Orrin Hatch

Mr. HATCH

Mr. HATCH. I thank my colleague for leading out here, talking about this very important issue. You and your senior colleague from Tennessee are great Senators and mean a lot to all of us. It is funny to me that the people in this body don't listen to the only two doctors in the body, and both of them are excellent physicians. Both of them are concerned about people. Both of them make such cogent arguments in the field of health care. I think we have had a very good argument by Senator Coburn, from Oklahoma--one of our two doctors in the Senate. Senator Barrasso is an orthopedist, a specialist. He has come here to fight for the causes he believes to be right. He knows what is trying to be put off on America today is not right. Our States are facing a historic deficit of more than $200 billion right now. Yes; that is what our States are facing right now without this bill. One of the biggest drivers behind this is the Medicaid Program, which takes up an increasing share of our States' budgets across the country. The Senate bill, which is nothing more than a 2,074-page takeover by Washington of our health care system, calls for the biggest Medicaid expansion ever--133 percent of the Federal poverty level. That is 150 percent in the House bill, if we pass that monstrosity. My home State of Utah only allows Medicaid coverage of up to 133 percent of the Federal poverty level for infants, children under the age of 5, and pregnant women. Other categories of citizens are, however, covered at different levels. For example, nonworking parents are only covered up to 48 percent of the Federal poverty level. This bill will now massively expand the level of Medicaid coverage to 133 percent for everyone. Who is going to pay for that? Our colleagues say the Federal Government will. What are they going to pay for it with? We are running the Federal Government right into bankruptcy. It is ultimately going to be the responsibility of the States and the States can't do it. Think of New York, New Jersey, California, just to mention three. Let's not forget that the House has already passed a Medicaid expansion of 150 percent of the Federal poverty level. The Congressional Budget Office estimates this massive entitlement expansion will cost States an additional $25 billion over the next 10 years. You heard me right, $25 billion more. That is over the next 10 years. However, if history has taught us anything about the way things work in Washington, I believe this number is actually a huge underestimation and the real impact on our States will be much higher. I would like to read the following excerpt from a letter sent to me by Governor Herbert, our Governor in the great State of Utah, and what this Medicaid expansion would mean for my State. It is a quote. This is what my Governor has to say: As I am sure you know, Utah, like most other states, is suffering from the negative impacts of nationwide recession. As we prepare the state's fiscal year 2011 budget, we face continued cuts to agency budgets and reduced government services on top of painful reductions made last year. The unfunded mandate of a forced Medicaid expansion will only exacerbate an already dire situation. If required to increase our Medicaid program as envisioned in Washington, Utah, and most every other state, will be forced to find the money to do so through other means. This will require states to either raise taxes or continue to cut budgets in areas currently suffering from a lack of funding, such as public and higher education. We are seeing a real life example of this in California right now. Faced with a mounting State budget crises, we recently saw that the State-run University of California system had to hike its tuition rates by 32 percent--32 percent! I don't know about anyone else, but I will not allow this to happen in my home State of Utah just because Washington thinks it is a good idea to keep expanding government programs on the back of our States. Here is the reality that our States are facing: Unemployment rates rose in 29 States in October. A significant number of States are facing unemployment rates much, much higher than our national rate of 10.2 percent--the highest in 26 years: Michigan, 15.2 percent; Nevada, 13 percent; Rhode Island, 12.9 percent; California, 12.5 percent. In fact, California, Florida, Delaware and Washington, DC, posted their highest unemployment rates since 1976. The last thing we need right now is for Washington to impose more liability on the states. This alone should be a reason enough for every Senator to stop and rethink their decision about letting this ``tax and spend'' bill move forward. But I have to tell you, I know what is behind all this. Ever since I have been here, there has been a push to have more and more people moved into Medicaid. Why is that? Because if they can push more and more people into Medicaid, then ultimately we will have a single-payer system--in other words, socialized medicine in this country, where the government will control everything. That is what is behind a lot of this bill. I have to tell you, what bothered me an awful lot about this bill is that even the CBO Director, whom I find to be an honorable, honest man, Dr. Elmendorf, he said that if we go to a government plan--which is a hallmark of what our friends on the other side want to do--then you could have almost 10 million people going into that plan. However, if you look at the Lewin Group study, they say if you go to a government plan, we could have 119.1 million people going into the new plan. What is it going to be, the 10 million or the 119.1 million? I guarantee it is going to be a lot closer to the 119.1 million than it will be to the 10 million. Our friends on the other side started criticizing the Lewin Group after this report. They have quoted them for years before this report. Now that they don't agree with our colleagues on the other side, they think it will only be 10 million. Don't kid yourselves. If you had to choose between the 10 and the 119 million, you know doggone well it will be closer to the 119. If we move millions of more people over from private insurance into government health care, I can't tell you the pressure that will be on America, the pressure that will be on the health care professionals. We heard from one of the great doctors in this body, whom we ought to listen to, that we can't get the primary care people to take care of people now on Medicaid, let alone adding millions more under this expansion. I thank my colleague from Tennessee for his leadership on this. I am happy to be here to say a few things about it because I have spent a lifetime working on health care issues. Before I ever got here, I actually tried medical liability and defense cases, defending doctors, nurses, hospitals, health care providers. I know what these costs are. They are just beginning to explode. If this bill passes, it is going to be an explosion of health care costs such as we never dreamed possible. I am very concerned about this. It is all driven by a desire to get, right here in Washington, control over all of our health care. If we do that, we deserve the problems we are going to have. I thank my colleagues for the great work they are doing.

Mr. HATCH. The Senator is absolutely right. They even said the premiums of the so-called government plan would be higher than private sector insurance premiums. It is incredible. I have enjoyed the comments by the distinguished Senators from Arizona, Utah, and Tennessee. If you look at what they are trying to do, they are going to throw out a system that 85 percent of the American people feel is basically OK, because they have not taken care of the 15 percent who don't have insurance. But when you deduct the 6 million people who work for companies that provide insurance but they don't take it--they would rather have the money--and you take out the 11 million people who basically qualify for Medicaid or SCHIP but are not enrolled, and you deduct those who earn over $75,000 a year and can afford their own insurance, and then you take the illegal aliens, the documented workers and undocumented workers, you basically come down to 17 million people who need and deserve our help. We are going to throw the whole system out for 85 percent of the people when we could, through subsidization, help those who deserve help. It doesn't make sense. What are they thinking over there? I hope it is not that they want to take us to socialism or to Europeanize us, when Europe is trying to get away from Europeanization. We are rapidly approaching one of the most important votes for all of us in the Senate. This is bigger than any of us, our parties or our ideologies. This is about the future of the greatest Nation in the history of the world. It is about your children and my children. It is about your grandchildren, my grandchildren. Elaine and I have three great-grandchildren and two more on the way. It is about giving the future generation the same opportunities and same sense of pride. It is about every American's way of life. Every American business will be subject to this. Look at that thing, a 2,074-page edict from Washington. I am going to spend my time before this historic vote to highlight some very important numbers. Every Member of this Chamber should understand what they are voting to advance. Make no mistake, our actions today will not be without consequences. History and future generations will judge us by what we do here today. Zero is the number of provisions prohibiting the rationing of health care, not one word prohibiting the rationing of health care. All you have to do is look at some of the things that happened this week and you start to worry about it. How about this? Zero is the number of government-run entitlement programs that are financially sound over the long term. Consider these important numbers: 10.2 percent national unemployment rate, the highest in 26 years; 70, the total number of government programs authorized by this bill, 70 new programs at a time when we are going into fiscal insolvency; 1,697 times the Secretary of Health and Human Services is given authority to determine or define provisions in this bill. We are turning the whole thing over to the bureaucrats here in Washington. More numbers: 2,074 total pages of this bill--look at that--2010, the year Americans start paying higher taxes to support this bill. My colleague from Utah and my colleagues from Arizona and Tennessee have brought that out in no uncertain terms. The year when this bill actually starts is 2014, most of the major provisions of this bill. Some of them don't even begin until 2015. The number $6.8 million is the cost to taxpayers per word in this bill; $8 billion is the total amount of new taxes on Americans who do not buy Washington-defined health care; $465 billion in cuts in Medicare at a time when Medicare faces a $38 trillion unfunded liability to finance more government spending; $494 billion is the total amount of new taxes in this bill. If you think that is all, I think you have something coming here. According to the Budget Committee, using CBO figures, $2.5 trillion is the real cost of this bill over a 10-year period. Our total national debt will be $12 trillion. These numbers are facts and they are indisputable. Let me finish by reading an excerpt from a fellow Utahn from Provo who is worried about what this bill will do to our country. I am writing out of deep concern over the increasing expansion of government. I moved here from Germany 20 years ago. I love America because it is free--free-er than Germany in that I have the freedom to choose among other things how I want to insure my family (we have six children). I'm all for affordable health insurance which requires affordable health care. I am self employed and have been hit hard by the economy. There is a good chance that we would actually benefit from [this bill]. Business has been so bad that we would qualify for free school lunches if we asked for it. But I don't want more government handouts. I don't want the government telling me what kind of insurance I need to have. I don't want the government telling me what services I can receive when I need them. I don't want them taking an ever greater part of my income to help finance government programs such as the ``public option'' and the army of government employees it will take to administer such a program. I do not want more government. I want less. A lot less. These people from Germany have been living in our country as citizens for 20 years. They know what it was like to have their type of a system. I think we ought to pay attention to that humble person who, in spite of the travails they have, don't want this big, massive government program to become law.

Mr. HATCH

Mr. HATCH. Mr. President, I thank my colleague.

Mr. HATCH

Mr. HATCH. Mr. President, I would like to take my time to talk about the critical issue of health care reform as this body stands at a historic crossroad on this national challenge. We have never seen anything like the issues facing our country right now. The line between private businesses and public government has never been so blurred. Just look at this chart I have in the Chamber. Government effectively owns several of our Nation's institutions: insurance companies, financial institutions, banks and automobile manufacturers. CEOs have been fired by government bureaucrats, and Washington is now in the business of dictating salaries in the private sector. With government takeovers on the rise, drastic labor law changes being pushed forward, and sweeping new corporate taxes circling overhead, we are truly moving toward a European-style government at a time when most European countries are moving away from it. I deliver these remarks with a heavy heart because what could have been a strong, bipartisan bill reflecting our collective and genuine desire for responsible health care reform on one-sixth of the American economy continues to be an extremely partisan exercise, pushing for more Federal spending, bigger government, and higher taxes as a flawed solution. At the outset, let me make one point as clearly as possible. We are all for reform, everybody on this floor. Every Republican colleague whom I have talked to wants to reform our current health care system. Ensuring access to affordable and quality health care for every American is not a Republican nor is it a Democrat issue or idea; it is an American issue. Our Nation expects us to solve this challenge in an open, honest, and responsible manner. Clearly, health care spending continues to grow too fast. This year will mark the largest ever 1-year jump in the health care share of our GDP--a full percentage point, to 17.6 percent. Growing health care costs translate directly into higher coverage costs. Since the last decade, the cost of health coverage has increased by 120 percent--three times the growth of inflation and four times the growth of wages. Rising costs is the primary driver behind why we continue to see a rising number of uninsured in our country and why an increasing number of businesses find it hard to compete in a global market. Without addressing this central problem, we cannot have a real and sustainable health care reform bill. Unfortunately, the Senate health bill, according to the nonpartisan Congressional Budget Office, will actually increase Federal spending by $160 billion in the next 10 years instead of lowering it. Mr. President, you heard me right: It will increase spending. After the rushed stimulus bill, Americans are rightly concerned about what is being pushed through this Democratic Congress. The rush to pass something that will affect every American life and business has raised concerns all around our Nation. In a recent Gallup Poll, a majority of Americans believed their health care costs could actually get worse under the Democratic health care plans. So why are Americans so skeptical and concerned? Because they are being promised the impossible. They are being told that this trillion-dollar addition of taxpayer dollars to our health care system will actually preserve their current benefits, not raise their taxes, and it will reduce the Federal deficit. Even David Copperfield would be hard pressed to pull off this trick. Many Americans recently had a firsthand encounter with the efficiency of the Federal Government in administering the H1N1 vaccination around the country. Their experience consisted of standing in long lines for several hours in sterile government buildings, only to be told they were suddenly out of doses. Republicans in Congress agree with the majority of Americans who believe that just throwing more hard-earned taxpayer dollars at a problem will not deliver meaningful reform. Simply telling the American people that the solution for solving a $2 trillion health care system is to simply spend another $2.5 trillion just does not make sense. With nearly a half trillion dollars in new taxes, this big stack of papers is a textbook example of the liberal tax-and-spend philosophy. Now compare that with the Constitution of the United States. This little booklet contains the whole Constitution of the United States. Yet we have a health care bill that is 2,024 pages long. Come on. That is an example of the liberal tax-and-spend philosophy we see around here. Here are some of the highlights of this piece--this piece of equipment, this bill, this massive, massive bill; I can hardly lift the darn thing--$28 billion in new taxes on employers through a mandate that will disproportionately affect low-income Americans, and all at a time when our unemployment rate stands at an unacceptable 10.2 percent; $8 billion in new taxes on Americans who fail to buy a Washington- defined level of health care coverage; $372 billion in new taxes on everything from insurance premiums, to prescription drugs, to hearing devices and wheelchairs--all of which are going to be passed on to the consumers, most all of whom are earning less than $200,000 a year. As I said, there is no such thing as a free lunch, especially when Washington is inviting you over. Representatives from both the Congressional Budget Office, CBO, and the Joint Committee on Taxation, JCT, have testified before the Finance Committee that these taxes will be passed on to the consumers. That is you and me. That is you and me and every other constituent in this country. So even though the bill tries to hide these costs as indirect taxes, average Americans who purchase health plans, use prescription drugs, and buy medical devices--everything from hearing aids to crutches--will end up footing the bill. By the way, we all know when this bill is fully implemented it will cost significantly more. Every time Washington tells you something will cost $1, you can count on it costing $10. History is prologue. Medicare started off with a $65 million--that is with an ``m''--a year budget and now it has a $400 billion budget. So look for these taxes only to go up in the future, as we have just given the Federal Government a whole new checkbook, if we pass this bill. Let me also talk a little bit about the myth of this health care reform proposal actually reducing the deficit. Here is the harsh reality: The Congressional Budget Office recently reported that our national deficit for fiscal year 2009 alone was a shocking $1.4 trillion. Let me put this in perspective. We have exploding deficits. In 2008, it was $459 billion--the last year of the Bush administration. In the first year of the Obama administration, it is $1.4 trillion. It is more than three times our deficit from last year and almost 10 percent of the entire economy. This is the largest yearly deficit since 1945. This should send shivers down the spine of every American out there. We are literally drowning this Nation and the future of this Nation in a sea of red ink. The biggest bait-and-switch on the American people about the bill's impact on the deficit is a simple math trick. If something is expensive to do for a full 10-year period, just do it for 5 years and call it 10 years. Most of the major spending provisions of the bill do not go into effect until 2014 or even later--coincidentally, after the 2012 Presidential elections. So what we are seeing is not a full 10-year score but, rather, a 5- to 6-year score. Now chart 3: This is the real cost of the Senate plan. The CBO score--because it only scores, really, basically 5 or 6 years because major provisions of the bill are not implemented until 2014, in some respects up to 2015--they claim, is only $849 billion, or less than $1 trillion. But the full 10-year score, according to the Senate Budget Committee, fully implemented, if you do it for 10 years, is $2.5 trillion. The House bill is even at a more astonishing level of $3 trillion. Let me go to chart 4, because in our current fiscal environment, where the government will have to borrow nearly 43 cents of every $1 it spends this year, let's think hard about what we are doing to our country and our future generations. For months, I have been pushing for a fiscally responsible and step- by-step proposal that recognizes our current need for spending restraints while starting us on a path to sustainable health care reform. There are several areas of consensus that can form the basis for a sustainable, fiscally responsible, and bipartisan reform. These include reforming the health insurance market for every American by making sure no American is denied coverage simply based on a preexisting condition; protecting the coverage for almost 85 percent of Americans who already have coverage they like by making it more affordable--this means reducing costs by rewarding quality and coordinated care, by giving families more information on the cost and choices of their coverage and treatment options, by discouraging frivolous lawsuits, and by promoting prevention and wellness measures. We should give States flexibility to design their own unique approaches to health care reform in accordance with their own demographics. Utah is not New York and New York is not Utah. Actually, what works in New York will most likely not work in New York, let alone Utah. As we move forward on health care reform, it is important to recognize that every State has its own unique mix of demographics and each State has developed its own institutions to address its challenges. And each has its own successes. There is an enormous reservoir of expertise, experience, and field- tested reform out there. We should take advantage of that by placing States at the center of health care reform efforts so they can use approaches that best reflect their needs and challenges. We should utilize the principle of federalism by having 50 State laboratories where we can look at the other States and see what works and what does not. Utah is a State where we have a tremendous health care system. It is rated one of the top three in this Nation. Wouldn't other States be benefited by looking at the Utah system, or Minnesota? The Minnesota system is a very good system, according to what they tell me. We could learn from them. You could learn from all 50 States what to do and what not to do. Utah has taken important and aggressive steps toward sustainable health care reform. The current efforts to introduce a defined contribution health benefits system and implement the Utah Health Exchange are laudable accomplishments. Just like you, I strongly believe a one-size-fits-all Washington solution is not the right approach. We should empower small businesses and self-employed entrepreneurs--the job-creating engines and lifeblood of our economy--to buy affordable coverage by giving them the same purchasing advantages as the large companies. Unfortunately, the path we are taking in Washington right now is simply spend another $2.5 trillion of taxpayer money to further expand the role of the Federal Government. Republicans want to sit down and write a bill together to achieve sustainable reform that we can all afford. We do not believe in the ``our way or the highway'' approach on an issue that will affect every American life and every American business. Republicans have put forth ideas, both comprehensive and incremental, through this health care reform debate, especially during committee considerations. These ideas were either summarily rejected on party line votes or simply stripped out in the dark of the night before the final version was released. And this version is no exception. This version was done in the back rooms of the Capitol with the White House and very few Senators cobbling together what they thought would be a compromise between the HELP bill and the Finance Committee bill, and maybe even with some consideration to the House bill. There was no real bipartisan work on this bill. There was no real attempt to try and bring people together. It was strictly a partisan bill, as have been the HELP Committee bill, primarily the Finance Committee bill, and above all, the House bill. I am especially disappointed that the President and the Democratic leadership in the House and the Senate have chosen to pursue the creation of a new government-run plan--one of the most divisive issues in health care reform--rather than focusing on broad areas of compromise that can lead us toward bipartisan health care reform legislation. At a time when major government programs such as Medicare and Medicaid are already on a path to fiscal insolvency, creating a brandnew government program will only worsen our long term financial outlook. To put this in perspective, as of this year, Medicare has a liability of almost $38 trillion, which, in turn, translates into a financial burden of more than $300,000 per American family over time. So what is the Washington solution to address this crisis? We will take up to $500 billion out of this bankrupt program and use it to expand another bankrupt program--Medicaid--and create a brandnew Washington-run plan, a Washington government-run plan. I am not an economist, but I know that taking money out of one bankrupt program to create another is not a good idea. We should be reforming Medicare and Medicaid for our people, but instead we keep spending, and to take $500 billion out of Medicare which has a $38 trillion unfunded liability to create another government run program I think is immoral. It is certainly not very economically sound. I could keep going, but the point here is simple: Washington is not the answer. The impact of a new government program on families who currently have private insurance of their choice is also alarming. A recent study estimated that cost shifting from government payers already costs families with private insurance nearly $1,800 more per year. This is nothing more than another hidden government tax. Do you all get that? Because Medicare pays doctors 20 percent less and pays hospitals 30 percent less, and other providers even less, those who have private health insurance have to pick up the cost, and it averages $1,800 per family. Think about that. That is because government has been running those programs. Creating another government plan will further increase these costs on our families in Utah and across this country. Let me take a couple of minutes to talk about process. The Democratic leadership spent almost--well, they took 6 weeks behind closed doors to write this bill. It is only fair to expect that we will at least have 72 hours to review these--I said 2,024 but it is 2,074--pages. This thing right here. This is the bill. My gosh, 2,074 pages. Tolstoy's ``War and Peace'' was about a little more than 1400 pages. This is a bill--we ought to have at least 72 hours to review these 2,074 pages before beginning any Senate floor action. We are going to vote on Saturday at 8 o'clock on whether we should proceed, but it won't be proceeding to this bill, it is going to be proceeding to a shell bill. If they are able to proceed, then they will bring up a substitute bill which will be the bill they have worked on for 6 weeks in closed rooms. It will be a shell bill that will get it going. It is a shell game, between you and me, one that is done right here in Washington by people who believe the Federal Government is the last answer to everything. As a bill that affects every American life and every American business, 2,074 pages is too big and it is too important not to have full public review. In fact, I think 72 hours is not enough. We need a lot more time. We are talking about one-sixth of the American economy. To enact true health care reform, we have to come together as one to write a responsible bill for the American families who are faced with rising unemployment and out-of-control health care costs. Our national debt is ready to double in the next 5 years. Look at that. The red lines are the projected national debt under the current administration. That debt is projected to double in the next 5 years and triple in the next 10 years. Let me tell you who catches onto this. It is our friends over in China to whom we owe $800 billion. Think about it. They are concerned about the devaluation of the American dollar because they see us being profligate here in Washington. Let's slow down and think about what we are doing to our future generations. I think there is still time to press the reset button and write a bill together that every one of us can support and be proud of. Right now, Republicans aren't just standing in the way. We actually believe we can do a bipartisan bill if we had a chance, if we had a real, good faith effort by both sides. The HELP Committee bill wasn't done that way. We did have a markup in the HELP Committee and almost every substantive amendment was voted down on a party line vote. The same thing basically happened in the Finance Committee, although I have to say that the distinguished Senator from Montana, the chairman of the Finance Committee, made every effort to try and bring people together. I give him a lot of credit for it. But he was so severely restricted by his side that there was no way people could support it. I was a member of the Gang of 7, but I began to realize what the final bill was going to be. I couldn't support it, so I thought the honorable thing to do, instead of coming out of every one of our meetings and finding fault with what they were talking about, was to leave the Gang of 7, and I did that. I felt bad doing it because I wanted to help work on a bipartisan bill. But the distinguished chairman was so restricted by his side that there was no way we could have a bipartisan bill out of that committee. It is disappointing to me, as somebody who has worked on so many health care matters over the years--everything from Hatch- Waxman to the orphan drug bill to the CHIP bill--you can name it--that we didn't have the guts or the ability to sit down and work this thing out together. Now we are going to get sold a bill of goods here that doesn't make sense. This is a travesty. It is a travesty. It is hard to believe they think they can pawn this off on the American people. My gosh. I know some of the folks who have done this are well intentioned, but not for this stuff. I was going to say something else, but I want to be very kind here. The Constitution--this is the whole Constitution, the most important document, political document in the history of the world. Plus it has a lot of interesting material in the back, plus an index and so forth, but that is it, right there. Here is what one-sixth of the American economy is going to be if we allow it to go forward. I personally believe we ought to kill this bill and then we ought to sit down and work it out together. If there were a real bona fide attempt to do that, I have no doubt we could do it. We have done it in the past. One of the things I found most disappointing is that the polls show that 85 percent of the people who have insurance are relatively happy with it. Yes, they would like premiums to go down, they would like to be able to have it be even better, but they are basically happy with their health care coverage. If you deduct the 6 million people who work for businesses that provide health insurance but they don't take it-- they would rather have the money--and you deduct the 11 million people who qualify for CHIP, the child health care program, which is a Hatch- Kennedy bill, by the way; or they qualified for Medicaid--if you deduct those 11 million people, and then you deduct the 9 million people who earn over $75,000 a year and can afford their own health insurance, and then you take away the illegal aliens, it comes down to 7 million to 12 million people who need health insurance. Think about that. We are going to throw out the whole system of health care that 85 percent of the people basically believe is worthwhile over, 7 to 12 million people whom we could help in a way that would be reasonable; and we are going to change our health care system from State-run systems and bring it right here to Washington where a bunch of Federal bureaucrats who are far removed from people in the States will determine every aspect of health care in our lives, and run our health care system into the ground even further, as they have Medicare and Medicaid, without the appropriate reforms that would keep those programs that could be great programs and are great programs in some ways, going. They will say, well, aren't those government programs? Yes, they are government programs, and they are both deeply in debt. Medicare goes into insolvency by 2017. Medicaid is also going bankrupt. What are we going to do, saddle our young people for the rest of their lives with untold expenses? We are going to saddle them with this huge stack of paper? My gosh. No wonder we are in such deep financial difficulties in this country. If we are going to rely on the Federal Government to solve our problems, we are making the most tragic mistake we possibly can. The Federal Government could participate, but let me tell you, if we work on a bipartisan bill--let me make one last point. If you have a bill that affects one-sixth of the American economy--and whatever passes here, if it does, will be a bill that will be concerned with one-sixth of our American economy--if you have a bill that is that important and you can't get 75 or 80 votes in the Senate, you know that is a lousy bill, and you know it is a partisan bill, and you know it hasn't been well thought out, and you know it is one sided, and you know it is going to cause an uproar throughout this country that has never been seen before--it already is--and you know it won't work, yet we are going to saddle this country with this monstrosity. I have to tell you, I can hardly believe it. I can hardly lift it. I am not exactly weak. All I can say is that it is a huge monstrosity. Think of the Constitution. There is the whole Constitution right there, yet we have a health care bill this big. I am concerned about it, as you can see, and I am worked up about it, because there are some of us who would like to work together and do a bipartisan bill, but we have to be honest about it, there hasn't been any chance to do it. This bill in particular has been worked on in the back rooms between the White House and very few Senators, and without any input from our side at all, frankly, ignoring many of the good things that have been expressed on our side. I hope we will think this through and I hope we won't pass this. I hope we can then sit down and do a bill that will work, that will not burden our future generations. I yield the floor.

Mr. HATCH

Mr. HATCH. Mr. President, I am privileged to stand here to say a few words about my friend, Robert C. Byrd. When I got here in 1976--I almost said 1776. But when I got here in 1976--some people think I have been here since 1776--Robert C. Byrd was the majority leader in the Senate. Actually, it was 1977 when I actually took my seat here. I have to say, he was one of the finest majority leaders I have seen in all of my 33 years in the Senate. There was literally nobody who knew the rules as well as Robert C. Byrd. Senator Byrd was an expert on the rules, and he taught me a great deal. In my first years in the Senate, we were on opposite sides in the labor and law reform debate, but it was a time of great learning for me as a young Senator, and he was very patient. He was very kind, very decent to two young Senators, Senator Lugar and myself, who both came at exactly the same time. I will never forget that. In the intervening years, I have seen this man play his fiddle and do it with such joy. I have seen him love his wife the way a man ought to love his wife. I have seen him be kind to his dog. I have seen him be kind to numerous people. I have seen him go out of his way for all of us, from time to time. Yet there was no more formidable Senator on the floor of this Senate than Senator Byrd. As he has continuously, through the years, educated us on ancient history, modern history, the Constitution, anybody who has listened to those discussions and remarks on the floor has to acknowledge this is one very bright and intelligent man. To think he got his law degree, if I am not mistaken, while he was serving as a U.S. Senator--and I know he hardly ever missed a vote. That he went on to law school and got a law degree while he was, at the same time, a sitting U.S. Senator is pretty remarkable to me. I don't know anybody else in this body who could have done that. It is an amazing thing. He has gone out of his way in those years for those of us who were younger and didn't know an awful lot about the procedural rules, who didn't know a lot about the Senate. He has been a stickler for the rules and made sure the Senate has always respected them as now we, the Senators, respect him--not only for his knowledge of the rules but for the way he has conducted himself all these years. I don't know of any other Senator who has done as much for his State as Senator Byrd--unless it was Senator Stevens from Alaska. In the many years they were both on the Senate Appropriations Committee, they were towers of strength. I have been amazed at the strength, the endurance, the intelligence, and the absolute kindness and decency Senator Byrd has shown as he has evolved as a Senator from those early days when not many people knew him, to today when all of us are honoring him. What an achievement, to be the longest-serving Member in the history of the Congress. This is a very important day to Senator Byrd and to all of us. I can truthfully say that I love and respect him. We have had our share of differences over the years, but they have always been cordial. I look forward to serving here in the Senate with Senator Byrd for many more years. I yield the floor.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to pay tribute to Rex E. Lee, a man whose legacy we recognize today by renaming the post office in Provo, UT in his honor. Supreme Court Justice Sandra Day O'Conner captured my own feelings about Rex when she said: Knowing him [Rex] was one of the greatest privileges of my life. Remembering him will be one of the easiest. Graduating first in his class from the University of Chicago Law School in 1963, Rex went on to serve as a law clerk for Byron White on the U.S. Supreme Court. Then, just 4 years out of law school, Rex argued his first case before the Supreme Court in 1967, and went on in 1972 to become the Founding Dean of the J. Reuben Clark Law School at Brigham Young University. In addition to serving as an Assistant Attorney General in charge of the Civil Division at the Department of Justice in the middle of the 1970s, Rex served as the Solicitor General of the United States from 1981 to 1985. In fact, over the span of his life, Rex argued 59 cases before the Supreme Court of the United States and his record as the Solicitor General is impressive. Never one to rest, Rex was then named as the 10th president of Brigham Young University in 1989, where he served thousands of students, faculty, and administrators faithfully for over 6 years. As a man, Rex is someone I respected; as a dedicated husband, father, and friend, Rex is someone who is deeply missed. Anyone who had the privilege of knowing Rex, as I did, well remembers his stellar service to his community, our State, and to the Nation as a whole. Long after his passing, his influence still lingers and is keenly felt everywhere from the classrooms at BYU to the corridors of our government's most revered institutions. Renaming the Provo Post Office in Rex's honor befits a public servant of his stature, and I am pleased to support this legislation in the Senate to honor Rex's legacy. In short, Rex Lee was a great man and I am proud to see the Provo Post Office named after him. There are thousands of Utahns throughout the State who join me in celebrating this man's great life with this fitting tribute.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to submit a resolution regarding the 10th Anniversary of the Reading Education Assistance Dogs, R.E.A.D., program by designating November 14, 2009, as ``National Reading Assistance Dogs Day.'' This is a nationwide program promoted by a number of organizations throughout the U.S. and even throughout countries around the world as an innovative, successful approach aimed at assisting some of our nation's most vulnerable citizens, our children, learn how to read. The R.E.A.D. program was the first literacy program in the country to use therapy animals as reading companions for children. This unique method provides children an opportunity to improve their reading skills in a comfortable environment by reading aloud to dogs. After 10 years of results, the program has proven to be incredibly successful in helping children who are struggling with this most-crucial and basic of skills. Simply put, this is a program that fills a vital place in the spectrum of a child's literary education and with over 2,400 voluntary therapy teams around the world, it would be an understatement to say this program has not touched and improved thousands of young lives. Over the span of the previous 10 years, this is an achievement that is virtually impossible to measure, yet today, as small token of my own personal appreciation, I submit a resolution that would designate Saturday, November 14, 2009, as National Reading Education Assistance Dogs Day. Once agreed to, this resolution will recognize the thousands of lives that have been touched as a direct result of this initiative. I am grateful to be the sponsor of a resolution recognizing such an accomplishment and am joined by Senators Bingaman, McCaskill, Cochran, and Risch in this effort. I commend Intermountain Therapy Animals, a nonprofit organization based in Utah, for first launching this program just ten short years ago. Therefore, in addition to the numerous news stories, television programs, and awards highlighting the value and benefit of this program, I urge my Senate colleagues and every American to join me in recognizing 10 successful years of the R.E.A.D. program with hopes of many more years of success to come.

Mr. HATCH

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

Mr. HATCH. Mr. President, this afternoon I wish to share my insights about health care reform efforts in the U.S. Congress and how beneficiaries who currently participate in the Medicare Advantage Program, Medicare Part C, would be impacted. When I think of health care reform, I envision legislation that reduces health costs and improves affordable access to coverage. Unfortunately, the bills reported by the Senate HELP and Finance Committees do not achieve either of those goals. As a Senator from Utah, I have cast many tough votes throughout my service. Regarding health care reform, I have pushed for a strong bipartisan vote. Unfortunately, it is obvious that Senate and House floor debates on this issue will be another largely partisan exercise. This summer I participated in more than a month of debate and partisan votes in the HELP Committee and 2 weeks of the same in the Finance Committee. Unfortunately, however, it appears those many hours of debate were all for naught. It is important to note that the bills the members of the Senate HELP and Finance Committees spent hours considering will not be the legislation debated on the Senate floor. In fact, we have yet to see a bill that will be considered on the Senate floor. I certainly hope Members of the Senate will have the opportunity--at least 72 hours--to review not only the entire bill but also the final Congressional Budget Office cost estimate before considering any such bill on the floor. This bill affects every American and every American business. Therefore, I believe there should be a comprehensive public review before it is even considered. Let me take a few minutes to talk about the specifics of how Medicare will be impacted by the health care reform proposals before Congress. The President has consistently pledged not to ``mess'' with Medicare. Again, this is another pledge that is not honored through the Senate health reform bills I have reviewed. The Senate Finance Committee bill reduces Medicare by over $400 billion--according to CBO, $117 billion comes out of the Medicare Advantage Program. I offered an amendment during the Finance Committee markup to protect extra benefits currently enjoyed by Medicare Advantage beneficiaries. Unfortunately, that amendment was defeated. Bottom line, the President's pledge assuring Americans they would not lose benefits was not met by the Finance Committee bill. Here is how supporters of the Finance bill justified it: The extra benefits that would be cut--such as vision care, dental care, reduced hospital deductibles, lower copayments, and premiums--were not statutory benefits offered in the Medicare fee-for-service program; therefore, those extra benefits do not count. I believe there is no logic to that position. Let me quote what our President said last Thursday about this important promise: The first thing I want to make clear is that if you are happy with the insurance plan that you have right now, if the costs you're paying and the benefits you're getting are what you want them to be, then you can keep offering that same plan. Nobody will make you change it. Quite frankly, when a promise such as that is made assuring Americans they will not lose their benefits, that promise should be extended to Medicare Advantage beneficiaries. Congress is either going to protect existing benefits or not. It is that simple. However, under the bill reported by the Senate Finance Committee, if you are a beneficiary participating in Medicare Advantage, that promise simply does not apply to you. I am a staunch supporter of the Medicare Advantage Program. I served on the Medicare Modernization Act House-Senate conference committee in 2003, which created the program. Medicare Advantage works. Medicare+Choice and its predecessors did not. I know it works. I represent a State where Medicare managed care plans could not exist due to low reimbursement rates. To address that concern, Congress included language, which was signed into law, establishing a payment floor for rural areas. But it was not enough. In fact, in Utah, all the Medicare+Choice plans eventually left because they were operating in the red. This happened after promises were made that Medicare+Choice plans would be reimbursed fairly and that all Medicare beneficiaries would have access to these plans. So during the Medicare Modernization Act conference, we fixed the problem. First, we renamed the program to Medicare Advantage. Second, we increased reimbursement rates so all Medicare beneficiaries, regardless of where they lived--be it in Fillmore, UT, or New York City--had choice in coverage. We did not want beneficiaries stuck with a one-size-fits-all government plan. Today, Medicare Advantage works. Every Medicare beneficiary has access to a Medicare Advantage plan. Close to 90 percent of Medicare beneficiaries participating in the program are satisfied with their health coverage. But that would all change should the health care reform legislation currently being considered becomes law. Choice in coverage has made a difference in the lives of over 10 million individuals nationwide. The extra benefits I mentioned earlier are being portrayed as gym memberships as opposed to lower premiums, copayments, and deductibles. To be clear, the SilverSneakers Program is one that has made a difference in the lives of many seniors because it encourages them to get out of their homes and remain active. It has been helpful to those with serious weight issues and has been invaluable to women suffering from osteoporosis and joint problems. Additionally, these beneficiaries receive other services, such as coordinated chronic care management, dental coverage, vision care, and hearing aids. Medicare Advantage is better for seniors than traditional Medicare because beneficiaries have a choice in coverage instead of a one-size-fits-all health plan. Another important point is, the House bill will affect Medicare Advantage enrollees differently than the bill reported by the Senate Finance Committee. The Senate bill includes competitive bidding in the Medicare Advantage Program. My analysis of competitive bidding is that some States will be hit harder than others, especially if there is not a competitive market. I worry about what happens if only one plan submits a bid. While CBO believes Medicare beneficiaries will continue to enroll in the Medicare Advantage Program should competitive bidding be implemented, fewer beneficiaries will enroll in the future. In the House health reform bill, Medicare Advantage plans will be paid at 100 percent of the Medicare fee-for-service rate, which is fine for Miami beneficiaries but will kill Medicare Advantage plans in rural parts of the country. Those beneficiaries living in States such as Utah, Montana, South Dakota, and North Dakota could be in serious jeopardy because it is possible Medicare Advantage plans serving that part of the country could pull out due to low reimbursement rates. CMS actuaries have estimated that more than 6 million Medicare Advantage enrollees would be forced out of the program under the House bill, leaving only 4.7 million in Medicare Advantage by 2014. This does not fulfill the President's goal that you can keep what you have. I believe it is unwise for Congress to take such a risk because, in the end, the Medicare beneficiaries will suffer the consequences. I also wish to touch on the recent CMS guidance on how Medicare Advantage plans may communicate with their beneficiaries. It is gratifying to know HHS will now allow plans to communicate with beneficiaries once prior authorization is received from the plan enrollee. To be frank, I was outraged by the actions taken by CMS in September. To me, there is a fine line between freedom of speech and government interference. I feel CMS may have crossed the line when it sent Medicare Advantage companies correspondence on this issue. While the new guidance is an improvement, I am still concerned about the beneficiary opt-in requirement. Another issue that needs to be discussed is the removal of the open enrollment period for Medicare Advantage beneficiaries. Prior to 2006, beneficiaries could enroll and disenroll from Medicare Advantage plans at any time. This open marketplace allowed beneficiaries to find the plan best suited for them. The Medicare Modernization Act included a transition to enrollment periods for Medicare Advantage plans to help beneficiaries become comfortable with the program and to ensure that the selected plan was the right plan for them. Today, there are two enrollment periods for most beneficiaries. First, the annual election period takes place between November 15 and December 31 each year. Changes take effect on January 1 of the following year. During this time, beneficiaries may change prescription drug plans, change Medicare Advantage plans, return to traditional Medicare or enroll in a Medicare Advantage plan for the first time. Second, there is an open enrollment period from January 1 to March 31 each year. One Medicare Advantage-related selection may be made during this timeframe, such as enrolling in a new plan, changing plans or disenrolling from a plan. Coverage is then locked in until the following December 31 for most beneficiaries. The House health reform bill essentially eliminates the Open Enrollment Period for Medicare beneficiaries starting in 2011. In addition, the House bill proposes moving the annual election period up 2 weeks, from November 1 to December 15, thus creating a 2-week processing period for enrollment--right around the holidays--before the January 1 effective date. The Senate bill also moves up the annual election period. It would take place from October 15 through December 7. The Senate bill does not eliminate the open enrollment period. However, it is important to note that while beneficiaries may disenroll from Medicare Advantage plans during the open enrollment period, they are not allowed to reenroll in another Medicare Advantage plan. Therefore, the only choice available to these beneficiaries under the Senate bill appears to be traditional Medicare. I feel like little has been said about the dramatic impact these changes will have on Medicare beneficiaries. The primary focus has been the reductions to the program. When we wrote the Medicare Advantage provisions in 2003, we viewed the open enrollment period as an important consumer protection for those who need flexibility when choosing health coverage. I am worried about the impact these little known changes will have on Medicare beneficiaries. I fear it could lead to a lot of confusion among seniors, especially when they are choosing their health care plans. Another issue that troubles me is the fee on health insurance plans included in the Senate Finance Committee bill. The Joint Committee on Taxation, JCT, estimates that this provision will save $60 billion over the next 10 years--$60 billion that comes from the health insurance industry. It is no secret that these fees will be passed on to consumers, including Medicare Advantage enrollees through premium increases and the reduction of health care choices. Most seniors are on a fixed income and are least capable of absorbing the added cost of this burden. I strongly oppose this fee and will continue to fight against it when the Senate debates health care reform. Finally, let me speak for a moment about the Nelson grandfathering amendment that was included in the Senate Finance Committee bill. While many Florida Medicare Advantage beneficiaries will not lose their benefits due to this amendment, that provision does little to help Medicare Advantage beneficiaries living in rural parts of our country. In fact, the grandfathering amendment approved during the Finance Committee markup only helps Utah beneficiaries living in two--just two--counties. What happens to Medicare Advantage beneficiaries who live in rural areas? I must conclude they will not be as lucky as the Floridian seniors. In my opinion, it does not make sense to only grandfather the Medicare Advantage plans of certain seniors living in certain States. Before I conclude, I would like to take a few minutes to discuss issues associated with abortion coverage and conscience clause protections for medical providers. I am concerned about the bills before both the House and the Senate. I believe it is a real possibility Federal dollars will be used to finance elective abortions through both the Federal subsidies to purchase health coverage and the new public plan created through the legislation; that is, Federal taxpayers' dollars. During both the HELP Committee and Finance Committee markups, we were told over and over again the health reform bill would not cover elective abortions. We were assured Federal dollars would not finance abortions and that the Hyde-like language would apply. More specifically, the Finance health bill attempts to segregate Federal dollars given to individuals to purchase health plans through the State exchanges. The reason these Federal funds would be segregated, we were told, is so Federal taxpayers' dollars would supposedly not pay for abortion coverage. Let me be clear. The provision included in both the Finance and HELP bills is not the way the Hyde language works today. For example, the Medicaid Program does not segregate dollars it receives either from the State or the Federal Government. Any Federal or State money received by the Medicaid Program simply does not pay for elective abortions. There is no separation of funds. Should a person want abortion coverage, that coverage is paid for separately, either by private dollars or State- only money outside the Medicaid Program. I think the way this needs to be resolved is simple: Hyde language, which, I wish to remind my colleagues, has been included in every appropriations bill that funds the Department of Health and Human Services since 1976, needs to be included in the legislation. The Hyde provision is a specific prohibition on the use of any public funds for elective abortions and is enforced through strict accountability. In addition, I am very worried about the government plan option that is included in both the House and the Senate health reform bills. The government option is, of course, a Federal program, and therefore all of the money it spends is Federal funds. If the public or government option pays for abortions, then that is, without a doubt, Federal funding using taxpayer dollars for abortion. Again, today Federal dollars may not be used to fund elective abortions. I believe the language in the House and the Senate bills as currently written would include the coverage of elective abortions through this government public plan. This must be addressed immediately. It is not fair to force people who are totally opposed to elective abortions, either for religious reasons, moral reasons, or whatever, to have their taxpayer dollars used to pay for these types of abortions. I also do not understand why it is necessary to require all State exchanges to offer at least one plan with abortion coverage. I view that as a mandate to cover elective abortions, and I wish to point out that today there is not one Federal health plan that has such a requirement. In addition, I strongly support including protections in this legislation to ensure health care providers are not required to perform abortions if they are opposed to abortions. It is unfair that these providers who strongly oppose abortion should be forced to perform this type of procedure. Why would we force Catholic hospitals, Catholic doctors and nurses, and other people of similar religious beliefs on abortion to participate in something they believe is inherently evil and sinful and wrong? It does not make sense. We have always protected the right of conscience. These bills do not. It is also extremely important that State laws regulating abortion, such as those requiring parental consent or involvement or prohibiting late-term abortions, for example, are protected and not preempted through this legislation. To me, it is unclear whether the current health care bills before Congress offer these protections. Before I conclude, I wish to read a letter from the esteemed former Surgeon General, C. Everett Koop, dated November 2, 2009. Mr. President, Dr. C. Everett Koop is one of the alltime great Surgeons General of the United States. Liberals and conservatives, moderates and Independents, Democrats and Republicans would acknowledge that. Here is what he says: Dear Majority Leader Reid and Madam Speaker: As the former Surgeon General of the United States, two terms, from 1981 to 1989, I am writing to express my deep personal concerns about the direction of the health care reform bills currently being considered by the United States Congress. More specifically, I am troubled about the possibility of Federal dollars being used to pay for elective abortions and Americans being forced to subsidize them. In addition, I firmly believe that strong protections must be included in this legislation so that health care providers are not forced to participate in abortions against their will. Polls have recently shown an increasing number of participants opposed to abortion. It is essential that a Hyde-like abortion funding restriction provision (like the amendment included in the annual appropriations bill for the Department of Health and Human Services since 1976) be included in any health care bill that is signed into law. He goes on to say: I believe that including this legislative language is necessary to ensure that elective abortions are not financed either directly through a public plan or indirectly through Federal subsidies provided to purchase health insurance through State exchanges. I also find it troubling that the legislation requires all State exchanges to offer at least one health plan that includes abortion coverage--no other Federal health plan has that specific requirement today. As a physician, I also want to ensure that laws and regulations remain intact, allowing health care providers to exercise their consciences and not be forced to provide services to which they have religious or moral objections. Congress has a long history of protecting the conscience of health care providers, first passing the Church Amendment in 1973. Finally, I believe that it must be made clear through this legislation that State laws are protected and not preempted through this legislation, especially those that prohibit abortion coverage. Since 2004, additional conscience protections were included in the annual appropriations legislation for the Department of Health and Human Services to include health care entities such as hospitals, provider- sponsored organizations, health maintenance organizations (HMOs), health insurance plans, or any other kind of health care facility, organization or plan. Today, virtually all States have conscience law protections for medical providers. From my first days as Surgeon General until today, I have always been honest and straightforward with the American people. Therefore, before this legislation becomes law, I believe that the important issues outlined above must be addressed so that it is consistent with current laws regarding abortion coverage conscience protection. I would appreciate your serious consideration of these matters before this legislation is debated and approved by the Senate and the House of Representatives. Sincerely yours, C. Everett Koop, M.D., ScD, U.S. Surgeon General (1981-1989) I believe Dr. Koop's letter says it all. Again, both the Medicare Advantage Program and pro-life related issues are matters that I believe must be carefully addressed in this health care legislation. Medicare Advantage beneficiaries should be able to continue to be covered by the plan of their choice without losing benefits, and the legislation needs to have specific and clear provisions stating that no taxpayer dollars should be used to finance elective abortions. In addition, individual State pro-life laws must be protected. Mandates that require abortion coverage should not be included in this bill. Finally, health care providers should not be forced to perform abortions against their will. I appreciate the opportunity to share my thoughts with my colleagues on these two very important issues. I yield the floor and suggest the absence of a quorum.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to speak regarding an effort that I have supported for a number of years and something I am very proud to have championed in the Senate for over 4 years. I speak, of Feed America Day. More than just the recognition of a single day, the Feed America campaign is a nationwide effort promoted by a number of charitable organizations and supported by numerous communities throughout the country. It is aimed at encouraging our Nation's spirit of selflessness and sacrifice in order to help those in need. Those who participate in Feed America Day encourage all Americans to sacrifice two meals on the Thursday before Thanksgiving Day and to donate the money they would have used for food to a charity or religious organization in their community for the purpose of feeding the Hungry. In a simple and practical way, this is an effort to harness the generosity of the American people in the spirit of the Thanksgiving season. We live in the most prosperous nation on the planet. Even in the face of our current difficulties, that remains true. Yet, according to the Department of Agriculture's most recent numbers, roughly 35 million Americans, including 12 million children, live in households that do not have an adequate supply of food. I think we can all agree that it is a good idea to encourage the American people to do more for the hungry in their communities, even if we don't always agree as to what Congress should do on such matters. Today, I have submitted a resolution that would designate Thursday, November 19, 2009, as Feed America Day. Once passed, this will be the fifth consecutive year that this day has been recognized by the Senate. I want to personally thank Senator Tom Udall from New Mexico for all his efforts in supporting and promoting this resolution and we are joined by Senators Bennett, Crapo, Lugar, and Reed. I urge my Senate colleagues and every American to join me in helping to assist those in need and affirming the long-standing values that have made our Nation great.

Mr. HATCH

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

Mr. HATCH. Mr. President, this health care debate is one of the most important debates we have ever had in this country. We are talking about one-sixth of the American economy. We better get it right because if we do not, this economy will never be able to recover. If we go down the wrong path and we spend too much time building the government at the expense of the individuals in this country, we will never be able to change it. So this is a very important time, and I am calling upon all my colleagues in both the Senate and the House to try to work together so we can come up with a program, a system that literally will work. We can build upon things we already agree upon. Things such as preexisting conditions should be covered, automatically covered. That is a very difficult issue; it is not something you can just say glibly. The fact is, we have to resolve this problem so people will not just wait until they get sick to buy insurance because they have a right to do so under any new policy we are coming up with. But they should be able to get into the insurance market now. Having said that, there are many on the other side who would like to have what they call a public plan or what I call a government plan. The problem with the government plan is that the central force would be right here in Washington, filled with bureaucracy, filled with expenses, filled with all of the clogs that occur in Washington, DC. And we will not be solving the individual problems of the various States, each of which has its own demographics. I have often pointed out that Utah's demographics are not the same as New York's or California's or those of Massachusetts. But neither are New York's the same as those of Massachusetts or California. Each State has its own demographic problems. Utah is considered one of the top three States in the delivery of health care. There is a good reason for that; that is, we thought it through and we basically bring health care closer to the people. We already have an exchange in Utah which is working to a large degree. It is just starting, but the fact is, it has been embraced and accepted by people. We would bitterly resent a one-size-fits-all Federal Government program to resolve all problems. This business of making sure preexisting conditions are covered is fraught with all kinds of difficulties if we do not do this right. There are all kinds of expenses if we fail to observe the past and, I might add, all kinds of bureaucratic problems if we do not work together to get this problem solved. On the other hand, are we going to go to a system where government tells people they have to buy insurance, whether it be a public plan or otherwise? I am not sure constitutionally that the government has that kind of power. If the government has that kind of power, to tell people they have to have insurance even if they don't want it--and that includes the public plan insurance--then what limitations are there on government? What happens to all the freedoms we all take for granted? What happens to the liberties we have embedded in the Constitution? These are important issues. They are not issues you just brush aside because one side or the other wants to have the Federal Government take over all control of our health care system. I might add, I think most of us agree there should be transparency in the system. If we had transparency over all of the hospitals, all of the physicians, and we could tell which ones are great, which ones aren't, we could make our own decisions as to where to go for particular types of care, especially very serious care. I think most of us would like to provide a system where our constituents could do that. What about medical liability reform? As a former medical liability defense lawyer, I defended doctors, hospitals, nurses, and health care providers who needed defending, many of whom did not commit negligence but were finding themselves suddenly in court in front of juries that may be empathetic to somebody who did not have a good result even though there was no negligence involved. I estimated 25 years ago that, in unnecessary defensive medicine, we are probably wasting upwards of $300 billion a year. That sounds very high. But I am finding more and more people are starting to come to the conclusion that we waste an awful lot of money on what is unnecessary defensive medicine. We all want defensive medicine because we all want the doctors to do what they should do. Our advice to the doctors back in those days happened to be, if somebody comes to you with a common disease or injury, you cannot afford to just give them--tell them to just do the minimum. You better have every test and every procedure you possibly can in your history, so if you ever do get sued, you will be able to say you went way beyond the standard of practice in the community and did everything you possibly could to try to help this person with their problems and that you should not have liability because of that. Well, I have to say we can go on and on. It was interesting to me, when I first asked Dr. Elmendorf, who heads our CBO, the Congressional Budget Office, what does unnecessary defensive medicine cost us, Dr. Elmendorf came up with an extremely low figure over 10 years. I think it was something like $10 billion. I chatted with him and I said: That cannot be so. I explained to him what my experience was and the experience of almost anybody who has any experience in this field, and he went back. He said: Well, I am going to go back and review it. He did go back and review it and came up with a figure of $54 billion over 10 years, just for Federal Government unnecessary defensive medicine. So it is much more than that if you add in everything else and extrapolate it all out. We should be able to save some of these dollars. That also would help us to be able to pay for real health care that needs to be done. We know the health care reform bill has been basically written in the office of the majority leader. While we do not know what this bill will look like, because it apparently has been written in the secrecy of the majority leader's office, and by very few people, by the way--and the same over in the House--every indication is, it will be similar to the bill reported out by the Finance Committee earlier this month. That bill, which would drastically change the very fabric of an industry that affects every American in the most personal way and represents one-sixth of our economy, contains roughly $409 billion in new taxes that are going to be passed on to the average taxpayer. Many Utahns are asking me who is going to have to pay these new taxes? Unfortunately, I have to tell them that it will not just be the wealthiest among us, but middle and even lower income American families as well. Perhaps the most solid promise that President Obama made during his campaign was that ``no [one] making less than $250,000 a year will see any form of tax increase!'' He further pledged that the 98 percent of Americans earning less than this amount would not see any tax increase on income and savings. Let me repeat that: The President promised that 98 percent of Americans earning less than $250,000 would not see any tax increase on income and savings. The majority leader is preparing a partisan proposal to which he hopes to attract at least a modicum of Republican support. Thus far, however, he has no takers from my side of the aisle, and support from some on his side appears to be waning. Perhaps a major reason for this is that everyone knows the bill would break the President's promises not to raise taxes on average Americans. That is not the only thing it would do. The Finance Committee product offers a cornucopia of revenue raisers that would fund health care reform. Some of these provisions include direct taxes on lower and middle income wage earners, while others would hit average families indirectly through penalties, fees, and higher costs. If your employer offers you a higher cost insurance plan, your taxes will likely rise under this plan. If you have a flexible spending account or a health savings account, your taxes will likely rise. If you or your family use a medical device costing more than $100, such as a hearing aid or an insulator, or if you purchase prescription drugs, the cost of those items will likely rise. And ironically, in a bill that is designed to lower the costs of health care, the cost of health insurance itself is likely to rise under this plan. And if you do not have insurance, the cost of not having health insurance will rise because the bill will impose a tax if you do not get insurance. My friends on the other side of the aisle will probably paint this rise in penalties, fees, and higher costs as Republican hocus-pocus. But do not take it from me or my colleagues; take it from the nonpartisan Congressional Budget Office and the Joint Committee on Taxation. Looking first at the direct taxes on the middle class, the Democrats' bill declares war on savings accounts for health care. For example, the bill would limit the amount that employees can set aside of their own money into flexible spending accounts. In addition, over-the-counter medicine would no longer be qualified expenses for FSAs and health savings accounts, unless you have a doctor's note. Lastly, the proposal includes an increase from 10 percent to 20 percent for the penalty for withdrawals that are not used for qualified medical expenses. All together, this means that employees could be facing a 55-percent Federal tax on a bottle of aspirin. I thought we were trying to make health care more affordable, not more expensive. This year, 35 million employees participate in employer-sponsored, employee-funded flexible spending accounts. These accounts provide relief for the ever-increasing amount of health care that families must pay out of their own pockets. How does cutting back on FSA accounts lower the costs of health care? These accounts are not just provided to the wealthy. On the contrary, the average income for flexible spending account participants is just $55,000 per year. Another clear increase on taxes for middle income families is the raising of the threshold for the itemized medical expense deduction from 7.5 percent of adjusted gross income to 10 percent. This tax deduction is already means-tested so that it only kicks in when medical expenses are catastrophic or nearly so. This is not a tax benefit for the wealthy. The Joint Committee on Taxation estimates that in 2013, approximately 11.5 million taxpayers would be affected by this proposal. Of that number, about half have incomes less than $75,000. Perhaps even worse are the indirect tax increases in the bill. One of the most troubling ones to me is an unprecedented fee levied on entire segments of the health care industry, including pharmaceuticals, medical devices, and health insurance. While these fees would be paid by corporations, they will ultimately be passed on to consumers in the form of higher prices or on to employees in the form of lower pay, or even layoffs. Under this plan, the cost of everything from contact lenses to hearing aids to thermometers would rise for consumers, creating one more unfair burden on middle income families seeking affordable health care. And if you decide to either not have health insurance or if you need a more expensive plan than is allowed, the Democratic plan would raise taxes on you, even if you do not make anywhere near $250,000 per year. This is part of the so-called individual mandate, which requires individuals to obtain health care coverage or pay an extra tax. The amount of tax could reach as much as $750 per uninsured adult. Some may say this is simply a penalty for not doing what Uncle Sam wants you to do, but let us face it, it is nothing more than a new tax. There are at least two provisions in the Finance Committee bill that raise serious constitutional questions. First, is the transition relief for the high-cost insurance plans that is granted to 17 yet-to-be determined States. This means that a different tax rate will apply depending on where you live. Second, is the individual mandate itself. The constitutionality of the mandate, as pointed out by the Congressional Research Service, has never been addressed. We are treading into new waters. Are we just going to simply ignore these serious constitutional questions? Again, President Obama promised from the beginning that he would not raise taxes on the 98 percent of Americans who make less than $250,000. Unfortunately, the Democratic proposal we will soon be debating would break that promise. We are all for real health care reform, everybody, Republicans, Democrats and Independents, but not all of us are willing to pass it on the backs of middle-income taxpayers. At a time when we have trillion-dollar-plus deficits and an unemployment rate nearing double digits, this would be a colossal mistake. Mr. President, I yield the floor.

Mr. HATCH. I yield the floor.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to speak about the passing of Clifford P. Hansen, a former Republican colleague of mine in the U.S. Senate and a devoted public servant whose contributions to this august body and to his home State of Wyoming will not soon be forgotten. Clifford Hansen, who was the Nation's oldest living former Senator until his passing this week at age 97, loomed as large on the Wyoming political landscape as his beloved Grand Tetons do on the natural one. This onetime Governor of Wyoming and two-term U.S. Senator leaves an impressive legacy of legislative achievement. Clifford was born in Zenith, a town so small that it no longer appears on State road maps. But growing up in Jackson, Clifford demonstrated the abilities and qualities needed to be successful in a wide variety of pursuits and political endeavors. After earning a degree in agriculture from the University of Wyoming, he rose quickly through the ranks, serving as a trustee of his alma mater, a Teton County commissioner, and later, in the mid-1960s, as Governor of Wyoming. As Governor, Clifford Hansen brought an end to laws banning miscegenation, boosted the minimum wage, and secured higher retirement pay for State workers, among many other things. He also increased fair employment practices and secured more financial assistance for public schools and higher education. He then served two terms in the U.S. Senate and compiled an equally impressive list of accomplishments there. I had the privilege of meeting Clifford Hansen in 1977, when I came to Washington as a wide-eyed freshman Senator. I will never forget the warmth and kindness Senator Clifford showed me, helping me get acclimated to my new surroundings and responsibilities. He was a conservative's conservative--a public servant of rock-solid integrity and unwavering devotion who believed in the time-honored principles of fiscal responsibility and less government. He was just as devoted to his beloved wife of more than 75 years, Martha, and their two children, Mary and Peter. One of Senator Hansen's many gifts was his human touch. He always treated everyone the same, no matter what their station in life--with a warm smile, a hearty handshake, and unfeigned respect. No wonder he was so beloved by so many, everyone from Senate colleagues and staff to custodial and cafeteria workers. More than three decades after coming to Washington, I am still privileged to serve in the Senate. And even though Clifford Hansen retired from the Senate in 1978, the years have not dimmed my memories of him and the high esteem with which I hold him. I cherish his memory and honor his service. And my thoughts and prayers at this difficult time are with his beloved Martha and other family members and devoted friends. He will be missed.

Mr. HATCH

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

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to discuss my decision to vote no for the fiscal year 2010 National Defense Authorization Act. Throughout my career I have always been a staunch supporter of our men and women that serve our Nation. Their courage in the face of danger to preserve our freedom is inspiring. And my vote on the Defense authorization bill does not change that belief at all. In fact, I was pleased to include legislation in this years bill that will require the Secretary of Defense to review and establish a long-term plan to sustain the solid rocket motor industrial base. This review will be vital to ensure we maintain a robust industrial base and our ultimate strategic defense for decades. I have always been impressed with the great working relationship I have enjoyed with my esteemed colleagues on the Armed Services Committee and their professional staffs. My vote by no means diminishes my respect for the Armed Forces. Unfortunately, the congressional majority has decided to needlessly inject controversy into what should have been a bipartisan effort to fund and support our troops in a time of war. I am, of course, speaking of the decision to attach the unrelated hate crimes provisions to this legislation. For one reason or another, the Democrats have once again decided that, even with their overwhelming majorities in the House and Senate, the Federal hate crimes legislation cannot be debated and passed on its own merits and that, instead, this divisive legislation should become part and parcel with our efforts to provide our military with much-needed resources. I have long been opposed to this approach with regard to hate crimes. Make no mistake, none of us are indifferent to the problems associated with violence motivated by prejudice and violence. However, I believe that the approach provided for in this bill would needlessly expand the powers of the Federal Government at the expense of the traditional police powers of the States. Worst of all, it would do so without a demonstrated need. Indeed, a few months back, I asked the Attorney General--who supports this legislation, by the way, in a hearing whether there was any evidence of a trend that these crimes were going unpunished at the State level. He stated without reservation that there was no such evidence and that, in fact, the States were, by and large, doing a fine job in this area. If that is the case, what is the purpose of this legislation? Why are we going to expand the law enforcement powers of the Federal Government into what are essential State crimes when these crimes are already being handled adequately by the States? I have yet to hear a decent answer to that question. Now, some of us may be tempted simply to vote for the Defense authorizations bill with the hate crimes provisions attached simply because the balance of the bill is good and worthy of support. Well, I worry that if we go along with this now, what will they add to so- called ``must pass'' bills in the future? I believe that when it comes to funding our troops, we should do our best to speak in a unified voice. By taking this path, it seems that the majority would rather make a political statement than offer the military our bipartisan support. For that, I am greatly disappointed.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today with my fellow cochair of the Senate Tanker Caucus, Senator Conrad, to lend my support to the expedited acquisition of the next aerial refueling tanker for the Air Force. We were pleased to hear Secretary Gates announced on September 16 that he was giving oversight authority back to the Air Force for this vital procurement program. This program will ultimately produce 179 new KC-X aerial refueling tankers through one of the largest military procurement contracts in history, worth approximately $35 billion.

Mr. HATCH. The current KC-X proposal has been refined to 373 key mandatory requirements that will allow this new tanker to ``Go to War'' on day 1. There are 93 additional areas that will enable offerors to enhance their proposals. If the bids are within 1 percent of one another, the 93 additional capabilities will be analyzed to break this virtual tie. If a competitor has a score that wins by more than one point then the award will go to that contractor. If the tally of additional requirements score is less than a one point difference, the contract will be awarded to the contractor with the lowest proposed price. After reviewing this process, we believe it is very clear and transparent. The contract award has been projected for May 2010.

Mr. HATCH. Mr. President, we are in great need of a new aerial refueling tanker now. No one can dispute this fact; the President, the Secretary of Defense, and the Secretary of the Air Force have all said so. President Eisenhower was our first President to see the current refueling tanker in service and it has served through every contingency for over almost 50 years. The venerable KC-135 is by far the oldest airframe in our inventory. The generation of men and women that defend our freedom deserve an aerial refueling tanker that capitalizes on the innovations of today while providing the taxpayer the best value.

Mr. HATCH

Mr. HATCH. Mr. President, today the Senate voted 80 to 17 in favor of the Energy and Water appropriations bill, H.R. 3182. I praise Chairman Byron L. Dorgan and Senator Robert F. Bennett, the Republican ranking member, and the other members of the Energy and Water subcommittee for putting together what I consider to be a good bill and certainly a big improvement over the energy budget sent to us by the President. Knowing that the funding measure would pass, I chose to vote against this bill, which funds the Department of Energy, as a signal to the Obama administration and the DOE that American taxpayers want and need a serious pro-energy plan, not the anti-energy strategy being pushed on us by the United Nations Intergovernmental Panel on Climate Change, which this administration has adopted. When the Secretary of Energy testifies before Congress that he believes it is his job to cut carbon-dioxide emissions by 80 percent in the next 40 years, then we know our Nation does not have an energy policy; rather, we have an anti-energy policy. Cutting our Nation's emissions by 80 percent would provide two certain outcomes: First, reducing CO2 at that reckless pace would certainly devastate our economy and ruin our Nation's global competitiveness. Secondly, according to the U.N.'s own calculations for CO2's warming ability, it would result in no perceptible reduction in global temperatures. At best, it would reduce temperatures by about 0.1 degrees Centigrade after 40 years of economic torture. Maybe the media have fallen for this dangerous distraction to a real energy policy, but the polls show that the taxpayers have not.

Mr. HATCH

Mr. HATCH. Mr. President, I rise today to pay tribute to U.S. Army SSG Kurt R. Curtiss of Utah who made the ultimate sacrifice for his country on August 26, 2009. The staff sergeant died from injuries sustained from enemy small arms fire in Paktika Province, Afghanistan. Staff Sergeant Curtiss was leading his unit into a hospital trying to rescue patients trapped inside when the attack occurred. Staff Sergeant Curtiss was assigned to Headquarters and Headquarters Company, 1st Battalion, 501st Parachute Infantry Regiment, 25th Infantry Division, Fort Richardson, AK, in support of Operation Enduring Freedom. On the day after the September 11 attacks, Kurt Curtiss enlisted in the Army. He wanted to protect his country and make the world a better place. This call to service led to two tours in Iraq and a final tour in Afghanistan. The sense of patriotism exhibited by his actions provides a striking example to us all. Early in his youth, Staff Sergeant Curtiss learned of selflessness and acceptance as he grew up in a home where his mother cared for over 60 foster children. He will be remembered for his love, devotion, compassion, and humor. Curtiss loved life. He was a caring man who always placed others before himself, a characteristic exemplified by his final moments. Staff Sergeant Curtiss left behind a wife and two young children who I hope can find solace in the immense gratitude that our Nation owes for his selfless service to his countrymen. We are forever in his and his family's debt. Therefore I know that I am joined by all of my colleagues in the Senate in mourning the loss of SSG Kurt R. Curtiss, our protector and hero.

Mr. HATCH

Mr. HATCH. Mr. President, I stand today to recognize and honor an extraordinary organization that began its important work 20 years ago, born from the words of a new President who was dedicated to engaging the American spirit of giving and service. The words of that President resonate even now: ``I have spoken of a thousand points of light . . . a new engagement in the lives of others, a new activism, hands-on and involved that gets the job done.'' This 1989 speech given by President George H.W. Bush outlined the vision for the Points of Light Foundation, now merged with HandsOn Network as the Points of Light Institute, the largest volunteer network in the country. This independent, nonpartisan organization has worked to encourage, recognize, and empower the spirit of volunteer service that is encoded in our Nation's cultural DNA and is, as President Bush stated, central to living a meaningful life. Throughout our Nation's history, Americans have demonstrated their willingness to give back and to serve in their communities, even in the hardest of times. Last year alone, over 60 million Americans performed volunteer service in this country. I am proud that my home State of Utah had the highest volunteerism rate, with over 45 percent of adults volunteering in the State in 2008. All told, these volunteers contributed almost 162 million hours of service in a single year. Earlier this year, I had the privilege of joining with my good friend, the late Senator Ted Kennedy in sponsoring the Edward M. Kennedy Serve America Act, a new law that expands volunteer opportunities for Americans of all ages. I know that the Points of Light Institute will be at the forefront in realizing the full potential of this important legislation, creating healthy communities by inspiring and equipping willing Americans to do more of the heavy lifting in their communities as we all work to improve our Nation. Mr. President, I once again commend the Points of Light Institute on this landmark anniversary.

Mr. HATCH

Mr. HATCH. Madam President, I have to object on behalf of our side.

Mr. HATCH

Mr. HATCH. Madam President, I have taken a lot of votes in my Senate service, as I have had the proud honor of representing my fellow Utahns and of course all Americans across this great Nation. I deliver these remarks with a heavy heart because what could have been a strong bipartisan vote reflecting our collective and genuine desire for responsible reform in the Senate Finance Committee has ended as another largely partisan exercise as we take another step forward toward the flawed solution of reforming one-sixth of our economy with more spending, more government, and more taxes. Having said that, I wish to compliment the distinguished chairman of the committee, Max Baucus, from Montana, for having worked so long and hard to try to get that bill through the committee. I disagree with the bill, but I also recognize that type of effort, and I have great regard for Senator Baucus and others on the committee as well. But I have worked through almost 4 weeks of debate in the Health, Education, Labor and Pensions Committee and now through 2 weeks of strenuous debate on the Senate Finance Committee. I was in the original Gang of 7 trying to come up with a bipartisan approach, but I realized that not enough flexibility had been given to Senator Baucus, and I decided to leave that group of seven, and I am glad I did, because I predicted when I left exactly what this bill would turn out to be. It almost seems as though these hundreds of hours of debate in the past were for naught. It is important for Americans everywhere to understand that the bills we have spent hundreds of hours working on are not the bills that will be discussed on the Senate floor. The real bill that is currently being written behind closed doors in the dark corners of the Capitol and the White House--and we can all only hope that all of us, especially American families, will have ample opportunity, at least 72 hours, to review the full bill before we are asked to consider this on the floor and vote on it--is a bill that affects every American life and every American business. The health care reform bill is too big and too important to not have a full public review. I wish to spend my time today talking about why the Baucus bill fails President Obama's own test for responsible health care reform. This bill is another example of Washington once again talking from both sides of the mouth and using technicalities and policy nuances to evade the promises made to our seniors and middle-class families. First, President Obama in his own words has consistently stated: ``If you like your current plan, you will be able to keep it.'' Let me repeat that: ``If you like your plan, you will be able to keep it.'' That was given on July 2, 2009, right at the White House, and we are all familiar with that particular commitment. One of the amendments I offered in the Finance Committee simply provided that if more than 1 million Americans would lose the coverage of their choice because of the implementation of this bill, then this legislation would not go into effect. This was a simple and straightforward amendment; no nuance, no double-talk. This amendment was defeated along party lines. It should come as no surprise to anyone on the Finance Committee that in a recent Rasmussen poll, a majority of Americans with health care coverage--almost 53 percent--said that the bill would force them to change their coverage. This bill is rife with policies that will do anything but allow you to keep your coverage. It cuts upward of $133 billion out of the Medicare Advantage Program, which will adversely impact the availability of these plans for millions of American seniors, especially in rural areas. That was what it was designed for. It is pushing for policies at the Federal level that actuaries acknowledge could increase premiums significantly for millions of Americans, not to mention the new insurance tax which will cost families another $500 in higher premiums. This will make current coverage unaffordable for countless Americans. American families are very smart; they are very astute. They realize that there is no free lunch, especially in Washington. They are being promised an almost $1 trillion bill--that is really an understatement of what it is, and I will get into that later--that will not increase deficits, not raise taxes, and not cut benefits. Only Washington speak could try to sell a promise such as this with a straight face. Second: The President has consistently pledged: ``We're not going to mess with Medicare.'' Once again, this is another simple and straightforward pledge that this bill has now evaded through Washington double speech or doubletalk. This bill strips, as I say, $133 billion out of the Medicare Advantage Program that currently covers 10.6 million seniors, or almost one out of four seniors in the Medicare Program. According to the Congressional Budget Office, under this bill, the value of so-called additional benefits such as vision care and dental care would decline from $135 to $42 by 2019. That is a reduction of more than 70 percent of benefits. You heard me right: 70 percent. I offered an amendment to protect these benefits for our seniors, many of whom are low-income Americans who reside in rural States. However, this amendment too was defeated in the Finance Committee. The majority chose to skirt the President's pledge about no reduction in Medicare benefits for our seniors by characterizing the benefits being lost--vision care, dental care, and reduced hospital deductibles--as extra benefits, not statutory benefits. Let me make this point as clearly as I can. When we promise American seniors that we will not reduce their benefits, let us be honest about that promise. Benefits are benefits, so we are either going to protect benefits or not. It is that simple. Under this bill, if you are a senior with Medicare Advantage, the unfortunate answer is no, you are going to lose benefits. Thirdly, the President has consistently stated: ``I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase.'' That was when the President was a candidate in New Hampshire on September 12, 2008, and he has said that since. Let us examine the realities of this bill. As I said before, there is no such thing as a free lunch, especially when Washington is the one inviting you over. According to the Joint Committee on Taxation, there is more than $400 billion in new taxes under this bill to continue to fund Washington's insatiable appetite for spending. Here are some of the highlights of the $400 billion: $23 billion of new taxes on employers through a mandate that will disproportionately affect low-income Americans and all at a time when our unemployment is rapidly approaching double digits. Some think we are already in double digits. There is $4 billion of new taxes on Americans who fail to buy a Washington-defined level of coverage; $322 billion of new taxes on everything from insurance premiums to prescription drugs to hearing devices and wheelchairs. Representatives from both the Congressional Budget Office, CBO, and the Joint Committee on Taxation, JCT, testified before the Finance Committee that these taxes will be passed on to the consumers. So even though this bill tries to hide these costs as indirect taxes, average Americans who purchase health plans, use prescription drugs, and buy medical devices--everything from hearing aids to crutches--will end up footing the bill. By the way, it is interesting to note here that although these tax increases and Medicare cuts will start as early as next year, subsidies to help people with their premiums which will skyrocket under this plan will not be available until July of 2013-- 3\1/2\ years later. By the way, they are going to cut $400 billion out of Medicare. I remember a few years back in 1975 when, for that budget that year, we were trying to find $23 billion out of Medicare and the other side just about went berserk over that. Here we are cutting $400 billion out of Medicare that already has $38 trillion in unfunded liabilities. So what about the promise of no taxes on families making less than $250,000? Look at the evidence. According to the data from the Joint Committee on Taxation and former CBO director Doug Holtz-Eakin, 89 percent of these new taxes will be paid by taxpayers making less than $200,000 a year. The insurance excise tax alone would cost families up to $500 more in premiums. That is not all. The Joint Committee on Taxation also found that at least 71 percent of all penalties collected from the individual mandate will also come from those making less than $250,000. As I said, there is no free lunch in this town. By the way, we all know when this bill is fully implemented it will cost significantly more. Every time Washington tells you that something will cost a dollar, it usually costs $10. History is prologue. Medicare started off as a $65 million a year program and now has a $400 billion annual budget. So look for these taxes to only go up in the future as we have just given the Federal Government a whole new checkbook. So based on my count, this bill already has three strikes against President Obama's own pledges to the American people. He said: ``You keep what you have.'' That is not true. ``No reduction in Medicare benefits for our seniors.'' That is not true. ``No tax increases on families making less than $250,000.'' That is not true. In fact, most of those taxes will go to the middle class at way below $250,000. Lastly, let me talk a little bit about the myth of this proposal actually reducing the deficit by $81 billion over 10 years. Here is the harsh reality. The Congressional Budget Office recently reported that our national deficit for fiscal year 2009 alone was a shocking $1.4 trillion. That is the highest deficit since 1945 in real terms. Let me put this in perspective. This was the largest yearly deficit since 1945. It was more than three times our deficit from last year. I remember how they were complaining about George Bush and those high deficits. It is almost 10 percent of our entire economy. George Bush's deficit was less than $500 billion. I thought it was too high. We are now talking about $1.4 trillion in the first year of this presidency. Keep in mind the Democrats controlled the Congress in the last 2 years of the Bush presidency. This should send shivers down the spine of every American out there. We are literally drowning the future of this Nation in a sea of red ink. Here is the fantasy: Congress will actually follow through with these massive Medicare cuts that are being used to make this $829 billion spending bill deficit neutral. I challenge a single Member of the Senate to tell me when have we ever followed through on such massive cuts. Let me use the words of Dr. Doug Elmendorf, the Director of the Congressional Budget Office, on this issue: These projections assume that these proposals are enacted and remain unchanged over the two decades which is often not the case for major legislation. The long-term budgetary impact will be quite different if those provisions were ultimately changed or not fully implemented. I could not have said it better myself. We all remember the Deficit Reduction Act of 2005 which attempted to reduce Medicare spending by a mere $22 billion over 10 years. That proposal was mercilessly attacked by the other side of the aisle as being, among other things, ``Orwellian'' and ``immoral.'' Now suddenly we are being asked to believe the Congress will follow through in almost $500 billion in cuts to Medicare? Take another example: the physician payment. This bill only contains a 1-year fix. After that, the doctors will face more than a 20-percent cut in their payments, seriously threatening access to Medicare for seniors. We all know that we have to fix this problem, and that we will. Unfortunately, the hundreds of billions of dollars needed to overhaul this broken system are not included in this score that is supposed to be balanced, and will go to further increasing our skyrocketing deficits. Let's be honest about it. The reason they can keep it down to $829 billion was by not counting the first 4 years; not having it implemented until as late as 2014. In other words, that is 6 years. If you extrapolate it out to 10 years, we have $1.7 trillion, $1.8 trillion that this bill is going to cost. One reason for that is because they know we are going to have to do the doctor fix rather than have doctors being paid 25 percent less by Medicare and even less by Medicaid, and hospitals 25 to 30 percent less by Medicare and even less by Medicaid. The biggest bait and switch on the American people about this bill's impact on the deficit is a simple math trick. If something is too expensive to do for a full 10-year period, just do it for 6 years. That is what they have done. Most of the major spending provisions of the bill do not go into effect until 2013 or even 2014, coincidentally, after the 2012 Presidential elections. So what we are seeing is not a full 10-year score but rather a 6-year score. According to the Senate Budget Committee, the full 10-year score of this plan will easily surpass $1.8 trillion, fully implemented over 10 years, the way it is written. I believe it will be more than that in actuality when we add the doctor fix that we are going to have to do. That is on top of the $2.4 trillion we are spending right now. In our current fiscal environment where the government will have to borrow nearly 43 cents out of every dollar it spends this year, let's think hard about what we are doing to our country and our future generations. Our national debt is on a path to double. We can see the red lines on the chart. That is the projected national debt since this administration has taken over. It is on a path to double in the next 5 years and triple in the next 10 years. There is still time for us to step back, press the reset button, and write a bill we can all support and be proud of. Madam President, what is their answer in the end? I guarantee you, the final bill is going to have some form of--it may be disguised semantically--a government-run plan. That scares every American. In 1965, when we did Medicare, the argument was that Medicare will be on an equal footing with the private industry. Well, it didn't take just a couple of years, and they found out they could not do it. So they had to set prices. Today, Medicare pays doctors 20 percent less and hospitals 25 percent less, and Medicaid is even worse than that. If we think the Federal Government can take over the whole health care system and save money, we haven't observed the history of Medicare. Medicare today is a $38 trillion unfunded liability that we are saddling our kids and grandkids with--and even in my case, my great grandkids. I am concerned. This should not be a political issue. We ought to be working together. I guarantee, if we turn all of this over to the government--I heard the distinguished Senator from Ohio, who is very sincere and very loquacious and has an interesting personality. I care for him. But if we do that, everybody is going to suffer because the Federal Government cannot do it better. It is just that simple. We have all the years since 1965 to prove that. The fact is, if we turn this over to the almighty Federal Government and the bureaucrats in Washington, it will cause a furor like we cannot believe in this country, and rightly so. I heard the distinguished Senator say: Well, if the insurance premiums should increase because of this bill, let's turn it over to the government, and we will save all that money. What about the $38 trillion in unfunded liability in Medicare as we stand here today? What about Medicaid going into bankruptcy within the next 10 years? There is nobody who doubts that who looks at the financial matters in this country. The reason they are is because they are run by the almighty Federal Government. I would much rather see a system whereby we allow the States themselves, which have different demographics--and the Chair is from New Hampshire, which is different from Massachusetts, and it is also different from my State of Utah. I will bet that the New Hampshirites can handle their problems a lot better than the Federal Government in Washington. I know Utah can. We have a good health care system because we do all the things that are necessary to make it good. It is closer to the people, and the government is closer to the people. They have to be responsible to the people. I would like to see a system where we basically block grant these funds and let the States set up their own programs and have 50 State laboratories that literally can show us the way; where we can compare plans and see the good in one State and maybe adapt it to ours. If we turn this all over to a government plan, run by Washington, I cannot begin to tell you the stifling that will be to innovation and good ideas compared to allowing the 50 State laboratories, as federalism was designed to set up. The majority leader said: The Republicans are just the party of no; they have no plan. We have 40 Members here and we have six plans. We find that even some of our plans are off the charts in cost. Some are good. The fact is, we know this system needs to be reformed. Every Republican is for reforming the system. We are not for bankrupting the country. We are not for having these almighty bureaucrats in Washington determine what we all have to do. We are not for turning everything over to the government, which is already running Medicare and Medicaid into bankruptcy. We don't believe a central form of government should control everything. Our Founding Fathers didn't believe that. That is why they did the Constitution the way they did it. Anybody who believes they can do it better in a government-run program hasn't studied history. I have to admit some of our colleagues on the other side do believe a single- payer system is better. Single-payer is socialism, pure and simple. They don't like to call it socialism, but that is what it is. When we get socialism, we get everything that goes with it, and that means rationing. We have to be reasonable about what services we can give. The States will do it the right way. The Federal Government will mess it up, I guarantee it. I don't know anybody who has been here as long as I have who could not acknowledge that. I don't think they should try to dispute that. I think they would be run out of Washington. If you want bureaucrats between your doctor and you, this is the way to do it--a government-run plan right here in Washington, with all the costs and expenses and the oblivious not caring about the future that we have seen year after year. That is why Republicans are up in arms. That is why we cannot support this bill. I wish we could work with our colleagues and get together. I wish we could do a bipartisan bill. I might add that one person is not bipartisan. You can call it that, but it really isn't. I deeply respect that one person, and she knows that. The fact is, we are a long way from having a health care bill. The further fact is, it will not be the bill that passed out of the committee today. It is going to even be worse. If I were sitting on the Democratic side, I would be worried to death about what they are finally going to come up with. They really do, for the most part--the majority--believe a single-payer system, run by Washington, DC, and the bureaucrats here is going to be better than one run by the States. I have to admit there are some States that would mess it up, no question. We can all name them too. There are generally States that are behind the single-payer system, but there aren't many of them. The vast majority of States would show us the way and help us to find the way and help us to do a good job on health care. Madam President, I am very concerned. I am one who likes to work in a bipartisan way, but it has to make sense. What we passed out of there today doesn't make sense, and it is going to get a lot worse. By the time they take the HELP Committee bill, which was a totally Democratic partisan bill, and take what they want out of that, and by the time they take the tricommittee bill over in the House, which is a partisan Democratic bill, it will get worse. When it does, the American people are going to be the losers. Madam President, I suggest the absence of a quorum.

Mr. HATCH

Mr. HATCH. Madam President, I have agreed to delay my 20 minutes in favor of the distinguished Senator from Michigan having 3 or 4 minutes. I ask unanimous consent that I be given the floor after that.