Judd Gregg

Mr. GREGG

Mr. GREGG. Mr. President, I would ask, is the Senator from North Dakota recognized under an order of a colloquy at this point?

Mr. GREGG. Mr. President, I ask unanimous consent that we have 20 minutes equally divided between myself and the Senator from North Dakota at this time. I see the Senator from Connecticut obviously wishes to speak also.

Mr. GREGG. Do we have time remaining on our side?

Mr. GREGG. Mr. President, I am privileged to join the Senator from South Dakota, the chairman of the Budget Committee, on this initiative. We have worked on it for a while, and we have come to a position of having a piece of legislation that accomplishes the goal as outlined by the Senator from North Dakota. That is good news. The outpouring of support in the Senate--over 31 cosponsors in just a brief period of time--is a sign that there is a willingness to move in a bipartisan way. That is good news. Right now, for this country, after the possibility of a terrorist getting a weapon of mass destruction and using it against us in the United States, the single biggest threat we have as a nation is the fact that we are on course toward fiscal insolvency. You cannot get around it. If we continue on the present course, this Nation goes bankrupt. We are already seeing the early signs of it. The early signs are devastating enough. We are seeing some of the nations who lend to us--and remember we are a debtor nation now of massive proportions-- saying: Hold on, you folks are not being responsible, especially about your outyear debt. Two days ago, we saw one of the rating agencies, Moody's, say England and the United States now are going to be put into a special category relative to the rest of the industrialized world because their fiscal situation is in such risk, and they are not managing their fiscal house correctly. We know, as the Senator from North Dakota has outlined so correctly, that within 10 years--maybe sooner--we are going to get to a point where our debt has gotten so large we simply cannot pay it or, if we have to pay it, we are going to have to do some extraordinary things to do that, such as inflating the currency or raising taxes to a level where we reduce productivity and the opportunity for jobs. It is akin to a dog chasing its tail when you get your debt to a certain level. When you have spent so much more than you have taken in and you have promised so much more than you can afford to pay and your debt gets to such a level, as a nation, you only have two choices: You inflate the currency and destroy the quality of people's lives, destroying the value of their savings, and you put in an inflation economy, which is one of the worst things that can ever happen to a country or you have to radically increase your tax burden to levels that are simply going to choke off the capacity of the Nation to create prosperity because people will not be able to be productive. You will start to lose tax revenues as a result of that. This is not a theoretical case. This is no longer something that is over the horizon. This problem is directly in front of us. We are hearing it from the people who lend us money, from the rating agencies, and we know it from intuitive common sense. Most Americans know this is an extraordinary problem. We talked about this for a long time and we worked on it for a long time. Yes, regular order should take care of this, but we know it will not because we have seen what happens. When you put an idea on the table to deal with major entitlement programs that affect so many people, in such a personal way, immediately, those ideas are attacked and savaged, misrepresented, exploited, exaggerated, and hyperbolized by the interest groups that populate this city and other parts of the country for the purpose of making their political agenda move forward or their money-raising formula move forward. When substantive, good ideas have been put on the table to try to correct this fiscal imbalance by dealing with questions of Social Security and Medicare or tax policy, we get clobbered on the policy side. We came to the conclusion from the right and the left that it is equally outrageous and equally destructive of constructive public policy. We came to the conclusion that the only way you can do this is to create a process that drives the policy, rather than put the policy on the table first, saying here is the policy and everybody jumps on it and kicks it and screams at it and so it never even gets to the starting line. We decided let's get to a process that leads to policy and leads to an absolute vote. The theory is, basically, threefold: One, the process has to be absolutely fair and bipartisan. Nobody can feel they are being gamed. The American people will not allow major policy to occur in these areas unless they are comfortable the policy is bipartisan and fair. So this process we have set up is a bipartisan affair. There will be 18 people. We decided to go with people who actually have a responsibility for making decisions and understand the issues intimately; 16 from the Congress, as was mentioned--8 Republicans and 8 Democrats--and the 2 from the administration, with a supermajority to meet, to report, and there will be cochairmen from each party. That gives us the bipartisan nature. The second part that is critical to the exercise is that it be real and that it not end up being a game. We have seen so many commissions end up being just commissions. They put their report out and it ends up on a shelf somewhere. Something has to happen. What happens is, when this Commission reports with a supermajority and comes to Congress, by supermajority it must be voted up or down. So there is an absolute right to a vote, and the vote occurs on the policies proposed. That is critical. It is much along the lines of what we did for base closures, for many of the same reasons. You couldn't close bases politically, so we did it by fast- track approval. Third, there will be no amendments. Why? Amendments allow Members to hide in the corners. It is that simple: Somebody throws an amendment up--even if it is well intentioned--and people vote for the amendment and then say it didn't pass or I will not vote for the final product. You have to have a policy put forward, and it will either attract a bipartisan supermajority and be a fair policy or it is not. If it doesn't attract a bipartisan supermajority, clearly, it wasn't well thought out. That is the process we have come to. The amount of sponsors we have reflects the fact that it is viable and that it is bipartisan. We have 12 Democratic sponsors already and 19 Republicans. What else around here has that with serious legislation? This is it. I congratulate the Senator from North Dakota for his efforts. I am hopeful we can get a vote on it. Then, I hope it can pass, and I am hopeful we can get White House support and House support to do this. We are running out of time. If we don't accomplish this fairly soon, the outcome is very simple: We will pass on to our children less opportunity, a lower standard of living, and a weaker Nation than we received from our parents. No generation in American history has done that. But that is what we are going to do if we don't take action. That is exactly what is going to happen. How can one generation do that to another? In American history, that has never happened. This is an opportunity to avoid having that occur or at least help avoid it. I hope it will move forward. I reserve the remainder of my time.

Mr. GREGG

Mr. GREGG. Mr. President, the Senator from Wyoming, first as a doctor and second as a Senator, raises a very important point; that is, this is the largest expansion in government in the history of the government. Let's begin right there. This is a $2.5 trillion expansion in the size of the government when fully implemented. It is a massive growth in the size of government. Most of that growth comes from the expansion of government in two areas: the expansion and creation of a brand new entitlement and the expansion of Medicaid, as was alluded to by the Senator from Tennessee. How is that paid for? How is this huge explosion in the size of government paid for? Well, a large part of that is paid for by reducing the amount of money in Medicare that is paid in Medicare, paid to Medicare providers, and available to Medicare recipients--$460 billion in the first 10 years, $1 trillion in the first 10 years when the program is fully implemented--that would start in about 5 years-- and then $3 trillion, by our estimates, which are linear--I suspect it will be more--over the first 20 years of this bill, a $3 trillion reduction in Medicare benefits. We heard arguments from the other side of the aisle: Oh, that is not going to affect benefits. Well, that is not believable. We know that. You cannot reduce Medicare provider payments and you cannot cut Medicare Advantage--with the total cuts of both, combined, by $460 billion in the first 5 years, $1 trillion in the first 10 years of full implementation, and $3 trillion over 20 years--and not affect benefits. This is money that is going to have the most significant impact we have ever had occur on our seniors in their Medicare system. This is a fundamental change in the way Medicare services are paid for and the insurance that is available to seniors under Medicare, specifically, Medicare Advantage. We know for a fact that of the 11 million people on Medicare Advantage, approximately a fourth of them will lose it--simply lose their Medicare Advantage. We also know hospital groups, provider groups, and doctors are all going to see significant reductions in their reimbursement rates, which means, of course, they are going to change the way in which they treat seniors. Seniors are going to find it harder to find a doctor. They are going to find it harder to get a procedure they need because the reimbursement rate for those procedures is going to have been cut so significantly under this bill. Home health care will be dramatically impacted. The Senator from Wyoming had a very interesting letter from his home health care groups in Wyoming which related to what percentage of home health care agencies would actually close. It was a very high percentage under this proposal. There is no question but that Medicare is in dire straights. It is headed toward insolvency. It goes into a negative cashflow in 2 years, and it has $35 trillion of obligations, which we have no idea how we are going to pay for. So Medicare reform is important. I have supported it. I proposed it. In fact, I proposed it a number of times and have always been voted against by colleagues on the other side of the aisle. But any reform to Medicare of this size--$464 billion in the first 10 years, $1 trillion in the first 10 years of implementation, $3 trillion over 20 years--anything that is going to cut Medicare by those numbers, those savings, if they are going to occur, those reductions, should go to benefit making Medicare more solvent. But what happens under this bill? That is not what they are used for. Those dollars which come right out of the pockets of seniors and the people who provide seniors care--and the ability of seniors to purchase insurance under Medicare Advantage--those dollars go from the senior over to creating these new major programs, these new entitlements. In fact, I was looking at the bill. It appears to me some of those dollars go to get votes around here. Isn't that incredible? They are going to take money away from seniors and use it for the purposes of getting votes to pass this bill by sending money back to States of Members who are maybe a little wavery on whether they want to vote for this bill. That is where some of the money goes. But most of the money goes to creating these new entitlements for people who may be deserving--probably are deserving--but who are not seniors and who probably have not paid into the insurance fund that seniors have paid into for all their life and, thus, it is totally inappropriate to do that. I have an amendment. It is very simple. It is an amendment that has real teeth, and it is actually an amendment that follows up on a number of statements from the other side of the aisle and some sense of the Senate which were voted 100 to nothing around here, which says, simply: No Medicare money can be used to fund other parts of this bill. To the extent Medicare savings occur under this bill as a result of cuts to home health care, cuts to Medicare Advantage, cuts to provider groups, those dollars will not be taken and used to fund new entitlements for people who are not on Medicare, not seniors. They will not be taken to fund the purchase of votes around here to pass this bill. This is a real amendment. A lot of stuff happening around here is sense of the Senate, where people stand up and say: Oh, I am for that. Exactly, what I said--let's do a sense of the Senate to that effect. But sense of the Senate has no impact at all. It is political cover. This is not political cover. This amendment, as structured, will actually accomplish the goal of not allowing Medicare dollars--cuts in Medicare that are $464 billion over the first 10 years, $1 trillion over the fully implemented period, and $3 trillion over the 20-year period--it will not allow any of those dollars to be used to fund new programs in this bill which do not benefit seniors. That is all it says. It seems to me, if you are going to stand up for responsible action in the area of Medicare, if you are going to live by the sense of the Senate that have been voted for here, if you are going to stand behind your word, as the sense of the Senate have called for-- that Medicare money be used for Medicare, and that Medicare money not be used to fund things that are extraneous to Medicare; Medicare cuts savings--then you have to vote for this amendment.

Mr. GREGG. I would be happy to yield.

Mr. GREGG. That is not related to seniors.

Mr. GREGG. My amendment has force of law behind it. Those amendments have no force of law behind them. They have no effect at all. As the Senator said: a political statement, an editorial comment, a piece of paper written. This amendment, if passed, will have the force of law behind it. It will very simply be structured in a way that the money cannot be taken out of Medicare if it is going to be used for the purposes of funding the new programs in this bill, whether they are the entitlement programs for people who are not seniors--this expansion of entitlements--or whether they are for the purposes of getting votes to pass the bill.

Mr. GREGG. That is correct. This is the first and only vote Members on this floor are going to have, to make it clear that Medicare dollars will not be used for something other than Medicare.

Mr. GREGG. Well, if I might interject, anybody who voted for that amendment would want to vote for mine.

Mr. GREGG. Well, the Senator has made an excellent point. Essentially, the Bennet amendment has no teeth. It has no substance. It has no substantive effect. It is just a statement of purpose. If the statement of purpose is as recited by the Senator from Georgia, then you would need to vote for this amendment, my amendment, if you voted for the Bennet amendment, because my amendment has the teeth that backs up the language of the Bennet amendment.

Mr. GREGG. That is, essentially, what it says. It says that CMS and OMB must certify that no funds are being used to fund the additional activity in this bill that does not relate to Medicare with Medicare funds. It does not say that Medicare savings--it agrees to the Medicare savings, but those Medicare savings would basically be used for the purposes of reducing the outyear fiscal imbalance of Medicare. So it doesn't contest the Medicare savings as proposed in this bill, although those amendments have--we have already voted on a number of those. We voted on home health care, and we voted on Medicare Advantage, but to the extent those savings go in, those cuts in Medicare benefits go in, the revenues from those cuts cannot be used and spent to expand the size of government in someplace else which has nothing to do with senior citizens.

Mr. GREGG. Well, the Senator from Wyoming is absolutely right. I think the New York Times got it right. It is a convergence of two unique forces of nature that the Republican minority in the Senate and the New York Times should be on the exact same page on this issue and both be right.

Mr. GREGG. It would be virtually impossible to make that argument with a straight face.

Mr. GREGG. Will the Senator yield for a quick question?

Mr. GREGG. I know the Senator from Idaho wants to speak, but if I can ask the ranking member a quick question.

Mr. GREGG. I heard the Senator from Montana and the Senator from North Dakota say the amendment I have pending would make it impossible for them, under this bill, to create their entitlement programs because the Medicare money that will be taken from Medicare would not be available. My amendment says they cannot do that. It says Medicare cannot be used to create new entitlements, but it doesn't say those entitlement programs cannot be created if they want to pay for them some other way. So really what they are saying is they don't have the idea, the courage, or the will to pay for them in a way other than by stealing from Medicare. Isn't that what they are saying?

Mr. GREGG. I thank the Senator.

Mr. GREGG. How much time remains on both sides?

Mr. GREGG. I yield 11 minutes to the Senator from Iowa.

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

Mr. GREGG. Mr. President, I am not sure when the vote is going to occur. I hope sooner rather than later. First, I congratulate the Senator from Iowa who has been involved in Medicare and the issue of how we manage Medicare for many years, both as chairman of the Finance Committee and as ranking member. His analysis of this situation relative to my amendment was absolutely dead on and accurate, as he always is. It was a breath of fresh air, common sense and plain speak in this institution, which often gets convoluted, gets tied around its own axle. In this case, it didn't. The Senator from Iowa was very precise, a Senator who used to be chairman of the Finance Committee and is now ranking. My amendment is simple. It says the cuts in Medicare in this bill, which are substantial--$460 billion over the first 10 years, $1 trillion over the 10 years when fully implemented, $3 trillion over 20 years, that is how much Medicare is cut--the cuts come out of primarily Medicare Advantage and provider payments, all of which will translate into a lesser quality of care for senior citizens, that those Medicare cuts cannot be used for the purpose of financing new programs which have nothing to do with seniors. The new entitlements in this bill are significant, they are expensive, and they benefit a number of people. But they don't benefit seniors. In fact, they benefit very few people who have even paid into the hospital insurance fund from which the Medicare trust fund is funded. It is totally inappropriate to take Medicare money and use it to fund a brandnew entitlement, a series of new initiatives, the biggest of which is a brandnew entitlement and the expansion of Medicaid. The other side of the aisle--and 100 participated in the vote-- sponsored an amendment, agreed to 100 to nothing, which said that wouldn't happen; that Medicare money would not be used for the purpose of funding new programs that had nothing to do with Medicare, the Bennet amendment. But that was a political vote. Everybody knew that was a statement. It was called a sense of the Senate. It didn't even raise to the standard of being an amendment. It is something around here that is a unique vehicle, the purpose of which is to make a political statement; not worth much more than the paper it is printed on. This is different. This amendment, as the Senator from Iowa pointed out, is real. It has a hardened enforcement mechanism which requires that moneys which are saved by cutting senior citizen benefits and by cutting Medicare will not be used for the purposes of creating new programs at the Federal level. I have heard from the other side of the aisle that this is an amendment that destroys the bill because all these new benefits they have plowed in here--there are benefits for a lot of new folks in here; there are benefits for Senators whose votes they need, and that has been publicly reported; all funded in large part by Medicare reductions or significantly by Medicare reductions--I have heard the other side of the aisle say that is going to destroy these new programs. No, it is not.

Mr. GREGG. I ask unanimous consent for 1 additional minute.

Mr. GREGG. These programs are not going to be terminated by this bill. The programs will still be in the law. They will still go forward. They just have to be paid for with something other than seniors' money, with something other than Medicare. That representation from the other side of the aisle is a straw dog. What is not a straw dog is that my amendment enforces the language which this Congress, this Senate has already voted on 100 to nothing in the Bennet amendment. It says Medicare money will not be used to fund new programs that are not Medicare related. In the end, that means Medicare money will be used, hopefully, to the extent that these cuts go into place and these changes and benefits go into place, for seniors, to make the Medicare system more solvent because it is already headed toward insolvency. I reserve the remainder of my time.

Mr. GREGG. Mr. President, reserving the right to object, I believe I still have 15 seconds left on my time. But independent of that, I would ask that this unanimous consent request be amended and that we agree to the Pryor amendment by unanimous consent.