Mike Johanns

Mr. JOHANNS

Mr. JOHANNS. Let me just interject something here because I think this is a very important point to make, following up on what Senator Hatch just said. Some say that a person would never want to purchase a separate rider to cover abortion. It just would not happen, they say. But they misunderstand what the Stupak language actually allows. Let me be clear about this. If a woman wants her health insurance plan to provide elective abortion services, she does have the choice to purchase a health insurance plan that provides that on the exchange. She just has to pay for it with her own money. Am I correct in that interpretation or have I misunderstood that?

Mr. JOHANNS. Absolutely. As the Senator offers this explanation about a Catholic health care provider, it hits right to the heart of this issue. I most certainly agree with the Senator and I want him to know that many Nebraskans agree with him and agree with me on this issue. I got a letter recently from a gentleman out in western Nebraska, from a little community called Ainsworth--a great area of our State. He wrote to me and said this: I urge you to support freedom of conscience which protects professionals from being forced to participate in abortion and other anti-life practices, which include end-of-life issues. I had another constituent from Gretna, NE, more on the eastern side of our State, and this constituent wrote to me and said this: I am also very disturbed to learn that health care workers may be forced to act and speak contrary to their own consciences. I find it shocking to believe that this is being considered within a serious conversation/debate. We are going to put up a chart. President Obama has weighed in on some of these issues. President Obama gave a speech to a joint session of Congress. We all remember that was on September 9 of this year. He said this: And one more misunderstanding I want to clear up--under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place. The President has gone on to state on multiple occasions that he would not support abortion in a health care bill. The President has stated that over and over. The President has also stated on multiple occasions--both as a candidate and as President--that it is his goal to lower the incidence of abortion. That is what he says, not what the Democrat-led Senate has done, though, relative to this bill, which he has embraced. And it is not what the leadership has done in this bill. You see, my colleagues, I see this as a radical abortion approach, a radical piece of language. And you can go right to the bill itself, to pages 116 to 124 of this 2,074-page bill, and you can read it yourself. I have to tell you, there is so much about this bill that is bad policy, but this is especially damaging. The President promised us he would not let it happen. Do the President and the Members of his party, who control the Senate, who wrote the bill behind closed doors, do they really believe abortion is health care? Why didn't they just strip this language out? Why didn't they adopt the Stupak language, which was voted upon in the House, the Stupak compromise? Why didn't they adopt that, knowing that 64 Democrats had signed on to that language? What do you think about the President's commitment and his promise to us not to use Federal dollars to fund abortions? I say to Senator Brownback, I would like to hear his thoughts on that.

Mr. JOHANNS. I thank Senator Corker on behalf of not only myself but the folks back home in Nebraska for giving me a few minutes today, and I also thank Dr. Barrasso. When he talks, I want to listen. I am so tempted to yield my time to him because he is so knowledgeable in this area. I do have a few things I want to say. It occurs to me that after the vote tonight, what we should do is declare a recess for 2 weeks. We should take this bill out across our States and listen to the people. We should listen to the doctors, like Dr. Barrasso, who are on the front lines every day. We should listen to the nurses and hospital administrators and say: What do you think? I think we would get an earful. I did four townhall meetings during the short recess around Veterans Day on health care issues. I have been all over the State of Nebraska. Let me tell you a story--and every single Senator can tell this same story. I visited a small hospital in our State, the critical access hospital--and Dr. Barrasso is familiar with these. Under Federal law, these hospitals are 25 beds or under. They are in our small communities, not only in Nebraska but all across America. They have no margin for error, because all they do is hospital services. They don't have an exercise program or whatever. It is hospital care they provide. I asked the same questions to those doctors and administrators. I would say: Let me ask you, first, could you run this hospital and keep it open on Medicaid reimbursements? It was 100 percent unanimous: We would go broke. I asked a second question: Could you keep this hospital open on Medicaid and Medicare reimbursements? It was 100 percent unanimous. They say: No, we would go broke. What does this bill do? It expands Medicaid. Fifteen million people will be added to Medicaid--the largest single expansion in Medicaid in the program's history. Nearly half of the reduction of the uninsured in this bill is due to moving people onto Medicaid, a program that if you had to live on those reimbursements, and you were a critical access hospital, you would close your doors. That is shocking to me. Who were they listening to when they wrote this bill? Why can't we take these staff people, who have been holed up in the majority leader's office for 6 weeks, to Nebraska or Wyoming or Oklahoma or Tennessee or Texas? It makes no sense to me. I came here saying I was going to work to solve real problems for real people. We say that a lot out there. Let me give you a real people perspective about my State. Again, every Senator can tell this story. I was in a beautiful little community hospital--a critical access hospital, with 25 beds or less--in Valentine, NE, in a beautiful part of our State along the northern tier. It is a beautiful area, the Niobrara River Valley. There are great people there. It is off the interstate. It is a beautiful part of our country. Pick up a Nebraska map, because when I say this--if you look at the map, it will bring home what I am talking about. Between Chadron, NE, in the northwest part of the State, and O'Neill, NE, closer to the north central part of the State, lies Valentine. That little hospital in Valentine is the only hospital in that northern area that is providing deliveries for babies. When you pass this bill and you expand Medicaid that they can't live on, and the reimbursement rates are disastrous for them--if you mess around with that hospital's ability to deliver babies, you have a crisis in the northern part of my State. You can tell that story over and over. I wanted to talk about this last thing, and I will do it quickly, because other colleagues want to speak. As a former Governor, I dealt with Medicaid to try to balance the budget. I was the Governor in Nebraska post-9/11, when our economy and the Nation's economy tanked. We had to cut budgets over and over. My State of Nebraska just finished a special session. They cut about $300 million from the State budget. Four hundred people, the Associated Press reported, will lose their jobs because of these very difficult budget decisions. Here is the point I want to make: When this is fully in effect, we will drop into the States--my State included--billions of dollars worth of unfunded mandates for Medicaid--billions of dollars in a program where already 35 to 40 percent of our doctors cannot afford to take Medicaid patients, and they are saying: We would go broke if we had to. We are adding insult to injury by telling our Governors they have to figure out that in addition to the historic problems they are having with their budgets, they have to deal with an unfunded mandate. In a moment of candor, one of my colleagues who worked on this for years said something when I asked: Why Medicaid? It is so problematic. Why all these millions on Medicaid? In a moment of candor he said to me: Because it makes the score look better.

Mr. JOHANNS. I thank the Senator. Let me, if I might, before I address that, tell my colleagues how proud I am to stand here with these two champions of this issue, Senator Brownback and Senator Hatch. They have a remarkable history of every time they had an opportunity standing strong on an issue that I must admit is not the most popular issue in Washington, DC, to promote, and I admire their courage. To address the relevant question of the day, the Stupak protections, that compromise that was reached in the House, it is not in this bill. Of course, since it is not in this underlying bill, this Reid bill, it is very unlikely to be in the final bill. I wish somebody could disprove this. But, very simply, there aren't enough pro-life Senators to break this provision and get the Stupak amendment passed on the Senate floor if we propose it as an amendment--and I am sure it will be--there just aren't enough. That is why I have been making the case over the last 48 hours that the motion to proceed is the key vote on abortion in the health care debate. The most important pro-life vote that a pro-life Senator will cast, I believe, in the entire time they are here is on this motion to proceed. I have seen all the arguments from many, saying this is a procedural vote; that there is nothing to worry about; that it just begins debate, and we might potentially vote this bill down, and we can do some amendments and some tweaking. But the facts suggest otherwise. The Congressional Research Service has looked into this. Between the 106th and 110th Congresses, there were 41 cases, according to the Congressional Research Service, in which the Senate approved a motion to proceed and then proceeded to a vote on the final bill. Do you know what the end result of those 41 cases were, when the motion to proceed was approved? It was 40 times out of 41--about 97 percent--went on to receive final approval. In other words, all but one passed into law. This suggests to me this vote tonight at 8 o'clock on the life issue is very well determinative. Some of my colleagues also argue if we don't like the bill, we should not block the opportunity to amend it, and they say let us proceed. I don't believe, if you are truly pro-life as a Senator, you can make that argument. Here is why: Everybody in the Senate knows what it will take to amend the Reid bill on something like this. It will take 60 votes. It is the way the Senate operates. It will take 60 votes. Again, I say to Senator Hatch and Senator Brownback, I wish I could count 60 pro-life Senators. I wish I could do that. But by anybody's count, I believe--mine included--there aren't 60 here. I believe if you are pro-life, every opportunity you get to stand for the life issue, you must stand for that issue. These truly are our most vulnerable citizens. I feel very strongly that at 8 o'clock, when we are gaveled to a vote, we need to stand up on this issue--this life issue--or there is a 97-percent chance it is lost. I will conclude my thoughts on this by saying this: There were many strong and courageous pro-life Democrats in the House. I watched that. That was remarkable. Can you imagine the pressure they were put under? This evening, we just need one--not many, just one Democrat--who will come here and say I am pro-life. If we don't stand together tonight, this bill will radically expand abortion, and I cannot live with that.

Mr. JOHANNS. I have. We have seen the polls. We have gotten letters from our constituents. Consistently, in poll after poll, we can see what the American people are saying. They do not want their tax dollars to fund abortions.

Mr. JOHANNS. Absolutely. It absolutely makes sense. I say to Senator Hatch and Senator Brownback, one of the things that has been very remarkable to me--this bill just came out, as you know. It was behind closed doors for weeks and weeks and came out in the middle of the night, actually.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I wish to compliment the Senator on his very excellent presentation on a bill we just got in the middle of the night last night. I am a little bit tempted to ask the Senator if I could have a copy of that bill on my desk, but the less we have to handle it, the less we risk bodily injury, so that is all right. Just keep it right there at your desk. I wish to zero in on one issue today. It is a very important issue to Nebraskans. It is a very important issue to Americans. That is the issue of abortion. An overwhelming majority of Americans suggest--take the position, I should say--that we should not use Federal funds for abortions. Just yesterday, I was looking at an article and it said six in ten Americans favor a ban on using Federal funds for abortions. I have found over and over again that Nebraskans feel the same way. A constituent in Gretna, NE, said to me, and I am quoting: Please know that I do support some health care reform; however, I cannot in good conscience support any legislation that contains any abortion mandates. Someone from Bellevue, NE, said, and I am quoting again: I am writing to urge you to ensure that language is included in any health care reform proposal or bill to explicitly exclude abortion . . . The use of my tax dollars forces me to support a procedure that is against my conscience. So as we move forward, we need to focus on what people are saying to us. That is why in this bill we need the exact language in the House bill. The Stupak amendment is the essence of a continuation of current law. Don't be fooled by those who suggest this is something new and different. The Hyde law prohibits Federal funding of abortion through Federal programs such as Medicaid. It prohibits Federal funding for private health insurance policies that cover abortion. An example is the current Federal Employees Health Benefits Program. The 250 participating health plans do not cover elective abortions. Federal employees pay a share of the cost. The Federal Government pays the balance--or the taxpayers. Federal employees cannot opt for elective abortion coverage because taxpayer dollars are subsidizing the cost of the employee plans. As many have said during this debate, if it is good enough for Federal employees, well, it should be good enough for the citizens. The Stupak-Ellsworth-Pitts amendment says: New government subsidies could not be used to purchase an insurance plan that covers abortion. The proposed government insurance plan also could not cover abortion. However, the stark and alarming differences that exist in the Senate bill are immediately obvious. The Senate bill says: People who receive a new government subsidy could--could--enroll in an insurance plan that covers abortion. It requires--requires--at least one plan on the insurance exchange to offer abortion services. Supporters say: Don't worry. Public funds would be segregated, so they wouldn't be used for abortion. But this provides no solace whatsoever. It is impossible to segregate funds. How will the government ensure citizens who receive a subsidy to buy a health insurance plan do not use those Federal dollars to pay for health insurance premiums? Put another way, citizens get charged a premium that includes abortion coverage. The taxpayers pay a percent of the premium. Who can determine what dollar went here or what dollar went there? Well, as many have pointed out already, it is a shell game--nothing more, nothing less. The Senate bill makes a sharp detour from current law. The very clear line established by the Hyde amendment is obliterated. The Federal Employees Health Benefits Plan does not allow this shell game and neither should this new regime. National Right to Life is not fooled by this game. They call this provision ``completely unacceptable.'' It was remarkable how quickly they read this language and saw through it. National Right to Life goes on to say that it ``closely mirrors the original House language that was rejected by 64 Democrats.'' I am going to quote: It tries to conceal that unpopular reality with layers of contrived definitions and hollow bookkeeping requirements. I stand here today to say to National Right to Life, thank you for standing up for life. I hope more will do the same. You are absolutely correct in saying that it would ``require coverage of any and all abortions throughout the public option program. This would be Federal Government funding of abortion, no matter how hard they try to disguise it.'' They weren't fooled. My best view of this is that other pro-life leaders will courageously stand up today and tell Americans they should not be fooled either. We have to draw a line. This isn't a partisan issue. Last week, a Democratic colleague said: What is clear is that for this bill to be successful, there can be no taxpayer funding for abortion. Yet the Stupak-Ellsworth-Pitts protections are stripped from this bill. Since it is not in the underlying bill, I want to be very candid, I don't see it in the final bill. I don't believe there are enough pro- life Senators to break a filibuster to make this a part of the final bill. That is why this motion to proceed we will be voting on in hours has become the key vote on abortion. It is the key pro-life vote. Some say cloture on a motion to proceed is just a procedural effort. It begins debate, and then you can do amendments and potentially even vote the bill down. The facts suggest otherwise. Listen to this, from the Congressional Research Service: Between the 106th and 110th Congress, there were 41 cases in which the U.S. Senate approved a motion to proceed and eventually then voted on final passage; 40 of those 41 bills received final approval. In other words, all but one passed into law. Well, that tells us all we need to know. This motion to proceed on this life issue is critical. Some of my colleagues would argue that if we don't like the bill, we must not block the opportunity to amend it; therefore, they would say we should vote for the motion to proceed. I don't think any pro-life Senator could take that position, and here is why: If we proceed to the bill, any changes will require 60 votes. I sincerely wish there were 60 pro-life votes in the Senate, but by my count I don't get there; therefore, we won't be able to change this. If there is a Senator willing to suggest otherwise, I respectfully invite him or her to come to the floor and share the list of 60 Senators who are willing to vote for a provision that ensures the Stupak amendment will be there. I don't think that is going to happen. So it comes down to this: If you don't believe tax dollars should fund abortion, vote against the motion to proceed. It is our last chance to protect life in this debate. Congressman Stupak and about 40 of his Democratic colleagues stood strong on their pro-life convictions, and they literally changed the outcome in the House. They stared the Speaker in the eye and said, about this procedural vote: Look, if it is not pro-life, we are not there. And the Speaker had no choice but to put the Stupak amendment up for a vote. Over 40 courageous Congressmen stuck to their convictions, and they made a difference. Today in the Senate, we don't need 40 Democrats to stand up for what is right; we need just 1. If just one pro-life Democrat would say: I will not vote to move this bill until it is fixed, until it is truly pro-life, that would happen. Those who say they are pro-life but refuse to take that stand, I worry they are not standing up for life. I have a record of voting pro-life. I know how I am going to vote on this, because it is the right thing to do. I ask for a pro-life Senator to come down here and stand up on this bill. Pro-life Americans are waiting, and they are not fooled. I yield the floor.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, thank you. I rise today to also speak about health care. I will tell my colleagues when the Senator from Tennessee was talking about Medicaid, we former Governors can relate to what he was saying. I had the opportunity, as the Presiding Officer knows, to be Governor of Nebraska for 6 years, and Medicaid was an enormous challenge. It is eating up State budgets. States are struggling. My own State, which has done better than just about every other State in the country, is in special session today trying to figure out how to find cuts of about $330 billion, which is a lot of money in our State. Plus, there are these tremendous access problems, how to get people into Medicaid. So I wish to associate myself with his comments. I wish to speak today, if I could, about some townhall meetings I had back home in Nebraska this last week. As soon as we recessed, I headed home. In about 48 hours we had four townhall meetings. Boy, if I were to give some advice, I would say whenever this bill comes out we should call a recess for a week. We should all agree upon it in a bipartisan way, and we should go home, and we should listen to the people. I got so much good prairie wisdom, as I call it, from the folks back home. I wish to talk about that today. One of the things I talked about as I was making my presentation is the proposed Medicare cuts and the impact it has on Nebraskans, real people. The impact on the current Nebraska health care delivery system cannot be denied. DISH hospitals we estimate today--and again we will see the final bill and we will figure out what the exact numbers are-- but the estimate is there will be $142 million in cuts to those hospitals. Our nursing homes across the State that do such a great job with our senior population estimate cuts of about $93.2 million. Home health is a program I have always respected and what they do. The idea is, if we can keep people in their home longer versus a nursing home, that saves money. So I promoted it as a Governor and I promote it now. They are projecting $126 million in cuts. By 2016, it is estimated that 66 percent of Nebraska home health agencies will be operating in the red. Then, hospice estimates they will have a 12-percent payment reduction. That is a real impact on services because in our hospice systems, oftentimes people are driving long distances to provide that service. Then Medicare Advantage, which is a popular program back home, especially with poor citizens in rural areas--about 35,000 Nebraskans currently have plans, and as my colleagues know, that has a big bull's- eye on it for cuts. Some say that wasn't a very good program, but I will tell my colleagues the people who have that program like it. Citizens came to me and they shared concerns about access to care. They shared concerns such as: Is this going to bring down the cost of health care? Those are promises that have been made as this health care debate has unfolded. Our President has made those promises. Questions were raised such as: How about Medicare? What impact will it have? Are there going to be negative impacts? Today, as I did during the townhalls, I wish to try to address these questions. In fact, I wrapped up my townhalls on Friday in Lincoln, NE, and then the experts over at the Center for Medicare and Medicaid Services actually answered these questions for us. On Saturday, the following day, the chief actuary of the Obama administration's CMS released a report that analyzed the recently passed House legislation. Why is that important? It is important because the House has finished its work for now and, ultimately, if the Senate were to pass a bill, it is the House bill and the Senate bill that will be conferenced. It concluded this: There are decreases in access to health care services. Medicare payments to hospitals and nursing homes are reduced over time based on certain productivity targets. The idea is that by paying institutions less money, they will be forced to become more productive. I will tell my colleagues that in Nebraska, if you have a critical access hospital in a rural area and it is serving 25 patients, today they are as productive as they can possibly get. If you have a nursing home in a small community and your idea as the Governor or as the family is that a loved one can stay close to home, they are about as productive as they can get. Congress could intervene and say, well, we are not going to make those cuts in the years to come, but the actuary said, and I am quoting: ``So doing would likely result in significantly smaller actual savings.'' So there we have it. We have experience in this area where every year Congress doesn't take the action, And it doesn't bend the cost curve, according to this expert. Earlier this year the President said--and I am quoting--that this ``will slow the growth of health care costs for our families, our businesses, and our government.'' Yet CMS forecasts an actual increase in total health care spending of more than $289 billion over the next 10 years. I am quoting here again from that report: With the exception of the proposed reductions in Medicare payment updates for institutional providers, the provisions of H.R. 3962 would not have a significant impact on future health care cost growth rates. In addition, the longer-term viability of the Medicare update reductions is doubtful. In other words, Health and Human Service experts don't believe it is even viable to make the kinds of cuts that are proposed long term. Even if Congress has the will to make the cuts, health care costs are going up, not down. Let me repeat this. This bill drives up the cost of health care, not down. Astounding, absolutely astounding. It doesn't allow you to keep the plan if you like it. How many times was that promise made? By 2014, Medicare Advantage enrollment would drop 64 percent from 13.2 million to 4.7 million because benefits would be cut. Every single advocacy group for senior citizens should be on the phone today calling Senators to say, Don't go there. This hurts seniors. Also, insurance plans will have to be government approved. In our State, I saw an estimate that said 61 percent of our plans are not going to be in compliance and would have to be changed. When it comes to health care, it is often suggested to get a second opinion. Well, I think here in the Senate we should follow this advice. Before we perform major surgery, very high-risk surgery on the Nation's health care system--16 percent of our economy--we should get a second opinion. That is why I sent a letter to the majority leader last Thursday and I asked for a CMS actuary to analyze the Senate bill before it is voted on so we can determine if the legislation bends the cost curve, and I am proud to report today that already I have 24 colleagues joining me in signing that letter. All we are doing is asking the majority leader: Please get a second opinion before you perform this high-risk surgery on our health care system. I will tell one last story from a townhall meeting that occurred in Grand Island, NE. This will be my last thought. A young man gets up and he says this, and I am quoting: What will you do to me and my generation, to me and my child? Will you ransom my future for your own? Our best intentions might end up destroying his American dream and the dream of his child. This is high risk, what we are doing here. Let's get the best opinions we can before we act. Thank you, Mr. President. I yield the floor.

Mr. JOHANNS

Mr. JOHANNS. Madam President, I begin my comments and thank the Senator from South Dakota for answering that question. Having been a Governor and, for that matter, a mayor, this is a very difficult time back home. When I refer to ``back home,'' I refer to Nebraska, but every Senator could say the same. State budgets are struggling. Today, I rise because I believe there is another important point to be stressed as Senators on both sides of the abortion issue decide how they want to approach their vote relative to this legislation. We saw a clear pro-life approach when the House passed what is now being referred to as the Stupak amendment. That amendment is straightforward. It says no Federal tax dollars will pay for abortions, whether that is directly or through subsidies or any other means. Put another way: If you accept a subsidy from the Federal Government, you cannot use that to fund an abortion. It is clear and straightforward. This carries on the longstanding tradition of separating tax dollars from abortions. Now the focus is on the Senate. The House passed their legislation on Saturday. I have heard very little about the importance of what some have characterized as little more than a procedural vote. In reality, it is an important vote that might well become the deciding factor in the debate over Federal funding of abortion. Let me explain. It all depends on whether the ban on Federal funding of abortions is weakened in the Senate bill compared to the House. As I speak today, the Senate bill is being written behind closed doors by the majority leader and others. If their final product includes anything less than the House-passed ban, the critical vote for pro-life Senators will be their vote on cloture on the motion to proceed. Why? Because if the motion to proceed is successful, it will end, in my opinion, any chance to match the House bill's ban on using Federal funds to fund abortion. It is the way the Senate works, according to its rules. Sixty votes would be needed to change the bill once a motion to proceed passes. Let me repeat: 60 votes would be needed to change the bill once a motion to proceed passes. We all know, regrettably, that there are not 60 Senators who would support the House provision that bans Federal funding for abortions; therefore, we would lack the votes to close the door on Federal funding of abortions if this bill proceeds to the floor with a weakened approach. The ban on Federal funding of abortions must be a part of the Senate bill before debate is allowed to proceed. Don't be fooled by the claims that the motion to proceed to the bill is a first step in improving the bill; it will be the final say for the pro-life community. I applaud my colleagues on both sides of the aisle who have declared they will accept nothing less than a complete separation between Federal funds and abortion services. I wish to express unequivocally, I stand firmly with them. If we are presented with a weakened ban on Federal funding of abortion compared to the House version, we must vote against cloture on the motion to proceed to the bill. In my judgment, this point should be nonnegotiable. I yield the floor and suggest the absence of a quorum.

Mr. JOHANNS. Madam President, if I may start out today and use a portion of my time to ask if the Senator from South Dakota would answer a question or two about Medicaid, the first question I have for the Senator from South Dakota is, when it comes to Medicaid, why would we be putting a mandate on States at a time when every State in the country is going through a difficult budget cycle? In fact, Nebraska literally, as I speak, is in special session to cut the budget by over $300 million. Why would we do that with this health care bill?

Mr. JOHANNS

Mr. JOHANNS. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. JOHANNS. Madam President, I ask unanimous consent that the pending amendment, if there is one, be set aside and that amendment No. 2752 be called up.

Mr. JOHANNS. Madam President, this is an amendment I have offered on several appropriations bills. Each time, it has passed with overwhelming bipartisan support. Additionally, the continuing resolution includes similar language. But, of course, the CR runs out on December 18. We need to continue passing this amendment; therefore, I need to continue to offer it. It basically says we are blocking all Federal funding under this bill to ACORN. I do have a piece of legislation pending that would take care of this across the Federal system, but that has not come to a vote yet. So I am offering today this amendment on ACORN. This amendment will continue to protect taxpayer dollars. I do want to indicate to the manager of the bill that, of course, I am happy to work with my colleagues on a voice vote whenever the appropriate time arises for that to occur. With that, Madam President, I yield the floor.

Mr. JOHANNS

Mr. JOHANNS. Madam President, I rise today to salute the 313th Medical Company of Nebraska Army National Guard on its upcoming and second deployment to Iraq. The 313th Medical Company is about to embark on an important mission, and I want its members to know how thankful I am for their service and how proud I am of their professionalism and dedication. Thanks to the sacrifices made by the 313th during previous deployments and those of so many other servicemen and women, 29 million Iraqis are free, Iraq is the most democratic country in the Arab world, and Iraq has become an ally in the war on terror. As conditions continue to improve in Iraq, with Iraqi armed forces and police taking the lead on security, the need for our presence in Iraq is diminishing. However, we must be vigilant in successfully completing the transition. Medical support from the 313th will be vital to ensuring our achievements in Iraq are lasting. Members of the 313th are some of the best-trained and prepared soldiers in our Nation's history. Some of them have already been deployed one or more times and their experience will undoubtedly be invaluable to mission success. The equipment they use is the best in world. But, ultimately, their individual patriotism and dedication has made and continues to make the difference in Iraq. I also thank the families of the 313th. They will also endure hardships in the name of freedom and security. Their support will undoubtedly enable the unit to focus on the mission. The Department of Defense and many private organizations have established programs to assist families while their loved ones are fighting overseas. My staff and I stand ready to assist them if they need help accessing these resources. The thoughts and prayers of all Nebraskans and of grateful citizens across this great Nation go with the 313th. I could not be more proud of them, and look forward to seeing them all back in a year. May God bless the 313th, and protect them and their families as they answer the country's call to duty.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I rise today to speak about health care and the debate that is heading our way, especially now following the action of the House this last weekend. We all read the articles, we hear the debate, we hear the talk about trying to find a compromise when it comes to the government-run health insurance program. Some oppose it with passion. Some say they will not support reform without it. There is a whole variety of opinions. One idea that seems to be picking up steam in this effort to find a compromise is the idea of a trigger, whatever that means. Proponents call it a safeguard. They say it will trip only if insurance premiums go up. Here is the problem with that. Inherent in the underlying legislation is the sure-fire trip that could set off the trigger. You see, we already know that current proposals in this health care reform initiative itself will cause premiums to rise. The government mandates and taxes and all of the other things that are going to be burdened upon health insurance policies are going to cause the premiums to rise. We are saddling policies with huge new fees and taxes and mandates. The Finance bill piles $67 billion in new fees on the very policies that the vast majority of Americans have. Can anyone claim with a straight face that premiums will not go up under these circumstances, caused by governmental action? The nonpartisan Congressional Budget Office--if you have any wonder about this--confirms it. Its analysis of the Finance Committee bill says the fees imposed would, and I am quoting from the CBO, ``be passed on to purchasers and would ultimately raise insurance premiums by a corresponding amount.'' This idea of a trigger that trips only if premiums rise is an illusory safeguard. It is because the trigger is rigged to shoot. Further evidence is the fact that the trigger fires if health insurance is deemed, and again I am quoting, ``unaffordable.'' Guess who gets to decide that. The government will decide that. It will decide what affordability is. So bureaucrats pull the trigger by simply labeling premiums ``unaffordable'' after all of these fees and higher taxes on these policies kick in. This illusory safeguard is meant to appease those of us concerned about making Washington the great czar of health care, but it doesn't work. I believe the American people see through this. I urge those who support a trigger to be straightforward about what their stance is. If they are for government-run health insurance, say let's go there. Incidentally, I will passionately debate that position. I don't believe it is in the best interests of our Nation, but I will not criticize them for holding that opinion. After all, that is what the Senate floor is for, to debate opinions. On the other hand, I take issue with disguising a government takeover of health insurance and calling it a trigger. I take issue with laying additional taxes on health insurance policies and then calling a press conference to complain that premiums went up. The implication that the trigger will never fire, quite honestly, gets to be folly. I gave a speech a week or so ago on the floor and I talked about the opt-in and the opt-out. There is no real option if States will have to face the unfunded mandate's tax and fees. I pointed that out in that speech. The only thing States can opt out of, or choose not to opt in to, I believe, when we see the actual language, will be the benefits. All of the other burdens will fall upon the taxpayers of that State. It is an illusory option. It is a false promise, just like the trigger. Just like the trigger. Some suggest the trigger is just like the trigger in the part D, the Medicare prescription drug benefit. I have heard that argument too. But, boy, is there a world of difference between what happened there and what is being proposed here. You see, Part D was designed to ensure competition in an entirely new marketplace. It was measurable. It was not discretionary. It asked this question: Would private insurance companies enter into this marketplace? Well, they did. The trigger being discussed now is very different. It is set up to shoot. It is based upon the word ``affordability,'' and the government holds the power of deciding that issue. Then the government holds the power to tax policies, and, of course, as the CBO pointed out, that is going to translate into higher premiums. You see, what I see happening here is that the government is setting itself up to be both the pitcher and the umpire--the pitcher, who throws the ball, and the umpire, who gets to call the strike. I do not think the game is working fairly. The goal of a trigger is to ensure competition. So let's drop the illusions, and let's enable real competition. Let's allow insurance companies to compete across State lines. The so-called trigger is just camouflaging the true intent: to establish a government-run system. I can't help but wonder, is the intention to confuse opt-in, opt-out, triggers, co-ops, exchanges? But it all boils down to the same thing: you are going to end up with a government-run health insurance industry and a government-run health care system. Whether it is opt-in, opt out, trigger, co-ops, it really is no real option. There is no free marketplace. Instead, it is government making your health care decisions, forcing you, dictating to you not only to carry insurance but dictating the kind of policy you will have and requiring that your plan be approved in Washington, causing many to be displaced from their private insurance. Now is not the time to raise taxes, add mandates, and put jobs in jeopardy. This massive, all-at-once approach is a very risky experiment with 16 percent of our economy. It is a huge gamble. It is a dangerous risk being taken with our health care. Common sense tells us that change is needed in this arena, but how about a step at a time to see if that change works, and then we can move forward to the next step. We can take positive steps. But opt- outs, out-ins, co-ops, exchanges, triggers--they are illusions and not solutions. I yield the floor, and I suggest the absence of a quorum.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I stand today to highlight the tax hammer, as I would describe it, that is being brought down on the American people relative to the health care bills that are making their way to the floor of the Senate and literally are about to be debated on the House side. In the Finance Committee bill, there are over $500 billion in additional taxes and fees and fines and penalties. In the House bill, there are over $750 billion in new taxes, et cetera. If you shrug your shoulders thinking: Well, that is a tax on those wealthy people; I don't have anything to worry about; I am not one of them--you are missing something. Actually, nothing could be further from the truth. In my judgment, these taxes will stifle small business. They are going to shock families who think there is no way their modest income could possibly be taxed more by the Federal Government. The House bill, let me start there. The first tax is a 5.4-percent surtax on what are referred to as the high-income earners. It raises taxes by about $460 billion. This is a gigantic tax increase. But supporters of it make the case that, again, this is the rich people, creating the feeling that somehow you don't have to worry about that if you are not making a lot of money. But what they don't want to acknowledge is that this is a tax on business and small businesses. In fact, I would suggest if you wanted to be fair in this debate, you wouldn't call it the millionaire tax; you would call it by the proper name--the small business tax. The Joint Committee on Taxation released a letter yesterday. It found that one-third of the tax--one-third of the tax--will be from business income. The Wall Street Journal has said this recently, and I am quoting: The burden will mostly fall on small businesses that have organized as Subchapter S or limited liability corporations, since the truly wealthy won't have any difficulty sheltering their incomes. In the United States, there are over 6 million small businesses. Last count, the last available information I could get my hands on, there were over 41,000 small employers in my home State of Nebraska. I have walked through many of these small businesses. I have visited with the people who are trying to keep these businesses going, and they are facing challenges to make the payroll. Many of these small businesses exist in small communities in my State, and their employees are not just faceless people, people without names. These are people with whom they went to high school. These are people with whom they worship on Sunday, they see at the grocery store. Our small businesses don't want to lay off these people. Now, what would a 5.4-percent tax do to their bottom line, to their employees, to any potential of hiring in the future, to the communities they support? Well, one can see the impact it will have. Shawne McGibbon, a former Small Business Administration official, said it very well and, again, I am quoting: Nebraska depends on small businesses for jobs and economic growth. During this time of financial stress and economic instability, policymakers need to remember that the State's small businesses provide the economic base for families and communities. Maybe to some from big cities or States that are mostly urban, the loss of 50 jobs is not a big deal. I can tell my colleagues it is a big deal to me. It is a big deal to my State. Fifty jobs in a community of 1,000 people is absolutely devastating. Those paychecks no longer spent on Main Street can literally bring Main Street to its knees. Making matters worse, this tax is not indexed for inflation, so what can we predict? What is the most certain thing we can predict about this tax? It is going to have the AMT problem all over again. Each year it is going to creep down, every year capturing more and more people in the middle class. The second tax I wish to talk about today is the 8-percent penalty on employers who don't offer insurance. Eight percent of their payroll or pay, at least 72.5 percent of workers' premiums, that is what they are faced with. Again, no matter how one sugarcoats it, this is going to cut into wages. For those who pay the 8 percent, that is going to total $135 billion more in taxes taken out of our economy. The Wall Street Journal, again, I think said it very well recently: Such ``play or pay'' taxes always become ``pay or pay'' and will rise over time, with severe consequences for hiring, job creation, and ultimately growth. I look over there at the House and they sure seem very determined to throttle the backbone of our economy--our small businesses. I will just tell them as somebody who has represented my great State as a Governor and now as a Senator: You take those jobs out of small communities and you will bring those small communities to their knees. I pay attention to the wisdom conveyed back home. That is why we do our townhall meetings and we walk in parades and we do everything we can to listen to the people. A constituent from Pierce, NE, a small community, a great community in our State, said it very well: With my husband self-employed, around 30 percent of our income is required to pay income taxes. If these income taxes weren't so high, we would be able to afford and choose our own insurance coverage. More taxes for public health care is not the answer. I wish to reference the Senate bill and a third tax--the penalty tax on individuals without insurance. It provides that if you don't have a government-approved health plan, you will pay a penalty of $750 for singles and $1,500 for married couples. The Congressional Budget Office has analyzed this penalty. Almost half of those paying the penalty tax would be between 100 and 300 percent of the poverty level. In some States, these good folks qualify for government assistance programs. So we are going to tax them or penalize them and then give them subsidies. Boy, only here could somebody make an argument that is rational. It makes no sense to the people back home. Listen to this: A family of four earning between $23,000 and $68,000 in 2013 would be saddled with the new tax. We are literally talking about taxing not just the middle class but even below that level. I remember a pledge being made. Last year, President Obama said: No one making less than $250,000 a year will see any form of tax increase. Yet a family of four earning $25,000 will be hit with a tax within a few years. Boy, that is a long way away--$25,000 from $250,000. Nebraskans believe they can make better decisions about their own health care than the Federal Government. Let me repeat that. Nebraskans believe they can make better decisions about their own health care for themselves and their families than can the Federal Government. I stand here today to tell my colleagues I agree with them. A constituent from Kearney, NE, said: Is there anything I can do to take a stand against what I consider a huge tax burden and a loss of freedoms? The individual mandate--just one more example of government intrusion into people's lives. I have covered three of the tax hikes pervasive in the bills, but it is the tip of the iceberg. There are new taxes, penalties, and fees as far as the eye can see. There is a very fitting quote from John Marshall. He said: ``The power to tax is the power to destroy.'' The power to tax is the power to destroy. As the health care debate continues, all of us should remember Chief Justice Marshall's wise words. Make no mistake about it. These various bills raise taxes and put burdens upon the American people at a breathtaking pace. Don't be fooled that this is all about taxing the rich people and the millionaires. This is really about taxing and taking from the American people, and Americans are seeing the truth. Thank you, Mr. President. I yield the floor.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I rise today to speak about health care. I want to focus my comments today, if I could, on specifically the Medicare cuts and the impact that will have across this great Nation, and also I would like too zero in on what those Medicare cuts mean for my home State, the great State of Nebraska. Medicare is a program that is a source of health care for about 45 million Americans. As we all know, it is essentially a program for those who are 65 and older. It dates back a lot of years. In my State, the State of Nebraska, there are 272,000 Nebraskans who are Medicare beneficiaries. As I have talked to them--and I have done townhall meetings and roundtables all around the State--they are pleased with the health care they receive. If they get sick, they have this program, this Medicare Program, that is there for them. I want to start out saying that I believe the current plan, which cuts Medicare and claims reform, is really off base with this population. The proposal says Medicare will be cut by over $400 billion. Let me, if I might, just walk down through the various programs that will be impacted within Medicare. There will be a $130 billion cut for the Medicare Advantage Program. If anybody has spent any time talking to senior citizens about Medicare Advantage, they will tell you they like this program. Mr. President, $45 billion will be cut from hospitals that care for recipients of Medicare; $40 billion will be cut from home health agencies; $14.6 billion will be cut from skilled nursing facilities; and nearly $8 billion will be cut from hospice programs. I suggest, very respectfully, that this health care reform, which will cut Medicare by over $400 billion, is not an improvement. These cuts ultimately will compromise the ability of Medicare beneficiaries to access the care they need. If I may spend a moment this morning to talk about the profound impacts this will have in Nebraska, the Medicare Advantage Program, as I said, will be impacted by about a $130 billion cut. Nationally, there are 11 million seniors enrolled. One Democratic Senator described these cuts as ``intolerable.'' I agree with that description. Mr. President, 35,000 Nebraskans have Medicare Advantage plans. The plans provide choice and options that people like. The President said that ``if you like your plan, you can keep it.'' And relative to the Medicare Advantage beneficiaries, he said you will get a plan that is ``just as good.'' The Finance Committee markup was very instructive on this issue. The CBO Director stated that those people who have Medicare Advantage ``will see changes and reductions in their benefits.'' Let me turn to hospitals. The news is no better with hospitals. Hospitals that serve large numbers of seniors and the poor will have reduced payments. The current government programs actually underpay for these services. Hospital administrator after hospital administrator has told me in my State: We could not keep our hospital open on Medicare and Medicaid. They need the additional payments they get from private insurance to keep the doors open. Yet this so-called reform bill cuts Nebraska hospitals by about $142 million; that is, 36 percent of Nebraska hospitals will be affected. Relative to home health care--a $40 billion cut nationally--seniors receive care in the home instead of going to a nursing home. That is what this program is all about. Under ``reform,'' Nebraska home health programs will lose $126 million over 10 years. By 2016, two-thirds of Nebraska home health agencies will be in the red. It is especially devastating to rural areas where 80 percent are expected to lose money under this reform plan. It is hard to keep the infrastructure in place right now, much less to look at what is coming. A home health director in a small rural hospital in Cherry County, NE, said this to me: Nebraskans are a tough and a convicted people. We have chosen to live in a more rural environment and respect the fact that not all services can be provided. However, there are two registered nurses that provide home health services for seven counties. Our radius to see patients is 100 miles one way. If a citizen was sick or injured, they may have to travel 100 miles to see a doctor. If they are unable to travel, they would just not receive the care they need. You see, home health care is not a convenience in our State, it is a necessity. Cuts will likely cause them to close that operation and quit providing the services. If the mission is to improve access, how does that do that? Skilled nursing care facilities is another area that is targeted with $14.6 billion in cuts. Registered nurses help provide 24-hour care to people who can no longer care for themselves. People depend on them for both short- and long-term care. What is the impact in Nebraska? The impact is $93.2 million. This dollar figure does not take into account the job loss and financial impact on local communities. I will mention a facility, a great facility, like all facilities in Nebraska, in Fullerton--the Golden Home Living Center. That is a population in that community of 1,300 people. The nursing home there is the second largest employer. They have a $1.5 million payroll. However, they are already struggling to try to figure out how to stay open, much less facing these cuts. The hospice program will have $8 billion in cuts nationally. Hospice provides dignity and comfort to seniors at the end of their life. With this ``reform,'' there will be a nearly 12-percent reduction in hospital reimbursements over the next decade. We have 38 licensed hospice programs in our State. We are so proud of them. Currently, 97 percent of Nebraskans have access to at least a hospice program. The cuts, I believe, would negatively impact the care of dying Nebraskans. Let me wrap up with this point. Every study that is out there says Medicare is heading toward insolvency, and 2017 is the date most often used. How do we keep Medicare viable? Cutting Medicare to fund a new entitlement, I respectfully suggest, is so misguided. Unfortunately, that is the determined effort of this reform plan. We can do better. We must do better. Nebraskans are watching. Americans are watching. We have to improve on what we are doing here. We need to be able to say to those who are Medicare beneficiaries: We protected Medicare. You are first and foremost in our mind. I yield the floor, and I suggest the absence of a quorum.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I rise today to speak to the amendment process with this unemployment bill. It is a very important point that we are making this afternoon. A few hours ago the very distinguished Member from Illinois, the senior Senator, got up and talked about how the unemployment insurance bill had been stalled by Republicans. He claimed that Republicans had been stalling it for 4 weeks. I rise today to respectfully disagree with that. We have come forward with a series of amendments. That is what the Senate is about. The other side has resisted votes on the amendments. So we started this process of trying to scale this back. We started out with eight amendments. The majority leader said, no, it could only be six. So Republicans got together and said we will come back with only three Republican amendments. Then, lo and behold, there was an objection to that. Let me repeat: We said eight, they said six, we said three, and they said no. It turns out there is one significant vote and it is the Senator from South Dakota who I think very appropriately and, I think, wisely put an amendment forward that would put TARP to an end at the end of the year. I am new to this process. But I have to tell you, in the first weeks I was here when we were voting on amendments I said to myself: This is the most remarkable institution. Somebody from the minority could literally come with an idea from a citizen back home, put that idea out here, and get a vote on that. There cannot be anything like this anywhere in the world. What is happening today, if I might point out, is that this is being thwarted by filling the tree. For those who are listening to this and saying what does this filling the tree mean, all it means is that the majority leader, who is in control of the process, simply puts all the amendments out there and there is no opportunity for anybody else to offer an amendment. It is called filling the tree. Look at what is happening. This is what does concern me as a Member of this great institution. If you go back through the history of majority leaders, you can see what has happened. Tom Daschle, when he was majority leader, I think used this once. Bill Frist, when he was majority leader, used this I think it was 12 times, if I remember correctly. Today, this will be 22 times that the majority leader has done this. What this graph means is if you have an amendment, as I do, that basically says I like what you are doing here. I don't have any problem with extending unemployment. I voted for the tax credit for homes. I voted, or I would vote, for the loss carryback. I talked about it on the campaign trail. But I have an amendment that says we should pay for this the way we did originally, with stimulus funding. That is simple. This is not complicated. All I am asking is for a vote on that. I think that makes a tremendous amount of sense. What I am saying is if we are going to act like a Senate, if we are going to give each Member the ability to make their case, then what we have to do is stop this and bring these issues to a vote. I yield the floor.

Mr. JOHANNS. Mr. President, may I inquire how much time is remaining?

Mr. JOHANNS

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

Mr. JOHANNS. I thank the Chair. This bill will ultimately lead to Government-run health care, will have more waste and fraud than the current system and will necessarily lead to arbitrary rationing and long wait times for treatment. Mr. President, I appreciate the indulgence to just wrap up my comments and say that if there were ever a time to go thoughtfully and carefully one step at a time and work in a bipartisan way to fix this issue, it is now. My hope is that in the weeks ahead, as we debate this issue, we will do precisely that. I yield the floor.

Mr. JOHANNS. Mr. President, as I start out this afternoon, I wish also to speak about health care. If I could, I wish to associate myself with the remarks of the Senator from Arizona. In his comments, I thought Senator Kyl hit the nail on the head. What we are looking for and I believe what the American people are looking for in this health care debate is a very thoughtful, step-by-step approach. That is what I hear when I go back home. I suspect other Senators are hearing the same thing. Today I want to talk about something that I as a former Governor--and I know the Presiding Officer was a former Governor; we were Governors together--have experience with and that is Federal legislation that comes along and it basically says to the States: If you don't like this Federal legislation, you can opt out. I often had that situation when I was Governor. Within the last 2 weeks or so, this idea came to the forefront with the health care debate. All of a sudden, there was this trumpeting going on that there would be a State choice here and that would be kind of a compromise, I think a compromise to bring some reluctant votes over in favor of the bill. I have to say I am very skeptical of this concept. We have not seen the bill yet here on the Senate side. That is being worked on behind closed doors. I was fascinated to listen to the Senator from Arizona talk about the fact that the majority leader said there is no bill yet. If we are going to start debate here, I hope a bill comes up soon so we have an opportunity to study it. But I think we can look from past experience and maybe get an idea of what this opt-out is going to look like. No doubt about it, in order for this health care legislation to be able to work at all, billions of dollars are going to have to be collected through taxpayers, be collected all across the country, from all States and their taxpayers. So if a State such as Nebraska is seriously considering the possibility that it might opt out of this bill, it is going to have to examine what choice is available and is there a choice at all. Does that mean the State of Nebraska will get to opt out of higher premiums? Does that mean the State of Nebraska will get to opt out of any individual mandates that are a part of the legislation? Does that mean that if the Governor of Nebraska says, We do not want any part of this bill, the Medicare recipients in Nebraska will not have to experience the nearly $500 billion in Medicare cuts? Does that mean that if the Governor of Nebraska chooses to opt out of this legislation, he literally has the ability to save Nebraska taxpayers from the $400 billion, or their share of that, that they would pay in taxes for this legislation, or is this going to be like so many other opt-out opportunities that the Federal Government gives to the States, and when you really get down to it, you begin to realize there really is not an opt-out, there really is not a choice; you have all of the burdens of the legislation but, of course, get no benefit. Further, it appears the legislation--again, I am speculating to some degree, but it appears the legislation would require States to opt out by 2014. Yet it is going to take about 3 or 4 years to get this government plan up and running. So almost at the same time that you are supposed to opt out, we will finally see, in terms of the regulations, what this government plan is going to do to States and taxpayers in those States. I can't see that there is much choice. You see, today we have the opportunity to opt out of various Federal programs--No Child Left Behind. Nebraska could opt out of the Federal bureaucracy. Why don't they opt out? Why don't other States? Because you really don't have a choice. The burden of the legislation is still going to be there, and by opting out, what you are saying is: I will force the burden upon my taxpayers and we will forego whatever limited benefit is available. So I just say, as we study this, don't be fooled. Opt-out in fact may have more of a downside and I suspect it is going to have more of a downside than any potential for an upside, and therefore that is not a choice. The other thing I have to tell you is that as I look at this, there really is not an opt-out. I think where we are headed is a first step toward a single-payer, government-type program. Government should not be the sole provider of health insurance. It should not be the sole arbiter of what kind of health care people will get in this country. What is the track record when there is a government program when it comes to health care? Well, we can look at the track record because there is a lot of it out there. Medicare and Medicaid would be perfect examples. Studies have been done of Medicare. They are done on a regular basis. If you are a Medicare recipient out there, you have heard about this. Medicare is due to be insolvent in 2017. And I am not talking about a little fix that is necessary here; this is trillions of dollars. That is frightening when you think about it. It is especially frightening when you recognize that the proposal is that about $450 billion will be pulled out of this program, not to stabilize Medicare, although I would argue that would make a lot of sense in terms of trying to say that any dollars that you can save in Medicare should stay with Medicare. No, that is not what is happening at all. You see, what is happening is that $450 billion will go to start a new government program, a new entitlement. Then there is that estimate that says about $10 billion annually is the minimum loss sustained by taxpayers every year due to Medicare fraud--$10 billion due to Medicare fraud. Medicaid has a 10-percent waste, fraud, and abuse rate. Neither is sustainable under its current form. Again, as a former Governor, I will tell you that Medicaid is the greatest challenge Governors face in keeping their budget together. We all talk about it, Democrats, Republicans; it does not make any difference. Yet a part of this health care plan will shift the burden to the States when they are already in very difficult times. I recently got a letter from a high school junior from Kearney, NE. She said to me: In my government class, we have discussed the health care issue. I feel very strongly about this issue for a few reasons, the first being the fact that all the money the government is spending is going to come out of the pockets of Americans. This will mostly affect the youth of this country. This will be my generation who will be paying off the bills that you will create with this health care plan. My goodness. Did she get that right or not? You know, it is just the commonsense approach. If you are really going to try to do what we are elected to do, why would you not shore up current government programs first before going off in this massive, 1,990-page bill to create a new entitlement? Why would you go off and siphon nearly $\1/2\ trillion away from Medicare? We should ensure Medicare's solvency first. I believe the current proposal is about advancing an agenda versus addressing a real need. The government-run plan will not make health care more affordable. I think we are going to see that confirmed over and over again as it is analyzed. If affordability is the goal, let people buy insurance across State lines. You will get virtually unanimous bipartisan support for that. Let small businesses and farmers and ranchers band together to get more competitive rates. Allow tax deductibility to level the playing field between corporations and individuals buying insurance. You see, again, if you did a step-by-step approach, I think you would get nearly unanimous support for these ideas. Nebraskans see through the rhetoric. I got another letter from a constituent in Omaha: Please oppose latest iteration of health care reform. This reform package will accomplish none of the objectives that have been laid out at the outset of this process.

Mr. JOHANNS

Mr. JOHANNS. I thank the Chair.

Mr. JOHANNS. Mr. President, may I inquire, is the procedure that we are going back and forth? If it is, I will defer to the junior Senator from Illinois.

Mr. JOHANNS

Mr. JOHANNS. Mr. President, I anticipate speaking about 10 minutes, and I rise to speak on the health care bill that is making its way to the Senate floor. Today, I wish to talk about just two topics relative to that health care bill, and those two topics are transparency and, of course, the all-important topic of taxes. We all have been through elections. We know elections lead to promises. We say things out on the campaign trail. We make promises to the American people and to the people of our State. Well, last election, by any measure, was a historic election. Over and over again, the American people were promised change. They were promised middle- class protections. Very specifically, our President promised increased transparency. There would be no tax increases on the middle class. We can all quote that language--not one dime. But I have to tell you, everything I see about the health care debate at this point leads me to the conclusion that campaign promises are about to be broken. Without a doubt--without a doubt--the American people clearly support more transparency in Washington. Yet health care has the same old politics. There isn't any transparency at the moment. I remember that famous tape of the President where he said: You know, we are going to do this in front of C-SPAN. We are going to see who is with the big insurance companies and who is with the people. Well, what is happening now? We are in the process of bills being merged--hugely different, monstrous bills--and we don't even know exactly what is going to be in those bills, and it is all happening behind closed doors. I just fundamentally ask the question: If this is good for America, then why be secret about it? It is altering one-sixth of our economy. It simply should not be happening behind closed doors. There is too much at stake. Everyone should support the 72-hour transparency bill. It simply requires that legislation and a CBO score be available at least 72 hours before consideration. That is a commonsense idea and I think kind of a minimal idea, actually. A 1,900-page bill came out of the House-- 1,900 pages. Yet they are talking about a vote on that next week. I think most people would say: What is the rush? But we should at least get 72 hours, with a score, so we could talk to the American people about what is in the bill and what is not. This leads me to the next piece of what I wished to talk about today, and that is taxes. A signature promise of the President's campaign was no taxes on families making under $250,000. Wow. What an important promise to the middle class. Let's look at the taxes in the Finance Committee's bill. There are over $500 billion of new taxes and fees. That is a very big number. Who is going to be hit with that? We have had studies done on it. The Joint Committee on Taxation analysis says this. It concluded that for 2019, roughly 77 percent of these taxes will be borne by middle-class tax payers; three quarters of the tax burden falls on those the President promised would not be impacted with higher taxes. What are the taxes? For anyone with a higher priced insurance plan, a 40-percent excise tax will be passed through to the worker. Higher health care costs, lower wages, I think. Any taxpayer who refuses to buy government-approved insurance will be penalized. These numbers could change, but right now it looks like $750 for singles and $1,500 for couples. The CBO says this: Almost half of those paying this penalty tax would be between 100 percent and 300 percent of the Federal poverty level--or a family of 4, earning $22,800 and $68,400 in 2013. Clearly they are in the middle class. Clearly they are under $250,000. Call it what you will, to the people paying this, to them it will be a tax. If you do buy insurance, prepare to be taxed by the new insurance industry fees. If you use a medical device, you will get hit with a new medical device fee. If you contribute more than $2,500 to a Flexible Spending Account, your taxes go up. Many taxpayers who purchase over-the-counter medicine will now see them taxed. Taxes and transparency--two issues. I will continue, in the weeks ahead, as will my colleagues, to discuss the dangers of health care reform done wrong. Health care reform is needed, no doubt about it, but not rushed legislation with no transparency and so many new taxes on the middle class. I will wrap up with this. I think overhauling 16 percent of the economy is too important to do fast and to not do right, so I respectfully suggest that we take the time to do it right and honor the pledges made. I yield the floor.