Bob Casey

Mr. CASEY

Mr. CASEY. I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 269 submitted earlier today.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today to join with Senators Kohl, Gillibrand and Shaheen to introduce the Senior Investor Protections Enhancement Act of 2009. This important legislation would increase the fines imposed on those who commit securities violations against seniors and thereby provide additional security to a group who relies on their savings for survival. Seniors increasingly rely on private investments for their retirement. Over the last 30 years, traditional employer sponsored pension plans, known as defined benefit plans, have been on the decline. In 1975, 88 percent of private-sector workers were covered by defined benefit plans; by 2005, that number had shrunk to 33 percent of the private-sector workforce. Today, seniors control nearly $15 billion in assets. These individuals face complicated decisions about how to best stretch their hard earned savings throughout their retirement. Unfortunately, these assets are at risk from traditional fraud and Ponzi schemes. Seniors are often offered complicated investment tools such as reverse mortgages and various annuity products. While these products can be very valuable to Americans generally and seniors specifically, they can also be abused by unscrupulous actors. In fact, research shows that senior citizens face serious risks from fraudulent salesmen. A MetLife study found that seniors incur an estimated $2.6 billion in losses due to financial abuse each year. In total, seniors account for more than half of all investor complaints received by state securities regulators. During the last Congress, under the leadership of Senator Kohl, the Aging Committee held a hearing to examine some of the questionable practices that so-called senior financial investment specialists use to gain access to the retirement savings of older Americans. A report by the Committee revealed that many seniors have lost their life savings because they followed investment advice ill-suited to their retirement needs and life expectancy. The Senior Investor Protections Enhancement Act will address these issues by increasing the penalties for existing securities violations by an additional $50,000 for financial crimes committed by those 62 and higher, the age at which many orient their investments to be in conjunction with social security eligibility. Violations could include selling them products that are unsuitable for their age, failing to disclose fees, charging large penalty fees, or switching the investment product actually sold from the one that was marketed. We need to enhance the protections afforded to seniors. Please join us in support of the Senior Investor Protections Enhancement Act of 2009.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today to join with Senators Kohl, Gillibrand and Shaheen to introduce the Senior Investor Protections Enhancement Act of 2009. This important legislation would increase the fines imposed on those who commit securities violations against seniors and thereby provide additional security to a group who relies on their savings for survival. Seniors increasingly rely on private investments for their retirement. Over the last 30 years, traditional employer sponsored pension plans, known as defined benefit plans, have been on the decline. In 1975, 88 percent of private-sector workers were covered by defined benefit plans; by 2005, that number had shrunk to 33 percent of the private-sector workforce. Today, seniors control nearly $15 billion in assets. These individuals face complicated decisions about how to best stretch their hard earned savings throughout their retirement. Unfortunately, these assets are at risk from traditional fraud and Ponzi schemes. Seniors are often offered complicated investment tools such as reverse mortgages and various annuity products. While these products can be very valuable to Americans generally and seniors specifically, they can also be abused by unscrupulous actors. In fact, research shows that senior citizens face serious risks from fraudulent salesmen. A MetLife study found that seniors incur an estimated $2.6 billion in losses due to financial abuse each year. In total, seniors account for more than half of all investor complaints received by state securities regulators. During the last Congress, under the leadership of Senator Kohl, the Aging Committee held a hearing to examine some of the questionable practices that so-called senior financial investment specialists use to gain access to the retirement savings of older Americans. A report by the Committee revealed that many seniors have lost their life savings because they followed investment advice ill-suited to their retirement needs and life expectancy. The Senior Investor Protections Enhancement Act will address these issues by increasing the penalties for existing securities violations by an additional $50,000 for financial crimes committed by those 62 and higher, the age at which many orient their investments to be in conjunction with social security eligibility. Violations could include selling them products that are unsuitable for their age, failing to disclose fees, charging large penalty fees, or switching the investment product actually sold from the one that was marketed. We need to enhance the protections afforded to seniors. Please join us in support of the Senior Investor Protections Enhancement Act of 2009.

Mr. CASEY

Mr. CASEY. Mr. President, today I wish to honor the members of the Women Airforce Service Pilots, WASP, hailing from the Commonwealth of Pennsylvania who have recently received our Nation's highest civilian award--the Congressional Gold Medal. Joan Frost, Julia Jordan, Ruth Kunkle, Eleanor Lawry, Kristin Lent, Barbara Posey, Florence Reynolds, and Lillian Yonally exemplify hard work, courage, and commitment to their country. The WASP were the first female pilots in America's Armed Forces. They were stationed at 120 Army air bases across America, from where they flew approximately 60 million miles in less than 2 years and in a variety of aircraft. Over 25,000 women applied to the program, a select 1,800 went through basic training, and 1,074 women graduated. The contributions of these brave women to the success of the United States in WW II cannot be minimized, and I am truly proud that several of these extraordinary women called Pennsylvania home. To each of these women, I would like to say thank you for your contribution to aviation. By going against convention, you broke important barriers and are the reason why female pilots fly in every type of aircraft and mission, including combat sorties, today. I am sure that each time a young person sees a black-and-white photo of a young smiling female pilot leaning out the window of her B-26 Marauder, she or he is inspired with a sense of adventure and a desire to discover the joy of flying that the WASP sought and achieved. Therefore, I again congratulate Pennsylvania's eight WASP and WASP nationwide. I wish you all the best as you continue to share your patriotism and courage with your family, friends, and communities.

Mr. CASEY

Mr. CASEY. Mr. President, I yield the floor.

Mr. CASEY. Mr. President, I rise tonight, as so many have, in the last several days, especially to speak about the nomination of Judge Sonia Sotomayor to be on the U.S. Supreme Court. As we all know, she is a distinguished Federal jurist who has been nominated to serve as an Associate Justice on the U.S. Supreme Court--a critically important decision that the Senate is charged with making to advise and consent on such nominations. Sonia Sotomayor's life story is an authentically American story. It is a story with which so many people in this capital and across the country can identify. It is a story of hard work and sacrifice. It is a story of struggle and triumph, overcoming barriers in her life that, candidly, many in this Chamber have not had to overcome. It is a story, like so many authentically and compelling American stories, that starts with her family and, in particular, her parents, not people of tremendous means or wealth. Her mother was a nurse, her dad was a factory worker, and she, unfortunately, lost him at a very young age. I think she was just 9 years old when her father died--a very difficult circumstance for anyone to overcome, especially a young girl. When we look at her record as a student, it is also a great American story of academic excellence, and I believe that is an understatement. Her record as a student through high school and then going on to Princeton and graduating with honors and going to Yale Law School and serving on the Law Review and being such a leader and a student in both college and law school--not only being a leader but also achieving academic excellence--is a record we would hope every member of the U.S. Supreme Court could bring to their nomination debate. I was reflecting the last couple of days about my remarks tonight, and I remembered that when our President, President Obama, was campaigning, I had the chance to introduce him a number of times. One of the times I introduced him, I was trying to convey the reality of what he had overcome, and it is very difficult to put that in a few words. But I said at the time, in one particular place in northeastern Pennsylvania, that then-Senator Obama did not have a path cleared for him, that he had to overcome barriers and obstacles in his life growing up, as a public official, and all the way to the Presidency. The same can be said of Judge Sotomayor. She had not, in her life-- and has not to this day--ever had a path cleared for her. She has had to work and struggle and achieve to get where she is today, to the point of being on the verge of being confirmed to serve on the Supreme Court. So I think it is very important to point out her life story, her remarkable life story, her achievements, but also to speak, as we must, and as we should, of her judicial expedience. We hear all kinds of comparisons, when someone is nominated to the Supreme Court, about how many years they have served as a judge, how many years they have served as a lawyer or as an advocate or as a public official--whatever their background is. But it just so happens this particular nominee, Judge Sotomayor, has more judicial experience, I am told, than anyone currently sitting on the U.S. Supreme Court--all distinguished in their own way. But if you add up the years, I guess it is 17--first on the district court, the trial court in New York, for the Southern District of New York--nominated and confirmed by the Senate--and the same when she was confirmed and served as a judge on the U.S. Court of Appeals for the Second Circuit at the appellate level. In both of those appointments, she gained enormous experience on the very matters that will come before the U.S. Supreme Court. First, she was on the district court where you have litigants coming before you, for example, in a trial or in a hearing--sometimes a criminal matter that involves someone's liberty, involves law enforcement issues, and all the complexities of our human condition in the context of a criminal case. Also coming before that court are very complex civil matters, and I know the record is replete with references to her rulings in various cases involving civil, criminal, and other matters. Then she went to the appeals court, working in a different court, with a different set of issues and, candidly, a different procedure, where someone is appealing to the Federal appeals court, in this case, in the U.S. Court of Appeals for the Second Circuit--all the complexities that involves, where you are not taking testimony as you do in a trial, not making determinations of fact, you are deciding the law, what the law should be, how to apply the law to the facts in the record, which is already established. Both are very different judicial responsibilities, but both are very important to serve on the ultimate appellate court, the top court in the land, that being the Supreme Court. So she has had broad and unprecedented experience as a Federal judge for 17 years. That is very important in this debate. She also served as a prosecutor dealing with all of the complexities and all of the difficulties that any prosecutor encounters, dealing with victims and the impact of a crime on a victim and his or her family, dealing with the impact of crime on a community and in a jurisdiction, dealing with judges and witnesses and law enforcement with whom often you work so closely--the prosecutor--to develop your case, to marshal the evidence that a prosecutor has to put before a judge and jury. That experience is particularly relevant because a number of the cases the Supreme Court will hear--and they do not hear every case; they take a number of cases per year--some of those cases will involve the rights of one party versus the other, will involve the rights of a criminal defendant versus the State. There are very complex matters that a Supreme Court Justice has to decide. So whether you look at her experience as a prosecutor, as a Federal district court judge, a trial judge, or her experience on the appellate court--hearing appeals at the Federal level--all are very relevant to and I think prepare her well for her service on the U.S. Supreme Court. Two more sets of experiences--one as a lawyer. I think it helps when you have been an advocate, a lawyer, to have that as part of your experience serving on the Supreme Court, where you have had to take on a battle for a client, to be their advocate, sometimes in very complicated matters, sometimes matters that will affect their lives in ways that will alter the course their life is taking when they have a matter before a court. Finally, her life experience. I would hope we nominate people to the Supreme Court who have a broad life experience, who have not just been in one area of a profession, but also have had challenges in their lives they have had to overcome because the people who come before the Supreme Court may be a little bit distant, but often arrive there after months or years or longer of struggle. I think Judge Sotomayor has a life story that indicates she not only understands struggle and understands how difficult life can be, but also has an appreciation for the complexities of life as well. She has been described, as a judge and as a prosecutor, as both tough and fair--tough and fair. That is a good description that you would want, when you are evaluating the role and the record of a Supreme Court Justice--someone who asks difficult questions and probing questions as a member of the Court, but also someone who is fair, who does not seek to gain an advantage over a lawyer in the course of an argument but is both tough and fair. I believe integrity is a central consideration that Senators should weigh when we are deciding who serves on the Supreme Court after a President nominates. We want someone with broad life experiences. We want someone with experience in the law and often as a judge. But we also want someone who has character. I got a sense of that when I met with her. I also got a better sense by reading the long list, which I will not read tonight, of all the organizations that have endorsed her. They did not just endorse a set of cases. They did not just endorse a resume. They endorse and give their support to a human being, a person who has had tremendous experience. And part of that, of course, is integrity. I think we saw both her integrity and her temperament, which is another very serious consideration. But we saw both of them tested in the course of her hearings, where she was asked a lot of tough questions by members of the Senate Judiciary Committee on both sides of the aisle, Democratic Senators and Republican Senators--hour after hour after hour, day after day, under very difficult circumstances, on live television, with all of the pressure that every word, every response is weighed and scrutinized and criticized often and examined. I think both her integrity and her temperament were on display, and, in my judgement, she passed both of those tests in considerations we have to weigh, that she passed them so easily and so effectively. I would make two more points. Inscribed over the building that houses the courtroom where the U.S. Supreme Court meets--that historic room where so many great cases have been decided--inscribed over the building, above it, is the phrase we all know well: ``Equal Justice Under Law.'' ``Equal Justice Under Law.'' That is what we expect certainly of every judge, even lawyers, but especially someone who becomes a U.S. Supreme Court Justice; that they would have that philosophy in every case, but also the reality that precept entails, that they would approach every case, every litigant, every party with the same approach, dispensing equal justice under the law--not equal justice under my law or equal justice under a philosophy of, in this case, Judge Sotomayor as a Supreme Court Justice, not her definition of what the law is, but what the law is, in fact, that she is required to apply. That equal justice under law is not just something inscribed above that building. I believe, based upon her record, based upon her experience, and based upon her character, she believes that and will be governed by that as a member of the U.S. Supreme Court. I conclude with this thought. When President Lincoln was speaking at Gettysburg, PA--a place we all learned about as children and learned about the Gettysburg Address and the meaning of it and the enduring value of that speech--in one of the lines Lincoln used in that speech, he was talking about the Nation being tested at a time of war, and, unfortunately, at that time, a time of civil war, the worst of all wars. He was posing the question about this Nation that had been conceived not too long before he gave that speech. He said that one of the questions he posed was whether a nation so conceived can ``long endure,'' whether our Nation could long endure, that we were being tested at a time of war. I believe our Nation has been tested at other times as well, not only in something as grave as a war, but we are tested in other ways as well. We were tested in the Great Depression, whether we could endure the misery and the difficulty, the joblessness of that, and all of the problems the Depression brought to America. We have been tested in other wars. We were tested in the battle for civil rights. We have been tested as a nation very often--maybe not every day, maybe not every week, but at some period of time in our lifetimes, we can see how our Nation was tested. In some ways, we are tested when debates occur in the Senate. We are tested in terms of appointments that a President makes. In this case, President Obama has nominated someone to the U.S. Supreme Court who I believe will allow us to be able to say that as long as we are nominating people with the experience, the character, and the integrity of Judge Sonia Sotomayor, this Nation will long endure. I have no doubt about that. I say that with as much confidence as anyone could because her record demonstrates that. Her experience demonstrates that if we have people such as Judge Sotomayor in the U.S. Supreme Court, this Nation will not only long endure, it will indeed thrive under that kind of judicial excellence and that kind of experience she will bring to the bench. So I have no hesitation at all in saying that I will vote for her confirmation to be an Associate Justice of the Supreme Court. We can be proud of her record and her experience but also her remarkable and authentically American story. Before I conclude my remarks, I ask unanimous consent to have printed in the Record a letter of endorsement for Judge Sotomayor that the Judiciary Committee received on July 15 from the National Hispanic Christian Leadership Conference, serving approximately 16 million Hispanic American born-again Christians and 25,434 member churches across the country.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today to address a topic we have been debating for many weeks and months but especially the last couple of weeks, and that is health care. We have spent a good deal of time in Washington talking about the details of various provisions, the different ideas that have been introduced in bills and through the work of the committee. I happen to be a member of the Health, Education, Labor, and Pensions Committee, known by the acronym ``HELP.'' In our committee, we spent about 60 hours in hearings and 25 hours or so in discussions with our Democratic and Republican colleagues, working through some ideas. We accepted about 160 Republican amendments before our bill came out of committee. As you might know, the vote in committee was 13 Democrats voted for it, 10 Republicans voted against it. But despite that divide in the vote, there was a good exchange on important issues. Mr. President, you know as well as I do some of the issues with which we are wrestling. We want to try to provide the President a bill that, first of all, in a general sense, provides stability--stability with regard to cost, lowering the cost and also controlling cost, and stability with regard to choices. I believe what we are going to send to the President this fall will allow people to keep the health care they want to keep if they like what they have and are happy with it. But if you don't have any health care or you have a plan that costs too much or is of poor quality, you can choose another option. I hope the options will be both private plans and a public option, but that is a point of contention we will be talking a lot about as well. Finally, we want to make sure there is quality, at long last that we reach a point where we are introducing quality measures into our health care system. Theories and proposals and strategies have been talked about too much and not enacted or put into the law. There are a lot of good examples by private companies across the country that have wellness policies, that invest in keeping people healthy so they do not have to spend money from our health care system treating a disease-- getting out ahead of a problem, so to speak. And there is prevention, with all kinds of ways to save lives, to improve quality, and to save money as well. I wanted to walk through some provisions in some detail, not to take too much time because I know we are at the end of our week. First is the fundamental urgency of where we are now. I believe we cannot wait. We have talked this issue to death for the last 15 years especially, since the early 1990s. But even if you look at it beyond that, for about 60 years or so since President Truman introduced this idea of doing something substantial on health care, we have talked about it. The time for action is now. In my judgment, this is no longer just a nice thing to do. It is a necessity for our economy. We cannot even begin to imagine a strong economy over the next decade or longer without health care reform. More American families are unable to get the coverage they need. So where we are now, the status quo, is not just unacceptable, it is economically unsustainable as we debate this issue today. Let me go to the second chart with that same concept about it being unsustainable, the status quo, staying on the road we are on. Premiums have doubled over the last 9 years, three times faster than wages. If we do nothing in the next 30 years, a third of our economy will be spent on health care. That is unsustainable. Health care spending will increase from $2.5 trillion to $7 trillion in the period between now and 2025. This might be the most stunning set of numbers of all. Every week, 44,230 people lose their health insurance. We cannot say that enough. We cannot repeat that number enough. How can we build an economy, how can we be a successful, vibrant, growing economy when every single week 44,230 people lose their health insurance? We could chart this just from the time our committee voted the bill out of committee a couple weeks ago in the HELP Committee. Every week since then, more than 44,000 are losing their health insurance. This is a Pennsylvania number, roughly a 3-year number. From January 2008 to December 2010, the projection is that 178,520 people will lose their coverage. For our State, the Commonwealth of Pennsylvania, that is unsustainable. We cannot grow an economy with those numbers. Without reform--this is a State of Pennsylvania number--family coverage would cost $26,679 in 2016, consuming 51.7 percent of projected Pennsylvania family median income. I don't know of any family in America, even a very wealthy family, who can pay half their income to health care, certainly not a middle-income family. But that is the road we are on. That is going to happen if we stay where we are and stay with the status quo. And that is 7 years away, that is not 25 or 30 or 50 years. In 7 years, staying on the road we are on means the average family in Pennsylvania is going to have to pay more than half their income to health care. To say that is unsustainable is something that is an assertion of an understatement by a mile. Here are some of the themes I talked about before--stable costs, secure choices, and quality care. These are some of the themes we have to keep mentioning. On the lower cost issue, preventing illness and disease, as I said before, does have a cost implication. It is not all the savings, but we know from research and experience that we will have savings. Uncompensated care. This is a factor we can consider today. People think: I have health care. There are uninsured people out there, maybe 50 million people uninsured. Someone who has health care might think: I wish they could get coverage, but I am afraid if they get coverage, I am going to be paying more. That is a lot of the debate. But what we fail to realize sometimes in the debate is people are paying right now for the uninsured. Having uninsured Americans is not free. We all pay for that, and by one estimate, $1,000 per year for every American who has health insurance. One of the things we are trying to do in this legislation is to cover 97 percent, or one bill might have it at 95 percent, but above 90 percent of Americans is the goal for coverage. I go to the next chart on reducing waste, fraud, and abuse. One estimate is we could save $60 billion per year. Some say that is an estimate and that is just what one group said. Let's say it is wrong. Let's say it is not quite $60 billion. What if it is off by a little? What if it is $40 billion? That is still a lot of savings. What if it is $30 billion? What if they are way off? That is a lot of savings every year. But we are not doing that today, preventing that kind of fraud, waste, and abuse. Capping out-of-pocket limits. Even when they have the benefit of health care delivery, the out-of-pocket costs keep going up and up. So many small businesses worry about this when they are forced, if they want to employ people, to pay more and more, and forcing people to pay more out of their own pockets. Small businesses and individuals join purchasing pools for lower rates. The reason that is important is because all the desks in this Chamber--every one of us has health care, really good health care, if you are a Federal employee. Thank goodness. I am blessed by that health care. My wife and my four daughters and I all benefit from that, just like every Member of the Senate and every Member of the House and everyone who works in the Federal Government. That is good. Guess what. The reason we have health care and choice of lots of options and plans is because we pool all those people, millions of Americans who happen to be connected in some way to the Federal Government pool. They are in one pool, and that keeps costs down. Why is that good enough for Senators and Congressmen, why is that available to them but small businesses don't have the same plan or the same option available to them? I think every small business in America should have the benefit-- the cost-reduction benefit, at a minimum--that comes from pooling their resources and their individuals. That is part of the reform we are talking about. It is not a concept, it is in the bill. And that is important to emphasize. Finally, if you like what you have, you can keep it. I said that earlier. We should keep saying that because it is important. Ensuring coverage even when families move, lose a job, or have an illness--why in America, if we can figure out so many complicated things, can't we guarantee when someone loses their job they will not lose their health care? It does not make sense that we have accepted that, tolerated that inequity for so long. ``Gateway'' is a word about which we have been hearing a lot. What does that mean? It is really a marketplace. It allows people to go to a Web site and find out what they want in their health care plan, not having to read hundreds of pages of fine print that the best lawyers in America sometimes do not understand. A marketplace is a gateway that allows families and businesses to compare rates, benefits, plans, both private and, we hope--we hope--a public option. Why can you go online and learn about a car or some other major purchase in your life and you can't do the same thing for health care? It is ridiculous, in a word. That is what this would allow--giving people the ability to do just that, just as they do for every other major purchase in their life. Secure choices is important. Individuals will have their choice of doctors and individualized care. Government and insurance will not interfere in the doctor-patient treatment decisions. I know there is a lot of talk about government getting in the middle. It is just not true, and people know it is not true. We have to make sure people understand that is a fundamental building block of what we are talking about. We want people to be empowered, we want them to have more choices, and we want them to have the choice of both the public option and private plans as well. I am almost done, Mr. President. My colleague from Arizona is here, and I want to make sure he has his time on Friday to speak. This is bill language. Sometimes we talk about concepts, and the American people never get to the point of seeing in front of them language from a bill that is actually understandable and is focused on the real problem. One of the biggest problems people in our State and a lot of States run up against is a preexisting condition prevents them from getting treatment. It is unbelievable that we have tolerated that for so long as well. Why can't we say we are going to pass a law that at long last says a preexisting condition will not prevent you, your son, daughter, spouse, or loved one from getting the care they deserve? We should not have to do it. Insurance companies have forced us to legislate, to make this the law. Here is the language. It is not complicated. It is not mysterious. It is not lawyer language: A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition exclusion . . . Let me read that again: . . . may not impose any preexisting condition exclusion with respect to such plan or coverage. That is in the bill. It is not a fuzzy concept, it is very specific. One of the reasons I and so many others are saying we cannot stay on the path we are on, we cannot accept again and again the status quo, is because of that--because the status quo means ``may not impose any preexisting condition exclusion'' does not become part of the law and we have to continue to deal with the horrific and inexcusable nightmare of a preexisting condition preventing someone in America, someone who might be very sick in America, from getting treatment, from getting the benefit of health care they ought to have a right to expect. So when we pass this bill, we have to make sure people understand that is in the bill, and that is very specific and it is very pointed and focused on a real problem for families. Finally, children. One of the goals here, obviously, is to make sure that no child, especially poor children and those with special needs, is worse off as a result of this bill. Children are different from adults. They can't be treated the same way. They need strategies and treatments that adults don't have. They have different health care needs. It is critical that children, especially those who are disadvantaged, who happen to be poor, who have special needs, get the highest quality care, which they deserve. That is why I have a resolution as part of that which I have introduced. Finally, with regard to children--no child worse off. Because we want them to grow into healthy and productive adults, they need to get the highest quality care throughout their childhood. We want them to get from this picture in a crib to that picture getting a diploma. So we want them to have the kind of quality health care that will allow us to prevent disease and illness in a child early enough which will allow them to lead a productive life and get ready to contribute to our great economy and to our great country. There is a lot to do. There is still more work to do, but we need to continue to talk about what is in these bills and to have a vigorous debate. We are a long way from getting this done, but I believe we are on the right track. I believe it is not only important, but unless we do this, I think we are heading down a path that is unsustainable for our economy, for our country, and especially for our families. Mr. President, I yield the floor, and I suggest the absence of a quorum.

Mr. CASEY

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

Mr. CASEY

Mr. CASEY. Mr. President, I rise today to join my colleagues in addressing one of the biggest issues facing our economy and our country; that is, the threat posed by global warming. This challenge presents us with an opportunity as well. It is the opportunity to revitalize our economy while simultaneously changing our national energy policy to reduce our dependence on foreign oil and to increase our energy efficiency and conservation, which will save money for the people of Pennsylvania, as well as people across the United States. We have a long debate ahead and a lot of issues to discuss, but I believe it is critically important, in these weeks in the summer leading up to the break Congress will take, to begin the debate, which I know will continue into the fall and maybe beyond that. I do agree with a majority of accredited climatologists and scientists that human-caused global warming is a threat. Specifically, global warming is a threat to our economic and national security. It threatens our economic security because the problems we face become more expensive the longer we do not act. If the past is any indicator of our future, we should be concerned that over the past 28 years--1980 to 2008--the cost of the 90 largest weather events that happened in that time period was $700 billion--$700 billion attributable to those weather events. If we do nothing and the worst-case scenarios become a reality, mitigating the change in our climate will be expensive and difficult. Global warming threatens our national security by setting off a chain of events that could lead to decreased food production, relocation of large numbers of people, an increase in extreme weather events, and a rise in sea levels. Like many Americans, I came to understand this challenge in a way that was very poignant. I remember reading a Time magazine story a few years back, and it talked about the percentage of the Earth that has been the subject of drought. That percentage of the Earth's surface that has been the subject of drought doubled in about 30 years. That is all we need to know. We know what drought means: it means disease and hunger and darkness and death. That is the threat posed by global warming. The threat is real enough that we are now currently assessing the readiness of our military to protect us and keep the peace should global warming continue unchecked. One area of the world we are examining in that analysis to determine the impacts is the region that encompasses Pakistan, India, Afghanistan, and the Indus River that is fed by the Himalayan glacier which all three countries share. The changing global climate is causing that glacier to retreat; that is, to melt and disappear. Once the glacier is gone, the Indus River is expected to lose 30 to 40 percent of its waterflow. India, Pakistan, and Afghanistan are already water-stressed countries that rely heavily on that river. I don't think I have to explain to this Chamber or anybody else the national security implications of that threat, especially with regard to Afghanistan and Pakistan. What a permanent drought would mean for countries is those countries not having enough drinking water and not able to grow food in those countries as a result of that threat. I understand this may seem a long way off to the people in Pennsylvania or in other States around the country who at this time, and at a time of economic stress, are leading lives of struggle and sacrifice and real hardship. They are struggling to keep their jobs, pay their mortgages, put their kids through college, or pay for this week's groceries. What we do on climate change does affect their lives directly--not indirectly, directly. I wish to talk this morning about the economy and jobs as it relates to this issue. We all know things are tough for so many people right now in our country. We are suffering through the worst recession since the Great Depression. But I think it is time--instead of talking about how we got here on a day like today--to focus on the future. One of the solutions is transforming the way we produce and use energy, which saves bill payers money and creates new jobs along the way. The good news is that these jobs are not the same hazy concept as relates to the future. We are creating clean energy jobs right now in Pennsylvania. To give one example among many I could cite, Aztec Solar Power in Philadelphia employs a team of solar experts, certified electricians, installers, and energy consultants to build systems for residential and commercial buildings. Not only is Aztec employing Pennsylvanians in clean energy jobs now, they plan to expand their business. The company is constructing a $10 million manufacturing facility in York, PA, and will create over 100 new jobs. I believe we in this country on this issue are right at a crossroads. One direction we could take--and some people in Washington want to take this direction--is business as usual, keep losing jobs, keep losing our competitive edge to countries such as China, which is outinvesting us and outinnovating us when it comes to new energy technologies and the jobs that come from that. I believe we can take a different direction. We should move down a different path, a path where America will reclaim its competitive edge, bring manufacturing jobs back home to Pennsylvania and States across the country, give us the opportunity to manufacture new technologies for exporting those technologies to other countries, and create a new economic engine that will put people back to work. This is a strategy for economic renewal. Creating a new energy policy with a focus on building clean energy jobs and innovative energy technologies will take time. Indeed, it will take time, but it will also take leadership. It will take the dedication, the know-how, the ingenuity, and the innovative skills of the American worker. A lot of those workers are in Pennsylvania. So the choice before us is clear: We can stay on the road we have been on, which we know leads to not just more drought and darkness and death but also leads to job loss in the end because our economy won't have the dynamism to compete with places such as China, or we can take a different path--the path of change, the path of reform, the path of not doing business as usual. I think it is time we create policies that will rebuild our economy and create permanent new energy technology jobs in Pennsylvania and in States across the country. We know how to do this. We have done it before, throughout our entire history in our State as well as States across the country. We have to do it again. Madam President, I yield the floor, and I suggest the absence of a quorum.

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

Mr. CASEY

Mr. CASEY. I yield.

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

Mr. CASEY. Mr. President, I rise to speak of an issue that has dominated a lot of the time and attention--appropriately so--of this Senate, of the Congress overall, and the American people. Of course, that is health care. We have heard so far a vigorous debate but, in my judgment, a debate that has not had nearly enough facts on the table. Some of those facts, of course, are the facts as they relate to what is in the legislation. Right now, what is before the Senate is one bill, the Health, Education, Labor, and Pensions bill, which came out of our committee. I am a member of that committee. It came out a few weeks ago with 13 Democrats voting for it, 10 Republican Senators voting against it. We await anxiously the deliberation, further deliberation and the markup and the amendments which will lead to a vote in the Finance Committee. We do await that with a lot of anticipation. That will cause further debate and properly so. But I rise to speak on two or three topics as they relate to where we are now. One is the question of the ``cost of doing nothing,'' the cost of staying on the same road, the status quo, because that is one choice for the American people. The other path is the path of change and reform, standing and working with President Obama to create the kind of stability the American people should have a right to expect from their health care system. That stability should relate to and is framed by a number of important considerations--certainly stable cost. Too many Americans, even though they have coverage, see the costs going up all the time, and they cannot afford to pay them. Whether they are in a family or whether they are running a small business, we need to give them, through this legislation, stable costs going forward into the future. We also need to make sure we have stability as it relates to quality. Millions, tens of millions of Americans, are covered by a health care plan from a health insurance company but are not getting the kind of quality that they deserve. That is a real indictment of our system. Strong as it is in some other areas, it is pretty weak in some of our quality indicators. Thirdly, I think we want to make sure we ensure stable choices. The American people have a right to expect, at the end of the road of this legislation, when it is sent to the President--I sure hope we can get there; I think we can--that the President will be able to sign a bill that has a sense of stability as it relates to choices. Why is it the American people should not be given choices not only from a menu of private options but also be given the opportunity for a public option--not a public option that is vague and overreaching but a public option that has the same rules, that every insurance company has to develop a plan. In other words, that the plan will be solvent, that the plan will be self-sustaining. All those features would be part of the public plan. But the threshold question still is: Do you want change? Do you want to stay on the road we have been on, the status quo? I speak about the people of Pennsylvania, but I also know these numbers I will cite have a national implication as well. If we do nothing, if we stay on the path we are on--now it is 2009-- by 2016, according to one report, by the New America Foundation, here is what happens in Pennsylvania if we do nothing, if we stay on the road that is called the status quo, the do-nothing, let's not change road. Here is the result from page 86 of the report. By 2016, Pennsylvania residents will have to spend nearly $27,000 or close to 52 percent of median household income to buy health insurance for themselves and their families. This represents a 93 percent increase over 2008 levels and the sixth highest premium cost in the country. I have not found yet, and I do not think I ever will find, a family in Pennsylvania, rich, middle income or poor who will walk up to me and say: You know what, you should not do anything about health care. Everything is fine. We should stay on the road we are on. When it comes to 2016, my family and I can afford to spend 52 percent of our income on health care. I do not think we are ever going to find anyone in Pennsylvania or America who will be able to make that statement because no one can afford that. But make no mistake about it, that is the path we are on right now as it relates to the cost to families across the country. Here is another segment of this report on the same page--again, as it relates to Pennsylvania. People seeking family health insurance through their employers in Pennsylvania will have to contribute-- Meaning by 2016-- more towards premiums than residents of all but one state. The people of Pennsylvania will also experience the second greatest percent change in their premiums contributions nationwide. By 2016, people in Pennsylvania seeking family coverage through their employer will contribute almost $9,000 to the cost of the premium. To be exact about it, we are talking about a premium increase from $3,510 in 2008 to $8,830, almost $9,000, for health care. I don't think I will run into anybody in Pennsylvania or America who says: Let's stay where we are. Everything is wonderful. Don't pass any bill. Don't worry about getting it done. We can afford to stay on the path we are on. In a word, that leads to, if anything, instability for a family, the inability to make ends meet for a small business. That is the road we are on right now. At some point in this debate, there are going to be people in the Senate and House Members across the way who will have to decide which team they are on. In my judgment, there are two teams: the reform and change team President Obama has developed and the set of policies behind that or the ``let's not change, everything is OK, let's stay on the road we are on and let's stay with the status quo.'' In my judgment--and I know the people of Pennsylvania pretty well-- people will support change, because the road we are on now is a road to ruin when it comes to our economy, when it comes to the bottom line of families and small businesses. Every week, 44,230 people lose their health insurance. That is unsustainable. We can do all kinds of positive things in our economy. We can talk about creating jobs and doing all of the actions we hope to do to build a strong economy, but when we are a country where 44,230 people every week lose health insurance coverage, we are all in trouble. For Pennsylvania, between January of 2008 and December 2010, a little less than 3 years, 178,520 people are projected to lose health care coverage. Again, I don't think we can stay on the road we are on right now. Let me share some thoughts about the other debate on cost. What I have outlined is the cost of doing nothing. The cost of doing nothing is very high. In fact, it is unsustainable, if we are to have economic growth and families and small business stability. Two or three quick examples of ways the Senate HELP Committee bill, the Health Choices Act, helps to bend the so-called cost curve to bring costs in line over time. In 2000, the Institute of Medicine conducted a comprehensive study of the economic cost to society of the uninsured, arising from poor health and shorter lifespans. An update of that study by the New America Foundation estimates that the economic loss is now up to $207 billion a year. By contrast, the CBO recently, when analyzing the House bill, said that it would cost some $202 billion in 2019--not today, 2019-- less than the savings to the economy from covering the uninsured. The bottom line is, we are spending currently per year $207 billion in terms of the cost resulting from poor health and shorter lifespans. One doesn't have to be a math major to cost that out over 10 years. Just add the zero. It is entirely possible from this formulation that if we are losing $207 billion to poor health and shorter lifespans as a result of the uninsured, we are talking over 10 years about $2 trillion by that estimate. We can choose to stay on the road we are on, which means we lose more than $200 billion every year because of what is happening to the lives of people who don't have health insurance. It is not free. By one estimate, every person pays about $1,000 a year because others are uninsured. The idea that if we cover more people somehow that is going to cost people money, it is already costing people money today. I argue we should abandon the idea of doing nothing. We should abandon and not even discuss the idea of staying on the road we have been on. The road we are on right now means people in Pennsylvania will pay more than half their income to health care, will continue to be part of the loss of revenue of over $200 billion each and every year. And finally, small businesses won't be able to make ends meet with those kinds of numbers. We will continue to talk about costs and how we can reduce cost. That is an essential item and priority in this debate. But we also have to talk about what is happening to people right now and what is the cost of doing nothing. The cost of doing nothing is far too high for any American and, candidly, for any country to sustain. We cannot stay where we are now. We have to bring about change. I believe we will do that this year, if we choose to be on the right team in this debate. I suggest the absence of a quorum.

Mr. CASEY. Mr. President, I ask unanimous consent that I be permitted to speak for up to 10 minutes as if in morning business.

Mr. CASEY

Mr. CASEY. I will submit for the Record only two pages of this; it is a long report. It includes the cover page and then a page on Pennsylvania which I will briefly refer to, and then I wish to talk about how the report implicates and examines the information on the chart I have on my left. Here is what the report says on page 86 for Pennsylvania. It is true of a lot of States, but unfortunately for Pennsylvania, it is a higher number. I am quoting from part of page 86: By 2016---- Just 7 years away---- Pennsylvania residents will have to spend nearly $27,000, or close to 52 percent of median household income to buy health insurance for themselves and their families. This represents a 93 percent increase over 2008 levels and the sixth highest premium cost in the country. So in Pennsylvania, if we do nothing, if we stay on that road to the status quo, which I believe is the road to ruin when it comes to the budgets of our families and our businesses--if we stay on that road, for Pennsylvania, it means that by 2016, the people of Pennsylvania will be paying 52 percent of their median household income to buy health insurance for themselves and their families. That is what it means. That is what the status quo is. That is where we are headed if we say, Well, we couldn't get the job done here in Washington. The chart on my left is also a chart that reflects the work of the New America Foundation, ``The Cost of Doing Nothing.'' These are U.S. numbers between 2008 and 2016. The cost of premiums now, as of 2008, is $13,244, going up to $24,291; in just 8 years, an 83.4 percent increase. That is the status quo. That is where we are headed. That is where we are going if we listen to the voices in Washington that say it is too tough to do this. People are not ready for this yet. There are too many powerful special interests telling us not to do it. It might be insurance interests, it might be business interests, or it might be very partisan politicians telling us we shouldn't do this. That is the cost of doing nothing. That is the status quo. I will go to the next chart which again is from this report, ``The Cost of Doing Nothing,'' and this is a U.S. number as well: Share of household income spent on premiums climbing. As I said, in Pennsylvania, where the share of median household income would go up to 52 percent, in those few short years, 7 or 8 years--the U.S. number fortunately for the rest of the country is a little less, but it is still very high. So if we do nothing, if we stay where we are and do the same old thing--runaway costs, lower quality, no prevention, all of the things we are not doing now--we will go from a median family income, them paying 26 percent of their income for health care, which is high in and of itself, to paying over 45 percent of their income for health care. Again, this chart depicts the status quo, the cost of doing nothing. When we talk about costs here, we have to talk about the cost of doing nothing. What people are paying now is in my judgment too high. We ought to try to bring that number down, but we should certainly avoid at all costs that number going up for the American people. I don't know too many families out there--maybe there are a few--but I don't know too many families in America and I don't know any in Pennsylvania who have come up to me and said, You know what. Don't worry about getting health care done because in 7 or 8 years I will be able to afford 52 percent of my income to go to health care. I haven't heard that from anybody in my State. I doubt there is anybody in America who will say, You know what. Let's not do anything. Let's stay on the road we are on. I can afford and my family can afford to pay 45 percent of our income to health care in a couple of years. Don't worry about it. We are going to be fine. So that is what the status quo is, and that is where we are headed. Finally, I would conclude with this. When we listen to the voices of the American people, people such as Trisha Urban, as I mentioned before, who in her letter to me of February, right in the middle of the letter said this: She talked about her husband having to make a change, that he had to leave his job for 1 year to complete an internship requirement to complete his doctorate in psychology. So as he is trying to advance his education, he pays a health care price. That is another whole part of this story, before he died. She said the internship was unpaid and they could not afford COBRA. Why should a change in someone's life to improve their education to complete a doctorate affect their health care? That is the system we have. That is the status quo. But then she says: Because of preexisting conditions, neither my husband's health issues nor my pregnancy would be covered under private insurance. Because of preexisting conditions. So because her husband had a heart problem and because she was pregnant, that works against them. That is the system we have for too many families. So when people talk about: Oh, the HELP Committee passed a bill, the Affordable Health Choices Act, which I believe does stabilize costs and ensures quality and secures our choices, it is more than that, it is more than the headlines and the descriptions. We can go right to the bill language and show how this legislation, in a very specific way in a number of instances, responds to what Trisha Urban has told us in her letter, what she has challenged us with. She didn't write to me to say, Well, this preexisting thing is kind of a nuisance. It was a bar, an impediment to her and her family getting health care, basic health care. Why should this even be something we have to legislate about? One would think that in America today, with all of the wealth we have and all of the great power, we would have fixed this years ago, but we have families who are not getting health care because the insurance company says you have a preexisting condition. Sorry, you have to wait; or sorry, you get no treatment at all. That is the status quo, and that is one of the costs of doing nothing. How do you calculate a preexisting condition being a bar to you getting coverage? I don't know. I know one thing: Despite all the talk in Washington about what this might mean, who is arguing with whom, what the debate is about between Democrats and Republicans, in this bill we answer Trisha Urban's question on preexisting conditions. Here it is. This is bill language not some talking point or some general description. This is in the bill that sometimes people in Washington don't want to examine because the language is reform. The language is against the status quo. The language on this provision, especially, is a dramatic change in policy--something the insurance companies have not wanted to do on their own. The American people are finally saying, through their elected representatives and this bill, that we are going to make sure preexisting conditions don't bar treatment, that preexisting conditions don't prohibit Trisha Urban and her family from getting the kind of health care they deserve. Here is what section 2705 says: Prohibition of preexisting condition exclusions or other discrimination based on health status. The American people want to know what is in the bill. A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition exclusion with respect to such plan or coverage. It is right in the bill. There are some people here who would not talk about that because they would rather debate no bill. They would rather debate, well, we have a suspicion that it is going to cost too much. But they don't show any evidence, and they don't have a competing argument or a bill. This is right in the bill--``may not impose any preexisting condition.'' That is a dramatic change in health care policy in America in 2009. It is not part of the debate. For the next couple of weeks and months, what we are going to do is tell people a lot about what we have been working on in Washington. Day by day, we will tell them what is exactly in this bill, and we will keep talking about it so more people understand it. Unfortunately, some would not understand it because the special interests in Washington would rather talk about the perceived controversy. I suggest that people go to the Web site for the committee that worked on this bill. The HELP Committee Web site is help.senate.gov. Go to that Web site and review the language on preexisting conditions or anything else. I believe at the end of the day, it is going to be very clear who stands for the status quo and doing the same thing and no change versus what the President and a lot of us are trying to do, which is change, reform, and give people, such as Trisha Urban, some peace of mind, some stability to know that she and her family--which is, now that her husband is gone, she and her daughter would not have to worry about this ever again. Isn't that what we ought to be doing? I think we can do that together and in a bipartisan way. I believe we have no choice but to turn away from the status quo and go down the path of change and reform. Mr. President, with that, I yield the floor and suggest the absence of a quorum.

Mr. CASEY. Mr. President, I rise this morning to speak on an issue that so many of us, not only here in Washington in the Senate and in the Congress, generally, but across the country have been concerned about, talking about, debating; and it is the issue, of course, of health care. We have a long way to go over the next couple weeks and months. I know there is a lot of coverage and debate about timing and what is going to happen this week or next week or by the August break. But I believe we are going to get this done, and I think it is important we have a good debate about it. I think too often in this debate we have focused on conflict and controversy as opposed to looking at some substantive parts of this legislation. I start this morning, as I have so many times when I have been discussing this issue over the last couple months, with a constituent, one person, but I think a person who speaks for many people across Pennsylvania and across the country. Her name is Trisha Urban. She sent me a letter back in February that I have noted before. This letter, I think, tells us an awful lot about all we need to know about what is wrong with our health care system right now. Despite all the positive features of it--great hospitals and medical personnel and people we can be justifiably proud of and boast about--there are problems with our health care system. Trisha Urban, when she sent this letter in February, was recounting what had happened in her life just a few weeks before. She talked about her husband Andrew, who had to change positions in life, change jobs because he was completing an internship. She said: Because of pre-existing conditions, neither my husband's health issues nor my pregnancy-- She referred earlier to the fact she was pregnant at the time of the letter-- . . . neither my husband's health issues nor my pregnancy would be covered under private insurance. She said: I worked 4 part-time jobs and was not eligible for any health benefits. She says later in the letter that they lost their health insurance coverage, and they had close to $100,000 worth of medical bills. Then she says: Concerned with the upcoming financial responsibility of the birth of our daughter and the burden of current medical expenses, my husband missed his last doctor's appointment less than one month ago. And this is how the story ends for this family. She talks about--just a few weeks before this letter--what happened to her. She says: My water had broke the night before, we were anxiously awaiting the birth of our first child. A half-hour later, 2 ambulances were in my driveway. As the paramedics were assessing the health of my baby and me, the paramedics from the other ambulance told me that my husband could not be revived. That is her story--a story of not having the kind of health care coverage that she and her husband and her new baby should have--the story of her husband missing his last doctor's appointment because of financial burdens and, of course, the tragic part of that story, which is the loss of her husband, the same day her daughter was born. I do not think every story we have told about our constituents ends the same way. But the blessing here of this story, of this letter, is this: Trisha Urban could have said: Do you know what? I have a terrible burden and I can't handle this, and I am not going to try to talk to anyone about it. I am going to carry this burden myself. And she could go off and not be heard from again. But she took the time to write to me. This is how she ends the letter. She does not just tell her tragic story and just say: Can you help me? And: I am in trouble. She thinks beyond herself. She thinks of an issue that is affecting so many Americans, and she says this: I am a working class American and do not have the money or the insight to legally fight the health insurance company. We had no life insurance. I will probably lose my home, my car and everything we worked so hard to accumulate in our life will be gone in an instant. If my story is heard, if legislation can be changed to help other uninsured Americans in a similar situation, I am willing to pay the price of losing everything. That is what Trisha Urban says to us. I would note that in this Senate Chamber, you can go to every single desk--100 Senators, including myself--every single desk, and if you were to ask a Member of the Senate: Do you have health care coverage? They would say: Of course. I am a Federal employee, and I get to choose a lot of options. You could say the same of people who work in the House and in the White House and in executive branch agencies. So individual Senators are taken care of pretty well. So when Trisha Urban says to us in a letter: ``I am willing to pay the price of losing everything,'' when she says that, I believe she is not just saying it to tell us what is on her mind, what is in her heart in the aftermath of the tragedy, I believe that line and her letter and her whole story are emblematic of the stories of Americans across the country. I believe all those sentiments and all those details of her life present a challenge to us. I am willing to pay the price of losing everything, she says to us. The question is--or I should say one of the important questions is-- over the next couple of weeks and months, as we debate this issue, what are we willing to lose? What are individual Members of the Senate willing to do and willing to lose to get this done? I believe part of that is having a constructive and thorough and far-reaching debate about not just the issues but what is in the legislation. I will spend some time on that this morning and I will for the next couple of weeks. As a member of the Health, Education, Labor and Pensions Committee, we have a bill. Sometimes the fact that there is a bill and there is a lot of positive features to it gets lost in Washington. There is a lot of talk about conflict between Democrats and Republicans; there is a lot of talk about controversy or issues that are sometimes easy to debate or cover, but what has been lost in a lot of this debate over the last couple of weeks is what is in the bill. We are going to get to that. We won't get to all of it today, of course. I believe the bill does a couple of things. First, it ensures that over time we are going to have stable costs. That is one thing American families are looking for, some kind of stability or peace of mind with regard to costs and with regard to other issues as well. So stable costs. I also believe this legislation and the bill we are going to send to President Obama this fall will also have secure choices. If you like what you have, you like the plan you have, you can keep it. It is not going to change. If you want to make a change, you are going to have options. Thirdly, it is about the quality of care. I believe the American people have a right to expect that we are going to control costs, that we are going to provide them with secure choices, but that we are also going to provide quality care. Any old health care, in my judgment, isn't good enough. I believe the bill does all three things: stable costs, secure choices, and quality of care. One of the threshold questions we have to answer in this debate is-- because it is going to be a choice. We are not going to have a choice between 10 options on health care in a general sense or 5 options; we are going to have a basic, fundamental choice, as we do on a lot of issues. It is going to be one or the other, A or B, or A versus B, maybe, and here is the choice. The first question we have to answer is do we want to keep the status quo, do we want to keep perpetuating a system which has costs out of control for families and for businesses, for government, which doesn't offer the kind of quality care across the board--some get it, we know that, and it is good care--but is there enough quality care across the board? I would argue there isn't. Are we going to offer that and say it got too tough and we weren't willing to take some risks with an important bill, we decided to not do anything? That is the status quo. That is what we have now. The other choice is change and reform. President Obama, fortunately, as a new President of the United States, has chosen to be about the business of reform and change. He has said to us, and I believe the American people have said to us: We cannot stay where we are. We cannot allow a system to perpetuate the problems we have right now. So that is the fundamental choice: the status quo, do nothing; or change and reform, working with President Obama and listening to the voices of the American people, people such as Trisha Urban and so many others. So when we debate this--the status quo, stay where we are, versus change and reform--we have to begin to examine some of the questions the American people are worried about. They are worried about costs. They are worried about change and legislation not leading to a control of costs, the kind of stability we want. One of the questions we are not spending much time in Washington debating is: What is the cost of doing nothing? What is the cost of doing nothing? What is the cost of the status quo? Well, fortunately, some people have begun to examine that. One of the examinations of that is a report by Families USA, and the report is entitled ``The Clock Is Ticking.'' It says: ``More Americans Losing Health Coverage.'' One of the points it has made--and of course I won't read the whole report-- but one of the points it has made in the report is this: Here is what the status quo means, here is what no change means: 44,230 more people losing health coverage every week. The report also goes on to talk about what it means in individual States; a State such as Pennsylvania where they are projecting over the next couple of years tens and tens and tens of thousands of people losing their coverage. By one estimate in this report, 178,000 more people just in Pennsylvania--just in Pennsylvania--losing their coverage. I ask unanimous consent that this report, ``The Clock Is Ticking,'' by Families USA be printed in the Record.

Mr. CASEY. Mr. President, the cost of doing nothing also has been examined, using those words, by the New America Foundation. This particular report is dated November 2008 and is written by Sarah Axeen and Elizabeth Carpenter. The name of this report is exactly those words: ``The Cost of Doing Nothing.'' The subtitle of the report is ``Why the Cost of Failing to Fix Our Health Care System is Greater than the Cost of Reform.'' The cost of failing to fix is greater than any other cost. Mr. President, I ask unanimous consent to have this report printed in the Record.

Mr. CASEY

Mr. CASEY. Mr. President, today I honor the service of Robert D. Steele, dean of the College of Agricultural Sciences at the Pennsylvania State University. After 12 years of serving the students, the college and the university, Dr. Steele is stepping down as dean and rejoining the faculty in the Department of Food Science at Penn State. As dean of the College of Agricultural Sciences, Dr. Steele was responsible for the day-to-day operation of a college that is renowned for its top-notch agricultural research. Dr. Steele administered an annual budget of over $175 million, managed a staff of over 2,000 employees, and was a leader for approximately 2,500 students. Bob Steele is dedicated to the students and the growth of the College of Agricultural Sciences. During his tenure he oversaw the transformation and planned growth of the college. Dr. Steele has to his credit many accomplishments as the college's dean, including major new additions including the new Food Science and Forest Resources buildings; implementation of new marketing and recruitment programs that have led to increased undergraduate enrollment, reversing a trend of declining enrollments experienced by colleges of agriculture nationwide; steady growth in the research funds for the college; addition of key new research initiatives in chemical ecology, reproductive biology, and infectious disease and immunology, which have resulted in the addition of internationally renowned scientists to the college and enhanced graduate education; a renewed focus on environmental and energy issues, including the establishment of the Environment and Natural Resources Institute, the Biomass Energy Center, and the Agriculture and Environmental Science Policy Center; and significant progress in the planning, development, and fund-raising for The Arboretum at Penn State. Dr. Steele has taken his academic expertise outside the campus of Penn State serving on many committees that moved agriculture forward on the national level. His passionate interest in the success of Penn State and other land grant universities is evident with his service on the Special Think Tank Committee on the future of land grant colleges of agriculture partnership with the U.S. Department of Agriculture. Dr. Steele was also instrumental in providing valuable ideas and leadership for the 2008 farm bill through his service on various national committees, such as the National Association of State Universities and Land-Grant Colleges Agriculture Deans. Although Dr. Steele's dedication and talents will be missed in the administration of the College of Agricultural Sciences at Penn State, the students enrolled in that program will benefit from his return to the classroom. I am certain that his expertise, knowledge, and experiences will serve them well. I congratulate Bob Steele on his outstanding achievements as dean and his distinguished service to Penn State and the Commonwealth of Pennsylvania and his continued commitment to Pennsylvania's farm families. I also personally thank him for his friendship and his invaluable advice to me and my staff. I wish him all the best as he returns to the classroom.

Mr. CASEY

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

Mr. CASEY. Mr. President, I rise to speak about an amendment I filed. I ask unanimous consent to be recognized for 12 minutes.

Mr. CASEY. Mr. President, I appreciate the time to speak about this amendment to the National Defense Authorization Act for fiscal year 2010 to implement a number of essential reforms to cost comparison studies at the Department of Defense. There is an old expression, principally in the legal community, in our system of justice, where they say ``justice delayed is justice denied.'' That theme--not the same concept necessarily--is part of what I am talking about. When we are studying how government agencies are delivering services to the taxpayers, sometimes we study too long, and especially in the context of what I am about to speak of. I do thank the cosponsors of this amendment, several Senators, including Senators Brown, Schumer, Mikulski, Kennedy, Murray, Gillibrand, and Feingold. The reforms included in the amendment will achieve two very important goals: First, it will save taxpayer dollars, and it will enhance protections for workers across the Department of Defense. I had the great honor to serve the people of Pennsylvania for 8 years--two terms as auditor general of the State--where I was a fiscal watchdog looking after money spent, and I audited and sometimes investigated how money was spent; then 2 years as State treasurer. So I have a sense of what government studies and reviews entail. Sometimes they take too long and defeat the purpose because of their length. Sometimes they should be doing their jobs every day instead of responding to an endless study. Some of the language is a little arcane, but when you talk about competitive sourcing, which is known, as a lot of these things are in government--I hate to use acronyms or short phrases--but competitive sourcing, in this context, is known as the A-76 process. Here is basically what it is. You don't need to know the numbers. We need to know what we are talking about. It is a government-wide initiative that subjects functions performed by government employees to public-private competition. We are all for competition and always have been. I believe many of my colleagues know in this context we have some real problems. This privatization process has been marked by controversy at great cost to taxpayers. Many workers in the Federal Government bring years of experience, dealing with problems and dealing with particular programs; and they also, because of that experience, bring a particular kind of expertise and skill to that work. We all know what happened just 2 years ago at Walter Reed Army Medical Center. The list could go on and on, but here are a couple examples: appalling conditions for those who serve our country, and run down facilities and inadequate care for our returning veterans. All of this was uncovered back then, and I know improvements have been made. Part of the problem rested with a 6-year cost comparison review, which had an impact on the center's staffing. In 2006, the Garrison Commander, who was responsible for managing base operation support activities at Walter Reed, wrote that as a ``direct'' result of the A-76 study, ``we face the critical issues of retaining skilled clinical personnel for the hospital and diverse professionals for the Garrison, while confronted with increased difficulties in hiring.'' Continuing with the quotation, ``Due to the uncertainty associated with this issue,'' meaning the review underway, ``Walter Reed continues to lose other highly qualified personnel.'' That was then, at the time; he wrote that a few years ago. The point is, even something as grave and serious as the problems we experienced at Walter Reed, part of the reason for that can be traced to the problems with these kinds of studies. Despite the heroic efforts by Senator Mikulski from Maryland, the study continued and the problems persisted at the facility. In 2008, GAO conducted reviews of the cost comparison process at the Department of Labor and the Forest Service, finding it impossible to verify cost savings. They concluded at that time that the problems with the A-76 process were systemic. Today, the Department of Defense is the only agency with A-76 studies in the process. According to the DOD, there are almost 30 A-76 studies still in process, involving about 3,600 employees. By next month, three-quarters of these studies will be at least 2 years old. A couple of examples bring this issue into clear life. Currently, the Defense Logistics Agency is reviewing 279 employees who perform installation management services in my home State of Pennsylvania and also in Virginia and Ohio. Prior to the study, this management of this agency said the A-76 study would be disruptive and recommended an internal effort instead, believing it would lead to greater savings. However, as is the common practice, the savings for this study have already been counted, and the people who ran the A-76 program refused the request from the agency management to scrap the study, as they should have. If it is not saving money and helping the taxpayers, it should be scrapped. Therefore, 279 employees, some of whom work in Pennsylvania, are uncertain of their future and have been forced to put off major life decisions. A similar situation is ongoing at West Point, where two studies continue despite requests to terminate them. These decisions to proceed with studies in the face of unyielding and reasonable opposition and alternatives are indeed troubling. The amendment before the Senate addresses these issues in a number of ways. First, the amendment establishes a Department of Defense-specific, 1- year suspension of new A-76 studies, consistent with the government- wide suspension included by Senator Durbin in the financial services appropriations bill. Secondly, my amendment closes the loophole that currently allows certain DOD functions to be given to contractors by converting smaller functions to contractors without conducting any cost comparisons. Third, our amendment establishes a 24-month time limit for how long studies can last--from the beginning of preliminary planning to the final award decision. Currently, there are no established time limits on A-76 studies, which only increases the costs. Fourth, the amendment addresses issues pending with A-76 studies and directs DOD to suspend these studies and determine, based on several criteria, whether their completion is justifiable. Fifth, the amendment improves the process for workers by adding briefings to affected employees about contracting out decisions. Finally, the amendment makes technical corrections to ensure that Federal employees have bid protest rights, building on previous efforts by Members of the Senate. The A-76 process is about cost comparison. Due to the ambiguity around the timelines and the process, these lengthy studies often fail to create promised long-term savings. This amendment addresses these lingering issues with A-76 studies by lending necessary clarity to the process. In addition, these reforms will improve conditions for workers. Lengthy studies have been shown to compromise the capacity of agencies to perform their missions by placing both the critical functions of the agency and employees who perform these functions in limbo. Finally, I urge my colleagues to support the amendment for this reason: It will promote fiscal responsibility, save money for taxpayers, while ensuring those who have the experience, expertise, and skill are able to carry out their tasks in the Department of Defense. I yield the floor.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today on behalf of myself and my colleague Senator Enzi of Wyoming to introduce the Carbon Storage Stewardship Trust Fund Act of 2009. This bill will encourage the commercial deployment of technology that will allow for the continued use of our Nation's vast coal resources to produce economical and reliable power while at the same time mitigating the impact of climate change. The capture and storage of carbon dioxide from power generation facilities and large industrial sources is a critical component of both U.S. and international policy to reduce global emissions of greenhouse gases. The criticality of this technology has been driven home by the Pew Center on Global Climate Change which has pointed out that ``carbon capture and storage, CCS, is the key enabling technology for a future in which we can continue to use our vast coal resources and protect the climate.'' And former British Prime Minister Tony Blair stated in November, 2008, that ``the vast majority of new power stations in China and India will be coal fired; not ``may be coal fired''- will be. So developing carbon capture and storage technology is not optional, it is literally the essence.'' The commercial deployment of CCS will require further large-scale development and demonstration of the technology. Just as important, however, it will also require a well thought out approach to address the risk and liability of injecting large volumes of CO2 into geological formations, such as saline aquifers, depleted oil and gas fields, and unminable coal seams, where it will be permanently stored. The risk of geological CO2 storage, also commonly known as carbon sequestration, is considered small. In fact, CO2 has been safely injected into oil and gas fields to enhance the recovery of these hydrocarbons for decades without incident. While the potential for CO2 to leak to the surface and cause human or ecological harm in a well designed and operated carbon sequestration project is minimal, the financial liability associated with this risk is uncertain given the huge disparity between the typical lifetime of a firm operating a storage facility and the need to ensure the safe storage of CO2 in perpetuity. This uncertainty can cause a chilling effect on private sector investment in CCS. The purpose of this act is to create a program for managing the financial risk, or liability, of the long-term storage of CO2 . This program will offer the private sector with a framework for how legal and financial responsibilities for commercial carbon storage operations will be addressed. Moreover, it will provide a strong incentive to industry to manage and reduce risk by deploying carbon sequestration in the safest possible manner. Specifically, the act will require the owner or operator of a commercial CO2 storage facility to self insure or obtain private insurance or other types of financial assurance to cover liability claims during the CO2 injection phase of the project and for an extended period of time after injection has stopped. After the operator has received a site closure certificate from the appropriate regulatory agency, the act would then convey stewardship for the long-term management of the site to the U.S. Department of Energy. The State where the storage facility is located may request to take on stewardship for the site from the Department of Energy. The act will also create a trust fund from fees paid by storage facility operators on a per ton of CO2 injected basis that will be used to pay for claims for damages made after storage facility stewardship is transferred to the Federal government. In summary, this act will give the private sector the certainty they need regarding the longterm stewardship of CO2 storage facilities. Just as important, it will strongly encourage the safe and responsible operation of these facilities while ensuring the prompt and orderly compensation for damages or harm to humans, to the environment, and to natural resources, should they occur, from the injection and storage of CO2 in geological formations. I urge all of my colleagues to join Senator Enzi and me in support of this act so that a clear signal is given about our commitment to the development, demonstration, and ultimately, the widespread commercial deployment of CCS technology as a key component of the Nation's strategy to reduce emissions of CO2. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CASEY

Mr. CASEY. Mr. President, I rise today on behalf of myself and my colleague Senator Enzi of Wyoming to introduce the Carbon Storage Stewardship Trust Fund Act of 2009. This bill will encourage the commercial deployment of technology that will allow for the continued use of our Nation's vast coal resources to produce economical and reliable power while at the same time mitigating the impact of climate change. The capture and storage of carbon dioxide from power generation facilities and large industrial sources is a critical component of both U.S. and international policy to reduce global emissions of greenhouse gases. The criticality of this technology has been driven home by the Pew Center on Global Climate Change which has pointed out that ``carbon capture and storage, CCS, is the key enabling technology for a future in which we can continue to use our vast coal resources and protect the climate.'' And former British Prime Minister Tony Blair stated in November, 2008, that ``the vast majority of new power stations in China and India will be coal fired; not ``may be coal fired''- will be. So developing carbon capture and storage technology is not optional, it is literally the essence.'' The commercial deployment of CCS will require further large-scale development and demonstration of the technology. Just as important, however, it will also require a well thought out approach to address the risk and liability of injecting large volumes of CO2 into geological formations, such as saline aquifers, depleted oil and gas fields, and unminable coal seams, where it will be permanently stored. The risk of geological CO2 storage, also commonly known as carbon sequestration, is considered small. In fact, CO2 has been safely injected into oil and gas fields to enhance the recovery of these hydrocarbons for decades without incident. While the potential for CO2 to leak to the surface and cause human or ecological harm in a well designed and operated carbon sequestration project is minimal, the financial liability associated with this risk is uncertain given the huge disparity between the typical lifetime of a firm operating a storage facility and the need to ensure the safe storage of CO2 in perpetuity. This uncertainty can cause a chilling effect on private sector investment in CCS. The purpose of this act is to create a program for managing the financial risk, or liability, of the long-term storage of CO2 . This program will offer the private sector with a framework for how legal and financial responsibilities for commercial carbon storage operations will be addressed. Moreover, it will provide a strong incentive to industry to manage and reduce risk by deploying carbon sequestration in the safest possible manner. Specifically, the act will require the owner or operator of a commercial CO2 storage facility to self insure or obtain private insurance or other types of financial assurance to cover liability claims during the CO2 injection phase of the project and for an extended period of time after injection has stopped. After the operator has received a site closure certificate from the appropriate regulatory agency, the act would then convey stewardship for the long-term management of the site to the U.S. Department of Energy. The State where the storage facility is located may request to take on stewardship for the site from the Department of Energy. The act will also create a trust fund from fees paid by storage facility operators on a per ton of CO2 injected basis that will be used to pay for claims for damages made after storage facility stewardship is transferred to the Federal government. In summary, this act will give the private sector the certainty they need regarding the longterm stewardship of CO2 storage facilities. Just as important, it will strongly encourage the safe and responsible operation of these facilities while ensuring the prompt and orderly compensation for damages or harm to humans, to the environment, and to natural resources, should they occur, from the injection and storage of CO2 in geological formations. I urge all of my colleagues to join Senator Enzi and me in support of this act so that a clear signal is given about our commitment to the development, demonstration, and ultimately, the widespread commercial deployment of CCS technology as a key component of the Nation's strategy to reduce emissions of CO2. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CASEY

Mr. CASEY. Madam President, let me move to a second topic in the remaining time I have, in addition to health care, and that is actually a related issue, the issue of hunger and food security, but on the scale of the world, the international stage. I wish to speak briefly on the subject of a significant achievement from last week's G8 summit held in Italy. The G8 leaders agreed to commit $20 billion over the next 3 years to international agricultural development, of which the United States will pledge a minimum of $3.5 billion over this period. As the President, the White House, noted, that comprises more than doubling of current U.S. levels of agricultural development assistance and represents a dramatic shift in the way our government conceives of global food security. For too long, the United States has relied on the traditional emergency aid model, a testament, of course, to the charity and generosity of the American people, but also an inefficient and often delayed response to hunger overseas. A real investment in international agricultural development can help the developing world grow self-sufficient in agriculture and provide a livelihood for the significant share of the population that are small farmers across the world. Everyone is familiar with the old saying: Give a man a fish and you feed him for today. Teach a man to fish, and you have fed him for a lifetime. We should bear that in mind when we think about this policy of global food security. That is exactly what the international community, led by the G8 and President Obama, is seeking to do, with an emphasis on several key principles, at least three: strategic coordination of assistance to ensure that aid is provided in a fashion that maximizes effectiveness and efficiency; investment in country- owned plans to provide genuine domestic ownership and inclusion of benchmarks and other standards of accountability; and a sustained commitment with followthrough at future summits to ensure that the leading States are carrying through on their pledges. This G8 initiative is a complement to the Global Food Security Act, introduced earlier this year by the ranking member of the Senate Foreign Relations Committee, Senator Lugar, and myself. As of today, eight other Members have cosponsored the Global Food Security Act, and I was pleased that Secretary of State Clinton recently offered her general endorsement of this legislation. This bill would achieve three major objectives. No. 1, enhance coordination within the U.S. Government so that USAID, the Agriculture Department, and other entities are not working at cross-purposes. We do that by establishing a new position, a special coordinator for food security, in the White House who would report directly to the President and would forge a comprehensive U.S. food security strategy. No. 2, the bill expands U.S. investment in the agricultural productivity of developing nations so that nations facing escalating food prices can rely on emergency food assistance and instead take steps to expand their own crop production. A leading agricultural expert recently estimated that every dollar invested in agricultural R&D generates $9 worth of food in the developing world. I am grateful to Senator Lugar for his bold proposal by the acronym HECTARE to establish a network of universities around the world to cooperate on agricultural research. No. 3, the bill would modernize our system of emergency food assistance so that it is more flexible and can provide aid on short notice. We do this by authorizing a new $500 million fund for U.S. emergency food assistance. This bill has been worked on and marked up in the Foreign Relations Committee and reported out. I am working with Senator Lugar to bring this legislation to the floor so the full Senate can take it up and pass it. We should not wait--as I said about health care earlier--we should not wait for another massive food crisis such as the one that hit the world last summer, before taking action on this legislation. Global food security is not only a humanitarian issue, of course--and that is of immense proportions--but it is also a national and international security issue. Hunger breeds instability, and instability can set the stage for failed states. Madam President, I yield the floor and suggest the absence of a quorum.

Mr. CASEY. Madam President, I rise to speak of two topics. The first is health care. We had a significant development yesterday in the Health, Education, Labor, and Pensions Committee, of which I am a member, where we actually voted the bill out of the committee. It is the first time in many years that a major piece of health care legislation, other than major initiatives such as children's health insurance, has been voted out of the Senate committee. We have a long way to go. We have the Senate Finance Committee working on this, the House is working on this, and President Obama has made this a major priority of his administration and I believe part of his economic recovery short-term and especially long-term. I commend two people for their work: Chairman Dodd, working in place of our chairman, Senator Kennedy. Between the two of them, they did a great job of leading this effort, not just in the course of some 60 hours of hearings and probably another 20 or more hours prior to the hearings-- prior to the markup when we were offering amendments--but many months and weeks and, in the case of both of these Senators, years working on health care. I also commend the staffs, and my staff, especially Morna Murray, who did great work. I say all that because it was a significant development. We know it is just one chapter in a long book. We have a long way to go. I think it is significant that a bill is out of a committee and moving through the Senate. I wish to focus in particular on a couple of aspects of the bill and then move to some reactions on the question of health care that we get from across Pennsylvania. The bill itself has as its foundation this principle: The status quo is not only unacceptable, it is, in fact, unsustainable. We cannot continue to ignore the issue of health care. We have to act on it this year--not next year or the year after but this year, 2009--at long last tackling a problem the American people have been debating for decades now across the country. Now we have a President who is leading, with the opportunity to finally make progress. The bill does a lot. First, as part of its foundation, it covers 97 percent of the American people. It is critical that we make that part of the final bill. Secondly, in terms of the overall impact of the bill, it will reduce costs, it will preserve choices, and it will, in fact, enhance quality. All of the issues we have talked about for years are now going to be part of this bill. People have been frustrated by the unfairness of the failure of insurance companies to cover preexisting conditions. It is right there in the bill. Preexisting conditions, in the bill, will no longer be a bar to treatment and to the curing of disease and the treatment of individuals. It also has as a foundation to it the question of what to do to preserve choice? The American people have a right to not only keep the health care they like, but also they should have a choice--if they don't like what they have or if they have no insurance at all, they ought to be given a choice. I believe part of that choice isn't just within the framework of private insurance, the insurance companies, but, in fact, a public option, preserving not just choice for the American people but also enhancing competition and bringing down costs. That is essential. Even as we are concerned about the almost 50 million Americans, including 5 million children, who don't have coverage, we have to make sure we are preserving that choice. So reducing costs, preserving choice, and enhancing quality are very much a part of the bill that does change the status quo. At some point, people in Washington are going to have to join one team or the other-- the status quo team, the ``can't do it now, satisfied with the current system'' team, or the side of changing the status quo, the side of reform, the team that is working with President Obama to at long last address the question of quality, the question of access, and the question of bringing down the cost of care for our families and our businesses. So they have to choose their team. In my judgment, there are two teams: the status quo team and the reform change team with President Obama. I wish to highlight just two excerpts of letters I have received from constituents in Pennsylvania. I will read a sentence from each. Before I do that, I want to cite an element of one recent report. This is a recent report from Families USA. I will read one line to make this point: . . . 44,230 more people are losing health care coverage each week. That is 44,230 people, every single week, who are losing their health insurance. With that data staring us in the face--and you can point to other data in Pennsylvania and across the country--can anyone really make the argument that we should slow down and maybe not get this done this year, wait a little longer, a year, another 2 years? In fact, if you do that, you are talking about waiting 10 or 20 years. We cannot do that. We have to act with a sense of urgency and a sense of common purpose. I will read two lines from two letters. One is from a gentleman in Pennsylvania and, secondly, a letter from another constituent of mine. They put this into sharp focus. This letter says, in part: I, for one, find it impossible to understand how the Nation that sent men to the moon, invented atomic energy, and won the largest conflict in history [a reference to World War II] cannot provide the basic right to medical care to all, and most importantly, its neediest citizens. That is a pretty wise summation of why we have to get this done this year. Here is a brief line from another letter I received from a constituent in Pennsylvania. She speaks of the economic pressure she and so many families feel with the status quo, the current health care system: I am only trying to keep my family from becoming another statistic. Another statistic like 44,230 families losing their health care coverage every single week, a statistic like the number of families going into bankruptcy every week and every month because of one issue principally for many families--not all but many--the issue of health care. I think we have to remember the wisdom and also the real-life experiences of the people who write to me, representing Pennsylvania, or any other State. I have two more points. The question is of premiums. There was a recent report that indicates that if we don't take action on the issue of health care reform, if we don't act now and finally, at long last deal with quality, cost, access, and preserving choice--this is a report by the New America Foundation, issued at the end of last year. It said: In Pennsylvania, family health insurance with a price tag of $26,879 in 2016 would consume 51.7 percent of the projected Pennsylvania median family income. The national number is very similar to that. So if you look at it over a 10-year period or an 8-year period, what we are looking at here, if we don't tackle this issue, is families in Pennsylvania and across the country will be paying half or more than half of their income for health care. That is the reality. That is why there is a sense of urgency and purpose and a resolute focus on this issue this year. We cannot sustain this. Our economy cannot continue to go in this direction. We have to begin to tackle it this year. Finally, before I move to my second topic, is the issue of children. I have made, along with Senator Dodd and so many others--this a central priority when we are doing health care reform. We are very happy this bill is moving forward, that health care is in sharp focus. One of the things we have to make sure of as we move through the process is that no children, especially poor children and those with special needs, come out of this worse off than they have been. One of my themes is ``No child worse off.'' Just four words: ``No child worse off.'' I add as a corollary: especially poor and special needs children. Unfortunately, we have some ideas in Washington floating around that run contrary to that. I urge those who are ignoring the question of children, who are forgetting about the impact of this bill on children--and it is a very positive impact--to remember that line from Scripture where it says that ``a faithful friend is a sturdy shelter.'' We have a lot of people in Washington who do a lot of talking about being a friend of children, being advocates for children, and standing up for children. It is wonderful that they say that. But if we are going to prove ourselves to be a faithful friend to children by being that sturdy shelter that protects them, not only from the ravages of a bad economy, not only from the other horrors so many children face, but even protecting them from unintended consequences of health care legislation, if that is what we say we are going to do, we should prove it through the work we do in the bill. I have a couple of points about that. One of the things I worked very hard on in the bill, working with Senator Dodd, was to make sure that enrollment in care, either through the so-called gateway, which is part of the health care bill, or through Medicaid or CHIP, is done in a way that we are actively assisting--actively assisting--families to get them enrolled and not just saying: You are on your own and try to figure it out--actively seeking to help families, especially poor families, get enrolled. I have worked with Senator Dodd on a requirement that pediatric preventive care be included in the list of mandatory preventive services that insurance plans offer, with minimum cost-sharing requirements for families. I have also worked with Senator Dodd on ensuring that medical homes-- which, as we know, is not a place but an approach to care, patient- and family-centered care that is comprehensive and coordinated; that is what I mean by ``medical home''--that there is a medical home as well for children. Pediatric medical homes for children are part of the bill. Finally, we ensure the establishment of an oral health care prevention education campaign at the Centers for Disease Control focusing on preventive measures targeted toward children and pregnant women. For all these reasons and more, we have to continue to focus on getting health care legislation passed at long last. I was honored to be with the Presiding Officer yesterday at a discussion about preventive health care. That is a central part of this bill. I commend her work in this area. It is a central feature of this health care bill. Global Food Security