Thomas Coburn

Mr. COBURN

Mr. COBURN. Madam President, our country is at a crossroads. Anybody who is watching Europe will find that they have been very slow to address the real underlying problems of debt and deficits there. They have a much more difficult time than what we should because they have a monetary union without a political union. We have a monetary and political union. The fact is that over the next 10 years we are going to have a debt-- including borrowing money for student loans, borrowing money to pay back Social Security, what has been stolen--we are going to have a true debt of about $27 trillion to $28 trillion. It is absolutely unsustainable. It won't happen--according to Ben Bernanke--because his statement is, the world will not loan us the money. What is going on in Europe today? What is going on in Europe today is the markets are punishing the countries that have excessive debt-to-GDP ratios. We sit at 100 percent debt to GDP. We see what has happened just in the last 2 weeks to bond rates for Italy. The differential between an Italian bond rate and a German bond rate is now about 430 basis points, a 4.3 differential for the same length maturity bond for Italy versus Germany. What is the difference? Germany is living within the confines of its economic capability. Italy didn't. How does that apply to us? It applies to us in that we are not and what will happen to us if we don't make the difficult changes that are necessary. There has been a lot of rhetoric on both sides of the aisle and there has been rhetoric from the President in terms of us looking at who pays what in terms of taxes in this country. But nobody is looking at what we are doing with our Tax Code that enables those who are the wealthy in this country to pay less taxes. So I had my staff put together a list of the subsidies for the wealthy in this country, because the answer isn't just to raise taxes; part of the answer is to quit subsidizing these behaviors. We came up with a piece that we put out called ``Subsidies for the Rich and Famous.'' It is a report that looked at every government program. We looked at everything we do. What we found is every year, for people having adjusted gross incomes above $1 million, we give $28 billion worth of benefits in the Tax Code or through our programs. I will tell my colleagues that if we wanted--I am one of those who thinks we ought to reform our Tax Code, we ought to lower the rates, we ought to make it where it actually increases productivity in this country, creates capital investment. But one of the first steps in doing that is to make sure our Tax Code and our safety net programs are for those who truly need it and not for those who don't. We went through the total tax breaks of $113.7 billion over the last 4 years. Mortgage interest: $27.7 billion in tax breaks to people who are making more than $1 million a year. That is a lot of dough. Rental expenses. The writeoff of rental expenses for those making more--we are not talking businesses. None of these are business deductions. These are personal deductions for the very wealthy in this country who are making more than $1 million adjusted gross income a year. We allow them to write off $64.3 billion in rental expenses. Gambling losses. We allowed the rich and famous to reduce their taxes by $21 billion because we allow them to gamble, and if they lose money, they get to write it off. So we are subsidizing the loss. We are subsidizing their gambling losses. Canceled debt, debt writeoffs, debt forgiveness. We have allowed $128 billion in terms of writeoffs for those people making more than $1 million adjusted gross income. Business entertainment--and this is not through business, though, not run through a business; this is personal deductions for business entertainment--$607 billion. Electric vehicle. What are we seeing? Who are the people taking advantage of our messing in the economy and creating an incentive for somebody to buy an electric vehicle? The vast majority are the people who don't need the writeoff in the first place. What we have is $12.5 million last year alone in tax credits for the very wealthy to take a $7,500 or $8,500 tax credit for buying an electric car. Childcare, nanny care for the very wealthy last year: $18 million. Renewable energy tax credits for the very wealthy: $75.6 million. The whole point of putting this report out is we are schizophrenic with our Tax Code. We have it upside down. When people talk about how they want millionaires to pay more--they are paying plenty. The top 1 percent pays 38 percent, the top 20 percent pays 80 percent of all of the taxes in this country. But if we want to start getting at this, the way we do it is start taking away the things that reduce their tax burden that don't make sense, that aren't smart, and that don't help those who need the true safety net in our country. These people aren't dependent on these. They will do fine without them. The whole purpose for most of these programs was to create and sustain a safety net for those who are less fortunate. When we allow $113.7 billion in tax breaks for the wealthy over 4 years, what could we do with that money? Well, we could run a NASA that is twice as big. We could not borrow $113 billion because the interest rates on that are significant; another $4 billion or $5 billion a year in interest that we wouldn't have to borrow. We wouldn't have to make some defense cuts that are going to have to come. We could maybe put more money into Medicare prevention and disease prevention rather than what we have done. There are all sorts of things we could do. The point behind the report is that most Americans don't realize how we are subsidizing through tax credits the very wealthy in this country. I don't have any real problem with them taking the tax credits. We put it out there. The real question we ought to be asking is why are we doing all of this in the first place. Does the economy itself in a free market not allocate resources better than we can do? How many Chevy Volts have been sold this year? The answer is 5,000. So 5,000 times $7,500 is what we paid in tax credits to have the Chevy Volt sold because everybody who bought it got a $7,500 tax credit. If it is a viable product, then let people buy it. If it is not, they won't. Yet who are the people who bought most of the Chevy Volts? People making significantly more than the average American. If we are going to play in the Tax Code, what we ought to do is play on a very level playing field. If we want to create incentives, then we ought to create incentives that actually will do something for the economy rather than benefit those who make the most money in the economy. I would say what this spells is a case for us to totally reform our Tax Code. Most people don't realize this is one of the side effects. That is not to say there are not some good side effects. But the fact is when we are running $1.3 trillion deficits, do we want to be subsidizing the rich and famous in this country with our programs? I would say no. When Medicare Part B started, 50 percent of the cost of Medicare Part B was to be borne by the Medicare recipient. We are at 25 percent now. There was never any thought--and, remember, nobody ever paid anything for that. In other words, that is all borrowed money to do that. Nobody ever contributed into a Part B fund. They contributed into a Part A fund which, by the way, will be bankrupt in 4\1/2\ years. What about those on Part D? Nobody ever paid a penny, and we have $13 trillion in unfunded liability in Part D. Why should the very wealthy get subsidized drugs in this country? Why should they get subsidized Part D? In other words, we ought to ask ourselves a question. Think about Social Security. Why is Canada's Social Security system not in trouble? Because Canada looks at how much income a person is making every year, and at certain levels a person gets half of their Social Security because they obviously don't need it because their income is up there, and at a certain other level they get none of it. Why? Because it is based on a means-testing mechanism that says this program is designed to be an underpinning for those who need it. We have gone completely the other way. My point is we have all this discussion about what we should do. We are wringing our hands. The first thing to do is to fix the Tax Code and the best way to fix it is to say 3 months from now it is going away, and have Finance and Ways and Means Committee in the House come together with a new Tax Code that fixes all of this. Everybody in Washington says that can't be done. Nobody outside of Washington says it can't be done, but we say it can't be done. It can be done. It needs to be done. If we want a healthy future, we need to reform our Tax Code to generate greater investment, greater job opportunity. We need to lower the rates, and we need to eliminate things such as these that don't truly help the economy, but help those who were smart enough to figure out how to play the game, who are the wealthiest in this country. I am proud of them. I want them to be more successful. But in these difficult times, we need to ask them to contribute more. We need to not have these kinds of programs in our Tax Code that actually subsidize those who need no subsidy. With that, I yield the floor and note the absence of a quorum.

Mr. COBURN

Mr. COBURN. Mr. President, I ask unanimous consent that following Senator Harkin, the Senator from Georgia, Mr. Isakson, be recognized.

Mr. COBURN. If the Senator will yield for a moment, one of the reasons our cancer cure rates are a third better than England is because we don't have an IPAB and they do. The No. 1 reason survival rates from cancer in England are lower is because treatments are denied by their IPAB for the best treatments, which will save more people's lives at the best price. That is something that should not be discounted. I yield the floor.

Mr. COBURN. Mr. President, myself and Senator Barrasso are two of the three doctors in the Senate. Both of us have practiced for over 25 years. We have put out several reports. Every year, Medicare recipients receive a message from Medicare, called ``Medicare and You.'' What we thought we would do is come to the floor and tell our colleagues, as well as the American people, that we also put out a ``Medicare and You'' report. There is a lot that wasn't in the ``Medicare and You'' report this year. I ask unanimous consent to have a colloquy between myself and the Senator from Wyoming, Dr. Barrasso, as to what we are reporting in our Medicare and You statement.

Mr. COBURN. This booklet, which will be available on coburn.senate.gov and barrasso.senate.gov to every Medicare patient out there, explains what has actually happened to Medicare in the last year and a half. It explains that $530 billion has been cut out of Medicare. It explains the physician reimbursement cuts were not addressed when we addressed health care and, consequently, a 27-percent cut is coming if Congress doesn't change that. It explains that Medicare Advantage--both the options and the number of people eligible for that--has been taken away by the Affordable Care Act. It explains that the CLASS Act was put in to save money, but it won't, and it has now been abandoned by the administration. The fact is there is an independent payment advisory board, whose sole purpose is to cut payments for Medicare procedures and supplies and drugs to save money--even when that will instigate the loss of available drugs. Finally, it creates a $10 billion trust fund for an innovation center that is a smokescreen for a rationing board very similar to the IPAB. I want Dr. Barrasso to go over the Medicare cuts now, if he will.

Mr. COBURN. The other thing Medicare recipients should recognize is that under the laws as previously set, the reimbursement for your physician in January is scheduled to decline 27 percent. When I talk to seniors in the State of Oklahoma, one of the No. 1 problems that somebody turning 65 has is now finding that physician who will care for them under the Medicare payment guidelines. What was never spoken of was the fact that there was no fix in the health care bill for the very real need to attract more physicians into caring for seniors. As we have seen, Congress may or may not fix that--it is $300 billion to fix that. That is the cost of it. Whether we fix it or not, the fact is we are playing with the access of Medicare patients to care. Denied access is denied care. If you live in a community much like mine where no new doctors have been coming in because there is a shortage of primary care doctors, and those who do come in will not take the lower reimbursement for Medicare because they cannot afford to, it may mean that you have to drive 70 miles to get that care. That is not access, and it is not health care. It means you don't have available health care because the government runs the program so poorly. Let me finish up, since we don't want to go over our time. The other thing I want to talk about for a minute is this innovation center. In the health care law, we set aside a $10 billion slush fund for innovation in payment and procedures for Medicare patients. We are going to be spending $10 billion to figure out how to pay for it more cheaply and limit the combinations, or increase the combinations of combining these things so that the reimbursements are less. First of all, I don't understand why it is going to take $10 billion, but it is a slush fund. No. 2 is that if you don't like the results of that, there is nothing we can do about it except reverse the Affordable Care Act, Obamacare. No. 2, you can't sue. You have no injunctive relief. You have no opportunity to express your desire in a court of law or through an administrative procedure to challenge their elimination of paying for certain procedures that may in fact save the country money but may in fact also hurt the very patients who are on Medicare. We have this fund that we cannot find out anything about; no rules have been put out on it, and we cannot find the details of it. Yet, we know what the purpose of the fund is. It is like the IPAB fund. It is designed to ration the care that seniors need to control the cost of Medicare. What do we know about Medicare? One dollar of every three dollars spent on Medicare doesn't help anybody get well and doesn't keep anybody from getting sick. The reason it doesn't work is because of the government's mandate--we have all these stories about shortages of drugs. The reason there are shortages of drugs in our country is because Medicare has mandated prices 90 percent of the time so low that we only have one supplier. Some of them either have a technical problem or have decided to stop making a drug that is critical to our seniors because we have a price control bureaucracy. There are large problems with the Medicare law. They need to be recognized and addressed. They need to be fixed, and the last thing we ought to do is spend $10 billion figuring out how not to get somebody treatment, or lessen the availability of treatment through the innovation council. I yield the rest of my time to the Senator from Wyoming.

Mr. COBURN

Mr. COBURN. Mr. President, I believe Congress should reexamine the federally mandated medical loss ratios in the Patient Protection and Affordable Care Act. Today I will outline four reasons I believe consumers will face increased costs, decreased choice, and reduced competition. The Patient Protection and Affordable Care Act, PPACA, included a provision that requires all health plans to adhere to a medical loss ratio, MLR, established in law. The MLR refers to the percentage of premium revenues for health insurance plans spent on medical claims. Thus, if a plan received $100 of premiums and spent $85 on medical claims its MLR would be 85 percent. Beginning no later than January 1, 2011, PPACA requires a health insurance issuer to provide an annual rebate to each enrollee if the ratio of the amount of premium revenue expended by the issuer on clinical claims and health quality costs, after accounting for several factors such as certain taxes and reinsurance, is less than 85 percent in the large group market and 80 percent in the small group and individual markets. Supporters of PPACA tend to herald the newly created, higher MLR requirement as providing ``better value'' for policyholders compared to a lower MLR. To the untrained ear, perhaps higher MLRs sound better since they force health insurance plans are required to spend a larger percentage of each dollar on medical claims. Jamie Robinson, a professor in the School of Public Health at the University of California at Berkley, noted that numerous organizations ``have assailed low medical loss ratios as indicators of reduction in the quality of care provided to enrollees and sponsored legislation mandating minimum ratios.'' However, he rightly concludes that while ``this is politically the most volatile and analytically the least valid use of the statistic.'' In fact, a close examination of the data suggests there are several reasons to be concerned with the one-size-fits-all federally mandated MLRs in PPACA. Here are four key reasons why PPACA's MLRs will likely negatively impact American consumers and patients. First, insurance markets across the country threaten to destabilize. During the health reform debate, opponents of the Federal takeover of health care warned that the federally mandated MLR could endanger the high-quality health coverage many Americans enjoy because it could lead to market destabilization in some States. Under PPACA, States are permitted to adjust the percentage for the individual market only if the Secretary of Health and Human Services grants them a waiver because the Secretary determines that the health insurance market would otherwise be destabilized. Unsurprisingly, a total of 15 States have applied for a waiver from the MLR. This means that nearly one in three States has found that the MLR could destabilize their market and threaten consumers' coverage. A review of the data shows why States are concerned. According to a study published in The American Journal of Managed Care, the specific impactof the new medical loss rules on the individual health insurance market ``has the potential to significantly affect the functioning of the individual market for health insurance.'' Using data from the National Association of Insurance Commissioners, the study's authors ``provided state-level estimates of the size and structure of the U.S. individual market from 2002 to 2009'' and then ``estimated the number of insurers expected to have MLRs below the legislated minimum and their corresponding enrollment.'' They found that in 2009, ``29 percent of insurer-state observations in the individual market would have [had] MLRs below the 80 percent minimum, corresponding to 32 percent of total enrollment. Nine states would have atleast one-half of their health insurers below the threshold.'' The study explained the impact in ``member years,'' which requires some explanation. Most health insurance policies typically have a 12- month duration, but individuals can enroll or disenroll on a monthly basis. As a result, much of the accounting and actuarial calculations that a health insurance plan makes are in member month or year terms. A member year is 12 member months and could be one individual or multiple persons. For example, if an individual is enrolled for 12 months, that is one member year, or if two people are enrolled for just 6 months each, that is one member year. The study found that ``if insurers below the MLR threshold exit the market, major coverage disruption could occur for those in poor health,'' and they ``estimated the range to be between 104,624 and 158,736 member-years.'' This empirical analysis highlights the huge disruption American consumers may face. As health insurers consolidate, stop offering some insurance products, or exit the market place altogether, Americans who like the high-quality private health plan they have will lose it. This effect would undermine the President's promise to Americans that if they like the health care plan they have, they could keep it. There is a second concern: Instead of consumers receiving ``better value,'' consumers face increased costs. Despite often-repeated arguments that federally mandated MLRs will result in ``better value'' for consumers, there is little substance to back up this claim. The assumption behind this claim is that spending more cents of a health care dollar directly on care is inherently better. But this may not necessarily be the case. University of California, Berkley, professor Jamie Robinson has studied the issue of MLRs closely, and he noted in Health Affairs that the connection between the MLR and good value is not as clear as some would claim. ``The medical loss ratio never was and never will be an indicator of clinical quality,'' he said. In fact, Professor Robinson explained that ``neither premiums nor expenditures by themselves indicate quality of care. More direct measures of quality are available, including patient satisfaction surveys, preventive services use, and severity-adjusted clinical outcomes. Although each of these is limited in scope, they at least shed light on quality of care. The medical loss ratio does not.'' While the MLR cannot guarantee better value for consumers, it can lead to higher premium costs. As the Congressional Research Services explained, the MLR provision in PPACA requires health insurance plans ``to pay rebates to their members if a certain percentage of their premiums are not spent on medical costs. This provision may provide an incentive for health insurance companies to reduce their compensation to and/or utilization of producers as they seek to reduce their administrative costs in relation to their medical costs.'' In this scenario, unintended consequences are important to consider. For example, an insurer may increase premiums in another product to make up for lost revenues in one where a rebate is issued. Also insurers may be incentivized to scale back utilization management techniques as a result of the MLR requirement. Accordingly the underlying medical trend which drives premium costs would increase for everyone in the risk pool, therefore leading to higher premiums for all consumers who have a health plan with that company. Costs for consumers may also increase because of increased fraud in the system. Because insurance plans are economically discouraged from activities not directly connected to medical care, there is a perverse incentive to reduce efforts to police fraud such as conducting utilization reviews and data analysis to root out individuals who defraud the system. This is such a significant problem that it was highlighted in congressional testimony before a House subcommittee earlier this year. ``Given the role that health plan fraud prevention and detection programs have played in establishing effective models for public programs, improved data for law enforcement, and successful prevention efforts, we believe the MLR regulation's treatment of such programs should be reevaluated,'' said the witness. According to the testifying witness, the specific concern is `` the MLR regulation only provides a credit for fraud `recoveries'-- i.e., funds that were paid out to providers and then recovered under pay and chase' initiatives.'' This effectively discourages preventative measures: The MLR regulation's treatment of fraud prevention expenses works at cross purposes with new government efforts to emulate successful private sector programs, and it is at odds with the broad recognition by leaders in the private and public sectors that there is a direct link between fraud prevention activities and improved health care quality and outcomes. Ironically, this myopic focus on MLRs obscures the best tool to evaluate the value of a health insurance product: consumer choice. As Professor Robinson explained: The best indicator of current and expected future value in a market economy is the willingness of the consumer to purchase and retain the product. In health care, this translates into measures of growth in enrollment and revenues, adjusted for disenrollments and changes in prices. Plans that are growing are offering something for which purchasers are willing to vote with their dollars and consumers are willing to vote with their feet. Let me turn to my third concern. Consumers face fewer choices, less competition in the marketplace. As noted previously, the MLR threatens to destabilize several markets by pushing some health insurance plans to stop offering some insurance products, or exit the market place altogether. The Congressional Research Service explained this more in detail in a memo to Congress. CRS said the MLR ``requirements of PPACA will place downward pressures on administrative expenses, including the use of insurance producers. Thus, there will be an incentive for insurance companies to cut back on the use of producers or reduce their commissions in order to rein in their administrative expenses. Some observers, including associations of producers, have suggested that the regulatory and market changes resulting from PPACA could put producers out of business.'' The very allowance in PPACA for waivers from the MLR provision is a tacit admission the one-size-fits-all MLR approach mandated under PPACA is neither in the best interest of consumer choice nor competition among health plans in many insurance markets across the country. President Obama once publicly pushed for a government-run health plan under the auspices of more ``choice and competition,'' Unfortunately, the controversial health care law he signed is set to reduce choice and competition for millions of American consumers. Mr. President, finally, the new mlr mandates further the government takeover of health care. Much ink has been spilled about the claim that PPACA represents a government takeover of health care. In my view, there is no disputing this claim. Even before the passage of PPACA, the nonpartisan Congressional Research Service issued a report showing that 60 percent of health care spending in the United States is controlled by State, local, and Federal governments. Now, after passage of the controversial health care law, the Federal Government will effectively regulate health insurance markets and dictate what types of health coverage Americans can buy--even penalizing employers and consumers who do not offer or purchase coverage. The law also massively expands the Medicaid Program--a program that began as a Federal-State partnership but that has evolved into a gimmick-ridden program threatening State budgets and too often promising patients coverage while denying them access to care. The law also includes hundreds of new powers for the Secretary of Health and Human Services and creates dozens of new programs that will further interfere in the practice of medicine. Yes, the law is a government takeover of health care. Interestingly, the nonpartisan Congressional Budget Office warned that if the MLRs in PPACA were only slightly higher, PPACA would result in a complete government takeover of all health insurance. In a December 2009 analysis, CBO warned that if the MLRS were 5 percentage points higher, all private insurance would become ``an essentially governmental program.'' In fact, this CBO analysis--publicized before the health care bills became law-- may be one key reason the Democrats refrained from pushing for a 90-percent MLR. CBO warned that if a 90- percent MLR were adopted, ``taken together with the significant increase in the Federal government's role in the insurance market under the PPACA, such a substantial loss in flexibility would lead CBO to conclude that the affected segments of the health insurance market should be considered part of the federal budget.'' If the bills' authors had, in fact, included a 90-percent MLR, they would have faced critics waving a CBO analysis affirming the government takeover of the health insurance industry was complete. However, even with this determination, CBO appeared to admit that determining at what point a high MLR triggers a complete government takeover of the insurance industry was not entirely cut and dry. CBO said, ``Setting a precise minimum MLR that would trigger such a determination under the PPACA is difficult, because MLRs fall along a continuum.'' Mr. President, in the end though, CBO settled on 90 percent as the tipping point, though, as they noted, any ``further expansion of the Federal Government's role in the health insurance market would make such insurance an essentially governmental program, so that all payments related to health insurance policies should be recorded as cash flows in the federal budget.'' In other words, this was just about as close as the Democrats could get without even CBO admitting it was a complete government takeover of the health insurance markets.

Mr. COBURN

Mr. COBURN. Madam President, this is a straightforward amendment on a program that fails 70 percent of the time. We spend $35 million a year. It has an abject failure rate. Only 30 percent of it results in anything positive happening; 70 percent of the time it does not. The Obama administration and the Bush administration thought this program should be canceled. I reserve the remainder of my time.

Mr. COBURN. Madam President, what the Senator from Maine just said is that $4.2 million is going to be unsuccessful and $2.8 million might be. The fact is that with a $1.3 trillion deficit and a $15 trillion debt, we can't continue to do this no matter how great it sounds when it fails 70 percent of the time. I ask for the yeas and nays on my amendment.

Mr. COBURN

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

Mr. COBURN. Might I be recognized?

Mr. COBURN. This is an amendment that addresses something that is going on that I think we should not allow. We have a lot of great programs that help a lot of cities and States out by creating loans that allow the cities and States to do something. What is happening is, when the project we gave the loan for fails, they turn around and take Federal grants to repay the loan. All this amendment does is to prohibit us from allowing grants to be used to repay Federal loans on local or city or State projects. Mr. President, I reserve the remainder of my time.

Mr. COBURN. Mr. President, they did offer, but they told us they didn't have the time to work it out. The fact is, these are life-threatening emergencies. If one person dies because we don't do this, it is on our hands. I ask for the yeas and nays.

Mr. COBURN. Mr. President, is the next ordered amendment No. 796?

Mr. COBURN. Mr. President, $1 million a year and we are giving them money. We have a $1.3 trillion deficit, and we continue to hear the defense of that. It would be great if we do a new farm program. But the fact is, that is not a given. If we pass this amendment and we do a new farm bill, this amendment has no effect.

Mr. COBURN. Mr. President, we have 2,705 people in this country who had adjusted gross incomes in excess of $2.5 million last year who got farm payments--direct farm payments. This is an amendment that will limit adjusted gross incomes above $1 million from receiving direct payments. We hear we are going to change that system. We may change that system. But that has not happened yet. All this amendment says, if you make more than $1 million, you should not be eligible to receive a direct farm payment from this government. Rather than taxing the millionaires, the first thing we ought to do is quit giving them subsidies. I reserve the remainder of my time.

Mr. COBURN. Mr. President, how much time do I have remaining?

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

Mr. COBURN. Mr. President, there are 4,000 properties in the United States that get money from HUD for housing to help people whom we want to help. There are 450 owners who are chronically on the list of slumlords, who put the people who live in these houses in danger; they are at high risk for losing their lives in that property. This amendment only says that if you are going to continue to put these people at risk of losing their lives, then we are not going to pay you anymore. We are not going to send you money if you continue to be in this group of slumlords who are not spending any of their money bringing their properties up to date and you are leaving people at risk of significant harm. I reserve the remainder of my time.

Mr. COBURN

Mr. COBURN. Mr. President, I rise today to congratulate and commend an outstanding citizen of my State. Next Tuesday, October 25, Albert ``Kell'' Kelly of Bristow, OK, will take office as the new chairman of the American Bankers Association. Mr. Kelly is CEO Of SpiritBank in Bristow, part of a family-owned cluster of businesses which includes farming, ranching and banking enterprises. In fact, even now, Kell continues to work his 900-acre ranch whenever he is not traveling. Mr. Kelly is equally active in community affairs. He once served as an assistant district attorney and also was chairman of the Oklahoma Bankers Association, and he is currently chairman of the Oklahoma Turnpike Commission. No wonder Kell Kelly has been called the most influential non-politician in Oklahoma. Education, transportation, and local business development are all key elements of Kell's community involvement. He understands that the purpose of a community bank is to build a community. Kell is also a champion of empowerment. Five years ago he started a program among his bank employees, teaching them how to write letters and speak with government officials about public policy issues. So far, 65 SpiritBank employees have been trained to be volunteer citizen- activists regarding the various issues that concern them. Kell's insight as a community banker will be vital in rolling back the excessive intrusion into the day-to-day business of banking that is stifling our Nation's economic recovery Banking is not only a barometer of economic health but also one of the key drivers of an economy. Under Kell Kelly's leadership, we can expect the American Bankers Association to be a strong advocate for more sustainable and more responsible banking policy and, God willing, to lead the way to a strong and lasting economic recovery for our Nation.

Mr. COBURN

Mr. COBURN. Mr. President, I have talked with Senator Webb. Some of what he wants to do is probably fine, but we are absolutely ignoring the U.S. Constitution if we do this. We have no role, unless we are violating human rights or the U.S. Constitution, to involve ourselves in the criminal court justice system or penal system in my State or any other State. The Association of District Attorneys is against this. There are a lot of times interest groups are for something, but we have no business deciding from a central committee in Washington whether Oklahoma is meeting the requirements of its constitution rather than the U.S. Constitution. I would urge a ``no'' vote against this, and that we honor our Constitution.

Mr. COBURN. Mr. President, I ask unanimous consent to call up the following amendments en bloc, displacing the amendment that is present, but considering each one of them individually: amendments Nos. 794 through 797, amendments Nos. 799 through 801, and amendment No. 833.

Mr. COBURN

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

Mr. COBURN. Madam President, I wish to speak for a moment in regard to amendment No. 739, which is Senator McCain's amendment. Senator McCain has been very careful with this amendment, to make sure, in terms of enhancements, that he excluded those things that were most important to a lot of people in this country in terms of alternate transportation. This amendment, which limits the expenditures, mandatory expenditures on enhancements of the Highway Trust Fund money, does not include--in other words, it would not prohibit funding for bicycle paths, or pedestrian and bicycle facilities, pedestrian and bicycle safety, and education activities, the conversion of abandoned railway corridors to trails, for either trails or bicycle paths. It would not prohibit funding for environmental mitigation of highway runoff pollution, reduce vehicle-caused wildlife mortality, maintain habitat connectivity, and it would not prevent funding for the acquisition of scenic easements and scenic or historic sites. I think Senator Cardin might have related something other than that. I wanted to clarify that for my colleague who cannot be here. What a lot of Americans do not realize is that we have several hundred thousand bridges in our country that are substandard, in disrepair, or are at great risk for those who travel over them. And by mandating that 10 percent of highway funds have to be spent on nonhighway needs, at a time when our country is running massive deficits, has almost $15 trillion worth of debt--as a matter of fact, we are in excess of $15 trillion worth of debt right now, that we should make sure we only apply those enhancements to the things that are most specifically needed. We do have a commitment from Senator Boxer and Senator Inhofe that we will have some flexibility with enhancements in the future on the next highway bill. What Senator McCain is trying to do here will legitimize that and certainly does not harm the purpose of that. Basically what Senator McCain's amendment would do, funding this bill for 7 of the 12 transportation enhancement activities, is it would prohibit funding for scenic and historic highway programs, including tourist and welcome centers. We should not be building a welcome center when there is one bridge in any State that is a danger for the American people who are going across it. Landscape and scenic beautification are nice things. But you know, when you are down making hard choices about the things that are most important, that is not one of them. Historic preservation we cannot have as a priority now. Rehabilitation and operation of historic transportation building structures or facilities; we should not, in fact, spend that money on archeological planning and research when, in fact, we have dangerous bridges that people are coming across every day. Finally, although transportation museums are great, that cannot be a priority today when we are borrowing $13 trillion every year to keep the transportation trust fund at a level that will not allow us to increase the level at which we resolve these difficult bridges. We cannot continue to borrow that $13 trillion. So this is a commonsense amendment. It is a modification of what I have offered in the past. It is a smarter amendment. It is a better amendment. It still allows the bicycle community and the enhancements associated with that to continue. I would remind my colleagues, the Federal Highway Administration obligated $3.7 billion in enhancement funds for 10,857 projects between 2004 and 2008. That included $1 billion for signing, beautification, and landscaping. That billion dollars could have fixed well over 5,000 bridges that are dangerous today. There was $224 million on projects to rehabilitate and operate historic transportation buildings. Another 2,500 bridges could have been fixed for that. And $28 million to establish 55 separate transportation museums. It is not about not wanting the money to get out there, about targeting the bicycle community--it is absolutely protected in this-- but it is about ordering our priorities. If there is anything we have not done a good job of in Congress over the last 10 or 15 years, it is making hard choices about what is a priority and what isn't. I think the vast majority of Americans would think the safety of the bridges they drive across is more important than any of these things Senator McCain is saying we are going to limit in this bill. Of the 604,000 bridges in the United States in 2010, 24 percent of them are deficient. This includes 69,000 that are structurally deficient. In other words, they have significant deterioration, and they have had to have load reduction carrying capacity limitations placed upon them. And 77,410 bridges are functionally obsolete; they don't meet the criteria of design standards. These figures expose a nationwide problem of deficient bridges as well as the misplaced priorities of Congress. We need to fix this, and I am in support of the McCain amendment. I yield the floor at this time and suggest the absence of a quorum.

Mr. COBURN

Mr. COBURN. Mr. President, I ask the pending amendment be set aside and my previous pending amendment No. 792 be brought up. I have a modification to that amendment that I sent to the desk. I thank the Senator from California for giving me this privilege.