Michael Enzi

Mr. ENZI

Mr. ENZI. Mr. President, I thank the Senator from South Dakota for his enthusiasm and passion and ability to explain things. The passion we have seen throughout the day from the Republicans who have spoken is a reflection of the passion we are hearing in our telephone calls and in our e-mails and in our letters. Our volume is much higher than the 61 percent the CNN poll says. Of course, we wouldn't expect the CNN poll to necessarily reflect our constituents. That enthusiasm across America, that passion, that concern should be reflected in this Chamber. I get a lot of mail and even phone calls from other States, and they say: How come my Senator isn't listening to me? How come he is not listening to all of my friends? Thank you for what you are doing on health care. What we are doing on health care, of course, is asking that it be done step by step so that we can get the confidence of the American people, not do something grandiose that can't be well thought out because it is so big. I spent time as the ranking member of the Health, Education, Labor, and Pensions Committee in an extensive markup on a bill that we had no input in writing. The other side says we had input into the amendments, and we did do some amendments and some were accepted. There were even some that were fairly significant that were accepted. Of course, what was disappointing was that after the August recess-- they didn't print it before the August recess because they didn't want people to know what was actually in it at that time. But following the August recess, when they finally printed it, we found out that provisions we had put in by agreement had been ripped out. Never have I had that happen in my 12 years in the U.S. Senate. Then I was part of the Gang of 6--the Group of 6, my mother would prefer to call it because she told me never to join a gang. But over a period of at least 60 days, we spent a lot of time and effort from morning until night trying to get a health care bill that would work for America. One of the things we discovered is that it is very extensive. Nobody can comprehend how big health care is in America. We talked about it being 16 percent of the whole economy. Well, does that register with you? We talk about the trillions that are involved. I don't understand trillions. We spend billions around here, but trillions is a whole other level. I don't even think the kids who work on billions understand trillions. When we say 1 trillion, a lot of people say: Well, that is just 1. Well, it is a thousand billion, and a billion is a thousand million. So it is a lot of money. But when we were doing this in this Gang of 6, what we did was kind of divide the issues up into 13 different parts--you might call them steps. We started working through those. Sometimes we would have to leave one because we had basic questions we needed to ask about those sections so we would have a big enough understanding to be able to draft legislation for it. Basic questions. Basic questions. We only made it through slightly more than half the 13 areas before we were faced with a phony deadline. They said September 15 is the drop-dead date for this group to finish work. If you don't have it done by then, we will put something together anyway. If you are still getting basic questions answered, don't you think you ought to work on it a little longer and have a few more people in? One of the groups we had in were the Governors. We were going to have a vast expansion of Medicaid--not quite as vast as is in here, and what is in this new bill that we have not yet seen, even though we are quite a ways into this, but a vast expansion of Medicaid. Medicaid works through the States and the States have to pick up part of the costs-- actually, they pick up a lot of the costs. As we have expanded Medicaid and expanded the rolls on Medicaid, we have put a greater burden not only on the Federal Government, though it is on the Federal Government, too, but also on the State governments. The State governments don't get to vote on it at all. The Senator from Tennessee, Mr. Alexander, who used to be a college president and was also a Secretary of Education, pointed out a number of times that when Governors are faced with this budget crunch on Medicaid, what do they do? Virtually the only place they can cut is universities and colleges. That is why there has been this dramatic increase in college tuition--because of what Medicaid has done to the States. Now we are talking about another drastic increase in the number of people in Medicaid. We thought it would be a good idea if we got the Governors on the phone--we hoped the Governors task force on Medicaid would meet with us, and I think they might have, but we were trying to rush it into a short period of time, so we did conference calls. They wanted to know how it was going to affect their States. We knew how many billions it was going to cost as a whole for those States, but we didn't have a breakdown individually. CBO and the Joint Tax Commission don't do breakdowns by States. But we had some people on staff--Democratic staff--who thought they could break that down, and they did. They presented us with these numbers, and I called my Governor and said: I know this is going to be a problem, and I will see what I can do about it, but it is a lot of money. Of course, if I am talking about how much it was for Wyoming, it would not sound nearly as much as for New York, but it is the same kind of percentages, we just have less population. Another surprising thing that happened to us was it looked like Nevada and New York would be hit real hard. The next day we got numbers and--we had the same CBO and Joint Tax score. That didn't change a bit. There was one set of numbers. But the evaluation, the next day, looked a lot better for Nevada and New York. It didn't bring it down enough, so there was a special provision that has been put in the bill--it was not done in the Gang of 6--that made it much nicer for Nevada and New York. We said: Wait a minute, why are you doing that for Nevada and New York? Some of the influential people around here from Nevada and New York said this economy is in a real downturn, and we are being hit harder than anybody else. I said: Well, that is a nice gesture, but this part of the bill isn't going into effect for 4 years. How do we know that in 4 years Nevada and New York are the ones that are going to be hard hit? We ought to have provisions for whoever is hard hit. Those are the kinds of things we were trying to take care of in committee with inadequate numbers. As we worked through--well, the President wanted to do a speech to the Nation, a joint session speech. They do those over on the House side, and the House and Senate show up for it. It was on health care. Following that health care speech, the next morning we went to the Gang of 6 meeting. I kept notes on what the President said. I had about 12 areas we had tried to draft legislation on that he had pretty specific suggestions on. I had to say: This is something we didn't do. We didn't do this yet. We talked about that for a whole day. Immigration was one of the big ones. Medical malpractice was another. That has been a huge concern to the medical community. I have several things I need to say on this health care bill. I know we are talking in the 30 hours following the appropriations bill. I have things to say about the appropriations bill too. I usually don't talk for very long down here, but I have some of that pent-up passion from all the calls and things I have gotten. So I will talk about both spending and health care. I will start with the spending because we just voted for a bill that costs $446.8 billion, and Senators didn't have any opportunity to debate the critical issues within that bill. Of the six bills, three-- Financial Services, Labor-HHS, and State and Foreign Ops--were airdropped into conference with no opportunity for debate on this floor. So we had no opportunity for consideration. The Transportation bill, the HUD bill, received a 23-percent increase over last year. The State and Foreign Ops bill received a 33-percent increase over last year. Collectively, the six appropriations bills account for a 12- percent increase in Federal spending over last year. Our national deficit for the past fiscal year stands at $1.4 trillion. I don't see that going down at all. Our current unemployment level is at 10 percent, despite the administration's insistence earlier in the year that Congress pass a $1 trillion-plus stimulus package. The Senate is currently in the middle of a debate on a health care reform bill that has a 10-year implementation cost of $2.5 trillion. Sometime in the next month, we will be forced to raise the Nation's debt ceiling for the second time this year to a level that exceeds the current ceiling of $12.1 trillion. The bill makes a number of significant policy changes with respect to the fairness doctrine. This omnibus does not include the fiscal year 2008 ban on Federal funds being used to enforce or implement the so- called fairness doctrine. The bill makes changes to several longstanding policy provisions contained in the Financial Services bill and specifically the District of Columbia section dealing with abortion, medical marijuana, needle exchanges, domestic partners, and the DC Opportunity Scholarships. The bill also contains 5,224 earmarks that total $3.8 billion. Well, let me go into the definition of an earmark. According to the champion of it for many years, Senator McCain, it is not an earmark if you take a specific project to the committee of jurisdiction, where they can debate it and decide whether it is a valid project and how it might fit in with other formulas and things they are already working on. If the committee that actually works that issue approves it, it is not an earmark. But, of course, it has to be put in, in the authorization process, not dropped in by airmail when the conference committee is meeting at the end of the bill. It is considered an earmark when it is just sent to conference, nobody got to debate it and vote on it, and it was shoved into the bill. There are ways special projects can be done and approved by several votes. Normally, it would be the committee of authorization and then the Appropriations Committee and then the floor of the Senate; and that same process would have already been done on the House side because they start all funding bills. So that is probably six or seven votes on an item before it can actually get passed, if it goes through the regular procedure. Of course, it is easier to have somebody to champion it and quietly slip it in without any votes, except a final vote. The final vote is what we are doing right now. It is on the whole package. You cannot pick out a section or an earmark and have a vote on that. Besides that, with 5,224 earmarks, that would take a long time. But it totals $3.8 billion. That is still a lot of money. It has been denigrated since we went into the trillion-dollar category, but $3.8 billion is still a lot of money. How is this playing out around the country? I found a blog I hadn't seen before. It kind of speaks to what we are doing in appropriations right now. This is uglytruthstudios.com. It begins: Don't tell me where your priorities are. Show me where you spend your money and I will tell you what they are. That is James W. Frick, who is not the author of this. The author then goes on to say: I was mad when I decided to start this blog and podcast. I was mad about the current state of our congressional spending. I know, I know, a lot of folks are upset about the government and what they spend. My anger starts with the simple fact that they cannot complete the spending process. They haven't been able to complete the process, not even one time, since 1999. You can see that this is directed against both sides of the aisle. Folks, you are right to be mad about the out of control spending of the Federal Government, but we all must start with a hard look at how the money is being spent before we can take an honest look at what it's being spent on. Take for instance the topic of Healthcare. You will be hard pressed to find a single soul in this country that doesn't think the system needs to be re-evaluated. For the last eight plus months we have heard on the morning news, the Sunday talk shows, from congressional leaders, the President of the United States, and even concerned citizens about the impending healthcare crisis. Primetime television has been interrupted for Presidential addresses. The President addressed a joint session of Congress, he held town meetings, he held focus group meetings, he met with members of industry. Congress itself has begged and pleaded for people to not get too excited about their plans, to work with them on putting reform in place. This was a crisis. A crisis that needed to be addressed immediately, the citizens of the United States of America needed to get behind the effort they were putting forth. The media was dominated with the urgency to get something done. Television showed outraged Americans at town hall meetings. Congress exchanged ideas and both sides pointed the finger at the other side trying to show that their side was most in tune with what our country needed. They were on top of this situation. Well they have ``sort of'' been tending to the business of our nation's healthcare. The ugly truth though is this: in their rush to be in the media on the Healthcare crisis, Congress has not yet completed the Labor, HHS and Education Appropriation for the 2010 Federal Fiscal year. The House completed their version of the bill on July 27. The Senate has not yet passed a version of the bill. The Senate in all their talk about getting Healthcare done has yet to even take the bill up on the floor for a vote. Well, that part isn't true anymore. It has been finally taken up. It was supposed to be October 1, but we are tardy in that. Now, mind you, tomorrow night you will probably have your football game, family dinner or general quiet evening interrupted by the Senate working through the weekend. That is where we are now. A vote of monumental importance during prime time television, but not on the job that they should have been doing; no, no, this is a vote on what they want to do. For simple reference sake this is the equivalent of taking out a trillion plus dollar loan, making commitments associated to the loan, and never spending a second asking yourself the following questions: Is this in the budget? Can we afford it? Hell have we even thought about what we are willing to spend on it? Have we decided yet what we are spending on healthcare this year? Healthcare was not a big enough problem this year for the United States Senate to complete the normal course of business by appropriating the spending for Fiscal Year 2010. However, it apparently is a big enough to deal to forward spend a conservative average of over $85 billion a year. It is not a big enough deal to spend the $160 Plus Billion this year that includes Labor and Education as well. The House of Representatives despite passing their appropriation in July has not accounted for the spending in their passage of a conservatively estimated $1.2 trillion Healthcare Plan. I am sure they would argue that they have, their actual spending doesn't start for a few years. I would argue that you had better start thinking about doubling spending in 5 years now. That is a slap in the face to hard working Americans. In my book we all have roles to play. If you got elected to Congress or in this specific case, the Senate, you were placed in a position of public trusteeship. You were elected to spend the people's money and make sure we are a solvent nation. I bet that they just got so caught up in solving the problem that they forgot to handle the process of budgeting and spending. But wait, they continue to spend, and they make forward commitments with our money that never come in on budget. You will find that I am not a big call to action guy. I am actually kicking myself for not stopping my normal job and getting started railing on this problem before now. I have watched in great horror over the last 10 years as both parties have ignored the process of spending, and funded our government with our tax dollars through one size fits all process. A one size fits all process that generally is traded on our hard earned tax dollars, votes exchanged for passage. It is time for the nonsense to stop. Keep watching them. I have heard and firmly believe that you can track someone's intentions by how they plan and spend their money. No matter what the claimed intentions may be, people normally put their money where their mouth is. Congress is putting our money where their mouth is. If Healthcare isn't important enough to finish the appropriations process on, then don't take the time to spend more money on it. Remember--It's all about the money stupid. Mr. President, we are finally getting to the spending. We have been spending all year, but we are finally getting to some of these pieces. It still leaves the defense piece undone. We are continuing last year's appropriations up to the current time. I have some things I have gleaned from different places. I particularly thank the Wall Street Journal for their articles and editorials that inform America. I think if I were picking one source of information, that is the one I would pick. I read the Washington Post, the Washington Times, the Wall Street Journal, and I get clips from every newspaper in Wyoming. I get a couple of those newspapers complete. I read a lot of news, but from a national perspective and one that is actually paying attention to what we are doing here, my favorite is the Wall Street Journal. Earlier in the week, I quoted from a cost article I had found in the Wall Street Journal. I was chastised for using them as a source and then was countered by a Senator using Wikipedia. You can go into Wikipedia and do your own editing. I am not sure if that is a good source. I would prefer to rely on the Wall Street Journal. There is not any article or opinion that cannot be quibbled with, and that is just like the amendments we have here. What I prefer to think is when an amendment or an article or a speech is given, we ought to be looking for the idea, the grain of truth, the juice of it that should be used, and we are not doing that right now. We are just doing amendments there and amendments here. We are defeating the amendments here. And it kind of bothers me that we have all these amendments from this side because, first of all, our amendments were voted down, all except two, when we went through the Health, Education, Labor, and Pensions Committee process to get the bill out of committee and when we went to the Finance Committee, the same thing happened. I think we had two amendments that were taken as well over a whole week of amendments. The two bills were taken to a closed door back here and were massaged into a new bill. Some pieces of those two bills can be found there, but not all of it and not in the same form. We had no input to that at all. No input at all. Now it is on the Senate floor, and we have the chance to do amendments. I contend the Democrats are filibustering their own bill because every time we put up an amendment, they put up an amendment. If you wrote the bill, that bill ought to be good enough that you do not have to keep countering your own bill. We did not get to write the bill so we ought to be able to make at least some points about what ought to be changed by using our amendments. Last week--one of the most fascinating things around here that I have seen--there was a Democratic amendment and then a Democratic side-by- side to it. Normally we get to present the side-by-sides. They are arguing within themselves. It is on a very important issue. Getting back to the spending, I will mention that since taking office, Mr. Obama pushed through a $787 billion stimulus bill. Hardly any of that money has actually gone out. I would guess about 25 percent of it is all because there is health IT in there. It is $47 billion, and that is not going to go out for 4 years. I don't know how you put something in a stimulus bill where you are trying to get something done immediately and not release the money for 4 years. Granted, there is some work that needs to be done in that 4 years in order to make that money worth anything at all. It just fascinates me. We had a $787 billion stimulus bill that was not anticipated to go into effect right away; $33 billion expansion of SCHIP; a $410 billion Omnibus appropriations spending bill; and an $80 billion car company bailout. The President also pushed an $821 billion cap-and-trade bill through the House and is now urging Congress to pass a nearly $1 trillion health care bill. The administration says it is now instructing agencies to either freeze spending or propose 5-percent cuts in their budget for next year. This will not add up to much unless agencies use the budget they had before the stimulus inflated their spending on their baseline in calculating their cuts. That is why we are talking about this bill right now, the minibus or omnibus that is pretty ominous, with all the spending in it, with every one of those bills having a huge increase over a year ago. That will get built into the baseline so next year there can be another huge increase. They compound dramatically. If the Education Department uses its current stimulus-inflated budget of $141 billion instead of the $60 billion budget it had before the President moved into the White House, freezing its budget will do nothing to fix the fiscal mess that has been created. As I mentioned, there is this little thing of second-degreeing their own amendment. The Democrats are having a little problem deciding on their message. On the one hand, the President said just this week that we have to ``spend our way out of this recession. On the other they keep telling us the deficit is too large and isn't 'sustainable.' In this tug of political spin, watch what they spend, not what they say. And that means watching this weekend's expected Senate vote,'' which we have had, ``on the 1,088-page $445 billion''--ominous--`` `omnibus' package of spending bills to fund the government for fiscal 2010. The House passed a similar elephant earlier this week''--I don't know why they are referring to it that way; it is similar to a donkey--``allowing spending federal agency budgets to increase spending by some $48 billion, or about 12 percent from 2009. That increase--when inflation is negligible--is in addition to the $311 billion in stimulus already authorized or out the door for these programs. Adding this new stash means that federal agencies will have received nearly a 70 percent increase in the last 2 years.'' Has anybody gotten that kind of increase? ``Oh, and that's not all. The President and Congress also want to spend as much as $200 billion more from the Troubled Asset Relief Program''--which is another stimulus, but it was done as a series of loans, so we are supposed to get the money back from that. What they are talking about doing is taking the money from that program and using it for some other programs. Anything that comes back is supposed to go to reduce the deficit. Lord knows that is big enough. As I mentioned, there are 5,324 earmarks in this bill. That brings the total for the year to about 10,000 or about 23 for every congressional district. That is after a promise that the President would not sign any bill that had earmarks, but he has already done that once. Hopefully, he will not do it twice. We have been talking about jobs this week. I even got invited to the White House to talk to the President about jobs. Of course, the message the Senator from Washington, Mrs. Murray, and I delivered to the President is, we ought to get the Workforce Investment Act done. That is a job training program that would train 900,000 people a year to higher skill levels to meet some of the skill levels we are missing in this country that we are having to export. What has been the status on this bill? We have been working on this for 4 years--4 years. This country did not need jobs before. Now we need jobs, so maybe we are going to get something done on that. She, I, and Senator Kennedy passed this bill through the Senate twice unanimously, but the House has never taken it up. I don't know how we are going to get jobs done if something that is that bipartisan--it passed the Senate both times with everybody voting for it. We cannot get more bipartisan than everybody voting for it. We are talking about bipartisan bills. That is really important. Talking about jobs, one of the things I mentioned at the White House was that 2 days before this meeting, the EPA had put out the notice of the new regulation where they are going to take care of greenhouse gas emissions, CO2 and seven other chemicals. According to Kimberly A. Strassel: In the high stakes game of chicken the Obama White House has been playing with Congress over who will regulate the Earth's climate. Right now the Copenhagen meeting is going on-- The president's team just motored into a ditch. So much for threats. The threat the White House has been leveling at Congress is the Environmental Protection Agency's ``endangerment finding,'' which EPA Administrator Lisa Jackson finally issued this week. The finding lays the groundwork for the EPA to regulate greenhouse gas emissions across the entire economy, on the grounds that global warming is hazardous to human health. From the start, the Obama team has wielded the EPA action as a club, warning Congress that if it did not come up with cap-and-trade legislation the EPA would act on its own--and in a far more blunt fashion than Congress preferred. As one anonymous administration official menaced again this week: ``If [Congress doesn't] pass this legislation,'' the EPA is going to have to ``regulate in a command-and-control way, which will probably generate even more uncertainty.'' The thing about threats, though, is that at some point you have to act on them. The EPA has been sitting on its finding for months, much to the agitation of the environmental groups that have been upping the pressure for action. President Obama, having failed to get climate legislation, didn't want to show up to the Copenhagen climate talks with big, fat nothing. So the EPA pulled the pin. In doing so, it exploded its own threat. Far from alarm, the feeling sweeping through many quarters of the Democratic Congress is relief. Voters know cap-and- trade is Washington code for painful new energy taxes. With a recession on, the subject has become poisonous in congressional districts. Blue Dogs and swing-state senators watched in alarm as local Democrats in the recent Virginia and New Jersey elections were pounded on the issue, and lost their seats. But now? Hurrah! It's the administration's problem! No one can say Washington isn't doing something; the EPA has it under control. The agency's move gives Congress a further excuse not to act. ``The Obama administration now owns this political hot potato,'' says one industry source. ``If I'm [Nebraska Senator] Ben Nelson or [North Dakota Senator] Kent Conrad, why would I ever want to take it back?'' All the more so, in Congress's view, because the EPA ``command and control'' threat may yet prove hollow. Now that the endangerment finding has become reality, the litigation is also about to become real. Green groups pioneered the art of environmental lawsuits. It turns out the business community took careful notes. Industry groups are gearing up for a legal onslaught; and don't underestimate their prospects. The leaked emails from the Climatic Research Unit in England alone are a gold mine for those who want to challenge the science underlying the theory of manmade global warming. But the EPA's legal vulnerabilities go beyond that. The agency derives its authority to regulate pollutants from the Clean Air Act. To use that law to regulate greenhouse gases, the EPA has to prove those gases are harmful to human health. That is the endangerment finding. One is CO2, and I am breathing that out right know. Put another way, it must provide ``science'' showing that a slightly warmer earth will cause Americans injury or death. Given that most climate scientists admit that a warmer earth could provide ``net benefits'' to the West, this is a tall order. Then there are the rules stemming from the finding. Not wanting to take on the political nightmare of regulating every American lawn mower, the EPA has produced a ``tailoring rule'' that it says allows it to focus solely on large greenhouse gas emitters. Yet the Clean Air Act--authored by Congress--clearly directs EPA to also regulate small emitters. This is where the green groups come in. The Tailoring rule ``invites suits,'' says Sen. John Barrasso-- Who is the other Senator from Wyoming-- who has merged as a top Senate watchdog of EPA actions. Talk of business litigation aside, Mr. Barrasso sees ``most of the lawsuits coming from the environmental groups'' who want to force the EPA to regulate everything. [The President] may emerge from Copenhagen with some sort of ``deal.'' But his real problem is getting Congress to act, and his EPA move may have just made that job harder. I thank Kimberly Strassel for those words. Staying on the topic of jobs: House Democrats keep stepping on President Obama's applause lines about innovation and job creation. On Tuesday, Mr. Obama announced that ``we're proposing a complete elimination of capital gains taxes on small business investment'' for 1 year. Responding with rare dispatch, the House voted yesterday-- Actually, that would be the day before yesterday now. Some of these things I wrote and hoped I would give before now. --the House voted yesterday to change the capital gains rate for venture capitalists who invest in technology start-ups. But rather than eliminating the tax, the House more than doubled it, moving the tax rate to 35 percent from 15 percent by reclassifying such gains as ordinary income. Private equity fund managers and managers of real-estate and oil-and-gas partnerships would also get socked with a 133 percent tax-rate increase. Now, there's a way to encourage economic growth and new jobs. Knowing how popular tax increases are with unemployment at 10 percent, the House majority rushed the bill to the floor without a hearing or even a committee vote. Then they buried it in a package advertised as an extension of tax cuts for research and development. And that is how it will come over here. And, of course, there are some other problems in the United States with jobs. There are projections that show unemployment in construction will rise by about 1.3 million and that will be outweighed by the continued drop in manufacturing and mining jobs. Goods-producing employment as a whole is expected to show virtually no growth in total jobs, according to the report. By 2018, that sector will account for 12.9 percent of the jobs, down from 14.2 percent of the jobs. You know, in order to grow the economy, you either have to produce something or you have to sell something. So separately, the number of workers filing new jobless claims rose 17,000 to 474,000 last week, the Labor Department said, which is an unwelcome change after 5 weeks of declines. Of course, accounting is one of my favorite things. I am the accountant in the Senate, and we have been doing some accounting on jobs that are saved. Clear back at the very beginning of the administration, when Secretary Geithner was appearing before the Finance Committee and the President was saying he will create or save 3 million jobs, I asked what is the definition of saving a job? After he explained a little bit on that, I said: Well, I think probably anybody who is employed, still employed would meet that criteria, so why don't you save or create 180 million jobs? But now we have had some measurements done on jobs that were saved, and this one particularly stuck with me. There is a report on the stimulus for a shoe store in Kentucky, and since I used to be in the shoe business as well, that kind of stuck out. This is from the Washington Examiner--a ticker on stimulus jobs created--and what they said is a shoe store owner claimed to create nine jobs on an $889 contract, when in fact he supplied nine pairs of shoes to the Army Corps of Engineers. A lot of accounting problems around here, and talking about saving jobs without a good definition is only one of them. Let's see. The government has taken over the banking industry, the car industry, trying to take over the health care industry, trying to take over the energy industry, none of which Washington knows much about, but one that hasn't had much said about it yet is student loans, and I am not sure exactly when that is coming to this body, but I did want to mention that the Department of Education right now is pressuring schools to move to a government-run student loan program in lieu of utilizing private lenders, who are more efficient and have traditionally offered better customer service. That is why people stay with them, is the better customer service, if the price is the same. However, it is also important to note that the proposed student loan takeover, which is H.R. 3221, would cause private lenders to cut an estimated 35,000 jobs across the country. That is according to a survey by the Federal Family Education Loan Program Industry Groups. With the unemployment rate lingering around 10 percent, it is nothing short of amazing that presumably vulnerable politicians continue to advocate big government programs that will result in private-sector job loss. We will be saying more about that as it comes up. I am not sure when it is going to come up, but I did hear the Secretary of Education--and again, this is good government accounting--said it would provide another $80 billion for them to work with. Under the best of government accounting, it would be $40 billion, I believe. And even that is only because of the way it is accounted for. Another problem we have now is with taxes, with the estate tax, and that is one that won't die because the Democrats are afraid to let the tax rate hit zero. For years, we have had people saying that the estate tax is not fair; that in this country you get taxed when you earn money, you get taxed when you buy something, you get taxed when you use something, you get taxed when you sell something, but the tax people are upset about is the tax you get after you are dead. We had a bill that already passed. The hated death tax is scheduled to expire, with the rate falling from 45 percent to zero for 2010. Then it will be restructured in 2011 at a rate of 55 percent. This bizarre policy goes back to 2001, when the Democrats wouldn't let President Bush permanently kill the death tax. So the Republicans bet if the tax were eliminated for 1 year, it would never come back. Well, the moment of truth has arrived and the House Democrats recently voted to cancel that repeal and hold the rate permanently at 45 percent with a $3\1/2\ million exemption. So now the majority leader wants to do the same, and would suspend the health care debate and turn to that estate tax, but he would need 60 votes to do that, and I think that is because all the Republicans and many of the Democrats are saying no to that. Blanche Lincoln and Jon Kyl, Arkansas and Arizona, have placed some proposals out there. The correct way to tax a gain in the value of assets bequeathed to an heir with capital gains of 15 percent is when the assets are sold. There ought to be some actual action that derives some revenue for it; otherwise, people out our way are having to sell off ranches prematurely in order to have the money to pay off death taxes when the founder of the family passes away. A recent problem we have had with that is that the land values are going up. I suppose they have stagnated at the moment, but it is hard to tell. These ranchers were putting money in, trying to do estate planning so they could pay this with not having to sell off part of the farm, and were doing a pretty good job of that. Of course, they made some adjustments when we made adjustments and started giving them a decline. And there is going to be a lot more said on that yet. We have this massive spending bill, this huge increase in spending, and I want to share with you some of the words of Douglas Holtz-Eakin, the former Director of the Congressional Budget Office, which we talk about here regularly and point out as being a nonpartisan office. He spoke recently at the Senate Committee on the Budget, or relatively recently--November 10. This is kind of what he said: President Barack Obama took office promising to lead from the center and solve big problems. He has exerted enormous political energy attempting to reform the Nation's health- care system. But the biggest economic problem facing the Nation is not health care. It's the deficit. Recently, the White House signaled that it will get serious about reducing the deficit next year--after it locks into place the massive new health-care entitlements. This is a recipe for disaster, as it will create a new appetite for increased spending and yet another powerful interest group to oppose deficit- reduction measures. Our fiscal situation has deteriorated rapidly in just the past few years. The Federal Government ran a 2009 deficit of $1.4 trillion--the highest since World War II--as spending reached nearly 25 percent of GDP and total revenues fell below 15 percent of GDP. Shortfalls like these have not been seen in more than 50 years. Going forward, there is no relief in sight, as spending far outpaces revenues and the Federal budget is projected to be in enormous deficit every year. Our national debt is projected to stand at $17.1 trillion 10 years from now, or over $50,000 per American. And per American means every man, woman and child. Continuing to quote: By 2019, according to the Congressional Budget Office's analysis of the President's budget, the budget deficit will still be roughly $1 trillion, even though the economic situation will have improved and revenues will be above historical norms. The planned deficits will have destructive consequences for both fairness and economic growth. They will force upon our children and grandchildren the bill for our overconsumption. Federal deficits will crowd out domestic investment and physical capital, human capital, and technologies that increase potential GDP and the standard of living. Financing deficits could crowd out exports and harm our international competitiveness, as we can already see happening with the large borrowing we are doing from competitors like China. Yes, the President went to China recently; Secretary Geithner has been to China. They weren't over there trying to visit the Great Wall. They were over there trying to explain to China how we would be able to pay off our bonds. And last week, it was said that Standard & Poor's and Moody's were taking a look at the United Kingdom and the United States to see if there shouldn't be a downgrade in their rating. And so Mr. Holtz-Eakin says: At what point, financial analysts ask, do rating agencies downgrade the United States? When do lenders price additional risk to Federal borrowing, leading to a damaging spike in interest rates? How quickly will international investors flee the dollar for a new reserve currency? And how will the resulting higher interest rates, diminished dollar, higher inflation, and economic distress manifest itself? Given the President's recent reception in China--friendly but fruitless--these answers may come sooner than any of us would like. Mr. Obama and his advisers say they understand these concerns, but the administration's policy changes are the equivalent of steering the economy toward an iceberg. Perhaps the most vivid example of sending the wrong message to international capital markets are the health-care reform bills--one that passed the House earlier this month and another under consideration in the Senate. Whatever their good intentions, they have too many flaws to be defensible. First and foremost, neither bends the health-cost curve downward. The CBO found the House bill fails to reduce the pace of health-care spending growth. An audit of the bill by Richard Foster, the chief actuary for the Centers for Medicare and Medicaid Services-- And that is the CMS, which is a division of Health and Human Services. So this is the chief actuary issuing this report. --found that the pace of national health-care spending will increase by 2.1 percent over 10 years, or by about $750 billion. Senate Majority Leader Harry Reid's bill grows just as fast as the House version. Yesterday, or the day before yesterday, we got a new actuarial report that addressed the Reid bill as opposed to the House bill, and we talked about that fairly extensively. I haven't seen any articles about it yet. But one summary comment on it is that, according to this Actuary of CMS--which is a part of the administration--the cost of health care under the Reid bill will increase by seven-tenths of 1 percent. That doesn't sound like much, but it is seven-tenths of 1 percent more--more--than if we did nothing. That is not bending the cost curve down. Mr. Holtz-Eakin goes on to say: Second, each bill sets up a new entitlement program that grows at 8 percent annually as far the eye can see--faster than the economy will grow, faster than tax revenues will grow, and just as fast as the already-broken Medicare and Medicaid programs. They also create a second new entitlement program, a federally run, long-term-care insurance plan. Finally, the bills are fiscally dishonest, using every budget gimmick and trick in the book: Leave out inconvenient spending, back-load spending to disguise the true scale, front-load tax revenues, let inflation push up tax revenues, promise spending cuts to doctors and hospitals that have no record of materializing, and so on. If there really are savings to be found in Medicare, those savings should be directed toward deficit reduction and preserving Medicare, not to financing huge new entitlement programs. Getting long-term budgets under control is hard enough today. The job will be nearly impossible with a slew of new entitlements in place. In short, any combination of what is moving through Congress is economically dangerous and invites the rapid acceleration of a debt crisis. It is a dramatic statement to finance markets that the federal government does not understand that it must get its fiscal house in order. . . . The time to worry about the deficit is not next year, but now. There is no time to waste. Again, Mr. Holtz-Eakin is the former Director of the Congressional Budget Office and a fellow at the Manhattan Institute. This is adapted from testimony he gave to the Senate Committee on the Budget on November 10. Since that time I have been talking about how we have maxed out our credit cards, but this is something known across the Nation. I have to share something. I mentioned I get things from all the papers in Wyoming. This comes from the Lovell Chronicle. That is a place that is probably about 120 miles from Yellowstone Park. That is always how I describe our State, in terms of Yellowstone Park, because a lot of people know where that is. Her name is Diane Badget and she writes a column regularly. My dad used to play this silly game with us. We'd hear ``THUMP, THUMP'' coming from the kitchen. One of us would ask, ``Dad, what are you doing?'' He'd reply, ``Beating my head against the wall.'' At that point another of us would dutifully respond, ``Why?'' Then we'd wait a second for the expected reply: ``Cause it feels so good when I quit!'' Has the bickering in Washington sickened you to the point where you almost don't care what they do as long as they shut up? Be careful! That's what some are hoping for. They are disdainful of our feeble attempts to get them to listen to us. They hope that if we beat our heads against the wall long enough we'll realize how much better we'd feel if we'd just quit. She goes on to talk a little about Copenhagen. The plans for building safe, clean nuclear power plants to provide electricity evaporated when the promise of a secure place to store spent nuclear fuel suddenly ended. Yet this same administration has decried coal fired plants as ``ecological disasters'' and large-scale wind and solar energy as too expensive to build yet. Nothing has been done to utilize the vast reserves of resources in Alaska. Okay, if we can't use coal plants, can't afford wind or sun, Alaska doesn't exist, and nuclear options just got flushed, what should we do? Oh, I know! Let's gather up half of the over-zealous geniuses who supported Obama's decision and put them on giant hamster wheels hooked to generators! Then we'll take the other half and utilize their hot air to turn turbines! It makes as much sense as anything in the Cap and Trade bill. My grandkids can't pray in school, but other kids are provided with prayer mats. No wonder so many terrorists are found right here in the very country they have sworn to destroy. How many more radicals are walking among us, undetected? She talks about: The decision to try the 9/11 conspirators in our court system is a travesty. These murderers have already pleaded guilty in a military tribunal. They are not entitled by our Constitution to a trial. U.S. citizens are entitled to a trial before a jury of their peers. But she does move on to healthcare as well. Are you confused yet? Apparently Congress is. The health care plan that the Senate voted to send to the floor for debate is a perfect example. One side says that it will be deficit neutral, will ensure competition, will not affect Medicare and won't result in more taxes. The other side says it will cost too much, eliminate competition, slash Medicare and tax us out of our underwear. Barbara Boxer (D. Ca) touted Medicare as a great example of how seniors are able to chose a ``public option''. Excuse me? When we turn 65 we are required to sign up for Medicare. How is that optional? I think at this point both sides of the aisle are trying to sell us snake oil, and somewhere in the middle is the truth. Are you worried yet? Are your children and grandchildren going to enjoy the same freedoms and opportunities that we enjoyed? The future of my grandchildren should have been better than the life I had, and my life has been pretty doggone good. Instead, future generations are going to be paying, financially and personally, for the mistakes made right now by a president who presumes too much power and a system of checks and balances that no longer works. We have been talking about having a bipartisan bill here. Maybe that would end the contradiction and furor that we are talking about here. I think a lot of people must have missed the speech Olympia Snowe made about durable social reform always being bipartisan. I want to share some comments on that. I know her speech wasn't noticed by the press corps. With Majority Leader Harry Reid's announcement this week of a double-secret bargain that Democrats hope will squeeze ObamaCare through the Senate after nine whole days of debate so far in the world's greatest deliberative body--the Maine Republican's words seem more pertinent than ever. Mrs. Snowe began by noting that this year's health debate is ``one of the most complex and intricate undertakings the Congress has ever confronted,'' and that she, too, has devoted much of her three-decade political career to promoting cheaper, better quality insurance. ``But it must be done in an effective, common-sense and bipartisan way,'' she cautioned. Far from ``systematically working through the concerns, the issues and the alternatives,'' Mrs. Snowe added, Democrats have instead favored ``artificially generated haste'' and settled on a strategy ``to ram it, to jam it'' through Congress. The Senator detailed her good-faith participation in the ``group of six'' on the Senate Finance Committee, which met some 31 times over the spring and summer and reflected ``the kind of extensive, meticulous process that an issue of this magnitude requires.'' The negotiators tried to build a consensus, blending the best ideas from both parties. Or at least they did before the group of six, and Mrs. Snowe in particular, became a liberal political target for supposed obstructionism. Chairman Max Baucus then pushed their unfinished work to the Senate floor, where Mr. Reid is now rushing to pass a bill in a race against its rising unpopularity and President Obama's falling approval ratings. Mr. Reid made his case with his usual intellectual nuance this week: ``Instead of joining us on the right side of history, all the Republicans can come up with is, `Slow down, stop everything, let's start over.' If you think you've heard these same excuses before, you're right. When this country belatedly recognized the wrongs of slavery, there were those who dug in their heels and said, 'Slow down, it's too early, things aren't bad enough.' '' Then, after equating opposition to Medicare cuts and tax increases with support for human bondage that it took a bloody civil war to end, Mr. Reid went on to draw analogies to women's suffrage, Social Security, civil rights and Medicare. Mr. Reid would have done better listening to Mrs. Snowe about the ``history'' of major social legislation, which she also discussed in her November speech. Her main and telling point was that durable social reform in America has always been bipartisan, and not merely with one or two opposition party votes. While Social Security passed when Democrats controlled both Congress and the White House, she said, 64 percent of Senate Republicans and 79 percent of the House GOP supported it. Civil rights passed with 82 percent of Republicans in the Senate and 80 percent in the House, while 41 percent and 51 percent, respectively, voted for Medicare. Mrs. Snowe could have added the 1996 welfare reform that President Clinton signed with the support of nearly all Republicans in Congress, 98 Democratic Representatives and 25 Democratic Senators. ``Policies that will affect more than 300 million people simply should not be decided by partisan, one-vote-margin strategies,'' Senator Snowe explained, and Congress should not be ``railroading solutions along partisan lines.'' On the debate that we have had, one of the points of contention, of course, has been Medicare. They talked on that side of the aisle about how good Medicare is. We talked on this side of the aisle about how Medicare is being harmed. I think what we are really giving people the impression of it is when we pass the bill, all of it will be free. That will not happen. But there was some contention that private insurance was less fair to people, Medicare was always fair. So I dug up some information on it. Investors Business Daily has done a little bit of research in that area. They found that: Throughout the health care debate insurance companies have been cast as greedy villains that gleefully deny medical claims. But when it comes to rejecting claims, they can't hold a candle to government. They found the most claims are the ones denied by Medicare, not the private sector. What has happened in the last couple of days, Medicare has been so popular that the leader has said he is going to include, now, a piece that will bring the age group to 55. We have been talking about how, under the present circumstances, with the money that is being stolen from Medicare, that it is going to go broke. The majority leader--and evidently it is just the majority leader because when we asked to see a copy of it yesterday in a little colloquy we had with the Senator from Illinois, Senator Durbin, he said he had not seen it. So I think--I know they had been briefed on it probably in a general way the night before. But it was explained to us that if anybody knew what was actually in that, that then the CBO score that comes out of that, how much it will cost, would have to be shared with everybody. I thought we were in the new era of transparency. That doesn't sound very transparent to me. Even Democrats didn't get to see it because, if they did, then all of us could see how much it is going to cost as soon as the Congressional Budget Office has declared that. That bothers me. I think it kind of bothers America. What we are worried about is it is going to come to the floor all of a sudden and we are going to have to make decisions on it. Evidently it is being talked about a little bit on the other end of the building, because I saw that Speaker Pelosi stopped short of endorsing the full Senate compromise, saying she needed to see ``something in writing.'' But she said, ``There is certainly a great deal of appeal'' in expanding Medicare. But the Washington Post did a little editorial. This would have been on December 10. They called it ``Medicare Sausage? The emerging buy-in proposal could have costly unintended consequences.'' Incidentally our side has only seen this based on what the media has heard, and I don't know what kind of briefings the media has had on what this particular proposal has. The Washington Post says: ``The emerging buy-in proposal could have costly unintended consequences,'' and begins by saying: The only thing more unsettling than watching legislative sausage being made is watching it being made on the fly. The 11th-hour compromise on health care reform and the public option supposedly includes an expansion of Medicare to let people ages 55 to 64 buy into the program. This is an idea dating to at least the Clinton administration, and Senate Finance Committee Chairman Max Baucus originally proposed allowing the buy-in as a temporary measure before the new insurance exchanges get underway. However, the last minute introduction of this idea within the broader context of health reform raises numerous questions--not the least of which is whether this proposal is a far more dramatic step toward a single-payer system than the lawmakers on either side realize. The details of how the buy-in would work are still sketchy and still being fleshed out, but the basic notion is uninsured individuals 55 to 64 who would be eligible to participate in the newly created insurance exchanges could choose instead the emergency coverage through Medicare. In theory, this would not add to Medicare costs because the coverage would have to be paid for--either out of pocket or with the subsidies that would be provided to those at lower income levels to purchase insurance on the exchanges. The notion is that, because Medicare pays lower rates to health- care providers than do private insurers, the coverage would tend to cost less than a private plan. The complication is understanding what effect the buy-in option would have on the new insurance exchanges and, more important, on the larger health-care system. Currently, Medicare benefits are less generous in significant ways than the plans to be offered on the exchanges. For instance, there is no cap on out-of-pocket expenses. Wasn't one of the promises that we were going to be sure that catastrophic was covered for everybody? One of the things I discovered early on in this process is that catastrophic is not covered in Medicare, not in the regular plan. You have to get the Medicare Advantage to get catastrophic or the more expensive Medigap policy. Of course, we are talking about taking a whole bunch of money out of the Medicare Advantage, which the companies say will either reduce benefits or eliminate it altogether. I think this book was delivered to every office. I got one in my office. It is called ``Voodoo Anyone?'' It is ``How to understand economics without really trying.'' I do hope every Senator finds their copy of this book and takes a look at it because it talks about prices, how prices are set, what affects prices, what happens when you fix prices. Then it talks about health care and energy and education and crime and social and agriculture and labor and monopolies, and financial markets and government action. I have never found a book that put it quite as succinctly or quite as understandably as this book does. We need to be paying some attention to the fixing prices part of it, for sure. He gives a nice example on this. You're in a college town, and you realize that there is no good place to buy a decent bicycle. So you get some money together (loans, the parents, investors, whatever) and you open up Deals on Wheels. But business at first is slow. So you figure you'll bring in customers for a sale. You look at your books and you make some tough decisions. You paid $100 for a bike from the manufacturer, and you sell it for $110. But without customers, you realize you need to do something. So you decide to sell the bicycles for $80 as a way to draw customers to Deals on Wheels. You know that you can't continue to sell your bikes at a loss, so you say it's a one- day sale only. And sure enough, the word gets out, and you've got more customers than you can handle. They can't fit in the store and spill out on the street. Little did you know that a lawmaker passed by, saw the crowd and realized something good was going on. The politician goes back to Washington, D.C., and convinces his colleagues that an $80 bicycle is a great thing. ``Bicycles have so many benefits,'' intones the lawmaker. ``They can help you get healthy. And the more people who ride bikes, the less pollution there is. And, of course, more people riding bicycles will help the United States become less dependent on foreign oil. To thunderous applause, the politician sits down and watches his bill that will cap the price of bicycles at $80 pass in a near unanimous vote. (The politician and all his colleagues have calculated a lot of votes will come their way in the next election as a result of this bill). But for you, the bicycle dealer, the one-day sale has become a permanent condition. You can't find bicycles for less than $90, so you're going to be selling all bicycles at a loss. Do you stay in business? You instead sell off the rest of your inventory and explore other employment opportunities. I read that to lead up to what he has on Medicare. He says: Remember the bicycle example? A price control on bicycles below the cost of production signaled to consumers to buy cheap bikes. But it also told producers that they couldn't make any money. When you have high demand and low supply, you get a shortage. And that's where the Medicare program stands today--waiting lists, fewer doctors who see Medicare patients and shorter hospital stays are all evidence of a shortage in the medical care for senior citizens. There are several more pages on Medicare I won't cover. I encourage my colleagues to read it. It is a very small book, a very short book, but it makes a lot of excellent points. Of course, the day before yesterday we got this report from the Actuary of CMS, which is part of Health and Human Services, which is a part of the administration. He said that Medicare would not be sustainable under the Reid bill. Is there a way to fix Medicare? I think so. We have promoted over here several times that instead of taking these cuts to Medicare and expanding them into brandnew entitlements--an entitlement is something that goes on forever without congressional approval--we ought to lop off the Medicare piece and make sure we get it right. Yes, there are things that have been noted that would save money. But that money that is saved ought to go right back into Medicare so that those seniors who are so nervous across the country would understand we weren't cutting their programs. They say: No, we are not cutting the program. We haven't cut a single guaranteed benefit. We also haven't fooled a single senior out there. The only ones we have fooled have been the AARP. Of course, the AARP is going to make more money off of Medigap than they ever made off Medicare Advantage. They have to look at where the bread is buttered here. Senator Dodd said that he would like to know exactly which pages had cuts to Medicare on it. I have a sheet here that shows the exact page numbers in the bill and the CBO report. I ask unanimous consent that the following be printed in the Record in this regard.

Mr. ENZI. Of course, the Democrats do recognize that there is a problem with Medicare going broke; otherwise, they wouldn't have to put a special commission in there. There is a special MedPAC commission. There already is a MedPAC, so there is going to be a MedPAC on steroids in there. That means it will have to report to us and we will have to take action on it or else they will be able to take action anyway. If we are not breaking the system, what do we need that for? Actually, if we use the money that comes from Medicare only for Medicare, the commission would have a much easier job. For one thing, we would be able to do the doc fix. The other side keeps referring to how the deficit will be reduced by this bill--$157 billion in the first 10 years and another number for the second 10 years. But that is only if you believe we will not fix any of these things that are major problems, such as the doctors. We are not paying the doctors enough. Right now, 25 percent of the doctors won't take a new Medicare patient. The number varies between 45 percent and 50 percent who won't take a new Medicaid patient because we pay too little. We did the price fixing such as I described in that book. If you do price fixing, you can't afford to pay the doctors enough. The doctors know that. They are not going to work for nothing or less than nothing. Consequently, if you can't see a doctor, you don't have any kind of insurance. That is a basic guarantee of insurance, that you will get to see some medical person and they will do some kind of treatment if you need it. We are also hoping the doctor gets to make the decision on the treatment you have. There is also a little medical commission in the bill, preventative commission, a task force that put out a report on mammograms and upset the whole country, with some justification. As those things are adopted for everybody, it takes away the right for the doctor to say: My patient is a little bit different. We are all a little bit different. Some of these commissions and task forces need to be looked at. Is America listening? Last week, there was a vote in Kentucky. There were two people running for the legislature there. It was a highly Democratic district. The Republican talked about health care. That was his whole pitch. He did a warning on health care. He won in a heavily Democratic district. This is being reported repeatedly across the country. I have some things where I could go into some of the poll numbers that are out there now. I know individuals are looking at those poll numbers and realizing the American people have figured it out. They really have. Congress hasn't figured it out, but the American people have figured it out. I have to talk about one specific part of the bill. Senator Harkin and I worked together on this bipartisan amendment. It wasn't one we invented; it is one we found from Safeway. Safeway has some programs they put into effect for their employees on a voluntary basis that cut the cost of health care for Safeways while increasing the benefits for the employees. That is not happening anywhere in America. You have seen the charts on how fast health care is expanding. Safeway was able to get about an 8-percent reduction the first year and has been able to hold it level since then. Senator Harkin and I asked: How did you do that? One of the ways was to give people incentives to do the right thing. Again, it was on a voluntary basis. We got the flexibility for these incentives put into the HELP Committee markup. It was approved. It was put in. It was bipartisan. It should have been approved and put in. It was also a good idea. There was this clinic that we call Safeway that had been the lab for it, that had tried it and it worked. It was to raise the limit people could have for doing these incentives from 20 percent to 30 percent and even up to 50 percent, if it worked. Without my approval, that was jerked out of the bill before it was actually printed. I hope people take a look at the November 29 issue of Roll Call, where there is an editorial by Morton Kondracke, who explains how this all works and what a difference it could make and how terrible it is that it got pulled out. It is interesting that some of the groups that were against it were ones such as the American Cancer Society, the American Heart Association, and the American Diabetes Association. They did it on the basis that it discriminates against people who want to stay fat and won't quit smoking. Incidentally, a smoker costs $1,200 a year to somebody else because it isn't included in their insurance that way. Ways of improving the system--I will talk about that at another time. I can see everybody is fascinated by all of this. We will talk about lawsuits and health savings accounts. The other side would like to eliminate health savings accounts. Actually, what they want to do is tell you what insurance you have to have. They want the government to tell you what the minimum acceptable insurance is. That is not bad enough. If you don't buy at least the minimum acceptable insurance, then you get fined. Under the House bill, you can go to jail. That is only if you don't pay your taxes as a result of the fine. That is done through the IRS. It is a huge expansion of the IRS at the same time. Health savings accounts have been working in this country. In fact, they work for our employees in the Senate. The health savings account is where you buy a high-deductible policy and you have the right to put money tax free into a savings account that can only be used for health, with the theory that if you do have something happen to you, you can draw out of your health savings account to pay this deductible. If you are young and healthy, it is a tremendous thing. One of the young ladies in my office said: Let's see, the amount I have to pay for regular insurance and the amount I have to pay for a health savings account are considerably different. If I took that difference and put that into a health savings account, it would still belong to me. It would roll over from year to year, and I would have that available tax free whenever I need it. She did that. Within 3 years, she had the entire deductible covered in there. She was smart enough to continue to put money in there, tax free money that will take care of her health care expenditures. Do you think she will be upset if we eliminate health savings accounts? Yes, I think so. There is another thing Senate employees use; that is, flexible spending accounts. Even if you pick the ones without the high deductible, you have the right to figure out how much your medical expenses are going to be the next year and put those into a special account, a flexible savings account. Over the next year, you can use that money from the flexible savings account, which comes out of your paycheck, tax free for the medical needs you have. People who know they are going to have medical needs find this to be useful. They find that they can tell--you have to do it by Monday--how much you think you are going to spend the next year. The downside of it is, if you don't spend it all, the extra goes back to the Federal Government. Even though it came out of your paycheck, it goes back to the Federal Government. A lot of people would say this would be a good deal if we could roll that over. There are a lot of eyeglasses and dentists appointments that are done in December for people to be able to use that flexible spending account. If it rolled over, they could continue to use it for what was really necessary. That is being limited in the bill. That will be a detriment to people who have some catastrophic things happening to them. Cancer would be one of those things. If they know how much they are going to have to spend on MRIs and CAT scans and other kinds of tests over the coming year, in December they put that amount of money in there, and then they can have this little bit of a tax advantage for taking care of their health care costs. That is much like big business provides in the much better plans than we have in the Senate. To conclude, I would like to have a document printed in the Record by unanimous consent, which is titled: ``A Specific Plan of Action: Lowering Health Care Costs.'' I am inserting this on behalf of Senator McCain because people keep claiming that when he ran for President, he said things differently than what is being said now, and with this as part of the Record, maybe we can get them to quit saying that. Because he did talk about waste, fraud, and abuse in Medicare and the need to contain it and physician payments and coordinated care and preventable medical errors. So I ask unanimous consent that document be printed in the Record.

Mr. ENZI. I hope, on future appropriations--I hope when the President gets this bill, if it makes it through the process--and it appears as though it should easily do that--he will veto the bill and send it back because the 5,224 earmarks, amounting to $3.8 billion--instead of talking about 5 percent of what the Cabinet members expend, it might be more valuable to talk about $3.8 billion. There are other things that need to be done. We do need to start being fiscally responsible. Of course, one of the questions is: Why haven't we been, in the past, fiscally responsible? That answer to that is, we did not have our credit cards maxed out before. We were able to print the money and nobody noticed. But now when we print the money, people do notice. So we have both the end of the year appropriations-- the end of the year, incidentally, was the last day of September, and we are doing them now--and we have this health care crisis to solve. There is not anybody who does not want to come up with a solution to it. But we want to do it step by step and get the confidence of the American people. The American people do not have confidence in what we are doing. I have several documents that would show what percentage of the people do not agree we are doing the right thing. That ought to get the attention in virtually every State because it is not just as a national whole, it is in every State. People have figured out what we are trying to do, and they do not think we are doing it right. We better get it right or people will be even more upset. I yield floor.

Mr. ENZI

Mr. ENZI. Mr. President, reserving the right to object, we are going to have three Democratic amendments and one Republican amendment voted on, and the Democrats wrote the bill. The Democrats are doing a side by side to their own amendment. It looks to me like they ought to get together and get some things figured out. There ought to be a little bit more fairness on the number of amendments. So I object.

Mr. ENZI

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

Mr. ENZI. Mr. President, for several weeks I have been saying, where are the appropriations bills? Under Federal law, we are supposed to have those done by October 1--October 1. Let's see. This is December 10. We must be past that deadline. Well, here come the bills. They are all packed into one. There won't be the debate we would get if we handled them one by one. It is fascinating to me that one of them is Health and Human Services. All year we have heard that health is what is breaking the people of this Nation, how important health care is; why we have to do health care reforms under strict deadlines--strict deadlines that have shifted a number of times and are irrelevant to getting a good bill. But health care is that important, and it is one-sixth of the Nation's economy. So why haven't we had the health care appropriations debate before October 1? Why did it get put off until now? I guess it is because all of the earmarks weren't ready yet or maybe it is because they thought this bill ought to pass and solve all of the problems. I think the bill could have passed much faster. I think it could have solved a lot more problems. If it would have had the kind of bipartisanship Senator Durbin keeps describing as having happened, we would already have the bill done. Much of what he keeps repeating--and the more times you repeat it doesn't make it more true--in every speech he gives, he makes the same comments about how long the HELP Committee worked on this bill and how many amendments from the Republican side were automatically accepted into the HELP bill. We always have to come out and correct that. Yes, there were a number of amendments. That bill was put together over a period of 2 weeks with a new committee chairman, without a single input from Republicans. It was brought to the committee for markup. We did have about 3 days to do amendments, and we did a lot of amendments. They did accept some of the amendments. Of course, we helped correct punctuation, we helped correct spelling, and we did have a few amendments that were accepted that actually made a difference. After the vote, they didn't publish the bill for the public to look at--the amended version of the bill for the public to look at. I think that was so they could rip out the Republican amendments they had accepted. That has never been done in committees. When amendments are accepted, they are left in the bill, or at least the Senator who proposed the amendment gets to talk about why maybe it should or shouldn't be in there, or at least he is informed that they are going to rip it out. Not in this case. The bill is published, we are looking for some of these things and find they are gone. Then they wonder why there is opposition to the bill. Then he talks about the hours we spent together working as the Group of 6. I appreciate him mentioning the hours, but hours don't make any difference if ideas aren't taken. The purpose of the hours is to be able to express ideas that can be included in a bill. Just getting to express them isn't enough. To make them bipartisan, they have to be included. Anybody who looks at the things we have on our Web sites would understand that we did have some good ideas, some things that would make a change in the way we do health care in America. Are those in this bill? No. This is the Reid bill. This wasn't put together by the HELP Committee or the Finance Committee, although significant parts of both of those bills, which we didn't have input into, are a part of it. How was that designed? That was designed behind closed doors right over there, with no Republican input whatsoever. How does that make it bipartisan? How does that even give us a chance to make it bipartisan? Then they wonder why we have amendments. Here is a fascinating thing on amendments: In the HELP Committee, the Democrats presented more amendments than the Republicans did. The Republicans did get two that we voted on and passed. The Democrats had over 30 that they presented to get passed. How come they even had to put in amendments? It was their bill. We are facing the same thing with the bill that is on the floor here. They are putting in more amendments than we are. Every time we put in an amendment they have a side-by-side on it to give them some cover to say, well, what they said wasn't that important. It wouldn't make a difference. Besides that, we don't want to do it, so we will have something that says we voted for that concept. If you put the bill together, you shouldn't be the ones filibustering and doing the amendments. They have a unique position here now. We have a Democratic amendment and a Democratic side-by-side. I don't remember ever seeing that before. But we had a request this morning for three Democratic votes and one Republican vote. That is real bipartisanship? Yet they want the cooperation. The thing that upsets me the most is they keep saying this will save money, this bill is going to save the country money, and we are in this appropriations process and we ought to be interested in saving the country money. But CBO didn't say that. CBO did not say that this bill will save money, unless you use a whole bunch of phony accounting, and there is phony accounting in this bill. That is how they are able to say, Oh, yes, we save money. We save money. This is going to save the American people a lot of money. No, it does not. Do not buy that story. Look at the accounting. I am the accountant. I have taken a look at it, but I am not that good of an authority. We just got the report from the CMS chief actuary. Yes, that is the actuary who is actually in charge of Medicare and Medicaid and he did an analysis on it. I am going to go into some more detail on that analysis, because he says this bill does not save money. This bill will cost seven-tenths of 1 percent more than if we did nothing. Is that health care reform? And where is the transparency we were promised would happen under this administration? Transparency? They built the bill behind the closed doors over on that side of the Senate Chamber and now a significant part of the bill--which is called the public option, government option, government-run program, whatever you want to call it--has been drastically changed. The newspapers have written about it. People have seen it. But the newspapers haven't seen what is in there. The Democrats, according to Senator Durbin, the majority whip, have not seen that bill. The only one who has seen it is Senator Reid and the Congressional Budget Office. He is not going to disclose any of that-- any of that--until after he sees what the score is going to be. That is the ultimate in transparency, in my opinion. If you think you have a good idea, maybe you ought to let people see what the score is and see what the bill is, and you ought to if you expect us to debate it in a hurry. That is what we are under, this hurry-up situation. Hurry up so a bill that isn't going to do anything until 2014 can be passed by Christmas. This side is ready to reform health care. This side is ready to stay in through the weekend. We already stayed in through last weekend. We will stay in until Christmas. We will stay in the days after Christmas. We will stay in next year. But it has to be right. The American public expects this to be right. There has never been a major piece of legislation passed by this body in the history of the United States that was passed by one party. Not yet, there hasn't been. There is a good reason for that. It is full of flaws if just one side's ideas are incorporated in the bill, and this is no exception. This has a lot of flaws. This is a real move to the left to incorporate most of the people over there, but they weren't able to incorporate all of them, so now they are doing a secret public option to expand Medicare to distract people without telling them what is in it and expecting us in a few days to vote on this thing. Well, I am going to share some of these numbers from the CMS chief actuary a little later, but I see my colleague is here and is actually going to talk mostly on the appropriations bill. I will say that what I have had to say ties in directly to appropriations. It is spending money. We are going to spend $464 billion of Medicare money from a system that is going broke and we are going to raise taxes--that is kind of an appropriation too--to cover the other $\1/2\ trillion in new programs that are not going to lower premiums or save the United States money, according to the CMS Chief Actuary Rick Foster. I yield the floor.

Mr. ENZI. Mr. President, what is the time situation?

Mr. ENZI. Mr. President, I rise to discuss a new report on Senator Reid's health care reform bill. This kind of fits in with the appropriations that deal with Health and Human Services that is over 2 months past due. Last night, we received a new analysis of the Reid bill we have been discussing about 11 days straight, performed by the Center for Medicare and Medicaid Services--that is CMS--which is under the Department of Health and Human Services. The chief actuary, Rick Foster--this is the guy in charge of all this. He is the chief actuary. This is not somebody outside the system. This is the guy who has to answer for all this. He serves as the independent technical adviser to the administration and Congress on estimating the true costs of health care reform. Some of the findings in this report directly contradict some of the claims we heard this week about the Reid bill. For a week now, we have heard how the Reid bill will help slow spending growth and reduce how much we as a nation spend on health care. Mr. Foster's analysis shows that statement is false. According to this report, national health expenditures will actually increase by seven-tenths of 1 percent over the next 10 years. That is seven-tenths of 1 percent if we did nothing different. Despite promises that the bill would reduce health care spending growth, this report shows the Reid bill actually bends the health care cost curve upward. We have also heard, over the past week, how this bill will reduce health insurance premiums. Again, the administration's own chief actuary says this is false. The new report describes how the fees for drugs, devices, and insurance plans in the Reid bill will increase health insurance premiums, increasing national health expenditures by approximately $11 billion per year. We have also heard how the Reid bill will reduce the deficit, extend the solvency of the Medicare trust fund, and reduce beneficiary premiums. According to the Foster report, these claims are all conditioned on the continued application of the productivity payment cuts in the bill which the actuary found were unlikely to be sustainable on a permanent annual basis. If these cuts cannot be sustained, one of two things will happen. Either this bill will dramatically increase the deficit or beneficiaries will not be able to continue to see their current doctors and other health care providers. In reviewing the $464 billion in Medicare cuts in the Reid bill, the Foster report found these cuts would result in providers finding it difficult to remain profitable. The report went on to note that absent legislative intervention, these providers might end their participation in the Medicare Program. In addition, if enacted, the report found that the cuts would result in roughly 20 percent of all Part A providers--that is hospitals, nursing homes, et cetera--becoming unprofitable within the next 10 years as a result of these cuts. As a former small business owner myself, I understand the impact this will have on doctors, hospitals, and other health care providers. In rural areas, such as my State, these providers will go out of business or have to refuse to take any more Medicare patients. The CMS actuary noted that the Medicare cuts in the bill could jeopardize Medicare beneficiaries' access to care. He said the Reid bill is especially likely to result in providers being unwilling to treat Medicare and Medicaid patients. That is what we have been saying for about 11 days. The Reid bill also forces 18 million people into the Medicaid Program. The Foster report concluded this will mean a significant portion of the increased demand for Medicaid services will be difficult to meet. These are not the claims made by insurance companies or anyone who might have a vested interest in the outcome of the debate. These come directly from the administration's own independent actuary. In light of this report, why are the sponsors of this bill continuing to argue for a $2.5 trillion bill of new programs which will increase health care spending, drive up premiums, and threaten the health care of Medicare beneficiaries? We can do better. We need to start over and develop a bipartisan bill that will address the real concerns of American people--develop a bipartisan bill. They cannot just exclude one side because there is a majority that won the election and gets to write the bills. We get tired of hearing that told to us. Where is your comparable bill? We are not trying to have a comparable bill, we are trying to have input into the current bill or the current bills: Sit down, talk about the principles, find the actual things that fit into those principles, develop the details, and have a bill that goes step by step so we get the confidence of the American people. The step we ought to start with is Medicare. That is why I present this report from the actuary of CMS, which is part of the Department of Health and Human Services, which is assigned most of the job of coming up with the details of the bill we have before us. That means actual elected officials would not be doing it. But this CMS actuary says everything that has been said by that side of the aisle is false unless there is some phony accounting that goes into it. I yield the floor and reserve the remainder of our time. Mr. President, I suggest the absence of a quorum and ask unanimous consent that we divide the time.

Mr. ENZI

Mr. ENZI. Mr. President, I appreciate the statistics the Senator from Montana cited about how long we have been debating this and how many amendments we have done. That is how few amendments we have done, actually. The majority is now filibustering their own bill. I have no idea why that is happening. We have been calling for votes on both of these amendments that have been proposed so far and haven't been able to get the votes. I don't understand how they can talk about how many amendments are being done. I also have to voice some other frustration. I don't know how many times I have heard the exact same speech by the Senator from Illinois, Mr. Durbin, on this floor talking about the amount of hours that have been spent together working on these bills in the HELP Committee and the Gang of 6 in the Finance Committee. It isn't about how many hours we spend together. It isn't about how many hours we spend on the floor. It is whether we are accepting ideas. I understand the other party won the last election, but somehow they will have to get over this attitude that they won the election, they get to write the bill, they don't have to take any ideas from anybody else. In the HELP Committee, I keep pointing out that most of the things we turned in were kind of punctuation corrections and spelling corrections. Any ideas we actually had that appeared to be accepted to be in the bill were ripped out of the bill before it was actually formally printed, without talking to us. What kind of bipartisan deal is that? Another thing with the HELP Committee, we have only had 10 days of debate on this. We did more than that in the HELP Committee when we were marking up the bill. But we are having, in the words of Yogi Berra, deja vu all over again. When we were having that markup, the majority withheld a significant part of the bill, a big part of the bill. It was the government-run option part of the bill. They wouldn't give us the wording on that. I think they were still writing it. Maybe that is what is happening right now too. But we couldn't get the text we were going to write amendments on so that we could deal with the bill. I think America noticed that in August. People said: How come everybody isn't reading the bill? You can't read what you don't have. The point I am making is, right now the newspapers are full of information--well, speculation; it has to be speculation--about what this new Medicare expansion does. I haven't run into anybody who has seen the text of that. I have asked some of the media, and they didn't see the text. They got a briefing. We haven't even had a briefing. The majority side has had a briefing, but our folks who have talked to those folks said: Wow, that was pretty general. How could you make up your mind on whether you are going to support it based on the little bit of information you received? That is not the way to run any kind of an organization, especially if you want bipartisan votes. You can't write the bill in secret, which is what was done with this bill. There wasn't a Republican involved in the behind-the-door stuff Leader Reid did to put together the bill we have now. That is not bipartisan. There hasn't been a single person from the Republican side briefed on this new proposal that is going to save the world. Actually, I noticed that the American Medical Association suddenly left the bill and said: This will be the worst thing that could happen to us. The hospital associations, which have been strong supporters of the bill, have also said this won't work, particularly the Mayo Clinic, which we have been holding up as one of the prime examples of the way to do health care, saying: If this Medicare expansion happens, it will cost us millions. We won't be able to provide the kind of care we have been providing. What is the deal around here? When are we going to actually get to see something? When is the majority actually going to share with us this marvelous idea they have had? What kind of a way to run a business is that? Are we going to recess for the weekend? I don't want to recess for the weekend. I am conscious of the 11 days we have been debating, and we have only covered 14 amendments. We have a lot of important amendments that either will be a part of the bill or will help the people in this country to understand what is being thrust on them. There has never been a bill of such importance as this one from the standpoint of how many people it affects. We are talking about reforming health care in America. That is everybody. That is every single individual, every single provider. Every single business will be affected by this bill. We talk about 2,074 pages, which seems like a lot. It would be for a normal bill that you could debate in a limited period, which is what we are being asked to do. But 2,074 pages isn't nearly enough to cover health care for America. So why is it only 2,074 pages? There are hundreds of references in there to how the Secretary of Health and Human Services is going to solve all the problems. The things we aren't able to put into detail in there we just assign to her, and she will magically be able to solve the problems for American health care. After all, it is her Department. But that is not going to happen. You can't give that many assignments to any agency, any department, any group of people and expect them, in a reasonable amount of time, to come up with solutions, solutions that ought to be decided on by this body, the elected officials--not appointed officials but elected officials. That is not going to happen with this bill. The only way that could happen is if we took significant parts of it and put it up one piece at a time and solved it. That is what seniors are asking for. They are asking for us to take the Medicare part and give them some assurance that when we are through, it will work. We are not even getting to see a significant part of it. We have been pointing out how taking $464 billion out of Medicare will break it, will ruin it. You just can't steal $464 billion out of Medicare and have it come out good. The majority recognizes that. That is why they put in the special commission that is going to come to us each and every year and suggest the kinds of cuts we ought to make to keep that solvent. The biggest thing we ought to do is take these cuts that are provided and make them actually apply only to Medicare. But how are you going to fund the expansion of Medicare now down to age 55? How do you do that? I guess you charge a premium to those people. That is kind of the rumor that is out there. How big of a premium? How big of a premium are you going to thrust on those people? I suspect it is going to be the older and the sicker people in that 55- to 64-age category who are going to want to shift over to Medicare. If it is a higher premium so the system stays solvent--having nothing to do, of course, with age, because we cannot do that under the bill, or sickness, because we cannot do that under the bill--and those are good ideas--but those better be up in that range of the high-risk pools that the States already have. People come to me and say: You have to do something about health care because we cannot afford that high-risk pool; it is too expensive. Well, how much more are we going to expect the young people to pitch in in their paycheck? That is where the Medicare money comes from right now. They deduct a portion of the paycheck from every single working American, and that goes into Medicare, and gets paid out right away to Medicare recipients, none of whom or hardly any of whom are the ones paying into the system. They are hoping that system is going to be there when they get older. What I am asking for is for the majority to show us the paper and give us a reasonable time to look at it and give America a reasonable time to look at it. I do not think it is unreasonable for that to be on the Internet. That is a significant part of the bill. That would be a significant bill all by itself. It was held from our view when the HELP Committee did it. Incidentally, that HELP Committee bill--that was put together in 2 weeks without our help and put on us--parts of it were withheld, as this has been withheld, until the last minute and then thrust in. That is what created this enormous outrage across America of: Did you read the bill? How can you read the bill if you have not seen anything in it, if it has not been given to you? I do not think it is intended to be given to us until we have to shuffle this thing through at the end. The anticipation was to get this done by Christmastime, and the majority side keeps talking about getting this done by Christmastime. Will we have time to read it before Christmastime? Will we have a chance to do any amendments on it before Christmastime? I am willing to stay around and work through the weekend and keep doing amendments, but I would like to see this marvelous idea that is going to solve the whole problem. If it was that marvelous and that good of an idea, I think it would be shared already. Mr. President, I yield the floor and reserve the remainder of our time.

Mr. ENZI. Mr. President, I am fascinated by the speech we heard. There has been a bipartisan proposal. The chairman of the Budget Committee and the ranking member of the Budget Committee have proposed a commission, and that bipartisan deal is being chastised here. So we are on the bill, where 64 percent of the amendments that have been filed so far were filed by the Democrats, and I keep wondering why they are filibustering their own bill. Then when something bipartisan does come up, they are opposed to that too. I know they think the only good ideas come from the other side of the aisle, and I do get frustrated with that.

Mr. ENZI. Certainly.

Mr. ENZI. I cannot fault the Senator from Montana for his efforts to get a bipartisan solution. As I have said many times, I am sorry he had to be cut off by phony time deadlines that kept us from reaching that kind of a solution, and then winding up with things that are in this bill we are talking about that were not a part of our discussions-- again, the things that were proposed by people on this side of the aisle that are not in that bill. There were some possibilities for solutions. But we wound up with that same situation of: We won the election, we get to write the bill, and it has to be done quickly. So I am disappointed in the whole process.

Mr. ENZI. I will.

Mr. ENZI. The Senator is absolutely right. We have not even seen this new piece. Nobody wants to show us the new piece. They keep talking about it. They have leaked it to the newspapers, but they will not show it to us, and then they keep talking about how this bill is going to solve the deficits for this country; that there is $157 billion or something saved in the first 10 years. That is only--only--if you use the phoney accounting they are using. It is only if you don't do the doc fix. It is only if you don't solve the myriad of other things we have brought out. We have a bill they keep talking about as being the solution. America has figured it out, but the Democrats haven't figured it out. I see the leader is on the Senate floor. I yield the floor. Recognition of the Minority Leader

Mr. ENZI. Mr. President, it is my understanding the leader spoke under leader time.

Mr. ENZI. So we should have an adequate 10 minutes to allocate to the Senator.

Mr. ENZI

Mr. ENZI. Mr. President, I yield myself 10 minutes.

Mr. ENZI. Mr. President, Americans across this country are facing the reality of an economy that is in trouble. The unemployment rate is now 10 percent. According to the Department of Labor's broadest measure, some 17.5 percent of Americans are without a job entirely or are underemployed. We have shed 3\1/2\ million jobs since January of this year and the average work week is now down to 33 hours for the American worker. Americans are struggling to find good jobs and, because of that, they are having trouble making their mortgage payments. Fourteen percent of all mortgage loans, meaning 7.4 million households, were delinquent or in foreclosure in the last quarter. That is the highest number since the mortgage bankers industry began this survey in 1972. Many economic indicators point toward a slow, unsteady and jobless recovery, and the American people know it. In a recent survey, 82 percent of Americans said our Nation's economic conditions are poor. In recent weeks, President Obama has convened a summit at the White House to discuss jobs and economic issues. He has given speeches to discuss proposals for job creation and economic recovery. There has even been discussion about spending additional billions of dollars on another economic stimulus bill. Unfortunately, the President has not advocated for the single quickest and simplest way to promote economic growth. If the President wants to save jobs and grow the economy, all he needs to do is tell the majority leader and the Senate Democrats to scrap this $2.5 trillion Reid health care reform bill and work it over, step by step, to get it right and to save costs. Senator Reid's prescription for our economic troubles is a $2.5 trillion bill full of tax increases, higher health care costs, and $500 billion in Medicare cuts. The Reid bill contains $500 billion in new taxes. Primarily that is how it is being paid for--steal money from Medicare and tax people additionally. There are new taxes on individuals, new taxes on small businesses, and new taxes on health care providers. These new taxes will raise health care costs. They will be passed on to the individuals in the form of higher premiums. According to the Congressional Budget Office, the Reid bill will drive premiums up by 10 percent to 13 percent. I know the other side likes to relate to those pieces of the bill that talk about--one section that brings it down by 7 percent and another one that brings it down by 7 percent, but they fail to notice that the bill actually raises it to 27 percent to begin with. When you subtract that out, it still winds up with a 10-percent to 13-percent increase. Who gets taxed under the Reid bill? If you don't have a government- approved health insurance, you get taxed. Incidentally, we are going to tell you--Washington is going to tell you what the minimum requirement is. That will be higher than most people have for insurance at the present time. The government will tell you what you need and they will fine you if you do not agree. The total amount of new taxes on uninsured Americans is $8 billion. According to the Congressional Budget Office, half of the new taxes on the uninsured will be paid by families earning less than $68,000 a year. If you do not have insurance, you will get taxed. If you have insurance, you can get hit twice by new taxes in the Reid bill. First, new taxes on health care providers will be passed on to consumers in the form of higher premiums. Second, if the government bureaucrats decide your employer-sponsored insurance is too generous, you will get taxed for that too. The Reid bill contains $150 billion in new taxes on employer- sponsored health benefits. These new taxes on benefits fall disproportionately on middle-income Americans. According to the Joint Committee on Taxation, 73 percent of those hit with new taxes on benefits earn less than $200,000--73 percent. That is a whole bunch of people down there in that category. The Reid bill also contains new taxes on businesses that cannot afford to provide health insurance. Most employers do provide health insurance to their employees, but there are some who simply cannot afford to and stay in business. Senator Reid's health care plan will mean they will have to pay $28 billion in new taxes. These are the same businesses that are barely making it. These are the same businesses that are having to lay off workers to keep the company afloat, the same businesses that are cutting shifts to prevent further layoffs, and they are cutting wages to keep their employees on the payroll. With our Nation's unemployment in double digits and millions more Americans worried about keeping their jobs and paying their bills, it is unthinkable to me that any Member of this body would support new taxes on businesses that are already struggling. These are the small businesses that absorb the extra employees that get laid off from the big businesses--and hopefully it is the small businesses that become the future big businesses. In addition to the job-killing taxes, the Reid bill raises Medicare payroll taxes by $50 billion. These will fall disproportionately on small businesses. Approximately one-third of America's small businesses will be hit with this tax increase. These are the same small businesses that employ 30 million Americans. I have to say, when you talk about taxing the rich, we are also talking about taxing the owners of small business corporations, because the money flows right through to them, even though they have to put most of it back into the business in order to keep the business going. Not only will small businesses see their taxes go up under the Reid bill, they will see their health insurance premiums go up as a result of new taxes on health care providers. Beginning in 2010--that is 3\1/ 2\ years before many of the health reforms go into effect--new fees will be imposed on health insurance companies. That is right now, 3\1/ 2\ years before the reforms go into effect. The Congressional Budget Office and the Joint Committee on Taxation have characterized these as excise taxes. They have also testified that these fees will be passed through to consumers in the form of higher premiums. If you need prescription drugs, you get taxed. Beginning in 2010, new fees will be imposed on prescription drug manufacturers. Similar to the health insurer fee, CBO and Joint Tax say it will be more expensive to buy prescription drugs. If you need a medical device, you get taxed. Medical device manufacturers will be subject to a 2\1/2\-percent excise tax on sales. Again, the Congressional Budget Office and Joint Tax have testified that this tax will increase the cost of medical devices. Just like prescription drug costs and health insurance, this new tax on devices will drive premiums up. If you have high out-of-pocket drug expenses, you will get taxed. A family will no longer be able to deduct medical expenses that exceed 7\1/2\ percent of their gross income as they can now. Instead, they can only deduct expenses that exceed 10 percent. In plain English, this proposal limits the tax deductions a family can take for medical expenses. For example, a family of four earning $57,000 in 2013 would lose a tax deduction of $1,425. A family of four earning $92,000 in 2013 would lose a tax deduction of $2,300. Instead of working toward a bipartisan solution to our economic problems, Senator Reid has brought a bill before us that spends $2.5 trillion over 10 years, raises taxes on middle-class families and small businesses. I support health care form, and I will continue to work to enact real reforms that lower the cost of health care. I cannot, however, support higher taxes that further jeopardize our economic recovery by punishing small businesses and raising health care costs for working families. I yield the floor.

Mr. ENZI

Mr. ENZI. Mr. President, I voted to support Senator McCain's motion to commit the bill back to the Finance Committee to protect all seniors from the Medicare cuts in this bill. Section 3201(g) of the Reid bill shields Florida from the sweeping payment reductions to Medicare Advantage plans. Democratic Senators from Florida, New York, Oregon and Pennsylvania have also reportedly sought carve outs to protect seniors in their States from these cuts. It is unfair to protect only seniors in Florida from these cuts. President Obama said if you like what you have, you can keep it. I believe that principle should apply to all Medicare beneficiaries. At least some of my Democratic colleagues are honest about what they are doing. The New York Times yesterday quoted the Senator from Florida as saying, ``It would be intolerable to ask senior citizens to give up substantial health benefits they are enjoying under Medicare . . . I am offering an amendment to shield seniors from those benefit cuts.'' Bloomberg News also quoted that same Senator as saying, ``We're trying to grandfather in seniors so that they don't lose the benefits they have.'' Now, I disagree with these sweetheart deals. But I understand the motivation behind them. We should not be taking benefits away from Medicare beneficiaries. What I don't understand is how other Democrats can deny that the Reid bill cuts Medicare benefits. I have heard my Democratic colleagues repeatedly argue that there no cuts of any ``guaranteed benefits'' in the Reid bill. I was not familiar with the term ``guaranteed benefits,'' so I asked my staff to review the Medicare statute. They searched through the entire Social Security Act, which governs Medicare, and could not find that term anywhere. That is because the term doesn't exist. The other side just made it up. Medicare Advantage plans provide extra benefits to beneficiaries who enroll in these plans. These are the benefits that will be cut under the Reid bill. Clearly the Senator from Florida understands the value of these benefits. That is why he and other Democrats are fighting tooth and nail to undo the cuts in their States. At the same time, other Democratic Senators continue to argue that Medicare Advantage is neither Medicare nor an advantage. That is false. Medicare Advantage is Part C of Medicare. If you go to the Web site of the Department of Health and Human Services, it says Medicare Advantage is part of Medicare. As to the ``advantage'' part, Medicare Advantage does provide extra benefits, and seniors place great value on them. It's that simple. That is why the Senator from Florida and others are trying to get carve outs for seniors in their States. Under the Reid bill, seniors will lose vision benefits. Apparently, the other side does not think vision care is an advantage. The Reid bill will cut dental benefits for seniors. These are also apparently not an advantage for seniors. The Reid bill will cut hearing benefits for seniors. These are apparently not an advantage for seniors. The Reid bill will cut home care for seniors with chronic illnesses. The other side thinks these benefits are not an advantage. The Reid bill will cut disease management programs for seniors. These benefits are also apparently not an advantage. The Reid bill will cut nurse help hotlines for seniors. The majority apparently does not believe this is an advantage. The Reid bill will end reduced cost sharing for primary care physician visits. This is apparently not an advantage for seniors. The Reid bill will eliminate reduced premiums for Part B. This is apparently not an advantage for seniors. The Reid bill will eliminate reduced cost sharing for breast cancer screening. This is apparently not an advantage for seniors. The Reid bill will eliminate reduced cost sharing for prostate cancer screening. This is apparently not an advantage for seniors. Most disturbing of all, the Reid bill will cut seniors' protections against catastrophic costs under Medicare Advantage. The other side says they want to keep medical bills from driving folks into bankruptcy. At the same time, they are eliminating Medicare Advantage benefits that actually protect Medicare beneficiaries from catastrophic medical costs. How is catastrophic coverage not an advantage to seniors? It seems to me few things could be more advantageous than not losing your life savings because of medical bills. It is obvious to anyone who listened to the list I just read that these are real benefits. Furthermore, it should be equally clear that the Reid bill will take these benefits away from millions of Medicare beneficiaries. Anyone who doubts what affect the Reid bill will have on Medicare beneficiaries should look at the last time that Congress made cuts like this. The impact was severe. Congress enacted the Balanced Budget Act of 1997, which included similar types of cuts. Once it took effect, nearly one out of every four of the plans, then known as Medicare+Choice, pulled out of the program. According to an article in the Fort Lauderdale Sun Sentinel, when the Prudential Medicare+Choice plan withdrew from Florida, nearly 12,000 seniors in Broward, Palm Beach and Miami-Dade lost their coverage of prescription drugs, eyeglasses, hearing aids or other benefits. You can bet seniors in Broward, Palm Beach and Broward counties haven't forgotten these cuts, losing their plans, sometimes their doctors, and certainly those benefits. According to the Baton Rouge Advocate, over 50,000 Louisiana seniors lost the extra benefits that had been provided by Medicare+Choice plans. The cuts were so disruptive and confusing that State Insurance Commissioner Jim Brown had to air public service announcements. You can bet Louisiana seniors remember those cuts. After these cuts went into effect, the Chicago Daily Herald reported that the Senior Health Insurance Program run by the Illinois Department of Insurance was ``deluged with phone calls from senior citizens affected by the move of some health maintenance organizations to drop Medicare.'' By that time, United Healthcare had decided to no longer offer Medicare+Choice plans in DuPage, Kane, Lake and Will counties. This affected 12,000 seniors in these Chicago suburbs. By 2000, the Daily Herald reported that Aetna and Humana were also pulling out, dropping coverage for 2,794 beneficiaries in Lake County and 6,180 Aetna enrollees in Cook, Lake, Kane and DuPage counties. All of these beneficiaries lost the extra benefits they had previously received from their plans. Brian Carey, director of Senior Services for Schaumburg Township, was quoted as saying, ``It's just thrown so many people into, in some cases, a complete state of panic.'' By 2002, the Chicago Tribune quoted CMS administrator Tom Scully as saying there were no--that's zero--Medicare plans serving Chicago and its suburbs. If the Reid bill is passed, we will again see millions of Medicare beneficiaries lose the benefits they currently receive from Medicare Advantage. Medicare beneficiaries understand this program provides real advantages to those who enroll in the program. They do not want to lose these benefits. I hope that all of my colleagues support the McCain amendment and ensure that these seniors continue to receive these benefits.

Mr. ENZI

Mr. ENZI. Mr. President, I yield up to 10 minutes to the Senator from Arizona.

Mr. ENZI. Mr. President, I yield up to 10 minutes to the Senator from Ohio, Mr. Voinovich.

Mr. ENZI. Mr. President, I yield up to 10 minutes to the Senator from Idaho, Mr. Crapo.

Mr. ENZI. I yield myself the balance of the time. Amendment No. 2962 to Amendment No. 2786 Mr. President, I rise to speak in support of the Nelson amendment. We have been talking about the McCain amendment, which provides fairness for seniors who have Medicare Advantage so everybody across the country can have the same thing Florida is getting. But the critical amendment I wish to talk about is the Nelson amendment. This amendment needs to be adopted if we truly want to prevent Federal dollars from being used to pay for abortions. I am asking my colleagues to support a Democratic amendment. This isn't a partisan issue; it is a human issue. Even if you are on the other side, I hope you can agree it is not right to force people to pay for a procedure they may find offensive to the core of their morality. This issue is very personal for many of us. It is for me. When my wife Diana gave birth to our first child, Amy was 3 months premature. She weighed just 2 pounds and the doctor's advice was: Wait until morning and see if she lives. The doctors couldn't do anything to help this newborn baby. She survived the night. The next day I took Amy to a hospital in Casper. An ambulance wasn't available so we went in a Thunderbird. It was in a huge blizzard, the same blizzard that prevented us to fly Amy to a hospital in Denver that specialized in that. But we took this car and went to the center of the State to the biggest hospital to get the best care we could find. We ran out of oxygen on the way because the snow slowed us. The highway patrol was looking for us, and they were looking for an ambulance. All along the way, we were watching every breath of that child. We arrived at the hospital in Casper and put her in the care of doctors. There were several times when Diana and I went to the hospital and found her isolette with a shroud around it. We would knock on the window and the nurses would come and say: It is not looking good. We had to help her to breathe again or: Have you had your baby baptized? We did have Amy baptized a few minutes after birth, as she worked and struggled to live. Watching an infant fight with every fiber of her being, unquestionably showing the desire to live, even though they are only 6 months developed, is something that will show you the value of life. Amy survived and is now a teacher so gifted she teaches other teachers. Amy's birth changed my whole outlook on life. It reminded me of the miracle of life and the respect we owe that miracle. The Reid bill, as it is currently, does not respect life. But the amendment before us will allow that respect to be given to every American who benefits from that bill. On September 9, President Obama told a joint session of Congress: ``No Federal dollars will be used to fund abortions.'' I agree. No Federal dollars should ever be used to pay for abortions. To do otherwise would compel millions of taxpayers to pay for abortion procedures they oppose on moral or ethical grounds. Unfortunately, the Reid bill fails to meet that standard set by the President. Section 1303 of the bill provides the Secretary the authority to mandate and fund abortions. Some have questioned exactly how this bill funds abortions. It is quite simple. The bill funds abortions through the government-run insurance option and through subsidies to individuals to help pay for the cost of private insurance. Both of these options are funded with Federal dollars. Under the community health insurance option, also known as the government-run plan, the Secretary of Health and Human Services could allow the plan to cover abortions. In addition, the new tax subsidies in the bill could also go to private plans that cover abortions. In both these cases, Federal subsidies would be paid to plans that cover abortion. The Reid bill attempts to use budget gimmicks so its sponsors can argue that Federal funds will not pay for abortions. As the accountant in the Senate, I am not fooled by these gimmicks and neither should anyone else be. If the Reid bill is passed, Federal dollars will be used to pay for abortions. Money is fungible. That is an interesting word. It means Federal dollars paid into a health plan could be shifted across accounts. We don't have a good accounting system for that. It can replace other spending and those dollars could then go to pay for abortions. There is no way to absolutely prevent Federal dollars from paying for abortions once they are paid to plans that cover abortions. That is why Federal laws for the last 30 years have explicitly prohibited Federal funding going to such plans. That is right. It is already Federal law, although it comes in, in the appropriations bill, on an annual basis. Federal law currently prohibits funds going to pay for abortions under the Medicaid Program, under FEHBP--that is the program where we get our health insurance; it is the one that provides all the health insurance for all Federal employees, the same choices of plans-- and the TRICARE Program, which is for all our Active military and their families. Current law recognizes the only way to actually prevent Federal funds from being used to pay for abortion is to offer the coverage of abortion in separate insurance plans and collect separate premiums to pay for that plan. This is what States who want to cover abortion for their Medicaid populations already do. As I said earlier, Medicaid is prohibited from using Federal dollars to pay for abortions. As a result, States set up separate plans and collect non-Federal dollars in separate accounts to pay for those services. If anyone has any doubts about the impact of the Reid bill, I would point them to the comments made by the senior staff at the U.S. Conference of Catholic Bishops. The associate director, Richard Doerflinger, recently described the Reid bill as ``completely unacceptable'' and said it was the worst health reform bill they had seen so far on life issues. It is probably worth it to note that the bishops have been longtime supporters of health care reform and covering the uninsured. Similarly, National Right to Life said the Reid bill ``seeks to cover elective abortions in two big new Federal health programs, but tries to conceal that unpopular reality with layers of contrived definitions and hollow bookkeeping requirements.'' There has also been some misinformation out there regarding this amendment, and I wish to take a minute to clear up a couple arguments used against the Nelson amendment. First, it does not prohibit individuals from purchasing abortion coverage with their own private dollars. When similar arguments were made during the House debate on the Stupak language, PolitiFact, a Pulitzer Prize-winning, fact- checking organization, concluded that such statements were false. The Nelson amendment only prohibits Federal funds from subsidizing those plans. Some have argued the Nelson amendment could cause individuals to lose the abortion coverage they currently receive from their current health insurance plans. That also isn't accurate. I would urge everyone to read section 1251 of the bill. Section 1251 says, clearly and unequivocally, that: Nothing in this act or an amendment made to this act shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled at the date of the enactment of this act. According to the sponsors of this bill, this section protects the ability of persons with existing insurance coverage to keep that same coverage. If section 1251 works as its authors describe it, this bill should make no changes to existing insurance plans that cover abortion and should allow individuals to keep the plans they have. Some have also said this amendment would ban abortion procedures. That, too, is false. The amendment does not ban abortions; it simply prohibits Federal dollars from paying for abortions, which is consistent with the current law. Many of my Democratic colleagues have argued during the debate that the health care we provide under this bill should be as good as the coverage given to Senators. If they believe that, they should all support applying the same rules regarding abortion coverage that apply to our own health plans. Federal employees' plans are prohibited from covering abortion--all Federal employees, not just Senators. I will work hard to see that taxpayers are not compelled to fund abortion services. I believe those of us in elected office have a duty to work to safeguard the sanctity of human life, since the right to life was specifically named in the Declaration of Independence. By safeguarding our right to life, our government fulfills the most fundamental duty to the American people. When that right is violated, we violate our sacred trust with our Nation's citizens and the legacy we leave to future generations. Regardless of what some people think, God doesn't make junk. He makes people in a variety of sizes, shapes, and abilities, and disabilities. There is a purpose even if we cannot understand it. I like the sign just outside Gillette. It says: ``If it's not a baby, you're not pregnant.'' I don't believe Federal funding should be used to pay for abortions, and I will work to ensure that it doesn't happen under this bill. I will vote in support of the Nelson amendment and encourage my colleagues to do the same to protect life and respect the miracle of life that I witnessed with the birth of my daughter Amy. I thank the Chair and yield the floor.

Mr. ENZI. Mr. President, I assume that added a few additional minutes to our time as well. I yield 10 minutes to the Senator from Nebraska.

Mr. ENZI

Mr. ENZI. Mr. President, I yield myself as much time as I might need out of the remaining time we have. I, too, thank the Senator from Vermont for his passionate comments on community health centers. In Wyoming we have community health centers and they serve a great role. For underserved areas across the Nation, they are absolutely critical. I wish there were more that we were doing in the area of community health centers. I think it provides some better solutions than some of the other things we are doing in this bill. Wyoming is considered to be underserved. The whole State is underserved. Even our biggest cities are considered underserved. We are missing every single kind of medical provider, including veterinarians. Usually when I make that comment, people say: People don't use veterinarians. But as far as our distances are, some people are happy to get to a veterinarian in an emergency situation. We do have situations across the country that need to be taken care of. One of my concerns is that we are doing this huge Medicaid expansion. And when we do the Medicaid expansion, we already have it priced for doctors so that 60 percent of the doctors won't take a Medicaid patient. If you can't see a doctor, you don't have insurance, period. I don't think we are doing enough to take care of that difficulty prior to expanding this population. So we are going to shove more and more people out of getting any health care. Amendment No. 2942 But the main thing I wanted to do today is rise in support of the Gregg amendment which would prevent Medicare cuts in the Reid bill from being used to create new entitlement programs to cover the uninsured. Yes, I want to have the uninsured covered. I don't oppose covering the uninsured, nor do I oppose reforming the Medicare Program. We need to do those things. We absolutely need to do those. But we shouldn't do it on a system that is going broke. We should not take the money from a system that is going broke to do new entitlement programs. I know the Senator from Montana admitted that if the Gregg amendment were to pass, it would limit some of these entitlements, that they wouldn't be able to do them. Again, we are not opposed to doing those new entitlements. We are opposed to paying for them with Medicare money because Medicare is going broke. They do say that if we put these extra burdens on Medicare, we will extend the life of it. And you can believe that or not. But we could expand it even more and we could solve some problems in Medicare if we took the money and we used it for Medicare. Medicare needs changes. Medicare needs to have money that we are now going to move away and put into other programs. But don't worry about it because we are going to form a Medicare Commission. Every year, that Commission is going to tell us what we ought to do to make more cuts. Before we start doing more cuts, maybe we ought to make sure the cuts we are doing go to what we anticipated needed the most help. I am not opposed to covering the uninsured. I don't oppose reforming the Medicare Program. We should do those things. What I oppose is the Reid bill. This is the wrong approach to solve the problems. The Gregg amendment would go quite a ways to solving some of my discontent with the bill. The amendment offered by my friend from New Hampshire highlights the main problems of the Reid bill and suggests a better approach. His amendment would protect the savings from the Medicare Program and prevent them from being used to create a new entitlement. This would mean this new program would not have to rely on cuts to Medicare to fund its operation. It would also reserve all money taken from Medicare so that it could be used to fix the problems in the Medicare system. Earlier, we had an amendment that said that the money for Medicare would go to Medicare. Every single program that we allocate money to, we have inspectors general who are supposed to make sure the money for that program goes to that program. But this is a different situation. What we are saying here is that we want the money from Medicare to go to Medicare, not the money for Medicare to go to Medicare. The money for Medicare has to go to Medicare. But we are going to take money from Medicare. I say, if we have that money we can take from Medicare, we ought to put it to Medicare and only to Medicare until we have the Medicare problem solved. Our seniors are relying on that. Don't be caught up by the little words in do-nothing amendments that say the money for Medicare is going to go to Medicare. What we want to say is that the money from Medicare goes only to Medicare.