Max Baucus

Mr. BAUCUS

Mr. BAUCUS. I thank the Chair. Mr. President, the unemployment rate is now 9.8 percent. Before long economists expect it to top 10 percent. That means nearly 15 million Americans have lost their jobs--15 million. That is 15 million people looking for work. About 5 million people have been looking for work for more than 6 months. There are about 3 million job openings. That is 15 million people chasing 3 million jobs. We are in what folks call the ``Great Recession.'' Real people are facing real hardships every day. On September 15 of this year, the Finance Committee held a hearing on unemployment insurance benefits and where we would go from there. Senators discussed the effects of the current condition on beneficiaries, the business community, and the State unemployment systems. We considered proposals to support unemployed workers through the continuing recession. A recent edition of the Federal Reserve's Beige Book reported that the economy is still stabilizing. Unfortunately, the labor market still remains weak. Companies are being cautious about adding permanent staff. Instead, they are asking more from their existing staff. We need to continue our work to create jobs, and we also need to help our neighbors who are looking for work. That is what we did in the Recovery Act. We need to act on behalf of unemployed Americans and their communities. In helping our unemployed neighbors, we also can help to keep open the neighborhood grocery store and the neighborhood gas station. That is how unemployment insurance benefits not just people who are unemployed but helps communities. In helping our unemployed neighbors, we also help to keep houses out of foreclosure. In helping our unemployed neighbors, we also help our economy and ourselves. The House of Representatives passed a bill to give an additional 13 weeks of benefits to unemployed people in States with unemployment rates of 8\1/2\ percent or more. That is what the House did. I commend our colleagues in the House for their rapid response. But Leader Reid and I want to make sure all Americans who have exhausted their benefits during these tough times get help. Today we are joined by Senator Reed of Rhode Island, Senator Shaheen, Senator Dodd, and a total of 38 Senators in all in offering an amendment to the House bill. Our amendment would give 14 additional weeks of benefits to unemployed people who exhaust their benefits no matter what State they live in--14 additional weeks of benefits for everyone. Our amendment would also give 6 additional weeks of benefits on top of that to unemployed people who exhaust their benefits in States with 8\1/2\ percent unemployment or more. So 14 weeks to all States, and then an additional 6 weeks in those States where unemployment is 8\1/2\ percent or more. The total cost of our package is $2.4 billion and paid for with an extension of the Federal unemployment tax, or FUTA, until June 30, 2011. Today we have a chance to lend support to unemployed Americans. In so doing, we have a chance to help our economy and ourselves. But first we have to proceed to the bill. I urge my colleagues to support this important legislation and vote for the motion to invoke cloture. Mr. President, I yield 5 minutes to the Senator from New Hampshire, Mrs. Shaheen, who is one of the main cosponsors of the amendment. She is the real strong advocate of getting this legislation passed and a strong advocate for the people of her State, and I deeply appreciate her work.

Mr. BAUCUS. Mr. President, if Senator Shaheen wishes to take more time, I am more than willing to extend it to her.

Mr. BAUCUS. I thank the Senator very much. I say to my colleagues that now is a good time to speak on extending unemployment insurance, now that we are on the motion to proceed. We will vote fairly quickly, but if Senators do want to come over to express their views, now is the time to do so. Pending the arrival of Senators, Mr. President, I suggest the absence of a quorum, and I ask unanimous consent that the time during the quorum call be equally divided between both sides.

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

Mr. BAUCUS. Mr. President, I ask the Presiding Officer, how much time is remaining on each side?

Mr. BAUCUS. I yield to the Senator from North Dakota as much time as he wishes.

Mr. BAUCUS. Mr. President, I suggest the absence of a quorum and ask consent that the time be equally charged to both sides.

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

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today, I am pleased to introduce the Foreign Account Tax Compliance Act of 2009. The bill gives the IRS powerful tools to find US taxpayers who are hiding their money in offshore accounts. It includes strong incentives for individuals to properly report income from assets held in offshore accounts. The days of sending your money offshore to avoid paying US taxes are over. This package is the result of a collaborative effort with the House and has the support of the White House and the Treasury Department. It is fully consistent with the policies in the preliminary draft of offshore compliance proposals that I released in March of this year to detect, deter, and discourage offshore tax evasion. The bill is a practical solution to a very challenging problem. For the first time, the tax law would authorize the IRS to receive information reports from foreign financial institutions disclosing the identities of their US account holders and the amounts being held in the accounts. Individuals with offshore accounts would be required to provide details of those accounts on their tax returns. Trust rules would be significantly strengthened to prevent the true beneficiaries from hiding behind a nominee owner. It will not be so easy to hide your money from Uncle Sam anymore. Following the recommendation of the Government Accountability Office, the IRS would have more time, up to 6 years, to find and examine unreported and misreported offshore transactions. Robust penalties would be in place for those who still try to skirt the rules. This bill would improve tax compliance without raising taxes on anyone. These are taxes that already are legally owed. Those who game the tax system by hiding their money in offshore accounts, like those in the recent UBS scandal, unfairly shift the tax burden to honest taxpayers who comply with their tax obligations. The IRS estimates that up to 52,000 individuals hid billions of dollars in offshore accounts through UBS. Offshore tax evasion is a significant part of the tax gap and it has gone on long enough. I believe this bill will be a turning point in putting an end to offshore tax evasion. I look forward to working with my Colleagues here in the Senate and in the House to enact this important piece of legislation this year.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today, I am pleased to introduce the Foreign Account Tax Compliance Act of 2009. The bill gives the IRS powerful tools to find US taxpayers who are hiding their money in offshore accounts. It includes strong incentives for individuals to properly report income from assets held in offshore accounts. The days of sending your money offshore to avoid paying US taxes are over. This package is the result of a collaborative effort with the House and has the support of the White House and the Treasury Department. It is fully consistent with the policies in the preliminary draft of offshore compliance proposals that I released in March of this year to detect, deter, and discourage offshore tax evasion. The bill is a practical solution to a very challenging problem. For the first time, the tax law would authorize the IRS to receive information reports from foreign financial institutions disclosing the identities of their US account holders and the amounts being held in the accounts. Individuals with offshore accounts would be required to provide details of those accounts on their tax returns. Trust rules would be significantly strengthened to prevent the true beneficiaries from hiding behind a nominee owner. It will not be so easy to hide your money from Uncle Sam anymore. Following the recommendation of the Government Accountability Office, the IRS would have more time, up to 6 years, to find and examine unreported and misreported offshore transactions. Robust penalties would be in place for those who still try to skirt the rules. This bill would improve tax compliance without raising taxes on anyone. These are taxes that already are legally owed. Those who game the tax system by hiding their money in offshore accounts, like those in the recent UBS scandal, unfairly shift the tax burden to honest taxpayers who comply with their tax obligations. The IRS estimates that up to 52,000 individuals hid billions of dollars in offshore accounts through UBS. Offshore tax evasion is a significant part of the tax gap and it has gone on long enough. I believe this bill will be a turning point in putting an end to offshore tax evasion. I look forward to working with my Colleagues here in the Senate and in the House to enact this important piece of legislation this year.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, an old Chinese proverb says: ``If you do not pay the doctor who cured you, beware of falling ill again.'' We are here today because we need to fix the way that we pay the doctors who cure us. The way that we pay for health care today contributes to spiraling health care costs. It contributes to quality-of-care that is not as good as it should be. Today's payment system rewards providers for the quantity, not the quality, of the services that they provide. Commonsense health reform must restructure the way that we pay for health care. Because of its size and purchasing power, Medicare can lead the way. But payment reforms won't be effective unless they're built upon a solid payment foundation. Unfortunately, the current Medicare payment system for doctors is fundamentally flawed. It does not provide stability and predictability for our doctors. It is not a solid foundation for the future. That is so, because in 1997, Congress created the Medicare physician payment system that we have today. Congress created a thing called ``the sustainable growth rate,'' or ``SGR.'' It was meant to control what Medicare spends on doctors. But the SGR is not working. It never really has. Had Congress not intervened, the SGR would have produced steep cuts in physician payments every year since 2002. And if Congress does not intervene now, the SGR will continue to produce steep cuts for the foreseeable future. Without action, next year, physician payments will be reduced by 21 percent. And the cuts will continue for the foreseeable future. The total cut over the next decade will approach 40 percent. Every year since 2003, Congress has intervened. Congress regularly acts to avert these cuts. And given the magnitude of the impending reductions, Congress will continue to intervene. The stakes are just too high. Allowing these draconian cuts to go into effect would jeopardize access to doctors for 40 million seniors--including 160,000 Montanans-- who rely on Medicare for their health coverage. That is why AARP unequivocally supports the repeal of the flawed SGR formula. But the damage would not end there. Because TRICARE--the health care system for active military personnel--bases its reimbursements on Medicare rules, 9 million members of the armed services and their families could also be left without physician care. The SGR must be repealed. But don't just take my word for it. The Medicare Payment Advisory Commission--or MedPAC--reported to Congress in 2007 that the SGR should be replaced with a more stable, predictable system. MedPAC recommended a system that rewards doctors based on the quality and efficiency of the care that they deliver. The Medicare Physician Fairness Act is the first step toward a 21st century physician payment system in Medicare. The Medicare Physician Fairness Act repeals the flawed SGR formula that has done nothing to promote more appropriate, evidence-based physician care. Repealing SGR will lay a solid foundation. And on that foundation, we can build delivery system reforms that fundamentally restructure the Medicare payment system. We can change it from one that focuses on the volume of services delivered to one that rewards doctors for the value of care that they deliver to patients. The bill that the Finance Committee reported last week includes these reforms. Our bill includes better feedback reports to doctors, so that they know how their utilization trends compare to those of their peers. Our bill includes incentives for physicians to work together with other health care providers in accountable care organizations that will share in savings they achieve for Medicare. And ultimately, our bill includes a payment system that rewards every doctor based on the relative quality and costs of care they provide to their patients. But first, we need to repeal the SGR, so that we can enact these meaningful reforms. Now, any honest discussion about repealing the current SGR system must also address the elephant in the room: the CBO budget baseline. The law requires CBO's budget baseline to assume that Congress will not suspend the SGR. The reality of the situation, however, is at odds with the CBO baseline. Future congressional action on the SGR is certain. Seven consecutive cuts have, for good reason, been averted. Rather than continuing to enact short-term fixes that produce steeper cuts in the future, the Medicare Physician Fairness Act adopts the Obama administration's more realistic budget baseline. It does not increase spending over recent trends or future action. It preserves spending at current levels. Adjusting the SGR baseline without an offset is not something I endorse without hesitation. I believe in fiscal responsibility. And I am proud that the Finance Committee health reform legislation will reduce the budget deficit in the first 10 years and dramatically bend the cost curve in the long run. But by overturning each of the last seven SGR cuts, Congress has made clear that the current baseline is broken. And temporary band-aids have only increased the size of future cuts and the cost of future interventions. Eliminating the SGR now will avert devastating payment cuts. And eliminating the SGR now will create a more honest picture of our future budgetary commitments. And so, let us avoid merely putting another band-aid on the broken physician payment system. Let us truly reform the way that we pay the doctors who cure us. And let us enact the Medicare Physician Fairness Act.

Mr. BAUCUS

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

Mr. BAUCUS

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

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

Mr. BAUCUS

Mr. BAUCUS. That is correct, 2 minutes.

Mr. BAUCUS. Madam President, what is the parliamentary situation? What is pending?

Mr. BAUCUS. I thank the Chair. Madam President, on another subject, I wish to say I am very distressed that the other side objected to a request by the majority leader to pass legislation offered by himself, by myself, and Senators Reed and Shaheen to extend unemployment insurance benefits. Our country faces very high unemployment rates nationwide. In some States, it is much worse than other States. It is only fair. It is the right thing to do for the U.S. Government to recognize those folks who don't have jobs--to help tide themselves over until they get a job-- with extension of unemployment insurance benefits. I think for every job that is available in the United States today there are about six applicants. There are too many people unemployed-- people seeking jobs who cannot get jobs. So the right thing to do, as we come out of this great recession, is to recognize those who are unemployed and help them tide things over to make sure they are compensated. The legislation we have introduced does that with 14 additional weeks for all States, and also would provide additional weeks for the hardest hit States--6 weeks of additional benefits for those States hardest hit, those States with the highest rates of unemployment. This unemployment rate we are facing is going to continue. It is not just a short-term phenomenon. There are estimates that we will see rates up to 9.8 percent through most of even next year. I am very disheartened myself, but more so for the folks who are going to be denied benefits by the action taken by the Republican side to object to extending benefits to those folks who are in need of them. I am hopeful at a later point in time--very soon in fact; hopefully by next week--the other side will see fit to let this legislation pass because it is sorely needed. I urge my colleagues to vote for it when it does come up next week.

Mr. BAUCUS

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

Mr. BAUCUS. Madam President, the Congressional Budget Office has issued its report on the Finance Committee legislation. That bill was sent over to the Congressional Budget Office a couple days ago. The report is quite promising. The report is good news. Our balanced approach in the Finance Committee to health reform has paid off once again. Today, the Congressional Budget Office confirmed that America's Healthy Future Act--that is the legislation in the Finance Committee--remains fully paid for and reduces the Federal deficit. In fact, it reduces the deficit by $81 billion in the first 10 years. CBO also says in its report that the legislation continues to reduce the deficit in the second 10 years; that is, it bends the cost curve in the second 10 years as well. More important, it improves and expands health care coverage for tens of millions of American families. That is done by raising the coverage rate of 83 percent to 94 percent. In fact, that might be a slight increase from what we earlier anticipated in the committee bill. This legislation, I believe, is a smart investment on the Federal balance sheet. It is an even smarter investment for American families, businesses, and our economy. Health reform will modernize the health care system for America for the 21st century. It is about time we got to that point. The bill also reduces inefficiencies and focuses on quality and ensures we are getting the best bang for our health care buck. Health care reform should be fiscally responsible as it expands and improves coverage. CBO confirms the legislation does that. I am very pleased with that report. It will help us move toward the next steps in merging the bill with the HELP Committee bill. Madam President, I yield the floor.

Mr. BAUCUS. Madam President, unless the Senate acts soon, millions of seniors and disabled individuals will face sharply higher Medicare premiums next year. In this great recession, we must act quickly to ensure we do not allow a formulated quirk to punish our seniors on fixed incomes in our financially strapped States. Many seniors have their Medicare Part B premiums deducted from their monthly Social Security checks. Normally, the Social Security cost-of- living adjustment is greater than the increase in the Part B premium for that year. As a result, the beneficiaries' monthly checks in the new year are greater than their monthly checks were in the last year. But next year there is not likely to be an upward cost-of-living adjustment in Social Security checks. When that happens, most Medicare beneficiaries are held harmless against reductions in their Social Security checks. The Part B premium is reduced so that their monthly Social Security checks in the new year are not less than they were in the prior year. However, 27 percent of Medicare enrollees do not benefit from hold harmless. The absence of a cost-of-living adjustment will expose these seniors to big premium increases next year. Under current law, these enrollees not only have to pay their own premiums, but they must make up the premiums by the 73 percent of beneficiaries we hold harmless. These 27 percent of Medicare recipients will be forced to shoulder the full load of next year's premium increases. This will mean an increase in premiums up from $96 to $120 a month next year. Who are these recipients? They include low-income beneficiaries who participate in both Medicare and Medicaid. They include new enrollees in Medicare Part B. They also include Medicare Part B enrollees who don't receive Social Security, such as some Federal retirees. They include higher income enrollees who already pay higher premiums. This burden will hit Medicare beneficiaries hard, but financially strapped States will also feel the effect because State Medicaid Programs pick up the cost of Part B premiums for Medicare beneficiaries who are also eligible for Medicaid. The premium hike would also hit State budgets because of that reason. States all across the Nation are facing huge deficits and difficult choices, and we should not allow this quirk in the law to add to their burden. The Medicare Premium Fairness Act would correct this. It would ensure that these 27 percent of Medicare beneficiaries would not have to shoulder any additional burden. No Medicare Part B enrollee would face a higher premium next year over this year. The bill would provide security to seniors on fixed incomes. To prevent Federal cost shift to States, the bill would pay for and would tap into the Medicare Improvement Fund, which was created to solve problems such as this. Inaction on this bill is not an option for seniors and States, and I hope the bill will have broad bipartisan support. Madam President, I ask unanimous consent that the Finance Committee be discharged from further consideration of H.R. 3631, the Medicare Premium Fairness Act, and the Senate proceed to its immediate consideration; further, that the bill be read a third time and passed, and the motion to reconsider be laid upon the table, with no intervening action or debate.

Mr. BAUCUS. None.

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

Mr. BAUCUS. Madam President, Hippocrates once said: ``A wise man should consider that health is the greatest of human blessings.'' Every day we see the real-world consequences for Americans who have been deprived of that blessing. A Harvard study found that every year in America, lack of health coverage leads to 45,000 deaths. People without health insurance have a 40 percent higher risk of death than those with private health insurance. No one should die because they cannot afford health care. Every 30 seconds another American files for bankruptcy after a serious health problem--every 30 seconds. Every year, about 1.5 million families lose their homes to foreclosure. Why? Because of unaffordable medical costs. No one should go bankrupt because they get sick. A Kaiser Family Foundation survey found that health care coverage for the average family now costs more than $13,000 a year. If current trends continue, by the year 2019, 10 years from now, the average family plan will cost more than $30,000 a year. No one should have to live in fear of financial ruin from crushing insurance premiums. Americans are looking for commonsense solutions to these problems. Americans want a balanced plan that takes the best ideas from both sides. Americans want their leaders to work together to craft a health care package that will get 60 votes it needs to pass. The Congressional Budget Office has just given us their analysis of legislation we put together in the Finance Committee and it shows that our bill reduces the deficit by $81 billion over 10 years. That is a reduction in the Federal deficit of $81 billion. CBO also says the legislation out of the Finance Committee continues to reduce the deficit in the outyears; that is, the years after 10 years, the second 10 years, and the legislation increases coverage from 83 percent to 94 percent, so 94 percent of Americans will have health insurance. For 2 years now, that is exactly what we have been doing in the Finance Committee--working to get that result. Over the last 2 years, the Finance Committee has held 20 hearings on health care reform. Last June we held a health care summit at the Library of Congress. The committee held three roundtable discussions with experts on each side of the area, especially on the three major areas of reform. We held roundtables on how health care is delivered, on coverage--that is insurance coverage--and on how to pay for health care. In connection with each roundtable--we had experts around the table, asked lots of questions, the experts just balanced--experts were not chosen for a certain point of view but just to get the facts. The committee put out a detailed option paper after those roundtables and we then held three walk-throughs to hash out those options--walk-throughs to see what might make sense after those walk-throughs. Six members of the Finance Committee--three Republicans and three Democrats--then had meetings. They held 31 meetings to try to come to a consensus. We held exhaustive meetings and met for more than 61 hours. We went the extra mile. I might say if a fly on the wall were to watch those six meet, three Republicans and three Democrats, I think Americans would be very proud. This was hard work. It was not ideologically driven. It was based on the facts. We asked questions of experts, actuaries were objective--of the Congressional Budget Office, the Joint Committee on Tax--a very solid effort to try to find out how the various parts would be put together in a balanced and fair way. I can say the Finance Committee has held the most open and exhaustive consideration of this health care proposal. I put out the starting point and posted it on the Web on September 16. That was nearly a week before we started our markups, a full week notice before we started our markup. In a first for the committee, we posted every amendment, all 564 of them, on the Web. We had never done that before, all posted, all available to the world. The committee has held a thorough markup, and I know the present occupant of the chair can attest to that. When the committee reconvenes to report the bill, the committee will have met for 8 days. Many of those were long days, often running past 10 o'clock at night. In fact, last Thursday we worked until 2 o'clock in the morning. It has been more than 22 years since the Finance Committee met for 8 days on a single bill. In the committee's consideration, Senators offered and the committee considered about 135 amendments. The committee conducted 79 rollcall votes and the committee adopted 41 amendments. The result is a balanced, commonsense plan that takes the best ideas from both sides. It is a plan that essentially implements President Obama's vision to improve America's health care and it is a plan designed to get the 60 votes it needs to pass. We have just received from the Congressional Budget Office the numbers that we need to have to proceed to the next step. The CBO says we reduce the deficit by $81 billion in the first 10 years and the legislation that will be reported out of the committee soon will reduce the deficit further in the next 10 years, and it increases coverage to 94 percent. I am confident that after Senators have had a opportunity to review the CBO numbers the Finance Committee will report the bill. Then we on the Finance Committee expect to work together with the HELP Committee to meld our two bills together. Our colleagues on the HELP Committee have done some wonderful things, especially in the area of prevention, workforce, and quality. We look forward to bringing together the best of both bills. Then the majority leader will offer the combined bill as an amendment on the floor and I expect we will have a full and vigorous debate here in the Senate. I am proud of our work. All Americans should have access to affordable, quality health care coverage. Our bill would raise the share of Americans with insurance coverage from about 83 percent currently to 94 percent, and our bill would deliver coverage to millions through new insurance exchanges and to millions more through Medicaid--that is the Finance Committee bill I am discussing. Our bill would dramatically increase prevention and wellness, will begin shifting health care delivery to the quality of care provided-- not the quantity of services rendered but the quality of care provided. It is so important. This is transformative. This is game changing. When we look back several years from now we are going to see this is probably one of the more important items in this legislation because it will begin American health care to focus on where it should be, on quality and teamwork and the patient, more than today, where it is focused on quantity under the fee-for-service system. This is clearly the major, most important part, I think, when we look back at this bill 5, 6, 8, 10 years from now. The bill also will lower prescription drug costs dramatically for seniors--no small point. Our bill would reform the insurance market. It would protect those with preexisting conditions. It would prevent insurance companies from discriminating and capping coverage. And it would require insurance companies to renew policies as long as policyholders pay their premiums. No longer would insurance companies be able to drop coverage when people get sick. These reforms would give Americans real savings. Under the Finance Committee bill, everyone making less than 133 percent of poverty would receive health coverage through Medicaid. Our plan will provide tax credits to help low-and middle-income families buy private insurance coverage. These tax credits would mean that our bill would deliver tax cuts for those whom it affects. Overall taxes would go down for people affected by this bill. These tax credits would help make insurance more affordable. Some have made some pretty outrageous claims about our bill. Some folks frankly have said some whoppers. Let me take a few minutes to bust some of those myths. Myth No. 1. Some say our bill cuts benefits for seniors. That is false. Nobody cares more about maintaining Medicare than I do. Medicare benefits will not be reduced under our bill. Seniors will get the same level of benefits they receive today. In fact, seniors have a lot to gain from health care reform by lower prescription drug costs and more free preventive care such as mammograms and colonoscopies. Plus our bill takes the long view to help preserve the life of the Medicare Program. Our bill puts the Medicare Program on sounder financial footing. Our bill will remove from a system that pays for volume to one that pays for value. It would improve Medicare solvency by reforming the way Medicare delivers health care. Don't just take my word for it. Don't just take President Obama's word for it. Go to the AARP Web site and see what they say. AARP is probably one of the greatest advocates for seniors. This is what AARP says: Myth: Health care reform will hurt Medicare. Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services. That is the conclusion of AARP in their letter to seniors. Myth No. 2. Some say our bill will lead to rationing because we encourage comparative research. That, too, is false. The Institute of Medicine--MedPAC, that is the bipartisan group, nonpartisan group that advises Congress on Medicare payments--and former CMS administrators have all recommended that Congress invest in research to compare what works and what doesn't work in medicine. Groups such as the American Medical Association and the American Health Association support this idea. Our bill would set up a nonprofit institute to provide for this ``comparative effectiveness research.'' The goal is better evidence, unbiased information that doctors and patients can use to make better health care decisions. Comparative effectiveness research is about giving doctors and patients the best information available on what works so they can decide, the doctors can decide in consultation with their patients, as to what procedure, what drug, makes most sense and what doesn't. If one treatment works far better than another, then doctors and patients have a right to know. That is what our bill tries to do, it tries to foster the kind of commonsense research that can get better information in the hands of doctors and patients. Nothing in our bill would ration care--nothing. The new institute could not make coverage decisions or issue medical guidelines. And our bill would prevent the HHS Secretary from using the research to ration care in any way. The Secretary could never use the evidence to discriminate against individuals based on age, disability, terminal illness, or their preferences between length of life and quality of life. Calling this rationing only supports a delivery system that is pro- waste and antipatient education. That is what opponents will end up doing. That is the effect of it. That is not the type of care people deserve. They deserve the information that comparative effectiveness research produces to help them make informed health care decisions. Myth No. 3. Some say our bill will cause premiums to go up. That, too, is false. There are a lot of things in our bill that would cause premiums to go down. Our bill would cut out fraud, waste, and abuse in our health care system. That is going to help. Our bill would spread insurance risk through a much broader population, including younger, healthier people. That would clearly help. And our bill would help to eliminate the cost of uncompensated care, which results in more than $1,000 in additional premium costs each year for American families. The effects of open competition in our new insurance exchange should bring premiums down as well. CBO has said there are a lot of factors in whether premiums go up or down and, frankly, they punted on a lot of those factors. But in the one part of premium costs about which they did make a projection, CBO said that premiums would go down. In a September 22 letter CBO said: CBO currently estimates that about 23 percent of premiums for policies that are purchased in nongroup market under current law go toward administrative costs and overhead. About 23 percent of premiums for policies goes toward administrative costs and overhead. CBO goes on to say: Under the proposal, that share would be reduced to 4 or 5 percentage points. So if 23 percent of costs are administrative overhead under the legislation the committee reported out, that should be reduced by 4 or 5 percentage points. That is lower costs, administrative costs, which should result in lower premiums. Myth No. 4. Some say you will not be able to keep your insurance. That, too, is false. Nothing in our bill would take people's insurance away from them. No one would be forced into a particular plan. This is the central feature of the way we have gone about health care reform. We have not tried to change the employer-based system, a system Americans know and understand. We improve upon it, make it work a lot better. We have not tried to fix something that is not broken. We have an employer-based system and it is very important we improve upon it, not eliminate it. Some who do not share our best interests assert that cuts to Medicare Advantage will cause some plans no longer to be offered. We do bring the government's subsidies to Medicare Advantage more in line with the government's own commitment to Medicare, but our bill would not cut benefits under Medicare Advantage. Rather, it would cut out waste in the system to ensure that Medicare is sustainable for years to come. Even after the cost of marketing and delivering benefits and after making a profit, insurance companies are paid about 14 percent more, on average, under Medicare Advantage than under traditional Medicare. Insurance companies pad their pocket with those subsidies. Our bill would end those subsidies for insurance companies. If insurance plans want to pass cuts along to seniors instead of reducing their huge profits, that is up to them. In a competitive market, it will be hard for plans that do that to keep their customers. Yes, under our bill Medicare Advantage plans will have to compete in the free market. But that has been true of insurance companies generally for as long as there has been insurance. It is true that we in our bill do not guarantee that the government will keep each and every insurance company in business. We should not and we do not, in our bill, guarantee that each and every insurance plan will continue to be offered. Those are business decisions. Those are decisions for the private sector. And that is where we leave it. It is absurd to say that people will not be able to keep their insurance because the government is going to trim back wasteful subsidies. That is a pretty absurd statement. Myth No. 5. Some stated our bill will raise taxes. That is false. In fact, our bill is a tax cut. Our bill will cut taxes for millions of Americans. When fully phased in, our bill will cut taxes by tens of billions of dollars every year. Let me restate that. When fully phased in, our bill will cut taxes by tens of billions of dollars every year. And millions of Americans will be able to use those tax cuts to buy health insurance coverage. Myth No. 6. Some say that a high-cost premium excise tax will raise taxes on working families. That too is false. The bill levies the high- cost premium excise tax on the insurance companies. It will put downward pressure on insurance company profits. And it will put pressure on insurance companies to offer more efficient insurance plans. In fact, the Joint Committee on Taxation tells us that much of the revenue that the high-cost premium excise tax brings in is because employers will give workers raises. People will avoid insurance plans with high-cost premiums, and as a result employers will raise workers' salaries with the money they save. That is what the Joint Committee on Taxation predicts will happen. That is what they say over and over again in publicly given testimony. Finally, the biggest myth of all, myth No. 7. Some say our bill is a government takeover of health care. That is so false. We have built our plan on the exchange marketplace that allows choice among private health insurance company products, choice among private health insurance products. People will be able to choose their own plan. They can choose their own plans among private options. Our bill does not include a public option. We did not include an employer mandate. And we pay for every cent. This is a uniquely American solution. We are not Canada. We are not Britain. We are America. This is a balance. We have a tradition of balance between public and private. This legislation accomplished that. We do not buy into government-only solutions in America, but we do believe in rules of the road. Our bill provides a balanced solution. And CBO says we do so in a balanced way. Soon it will come down to the Senate. My colleagues, this will be our opportunity to make history. Think of it. Our actions here will determine whether we will extend the blessings of better health care to more Americans. Ours is a balanced plan that can pass the Senate. Our bill should win the support of Republicans and Democrats alike. Now the choice is up to Senators. Hippocrates said that ``health is the greatest of human blessings.'' But too many Americans are being deprived of that blessing. Let us enact this balanced, commonsense plan to improve health care. Let us reform the health care system to control costs and premiums. And let us extend the blessings of health care coverage to all Americans. I yield the floor and I suggest the absence of a quorum. The PRESIDING OFFICER (Mr. Nelson of Florida.) The clerk will call the roll.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I am very honored by all the comments of the majority leader, who is a good friend; Senator McConnell; my good friend Jon Tester; and the Senator from Iowa, Mr. Grassley. I am also honored to have served in this body. Everyone here cares a lot about public service and about people. We are all here because we care. I very much appreciate working with all of you. There are a lot of characters here, different personalities. The bottom line is that everybody is here for their State and the Nation. I feel as if I am the luckiest guy in the world. I think this is the best job one could have. I have 900,000 of the world's greatest bosses, the people of Montana. They are terrific and wonderful. I am just a hired hand working for them. Combined with all of you and all the staff here, you are all people here who care about our great country. I thank you very much. I could not be more touched and appreciative. Thank you. (Applause.) Amendment No. 2580

Mr. BAUCUS

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