Floor Statements

Mr. President, I wish to pay tribute to Richard Francis Cline, a member of ``The Greatest Generation.'' Mr. Cline, who passed away last September at the age of 89, will be honored today by interment at Arlington National Cemetery. Mr. Cline was a dedicated father and patriot who, like so many of his generation, left friends, family, and the comfort of home to take up arms in defense of his Nation.

A native of Chicago, and North Carolinian later in his life, Mr. Cline and his eight siblings knew hardship early in life, coming of age during the Great Depression. To help support his family he worked at several jobs as a boy and as a young man. He began working by selling popcorn at Wrigley Stadium at the age of 9 and learned, out of necessity, the merit of a strong work ethic that would follow him for the rest of his life.

After graduating from high school, he joined the U.S. Army at the age of 18. He served his country in General Patton's famous 3rd Army Corps, where he was a member of the 15th Medical Supply Division that operated in England as well as France and Belgium during the Battle of the Bulge. He witnessed the horrors of war and served his country to provide not only for his family, but also for the freedom of all Americans.

While stationed in a small town in Belgium, he met his future wife, Jeanine. She returned with him to America and they continued their lives together following the war. They were married for 64 years, and together they raised 4 children who saw their father not only as their parent, but as their friend.

Once Mr. Cline returned home, he started what would become a 44-year career with the Continental Can Corporation. Those who knew him would tell you that he expected nothing he did not earn, and worked hard to achieve the American dream he fought so hard to protect. He gave earnestly to his community in many ways throughout his life, often making wooden toys for children who might not otherwise have had any presents at Christmas. Richard Francis Cline embodied the spirit of the ``greatest generation'' and made many who knew him proud to call him both a fellow American and a friend.

I am honored to have been able to call Mr. Cline a constituent. His interment at Arlington National Cemetery is recognition of his loyal service to this great Nation. I offer my condolences to his family and those who knew Mr. Richard Cline, for we have lost a remarkable man and role model.

Mr. President, I thank my friend and colleague for withholding on that quorum call.

We have made tremendous progress. Our joint staffs worked well into the night with Members who have amendments to this bill that they think improve the bill. We have worked aggressively to try to work out as many of those as we possibly can, and I am here to report to our colleagues we have made tremendous progress. We have processed, since we started yesterday, a number of amendments and this bill has become better. We still have several on both sides that we are still working on with our Members to try to accommodate their intent with language that is acceptable and continues to improve this bill, and we will do that.

Let me say to our colleagues who still might have amendments, if you have them, we need you to come to the floor. We need you to offer those amendments. If you have amendments that have yet to be cleared, I would urge you to come to the floor and work with Senator Mikulski and myself and our staffs to figure out how we can process those in a timely fashion.

It is our intent that in approximately 1 hour, with agreement from our leaders, we would move to votes--both recorded and voice votes--on all amendments that remain on this bill in the hopes that Members could then leave to go to their caucus lunches, and after returning from those lunches, hopefully, we would be in a position to have final passage on this legislation; again, that is with the chairman's, the ranking member's, and the leaders' blessings, but that is certainly the intent of Senator Mikulski and myself.

We can only do that if, in fact, those Members who want to offer amendments offer them and those who still have some to be worked out come and try to work out those differences.

I urge my colleagues now, we have over an hour before we intend to move to a period where we might process the remainder of the amendments. We would like to be in a situation where we can give certainty--at least as it relates to the disposition of this bill--to our Members that we would finish shortly after the lunch. I encourage all of our colleagues, if they have interest in this bill, come to the floor. Work with us.

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

I yield back the remaining time.

I yield back the remaining time.

Madam President, I do concur. I urge those Members who might be the subject of us trying to work out some language on their amendments, if they have not spoken on them, they exercise the opportunity between 1 o'clock and 2 o'clock, while the caucuses are at lunch, to come to the floor and speak on their amendments. But we are confident we have made tremendous progress and we think we can wrap this up shortly after lunch on the remaining amendments, as well as on passage of the bill.

I yield the floor.

Madam President, I also want to thank my colleague from Louisiana and the chairman of the committee for working out this amendment.

Madam President, I know of no further debate on this amendment, and I would ask us to proceed to a vote on the amendment.

Madam President, I have a question for my friend from Iowa, the chairman of the Committee on Health, Education, Labor, and Pensions. The Department of Health and Human Services, HHS, in May 2013 issued a notice of proposed rulemaking to the Child Care and Development Fund, CCDF, that would make several health and safety, quality, background checks, and other related changes. That NPRM is currently in the comment period and has yet to be finalized.

Am I correct in my understanding that HHS has shared with you, as well as with me, their interpretation that, should S. 1086, the Child Care Development Block Grant Reauthorization which we are considering in the Senate today along with any subsequent changes through the legislative process, become law, the proposed rulemaking for the CCDF would be overridden by S. 1086?

I thank the distinguished chairman for this important clarification and for his hard work in developing this important legislation.

Madam President, I would like to take this quick opportunity to thank my colleague Senator Mikulski for those kind words and, more importantly, for her passion on this issue. I thank the chairman and the ranking member for their help. But more importantly, I would like to thank the committee staff and personal staffs who have been over here for the last several days and late last night trying to work out amendments. I thank the Members who have been very accommodating to changes so we could get this bill up.

I might take a personal privilege to say that part of this bill was done by a former staff member of mine, Celia Sims, and she is one proud woman today because of that being included in this bill and its passage. I look forward to it.

I yield back.

Madam President, I thank the Chair, and I thank my good friend and colleague from Maryland, Senator Mikulski.

In the Senate, for those of us who have been around for a while, we understand how it works. I am not sure the media does justice to the American people in terms of how difficult it is for legislation to actually pass the Senate. As a matter of fact, the historical threshold of 67 and then 60 in agreement means that if a Senator is a serious legislator and their interest is to work on good policy--not perfect; I think Senator Alexander said we have never seen a perfect bill--then the first thought that goes through a Senator's mind as they work on a legislative agenda is, who on the other side of the aisle can I look to whom this would be appealing to from the standpoint of their interests and, No. 2, an individual who understands how to get through difficult times? I am here to say to my colleagues that Barbara Mikulski is a Senator who fills that category not just as it pertains to this legislation but as it pertains to so much because of her great depth of knowledge and, more importantly, her tenacity and her willingness to tell people no and to pursue what is right. Because at the end of the day--I think I can speak for both of us--this is not about headlines; this is about looking at a generation of kids who will be benefited by reforms to a reauthorization that hasn't happened since 1996.

Historically on this issue, George H.W. Bush started the program, and it was under the Clinton administration, under welfare reform, that we formalized these vouchers. The vouchers were really created so families who struggled to keep a job and were low income but had childcare needs didn't have to worry about the childcare piece. There was Federal assistance that was determined on a sliding scale.

By the way, let me say to my colleagues, if a State doesn't provide a waiver to a family, then they have skin in the game on these vouchers. So this is not free across the board.

This has benefited now 1.6 million families. In North Carolina, there are 74,000 vouchers on an annual basis that benefit our children. Those are family members who are either in education or who work, and they can commit to those jobs because they know that childcare is available and the cost is affordable because of this Federal voucher program.

I think Senator Mikulski would agree with me in saying we hope we never see a program that waits this long to be reauthorized. Every program here deserves to be reevaluated every 5 years--No. 1, on its effectiveness, and No. 2, do we still have the problem we had when the program was started. I daresay in her time here--and she has been here a lot longer than I have, and I don't say that with regard to her age-- there are programs still on the books that don't have a constituency anymore. But the hardest thing for Congress to do is to get rid of something or to consolidate. I think Senator Mikulski and I have always taken the attitude that if we can make this better and have a positive effect on the folks it was intended for, then that is our job. That is our responsibility as Members of the Senate.

So I certainly look forward, after the 2 years we have spent on an issue--some might listen to the debate today and say: Geez, why didn't they go to the floor and pass it by unanimous consent?

That is an option. But we also believe we are not perfect, and by reaching out to Members and colleagues and saying: Come to the floor; if Senators can make this bill better, then come to the floor and offer amendments--if a Senator comes to the floor with an amendment and we think it makes the bill worse, then we are going to vote against it, but we promise this: We will have a vote. That is an important part of the Senate, that Members always feel they can put their fingerprints, they can put their State's interest into every piece of legislation whether or not they are on that committee or subcommittee. We have now, with this bill, returned to a process that I think reaches out and incorporates that.

Let me say to our colleagues, it is our intent when I finish speaking to start accepting amendments. At some point, with both leaders' agreement, this afternoon we will target a period when we will vote on whatever stacked amendments we have been able to process. After that, we will hopefully go back and consider more amendments. I think it is our intent to not have votes tonight but to work with the leaders in order to roll those votes to tomorrow morning.

Let me make this perfectly clear to our colleagues: It is our intent to finish this bill tomorrow afternoon, period. So the way to effect positive change in this legislation--to get Senators' input into it and fingerprints on it--is to not wait until tomorrow afternoon but to come down this afternoon and debate the amendments, process the amendments, and let's work as the Senate is designed to work. So I encourage my colleagues on both sides of the aisle to do that.

I rise today to speak about S. 1986, the childcare development block grant reauthorization bill, with my good friend Senator Mikulski. I must say we wouldn't be here if it weren't for the cooperation of Senator Harkin and Senator Alexander. Senator Harkin has a long history of interest and involvement with policies that affect children. He is passionate about it. Senator Alexander has a similar lifetime commitment, a Senator who has served as the education governor of Tennessee, the Secretary of Education of the United States, and the president of the University of Tennessee in Knoxville. So both of them come with a tremendous amount of expertise and passion for this issue.

This legislation is actually necessary to build on what the Child Care Development Block Grant Program was established for. As I said earlier, 1.6 million children nationally are served today--74,000 in North Carolina--and there tends to be a lot of talk in this body about strengthening job training, getting people back to work, and incentivizing self-reliance. I wish to recommend to my colleagues that is exactly what the Child Care Development Block Grant Program does. It says to a family: Work and we will help you with childcare. Get additional education and we will help you with childcare.

But one of the problems since 1996 when this program was created was the way we looked at one's income was an instantaneous snapshot. So as a parent, if I was offered a second shift where I could earn a little more money, I would look at how that might affect my child's childcare voucher and realize that they will take my voucher away if I take that second shift or if I work overtime and get time-and-a-half pay.

Well, this is evidence that we have looked at all angles. We have reached out to the communities that are affected. We have talked to people who are providers. We have talked to parents. We have looked at the difficulties they struggle with, because our intent is to make sure we have a piece of legislation that parents can choose to accept that shift offer, can accept working overtime and know they are not going to be adversely affected because now we are looking at the yearlong versus the individual snapshot.

So through Federal vouchers, parents who demonstrate that they are working or they are in job-training programs or furthering their education and who are below 85 percent of the State median income are eligible to receive the childcare voucher and to use that at a childcare provider of their choice in their State. This is not one where we are saying: You have to go here and you have to go there. We open it for the choice of the parent.

In addition, CDBG requires families, as I said earlier, to have skin in the game on a sliding scale based upon their income. As a block grant, States have great flexibility in how they administer these funds but are generally required to set health, safety, and quality guidelines to promote parental

choice, assist parents in becoming independent through work promotion, and provide good consumer information so parents can make good decisions about their child's care.

S. 1086, the legislation we have offered, would reauthorize this law for the first time since 1996. It would do so by making some commonsense changes that address the realities which I have highlighted, prioritizing the safety of children who receive care with Federal dollars.

First, we would require all providers and individuals who have unsupervised access to children to submit to a criminal background check. That check would ensure our young children are not left alone with individuals who have committed felonies such as murder, rape, child abuse, neglect, robbery, and other serious offenses. This provision is the result of legislation I introduced over the past several Congresses called the Child Care Protection Act, which I believe will do a great deal to improve the safety of our children.

Let me just stop there and say this is incredible because I think most Americans probably believe these background checks take place today. And to some degree they are right. States such as North Carolina have been responsible, and they do carry out some degree of background checks--although not all States, not all providers. But when this bill becomes law, it will say to all States and to all providers that receive Federal vouchers: You must do this. You must assure every parent that these felons are not part of the workforce that has unsupervised access to your children.

Second, this bill asks States to monitor through inspections the quality of childcare settings so that basic health and safety precautions are taken. Many States currently conduct no checks at all for certain settings or conduct them years apart, all while providers receive State and Federal tax dollars. At the very least, parents who are working several jobs just to make it should know that their child is in someone's care who has been trained in the basics of CPR, fire prevention, and other commonsense precautions.

I think one of our colleagues--Senator Landrieu--will come to the floor sometime this afternoon and offer an amendment that requires evacuation plans. Well, for a Senator from Louisiana who lived this firsthand, this is really important. It is a great job of where a Member's amendment is going to help to perfect our bill. For anybody who lives in a coastal State such as North Carolina--I am sorry I didn't think of exactly what she did--but when we look at tornadoes and when we look at fires, we are all susceptible to the need of a daycare facility having an evacuation plan so that local officials and, more importantly, parents and the providers who work there understand what to do.

Third, it asks States to make transparent all the information as widely as possible so parents are armed with all the information they need when they shop for childcare under the Federal childcare vouchers.

Fourth, in keeping with the maximum flexibility afforded to States under the CDBG, this bill provides States the option of seeking waivers from any Federal law that funds early learning or childcare that might have conflicting or onerous results for the delivery of that care and requires the Secretary of HHS to work with other agencies to provide a waiver for those requirements so States and childcare providers can focus on providing quality care and not just complying with Washington's confusing set of requirements. In other words, the focus of this is to make sure the childcare quality component is the single most important feature to providers.

Fifth, it promotes continued employment incentives for parents to move higher in their careers by providing better guidance to States on how they determine the eligibility of parents and their children. To me, it is just common sense that we should not penalize a parent from taking on an extra shift or working overtime. But at the same time we require States to make sure that only the most needy parents receive the childcare vouchers and that they can demonstrate they are following the law's work rules. Let me say again--because I think this is lost because we have not talked about this in almost two decades--for many in the communities we all represent, this is the difference between a family being able to keep a job or to be 100 percent on assistance. What we have is a Federal program that is not just beneficial, we have the data to prove it works, and that matrix continues to be in place.

Finally, it asks States to place a greater emphasis on building quality care settings by gradually increasing the amount of Federal dollars that can be set aside from the current law's 4 percent to 10 percent over the several years that must be used to improve quality programs.

Let me explain. Today, we say you can set aside up to 4 percent for quality. We want to extend that. We want to create an incubator that is an investment in what we can do to further enhance the quality of what these children are exposed to.

I think Senator Harkin, Senator Alexander, and Senator Mikulski have all pointed out that when we go from infancy to age 13, we have the majority of the learning period of a child's life. Some of it we pick up in the education system. But if they go to childcare after that or they go to childcare before it, we want to make sure the quality of that, and, more importantly, the innovation of that quality, is such that all students, all children can advance because of it.

This bipartisan legislation is the result of work in the HELP Committee. It was influenced and really ramrodded by my good friend Senator Mikulski. She was tireless at inviting experts. She sought practitioners in all of our States. It was that, and the leadership of our chairman and our ranking member, that brings us here today.

I believe this legislation will go a long way toward improving childcare in our country but also toward promoting self-sufficiency and independence for working parents. This is not a Federal handout. This is a partnership between the Federal Government and the opportunity for parents to have a better life. I think the way we have addressed the commonsense changes in reauthorization makes it more likely, not less likely, that more parents will succeed at that.

So I encourage my colleagues to support this bill. But I really do stress with my colleagues, now is the time to come to the floor. Bring your amendments to the floor. Let's debate the amendments. Let's vote on the amendments. Let's prove the Senate can function in a very open process because in this particular case those vulnerable parents and those children, who are the next generation, really do matter and what we do really does affect them.

I thank the Presiding Officer, I thank my colleague from Maryland, and I yield the floor.

Madam President, I want to take this opportunity to say to my colleagues, we are now at a point where we would like to consider amendments. So if you have improvements to this bill, it is now after lunch. Before you take a nap, come down to the Senate floor, offer your amendment. Let's talk about it, and let's process as many as we possibly can. It is our intent to consider amendments for the majority of the afternoon, at some point--with the cooperation and agreement of leaders on both sides--to set a time that we would then vote on the amendments that have been processed, hopefully continue to take some amendments early in the evening, but our intent would be not to have votes tonight so that the schedules are predictable, and to come back in the morning, with the leaders' agreement, at a specified time to consider the votes that might be stacked, any additional amendments that need to be debated and voted on, and it would be Senator Mikulski's and my intent, and it is our goal--and when she has a goal, let me say to my colleagues, she will achieve that goal--it is our intent and our goal to finish this bill tomorrow afternoon.

We want to make sure we have accommodated every Member who has an amendment, every Member who wants to make an improvement to this bill, but we ask Members to come to the floor, preferably today, to introduce that, call it up, debate it, let us schedule in a queue of votes, and we will feel more confident of exactly the timeline we are on as that process starts.

I remind my colleagues that the key enhancements in this bill are it improves quality while simultaneously ensuring that Federal funds support low-income and at-risk children and facilities; two, it addresses the nutritional and physical activity needs of children in a childcare setting; three, it is strengthening coordination and the alignment to contribute a more comprehensive early childhood education and care system; four, it meets the needs of children with disabilities who require childcare; five, it provides protections for children and families who receive assistance; six, it safeguards the health and the safety of children.

I cannot think of points that are more important as it relates to changes to a bill that was created in 1996 and still embraces, I might say, the context that it was negotiated in, which was welfare reform.

How do we provide the avenue for more individuals to enjoy what great things this country has to offer for those who are willing to work? Welfare reform was a pathway, bipartisanly agreed to, to lead people from unemployment to employment and hopefully to continue to whatever degree of prosperity they chose to pursue.

We all know that means you have to have a partner and you have to have flexibility, whether that flexibility is being able to meet the hours that might put you up for a promotion or to get the skills you need to consider a different career or the next level. Every parent should probably look at this as I did with mine; that they are the single most important part. There are sacrifices every parent makes for themselves because of what they provide for their children. That is the right thing to do. But through this partnership, for 1.6 million children and for 900,000-plus families, we have now provided for over two decades a Federal program that helps make that decision so it is not either/or; they can pursue a career, they can pursue advancement, they can increase their skills, they can increase their education without sacrificing that Federal subsidy that provides them the ability to drop their kids off in the morning and those kids are taken care of.

This is a win-win. It is what welfare reform was written to do. I am proud

to work with my good friend Senator Mikulski to make sure we get this across the finish line. Come to the floor. Bring your amendments. Make this bill better. Let's debate them, let's vote them, but we are going to finish tomorrow afternoon.

I suggest the absence of a quorum.

Madam President, let me admit I was not a Girl Scout. I guess I should have assumed Barbara Mikulski was a Girl Scout because scouting has made a significant difference in the lives of so many, not just in America but globally.

It is many of the qualities that come from that experience that lead to some of our most important national leaders, both in the past and in the future. So I join her in recognizing this significant milestone for the Girl Scouts. I know it must be challenging in today's nutritional environment to actually fund everything off of cookies. But as we have seen the drastic change in the way they are marketed, I will assure you we are raising a generation of Girl Scouts who are the most creative in how they market and sell their products to fund their programs of any generation I have seen today.

I think when kids are challenged at that age to be their own entrepreneurs, it is good for this country. We should be proud as parents and we should continue to support programs such as Scouting.

Mr. President, I also applaud my colleague Senator Enzi. This is a needed amendment. It makes the bill better.

I will note for my colleagues, most recently the 2014 Omnibus appropriations legislation created two new programs, including the Early Head Start-Child Care Partnerships Program funded at $500 million and the Race to the Top pre-K program funded at $250 million.

I point these out because both of these further underline the interactions which might exist with the current programs. I would think any attempt of this would be an administrative responsibility to find ways to consolidate, but clearly this is a case where more is not better.

This requires the Secretary to look at all these programs and find ways to consolidate in a way which provides a better outcome for those who are the beneficiaries. So I urge my colleagues to support this amendment.

I also say to my colleagues, through their staffs, it is probably the intent of the Senate to have some votes about 2:30. I think there are notifications going out on both sides, but I just want Members to be aware. We are trying to accommodate the afternoon schedules of both sides of the aisle on commitments they have, one at the White House and a Member's meeting on Ukraine this afternoon. So it is our intent right now to have up to two votes by 2:30 this afternoon.

I yield the floor.

I would say, it is our intent probably right before the Ukraine briefing to hopefully be in a position to dispose of about two additional amendments.

Mr. President, I rise in strong support of the amendment, and I urge my colleagues--this is a reasonable improvement to the bill, and I think Senator Franken stated it very well.

This amendment increases the amount of CCDBG funding set aside for tribes from not more than 2 percent to not less than 2 percent. It sounds like not much of a difference, but this has a tremendous impact on the predictability to tribes of the dollars that are going to be available to them.

So I would urge my colleagues to support the Franken-Murkowski amendment.

I yield the floor.

I ask for the yeas and nays.

I ask for the yeas and nays.

Mr. President, I ask unanimous consent to call up Lee amendment No. 2821.

Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. President, I ask unanimous consent that the amendment be modified with the technical correction which is at the desk.

Mr. President, I believe this amendment is agreeable on both sides, and I know of no further debate on the amendment. I would ask for the question.

I thank the Presiding Officer and yield the floor.

Mr. President, I understand the Scott amendment No. 2837 and the Boxer-Burr amendment No. 2809 have been cleared on both sides of the aisle; I know of no further debate on either amendment, and I urge adoption of these two amendments.

Mr. President, we have had a very productive day on the child care and development block grant bill, and we have processed a number of amendments, some by voice, some with record votes. All Members have had the opportunity to come to the floor during the day and offer their amendments, and we continue to have amendments that are either filed or talked about. It is still the intent of Senator Harkin, Senator Alexander, Senator Mikulski, and myself that we finish this bill tomorrow afternoon. We see no reason why we can't do it with the level of cooperation all Members have shown.

Let me try to sketch out for my colleagues what our intent will be. We intend hopefully to go to a period of morning business, a length to be determined by the leaders, when we conclude our remarks. At some point in the morning, probably 10:30, we would resume consideration of amendments and we would process those amendments until shortly before lunch. It is our hope Members would take the opportunity to file those amendments tonight so that our staffs can work with them to make sure as many amendments as possible can be adopted with the support of both sides of the aisle.

We certainly can't force everybody to do so, but I implore Members on both sides of the aisle, file those amendments tonight, work with our staffs.

They will be here as late as they need to be. By 10:30 tomorrow morning we should be able to move to amendments, have debate on those where there is additional debate needed; hopefully, start any votes by 12:15 and finish the amendment process before both sides break for lunch. It would be my hope we could come back right after lunch, with the leader agreements, and have passage on the child care and development block grant bill.

Let me just say, Mr. President, that I want to thank Chairman Harkin, Ranking Member Alexander and Senator Mikulski. I think we have gone into this and we have tried to urge our colleagues, if they can make this bill better, to come to the floor and to do that. I think we have seen, by the action of people who have done this in a responsible way, that we have worked in a bipartisan way to make sure we could present to the Members of the Senate amendments that didn't cause a great deal of concern, and, in fact, they did improve the bill.

So I encourage my colleagues to file those amendments tonight, to be prepared to finish this bill before the middle of the afternoon tomorrow, and we can expect to have a successful passage of this bill.

I thank the Chair, and I yield the floor.

Mr. President, I ask unanimous consent that Max Freedman, an intern in Senator Ayotte's office, be granted floor privileges for the duration of today's session.

Mr. President, my only wish is that we had been on the Senate floor debating reforms within the system so we could fulfill and keep the promises we made to our veterans who are currently in that system.

I yield back the remainder of our time.

Mr. President, as Paul Harvey used to say on the radio: Now the rest of the story. We just heard a very glamorous description of bipartisanship and benefits that have been not provided equitably to veterans. What I would like to do is try and focus on reality and discuss what is actually in the bill, what is not in the bill, and what was the intent of Congress. What is the shape of the Veterans Administration?

I will start with one very important thing. My colleague pointed out that most of the veterans organizations support this bill. He is, in fact, correct. I will read from an editorial written by the CEO of Concerned Veterans of America. I won't read the whole thing and bore the President or those who listen, but he says:

But given the vast scope of this bill, we should be

skeptical. In recent years, the VA, which will take on a wide

range of expanded responsibilities should this bill become

law, has come under fire for dysfunctional management and

poor service to veterans. If the VA is already failing to

meet its obligations to veterans, is it wise to extend its

mission even further? Of course not. And while we need to

restore the shortsighted cuts to the military pensions, there

are more narrow ways to address these cuts, such as Sen.

Kelly Ayotte's (R-N.H.) military pensions bill, S. 1977.

It's troubling that under this bill, VA services would be

expanded far beyond veterans with combat injuries and

service-connected disabilities, fundamentally changing the

founding mission of VA. This will only flood the VA system

with new claimants, many of whom would be better served by

health coverage in the private insurance market.

Veterans seeking VA care already face wait times of months

and even years; further expanding eligibility to veterans who

would be better served by other healthcare options will only

stretch the VA to its breaking point. There is also currently

no cost estimate of this massive expansion.

Meanwhile, there is another compelling question of costs.

Sanders has proposed shifting funding from the Pentagon's

Overseas Contingency Operations to pay for these expanded

veterans priorities. But taking funding from the men and

women serving in Afghanistan and elsewhere is shortsighted

and could otherwise endanger their lives. That approach will

likely meet a chilly reception in the House of

Representatives, and justifiably so.

This means that Sanders' $30 billion bill would be paid for

through the accumulation of additional debt. The CVA has been

clear that Washington needs to ``cut debt, not vets.'' With

$17 trillion in debt and massive annual deficits, our country

faces a fiscal crisis of unparalleled scope. Now is not the

time, in any federal department, to spend money we don't

have.

To be sure, there's much to like in the Sanders bill. And

if those components were presented as separate, smaller

bills, as part of a carefully considered long-term strategy

to reform the VA, hold leadership accountable and improve

services to veterans, we would have no problem extending

enthusiastic support.

As with so many bloated legislative projects in today's

Washington, the overreaching and overpromising in this bill

will only lead to disappointment and recriminations as the

high costs and unanticipated consequences are revealed. That

will be followed by demands for an entirely new round of

``comprehensive'' reform, and the cycle will begin anew.

Congress should go back to the drawing board, assume a more

modest approach and take up these proposals on an individual

basis. That's the better path to achieving enduring and

effective reform of, and accountability for, the services we

provide to our veterans.

I point that out because he is a CEO of a veterans organization. Not all veterans organizations agree that more is necessarily better and that to blindly add to the system is not necessarily good.

My colleague mentioned that there was a 5-year implementation. I have the legislation right here. It is title 3, subtitle A. Expansion and improvements of benefits generally, requirements for enrollment in the patient enrollment system of the Department of Veterans Affairs of certain veterans eligible for enrollment by law but not currently permitted to enroll.

It goes through all the subsections and basically says the Secretary shall provide for the enrollment in the patient enrollment system of veterans specified in paragraph 2 by no later than December 31, 2014.

Well, in section 2, veterans with noncompensible service-connected disabilities rated as zero percent disabled who are not otherwise permitted to enroll in a system as of the date of enactment of the Comprehensive Veterans Health and Benefit Military Retirement Pay Restoration Act of 2014--under this section they do not have access to health insurance except through a health exchange.

My colleague sat on the floor and begged me not to talk about the Affordable Care Act. The Affordable Care Act is in his bill. It is referenced in his bill.

Now, get this: The Affordable Care Act has been portrayed as the solution to the health care problem in America. Forget for a minute the fact that premiums have increased for practically everybody in America--90 percent have seen increases. The $2,500 savings per family is a wish, a hope, and a dream.

My colleagues think so much of the Affordable Care Act that if the only choice for a veteran is the Affordable Care Act, then they can opt to go into the VA. If the Affordable Care Act and the exchange are so good, why would we want to shift them from something good into something that is questionable, based upon what the editorial said.

My colleague said the VA has the best health care system in the world. It does. The hospital system has been rated high practically every year it has been rated. I made the statement yesterday: Why would we take a system that is broken and stuff more people into it? Why wouldn't we focus the debate on how to reform the system?

This is one year's worth of inspector general reports on health care facilities, over 40 healthcare inspections reports that have been released by the inspector general. I can tell my colleagues what is in front of the VA. They can't even get their hands around their own inspector general's report. These are deaths of veterans. These are individuals who used somebody else's insulin pen. This is legionnaires disease. This is a system that drastically needs reform. This is not a Member of the Senate making an accusation, it is the inspector general of the Veterans' Administration and all of these reports from 12 months. Yet we are talking about a massive expansion of the Veterans' Administration, where the chairman says: Oh, they have 5 years to do it.

I am reading the legislation. There is no 5 years. There is a specified expansion of who is included in it, and it says the Secretary will do it by December 31, 2014. If the phase-in is there, then the chairman can come down and read me the language where it says 5 years. I am certainly not trying to mislead anybody, although I am trying to make sure we get the facts on the floor of what this legislation actually does.

The chairman talked about bipartisanship. He is correct. Quite a few of the bills in his package are my bills, and they passed out of committee with unanimous support. Incorporated in his bill are 143 provisions, 26 of which are Republican. I have never judged whether I liked the bill based upon how many of my proposals were in it or how many proposals from my side of the aisle were in it; I base it on what is in the bill. What are the policies? What is our intent? Do we accomplish that in the language of the legislation?

Let's look at it for just a minute. There are no reforms--zero. Zero reforms are in the bill. It is a massive expansion of individuals in the system. As a matter of fact, under this piece of legislation, the VA doesn't even support it. Let me read what the Principal Deputy Under Secretary for Health, Dr. Robert Jesse, said. He indicated that expanding enrollment of Priority 8 veterans ``presents many potential complications and uncertain effects on VA's enrollment system.'' This is the individual in charge of health at the VA who says: I don't think this is a good idea.

So I guess the only mistake the chairman made was--he suggested that I was opposed to it, and he was accurate, but he didn't ever say the VA is opposed to this massive expansion.

He talked about the caregiver bill. I know something about it because I wrote it. We implemented it as a demonstration project. Why? Because Senator Akaka and I believed the VA was not in a position to absorb this massive program and to administer and implement it in an effective way. As a matter of fact, Senator Akaka said at the time--he was then the chair of the veterans' committee--he said there were three reasons he was reluctant to--well, let me just say that when the caregivers program came up in debate on the Senate floor, Senator Akaka, then chair, noted that these benefits and services were not made available for all veterans for three reasons:

[O]ne, the needs and circumstances of the newest veterans

in terms of injuries are different--different--from those of

veterans from other eras; two, the family situation of the

younger veterans is different from that of older veterans;

and three, by targeting this initiative on a specific group

of veterans, the likelihood of successful undertaking is

enhanced.

I say to my colleagues, would the author of the caregivers program not be the first one to come to the floor and lobby for an expansion? I think the answer is yes. But would the author of the caregivers legislation want to wait until the system can handle it?

Do my colleagues realize that in two States in America, a veteran can file for caregiver status in one State and be denied and file the same application in another and be granted caregiver status? It happened in Colorado and Florida. How, in a system that is created to equally treat veterans, is that possible? Now we want to extend it to veterans of all eras. I would suggest to my colleagues that this is almost ludicrous to even think about.

I see quite a few Members here, and I am not going to take up but a couple more minutes. I want to make sure my colleagues understand that my opposition is not to veterans. My opposition is to proceeding with legislation that could hurt veterans, not help them. In this particular case, more is not necessarily better. As the CEO of Concerned Veterans of America stated, the right congressional action would be to stop, take a breath, and focus what is broken. Fix the system. Then have a debate about which veterans, if any, should be included in the VA delivery of care.

The chairman highlighted yesterday that incorporated in both his bill and my bill is a House provision that provides leases for 27 new VA outpatient facilities. He said: That is proof we have in the system enough facilities to handle the population. No, Mr. Chairman, that is not proof. Those 27 leases are for trying to make sure we have facilities to handle our current population within the VA. Those veterans who are driving over 2 hours for a primary care visit, those individuals whose transportation is their No. 1 issue--27 doesn't even get us up to taking care of today's population.

As I said yesterday, we have I know $14 billion worth of construction that is currently underway in the VA; yet we appropriate $1 billion a year. It will take us 14 years to build out the inventory we have today. But the legislation calls for an incredible increase in the size of the veterans population by December of 2014. We won't have any of those 27 facilities that would be legislated in this bill done by December 2014.

So I am going to urge my colleagues, as we move forward, let's not do anything to damage veterans. Let's not do anything to overwhelm the Veterans' Administration. Let's commit to work with them to reform the system. Let's listen to what they want and not put them in a situation where they are telling us: We don't want what you are proposing. Let's listen and let's apply common sense to legislation versus to just be focused on the cheers we receive from a few who are paid to represent folks in Washington.

The chairman said a number of times that this is about veterans. I can tell my colleagues it is a little bit more. It is about the American people. It is about my kids, our kids, our grandchildren. It is about what they inherit from us. They are going to inherit from us probably the most important thing: the obligation to keep our promise to veterans of all eras.

I think the decision we have to make as we debate this legislation is whether we are going to commit to a promise that is bigger than what our kids can fulfill, that costs more than our kids can afford, and that doesn't necessarily enhance the health care delivered to our veterans. If anything, today it would probably be detrimental to those who need it the most.

I thank the Presiding Officer for his patience. I thank my colleagues for their indulgence as they have patiently waited. This is way too big an issue to rush forward with. I look forward over the next several days to a real debate about the specifics in this bill and, more importantly, about what we should do as a Congress to help veterans and to help the Veterans' Administration.

I yield the floor.

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

Mr. President, I come to the floor as the ranking member of the Veterans' Affairs Committee as we consider S. 1982, the Sanders bill. I have been down to the floor several times, and I will not take up a lot of the Senate's valuable time right now. But I do want to cover some things that have transpired since the last time I was on the floor today, when I read from an editorial that was written by Concerned Veterans of America. The group was challenged by some of my colleagues here as to whether it was a front group, whether this was a political front group.

Let me assure my colleagues, it represents real veterans. But in an effort to try to debunk the belief that this is just about one political group, I want to read some from another editorial written by Stewart Hickey of AMVETS. Now, nobody can question whether AMVETS is a legitimate veterans service organization. They have been around for a while. I will be selective in my reading:

While we agree the bill addresses many critical issues and

recommends important solutions for our veterans, we do not

support this bill for several reasons. First, it would be

morally irresponsible and fiscally unsound, given the

historically volatile situation in Afghanistan, to hang the

funding for such robust legislation on any potential ``peace

dividend.'' Throwing more money--upwards of $30 billion, and

taken from war funds no less--at a failing department will

only make matters worse.

This kitchen sink-like bill also endeavors to be all things

to all veterans, and is very enticing to all of us ``Veterans

Service Organizations'' as the panacea for all of our

legislative agendas. The problem is, in its current

configuration, it has little to no chance of passage, it's

just too ``pie in the sky'' and lacks the power base to hold

VA accountable for providing excellent care and services to

veterans currently accessing the system.

It goes on to say:

We all want what is best for the veterans community, and

many of the provisions in S. 1982 are positive. However,

``bigger'' does not mean ``better.'' And the Sanders bill

further expands a VA system that is already overwhelmed and

cannot meet the current needs of veterans. Before

overcommitting the Department of Veterans Affairs and

subjecting our veterans to more broken promises, Congress

should rally on legislation that keeps the promises already

made.

Yet another veterans service organization says: Reform the Veterans Administration.

Dr. Coburn from Oklahoma, the Senator from Oklahoma, was talking about horror stories within the veteran's facilities. So I say to my colleagues: You know, the mistake here is that we are not on the floor debating the reform of the VA and then debating any expansion.

But the fact is that we look at editorial after editorial of people who have some contact with the VA. They are saying: The last thing you should do is expand service. The last thing you should do is use gimmicks to pay for it. The last thing you should do is saddle our kids with not only the debt for it but the responsibility to uphold a promise that might be impossible.

Let me speak a little further on some of the things Dr. Coburn hit on. This is about hospital delays, veterans dying at VA facilities. I came down earlier--and I might add right now that this is the stack of the Inspector General of the VA for 1 year, 1 year's worth of investigations on VA facilities where they made specific recommendations of changes that had to be made.

This dealt with the death of veterans. It dealt with Legionnaire's Disease. It dealt with things as simple as more than one patient using a disposable insulin pen--something meant for one patient that was used for multiple patients, exposing them to potential illnesses.

If the question is, do we keep the promise of the quality of care to our veterans? And if that is not important enough, let me go to the veterans that are in the system trying for the first time to get a disability rating because of a service-connected disability.

The number of claims pending in America right now is 673,000 veterans. These are individuals who have filed a claim with the Veterans' Administration, who are waiting in line for the determination to be made about what percentage of those claims they will approve. The number of claims that are considered backlogged right now is 389,000 veteran's claims.

Once a veteran receives a disability rating, if in fact they feel that the VA has come to the wrong conclusion as to the percentage, they file an appeal. The

number of appeals pending is 272,000 appeals. So one can conclude from this that the number of claims pending is 673,000 plus 272,000. So there are over 1 million veterans right now waiting for a determination by the VA specifically or by the Court of Appeals to sort out their disability status.

The number of days to complete a claim is 265 days. Let me say that again: 265 days to complete a claim. Right now, claims pending are 673,000. The number of days for an appeal that is pending is 600 days-- 600. So let's just say of that 1 million claims that are either pending or that have been appealed, which is 1 million veterans, the number of days to complete the claim on average took 265 days, and the number of days for an appeal, on average, was over 600. We are now at 800 days. That is almost 3 years.

I hope my colleagues are understanding what I am saying. We have a severely dysfunctional Veterans' Administration today. We have a population of warriors who are coming out of the battlefield in Afghanistan. They are coming back from deployments. They leave the service; they file for disability; they wait, they wait, they wait, they wait. When they finally get their disability claim and they are going to the VA, now all of a sudden we are talking about dumping millions of additional veterans into the line with them.

My good friend and chairman Senator Sanders said: We can handle this because we have 27 clinics, outpatient facilities in this bill that, under a lease agreement, we are going to build out--27 facilities. They are for the veterans we have today. We don't have enough facilities to handle the current population, and he said this could handle the millions who are going to come in.

Let me remind my colleagues once again that currently we have $14 billion worth of veterans construction underway. We appropriate about $1 billion a year. That is a 14-year backlog on the construction of these facilities, and none of the 27 leases that are in this bill will be ready in December 2014 when the enactment of this legislation takes place.

There is one other area of massive expansion other than to veterans with nonservice-connected disabilities, and that is to a program called our caregivers program. I am pretty passionate about this because I wrote the legislation. My good friend Senator Akaka, who is no longer here, who was chairman of the Senate veterans' committee, became a champion of it. Earlier, I read Senator Akaka's statements on the Senate floor the day it was passed. He stated as clearly as anybody ever has why we limited this to a demonstration project, why we rolled it out to a small group. Our intention was that when the VA was fixed, reformed, and was capable of implementing a plan that expanded the caregiver program, we would do that but not a day sooner.

Now, all of a sudden, we are not just talking about extending the caregiver program to every current-era veteran; Senator Sanders' bill extends it to every era. Veterans from every era who served who are still alive would be eligible for caregivers.

On occasion, he has pointed to the wounded warrior program. I will read a letter the Wounded Warrior Project sent to the committee when this legislation was being considered.

They said:

More than 2 years after initial implementation, VA still

has not answered--let alone remedied--the problems and

concerns that WWP and other advocates raised regarding the

Department's implementing regulations. For example, those

regulations leave ``appeals rights'' unaddressed (including

appeals from adverse determinations of law); set unduly

strict criteria for determining a need for caregiving for

veterans with severe behavioral health conditions; and invite

arbitrary, inconsistent decisionmaking. Simply extending the

scope of current law at this point to caregivers of other

veterans would inadvertently signal to VA acquiescence in its

flawed implementation of that law. We recommend that the

Committee insist on VA's resolving these long-outstanding

concerns as a pre-condition to extending the promise of this

law to caregivers of pre 9/11 veterans.

If there is one thing I have made perfectly clear yesterday and today, it is that there is nothing in this bill that reforms the VA. Look at any area of the legislation. There is no reform. Yet editorials from service organizations, letters from the Wounded Warrior Project-- and they were, make no mistake, behind caregivers. Their letter to the chairman said: Don't do this until it is fixed.

Well, we are where we are. To suggest that all veterans, all veterans organizations, all organizations that deal with veterans are for this is just inconsistent with the paper trail that exists, letters and editorials.

There are two things that don't go away: one, the need to reform and, two, the promise we made to our country's warriors.

We have to ask ourselves: Are we better off fixing the VA before we enlarge the population or after we enlarge the population? I can answer that. It is tough to do now, and it is not going to happen without congressional leadership. But if we expand the population, dump it on a system that is physically not capable of handling it, administratively not capable of handling it, what do we say to those veterans who need the VA health care system and can't get in to see a primary care doctor? What do we say to a person who needs mental health treatment but can't see a psychiatrist, can't get in to be evaluated, and doesn't get the medication they need?

I plead with my colleagues, don't make this mistake. There is an alternative bill. It is taken from the Sanders bill. It is 80 percent, but it doesn't have the massive expansion. It doesn't reform, but it really moves forward on some important issues.

No matter what we do, at some point we are going to have to show the leadership how to reform the VA. Why? Because we are going to keep our promise to veterans. The promise to veterans was that we would provide them a quality of care that was unprecedented.

I am not sure there is a Member of this body who believes we can dump this population onto the Veterans' Administration and that we can look any veteran in the face and say: We kept our promise to you. Yes, you may have access, but it may be months from now. You may have the ability to go to the VA, but we don't have any room; there is no room in the inn.

These are all part of keeping your promises.

I will go back to what the AMVETS editorial said, and I will end with that because I see my colleagues here.

Bigger is not necessarily better. When I gave these statistics on backlogs of claims and appeals, these are veterans who aren't asking for bigger, they are asking for better. They are asking us to sort out this system and make it work in a way they deserve. All we will do is exacerbate the problem if, in fact, we pass S. 1982.

I urge my colleagues, support the alternative--if we are given the opportunity to offer one. If not, then don't do this to our country's veterans. Wait and let us reform the VA. That is our responsibility. That is our promise.

I yield the floor.

Mr. President, may I inquire how much time exists on both the majority and minority sides?

I thank the Chair, and I thank my colleague for his comments on the Affordable Care Act.

I am actually excited to be here having a debate about veterans and about the promises we have made to those who are reliant on not only the VA but on this institution to actually look at the programs and the services provided, and when we, as a body, see deficiencies, reforming them, fixing them, so our customer--who is that person who made that ultimate sacrifice, who put on that uniform and, in many cases, now has a lifetime disability because of it--can count on that health care system to be there.

I would have expected we would be on the floor debating in a bipartisan way those fixes that were needed to make sure that veterans with disability claims didn't have to wait hundreds of days to determine whether they were going to have a disability that was signed off on and, if so, what the percentage was and that percentage then provided them income.

I thought we would focus on the challenges the Senate has to reform how the appeals process works. Because when a veteran is denied a disability claim or he gets less than he thinks he should have been awarded, then he has the opportunity to appeal that to the court of appeals. The time now for the appeals decision has grown to years. It shouldn't be like this. It is absurd that the Congress of the United States, much less the Veterans' Administration, is content with the deficiencies we have in this broken system.

Instead of being here to look at fixes provided under the Sanders bill, we are here looking at how to expand the population of coverage. We are here on programs that have had little to no hearings. We are here without understanding the intended or the unintended consequences.

Let me share the knowledge I have of North Carolina where we have the largest growing veterans population in America. I don't have the facilities today to handle that veterans population in the timeframe Americans are used to being delivered health care. I could go out and start construction tomorrow, if my good friend the Presiding Officer would allocate me the money, since he sits on the Appropriations Committee, and build facilities, and I still couldn't meet the facilities requirement needed to provide that level of care. As a matter of fact, we have about $14 billion worth of construction currently underway in the country, and on an annual basis, this body-- the Congress of the United States--allocates about $1 billion in facilities construction and maintenance money.

We have 14 years of backlog right now and we are not even anticipating what the effects are going to be of our current warriors who have come out of Iraq, who will leave Afghanistan, who might enter Syria or who might be in a conflict down the road. No, we are here debating in the Sanders bill a massive expansion in who is provided benefits in the VA.

So who is that? It is veterans who have no service-connected disability. It is veterans who are above the means-testing threshold. Let me put that in layman's terms. These are not people who are low income and these are not people who have a service-connected disability.

We are going to have days to debate this bill, and I will introduce an alternative. I will openly confess, upfront, that I don't get into fixes, because to do fixes there has to be bipartisanship. To reform programs in the Federal

agencies, Republicans and Democrats have to come together.

We are here today because there was no outreach to attempt to put together a compromise bill. If the conversation we had about a day before we left a week ago, where my colleague said, this is what I am going to do, why don't you sign on, but he wasn't willing to talk about changes--if that was compromise, then he did that. But I don't consider that to be compromise. I don't consider it to be good-faith negotiation.

But that is behind us. We now have this bill to consider, and it is a massive expansion. And what does it do? It basically says to those warriors who have service-connected disabilities, those individuals who are low income--and this is where they get their service, their health care--you are going to have to wait in a bigger line. You are going to have to get behind more people. So what veterans expect, which is that the most needy will receive the services they need, is not what this bill does. It is not at all what it does.

As a matter of fact, section 301 of the Sanders bill would expand eligibility of the VA health care system. It would qualify to enroll in the VA health care as priority 8 veterans if they do not have access to health insurance except through a health exchange and do not qualify for higher priority.

Before getting into my concerns about this affected section and what impact it would have on VA, I wish to comment on how this section has been drafted. The section says:

If a veteran qualifies as a priority 8 veteran and has no

other option but the health exchange under the Affordable

Care Act, they could enroll in the VA.

Let me read that again:

If a veteran qualifies as a priority 8 veteran and has no

other option but the health exchange under the Affordable

Care Act, they can enroll in the VA.

We have just mandated that everybody in this country--except when the President delays the mandate--has to be under the Affordable Care Act and they are part of the health exchange. Here we are saying to priority 8 veterans, if your only option is the health exchange, we will let you opt into the VA. Well, if the health exchange is that good, why would we dare risk all other veterans who have service- connected disabilities or low incomes having to wait behind people who were provided health care out of the health exchange?

Some priority 8 veterans may even qualify for a subsidy under the exchange, something they would not receive if they were to enroll in VA health care. I don't know, are they concerned these veterans will be unable to find a plan that meets their needs? Everybody else in America was shoved into it. Why should we be concerned about them?

My intention today isn't to open a health care debate. I do have serious concerns about this expansion. Expanding eligibility could stress an already overburdened system. There is a reason why the priority 8 veterans program was halted. The VA found they could not provide timely access to services while sustaining a high level of care. And judging by the well over 30 health care inspectors reports issued by the Office of Inspector General in this Congress alone, the VA is having trouble with the limited group they currently serve.

Here are some examples of the IG's health care inspections report released since January 2013: 1. Three deaths in Atlanta because of delays in mental health care; 2. Two reports regarding delays in GI consults and issues with facilities operating services in Columbia, SC; 3. Emergency department patient death at the Memphis VA center; 4. Two reports on the inappropriate use of insulin pens at both the VA Western New York Healthcare System and the Salisbury VA Medical Center; and 5. Two reports on Legionnaires' disease at VA Pittsburgh and a review of Legionnaires' disease prevention at VHA facilities.

If we expand enrollment, if we expand the coverage, it would surely require an increase in funding at the VA. When we increase the number of patients entering the system, we certainly need to hire additional staff and to provide more space to treat the new veterans. I have already talked about the 14-year backlog we have on facilities now. Without followthrough on secondary cost, we only frustrate veterans when their expectations aren't met, not satisfy them.

I truly believe if we expand government programs we need to do it responsibly. We need to understand the intended consequences and plan for the unintended consequences. We should explore whether the VA can manage the implementation of this expansion. We should explore what impact this will have on the VA's ability to treat combat veterans and veterans with limited incomes and find out what new needs, both in staffing and space, would be created by this expansion.

Unfortunately, we don't know the answers to these questions, because in preparation for this section the majority didn't hold an oversight hearing looking specifically at the consequences--intended or unintended--to expand enrollment of priority 8 veterans. In fact, the only hearing on this subject was a hearing on legislation pending before the committee on October 30, 2013. At that hearing we heard testimony on three dozen bills--clearly, not enough time to examine the details of any of the 30 bills.

From their testimony at the hearing, the VA obviously agrees with me. Dr. Robert Jessie, Principal Deputy Under Secretary for Health, indicated that expanding enrollment of priority 8 veterans ``presents many potential complications and uncertain effects on VA's enrollment system.'' That comes from a guy pretty high up within the Veterans' Administration. They are not necessarily for this.

Finally, I want to address a comment my colleague from Vermont made at a press conference a few weeks ago. He said:

We're not going to bring one new person in without making

absolutely certain that the VA has the resources to

accommodate those people.

As I read the bill, there is nothing in this provision or in the bill itself that would restrict implementation in that way. However, I would gladly support an amendment which would delay this provision until GAO reports that the VA could manage this additional population of veterans.

Mr. President, you might be thinking, as others who are listening might, what does all this cost? How is it paid for? Is the funding recurring or is it one-time funding? Is it permanent expansion?

Let me try to answer some of that for you. The way the Sanders bill is paid for is with money out of the overseas contingency operations. That is more money we were going to spend that we haven't spent, that we never had because we were borrowing it, and now we are going to use it to expand this. It is one-time funding for a permanent program. Let me say that again. It is one-time funding for a permanent program.

It is not as though we are going to fund this expansion of priority 8s, and all of a sudden, when OCO money is gone, we say: Oops, we didn't mean it; we are going to pull it back. No, these are going to be in the system regardless of the impact, regardless of the consequences.

So who is adversely affected? Today's warriors. The same warriors who are waiting in line to get health care services are now going to compete for a limited number of slots to be seen by people who might have had private insurance, by people who might have been in the health care exchange, by individuals who are not low income and who have no service-connected disability. Who else? Those veterans with disability claims who are waiting for a determination. I mean these veterans are going to be impacted by this because we will have such an influx of people within the system. Veterans are waiting for disposition of their disability claims, their appeals. Those who have gone back and have waited, they have finally gone through hundreds of days for a claim to be determined only to find out they have to appeal it. Now they are going to go through hundreds of days of appeal, and we are saying we are going to have to start using some of these people to administer new services which far exceed and are outside of priority 8 which I focused on. But we will talk about the entirety of this bill as the next several days go on.

The last one, and I will stop for this afternoon: Who is adversely affected? Our kids, our grandchildren, the ones who sit at home today hoping the decisions we make about future obligations

take into account that they are paying the tab. They are the ones who will be here years from now keeping the promises we make, and they are hoping we only make the ones we can keep.

Mr. President, how much time is remaining on our side?

I will tell a personal story about a trip to one of our military cemeteries abroad.

We were in the country of Belgium. I was there for a Memorial Day service. Much to my amazement, there were probably 4,000 to 5,000 individuals.

We got through with the formalities of a very well-constructed Memorial Day celebration. As I wandered through the graves, I found a Belgium couple with their two young children at the headstone of an American soldier from World War II. I asked them one simple question: Why are you here?

The Belgium father, younger than I, looked at me and he said: Sir, I inherited this grave from my father. My father took the responsibility for this grave to always make sure it was just like it was the day he got it. I have now inherited that from my father, and my children will inherit that responsibility from me.

I know there are a lot of veterans organizations who hope Senator Sanders' bill becomes law, but I think there are a lot of veterans who are hoping it doesn't: the veterans who need the VA system and count on it for their mental health treatment, for their substance abuse treatment, for their primary care. They count on it for diabetes maintenance, they count on it to stay alive, and we promised it to them.

I am sure future generations will look at the decisions we make this week and will belly up to the bar for whatever it costs, but I think it is important for us to remember our obligations stretch long past our service here. Although it seems somewhat easy to spend somebody else's money, our kids want us to reform this, our veterans want us to reform this, the VA wants us to reform this.

Once we reform it, we can talk about expansion. Until then, it is irresponsible for the Congress of the United States--for the Senate of the United States--to talk about dumping more people into a broken system, to ask those who have already waited so long to wait longer because of our actions.

I yield the floor.

Mr. President, I thank my colleague, the chairman of the committee. He is right when he said we have a lot of agreements. As a matter of fact, about 80 percent of the policies in his bill are in my alternative bill, but I have a big problem with the other 20 percent. I have a problem with the cost. I have a problem with the unintended consequences. I wish we could figure out the intended consequences, but we cannot because there has not been much time to do it.

I look forward to the next several days. I believe the chairman made a plea that the amendments be limited to VA issues. That might be possible if the minority had the opportunity to amend legislation in this institution. I think we have had four votes on Republican amendments since July. To suggest that Iran is not important is, in fact, turning a blind eye on the world.

In my bill I have a piece of legislation that is cosponsored by 59 Senators, and it is bipartisan. My legislation is the Iran sanctions bill. Why? Because it is the only way we can get this to the floor. We have been denied the opportunity to deal with this issue in any other way. This is important to the American people, and it is important to our friends and allies around the world. I am sure it will dominate part of the debate.

Make no mistake about it, the one matter the chairman didn't point to was what we are fixing. We are adding a lot of stuff, but we are not fixing anything. Ask any veteran.

Mr. President, I ask for an additional 30 seconds.

If you ask any veteran about the areas that need reform, I believe they would tell Chairman Sanders, just like they would tell me: Yes, there are a lot of places that need reform. To suggest that should not be part of this debate is ludicrous.

I look forward to the next several days, and I urge my colleagues to support getting on this bill and to vote yea when they come to the floor for this next vote.

I thank the Chair and yield the floor.

Cloture Motion

Madam President, I thank my colleague from Illinois, and I should have told him I was going to come out to be recognized. Let me thank him because he has raised a very important issue on caregivers.

I also want to thank him for the interest he took in Eric Edmundson, who is from North Carolina. I might add to the story, for my colleagues, there was not a caregiver program when Eric Edmundson's dad took over his care. He did what I think parents have a tendency to do. He said: It can be better for my son if I take control of it--and he ended up in Illinois at his dad's request. Although he has not made a full recovery, he has made a spectacular recovery from the prognosis. I know my good friend from Illinois has to go, but I appreciate him highlighting that.

Let me just say that I think all Members of the Senate would like to expand the caregivers program. I wrote the caregivers program. Senator Akaka, who was then the chairman, came to the floor and it was passed. As written, section 303 would expand the caregivers program to veterans of all eras. Let me say that again: Veterans of all eras we would extend the caregivers program to if the Sanders bill was passed.

I have the alternative bill, which is in the process of being filed. It does not expand the caregivers program--a program I am passionate about. I wrote it. It does not do it for a reason, and I want to turn to Senator Akaka's comments on the Senate floor when we passed this bill, where Senator Akaka, the chair of the Senate Veterans' Affairs Committee, said this:

[O]ne, the needs and circumstances of the newest veterans

in terms of the injuries are different--different--from those

of veterans from earlier eras; two, the family situation of

the younger veterans is different from that of older

veterans; and three, by targeting this initiative on a

specific group of veterans, the likelihood of a successful

undertaking is enhanced.

To me, the most important of these reasons mentioned by Senator Akaka was the belief that the VA would not be able to implement a program of that magnitude. That is why caregivers was crafted to be a program that we ramped up over time. It was targeted at a very specific population, and we envisioned that as the VA got more proficient at actual training and implementation of this program, it would be ramped up.

The VA has proven us right. They have had trouble in implementing this program in what is a very limited program. Their rollout and management of the program has been flawed in several areas and has been a disservice to those veterans in need of these critical services. Since the start of the program 2\1/2\ years ago, several problems have been brought to my attention. These problems include decisions regarding eligibility for the program which are inconsistent across the country--no quality assurance program to monitor the quality, consistency and timeliness of those decisions, and no formal process to appeal the decisions of eligibility for caregiver assistance.

Let me highlight the issues with this program. I want to share some stories of veterans' experiences. A veteran applied to the program at the VA in Colorado. His application was denied. Yet, after moving from Colorado to Florida, he applied again using the exact same information he had previously submitted in Colorado. The VA in Florida granted his application. How can this happen? It is because we have an agency that has yet to draw on the consistency needed to apply equally to our veterans.

Another veteran in Florida suffered from multiple gunshot wounds resulting in paraplegia. VA denied him entry into the program because he did not require assistance with at least one activity of daily living or ADL. He was being compensated through an aid and assistance or A & A program. I find it interesting that this veteran did not qualify for caregivers. He was actually compensated under the aid and assistance program because what he needs is ADL services, not just the one required under the caregiver program.

In addition, I have also heard many veterans and their caregivers were

treated rudely by the VA staff when applying to these programs for a PTSD diagnosis. VA staff have told them that PTSD--get this--that PTSD is not a disability that requires assistance with ADLs or activities of daily living.

Assistance with the activities of daily living is only one of the four criteria needed as having a serious injury. Under the law, a veteran needs to meet one of the four. Even the appeals process does not seem to be well thought through. You see, we can write the laws, but it is the agency's regulations that they write that dictate how these programs are run.

VA says that they have an appeals process. However, it is vastly different from the appeals process at VBA, the Veterans Benefit Administration. It leaves Veterans Service Officers or VSOs at a disadvantage to help veterans and their caregivers. VSOs have been told that VA considers it a medical decision and they cannot question the denial. The only recourse veterans and their caregivers have is to appeal to the medical center director. The problem with this is that it was the medical center director who denied the appeal in the first place.

I am going to go on as the days go on, describing the things in this program that we would all like to embrace, things that I think every Member of the Senate says: Yes, we ought to do this for veterans. Here is the problem. If we have a broken system, jamming more people into it is actually the worst thing we can do.

As I said earlier, there is nothing in the Sanders bill to fix the things that are broken at VA. There is nothing in the alternative bill to fix things in the VA. But the one thing that I do not do in the alternative bill is I do not jam millions more veterans into the system. Caregivers should be expanded as VA perfects how to implement it, to educate the caregivers, to be able to address the concerns, and, more importantly, the intent of why we wrote the program.

Enrollment or access to VA should only open if we have the health care professionals or the facilities to handle them, but not to crowd out those current veterans who leave the battlefield today and need the services that only the VA can provide. So, even though in everybody's wish list we would like to expand to every veteran, in the caregiver program we would like to expand to everybody who wants to care for a loved one, the truth is, we do the ones who are in the system an injustice if we are not prepared to be able to implement it, to handle it. That is the difference between the Sanders bill and my alternative. We simply look at the things that have bipartisan support, but do not necessarily grow the problem worse than it is today.

I said earlier, my regret--and I see my colleague from South Carolina is here. My regret in this debate is that we are not on the Senate floor debating reforms to the Veterans' Administration. I think the presiding officer would agree that there are areas--these are areas that do not have a partisan leaning. When we look at our Nation's veterans, we do not see one side of the aisle or the other. We see a promise we made to them and a commitment we have got to fulfill.

To ignore the things that need reform really is a mistake. To talk about expanding the population without reforming these areas, quite frankly, is disingenuous to the veterans to whom we owe so much.

I yield the floor.

Madam President, I came to the floor last week and for 45 minutes I pulled this file out of my desk. It was my notes that I talked about in 2009 about the Affordable Care Act before it became law. I talked about the increases that were projected in premiums and deductibles. I talked about the networks that were changed, the doctors that would not be available.

I was not a prophet. I was reporting what people such as the Chief Actuary

at CMS were saying at the time. Hospitals were going to close, doctors were not going to take patients under the new plan. More important, the premiums and deductibles were going to become unaffordable, not affordable. I am tonight going to read a letter from Donna Hulcher from Clemmons, NC, right in the middle of the State.

We own a small automotive repair shop and have had

continuous health insurance coverage our entire life, either

through our company or for the past several years on the

individual market. We learned that our high deductible plan

with an HSA was not grandfathered into the Affordable Care

Act about 4 months ago. Of course at that time, no pricing

was available. We were paying 679.00 per month, and felt that

we were protected from catastrophic sickness/injury, and we

liked the flexibility the HSA provided in meeting our other

expenses like dental and optical. We checked with Blue Cross

once the cost for the new silver plans they are mapping us to

was available, and it is going to cost 1379 per month. What a

shock to the system and I am not at all sure it has as much

coverage as what we are losing. I am pretty much a deer in

the headlights, not knowing where we are going to turn,

afraid to get onto the ACA website and give my information

because I don't trust its security. It is totally foreign to

me to apply for government subsidies for something we have

always paid for and never depended on the government to help

us. This goes against everything we believe in as being hard

working, independent people. There are problems with health

care and with costs, no doubt but this is not making it more

affordable and from what I am hearing, doctors are retiring

early or not taking this new policy. I feel like I am

spinning the wheels of my brain trying to find out what is

the right way to go. This has pulled the rug from under our

family!

We are now within 3 days of what was the cutoff. We have now extended the enrollment period to the end of March. But insurers are required, April 1 to April 27 of 2014, to submit their pricing for 2015. I have heard the folks talk about this is only about 8 percent of the American people that this applies to in 2014. In 2015 it is all of the American people. It is big business, it is small business.

You know what is going to happen when they price this product with no experience of the risk pool this year. Prices are going to go up. Deductibles are going to go up. If you think it is unaffordable this year, wait until you see what hits the 90 percent of the American people in 2015.

It is time for us to change this. It is time for us to fix it. It is time for us to get an affordable health care policy in place in this country.

I yield the floor.

I rise to address the nomination of Cornelia Pillard to the DC Circuit Court. This nomination is a good example of government overreach that has led to things such as the ObamaCare debacle.

Let me say to my colleagues who have been on the floor speaking about Newtown, I had an opportunity to spend an hour with parents of Newtown children. It is a compelling personal story that they shared.

No parent should have to watch a child die. No parent should have to live and a child die. My heart still goes out to those who lost children at Newtown.

Today, with the Affordable Care Act fresh on my mind, I venture back to think about when I came to the floor in 2009 and said in front of my colleagues of the Senate and the American people--I wish to spend the balance of this second half of the hour rehashing some of the things I came to the floor to talk about.

There were numerous opportunities before the legislation was passed. I remember it was very close to Christmas in December of 2009.

I said premiums will increase for younger and healthier individuals because of the new federally mandated rating rules. Over 40 percent of the uninsured are ages 18 to 34, the same group that will be hit with the highest increases if this bill passes.

What do we hear Americans are focused on today? Young people. Are they going to join?

Today their insurance is three times lower than what it will be in January of 2014. Why? Because of the Affordable Care Act.

No. 2, premiums will increase because of new federally mandated insurance standards. Experts estimate many of the health plans purchased today by individuals and small businesses will not meet the minimum requirements mandated by this bill, which means that all Americans will be forced to buy richer plans.

Let me remind those who are listening that this was in 2009 on the Senate floor. Listening to the comments of those today who say we never anticipated some of these things would happen--if they didn't anticipate, it is not because people weren't on the Senate floor. It wasn't because we made this up. It is because people who were experts, CMS actuaries, CBO administrators, were sharing with us what would happen if this legislation became law.

Premiums will increase because of new federally mandated benefit packages. The bill empowers the Secretary

of Health and Human Services to decide which benefits are covered and which benefits are not.

What are Americans learning every single day? When they can get on the exchange, they are finding that they are 65 years old and they have to have maternity coverage.

I turned 58 and my wife has pretty much informed me we are not going to have more children, but I can't buy coverage without maternity coverage. Why? Because they want to charge me more to shift that cost.

We didn't have health care reform. We just changed where we are shifting the cost from. Now we are embedding the premium versus charging more at the delivery point of health care and shifting it within the delivery system.

We are shifting it within the population by charging those of us who are a little bit older more--because we mandate that we have to have services we are never going to use--and younger people who are healthy who probably are never going to need to go to the doctor. I hope they do because prevention is actually one of the most beneficial things we can promote. Now we are going to charge them three times what they were paying, and we believe they will take it?

Premiums will increase because of the new excise tax on medical devices. Innovation is what saves health care dollars. Yet in the Affordable Care Act, or what some call ObamaCare, we actually put new taxes on medical devices.

Every time we have a stent that is inserted, every time a medical device is used on a person, their health care bill goes up because we have now taxed the device they are using. If the device price goes up, and the reimbursement goes up, the premium goes up.

It is starting to make some sense. Again, this was in 2009 before we passed the bill. Premiums will increase because of a new excise tax on health plans.

We actually taxed the same health plans that are in the exchange that we told everybody would save them money. Premiums will increase because of the new excise tax on prescription drugs. Wait a minute. I thought we were bringing down the cost of health care.

In 2009, again, new taxes on devices, new taxes on health plans, new taxes on prescription drugs, these were all things that we all knew. The President knew it. My colleagues who voted for the plan knew it, but everybody seems to have amnesia today: Oh, my gosh. How could the costs go up? I never knew this was going to require people to buy a health insurance policy that had benefits they would never use.

Premiums will increase because of a new fee to sell plans in the mandated exchanges. This phenomenal exchange market that created competition, we now created a new fee on the part of insurers to enter the exchange. Premiums will increase because of a new tax for comparative effectiveness.

Comparative effectiveness means we are trying to bring new generics, whether they are in pharmaceuticals or biologics to the marketplace. We have decided to tax that process. Premiums will increase because the bill forces 15 million more Americans to enroll in Medicaid.

Why is that happening? It happens because doctors are paid so little on Medicaid that they have to charge more for everybody else. We are cost shifting when we purchase the premium, and all of a sudden we are learning we are cost shifting even when the service is delivered. Reform? No.

In 2009, again I came to the floor and I talked about the Affordable Care Act, ObamaCare. Zero times did it mention provisions prohibiting the rationing of health care--zero. Nine times it mentioned new taxes created in the bill. Thirteen pages are in the table of contents. The bill weighed 20.88 pounds and it took 36 pages for the CBO to estimate the pricetag of ObamaCare; 70 government programs authorized by the bill, and 1,697 times in the Affordable Care Act the Secretary of Health and Human Services was given the authority to create, determine, and define things in the bill. This is a bureaucrat whom we allowed 1,697 times to determine what Congress's intent was in the legislation through almost 3,000 pages; 3,609 times the word ``shall,'' not ``may,'' was in the bill. It cost $6.8 million to taxpayers per word.

Let me remind you. This is what I came to the floor and talked about in 2009 before the Senate passed this legislation in the dark of night.

Twenty-four million people left without health care. This is the bill that was supposed to insure everybody. Twenty-four million people without health insurance; a $1.2 billion cost to the taxpayer per page, and $5 billion to $10 billion of additional funding needed for the IRS' implementation of the bill.

In other words, we are going to fund $5 billion to $10 billion for the IRS to chase down people who owe a penalty because they made the determination they couldn't afford or they didn't need health care insurance.

There are $8 billion in taxes levied on uninsured individuals. There is a way to make health care affordable--tax people who don't have it.

So $25 billion of additional Medicaid mandates placed on States; $28 billion in new taxes on employers not providing the government-approved plans; $100 billion estimated annually of fraud in Medicare and Medicaid; $118 billion in cuts in Medicare Advantage--to seniors all across this country who found this product to be the one that provided the most security and benefits for them; $465 billion in cuts to Medicare--cuts to Medicare. This was the health care system that was at that time projected to be insolvent by 2017.

There are $494 billion in revenues from new taxes, fees, levied on American families and businesses; a $2.5 trillion cost for full implementation of the legislation.

At that time we had a $12 trillion debt. Today, we have a $17 trillion debt. Health care was supposed to be more affordable because we reformed it. We didn't reform it. We took it over. The Federal Government took it over.

Let me go to another process I talked about in 2009. This is all marked up. It has been in my desk drawer since then. It is a word search of the bill. There are 4,677 times where the legislation said shall, must or require; 899 times it said tax, fee or revenue; 470 times it said agency, department, commission, panel or bureau; 196 times it said regulate or regulation; 134 times it mentioned treatment; 180 times it mentioned prevention; 40 times it mentioned choice; 25 times it mentioned innovation; and 13 times it mentioned competition.

If we listen to those who are out selling this awful plan today, what are the three words we hear? Choice, innovation, competition--those things that are mentioned the least in the almost 3,000 pages of health care legislation in 2009. This bill wasn't reform. This bill spent trillions of dollars at a time of record deficits and debt. When fully implemented, I said then, this bill is projected to cost $2.5 trillion over 10 years. CBO said at the time that this bill will increase Federal health costs, not lower it.

What have we heard from the President? It is going to lower health costs. It is going to bring it down. It is going to be more affordable. Middle class, this is the greatest deal for you.

The bill raised taxes by more than $500 billion at a time of record unemployment. The bill violated the President's own pledge to protect the middle class. Who gets taxed in this bill? Again, this is from 2009 on the Senate Floor, right here, before the vote. Uninsured Americans, insured Americans, families with high-value insurance plans, high health costs, small business, individuals who need medicines or medical devices, and employers that provide retiree drug coverage. Employers that provide retiree drug coverage, we tax them.

The bill cut $466 billion in Medicare to fund new government programs. Medicare faced at that time a $38 trillion underfunded liability and insolvency that was projected to occur in 2017. Instead of fixing those problems, this bill raided Medicare to start a new government entitlement. The bill cut Medicare Advantage. It cut hospitals, it cut nursing homes, it cut home health, and it cut hospice.

Nobody in the administration can go out today and say: Oh my gosh, we didn't know this was going to happen. We talked about it right here day after day after day.

These are not things we made up. If we did, we would be prophets, because they are all coming true. Everything is aligning with what we said.

The bill would increase premiums, making care more expensive, not less. I mean let's get past what was the easy

part, and that was setting up the exchange, setting up the Web site. Or at least it should have been.

New taxes in this bill will get passed on to consumers, increasing yearly premiums--this is what I said then; listen to this--by $488 a year, according to some estimates. The average premium would increase by $2,100 for a family policy in the individual market.

There are individuals who are seeing $488 a month in increase, and in addition to that a deductible they have never had applied to them before.

This bill imposed costly new burdens on struggling States. The bill threatens health care choices millions now enjoy with a tangled web of new rules, regulations, and government-run plans. The government will require you to purchase insurance or face a fine and will tell you what kind of insurance you have to have, even if you like what you currently have.

I am not a prophet. I was going by what the experts said in reading the bill. So for everybody who went out and said: If you like your insurance, you can keep it; if you like your doctor, you can keep him; if you like your hospital, you can keep it--we were on the Senate Floor saying: That is not what the bill says. It is not going to happen.

This bill cut $135 billion from hospitals, $120 billion from 11 million seniors on Medicare Advantage, nearly $15 billion from nursing homes, nearly $40 billion from home health agencies, nearly $7 billion from hospice. Cutting Medicare to fund a new government program in my book is not reform. It is ignorance.

The CMS Office of the Actuary--let me tell you, the Actuary is like the gold standard. The CMS Actuary is like the guy who puts that stamp of approval on it, and there is nobody higher from the standpoint of what the actuary says. He says the bill increases national health expenditures. National health expenditures under this bill would increase by an estimate of a total of $234 billion, 0.7 percent, during 2010 and 2019.

That is exactly the opposite of what everybody is out saying today. Despite promises that reform would reduce health care spending growth, the bill actually bends the health care curve upward. According to the analysis, the national health expenditure as a share of GDP is projected to be 20.9 in 2019, compared to 20.8 percent under current law.

How could you go out and make a claim this was bending the cost curve down? How could you promise the American people it was going to be cheaper?

The total number of persons with employer coverage in 2019, according to the CMS Actuary pre-2009, when the bill was passed, was projected to be 5 million lower under the reform package than under current law. Let me say that again. The CMS Actuary told us in 2009, before we passed this bill, that employer-based coverage would drop by 5 million individual covered lives. I might say that some estimates are coming in at 100 million employees losing their health care under employer plans right now.

The new fees for drugs, devices, and insurance plans in the bill will increase prices and health insurance premium costs for consumers, and this will increase the national health expenditure by approximately $11 billion per year.

The bill funds $930 billion in new Federal spending by relying on Medicare payment cuts which are unlikely to be sustainable or permanent. As a result, providers could find it difficult to remain profitable; and absent legislative intervention, they might end their participation in the Medicare program, possibly jeopardizing the care to beneficiaries.

See, it wasn't Republicans who talked about rationing, it was the Actuary at CMS in his analysis of the Affordable Care Act. He said: Here is what is going to happen. It is seniors who are going to get hosed on it because they are not going to have access to the doctors anymore.

The bill is especially likely to result in providers being unwilling to treat Medicare and Medicaid patients, meaning that a significant portion of the increased demand for Medicaid services would be difficult to meet.

How could anybody listen or read what the CMS Actuary said and remotely go out and tell the American people: Geez, this is going to increase coverage for everybody.

The CMS Actuary noted that the Medicare cuts in the bill could jeopardize Medicare beneficiaries' access to care. He also found that roughly 20 percent--20 percent--of all Part A providers--hospitals, nursing homes, et cetera--would become unprofitable within the next 10 years as a result of these cuts, meaning they are going to go out of business.

You know, pretty soon it is not going to be the network the insurance provider put together, it is going to be the fact the hospital went out of business because they couldn't withstand what this bill has done to them.

The CMS Actuary found further that reductions in Medicare growth rates through the actions of the Independent Medicare Advisory Board-- now, that is going to sound a little odd to some because prior to the bill passing it was called the Independent Medicare Advisory Board, but it is now called the Independent Payment Advisory Board--IPAB--an entity that when set up and it is kicked in--16 members picked by the President--will determine reimbursements and scope of coverage. It is not the Congress of the United States. If we don't legislatively do something with their recommendation, it becomes law. It goes into effect.

The bill would cut payments to Medicare Advantage plans by approximately $110 billion over 10 years resulting in less generous benefit packages and decreasing enrollment in Medicare Advantage plans by about 33 percent. So 33 percent of seniors would lose their Advantage plan. Again, this is 2009. This is not today.

The President, in 3,000 pages said it would reduce costs. The chief actuary says that is not the case.

Let me read a letter I got in the last couple of weeks from Lori Perez from Willow Springs, NC.

I am a divorced mom of three. I received insurance through

my employer. My rate has increased $100 a month. This is a

huge difference that will have to be budgeted by reducing

groceries and foregoing my son's braces I had planned for

2014. I looked into dropping my company provided insurance to

join an exchange but I do not qualify to receive a subsidy

because my insurance rate is less than 9\1/2\ percent of my

income. It is 9 percent. My yearly income qualifies.

Apparently, Obama thinks I can afford an additional $1,200 a

year. I am considering dropping my insurance, paying out of

pocket as needed for health care, and paying the fine at the

end of the year. It would be less expensive. This is

ridiculous. What can we do?

What do you say to Lori? Oops. That is the law. Here is somebody who was 100 percent satisfied, an employer doing the right thing, and the Federal Government has now put her in a situation where she is considering just giving up her health care, doing away with it. Why? Because she can't afford it. This is a woman with a job. She is thinking about giving up her groceries and delaying her son's braces. Why? Because of ObamaCare.

Where are we today? Let me speed forward. I said we have the health care exchange, the healthcare.gov Web site. There are companies every day that get Web sites set up. This one is complicated. They had 3 years to do it. It still is not right today. But I am convinced they will get it right.

For the first time the American people are getting on the Web site and they are able to look at the health care options they have. And what are they finding? They are finding that the premium costs for something equal to what they had are two times, three times more expensive per month. They are finding this new thing they have never had before called deductibles. And I am not talking about a $100 deductible that you pay before you get participation in a doctor's visit or an emergency room visit; I am talking about $1,000, $3,000, $5,000. I have heard from friends who have now signed up for plans and have a $15,000 deductible.

I say to my colleagues--especially my colleague from Florida--it sounds like a health savings account, doesn't it? You have insurance, but you are responsible for the first $15,000. The guy who shared that with me, his premium is $1,444 a month with a $15,000 deductible. I don't think he is going to drop it, but sticker shock is rampant.

Benefit package. How many people have come up to me and said: I am not going to have any more children, but I have to have maternity coverage. Something is wrong.

They are right--something is wrong.

How many kids would like to have a scaled-down version that allows them to have a set of benefits, and they are willing to roll the dice, and if something bad happens, they will pay out of pocket? No, they don't get that option. The choice does not exist--unless it is a choice of the things created in the Affordable Care Act.

Networks. This is one the American people haven't gotten to yet, and I can't wait until it happens. I have gone through getting on the DC exchange and going through the process of trying to figure out whether my doctor in North Carolina is available in this plan or that plan. Wait until the American people go onto healthcare.gov and they start picking a plan and look to see: Is my primary doctor on there? Is my hospital on there? Is the specialist I see on there? Are the drugs that I take on this plan?

This is incredibly complicated. The American people were used to calling their insurance broker and saying: Here is how much coverage I want, here is how much I have to spend, and here is my health condition. And they designed a program to meet their health condition, their income, and their age. Now we penalize you for your age--if you are old or young--and we force everybody to take the same benefit package regardless of whether they can afford it, and we say: If you don't get it, we are going to charge you this year a 1-percent penalty on your income, and that goes up to 2\1/2\ percent at the end of the transition period.

We are going to get past this period which I call the enrollment plan period. Next, we get to the part the President delayed. We never understood that something that was in statute, the executive branch could just decide, no, it is not going to go into effect. But for large and small employers, they had a 1-year delay. All of a sudden, in 2015, their employees are going to be in the same marketplace that we are.

What makes that particularly difficult is we extended the enrollment period for individuals in healthcare.gov until March 31, 2014. They can still enroll. Well, April 1, 2014, through April 27, 2014, insurers will have to decide what their premium cost will be in 2015. So given that they have no real experience on what the mix of ages and health conditions in their plan is, what are they going to do? They are going to err on the side of higher premiums; that is, higher than we will see in 2014, which a majority of the American people say are higher than they can afford. Imagine what it is going to be like in 2015. And in that group is the 80 percent of America, not the 5 to 10 percent who are provided for by employers today.

I see my colleague here, and I am infringing on his hour, but I do want to stress one last thing. I mentioned only once the Independent Payment Advisory Board, IPAB. At the end of the day, mark my word, everything that I commented on I read from my 2009 notes--notes that I came to the floor then and said: This bill shouldn't become law, and here is why. I spent 5 minutes talking about that today.

But I am going to make this statement, and I will come back to the floor 2 years from now when IPAB is up and running and the benefit packages have been cut down and the reimbursements have been cut to doctors and hospitals, and I will point to the statement that I made here that picking a 16-member advisory panel that has the authority and the power to set the scope of coverage and, more importantly, the reimbursements will have a most devastating effect on health care in this country.

It will ration health care because of the doctors who choose not to participate in plans that participate in the exchange. It will force hospitals out of accepting plans that participate in the exchange. And for those of us forced by government to be in the exchange and to choose, our choices will be gone. Our costs will go up. We will get care--when we are queued in line or at the emergency room or from a doctor we don't know or don't trust or from a hospital we have to drive to. It is not going to be reassuring to that mother who now has maternity coverage but no obstetrician and no local hospital to deliver a child because, you see, we didn't reform health care. We didn't do anything to liability. We just changed the pocket we pay out of. We taxed everybody we could find to pay for it. And still--as I said in 2009 and I believe will be true today--at the end of the process, there will be 24 million people without health insurance. Why? Because of ObamaCare. Because of the choice--or the lack of choice--we gave them.

I yield the floor.

Mr. President, we worked to ensure that the Drug Quality and

Security Act achieves a balanced approach to strengthen the safety, security and accountability of our Nation's pharmaceutical drug supply chain. This legislation establishes a uniform electronic unit-level system over the next decade that will increase security and ensure a safer pharmaceutical drug supply chain from manufacturers to dispensers. The charitable distribution of prescription drugs from the manufacturer to patients through patient assistance programs, PAPs, is a valuable and unique approach to providing American patients access to critical, lifesaving medicines. As this legislation is implemented, the varied and unique approaches of PAPs should be taken into consideration to ensure patients who access needed treatments through these effective programs are able to continue accessing the prescription drug medications provided through PAPs.