Max Baucus

Mr. BAUCUS

Mr. BAUCUS. Madam President, I ask unanimous consent that all pending amendments be set aside so that I might call up amendment No. 1054 on behalf of Senator Feingold, with respect to Medicare beneficiaries.

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

Mr. BAUCUS. We have looked at this amendment. I agree with Senator Grassley. We accept the amendment.

Mr. BAUCUS. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. BAUCUS. I suggest the absence of a quorum.

Mr. BAUCUS. Mr. President, I listened quite closely to the Senator from Illinois, as well as to the Senator from North Dakota. They are each offering a separate amendment, but they are both similar in an attempt, generally, to accomplish the same result. I say to my good friend from Illinois, as well as my good friend from North Dakota, who is presently not in the Chamber, I am very sympathetic. If I had my way, we would be spending this newly found $12 billion very much in the way the Senator suggested. In fact, there are a lot of good ways. It is not only helping those with Alzheimer's, but it is also lowering the premium. There are a lot of ways we could be spending dollars to help get more drug benefits to more seniors. There is no doubt about that. But, unfortunately, we are 100 Senators. The Senator from Illinois, the Senator from North Dakota, and I have a view of how some of these dollars should be spent in a perfect world, but the world is not perfect. This is a democracy. It is messy. As Winston Churchill once said--I will paraphrase very poorly, but the Senator knows this quote--basically, Winston Churchill said: A democracy, for all its fits and starts and delays and inefficiencies and herky-jerky jolting, and all that, is the world's worst form of government, except for all the others. Here we are, in a democratic process, trying to figure out how to get prescription drug benefits to seniors. We have 100 Senators. I don't know of very many timid Senators. We don't have many Senators who don't speak their views. I don't know very many Senators who don't have strong views about subjects. I don't know of many Senators who are not thoughtful, articulate, and fighting hard for their constituents. And we have, as it turns out, Senators from two political parties: 51 Republicans, 48 Democrats, and 1 Independent; and at this time we are attempting to finally get prescription drug benefits to seniors. This issue has been debated for 4 years, at least. It has been a politicized issue for 4 years. There has been a lot of talk for 4 years, a lot of rhetoric on both sides of the aisle for 4 years, and during all the talking there has not been any action; it has been all words, no deeds. Well, here we are, at a time--after 4 years of just political posturing, to a large degree--where we are on the brink of getting prescription drug benefits passed for our seniors in our country. Is it the best bill in the world? No. Could it be better? Yes. Do all Senators wish it could be better? Yes. But is it a good start? Is it a beginning? Is it a platform on which we can begin to build? Absolutely. If we go back and look at the history of health care and assistance by the Government in providing health care to the needy and to Americans generally, it is a history of building, of starting somewhere, building on it, and making it better and better all the time. Back in the 1930s it was the Wagner-Murray-Dingell legislation that was introduced to provide national health insurance for Americans. That was the idea: We need national health insurance for Americans. Well, it was debated and debated. Not a lot more really happened. Then suddenly things changed in the 1960s. The idea of Medicare came along: Why not help at least our seniors? If we can't get national health insurance, the very least we can do is help our senior citizens get a break with respect to their health care bills. That is a good place to at least begin--by helping a good, solid segment of the population. And we did, back in 1965, by providing Medicare. And look what has happened since then. We have kept building on Medicare to make it better. When Medicare was first enacted, 50 percent of a Part B premium was paid by the senior and the Government paid the other 50 percent of the premium for Part B. That is for doctor services. Now it is 25 percent. It has been improved over time. We also have added more benefits, some screening provisions. End-stage renal treatment has been added. There is a list of new additions to help our senior citizens. Here we are now, on the brink of adding another major benefit: prescription drugs. After all these years, all the years of talking and talking and politicking and giving statements and speeches, we are finally on the brink of getting prescription drug benefits passed. It has not been easy. Why has it not been easy? It has not been easy because there are two competing philosophies on the floor of the Senate on how to get prescription drug benefits to seniors. Even though the two competing philosophies are very different from each other, Senators on both sides of the aisle--most Senators, maybe even all Senators, but certainly most Senators--still want to work as hard as they can to try to fit these competing philosophies together in order to pass legislation this year to begin finally getting prescription drug benefits to seniors. Also, these two competing philosophies are very different. One is competition. The argument is: Let private companies, themselves, with assistance from the Government, design how they give prescription drug benefits to our senior citizens, make them available at a big discount for senior citizens. The other philosophy is: Medicare should be the agency that should be the way--traditional Medicare, basically--to provide discounts for senior citizens to get drugs. Essentially, the competing philosophies are 50-50. You have 51 Republicans, 48 Democrats, and 1 Independent. What are we going to do? Well, all we can do, if we want to get this done, is to just try our best to put these two together in a fair, balanced way--and the private competition model gets a break, gets a fair chance to see the degree to which it might work--so that senior citizens really do get the benefits and are not taken advantage of during our efforts to pass legislation. It is a balance. It is trying to find the right way to accomplish that balance. It has been extremely difficult. I do not have to tell the Presiding Officer just how hard this has been. But we are right on the brink. We are limited to $400 billion in providing the drug benefits for seniors over the next 10 years. Why are we limited to $400 billion? Well, this body passed a budget resolution not too long ago--both the House and the Senate--saying we are going to set aside $400 billion for prescription drug benefits for seniors. We never set aside anything like that in the past. So we have an opportunity now to use it. I don't think Senators want to miss this opportunity. I think they want to use the dollars that are there to get prescription drug benefits for seniors. Well, as it turned out, when the Senate Finance Committee wrote this bill, trying its hardest to be balanced--and it is balanced; the best evidence of that is it passed by a large majority from both parties in the Finance Committee--we found it actually cost only about $388 billion. There was $12 billion remaining. So the question before us is how we can spend that $12 billion. That is the question. In an attempt to maintain a balance and to work on two competing models and in an attempt to get the legislation passed so we can provide a prescription drug benefit to seniors, we have decided to split it, 6 and 6; $6 billion to the PPOs, have it available potentially for PPOs, if that is needed for the bidding process, beginning in the year 2009. I don't know how many Senators are going to be here in 2009, but at least beginning then. The other $6 billion, beginning in 2009, will then go, under Medicare fee for services, for disease management, chronic care, to help particularly seniors who really need that disease management and chronic care. It is really needed because there is very little disease management today under traditional Medicare. That is one of its shortcomings. That is what we have done. Again it is a balance, a start, a beginning. I have a lot of sympathy with my friends on this side of the aisle. If I had my druthers and I were the only one writing this bill, I would take that $12 billion and spend it along the lines they are suggesting. But I am not the only Senator here. I am one of 100. It is my job and that of the chairman of the committee, Senator Grassley, to try to find a balance--not for the sake of balance but for the sake of getting legislation passed so we can finally get prescription drugs to seniors. If the amendments offered by the Senators from North Dakota or Illinois were to pass, guess what would happen. First of all, those are killer amendments. If those amendments were to pass, that would mean this bill is in jeopardy of passage. That would mean senior citizens may not get the prescription drug benefits we are all trying to get; albeit just a first step, or it could also mean, on the other hand--and this is perhaps even more likely--if that amendment were to pass, I will bet you dollars to donuts--which is not a good phrase to use because we are trying to put dollars in the donut hole--the conservative part of this body, the Republican side of the aisle, would say: We are going to take that $12 billion and spend it our way. And they have the votes. They have the White House. So this amendment puts in jeopardy a very delicate, very balanced kind of deal between competing philosophies, fairly and evenly, so that we can get prescription drug legislation passed, so that we are just not talking about it anymore and finally doing something about it. If it were to pass or looked like it would pass, the other side, which has more votes than this side has, would say: We will spend it our way. Then colleagues on my side of the aisle would be quite distressed. They would be forced to ask themselves if they would support on final passage a bill way off to the right for competition instead of the bill which currently exists, particularly with the underlying amendment. I wish we could do more but at least it is a first step. If the history of Medicare is any guide, in future years we will continue to make it better. We will work on that donut hole. We will fill in the gaps. We will make sure premiums are not too high. We will try to help with Alzheimer's and all the other measures we desperately need to pay attention to as the days and years go by. I implore my colleagues to think a little bit. Resist the siren song of doing something that sounds good but which very well could put the bill in real jeopardy. This is fair. It has $6 billion which may or may not be used for PPOs, depending upon what the bids are. This bill cuts off after a 5-year period; no more $6 billion can be spent. And $6 billion for disease management under traditional Medicare which will be spent. That is the question. Do you want balance or do you want to try to get something else passed right now that you like in the short term but could very well jeopardize the whole bill, which means another year, year 5, Congress is talking about this issue, Congress is not doing anything about it. Rather, we want year 1, we have finally got it done. We are very close to getting it done. It is not perfect, but we will keep working on it over the years.

Mr. BAUCUS. Mr. President, on behalf of the Senator from New Jersey, Mr. Corzine, I ask unanimous consent that amendment No. 1037 be modified with the text that I send to the desk.

Mr. BAUCUS. Mr. President, I ask unanimous consent that the pending amendments be temporarily laid aside.

Mr. BAUCUS. Mr. President, on behalf of the Senator from Michigan, Mr. Levin, I send an amendment to the desk and ask for its immediate consideration.

Mr. BAUCUS. Mr. President, on behalf of the chairman of the committee, Senator Grassley, I ask unanimous consent that the pending amendments be set aside and that the following amendments be agreed to en bloc, and that the motions to reconsider be laid on the table en bloc: Amendments Nos. 936, 938, 988, 1027, and 1041.

Mr. BAUCUS. Mr. President, I ask unanimous consent that the time I used be charged equally to both sides.

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

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I say to my colleagues, this is the key amendment that will provide for the passage of this legislation and, therefore, prescription drug benefits for seniors. It is the key amendment. Why do I say key amendment? Very simply because we have $12 billion, and we have to find a way, in an evenhanded, balanced way, to spend that $12 billion. We have to marry two competing philosophies: private competition and Medicare. We have, therefore, designed the solution that the $12 billion will be evenly divided to keep the balance so that we can get this legislation passed and, more importantly, so seniors get a prescription drug benefit as quickly as possible. If this amendment is not adopted, we are going to be in the soup. There are going to be Senators from one side of the aisle who are going to want to spend all of it their way; there are going to be Senators on the other side of the aisle who want it all spent their way; and we are going to be nowhere. We are going to be back where we have been the last 4 years, talking about prescription drugs benefits but not doing something about it, not providing the benefits to our seniors. This is a key amendment. This is the amendment which will allow benefits to go to seniors.

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Senator from North Dakota be given 2 minutes.

Mr. BAUCUS. Mr. President, I yield 5 minutes to the Senator from New Mexico.

Mr. BAUCUS. Mr. President, I ask unanimous consent that the Senator have 30 additional seconds.

Mr. BAUCUS. Mr. President, I know we have an agreement that the vote will start at about 5 o'clock. I ask unanimous consent to speak for 2 minutes.

Mr. BAUCUS. Mr. President, I will divide my 2 minutes between two issues. First is the dual-eligible issue, concerning the amendment offered by the Senator from West Virginia, Mr. Rockefeller. I have a lot of sympathy for what he is trying to do. In fact, my preference would be that low-income senior citizens get benefits under Medicare, not Medicaid. Regrettably, we tried to strike a balance at this time so that the money spent on the bill, the $400 billion, was spent more on seniors, other beneficiaries, so they get better benefits, rather than spending the money in States to, in effect, bail out the States for their responsibilities under Medicaid. When we go to conference, I plan to do what I can, along with the chairman, to work this issue out. I think the Senator from West Virginia made a very good point. Amendment No. 1011 On the other issue, the Sessions amendment, this provision is a health care provision, not a welfare provision. It is whether legal immigrants should get Medicaid benefits. That is all it comes down to. My view is that it is the right policy. It is not neat and tidy, or perhaps not on the right bill, but it is something that should be done. It is the right thing to do. I urge Senators to not vote in favor of the Sessions amendment. I yield the remainder of my time.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I ask for the yeas and nays.

Mr. BAUCUS. I ask for the yeas and nays.

Mr. BAUCUS. It is my understanding the sponsor, Senator Levin, is in the Chamber.

Mr. BAUCUS

Mr. BAUCUS. Amendment No. 1041.

Mr. BAUCUS. Mr. President, this side agrees.

Mr. BAUCUS

Mr. BAUCUS. I agree with the chairman and look forward to moving on these issues. My home State of Montana is currently operating under a waiver that expires on December 31st of this year. I know that Montana, like Oregon, has been able to craft a successful TANF program because of its waiver, and I look foward to working with my distinguished colleagues to see that it is retained.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I rise today in celebration of a great Montanan and American, Anthony J. Preite. Today, Mr. Preite, the director of the Denver Regional Office of the U.S. Department of Commerce Economic Development Administration is retiring. I have known Tony Preite for about 30 years. He was raised on Montana's ``High Line'' in Havre, MT. After a short time as a high school teacher and coach, he was lured by the Bear Paw Development Corporation, an EDA designated economic development district, to come to work for them in 1968. A year later, he became the executive director of that fledgling organization and thus began a career in economic development that is virtually unparalleled today. Under Tony's leadership, Bear Paw Development Corporation quickly developed a reputation as one of this Nation's premiere economic development organizations. Tony spearheaded literally hundreds of economic and community development projects and programs in that part of northern Montana. These projects resulted in hundreds of jobs, scores of infrastructure improvements, and other activities that have improved the lives of people in that area. Among his other accomplishments at Bear Paw, he was a founding member of the Montana Economic Developer's Association, served on the Montana Private Industry Council, and was chairman of the Governor's Economic Development Council. Tony's work at Bear Paw Development Corporation was so successful that I felt the need to bring the benefit of his expertise and enthusiasm to more Montanans. That is why, in 1993, I recommended his appointment by President Clinton as State Director of the Montana Farmers Home administration. Through a reorganization at the U.S. Department of Agriculture, Tony led a successful transformation of the Farmers Home Administration Agency to the current Rural Development agency. While at the U.S. Department of Agriculture, Tony served on many national committees within the rural Development Agency, helping to guide the agency during its formative years. The success of the Rural Development Agency and the value of its programs today are largely due to the efforts that Tony made during his tenure there. In December 1999, Tony accepted the position as Regional Director for the economic Development Administration. In this position, Tony has continued to impart his expertise and enthusiasm to a 10 State region. In his professional life, Tony has received accolades and awards too numerous to mention here. Instead, let me say that I have not met anyone as dedicated to public service as Tony Preite. Tony does not leave his work at the office. He lives and breathes ``public service'' every day, all day. It's immediately apparent to anyone who meets him that he always cares about the people he serves. His works has made an enormous difference for Montana and for all of us who work and play there. While Tony's retirement is a sad occasion to all of us who work with him, it is well deserved. I can take comfort that he will be returning to Montana and that he will find some other way to continue to serve his State. I wish Tony and his wife Betty all the best and I thank him for more than 35 years of public service. Good luck, Tony, and welcome back to Montana!