Max Baucus

Mr. BAUCUS

Mr. BAUCUS. Madam President, this amendment is a thinly disguised attempt to kill health care reform. Let me explain why. I remind my colleagues that the Congressional Budget Office has told us that in the first 10 years the bill actually will reduce the deficit by a significant amount. CBO also informs us that health care reform will lower premiums for 97 percent of Americans, improve benefits for many who are underinsured, and health care reform will bend the growth curve of health care spending. The CMS Actuary also says that national health care spending will be lower under the law than it will be without reform. In 2019, health spending will be 6.7 percent, compared to 7.2 without reform. To prohibit implementation unless all these projections bear out is just another attempt to kill the bill. For that reason, I urge colleagues to resist this amendment.

Mr. BAUCUS. Madam President, I move to table the Cornyn amendment and ask for the yeas and nays.

Mr. BAUCUS. Mr. President, I have the highest regard for my good friend from Iowa. We work very closely together. We want to make sure our States are fully incorporated, involved in the national health care delivery system; that is, rural States. We also want a balance between urban and rural. It is the only fair solution. This bill has that balance. I might say, there are some--I chuckle a little bit--I have talked to some of my friends in the East who talk about rural America--rural New York or rural Illinois or rural Indiana--and I appreciate that very much. But we are talking here, with frontier States, with what is really rural: only about six people per square mile. So I say to my friend from Iowa, we have the balance in the bill. We should maintain that current balance. I think this amendment is inadvisable, and I urge us to not support it. Mr. President, I move to table the amendment, and I ask for the yeas and nays.

Mr. BAUCUS. Madam President, I have a lot of sympathy with the amendment. We don't want to get into an AMT situation. The AMT was not indexed when the AMT was enacted. We are now paying the price today. It is very possible that if this level is not indexed, we may be paying the price later on, in several years' time, but this is not the time or place. I might also say there are other provisions in the bill that are not indexed, such as the affordability provisions. That is not indexed. I don't think it is fair to index only for upper income and others whose incomes are below $20,000. But it is an issue, and we will address this at a subsequent date because it must be. In the meantime, I move to table the amendment and ask for the yeas and nays.

Mr. BAUCUS. Madam President, we have had all sorts of amendments this morning. We have had amendments on malpractice, we have had amendments on guns, we have had amendments on immigration. Even last night we had amendments on some very interesting subjects, but this is the return of the killer amendment. We had a few killer amendments yesterday, and this is the return of the killer amendment. Why is it a killer amendment? Basically because this would suspend health care reform if certain arbitrary budget targets are not met. It is on again, off again, wondering about the other. It is clearly designed to kill the bill. Therefore, Madam President, I raise a point of order that the Vitter amendment violates section 313(b)(1)(c) of the Congressional Budget Act.

Mr. BAUCUS. This is a motion to commit to the Finance Committee obviously designed to kill the bill. Clearly, there is inadequate competition among insurance companies in most of our States. In fact, in most States I think there are maybe just two major companies. We want to encourage much more competition. Allowing them to sell across State lines is in concept a good idea, but it must be done responsibly. The underlying bill--the bill that passed, actually--does allow for interstate compacts. States can compact to sell across State lines. Once the exchange is open in 2014, insurance companies will automatically be able to sell across State lines. But to allow sales now would be irresponsible because it would encourage a race to the bottom. By that, I mean that irresponsible companies will be inclined to go to States with the lowest standards and then sell health insurance to other parts of the country, so people in other States will have virtually no remedies. It makes sense to have health care reform provisions in place, and then we can sell across State lines with compacts through the exchanges.

Mr. BAUCUS. I move to table the DeMint motion, and I ask for the yeas and nays.

Mr. BAUCUS. Madam President, the whole premise, the theory of health care reform is that it is a shared responsibility--employers, employees, American citizens, companies, a shared solution here. The bill already waives any criminal penalties. That is taken out of the bill. No criminal penalties. A person cannot go to jail. That is provided for in the bill that was signed a couple of days ago. The bill also limits collection activities. It is very sensitive to the points made by the Senator from Nevada. It has a good balance of responsibility and accountability. But there must be some consequence of somebody not living up to his or her shared responsibility. It is very sensitive to doing this in the right way. I think it is a good balance. Their amendment goes way too far by eliminating any consequences. I move to table the amendment and ask for the yeas and nays.

Mr. BAUCUS. Madam President, as I said on the Brownback amendment, there is much to be said for indexing this provision. It is true we don't want to get back into the situation we now face with the AMT because the AMT was not originally indexed. Unfortunately, the current amendment will be offset with unspent, unallocated mandatory spending of stimulus funds. Unemployment is still hovering close to 10 percent. There is growing evidence the recovery package is working. I don't think we want to stifle the stimulus now. Over the last 6 months of 2009, the economy grew at an annual rate of 4 percent. The fourth quarter grew at a higher rate, but that was due to an inventory situation. By and large, it is not proper to offset this with stimulus dollars. We will find some time at a later date to deal with this issue. I do think it is a serious issue. I raise a point of order that the Murkowski amendment violates section 313(b)(1)(c) of the Congressional Budget Act.

Mr. BAUCUS. Mr. President, in an effort to help small business, there are many provisions in this bill to accomplish that result. One is $37 billion in tax credits that are in this bill already for small business. I do agree with the Senator from Texas, though, that it would be better if the credit, which is available for 2 years beginning in 2014 when the exchange is up and running, was extended. That would be my preference. But right now, in 2010, we are short on money, frankly, and we can't find all the money that is necessary to make that permanent to accomplish the wishes of the Senator from Texas. But I do say I am sympathetic with extending that 2 years, and we will work to try to find ways in the future to accomplish that. In the meantime, I move to table the amendment, and I ask for the yeas and nays.

Mr. BAUCUS. Mr. President, we all want to fight fraud, waste, and abuse. In fact, there are many provisions in this bill which so provide. To add to that, when we negotiated the bill, the White House came up with even stronger provisions. They have the screening, time to check for payments, and so forth. I talked with the Senator from Florida, Mr. LeMieux, who also has good ideas. I pledge to him to do what we can to get some of that passed this year. However, the amendment before us is much too punitive. It is arbitrary in its numbers. I think it would be counterproductive, especially at a time when States are already struggling with their Medicaid Programs. I think it would be inappropriate for us to lay this arbitrary punitive measure on them.

Mr. BAUCUS. And other measures.

Mr. BAUCUS. I might reconfirm, this is the last amendment. There will be points of order raised and other business will transpire before we get to the points of order, which I understand will begin about quarter of 2. We are going to finish at 2 o'clock. We are right there. It is going to work. Mr. President, I move to table the Cornyn amendment and ask for the yeas and nays.

Mr. BAUCUS. Mr. President, that was the last vote on amendments. I wish to repeat that statement: That was the last vote on amendments.

Mr. BAUCUS. That is right. Due to the Senator's leadership and hard work, we were able to make sure those here legally had a place to find affordable health coverage.

Mr. BAUCUS. The Senator is exactly right. The health reform legislation that was signed into law allows immigrants who are here lawfully, who are otherwise ineligible for Medicaid to receive tax credits in the exchange. However, the size of those tax credits should be based on the families' actual income, not an artificial level of 100 percent of the poverty line. I expect this provision will be implemented as such. I look forward to working with Senator Menendez to ensure that these families receive access to affordable health insurance coverage.

Mr. BAUCUS. I now ask unanimous consent that Senators Grassley and Conrad be permitted to engage in a colloquy and inquiries of the Chair for up to 5 minutes.

Mr. BAUCUS. Mr. President, there are a flood of emotions going through all of us today as we pass this reconciliation bill which improves upon the bill the President signed 2 days ago. I would like to focus only on one part--a very important part but only one part--and that is to thank the people who have worked so hard, especially in this body, to help accomplish this result. I thank especially my friends Senator Dodd, the chairman of the Banking Committee, who many times acted in the capacity as chairman of the HELP Committee, and Senator Harkin, chairman of the HELP Committee, working so hard with their staffs. As well, I thank Senator Conrad, especially for his acumen, his budgetary acumen. I don't know anybody who knows this stuff better than Senator Conrad. We all rely on him very much. I thank Leader Reid for his strategic vision--he helped put the Finance Committee bill together; he saw a path forward--and his staff, who are so competent--Kate Leone, Bob Greenawalt, Randy DeValk--his top three staff. I also thank my friend from New Hampshire, Senator Gregg, for his courtesy in managing this bill. He was very decent and a very good person to work with. We all want to thank so many people. Once we start mentioning a couple or three names, we run the danger of offending people whose names are not mentioned. We all know that. There will be an appropriate time for us to make all the thanks, and I will make mine so sincerely because I am so grateful for all the hard work my staff has put into this. I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her profession lifetime goal. She put together the White Paper last November--2008-- the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came. She is an amazing person. She is a lawyer; she is a Ph.D. She is just so decent. She is always smiling, she is always working, always available to help any Senator, any staff. I thank Liz from the bottom of my heart. In many ways, she typifies, she represents all of the people who have worked so hard to make this bill such a great accomplishment. I will have printed in the Record the names of all my professional staff. There are more than I realized, so I can't name them all. I ask unanimous consent to have that list printed in the Record and just regret that I cannot thank everybody personally.

Mr. BAUCUS. Mr. President, is it appropriate to ask for the yeas and nays?

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

Mr. BAUCUS

Mr. BAUCUS. Madam President, I would like to follow up a little bit and address the same subject addressed by my good friend from Rhode Island, Senator Reed. Just a little reminder first. On March 10, the Senate passed legislation to extend both tax provisions and safety net programs through to the end of 2010. That legislation included $34 billion worth of tax cuts, an extension of unemployment benefits, an extension of COBRA health benefits for laid-off workers, and several other items. That legislation was also partially paid for. The Senate bill differs from similar legislation passed by the House, and we have not yet had a chance to reconcile these differences--one bill in each body. In the next couple weeks, however, several of these programs will expire. Beginning April 5, some laid-off workers will begin losing their unemployment benefits. That is not long from now. Workers laid off after March 31 will lose the 65-percent tax credit currently available to purchase temporary health insurance. After March 31, doctors will see 20 percent reductions in their reimbursements under Medicare. We should not let these programs expire. Today, we should extend them for a month, at least, while we try to meld the Senate and the House versions into one bill that the President can sign. I think all of us can recall 2 days at the beginning of this month when Congress did let these programs temporarily expire. It was not our finest hour. I hope we will not do the same this month. So I ask, what is holding us up from keeping these programs in place? There is no controversy about whether to extend the programs for 1 month. Both Republicans and Democrats have proposed doing that. Both propose extending the programs for at least 1 month until we get the yearlong bill resolved. There is only an honest disagreement over whether to provide offsets for this bill. Most Republicans believe the package should be fully offset. My good friend from Iowa offered an amendment to do just that. Most Democrats believe unemployment benefits during a recession when we have seen unemployment rates rise to double digits signify an emergency and need not be offset. We are still in a very dire situation. In a moment, I will propound a unanimous consent request that seeks to resolve these differences. We should do that. Clearly, we should for the benefit of thousands of Americans who are struggling as a result of the downsizing that has occurred across our Nation in this recession. They are the ones bearing the brunt of our failure. They are the ones bearing the brunt of our inaction and of our--to be honest--partisan differences. It is astounding to me we just cannot get together for the sake of people who otherwise will lose their unemployment checks, who will not have the benefit of COBRA health insurance, and seniors who are in jeopardy because their doctors are not going to get paid for Medicare. There is no one to blame but us. The COBRA tax credit has helped millions of unemployed workers and their families afford health care while looking for a job. Without this assistance, the average family would need to pay $1,100 per month to keep their health insurance, which is simply unaffordable for most unemployed workers. This provision would extend the COBRA tax credit through April 30 to ensure newly unemployed workers can also receive assistance in affording their health insurance. Unemployment insurance benefits have helped millions of Americans stay afloat after they have lost their job. We want them to keep those benefits, at least for awhile. Folks who lose a job then face an economy that has few and sometimes no options for returning to work in their community and in their chosen field. In fact, I read recently that there are five people looking for every single job opening--five, at least five--in America. Approximately 1 million workers--that is about 200,000 per week--will lose their benefits in April alone. Not only will this cause them and their families untold hardship--just think of it, no job, no unemployment insurance--it will also cause important money to stop flowing through their communities, and that could very well lead to an immediate application for food stamps. Unlike last month, when the program lapsed for just 2 days because of the upcoming recess, the programs will lapse this time for at least a week. The State agencies will have absolutely no ability to keep their programs up and running. They will have to terminate benefits. Over 6 million workers are depending on extended benefits and they are distraught. Yet again, this debate is going down to the wire, causing them unnecessary stress, unnecessary anxiety. They have already been through enough. They deserve better. They deserve our support. Unemployment benefits are used for basic necessities--food and shelter--while the laid-off worker seeks a new job. These benefits are critical to a worker and his or her family and to the economies of the community. I hope we do what is right and find a solution to help the people whom we work for. Madam President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar No. 323, H.R. 4851, to provide a temporary extension of certain programs; that the bill be read three times, passed, and the motions to reconsider be laid upon the table.

Mr. BAUCUS. I yield.

Mr. BAUCUS. This is a bill which requires urgent attention. It is not paid for.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I wonder if the Senator from Tennessee would agree to modify his request so that the earlier amendments be set aside until a time designated by the leaders and this motion then be taken up at a time to be decided by the leaders, which is the customary practice we have been utilizing with previous amendments.

Mr. BAUCUS. The Senator would withdraw the request and make the request later?