Tom Harkin

Mr. HARKIN

Mr. HARKIN. Mr. President, the debate has now begun on the bill we call our health care reform bill. It has taken us a long time to get here. After a lot of hearings, a lot of markup, a lot of public discussion, a lot of town meetings around the country, now we are at the final pivotal moment, a historic moment in the long march to pass meaningful health care reform. I say long march because it started with Theodore Roosevelt and continued on through the New Deal, continued on to Harry Truman's administration, and on to this time. Every time we have been turned back by the status quo forces, those who want to stick with what we have, those who are afraid of making changes. This time they are not going to stop us. This time it is unstoppable. We have come this far, and we are not going to turn back. Just listening to a little bit of the discussion on the Republican side today and listening to what the Republicans have had to say about health care reform in the last few months and anticipating what we will hear from Republicans in the next few weeks, it will be a message of fear that somehow by changing the status quo, the American people are going to be worse off than they are now, that somehow we are going to take away something they have, that somehow if we just stick with what we have, everything will be fine. But you will hear a lot of words and messages from the Republican side meant to frighten people, to put a pall of fear over what we are trying to do. The frightening thing for the American people is if we do nothing, if we stick with the status quo. Too many people in this country have no health insurance whatsoever. Thousands every day in this country, every single day thousands of people lose health care insurance coverage. So many people who have preexisting conditions cannot get coverage at all. People who are beginning to retire but they are not quite 65 and cannot get on Medicare are left in a state of limbo, where they cannot get health care coverage. So many people in this country are being discriminated against in health insurance because--well, because they are a woman or perhaps because they are older, perhaps they are a person with a disability. For a variety of reasons, they are being discriminated against in health insurance coverage. We have to make these changes. We cannot continue to spend over the $2 trillion a year and still be so lacking in the essential health care services for the people of this country. We spend twice as much in this country on health care as Europe. Yet we have twice as many people sick with chronic illnesses. That does not seem to make sense. We have some of the highest of high-tech medical devices and procedures and interventions anywhere in the world and, of course, people who have a lot of money in other countries--we always see kings and princes and wealthy people from other countries come here. They come here for the very high-tech, high-cost interventions. We are very good at that. We are the best. We are unequaled in that. But where we fall short is helping the very broad mass of American people to have the peace of mind knowing that if something happens to them, if they do get ill, they are not going to lose everything. The single biggest cause of bankruptcy--I know in my State of Iowa and I think most of the country, the single biggest cause of bankruptcy is because of medical expenses because people bump up against lifetime caps or annual caps, they cannot make it, and they declare bankruptcy. In no other country in the world is this allowed to happen. It is incumbent upon us to get this bill through. At the beginning, I wish to salute our majority leader Harry Reid for what he has done. We had our bill that came out of the committee that I am now privileged to chair after the untimely death of our esteemed colleague and friend, Senator Ted Kennedy. Our HELP Committee bill came through under the great leadership of Senator Chris Dodd. We passed it on July 15. Then the Finance Committee, under the able leadership of my friend and classmate Senator Max Baucus of Montana, did their work. Then the two bills had to be put together and that was done by the majority leader and he did a masterful job of putting the two bills together and getting it down to the Congressional Budget Office and getting a score on what it would cost, what it would cover. When we saw the bill come back--the bill we now have in front of us, the so-called merged bill--it truly is a work of genius by the majority leader. I said the other day that he has the patience of Job, the wisdom of Solomon, and the stamina of Sampson to get this job done. I also salute all the Senators--Democrats and Republicans--whose ideas are incorporated in this bill. It is a robust bill. It went through a long, bipartisan process. In our committee, we had proceedings that spanned 13 days, 54 hours. Republicans were full- fledged participants. They offered 210 amendments. We accepted 161, many of them making substantive changes in the bill. A similar open and inclusive process was followed in the Finance Committee. I daresay, when we got our bill through, after all that, after all the amendments offered, accepted or adopted, not one Republican would vote for our bill--not one. It is truly unfortunate now that we have put these bills together, we have gone through this long process that has taken most of this year, that Republicans have now chosen the path of delay and filibuster and obstruction. Why are we even here today? We are here because the Republicans are trying to prevent us from even bringing the bill to the floor for debate. How many people in America know that? The reason we are here is because the Republicans do not even want to bring the bill to the floor for debate and amendment. That is their right under the rules of the Senate. It is their right. They can filibuster. They can delay. They can obstruct. They can say no. But just as surely as that is their right, it is our responsibility, as Democrats, to move this bill forward. I remind my colleagues on the other side of the aisle that last year voters overwhelmingly voted for Barack Obama to make changes, and one of the changes he campaigned so hard on was changes in the health care system and, just as surely, voters elected Democrats to majorities--big majorities--in the House and the Senate to do the same thing. So it is our responsibility to lead, and that is what we are doing now by bringing this bill to the floor. We are taking another giant step toward fulfilling the mandate--the mandate--the people of this country gave to President Obama and the Democratic Party last November to undertake a comprehensive reform of America's health care system. As not only the long debate has made clear to the American people, but innately the American people know and they understand the current system is hugely dysfunctional, it is wasteful, and it is abusive. People are aware of the abuses that have become standard practice in the health insurance industry: denied coverage because of preexisting conditions; health insurance being dropped because they get sick; their insurance premiums jacked up 100 percent, 200 percent in a year simply because they had an illness. People know they can be charged higher rates simply because they are a woman. We know, we have the data. Woman, man, same age, same occupation, same status--a woman is charged more than a man for the same policy or they are charged more if they are older. We know about annual caps and lifetime caps I just mentioned that cause people to go into bankruptcy. The bottom line is this: Every American family knows that in many cases, they are one illness away from financial catastrophe. If you want to talk about fear, that is what people are afraid of, not so much of getting sick--that is part of life--but the fact that illness will drive them to financial ruin, that they will not have enough money to take care of their kids, to send them to college, or to take care of themselves in their old age to supplement their Social Security because the money will be used for an illness. As I said earlier, 62 percent of U.S. bankruptcies are linked to medical bills. What is the kicker in this is that 80 percent of those were people who actually had health insurance, but they ran up against their lifetime cap. Abuses, abuses by the health insurance industry because they can do it and they can get by with it. Think about it this way: Health insurance companies employ armies of claims adjustors who routinely deny requests for medical tests and procedures. Why do they do that? Because they get bonuses by saying no to the policyholder. Think about that. An insurance company says to their claims adjustors: We will pay you more the more people you deny. What a system. It is outrageous. It is intolerable, and we cannot afford to let it go on any longer. One of the many things we do in this bill is to crack down on these health insurance companies' abuses in a very strong and robust way. Again, I deeply regret that our Republican colleagues refuse to join us in this reform effort. They have chosen to defend the status quo, protect the insurance companies and their profits over the health of the American people. Indeed, my friends on the Republican side and the health insurance companies are now joined at the hip--same talking points, same distortions, same untruths about this bill, same bogus, cooked-up studies, the same determination to obstruct and kill any health care reform effort. As I said earlier, this time they will not succeed. The more the American people learn about this bill and what is in this bill, the more they like it and the more they are demanding that we get the job done. President Obama pledged that we would do health reform and not add to the deficit. We have done that with this bill. The Congressional Budget Office says this bill will actually reduce the deficit by $130 billion next year and by $650 billion in the next decade--$650 billion--and it will reduce the deficit continually every decade thereafter. All the budget concerns have been put to rest. Now we can focus on what is in the bill. The Congressional Budget Office says our bill will cover 94 percent of the American people; 94 percent will now be able to have the peace of mind to know they have health insurance coverage. Our bill says if you have a health care plan that you like and that you want to keep, nothing will disturb that--nothing. You can keep whatever plan you want if you like it. A lot of people say this plan doesn't go into effect until 2014. It does take some time to get these exchanges and things set up, but there are some immediate things that will happen next year, and the American people ought to know what that means. For example, our bill right now would ban lifetime and excessive annual limits on coverage next year-- not 2014 or 2015, next year. Think about that in your own policy. Your policy, I guarantee, has some kind of lifetime cap or annual caps. Next year, they will not be able to do that any longer. Our bill bans rescissions. What that means is that right now so many people don't know that their health insurance policy can drop them. There is a clause in it that says that when you are up for renewal, they can drop you for any reason. The reason they use is, if you get sick. Think about that. I can't tell you how many people I have talked to in my State of Iowa who have come up to me, especially during the town meetings we have had this summer, and have said: I like my health insurance policy. I have a good policy, and I would like to keep it. My rejoinder is: That is fine, but I want to ask you a couple of questions. What is your lifetime or annual cap? Most often, people say: I don't know. I say: Do you have a lifetime or annual cap in your policy? They aren't certain. I say: Do you have a rescission clause in your policy? I can tell you 100 percent of the people I have talked to said: What does that mean? I said: What it means is, if you get sick, if you have to have a kidney transplant or if you have cancer or heart disease, can your insurance company drop you when your policy comes due, with no explanation whatsoever? They don't know. I said: You have to look at your policy and find out, because most policies have those rescission clauses. I daresay, when a lot of people say they have a good health insurance policy, they answer yes, they do have a good health insurance policy, as long as they are healthy. As long as you are healthy. Once you get sick, out the window it goes because you have a cap, either a lifetime or an annual, or you have a rescission clause. The other thing I hear from a lot of families: You know, my kids were covered when they were in school. They are now out of school, they have not quite gotten a job yet, and I can't keep them on my policy and it costs a lot of money to put them on a different policy. Our bill says that now these young people can stay on their family policy until they are age 26. This is a huge benefit to working families. I have said many times that the two biggest winners under our health care reform bill are small businesses and the self-employed. Small businesses--we are in a deep recession. If we want to get out of that recession, we better start focusing on small businesses because it is small businesses that create over 65 percent of the jobs in this country. Yet small businesses are thwarted in their effort to expand and grow. One of the biggest reasons is because of the cost of health care for their employees. So many small businesses now have dropped health care coverage for their employees because they simply cannot afford it or the premiums have gone up, the deductibles are huge, and basically what it has gotten to be is basically catastrophic coverage for their employees. Small businesses need help in order to grow and expand and get us out of this recession. This bill will provide immediately, next year, up to a 35-percent tax credit for health insurance policies for their workers. That is a big deal. It is not just for small businesses, it is for my farmers and for those who are self-employed--for so many self-employed in this country, next year, a tax credit of up to 35 percent. Next year, we are going to have a new policy option for people who have preexisting conditions. So if you had an illness in the past, if you have been living with cancer and you have it under control, you have a chronic illness, next year we are going to provide a new policy option to put people like that into a high-risk pool and provide that they can get insurance coverage at prices they can afford. When the exchanges come on in 3 years, all of that will go by the wayside. They will not be able to discriminate because of preexisting conditions. But next year, right away, people who have preexisting conditions can get policies at prices they can afford. How many times do I hear people tell me: Here I am, I have been working hard, I have been a construction worker, or something like that, that is hard work. I am 55. I have had some accidents. I have a bum leg and my back is bad. I can't work until I am 65. But what am I going to do about my health insurance? We have in here, starting next year, if you are an early retiree, we have a program to protect your coverage and at the same time reduce your premiums, both for you and your employer, until the time you get to be age 65. This is a big deal for so many people in this country. Last, in whatever time I have left--parliamentary inquiry: How much time does the Senator from Iowa have left?

Mr. HARKIN. Madam President, I understand my friend from North Dakota wishes to speak. I will wrap this up by saying there is one other part of this bill that is so important that doesn't get much play but I consider to be one of the most significant parts of this bill, and that is an emphasis on prevention and wellness, keeping people healthy in the first place. There is a lot of talk about bending the cost curve and how we are going to bend that curve and get costs down. I submit that not only the best way but perhaps the only way we are going to do this is by keeping people healthy in the first place, putting more emphasis on prevention. I have often said that we don't have a health care system in America, we have a sick care system. If you get sick, you get care. Almost all of our expenditures go for interventions and patching and fixing and mending once somebody gets sick. Very little goes for prevention. About 96, 97 cents of every dollar goes for taking care of you after you get sick. Only about 3 or 4 cents goes to prevention. It is time to do more for that, time to do more for prevention and wellness, keeping people healthy in the first place. In this bill, we have a provision that says that if you want to go in for your annual checkup and your annual screening, no copay, no deductions, and for certain other screenings, such as colonoscopies, breast cancer screenings, and things like that, no co-pays, no deductibles. In the ensuing days and weeks when we debate that, I will be talking a lot more about the prevention and wellness part of this bill. It is big. It is the first time we have ever done anything like this, to begin to move the paradigm in this country away from sick care to health care. Our goal in this bill with this provision is to change America into a wellness society, where it is easier to be healthy and harder to be unhealthy--just the opposite of what it is today. It is easy to be unhealthy in America today. It is hard to be healthy. We are going to change that around, and we are going to start with this bill. One of the most important parts of this bill is the massive change we are going to make in prevention and wellness. I note the presence on the floor of my distinguished colleague from North Dakota. I yield the floor.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that the following HELP Committee fellows be granted the privilege of the floor for the duration of consideration of H.R. 3590, the legislative vehicle for the Patient Protection and Affordable Care Act of 2009: Sara Selgrade, Bill McConagha, Stephanie Hammonds, Joe Hutter, and Caroline Fichtenberg.

Mr. HARKIN

Mr. HARKIN. Mr. President, this body often finds itself divided. But today we are united in our respect and affection for the senior Senator from West Virginia, Robert Byrd. I join with my colleagues in congratulating him on yet another historic milestone: becoming the longest serving Member of Congress. But I hasten to add that to salute Senator Byrd only for his remarkable longevity is to really kind of miss the point. The measure of a Senator is not just how many years he or she serves but the quality and the consequences of that service. That is where Senator Byrd has truly distinguished himself in Congress over the last 20,774 days. The ``Almanac of American Politics'' says, Robert Byrd ``may come closer to the kind of Senator the Founding Fathers had in mind than any other.'' I could not agree more. He is a person of wise and mature judgment, a patriot with a deep love of country. He is passionately loyal to the Constitution, and a fierce defender of the role and prerogatives of Congress, the Senate in particular. Senator Byrd was once asked how many Presidents he has served under. He answered he had not served ``under'' any President, but he has served ``with'' 11 Presidents, as a proud Member of a separate and coequal branch of government. During his more than 56 years in Congress, Senator Byrd has witnessed many changes. Our population has grown by more than 125 million. There has been an explosion of new technologies. America has grown more prosperous, more diverse, more powerful. But across those nearly six decades of rapid change, there has been one constant: Senator Byrd's tireless service to his country, his passion for bringing new opportunities to the people of West Virginia, and his dedication to this branch of government, the U.S. Congress, and especially to this House of Congress, the U.S. Senate. Senator Byrd is a person of many accomplishments and a rich legacy. But, above all, in my brief time today I want to focus on his commitment to improving K through 12 public education in the United States and expanding access to higher education, especially for those of modest means. As my colleagues know, Robert C. Byrd was raised in the hardscrabble coal fields of West Virginia. His family was poor but rich in faith and values. And his parents nurtured in young Robert Byrd a lifelong passion for education and learning. He was valedictorian of his high school class but too poor to go to college right away. Of course, that was in the days before Pell grants and loans and Byrd Scholarships. So he worked as a shipyard welder and later as a butcher in a coal company town. It took him 12 years to save enough money to even start college. He was a U.S. Senator when he later earned his law degree. No other Member of Congress before or since has started and completed law school while serving in the Congress. But degrees do not begin to tell the story of the education of Robert Byrd. He is the ultimate lifetime learner. It is like for the last seven decades he has been enrolled in the Robert C. Byrd School of Continuing Education. Senator Byrd's erudition has borne fruit in no less than nine books he has written and published over the last two decades. We all know that he literally wrote the book on the U.S. Senate--a masterful four- volume history of this institution that was an instant classic that will bear the burdens of time. What my colleagues may not know is that he also authored a highly respected history of the Roman Senate. Now, there are some who think Robert Byrd served in the Roman Senate, but that part of the Byrd legend just is not so. I have talked at length about Senator Byrd's education because this explains why he is so passionate about ensuring every American has access to a quality public education--both K through 12 and higher education. One thing Senator Byrd and I have in common--and we always kind of talk about it when we get together--is we are the only two Senators whose fathers were actually coal miners. We are both the sons of coal miners, neither of whom had very much formal education. My father only went to the 8th grade. Actually, he only went to the 6th grade, but we will not get into that. But, anyway, he said he went to the 8th grade, but, like I said, I will not get into that. But coming from a poor background, Senator Byrd believes, as I do, that a cardinal responsibility of government is to provide a ladder of opportunity so everyone, no matter how humble their background, has a shot at the American dream. Obviously, the most important rungs of that ladder of opportunity involve education--beginning with quality K through 12 public schools, and including access to college, vocational education, and other forms of higher education. During my 25 years in this body, no one has fought harder for public education than Senator Robert Byrd. As the longtime chairman and still the senior member of the Appropriations Committee, he has been the champion of education at every turn--fighting to reduce class sizes, improving teacher training, bringing new technologies into the classroom, boosting access to higher education. In 1985, he created the only national merit-based college scholarship program funded through the U.S. Department of Education. Congress later named them in his honor. Originally, the Byrd Scholarships consisted of a 1-year $1,500 award to outstanding students. Today, Byrd Scholarships provide grants of up to $6,000 over 4 years. Senator Byrd is a great student of literature, and I am sure he knows The Canterbury Tales--a lot of it, probably, by heart. Describing the Clerk of Oxford, Chaucer might just as well have been describing Robert C. Byrd. Chaucer wrote: Filled with moral virtue was his speech; And gladly would he learn and gladly teach. Senator Byrd is a great Senator and a great American. He has both written our Nation's history and left his mark on it. It has been an honor to serve with my friend, my longtime chairman, Senator Byrd, for the last 25 years. Today, as he reaches yet another historic milestone that no other Member of Congress has ever achieved--and I daresay probably no one ever will--we honor his service. And we express our respect and our love for this remarkable U.S. Senator. I yield the floor.

Mr. HARKIN

Mr. HARKIN. Mr. President, I want to speak in support of extending the unemployment insurance program, to provide up to 20 weeks of additional unemployment insurance benefits for out-of-work Americans and their families. American workers are facing tough times. During the last recession, our country lost millions of good jobs--jobs that have never been replaced. And the downturn of the past 2 years, brought on by the subprime mortgage disaster and skyrocketing oil costs, has created a perfect storm leading to severe unemployment, with official unemployment approaching 10 percent. Today, 15.1 million Americans are out of work, and more than a third of them have been out of a job for 6 months or more. Unfortunately, the jobless rates jumps closer to 20 percent when you take into account the millions more who have given up looking for work, or can only find part-time work when they need full- time incomes. In recent weeks we have seen signs that our economy is starting to turn the corner, with growth in consumer spending, improved home sales and expansion in some manufacturing industries. Thanks to the Recovery Act, we have also been able to keep teachers in the classroom, and get construction workers started on new jobs because this administration and this Congress made significant investments that saved or created these and hundreds of thousands of other jobs. But we know that achieving a full economic recovery won't happen overnight. As our economy gradually improves, American families will still need help to get by. The recession has meant hardship for many thousands of families in my home state. Des Moines' nine food banks have seen a significant increase in demand. And organizations like the Salvation Army are also seeing a surge of requests for assistance with utilities, food, and clothing. When a family member is out of work, times are particularly tough. One survey found that 70 percent of families with a person out of work reported having cut back spending on food and groceries. That is why it is important that we act now to extend unemployment insurance benefits. The unemployment insurance program provides a vital safety net during times of economic hardship. Workers have paid into the system through their hard work, so when they are out of a job they deserve support to see them through tough times. These benefits are fundamental to helping families meet basic necessities--to provide a roof over their heads, to put food on the table, or to keep the heat on. A recent survey found that 90 percent of people receiving unemployment benefits used them for just such necessities. With over one-third of unemployed Americans out of a job for more than half a year, unemployment benefits have been a lifeline for these families. The critical nature of these benefits has enabled us to pass previous extensions with bipartisan support. Earlier this year we provided additional weeks of unemployment assistance and a small increase in workers' weekly benefits. Yet 400,000 workers ran out of benefits last month and another 200,000 exhausted their unemployment by the end of October. Over 30,000 Iowans have run out of State benefits since June. Running out of unemployment support means even tougher times for Americans who are already strapped--and so I hope my colleagues will join me in supporting and quickly passing this extension of unemployment benefits. The amendment before us will provide critical help to working families as our economy gets going again. Nationwide, it provides 14 additional weeks of benefits for workers who have run out of safety net support. In States where unemployment is at or above 8.5 percent, workers are eligible for 20 additional weeks of benefits. This amendment will provide much needed help to 1.9 million people across the country, including 31,000 in Iowa. This help can't come too soon for hardworking men and women who are trying to hang on for better times ahead; people like Kimberly Anders, from West Des Moines, IA. She writes: As an older person, I feel lost in the face of not being able to find a job, especially after I've worked hard my whole life and never once relied on any state or federal aid . . . now my unemployment is about to run out, and my hope with it . . . Unemployment benefits help Michelle Paulson from Huxley, IA, who is trying to train for a new career while caring for her family. A mother of two, Michelle went back to community college after she was laid off by a window manufacturer last August. As the lagging economy continues to take its toll on Iowans, Michelle is pursuing a degree in advanced manufacturing. Unemployment benefits provide Michelle the safety net to meet basic needs for her family while building her own workforce skills. The American people are counting on us to help them. It is time to act now. Passing this amendment now will give people like Kimberly Anders and Michelle Paulson the immediate help they need. What's more, it will benefit them and all American workers in the long run by helping to get our economy back on track. That is because unemployment benefits provide a major, immediate boost to the economy. Economists calculate that every $1 invested in the unemployment insurance safety net generates $1.63 in economic activity. Unemployed households spend these dollars on immediate needs--to pay the rent or a medical bill, buy groceries and school supplies, or repair the family car--all economic activities that quickly inject dollars into our communities. An extension of unemployment benefits gives workers and their families the support they need while people continue to look for work. And it provides a needed stimulus to the rest of our economy. I urge my colleagues to support this amendment and pass it without delay.

Mr. HARKIN. Mr. President, I move to reconsider the vote.

Mr. HARKIN

Mr. HARKIN. Mr. President, I move to reconsider the vote and to lay that motion on the table.

Mr. HARKIN

Mr. HARKIN. Mr. President, the legislation I am introducing would suspend temporarily, through the end of 2011, the import duty on ortho- toluidine, a chemical compound used by several U.S. companies in manufacturing an important agricultural herbicide used for crops including corn, soybeans, peanuts, and cotton. One of the manufacturing plants is a facility in Muscatine, IA, that employs 500 workers. Other U.S. companies use the compound in manufacturing dyestuffs, pigments, optical brighteners, and pharmaceuticals. This legislation is drafted and intended for inclusion in the miscellaneous tariff bill being assembled by the Committee on Finance. Currently, there is only one U.S. manufacturer of orthotoluidine, and that company has already announced plans to end production of the compound by the end of this year. Manufacturers in the U.S. will soon have no choice but to import this ingredient and to pay a duty of 6.5 percent unless it is suspended. Suspending this duty will help to control U.S. production costs, keep jobs at home, and enhance the competitiveness of U.S. businesses, workers, farmers, and the communities in which they are located. I encourage my colleagues to support this legislation.

Mr. HARKIN

Mr. HARKIN. Mr. President, the legislation I am introducing would suspend temporarily, through the end of 2011, the import duty on ortho- toluidine, a chemical compound used by several U.S. companies in manufacturing an important agricultural herbicide used for crops including corn, soybeans, peanuts, and cotton. One of the manufacturing plants is a facility in Muscatine, IA, that employs 500 workers. Other U.S. companies use the compound in manufacturing dyestuffs, pigments, optical brighteners, and pharmaceuticals. This legislation is drafted and intended for inclusion in the miscellaneous tariff bill being assembled by the Committee on Finance. Currently, there is only one U.S. manufacturer of orthotoluidine, and that company has already announced plans to end production of the compound by the end of this year. Manufacturers in the U.S. will soon have no choice but to import this ingredient and to pay a duty of 6.5 percent unless it is suspended. Suspending this duty will help to control U.S. production costs, keep jobs at home, and enhance the competitiveness of U.S. businesses, workers, farmers, and the communities in which they are located. I encourage my colleagues to support this legislation.

Mr. HARKIN

Mr. HARKIN. I ask unanimous consent that the order for the quorum call be rescinded.

Mr. HARKIN

Mr. HARKIN. Madam President, yesterday I got a call from my friend and my colleague from Pennsylvania, Senator Specter. He said: Have you read the New York Times yet? I said: Well, no, as a matter of fact I have not. He said: Well, there was a front page story in the New York Times on Sunday about what was happening with small businesses, in terms of their insurance rates going up unduly, huge increases. I said: Well, no, I have not read about it. I will get the paper and read it. It struck a chord with me because somehow, over the last several weeks, I have gotten an influx of inquiries to me personally and also into my office from small businesses in Iowa, some elsewhere but mostly from my State, wondering what was happening to the huge increases in their premiums this year. They have always been used to increases in premiums, but these seemed unduly large. Plus, a lot of copays and deductibles were going up. So I went out and got the newspaper and read the story in the New York Times that Senator Specter pointed out to me. It was alarming. As I said, I thought about all the inquires that had come into any office. I said: Something is going on out there. Something is going on out there. So we have this health care bill now, reform, that will be going down to CBO, I guess today, for scoring. I wish to commend Senator Reid for his leadership. I was actually in Pittsburgh today giving a lecture on disability policy at the University of Pittsburgh law school, with former Attorney General Dick Thornburgh, who had endowed the law school with an endowment. They have a very strong legal scholarship program dealing with disability law at the University of Pittsburgh law school. So I rushed back from there so I could be on the floor with Senator Specter to talk about this a little bit because there is something very funny going on. When I was in the airport, I saw Senator Reid had said he was sending the bill down to CBO for scoring. I commend Senator Reid for his leadership and for putting in a strong public option. I am told it is basically the public option the Senator from North Carolina worked so hard on in the committee to develop. I guess he married that up with the provisions from the Finance Committee bill that would allow States to opt out by 2014. I commend Senator Reid for putting that strong public option in the bill. The vast majority of the American people want that. They see it as necessary for trying to keep some control on cost and leaving more choice and more competition for policyholders. As a matter of fact, this would be a great help to small businesses, because small businesses could go on the exchange, and they would have that public option also available to them. I have said many times: The two biggest winners I can see in the health reform bill are small businesses and the self-employed. Small businesses are at the end of the line. They have been whipsawed all over the place. They have no bargaining power. The same with the self-employed. This bill will turn the tables by providing the exchanges and providing more help for small businesses. They will be much better able to negotiate and to pick and choose among different policies rather than what they have now. Now in many cases they get one or two, and that is about it in a lot of States, one or two different insurance companies. In the New York Times article, some suggest the insurance companies are raising their rates to generate as much revenue as possible before health reform obliges them to change the way they do business. Isn't that interesting. They are anticipating health reform passing so they want to jack up their premiums as much as possible before that happens. Others assert the industry is responding to Wall Street's demands for ever higher profits in the health insurance industry, that Wall Street is putting pressure on them to increase profit margins. Again, I always have to ask: Why are we doing health reform? Are we doing health reform to help the health insurance industry or are we doing health reform to help the American people? That had to be our first response, that we are here to help the American people, not to help the health insurance industry. I have had many small businesses tell me how tough it has been. I have a small newspaper in Iowa with 12 employees. The owner Art Cullen recently turned 50. Their insurance premiums for his small business jumped by 58 percent in 1 year and more than 100 percent in 2 years. They have a $5,000 deductible. I asked Art: Why don't you get another company? He said: I can't. I only have one in this area that will offer insurance. So that is why we need the exchanges, why we need health reform, so that Art Cullen and his small business can join with other small businesses on these exchanges to get a better deal. Mike Landeaur owns a muffler shop. He has 10 employees. He offers insurance to them, but his premiums have jumped 66 percent in the last 3 years. His deductibles have gone from $4,000 to $16,000. Mike is expensive. He was born with a congenital heart disease, so he dropped himself from his company's policy. He is the owner, taking himself out of the pool. But he can't get any kind of individual insurance because of his preexisting condition. Now he is worried he will have to sell the small business, all because of excessive health insurance costs. This is unconscionable. As we speak, the majority leader is sending his bill down to CBO. And make no mistake, the bill we are bringing to the floor will offer real solutions for small businesses. It will enable them to purchase insurance through an exchange so they can choose among multiple plans at lower costs than are now available in the small group market. Small businesses and the self-employed can go on the exchanges and, if they want, they also are eligible for the public option. It will sharply reduce administrative overhead that drives up the cost of insurance through such practices and medical underwriting and preexisting condition exclusion clauses. We provide a new small business tax credit to make insurance more affordable for the most vulnerable small businesses. We make new investments in wellness and disease prevention for all businesses, including small businesses. In addition, we will put a stop to the outrageous and unacceptable insurance industry practices that harm the ability of small employers to cover their workers. We will require that insurance companies document how much of each premium dollar is going for medical expenses. We will require that insurance companies document how much of each premium dollar goes for medical expenses, and we are going to require rebates for excessive overhead charges. We will end the broken status quo where insurance executives make tens of millions of dollars in salaries and bonuses while their small business customers go out of business because they can't afford health insurance. We will end the exceptional and unwarranted antitrust exemptions the industry has enjoyed without public benefit for far too long. We will end the ability of insurers to jack up premiums by as much as 160 percent, which is what they did for one small business, because they thought the group was ``getting too old.'' Therefore, they jacked up their premiums by 160 percent. I thank Senator Specter for having a keen eye and for giving me a heads up on this yesterday. There is something happening out there right now all over this country. Small businesses are being inundated with higher costs and huge increases in their insurance premiums. To America's small business community, we have a simple message: Help is on the way. We will get this health reform bill done, and we are going to help small businesses and the self-employed. I hope they can hang on long enough so we can get this bill through, hopefully before the end of the year, so that next year when their policies are up for renewal, we won't see these kinds of huge increases and gouging of small businesses. We need reform. We always think about it in terms of individuals and how this affects individuals. But we also think about how it affects the majority of workers who work for small businesses who don't have the kind of large group power that maybe big businesses and bigger industries have. That is why this health reform bill is so important for everyone, but none more so than the small businesses and the self- employed. I am hopeful, along with Senator Specter, that we can bring some more of this to light. I encourage anyone who has any evidence, stories, anything we can document of what the increases are to small businesses, please get them in to us. I have heard about enough of these to know it is not just a few here and there. It must be more widespread. We need those. Hopefully, we can shed more light on this as we move forward to bring the bill to the floor. I thank my colleague for his leadership and for bringing this out. I look forward to working with him to try to help small businesses in Pennsylvania, Iowa, and everywhere else. I yield the floor.

Mr. HARKIN. Madam President, I thank the Senator again for bringing this to light and urging us. I think we do need information. We do need to bring them in and check on what is happening with small business. We need to bring in some small businesses, some representatives of small businesses. I think we need to bring in some of those insurance people, find out what is going on here. How come premiums are going up so much this year? I think we were in a recession, were we not?

Mr. HARKIN. Madam President, I am not in the former prosecutor's league in that regard, I can say that. But we are working on that. As the Senator knows, sometimes it is tough to get these hearings put together. But hopefully we will have something we can pull together by next week.

Mr. HARKIN. I thank my friend from Pennsylvania.

Mr. HARKIN

Mr. HARKIN. Mr. President, today marks an important milestone in our ongoing national effort to combat HIV and AIDS. Twenty-eight years ago, the Centers for Disease Control and Prevention issued its first warning about the disease we now know as AIDS. Today, we are approving the fourth extension of the Ryan White CARE Act, comprehensive legislation first enacted in 1990 for the prevention and treatment of HIV and AIDS. In those early days, the Nation failed on all levels to fully recognize the dangers posed by this disease. Its victims suffered in silence and stigma. Shamefully, those who had the power to help did nothing. Then, belatedly, in the mid 1990s, a young boy's courage opened the Nation's eyes to the tragedy of AIDS. A disease that had seemed distant was suddenly a potential threat to any of us. We realized that it is a deadly virus that does not discriminate based on color, religion, political affiliation, or income status. I have no doubt that Ryan White would be proud of the bipartisan effort that, after months of negotiation and compromise, has produced the bill before us today. In 1987, bipartisan legislation was first introduced calling for a comprehensive national strategy focusing on education, prevention, and research to halt the spread of AIDS. We summoned government, the public health community, and the media all to do their part raise public awareness and combat the AIDS epidemic across America. Yet, today, more than two decades later, the battle continues. We mourn the more than 500,000 Americans who have been lost to the AIDS virus. However, we take heart from the fact that AIDS is no longer a death sentence. Through testing and treatment, people are living long, full, productive lives with HIV. We are identifying victims earlier in the progression of the disease, and keeping them healthier longer. However, we still have a long way to go. Many who live with HIV and AIDS do not have insurance to pay for costly treatments. As a result, heavy demands are placed on community-based organizations, as well as on State and local governments. For most of these citizens, the Ryan White CARE Act continues to provide the only means to obtain the care and treatment they need. The Ryan White CARE Act began as an emergency response to the HIV/ AIDS crisis in urban America, but today it has been broadened into a national strategy to provide care and support for people living with HIV and AIDS anywhere in America. This bill builds on a consensus among States, cities, community-based organizations, hospitals and health providers, and persons living with HIV and AIDS their families and advocates: It maintains access to life- saving medications, quality health care, and support services for persons living with HIV and AIDS who have come to depend on publicly funded systems, it extends this system of quality care to persons with HIV and AIDS who have faced long waiting lists for medications and severe limits on their access to specialty health care; it bolsters governmental and community-based institutions charged with providing this care, all of whom face growing case loads and the greater challenges of an evolving population of persons with HIV/AIDS; it balances the needs of high-prevalence cities and States with those facing rapidly growing epidemics; it assures those who have been relying on their local system of care that it will continue to be there for them; and it reassures persons seeking tests for HIV that comprehensive care and support will be available. At its best, the United States has the finest HIV/AIDS care system, truly the gold standard for the rest of the world to emulate. Our goal in this legislation is to make the U.S. HIV/AIDS care system also the fairest in the world, with equal access for all, high quality standards, and guaranteed continuity of care--regardless of geographical location. This bill is a great example of the good and important things we can accomplish in this body when we work together with bipartisanship, goodwill, and a spirit of compromise. This is also complex legislation, and all our committee staff members, Democratic and Republican alike, deserve great credit for their expertise, and for their diligence in bringing us to this day. I want to recognize Connie Garner and Jenelle Krishnamoorthy from my staff, Hayden Rhudy from Senator Enzi's staff, Tamar Magarik Haro from Senator Dodd's staff, and Evan Feinberg from Senator Coburn's staff for their dedication and hard work on this legislation. To say the least, this legislation is extremely important to Americans living with HIV and AIDS. For them, it is a lifeline. It offers hope for an active, productive, dignified life. This legislation shows America at its very best: compassionate, generous, extending a hand up to those in great need. Mr. President, I thank my colleagues for coming together to support this important, bipartisan bill.

Mr. HARKIN

Mr. HARKIN. Mr. President, all five congressional committees involved in the health care reform debate have completed their work now and the core elements of this landmark legislation are now clear. The media has done a good job of reporting that the emerging bill will crack down on abuses by health insurance companies and extend quality health coverage to the vast majority of Americans. In addition, much attention has been paid to the public option which I am confident will be in the bill we send to the President later this year. So there has been a lot in the press about the public option; about coverage; how much this costs; will there be an excise tax; what will the penalties be. Almost all of the debate we see--I should say discussion--surrounding the health care reform is about how we pay the bills, when we think about it. It is about how are we going to pay all of these bills. There is one huge part of the health reform bill that is not being discussed very much that I believe will have a transformative effect on the system we have in America today, which I have often referred to as not a health care system but a sick care system. When we think about it, that is what we have in America: a sick care system. If you get sick, you get care one way or the other, but we do precious little to keep you healthy in the first place. As one of the comedians on one of these late night talk shows I happened to tune in to one night said, you know, they are talking about everything except health care. What do we need to do to keep people healthy in the first place? Well, quite frankly, that is in our bill. That is what I wanted to discuss this morning, which is some of the aspects of the bill that I believe will bend the cost curve in the future and make us a genuine wellness society. The bill we reported out of our HELP Committee creates a sharp new emphasis on fitness, physical activity, good nutrition, disease prevention; in short, keeping people out of the hospital in the first place. This will give Americans access to a 21st century true health care system focused on preventing disease and helping us live healthy, active, productive lives, and it will reduce wasteful, avoidable costs that are built into our current system. Again, this sort of disease management approach we have in our country now is about patching things up after people develop a serious illness or a chronic condition. It is a system that overspends, which we know, and underperforms. It has been a colossally expensive failure. We can and must do better. As President Obama said in his speech to Congress back in February: [It is time] to make the largest investment ever in preventive care, because that's one of the best ways to keep our people healthy and keep our costs under control. To most of us, it is self-evident that cost-effective preventive services will save money in the long term. This first chart is of a poll taken which shows that 76 percent of the American people said we should invest more in preventive care--76 percent. They get it. The American people get it. This support comes from across the political spectrum. Eighty-six percent of Democrats, 71 percent of Republicans, and 70 percent of Independents say we should be spending more on prevention. This next chart shows that 77 percent of Americans support a new emphasis on prevention in a health care reform bill because they know it is the right thing to do. It is common sense. If we can use cost- effective screenings and other upfront intervention programs to prevent tens of millions of occurrences of chronic diseases such as cancer, diabetes, and cardiovascular disease, it is self-evident that we are going to slash health care costs very significantly. Some critics have claimed that a new emphasis on wellness and prevention will cost more money and it will drive up health care costs. To support this claim, they have created a straw man, assuming that we are going to do all of these preventive services for everybody all the time, but that is not what is in our bill. I wish to emphasize that our committee's bill takes a very rigorous approach to prevention. We target appropriate preventive services and screenings only to those segments of the population that are at risk of a disease or a condition. For example, under our bill, mammogram screenings would be free--no copays, no deductibles--but to those most at risk of breast cancer-- women over the age of 40. At every step, what we have relied on are the latest recommendations of the U.S. Preventive Services Task Force. This task force has been in existence since the early 1980s. It evaluates clinical preventive services on the basis of scientific evidence related to effectiveness, appropriateness, and cost-effectiveness. So what we have said is that if the U.S. Preventive Services Task Force gives a certain preventive measure or screening an A or a B score, then the insurance companies and providers must provide that without any copays or deductibles. So it is targeted. It is not everything, but we are targeting the most cost-effective. We also say that this task force has to meet at least once every 5 years and take in the latest scientific evidence and make recommendations for revising the mix of clinical preventive services. Let me review some of the ways the Senate HELP Committee bill, in a very careful way, will put prevention and wellness at the very heart of health reform. First, we create a Federal level prevention and public health council to improve coordination among Federal agencies in incorporating wellness into a national policy, and will develop a national prevention and a public health strategy. All of the departments should be doing this, not just the Department of Health and Human Services but the Department of Agriculture, the Department of Defense, the Department of Veterans Affairs, the Department of Transportation, and on and on. All of them ought to have as an integral part of their deliberations and proposals for future legislation that they might propose in the Congress an element of prevention and wellness. Take the Department of Transportation, for example. When they are thinking about highways, bridges, roads, and things such as that, are they thinking about bike paths and walking paths and sidewalks in cities that could be incorporated into the planning if they want Federal money? Well, they have not so far. This is what I mean. We need this kind of an overall coordinating council at the White House level, at the department level. We also start a prevention and public health investment fund to provide for expanded and sustained national investments in prevention and public health programs in communities all across America. A 2007 study by the Trust for America's Health found major savings from community-based prevention programs. There is clinic-based prevention where you get a screening, but then there are community- based programs to improve physical activities, nutrition, reduce smoking rates, and things such as that. They found that a national investment of just $10 per person per year--think about that, $10 per person per year--in certain community-based wellness programs would yield these kinds of savings: in 1 to 2 years, $2.8 billion; 5 years, $16 billion; and 10 to 20 years, $18.5 billion. Again, on both the community level and the clinical level, we provide for funding and a structure to make wellness and prevention an integral part of our health care system. For example, our bill would target nutrition counseling to prediabetic patients. Right now, under Medicare, for example, and most insurance companies, they will reimburse thousands of dollars to take care of your diabetic conditions once you get diabetes. They will pay for amputating a foot or a leg. They will pay for all these expensive things after you get diabetes. They will pay for a lifetime of treatment. But now they will not reimburse for the cost of nutrition counseling--a few hundred dollars for someone who is prediabetic and who could prevent the disease through changes in diet. That doesn't make sense. Our bill would change this by requiring insurance plans to reimburse for nutrition counseling for prediabetic individuals--another example of a cost-effective approach. For essential screenings and annual physicals, our bill would get rid of copays and deductibles for things such as your annual physical checkups, vaccinations, mammogram screenings, and colonoscopies for the right population group, things like that--no copays, no deductibles. We are going to make major new investments in the public health and primary care workforce. Senator Murray, of Washington, did a great job of incorporating workforce development in our committee bill. A lot of that workforce development is in the area of primary care and preventive care and wellness. Finally, we give a powerful boost to employer-sponsored wellness programs. Our bill would allow employers to reward employees for participating in wellness programs by giving them a health insurance premium discount of up to 30 percent. In other words, if you participate in a wellness program that is provided by your employer, you can get a discount of up to 30 percent on your health insurance premium. I believe this is something that has been done by Safeway and others, and they have shown that they have had great results. People can see the benefit of wellness and prevention by getting a reduction in their health care premiums. Workplace wellness programs--everything from nutrition counseling to smoking cessation--typically cost about $20 to $200 per employee per year. Again, they have a proven rate of return, ranging from $2 to $10 within 18 months, for every dollar spent. If you don't believe me, ask Pitney-Bowes what they did or Safeway. I single those two out, but many companies have gone way ahead of us in providing wellness programs for their employees. Are they doing it just out of sheer generosity? No. They know the bottom line. They know that when they provide wellness and prevention programs for their employees, their rate of return per dollar spent on an employee is 2 to 10 times as much within just a year or two. They have healthier employees. They don't go to the hospital as often. They don't have chronic diseases and they are more productive. They show up for work and they are more productive. What we have done in our bill is expanded this nationwide to give more companies the incentive to do that. Our bill also directs the CDC to study and evaluate the best employer-based wellness programs and to create an educational campaign to promote these workplace wellness programs throughout America. We think about the United States and our sick care system this way: We spend twice as much per capita on health care as European countries--twice as much--but we are twice as sick with chronic diseases. How is this possible? The reason is clear: We have neglected wellness prevention and disease prevention. In the United States, 95 cents of every health care dollar is spent on treating illnesses and conditions after they occur. Two-thirds of the increase in health care spending is due to increased prevalence of treated chronic disease. This chart illustrates that. In the late 1980s, we were spending about $313 billion a year on chronic disease. We have now doubled that. It is up to $627 billion, and it is going up at an ever-increasing rate. These are diseases that are mostly preventable. Yet we just continue to spend the money dealing with these chronic diseases. The good news is that by reforming our system and keeping people healthy and preventing chronic illnesses, we have a great opportunity to not only save hundreds of billions of dollars but to improve the health of the American people. Right now, 75 percent of health care costs are accounted for by heart disease, diabetes, prostate cancer, breast cancer, and obesity--five of them. These five diseases account for 75 percent of our health care costs. What do they have in common? They all have this in common: They are largely preventable, and even reversible, by changes in nutrition, physical activity, and lifestyle. Again, for every dollar spent, 75 cents went toward treating patients with chronic disease. The CDC said this: The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases. Ninety-six cents of every Medicare dollar--we always hear that we are not going to have enough money for Medicare in the next 10 or 12 years, however long it is. Well, 96 cents goes for chronic disease. If you want to cut down on how much money we spend on Medicare, let's focus on prevention and wellness, especially for that group of individuals who are between 55 and 65, about ready to go on Medicare. Eighty-three cents of every dollar spent on Medicaid is spent on chronic diseases. Why don't we understand this and get it right? Yet, just like blind dodos, we say we will just keep spending the money and we won't address wellness and prevention. And we wonder why we can't get health care costs under control. Well, that is why. We are not addressing the underlying issues of wellness and prevention. Again, it makes no sense to me that we spend all this time and all this effort to figure out a better way to pay the bills in a system that is dysfunctional, ineffective, and broken. We have to change the health care system itself. We have to change from a sick care system to a health care system, beginning with a sharp new emphasis on prevention and public health and wellness. That is in this bill, and that is not being talked about by the media. It is one of the fundamental parts of the health care reform we are going to be putting through here on the Senate floor and, hopefully, in Congress and to the President by the end of the year. It also has to be comprehensive. Not everything that deals with wellness and prevention can be done in this bill. For example, very soon we have to reauthorize the child nutrition bill, which deals with the School Lunch Program and the Breakfast Program. We have to get better food, more nutritional food for our kids in school and get the junk food out. Why do we have vending machines in schools? Do we have vending machines in schools to provide more healthy food for kids in school? You know the answer to that. Of course not. Why do you have the vending machines in schools? Is it so that the school can make money so it can buy band uniforms or maybe football uniforms and things like that? Is it so we can get our kids on junk food and high-sugar sodas, which leads to obesity and leads to diabetes and other kinds of chronic illnesses? Do we really want that for our kids in school? We have to have more nutritional foods. That is the child nutrition reauthorization. Next year, under our committee, I say to the occupant of the chair, who is now a distinguished member of our committee, we are going to reauthorize the Elementary and Secondary Education Act, which is also called No Child Left Behind. What about making sure we leave no child behind also in terms of their health? Right now, we are cutting down on physical activity with kids in school. We are cutting down on recess and time for them to exercise. That is just nonsense. We have to do more to provide for exercise and healthy foods for our kids in school. That is where it all begins. To close, Winston Churchill once said something I always thought was pretty much right on point: Americans always do the right thing--after they have tried everything else. We have tried everything else in health care, and it has failed. It has led us to bad health and to the brink of bankruptcy. Let's try something new--wellness and prevention. Times change the paradigm of health care. Let's recreate America as a genuine wellness society. Let's change the focus and make it easier to be healthy and harder to be unhealthy. Right now, it is easier to be unhealthy and hard to be healthy. Let's change that around, and in doing so we will build a health care system and bend that cost curve. That is the only way to get the job done.

Mr. HARKIN. Mr. President, I will be glad to get that for the Senator. I will get that to the Senator.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that Shauna Agan and Amber Oldham of my staff be granted floor privileges for the duration of today's session.

Mr. HARKIN

Mr. HARKIN. Mr. President, I would like to congratulate the Muscatine History & Industry Center for being selected to participate in the rigorous Museum Assessment Program sponsored by the American Association of Museums. The entire Muscatine community takes great pride in the History and Industry Center's success in showcasing the city's past role as ``pearl button capital of the world,'' as well as the historic contributions of three local enterprises: Bandag, a half-century-old company specializing in silver tubes, mesh venting, and tire treads; HNI Corporation, the world's second largest manufacturer of office furniture and the nation's No. 1 maker of gas- and wood-burning fireplaces; and Stanley Consultants, a global provider of engineering, environmental, and construction services. The Muscatine History and Industry Center is a relatively small museum, but it has a very big impact. Not only does it welcome many thousands of visitors annually, it reaches out to the community with a variety of programs and activities, and hosts daily visits by school groups--from prekindergarten through high school. Students and youth groups learn by interacting with the Center's artifacts and many hands- on activities. As the center begins participation in the Museum Assessment Program, it looks forward to an extended period of self-examination and peer review designed to improve its operations and programming, and to identify current and future challenges. I congratulate the Muscatine History and Industry Center for taking this giant step forward in its development as a museum. And I salute all the outstanding professionals and volunteers at the center whose vision and tireless efforts have made this institution such an important part of Muscatine's cultural life.

Mr. HARKIN

Mr. HARKIN. Mr. President, on Tuesday, October 6, I introduced S. 1756, the Protecting Older Workers Against Discrimination Act. To appreciate the need for this bill, consider the case of a hard- working Iowan named Jack Gross. Mr. Gross gave the prime of his life, a quarter century of loyal service, to one company. How did that company reward him for his dedication and hard work? It brazenly demoted him and other employees over the age of 50, and gave their jobs to a younger employee. Expressly to prevent this kind of discrimination, over 40 years ago Congress passed the Age Discrimination in Employment Act, ADEA. The ADEA, which made it unlawful to discriminate on the basis of age, was modeled on and used the same language as title VII of the Civil Rights Act of 1964, the law that prohibits employment discrimination on the basis of race, sex, national origin and religion. When Mr. Gross sought to enforce his rights, a jury of Iowans heard the facts and found that his employer discriminated against him because of age. That jury awarded him almost $47,000 in lost compensation. The case was ultimately appealed to the Supreme Court. This past June, in Gross v. FBL Financial, Inc., five Justices rewrote the rules-- indeed, effectively rewrote the law--and ruled against Mr. Gross and other older workers. In doing so, the Court made it harder for those with legitimate age discrimination claims to prevail under the ADEA. For decades, the law was clear. In 1989, in Price Waterhouse v. Hopkins, the Court ruled that if a plaintiff seeking relief under title VII of the Civil Rights Act demonstrated that discrimination was a ``motivating'' or ``substantial'' factor behind the employer's action, the burden shifted to the employer to show it would have taken the same action regardless of the plaintiff's membership in a protecting class. As part of the Civil Rights Act of 1991, Congress formally codified the ``motivating factor'' standard with respect to title VII. Because the Age Discrimination in Employment Act uses the same language as title VII, was modeled off it, and had been interpreted consistent with the Civil Rights Act of 1964, courts correctly and consistently held that a victim bringing suit under the ADEA need only show that membership in a protected class was a ``motivating factor'' in an employer's action--the same standard for plaintiffs claiming discrimination on the basis of race, sex, religion, or national origin. If an employee showed that age was one factor in an employment decision, the burden was on the employer to show it had acted for a legitimate reason other than age. In Gross, the Court--addressing a question on which it did not grant certiorari--tore up this settled decades old standard. In its place, the Court applied an entirely new standard that makes it prohibitively difficult for a victim to prove age discrimination. According to the Court, a victim of age discrimination bears the full burden of proving that age was not only a motivating factor but the decisive factor. This extremely high burden radically undermines older workers' ability to hold employers accountable. Bear in mind that unlawful discrimination is often difficult to detect. Obviously, those who discriminate do not often admit they are acting for discriminatory reasons. To the contrary, they go out of their way to conceal their true intent. Discrimination cases rarely involve a smoking gun. The reality, however, is that while employers rarely post signs saying ``older workers need not apply,'' ageism in the workforce does indeed exist, as Mr. Gross and his colleagues learned the hard way. Indeed, according to an AARP study, 60 percent of older workers have reported that they or someone they know has faced age discrimination in the workplace. Countless thousands of American workers who are not yet ready to voluntarily retire find themselves jobless or passed over for promotions because of age discrimination. Older workers often face ugly, baseless stereotypes: That they are not as productive as younger workers; that they cannot learn new skills; that they somehow have a lesser need for income to provide for their families. These stereotypes--and the discrimination they feed--are wrong and immoral. This is also harmful to our economy, inasmuch as it deprives us of the skills and talents of millions of older workers. The timing of the Court's decision is particularly troubling. As our economy continues to struggle, older workers are being hit particularly hard. According to the Department of Labor, there are 2 million unemployed workers over the age of 55. This is an all-time high since the Bureau of Labor Statistics began matching age and unemployment in 1948. According to the Equal Employment Opportunity Commission, in 2008 nearly 25,000 age discrimination claims were filed, a 30-percent increase over 2007. Given the stereotypes that older workers face, it is no surprise that, on average they remain unemployed twice as long as all unemployed workers. The Protecting Older Workers Against Discrimination Act reverses the Court's decision and restores the law to what it was for decades. The bill makes clear that when an employee shows that discrimination was a ``motivating factor'' behind a decision, the burden is properly on the employer to show it complied with the law. The act is modeled on part of the Civil Rights Act of 1991, which passed the Senate 93-5. As under title VII of the Civil Rights Act, once a plaintiff establishes that age was a motivating factor, the burden shifts to the employer. If the employer establishes that the same decision would have been made regardless of discrimination, the employer remains liable, but remedies are limited. Only the employer is in a position to know his or her own mind and offer an explanation as to why a decision that involves discrimination was actually motivated by legitimate reasons. By putting the entire burden on the worker to demonstrate the absence or insignificance of other factors, the Court in effect gave employers license to discriminate, so long as they do not actually say they are singling out an employee solely because of age. Finally, the Protecting Older Workers Against Discrimination Act makes clear that the ``motivating factor'' framework applies to all antidiscrimination and antiretaliation laws. In Gross, Justice Thomas defended the Court's radical departure from well-established law by noting that the Court ``cannot ignore Congress' decision to amend title VII's relevant provisions but not make similar changes to the ADEA.'' In other words, the Court found that because Congress, in the Civil Rights Act, codified the ``motivating factor'' framework for title VII of the Civil Rights Act, but not for the ADEA, Congress somehow must have intended Price Waterhouse not to apply to any statute but title VII. This is a serious misreading of the intent of Congress. Unfortunately, this reasoning in Gross has already had reverberations in other civil rights cases since many antidiscrimination and antiretaliation statutes utilize similar language as title VII and the ADEA. As the Seventh Circuit recently held, ``[Gross] holds that, unless a statute (such as the Civil Rights Act of 1991) provides otherwise, demonstrating but-for causation is part of the plaintiff's burden in all suits under federal law.'' The Protecting Older Workers Against Discrimination Act, therefore makes clear that Congress is in no way questioning the ``motivating factor'' framework in other antidiscrimination and antiretaliation statutes. The aim of this bill is very simple. It reiterates what Congress said 40 years ago when it passed the ADEA: When an employer makes an employment decision it is illegal for age to be a factor. A person should not be judged arbitrarily because he or she was born on or before a certain year, despite the fact that he or she still has the ability to contribute as much, or more, as the next person. This bill will help ensure that all our citizens have an opportunity commensurate with their abilities, for productive employment.

Mr. HARKIN

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

Mr. HARKIN. Mr. President, I rise in opposition to the amendment offered by the senior Senator from Arizona. The amendment by Senator McCain singles out one instance of congressionally directed funding that I had included in the bill now before us, fiscal year 2010 Interior appropriations. The Senator claims this earmark, which provides $200,000 in funding for repair and renovation of the historic Des Moines Art Center, is somehow inappropriate and should be removed from the bill. Well, it comes as no surprise that I strenuously disagree. First of all, as a constitutional matter, I take issue with the premise underlying the Senator's amendment--the idea that Congress has no business directing the expenditure of Federal moneys to earmarks, that there is something inherently wrong or evil in this traditional practice, and that only the executive branch should determine where Federal moneys are spent. Well, I beg to differ. The Constitution, article I, section, 9, expressly gives Congress the power of the purse. The executive branch can't spend one nickel unless this Congress gives it the authority to do so. Over the centuries, over the last couple hundred years, we have given to the executive branch the authority to make budgets, spend money on different things through all the different departments and agencies, but if Congress wanted to, we could take it all back. We could take it all back because the Constitution gives Congress the sole power to spend money. What is more, compared to executive branch individuals, Members of Congress have a much better understanding of where and how Federal funds can be spent most effectively in their respective districts and States, and that is certainly the case with the earmark in question. I assume the Senator from Arizona doesn't know a lot about the Des Moines Art Center. Well, let me explain it for the Record. The Des Moines Art Center encompasses three nationally significant buildings, two of which have been listed on the National Register of Historic Places since 2004. One of these buildings was designed by the famous architect, Eliel Saarinen, and another by the world renowned I.M. Pei. These buildings are architectural gems but, unfortunately, they have suffered from deterioration over the years. So I secured the modest funding in this earmark--$200,000--for the specific purpose of replacing windows that were causing inconsistent temperatures and high condensation, resulting in damage to the building's plaster, the wood paneling, and the floors. There is nothing the least bit wasteful or frivolous about these renovations. In fact, they will create jobs and put people to work. I also wish to point out that this funding is awarded through an authorized program called Save America's Treasures. This program was established within the National Park Service to protect: America's threatened cultural treasures, including historic structures, collections, works of art, maps and journals that document and illuminate the history and culture of the United States. Money for the program is awarded both competitively through grants and through congressionally designated funding. Over the years, the Save America's Treasures Program has helped to protect many important buildings and artifacts across our country. There is no question that the Des Moines Art Center is both worthy and in urgent need of this modest funding. The buildings of the center, as I said, are architectural masterpieces. They contribute mightily to making Iowa's capital city a livable, attractive urban center with a lively cultural scene. Bear in mind that the Des Moines Art Center is a cultural institution in the State of Iowa, drawing hundreds of thousands of visitors not only from Iowa but from around the United States and from all over the world every year. In the last 12 months, the center has served nearly half a million people. School kids from all over our State come into Des Moines in buses from their schools out in the countryside, out in the small districts, to go to the art center to see these magnificent, wonderful works of art and the buildings themselves. I wish to emphasize that in terms of fundraising for renovations and operations, the art center and the Des Moines community are more than pulling their own weight. The center currently is in the midst of a $34 million fundraising campaign. However, only $7.5 million of that is for capital and building improvement. The remaining $26.5 million is for the center's operating endowment. That allows the art center to be free and open to the entire community all year-round. Moreover, the $200,000 in Federal funds will leverage $1.9 million in public and private challenge grants--not a bad leveraging of Federal dollars. The fact is, the Des Moines Art Center is struggling to meet its fundraising targets in any and all ways possible, including in relatively modest increments. The center has received $275,000 from Polk County--that is the county encompassing our capital city of Des Moines. They received $25,000 from the city of Des Moines. At this point, the center has exhausted their private fundraising options. So the $200,000 grant from the Federal Government, along with the additional $1.9 million that it will leverage, is critical to meeting the center's goal of renovation. I appreciate this opportunity to share with our colleagues my reasons for including this earmark in the bill before us. I am proud of this congressionally directed funding. It would go to a worthy and urgent public purpose. I believe the effort by Senator McCain to remove this money from the bill is misguided, and I urge my colleagues to vote against the McCain amendment. Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent the period of morning business be extended to 2:30 p.m., with Senators permitted to speak therein for up to 10 minutes each.

Mr. HARKIN. Mr. President, as I look around this Chamber, I see men and women of remarkable talents and abilities. I also have a strong sense, we all do, that there is a tremendous void now in our midst. A very special Senator, a very special friend, a Member who played a unique role within this body for nearly a half century is no longer with us. We have had many glowing and richly earned tributes to Senator Ted Kennedy over these last couple of weeks. He was not only the most accomplished and effective Senator of the last 50 years, he was truly one of the towering figures in the entire history of the Senate. Yet for all his accomplishments, for all the historic bills he authored and shepherded into law, for all the titanic battles he fought, I will remember Ted Kennedy first and foremost as just a good and decent human being. I remember his extraordinary generosity, his courage, his passion, his capacity for friendship and caring, and, of course, that great sense of humor. I remember one time I was in my office and we had a phone conversation. It was about a disagreement we had. It was right at St. Patrick's Day so we were having this discussion on the phone and tempers got a little heated. I think I was holding the phone out about like this. He probably was too. I think our voices got raised to a very high decibel level, sort of yelling at each other, and pretty soon we just hung up on each other. I felt very badly; I know he did too. So several hours later, when I came on the Senate floor and I saw Ted at his desk, I went up to him, I pulled up a chair next to him. He would get that kind of pixie smile on his face, have a twinkle in his eye. I said: Ted, I'm sorry about that conversation we had. I should not have lost my temper as I did. I said: My staff is a little concerned about our relationship. He sort of got that great smile and chuckled. Well, he said, forget about it. I just told my staff that is just the way two Irish men celebrate St. Patrick's Day. That is just the way he was. He could disarm you immediately and you would move on. He had a great disarming sense of humor. Ted came from a remarkable family--so many tough breaks, so many triumphs, so many contributions to our Nation--both in war and in peace. Ted and his siblings were born into great wealth. They could have lived lives of luxury and leisure, but they chose instead to devote themselves to public service. They devoted themselves to making the world a better place for others, especially those in the shadows of life. There are so many things I could focus on this morning in my brief remarks, but I want to focus on just one aspect of Ted Kennedy: all that he did to improve the lives of people with disabilities in our country. I thought about this: With the death of Eunice Kennedy Shriver on August 11, and all she did to found the Special Olympics now being carried on by her son Tim, then the death of Ted on August 25, people with disabilities in this country lost two great champions. Their sister Rosemary lived her entire life with a severe intellectual disability. The entire Kennedy family is well acquainted with the joys and struggles of those with disabilities. Those of us who were in the church in Boston at the funeral--and those probably watching on television--heard the very eloquent speech by Teddy Jr. about his battle with cancer at a young age, losing his leg and his confronting his disabilities, and how Ted helped him get through that. In 1975, Senator Kennedy helped to pass what is now called the Individuals with Disabilities Education Act--IDEA. In 1978 he passed legislation expanding the jurisdiction of the Civil Rights Commission to protect people from discrimination on the basis of disability. In 1980 he introduced the Civil Rights for Institutionalized Persons Act, protecting the rights of people in government institutions, including the elderly and people with intellectual and mental disabilities. Nineteen years ago he was one of my most important leaders and partners in passing the Americans with Disabilities Act--1990. I will never forget, after I had been in the Senate for 2 years, Republicans were in charge, and then in 1986 Democrats came back, took charge, and Senator Kennedy wanted me on his education and health committee. I sort of played a little hard to get. I said: Well, maybe, but I am really interested in disability issues. He knew about that. He knew about my work on some of the stuff I had done in the House before I came here, especially for people with hearing problems. I said I would like to come on his committee, but I said I would be interested in working on disability issues. He got back to me and said: Tell you what, I have the Disability Policy Subcommittee and you can chair it. I am a freshman Senator. He didn't have to do that for me. I was astounded at his great generosity. So I have always appreciated that. He had already had this great, extensive record on disability issues. Yet he let me take the lead. Then when the Americans with Disabilities Act came up, he could have taken that himself. He was the chairman of the committee. As I said, he had this long history of championing the causes of people with disabilities. Yet he knew how passionately I felt about it, and he let me author the bill. He let me take it on the floor. He let me be the floor manager of it and put my name on it. He didn't have to do that. He was the chairman. He could have had his name on it. He could have floor-managed it. But he let me do it in spite of the fact that I was just a freshman Senator. He was an indispensable leader in bringing disparate groups together to get the Americans with Disabilities Act passed. I will never forget that great act of generosity on his part in letting me take the lead. Ted always insisted that our focus should be not on disability but on ability; that people with disabilities must be fully included in our American family. Americans with disabilities had no better friend, no tougher fighter, no more relentless champion than Ted Kennedy. Yesterday I accepted the chairmanship of the Senate HELP Committee, the Health, Education, Labor and Pensions Committee. It is a great honor and a great challenge and, I must add, somewhat daunting to carry on the legacy of Senator Ted Kennedy. He dedicated his life to making our economy work for all Americans, to secure a quality education for every child and, of course, securing quality, affordable health care for every citizen as a right and not a privilege. In the Democratic cloakroom, there is a page from the Cape Cod Times with a wonderful picture of Ted and a quote from him. Here is the quote: Since I was a boy I have known the joy of sailing the waters of Cape Cod and for all my years in public life I have believed that America must sail toward the shores of liberty and justice for all. There is no end to that journey, only the next great voyage. We have heard many eloquent tributes to Senator Kennedy. But the tribute that would matter most for him would be for his colleagues to come together, on a bipartisan basis, to pass a strong, comprehensive health reform bill this year. It is time for us to sail ahead on this next great voyage to a better and more just and more caring America. So as we sadly contemplate the empty desk draped in black, we say farewell to a beloved colleague. He is no longer with us, but his work continues. His spirit is here. And as he said, the cause endures. May Ted Kennedy rest in peace. But may we not rest until we have completed the cause of his life, the cause he fought for until his last breath, ensuring quality, affordable health care for every American. I yield the floor.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that April Saylor and Elyse Kamps of my staff be granted the privilege of the floor for the duration of today's session.