowed the issuer to raise any interest rate at any time by changing the account agreement.

I am voting for this bill because it protects consumers from excessive fees, ever-changing interest rates where you do not even get notice, and complex contracts intended to confuse you until you give up even trying to understand.

It protects consumers by establishing fair and sensible rules for how and when credit card companies can raise interest rates. Card companies must give 45 days' notice before increasing rates, and can no longer do so on existing balances.

It cracks down on abusive fees. Consumers no longer will have to pay a fee just to pay a bill. And credit card companies must mail statements 21 days before the bill is due, instead of the current 14 days, so cardholders can avoid hefty late fees. It also stops credit card companies from raising rates on a consumer's existing balance because of a payment issue with a separate credit card. These reforms will save some families thousands of dollars a year. And all Americans will be able to access better information to make important financial decisions.

I also want to take one moment in particular to highlight the importance of a new provision in the bill that connects the dots for some of our younger borrowers. The bill provides for consumer literacy education classes, so that when a young person does not have a parental cosigner, and cannot show ability to repay, they can at the very least approach the credit card system with some understanding of the potential dangers they are facing. I am all for consumer choice, but we need our young people making informed choices before they find themselves in a world of debt.

I believe more educated young consumers will stay solvent, stay debt free, learn the value of saving, and make better decisions for their future.

At the same time, this legislation is not doing anything that the industry has not known was coming. It builds on rules that the Bush administration scheduled to go into effect in mid-2010.

The industry will adjust. In a few instances, it may not be seamless. But this is one moment when we all need to band together and remember that Main Street matters.

People in Colorado are struggling, they cannot afford a sudden hike in their interest rates that they were not informed of and could not do anything to avoid. No longer. I stand proudly with Senator Udall, who has worked to protect consumers from credit card company excesses for years, in urging the full Senate to stand together, break through the partisan divide and come together and pass the Dodd-Shelby legislation.

Mr. President, I rise today to speak in support of the nomination of Thomas L. Strickland, to be Assistant Secretary for Fish and Wildlife and Parks at the Department of Interior.

Secretary Salazar and Thomas L. Strickland are both legendary Colorado public figures in their own rights, and I cannot think of any two people better qualified to provide leadership in the Department of the Interior.

Thomas L. Strickland was born and raised in Texas and later attended Louisiana State University, where he played football. He earned a J.D., with honors, from the University of Texas in 1977.

Early in Strickland's career, he worked for Colorado Governor Dick Lamm, and later became Lamm's director of policy and research. In Colorado, such a prestigious statewide policy position requires one to be well-versed in important issues affecting the West, and impacting public lands and water. In 1984, Strickland accepted a position at Brownstein, Hyatt & Farber, where he eventually became partner.

Strickland was the Democratic nominee for the U.S. Senate in both 1996 and 2002, but the seat eluded him, and though he lost both times to Senator Wayne Allard, Tom became well known throughout our State and he is extremely well liked and respected on both sides of Colorado's aisle.

After the 1996 campaign, Tom returned to his law practice.

In 1999, President Clinton appointed him U.S. attorney for Colorado. He assumed office the day after the Columbine High School massacre and

worked to enforce existing gun laws in the wake of that horrible disaster. He was cognizant of how important gun rights interests are, but at the same time, he firmly believed in enforcing gun laws and preserving school safety. He worked with Federal and local prosecutors to bring gun charges under State or Federal laws, whichever were most stringent.

Strickland also worked with the Hogan & Hartson law firm, serving as, managing partner for the firm's Colorado offices, and was a member of Hogan & Hartson's executive committee.

I was pleased when I first heard that President Obama and Secretary Salazar wished to make Tom such an integral part of their team. As a chief advise on fish, wildlife and parks issues, I know Tom will be a vital asset to my dear friend and predecessor Ken Salazar, and I urge my colleagues to vote in favor of his nomination.

Mr. President, I ask unanimous consent that the remaining Republican time be reserved.

Mr. President, I believe I have 25 minutes. I would appreciate it if you would let me know when I have 5 minutes remaining.

Thank you, Mr. President.

Mr. President, today we celebrate the first 100 days of our new President's administration. It has been somewhat less remarked upon, but this week also happens to mark my first 100 days in office.

Together, we have done important work in these 100 days. We have taken decisive action to get our economy moving again. We have provided better access to health care for our children. We have made the workplace fairer for women.

For me, these 100 days have provided a remarkable opportunity to listen to Coloradans. In dozens of townhall meetings, in each and every corner of the State, in cities and small towns, in good weather and bad, I have listened to thousands of Coloradans--young and old, Republicans, Democrats, and Independents, teachers, nurses, farmers, workers, ranchers, and small business owners, people from all walks of life with every conceivable point of view.

I have been struck by how much--despite the trials we face at this moment in our history and despite whatever disagreements we might have--more than anything the people of Colorado long to build a better future for the next generation.

America has always embraced the promise of a better life for our children.

My family's story is no different. After their lives were shattered by World War II, my grandparents set their sights on Franklin Roosevelt's America as the one place they could rebuild their lives. And it was.

My mother had even more opportunities than my grandparents dreamed, and she and my father were able to create a better life for me, my brother, and my sister. Since our founding, generation after generation, we have worked to form a more perfect union, always fulfilling the promise of a better life for those who come after us.

Yet now that promise is in question.

I am here today as the father of three young daughters of my own-- Caroline, Halina, and Anne. I think of them and worry that we are at risk of being the first generation of Americans to have less opportunity than we ourselves were given.

Our economy is in turmoil; 5.1 million Americans have lost their jobs since the beginning of this crisis, and our unemployment rate is at 8.5 percent and rising. Between 2000 and 2007, median family income in this country actually declined by over $300. At the same time, the cost of health care rose by nearly 80 percent and the cost of higher education by roughly 60 percent.

The gulf between rich and poor has gotten wider. Americans are now less likely than people living in a number of other industrialized countries to improve their economic status in their lifetime. As many as 100 million Americans now live in families earning less in real terms than their parents did at the same age.

This crisis stemmed from much more than foreclosed houses and credit swaps. It is a symptom of this generation's lack of attention to the legacy of our grandparents who built for the future. Now we must ask ourselves who we will be as a country when we emerge from this crisis. Will we answer the call of this time or will we fall back on the same tired arguments of the past?

This time demands that we cast our eyes to the future, that we take a 21st century approach to meet our 21st century challenges and seize our 21st century opportunities. With President Obama's leadership and our resilient American spirit, we can emerge from this crisis stronger and truer to our creed than when we entered it.

Each generation of Americans with hope for their children has courageously shed old ways of thinking and, on their behalf, reached out to new ideas. We are no different. We, too, must be willing to abandon our commitments to the weary forms of the past and attend to the future. That is our cause.

We have to address critical structural issues stifling our economy and threatening our children's opportunities. We need to pursue comprehensive financial reform that will prevent the kind of recklessness that got us into this mess. We have a rising deficit, and we must bring discipline to our budgets, even as we invest in the future. We have a unique opportunity this year to drastically reform our health care system and control its skyrocketing costs, and we must seize it. It is time to invest in the new energy economy and break our dependence on foreign oil.

If we are going to emerge from this economic crisis and succeed in the long run, we must fundamentally change public education in this country. Throughout our history, public schools have allowed America to make good on her promise to the next generation. Our schools propelled our children toward their parents' aspirations and prepared them to rise to the challenges of their times.

If we are honest with ourselves, we see that our public schools too often become traps--traps that perpetuate a cycle of poverty and foster mediocrity. Our children--my girls and millions of others like them-- are attending schools that were built to prepare their grandparents for an economy that no longer exists. Our public education system, as designed, does not work well enough for all children in this country, and for our poorest children barely works at all.

Across America, 1.2 million children drop out of high school each year. Globally, we rank 20th among industrialized nations for high school graduation rates. Forty years ago we were first. Seventy percent of our country's eighth graders can't read at grade level. On average, a 9-year-old from a low-income family is already 3 years behind their high income peers, has a 1-in-2 chance of graduating from high school, and a 1-in-10 chance of finishing college. Despite many efforts to close our stubborn achievement gap, a report released yesterday shows we have made almost no progress. How can we as Americans accept this reality, especially when none of us here would accept these odds for our own children? These are our children too.

There are teachers throughout the country who have rejected the defeatism that too many of us have accepted for our schools. They have come in early and stayed late. They have visited their students' houses and bought school supplies out of their own pockets. They have expected more from their students than their students knew to expect from themselves. Yet too many of us have accepted the existing odds, considering them a natural consequence of poverty. At the same time, we have entered into tiresome debates--debates that take ideology seriously and the fates of our children lightly.

Children's futures have been wasted while adults have endlessly debated techniques for assessing failing schools instead of changing or closing schools that are obviously failing on every dimension that can be assessed. We have debated modest and incremental reforms instead of doing the hard work of identifying successful school structures and human capital strategies and taking them to scale. We have been stuck debating whether teachers should be paid more based on merit, while roughly half of our teachers quit in the first 5 years of their career. A narrow, small politics has allowed us to duck ever making real choices about anything, and it has, failure after failure, shriveled our shared ambition for America's children. As long as we have these same conversations, today's 9-year-olds will see their younger brothers and sisters enter fourth grade with the same low odds of graduating from college they have, just as they saw their older brothers and sisters face the same odds, generation after generation.

When I took over as the superintendent for Denver public schools, in a school district of 75,000 children, only 33 African-American students and 61 Latino students--fewer than four classrooms worth of kids-- scored proficient on the State's tenth grade math test, a test that measures a junior high school standard of proficiency in Europe. Spending time with our students and their families in Denver, I was struck not by their fragility but by their resilience. Their parents-- like many before them--had made tremendous sacrifices to provide their children with greater opportunity. The students I knew were willing to work harder and stay in school longer. We were selling them short.

I joined the Denver public schools with kind of an abstract understanding that what was happening in our schools was unfair. My experience there left me with a profound sense of urgency to change what is unfair and fundamentally unjust.

We can do better, and we will do better. In Denver we have made progress. From 2005 to 2008, Denver students scored higher in reading, math, writing, and science. We did not get there by doing things the same way as they had been done before. We closed failing schools and opened new ones. We implemented a groundbreaking teacher pay system that rewards teachers who improve their students' performance and provides incentives for teachers to go to the neediest schools. We accomplished this change by working with the union. It took a lot of effort. We had a lot of disagreements, but we made progress together because of a fundamental commitment by all of us to get the job done, not just score political points.

With the leadership of our mayor and our city council, voters expanded our early childhood education. As a result, this year there are 1,500 more 4-year-olds in full day programs, a 300-percent increase. We increased full-day kindergarten by 25 percent, so that for the first time more than 95 percent of our 5-year-olds have the benefit of a full day of school. Research tells us there is no smarter investment we can make.

In 2008, we launched a school performance framework that measures the progress of actual students year over year throughout their career, rather than meaningless measurement of one year's class against the next year's class.

We still have work to do in Denver. There is still a long way to go before these reforms materially change the odds for our students, but we are moving in the right direction. In other districts we will see similar success if we support reform efforts that work.

Our job in the Senate should be to help the administration spur innovation and identify and expand what works. I look forward to working with our Education Secretary, Arne Duncan, my colleagues here-- and I notice our former Education Secretary, the Senator from Tennessee, is here today, and I am glad that he is here--my colleagues here, as well as parents, teachers, students, and community members in Colorado to support innovative solutions to the problems plaguing our schools.

Our commitment to our children and grandchildren requires that we hold ourselves to a higher standard than we have in the past. This is not a time to spend new money on old programs or to timidly attempt changes that have already failed too many of our children. Now is the time to reimagine our schools as magnets for talent, centers for communities, and incubators of innovation. Only then can we ensure that our students are getting the 21st century skills that will equip them for the new economy.

We must do the same for our teachers. As President Obama said yesterday:

In a global economy where the greatest job qualification

isn't what you can do but what you know, our teachers are the

key to our Nation's success; to whether America will lead the

world in the discoveries and the innovations and economic

prosperity of this new century.

Study after study has shown that nothing makes a greater difference to student learning than great teaching. We need to support effective teachers and make sure they stay in the classroom. That means creating school environments where teachers and students want to spend time, and it means restructuring our schools and our school calendar so that teachers have time to plan together and learn from each other. Also, we need to pay teachers in ways that reward their success and provide incentives for them to stay in the profession. More fundamentally, we need to recognize that our system of hiring, compensation, and training designed deep in the last century, is utterly inadequate for 21st century labor market realities. In 1960, a gallon of gas cost 30 cents. Elvis and the Everly Brothers were at the top of the charts. A first- year lawyer earned about the same as a first-year teacher, and women had basically two professional choices: becoming a nurse or going into the classroom. In 2009, as nation after nation moves past us in educational achievement, we are kidding ourselves if we think a teacher recruitment and retention plan that came in when the Hula Hoop went out--and effectively subsidized our schools by limiting women's opportunities--is a serious response to America's needs.

We must invest in proven training that equips teachers with the content, knowledge, and classroom management skills to be successful in helping their students, and we need to ensure that we provide ongoing, high-quality professional development that actually helps them do a better job in the classroom; otherwise, we risk losing our best teachers.

We need to expand alternative pipelines for teachers, to enhance the traditional pathways we already have. President Obama has called on the Nation to create a new army of teachers. We must recruit a diverse, excellent, and committed group of Americans to teach our children. The talent is all around us--in the veterans returning from Iraq and Afghanistan, the baby boomers who have spent their careers running successful businesses or working in manufacturing or medicine or law, and the college graduates looking to find a rewarding vocation--all of whom can inspire and challenge our students to become the engineers who will build green cities, the doctors who will cure cancer, and the entrepreneurs who will start businesses we can't yet even imagine. As we open the profession to allow talented and committed people to become teachers, we must have rigorous selection for every spot in front of a class, and replicate effective training for new teachers.

As we work with States and districts to redesign our schools for the 21st century, we should do so in conversation with business and labor to inform our efforts about what skills the market will require. Competitive workers must be problem solvers, not just test takers. They must be able to think critically and communicate effectively in multiple mediums. Students won't need to write cursive; they will need to know how to use technology to solve tough problems. They don't need only to memorize facts; they need to understand how to filter and use the information at their fingertips.

We need updated standards that reflect these 21st century skills. We should invite States to embrace voluntary national standards, benchmarked against international norms that allow the public to see the progress students are actually making from year to year. We need an accurate measuring system so that we know when reforms are working and when students are achieving. We need to ensure that the tests we give kids ask them to deploy the knowledge and skills they have, rather than demonstrate their ability to take a test. And we must ensure that when we do give students tests, teachers get the results in time to use them to drive their instruction.

But our tests shouldn't be the sole driver of our instruction. We should look beyond the narrow window of standardized test scores, to parent and community engagement and student retention rates. We should expand learning opportunities to start earlier, be broader in scope, and beckon everyone in the community.

Our schools should become centers where communities gather for skills and services. Schools are uniquely positioned to deliver health and support services. Research shows a statistical link between nutrition and achievement for all students. We need to look at nutrition in schools not as something extra but as central to student success.

Our schools should be on the cutting edge of using new technology for both teaching and learning. Technology can connect students to resources and teachers to each other. Effective use of technology can allow a teacher in a rural area to get feedback from a mentor elsewhere. We should be using technology to disseminate effective practices and share great lesson plans. We can look to technology to help train teachers in new ways by simulating classroom experiences and delivering real-time feedback on lesson plans.

There is something wrong when students who enter the schoolhouse find they are moving backwards in time, leaving behind all the technology that in the rest of their day expands and enriches their lives.

While we know we can't fix our schools by spending more money on the same inadequate programs, we must commit to funding what works in our schools. We now have the largest investment in public education in history with which to do it. The stimulus package and the budget are working in tandem to increase access to early childhood education. States and districts are competing with one another to build on their efforts to revamp standards and turn around failing schools. There are additional resources to reduce high school dropout rates and increase college graduation rates.

If we continue to spark this kind of innovation, if we can allow ourselves to think big again about education, we can start to imagine school buildings as prototypes for energy efficiency and classrooms as job training centers for the new energy economy--preparing parents and students alike. School-based health care can advance from one nurse stretched between multiple schools to clinics that are leaders in efficient health care. School lunches can progress from packaged feedings in the cafeteria to live lessons on nutrition and wellness. In sum, our schools can become what they should be: the institutions that are preparing our children and their children to lead in the 21st century.

Our cause is clear. It is time for policies that serve not the ideologies of adults but the needs of kids. I will be working in the coming months to develop legislation that will outline ways in which the Federal Government can better support our States and school districts in providing a public education that meets the challenges and possibilities of our times.

I look forward to working with my colleagues on both sides of the aisle, as well as with parents, teachers, students, and community leaders across Colorado to ensure that we do our part to increase opportunity for our children. We will know we have succeeded when we see not only more students graduating high school but more of those graduates going on to complete college as well. We will not only see the achievement gap shrink, but we will see the United States once again lead the world in academic achievement.

We are lucky. In our time, history is once again beginning to run in the direction of change. We have the chance to honor our grandparents' example and move forward together to create a better future for our children. If we do, those children and their children will say we rose to the moment, that we laid down our adult burdens and our differences to lift up our country and our children instead. Let them say that a spark flew in America in this new century that ignited a generation of educators, children, parents, and communities and gave them courage to abandon the status quo for a better future. Let our schools once again be the cradle of the American dream and act to fulfill the solemn promise of one generation to the next.

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

Mr. President, I thank the Senator from Tennessee, and I acknowledge his great work as Secretary of Education. This is one of those issues on which I think Republicans and Democrats have a lot of work they can do together. There isn't one solution. This is a time when we are long overdue, and we have been short on answers. I think the Education Secretary is perfectly positioned to carry on the work that needs to be done. I look forward to working with the Senator, and I appreciate him enduring my speech.

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

Madam President, I rise to discuss amendment No. 799 that prioritizes small towns and rural communities in Colorado and all over this Nation at a time when so many there do not have sufficient access to quality, affordable health care. My amendment establishes a reserve fund that addresses inequalities in Medicare and Medicaid reimbursement that fall most harshly on rural areas.

I thank Senator Roberts of Kansas for his strong support on this issue. Rural health disparities are truly a bipartisan issue, and I am honored that the distinguished Senator has cosponsored this amendment. I also thank Senator Lincoln of Arkansas for her cosponsorship. I ask unanimous consent to print letters of support for my amendment in the Congressional Record following my remarks.

The current system disadvantages rural areas in primary care and outpatient services, hospitals, and the supply of providers in the workforce. The problem is truly widespread. In Colorado, almost 75 percent of the counties are considered rural. Health care providers in our rural communities are under enormous pressure to provide broad access to quality health care. They need our help. My amendment can open doors to reducing these disparities. It is important to know that this amendment is written to ensure deficit-neutrality as well. Thus, it is fiscally responsible.

Colorado, like many other States, has a strong backbone of rural communities that work with the limited resources they have. For years, there have been payment disparities between rural and urban areas in Medicare and Medicaid. This imbalance only discourages providers from staying in rural communities and underfunds hospitals that serve as a safety-net for a majority of my population.

Over 90 percent of Colorado counties are considered health professional shortage areas. These areas are severely underserved. They lack an adequate workforce. For example, six counties in Colorado do not have a full-time primary care physician. Fourteen counties do not even have a hospital. We will work hard to ensure that every family has insurance coverage, but this alone will not lead to access to health care services. Small communities need doctors and nurses, along with many other providers. Yet it must be worth their while to take new Medicare and Medicaid patients. Understanding this reality is critical if we are to improve our health care system.

My amendment would highlight that future health care legislation should address rural disparities in a deficit-neutral way. I thank the chairman for all his good work on this budget resolution. I urge support from all my colleagues on this issue and the chairman's thoughtful, important underlying legislation.

I yield the floor.

Exhibit 1

Colorado Rural Health Center,

Aurora, CO, March 31, 2009.

To Whom It May Concern: The Colorado Rural Health Center

(CRHC) is writing this letter of support for Senator Bennet's

proposed amendment, which emphasizes the importance of

Medicaid and Medicare reimbursement in accessing healthcare

services in rural areas of the United States. Serving as the

State Office of Rural Health, representing 29 Critical Access

Hospitals and 44 Rural Health Clinics throughout Colorado,

CRHC would like to encourage Congress to consider rural

clinics and hospitals, when deciding future budgetary

actions. CRHC understands these are tough economic times, but

it is essential that these rural safety net clinics,

hospitals, and other providers are able to survive since they

are often the sole source of healthcare services serving a

community or county.

There are a number of primary care clinics across rural

Colorado that are not designated as Federally Qualified

Health Centers (FQHCs) also known as Community Health

Centers. These rural clinics that are not FQHCs are valuable

safety net clinics, yet they have not received the same sort

of boost in funding from the federal stimulus package nor do

they receive the same amount of assistance from the federal

government, leaving them to rely more on reimbursement rates

from Medicare and Medicaid to remain viable.

In addition to the Rural Health Clinics and Critical Access

Hospitals with whom CRHC directly works, there are numerous

other non-FQHC clinics that deliver care to rural Coloradans.

As stated above, for some of these clinics, it is the

Medicaid and/or Medicare reimbursement rates that help keep

their doors open. Any substantial cut in Medicaid and/or

Medicare provider rates greatly impacts and potentially

threatens the viability of healthcare in rural and

underserved areas of our state. At current reimbursement

rates, it is becoming more and more difficult for providers

to continue to accept Medicare and Medicaid patients due to

the abysmal reimbursement. Colorado is set to cut provider

rates yet again this year, due to the $1 billion dollar

shortfall in our state general funds. Unfortunately, this

means the federal government is being looked to in order to

help strengthen these vital rural healthcare services.

CRHC understands difficult decisions need to be made in

regards to the federal budget. We urge you to please consider

and improve rural healthcare services by improving the

sustainability of Medicare and Medicaid reimbursement rates.

Thank you for your consideration.

Lou Ann Wilroy,

Executive Director.