Jon Kyl

Mr. KYL

Mr. KYL. The following Senators are necessarily absent: the Senator from Arizona (Mr. McCain) and the Senator from Virginia (Mr. Warner).

Mr. KYL. Mr. President, I ask unanimous consent the agreement be amended by also providing that Senator Judd Gregg would follow Senator Klobuchar.

Mr. KYL. Mr. President, it will only take me 5 minutes to describe this amendment. If we need to have debate about it later, we can certainly do that. This is an amendment to the bill. The bill, recall, provides for an authorization of $50 billion over 5 years. If you divide $50 billion by 5 years, you get $10 billion a year. All my amendment does is to provide that, at least in the last year of the 5 years, the appropriation to fill the authorization would be limited to $10 billion. If it were more than that, there would be a point of order that would lie against that. The reason for the amendment is twofold. First, the House of Representatives provides for an annual authorization of $10 billion per year for 5 years. The Senate bill doesn't break it down that way. We are open as to that. I am not trying to limit what the appropriations would be during years 1 through 4, but what I am saying is the fifth year would be $10 billion, exactly one-fifth of the amount authorized. The second reason is this. Frequently in the reauthorization of legislation we take as the baseline the last year of appropriations. I want to make sure if we are authorizing $50 billion that when we get to the end of this, the baseline for the next year is at least not going to exceed $10 billion, which would be one-fifth of the $50 billion. It turns out under the existing program we have not limited ourselves to that degree of discipline. The existing law authorizes $15 billion over 5 years. You would think that would be $3 billion year. If you think that, you would be wrong. What the Appropriations Committee has done is to appropriate more money than that authorized. In the last year, the current year, for example, there is about $6 billion that has been appropriated as a result of which, over the 5-year period, the total amount appropriated is just under $20 billion. That is $20 billion appropriated for a $15 billion authorization. All I am trying to do is to keep us honest here. If we are saying this is going to be a $50 billion authorization--I think that is way too much money--let's leave it at $50 billion. All my amendment does is to say in the last year, the appropriation to fulfill that would be limited to $10 billion. I think that is eminently reasonable. To those who say, ``We are going to oppose all amendments to the bill, let's just do it the way it was written,'' I say think for a moment. You are going to make people feel a lot better about this if there is some discipline in our spending in furtherance of the authorization. There is some degree of skepticism, at least by some on my side, that Congress will restrain itself to the level of authorization. This amendment doesn't go as far as the House in setting an amount every year, but it does at least set an amount for the last year. Theoretically, we could appropriate more than $50 billion. In the first 4 years you could appropriate $12 billion a year. This amendment doesn't prevent that. But I do want to say in the last year we confirm the discipline of limiting it to $10 billion. That is the extent of my amendment. I hope my colleagues will approve it. We don't need a great deal of debate time, as far as I am concerned. If somebody wants to argue against it, I wish to have the last word and then have a vote on it as soon as is agreeable to the Members on the other side.

Mr. KYL

Mr. KYL. Mr. President, reserving the right to object, Senator Grassley, on our side, is responsible for this. I am waiting to consult with him. I would ask my colleague to wait a moment on that request, and we will see if we can find Senator Grassley.

Mr. KYL. Mr. President, if we can have the time run----

Mr. KYL. Mr. President, if Senator Grassley arrives, I will defer to him, but let me make some comments. It is distressing that the effect of this bill has been misrepresented to the extent it has. There have been some very wild claims that this has to do with killing Medicare, that it has to do with punishing America's doctors, that it has to do with hurting America's seniors. This is not the language of a reasoned debate of the Senate. The bill has nothing to do with any of those things, and all my colleagues know that. Let me describe why we are where we are today. I will take a minute to remind everyone of the promise we made to America's seniors 5 years ago. The 2003 Medicare Modernization Act achieved two very important goals. The first was to provide comprehensive drug coverage, prescription drug coverage, a very important benefit for America's seniors. Secondly, to explain private health plan choices, similar to the options available to Members of Congress and other Federal employees. We wanted America's seniors--the Medicare patients--to have the same kind of private health insurance options for Medicare that all of us have. Today, as a result of this plan, somewhere in the neighborhood of one-fourth of America's seniors have taken advantage of this private insurance alternative to traditional Medicare. From the beginning, I know a lot of people on the other side of the aisle didn't like that. They wanted a one-size-fits-all program, one program. Republicans said we need more choices. Seniors have been happy with the prescription drug benefit and with those choices. The problem with this bill is it cuts both the choices for America's seniors and negatively impacts the prescription drug coverage. That is why Members on this side of the aisle have said they would like to see an opportunity to amend the bill, to try to fix the bill, to have a bipartisan bill instead. But, no, we were jammed--not once, twice, but three times: Take it or leave it. It is the partisan approach, despite the fact that the chairman and ranking member negotiated a bipartisan bill in good faith. Nonetheless, we had to revert to a strictly partisan approach. That is what this was all about. It was never about covering the physicians to make sure they didn't take a pay cut. I doubt that there is any Senator who doesn't support the 1.1-percent increase in physician reimbursement, an increase for physicians who treat Medicare patients. We all support that. It was in the Grassley proposal, it was in the Baucus proposal, and it was in the bipartisan Grassley-Baucus proposal. So this was never about that. None of the Republicans ever opposed providing the physicians their update. It had to do mostly with an attempt that has been undertaken for many years to undercut the private insurance part of Medicare that many on the other side of the aisle have never liked. It is one of the signature achievements of the Bush administration, and it is no wonder that the President vetoed the bill because of the fact that was hurt. First of all, according to the nonpartisan CBO, as a result of this bill, 2.3 million seniors will be removed from their private coverage option under Medicare. That is one of the effects of this bill. Instead of all the scare tactics you have heard, I can honestly say that voting for this override of the President's veto will result, according to the CBO, in the removal of 2.3 million American seniors from this private health care option. That is not a good result. Here is what the President's veto message personally said today: . . . the provisions that would enable the expansion of protected classes of drugs would effectively end meaningful price negotiations between Medicare prescription drug plans and pharmaceutical manufacturers for drugs in those classes. If, as is likely, implementation of this provision results in an increase of a number of protected classes, it will lead to increased beneficiary premiums and copayments, higher drug prices, and lower drug rebates. That is the second pernicious effect of the bill. It will undermine the Medicare prescription drug plan's ability to negotiate good drug prices for seniors. I know some on the other side were always skeptical of the ability to bring down drug prices. In fact, the Medicare Part D has reduced them precisely because of this competition in the market. This bill partially eliminates that competition. That is the reason some of us oppose the bill, and they are good and legitimate reasons. I believe the President was correct to veto the bill because of these provisions. Five years after the Medicare passage, we are rewinding the clock, chipping away at the very plan choices and prescription drug coverage that seniors asked us to provide. These are not pro-patient policies. Rather, the bill reduces access, benefits, and choice for Medicare beneficiaries. In conclusion, it was a very flawed process. As we know, there was an attempt at a bipartisan solution. There are 51 Democrats and 49 Republicans. You would think that Republicans could have a say in writing the legislation. But, no, that was not to be. We were required to deal with the take-it-or-leave-it proposal of the majority. Twice the majority walked away from these bipartisan negotiations I talked about before. When we tried to suggest, at a minimum, that we should extend existing law so that doctors would not see the reduction in their payments, we were told it was a ``phony exercise.'' It was, in fact, a good-faith effort on our part to ensure that physicians would be protected. As I stated earlier, I support the need for a positive physician update. We all do. I know physicians in Arizona know I mean that when I say it. I have led the fight for this in past years. However, I am strongly disappointed that the Senate was blocked from a bipartisan solution, and I regret that seniors, as a result, will suffer if this legislation is adopted.

Mr. KYL. Mr. President, I never said there was a rate reduction. I said all Senators, I suspect, on both sides support not having a 10.6- percent cut in physician fees and that we all support the 1.1-percent positive update. That was never the issue. The issue had to do with the other items I talked about. The fact that 2.3 million seniors will lose their private coverage option has to do with the way that the Medicare Advantage Program was used as an offset to pay for the additional benefits in the bill as a result of which CBO claims and believes--and I believe they are probably correct--that 2.3 million seniors will lose their private option coverage.

Mr. KYL. The following Senators are necessarily absent: the Senator from Arizona (Mr. McCain) and the Senator from Virginia (Mr. Warner).

Mr. KYL

Mr. KYL. The following Senators are necessarily absent: the Senator from Tennessee (Mr. Alexander), the Senator from Tennessee (Mr. Corker), and the Senator from Arizona (Mr. McCain). Further, if present and voting, the Senator from Tennessee (Mr. Alexander) would have voted ``nay.''

Mr. KYL

Mr. KYL. Mr. President, I wish to pay tribute to my late colleague, Senator Jesse Helms of North Carolina. Other Senators have spoken at length in remembrance of our friend, recalling the man and his many accomplishments in this body. It was wonderful to hear the tributes by friends and family at his services in Raleigh, NC. It was my good fortune to come to the Senate when Senator Helms was leading a lot of fights for a strong America. Senator Helms took charge of the Foreign Relations Committee at the same time I arrived in the Senate. From that perch as chairman, he steadfastly defended the Nation's interests. Senator Helms relished defending his principles, and I am sure he enjoyed his victories. One such victory in this body is of particular note to me, for I was privileged to play a part in it. In 1999, in Senator Helms's fifth and final term in office, the Comprehensive Test Ban Treaty was before the Senate, and it was poised for ratification. But, with his support and blessing, I helped secure the votes to defeat the treaty, and it fell far short of the two-thirds vote that had at one time seemed assured. That is but one of the many victories for U.S. national security in which Jesse Helms was involved in his three decades in the Senate. Senator Helms fought some of most contentious and courageous fights in the Senate on issues of profound significance. Yet even when the stakes were so high that they involved preserving and safeguarding this Nation, Senator Helms remained unfailingly courteous. He held to his principles even when they were not popular, but he did so in a way that did not damage friendships. My wife Caryll and I offer our sympathies to Jesse's wife Dot and their family. Senator Helms took the positions he judged to be right and he didn't flinch. He was a kind and gentle man who deeply believed in his country, his family, and his God.

Mr. KYL

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

Mr. KYL. I ask I be allowed to speak in morning business for 30 minutes.

Mr. KYL. Mr. President, I want to speak about the bill which we had hoped to have taken up by now, the PEPFAR Reauthorization Act. Because of some procedural questions, we are not on the bill right now, but I thought I would utilize this time to make some remarks about the bill which I hope we will be able to begin dealing with in the not too distant future. This bill is called PEPFAR, as I said, but that stands for the President's Emergency Plan for AIDS Relief. It is a program that President Bush brought to the Congress in 2003 and was enacted. It authorized $15 billion over a 5-year period for the purpose primarily of supporting the treatment of AIDS in Africa and elsewhere. Between 2004 and 2008, according to the Bush administration, PEPFAR has supported a cure for about 10 million people infected by HIV/AIDS, including children orphaned by AIDS. It prevented 7 million new HIV infections. It supported efforts to provide support to another 2 million HIV-infected people. As a result, I think when the President indicated in his State of the Union speech that he wanted to reauthorize the program, most of us in the Congress, in the House and in the Senate, were supportive of that. I supported the initial legislation and fully intended to support the reauthorization. There is one little catch. When the President made his announcement, he offered to double the amount of the authorization from $15 billion to $30 billion. I swallowed rather hard because doubling the amount is a big change in the amount of money available, but I assumed I would be able to support the reauthorization of the bill. However, when the bill was written in the House of Representatives and then sent over to the Senate, two things happened. First, one of the things that made the legislation effective in the first place was that we had several conditions attached to it as to how the money would be spent. We were very careful to ensure that the money was spent appropriately. That is one of the reasons it has been effective. And, secondly, when the bill was written in the House of Representatives, lo and behold, it was not doubled from $15 to $30 billion, it was more than tripled to $50 billion. Now, there was not anything magical about $50 billion; it seemed like a nice, round, symbolic number. As a result, several of us at that point said: Wait a minute. That is a lot of money. In Washington when a program doubles, that is something. When it more than triples, it bears some looking into. Because of many of the problems with the substance of the bill, as well as this tripling of the amount from $15 to $50 billion, several of us began to take a harder look at it. Then, as the gas crisis hit, the housing crisis hit, and we find that more and more Americans are feeling the real pinch of a downturn in our economy, the question began to solidify: Should America be committing to spend $50 billion on this program, which at $15 billion was quite successful, without at least considering whether we can reduce the amount and certainly taking a look at the substantive provisions of it to see if it can get back to the original purpose rather than some of the expanded purposes under the House bill. That is why several of us said, when the bill came through the Senate Foreign Relations Committee: We object to simply passing the bill out of the Senate without any opportunity to amend it, certainly without any opportunity to reduce the amount of it and without an opportunity to fix it. I know some of us were criticized. But I would hope that when we talk about some of the changes that have already been agreed to, those who were critical of us who said: No, we are not going to automatically pass it, would at least acknowledge there have been numerous improvements in the bill because of the negotiation process which ensued. I wish to particularly thank Senators Coburn, Burr, and Enzi for working on several provisions of the bill and, frankly, restoring the original purpose of PEPFAR in the process. They did a good job. Let me note two or three of the areas with which I think they did a good job. One key to PEPFAR working in the first place was that at least 55 percent of the funding had to go directly to the treatment of AIDS patients. That was a good thing. Once the House said: No, we can spend this money on other things, too, you could see the same kind of problems with some other foreign aid bills, where money is going to governments or NGOs and you never see it again. As a result, what Senators Coburn, Burr, and Enzi did was say: Look, we need to get back to the proposition that at least half the bilateral AIDS funding is spent on treatment, for treatment for HIV/AIDS. That, in fact, was agreed to. But I would note, again, that the original House and Senate bills proposed simply eliminating that treatment floor. Another thing they negotiated was to strengthen the protection of funding for abstinence and fidelity programs, clarifying that 50 percent of any funding had to go to those kinds of programs. I would note, again, that the original House and Senate bills eliminated the requirement in the previous law that a third of the prevention funds would go to abstinence education. Another thing that they did to make the bill better was to protect faith-based groups and others from discrimination in all funding. Again, the House and Senate bills had very weak conscience clauses, so- called conscience clause provisions. This was, again, an improvement of the bill which would not have occurred if we had simply agreed to the unanimous consent that we pass the bill that had been posed earlier and that some of us had objected to. To some extent, it strengthens the Global Fund transparency and accountability. This is an area that needs additional strengthening. But there is a part of this bill that is not the bilateral U.S. money, it goes into this big Global Fund. And the Global Fund is not well monitored. It is very possible for our funding to be wasted as a part of that. Again, there was nothing in the original House and Senate bills on this and they at least got some strengthening of the Global Fund transparency and accountability provisions. Another provision was to protect AIDS patients from substandard medicine, which again was not in the original language. There were other things. My point is that when those of us objected originally to passing the bill as it came out of the House, we were criticized: Well, this is a perfect bill, we were told. It turns out it was not so perfect after all. That is point No. 1. Point No. 2, there are some additional things which should be done to the substance of the bill. Point No. 3 deals with the amount of money that is being spent. Here are some of the remaining areas that are problematic: The bill would not prohibit funding for countries such as China, Russia, and India, countries that are quite wealthy, that have their own nuclear weapons and space exploration programs. Russia is awash in petrodollars. China has hundreds of billions of dollars in its foreign currency reserve, has an exploding military budget, and so on. So, certainly, we ought to limit the funding of the bill to countries that actually need the money. Secondly, it adds a variety of lower priority programs to spend the extra money above the $15 billion, including--well, I am not going to mention all of these, but educating males about the dangers of visiting prostitutes. That is a fine thing, but is that a priority that we need to spend this money on? Addressing the inheritance rights of women and orphans. There is money in here for legal aid and the like, legal aid services. There is mission creep in the new legislation. It calls for PEPFAR dollars to support nutrition programs, drinking water and sanitation and income-generation activities and livelihood activities--legal services, as I said. All of these might be fine, but this is not the PEPFAR program, this is foreign aid. There are not any kind of constraints on this mission creep that ought to be in existence if we are going to authorize this kind of money for it. The bill diverts funding from AIDS treatment for other purposes. I mentioned legal services and substance abuse and so on. It doubles the funding for the U.N.-affiliated Global Fund, which disregards U.S. policies on positions such as abortion and needle exchange and has been linked to funding for corrupt and criminal regimes. It strikes current law regarding the inadmissibility into the United States of HIV-positive aliens. It calls for a strategy and objective over the next 5 years with these funds to train and hire 140,000 new nurses and other health care professionals in these countries. This at a time when the United States is drastically in need of health care professionals and nurses. We are wealthy and can afford to be a very generous country, but we also have needs in this country. I mentioned the water development projects and so on. I happen to be familiar, and Senator Thune has offered an amendment on this, with the needs in the United States of America for water development in our Native American communities, on Indian reservations. There is a study out right now that demonstrates the need that many, thousands of our Native Americans have to rely on water being hauled to their communities, which they then take to their individual hogans or residences. We need water development right here in the United States for American citizens, and I might add to whom we have a trust responsibility, at least as a priority before we send money abroad for folks who do not fall into that same category. The final point I wished to make is that this legislation, at $50 billion of authorization, is more than we can afford. The Congressional Budget Office, in fact, says that if it is authorized at $50 billion, we cannot efficaciously spend more than about $34 billion. In other words, it is very hard to spend that much money, at least to do so without a lot of waste, fraud, and abuse. As a result, even the Congressional Budget Office, the nonpartisan entity that we ask for advice on such things, said we could not spend more than $34 billion in that event. As I said, $50 billion is the amount of the authorization here. To put it in perspective, what is $50 billion? What could we spend $50 billion on? We passed a new GI bill. It could pay for the GI bill twice. It could pay for the Apollo Program to land a man on the Moon twice. It could pay for about half the entire interstate defense highway system. It could pay the pensions of our military veterans for over a year. Now, $50 billion is a lot of money. As I said, I do not know of anybody who would not be willing, especially if we are able to clean up some of the other language in the bill, to authorize it at $15 billion, maybe to even double it to $30 billion, but $50 billion? I note President Bush has, at least in more recent months, begun to focus on the wasteful Washington spending, the programs he believes spend too much money, and to put some fiscal discipline on the Congress. In fact, since the Democratic Party takeover of the Congress, the President has threatened to veto more than 25 authorization and appropriations bills. This amounts to about $188 billion in spending because of his view that this is excessive beyond what the American taxpayer can be burdened with. I will note a couple of those. But it illustrates where the President has been willing to say: I am going to veto a bill. That is his ultimate authority here. In the case of the Labor-HHS 2008 Appropriations Act, the President would have vetoed the bill by exceeding his request by $9 billion. Now, this is $35 billion more than the previous funding, $20 billion more than the President announced in his State of the Union speech that he would be willing to reauthorize the bill at. He would have vetoed $2.3 billion beyond the budget in the Commerce State and Justice Appropriations Act in 2008; $2.2 billion in the Department of Homeland Security Appropriations Act. Then, for some authorizations--because this is an authorization, not an appropriation--the Water Quality Financing Act, H.R. 720, which authorizes Federal spending for State clean water revolving funds, that bill would have been vetoed for providing $14 billion in excess above the current $5.6 billion authorization. I know many of my colleagues have said a $50 billion authorization for PEPFAR is not a big deal because it is only an authorization, not an appropriation. But that certainly was not the position of the administration when it threatened to veto this bill that was over $14 billion more than what the President wanted, or H.R. 1495, the Water Resources Development Act, which authorized water infrastructure projects. That bill was vetoed for going about $7 billion over what the President had authorized or had budgeted. So it is kind of difficult to understand how the administration or my colleagues can support more than tripling a foreign aid program by spending $50 billion on PEPFAR when the administration was so keen, and I believe correctly so, to finally put the stake down in the ground and say: I am going to veto legislation that is $2 billion or $3 billion or $7 billion over what it should be, including authorizations. As I said before, we are very wealthy and therefore should be and can be a very generous country. But we also have to establish our priorities. Changing this legislation and tripling the money is not necessarily going to make it triply effective. In fact, if anything, as I said, I think it is going to make it less effective. I make this point: We have now an American economy which is struggling and American families who are struggling with their budgets. They do not need additional liabilities, either in terms of taxes or more debt, which they and their children and grandchildren are going to have to pay. Someone has to pay for the $50 billion. I do not know where the money is going to come from. Are we going to take it from other spending? Not likely. Are we going to increase taxes to pay for it? Quite conceivably. Or are we going to add it to the deficit? That is the only other choice. So $50 billion does not grow on trees. It is very easy to be generous with other people's money. But we are talking about the taxpayers' money. I think, when we are taking about taxpayer money, we need to be good stewards of it. More than tripling a program to get it up to $50 billion in foreign aid is more than I think most Americans--if you put the question to them and said: Is this what you want to do with $50 billion of your money, I would bet you the vast majority of Americans would say: Look, we are willing to be generous, provide something for that program but not $50 billion. That brings me to my final point. In prioritizing, and that is what Congress needs to do, prioritizing what we spend our money on, we have to look at our domestic needs as well. I have supported some increases in funding for years on programs that I think are very important. The answer has always been: Well, there is not enough money. We would love to help you out, Senator Kyl, but there is not enough money. OK. Now we have gone from $15 billion to $50 billion that we are ready to spend on PEPFAR. So, clearly, the majority around here has decided, along with the administration, that we can afford to spend $50 billion on something. My approach would be to say: OK, if we have decided we can afford to spend $50 billion, why don't we only spend part of that on PEPFAR, and why don't we spend part of it on America for what we know are top priorities? We have already decided we can afford to spend $50 billion. How about some priority for American spending as well? I can think of a lot of things that almost all of us would agree upon as good projects for spending some of this money. I mentioned before the fact that the U.S. Government has a trust responsibility to Native Americans in this country. We have an obligation to help them pay for what is important to them. Health care. We passed an Indian health care bill. So I asked: Are there additional health care needs? Well, mostly they were taken care of thanks to Senators Murkowski and Dorgan in the Indian health bill, which I was happy to support. There are two other needs on Indian reservations that are drastic, emergencies, and an embarrassment in that we in the Congress are not able to meet these requirements for the Native American population. Yet we are willing to spend $50 billion on this foreign aid program. This trust responsibility includes public safety and drinking water. There are Federal Government reports that identify needs in both of these areas. As a result, Senator Thune and I have an amendment which would designate $2 billion--$1 billion for public safety, $1 billion for drinking water--for Indians on reservations. Is that too much to ask, out of $50 billion, that we take $2 billion and authorize programs for public safety and water development on Indian reservations? To me, this would be a better prioritization of funding. I mentioned reports. There is a 2004 report by the Department of Interior inspector general. Here is what it says in part: That some Indian detention facilities were egregiously unsafe, unsanitary, and a hazard to both inmates and staff. BIA's detention program is riddled with problems and is a national disgrace. A recent 2008 Department of Interior study, called the Shubnum report, confirms that tribal jails are still grossly inefficient and says: [O]nly half of the offenders are being incarcerated who should be incarcerated, the remaining are released through a variety of informal practices due to severe overcrowding in existing detention facilities. Life and safety of officers and inmates are at risk for lack of adequate Justice Facilities and programs in Indian Country. It goes on to recommend that we construct or rehabilitate 263 detention facilities at a cost of about $8.4 billion over the next 10 years. So there is a need identified for American citizens. What the Thune-Kyl amendment asks is that we take a billion out of PEPFAR and apply it to this $8.4 billion need. I have personally visited detention facilities in Arizona. I have witnessed firsthand their deplorable conditions. The Navajo Nation, to mention one, in New Mexico, Utah, and Arizona is about the size of the State of West Virginia. It has a population of more than 180,000 people. In fact, it is over 200,000, if you count all of them. Yet a number of its detention facilities have been closed for health and safety reasons. It has bed space--this place, the size of West Virginia--for 59 inmates. That is to serve a total of over 50,000 inmates booked in its facilities in 2007. I think everyone would agree this is a deplorable state of affairs. This represents only a fraction of its needs. There is much more we can discuss. When people are released, it is impossible to protect the people of the community. Let me briefly turn to water. The managers' amendment to S. 2731 includes assistance to foreign countries for safe drinking water and adequate sanitation. This is supposed to be an AIDS bill. Why are we providing drinking water facilities abroad? I concede that they are a good thing to do, and there is a need for them, but when there is a very big crisis in our country, primarily involving people to whom we have a trust responsibility, why aren't we prioritizing funding for those projects? According to the Indian Health Service, safe and adequate water supplies and waste disposal facilities are lacking in approximately 11 percent of American Indian and Alaska Native homes compared to 1 percent for the U.S. general population. In some areas of Indian country the figure is as high as 35 percent. In Arizona, the Navajo Nation estimates that approximately 30 percent of the households on the reservation do not have direct access to a public water system and are forced to haul water long distances to provide drinking water. I have seen it. They have water trucks, and they fill them at some central location. They come to another central location. People drive up in their pickup trucks and fill their gallon jugs and barrels, take them back to their hogans, and so on. That is in the United States today. If we have decided that we can afford to spend $50 billion on something, starting with a $15 billion AIDS program, then why not double that to $30 billion, as the President originally proposed, and spend some of the rest of the money on American requirements? This lack of a reliable potable water supply in Indian country results in a high incidence of disease and infection as a result of waterborne contaminants. IHS estimates that for every dollar it spends on safe drinking water and sewage systems, it achieves a twentyfold return in terms of health benefits. The cost to provide American Indians and Alaska Natives with safe drinking water and adequate sewage is estimated to be over $2.3 billion. Delivering water to the people within the tribe would be several billion on top of that. These are priorities in the United States. I wouldn't be raising it except for the fact that there seems to be an assumption that we can afford to spend $50 billion. My point is, if we can afford to spend $50 billion, let's at least take a little bit of that money and spend it on Americans. In conclusion, I supported PEPFAR when it was authorized 5 years ago. Because of its success, I would vote to extend the original funding policy for another 5 years. I would even consider the doubling which the President had asked for in his State of the Union speech. For the United States to have the resources to continue funding U.S. Government responsibilities both to our citizens and to be generous with others around the globe, we need a strong economy that creates wealth. I can think of a lot of things we could do with part of this $50 billion to improve our economy so that we will be better able to help others in the future. I have discussed some of them. I will continue to work to improve this bill. It will take some time in this body, but I think it is worth moving forward. I hope we will be able to move forward on the 10 amendments we have agreed to. I won't describe all of the amendments. They have been described. One of them I have mentioned Senator Thune and I will offer. I hope we will have a process by which we consider these things; that my colleagues will be open to their adoption, and at the end of the day, when we do pass a PEPFAR bill, it will be a bill we can all be proud of that will meet the purposes of the original legislation, that will not waste American taxpayer dollars, and that will prioritize American needs as well as those with respect to foreign aid programs. I yield the floor.

Mr. KYL. Will the assistant minority leader yield for one quick point?

Mr. KYL. Having mentioned my name and alluded to the fact that we had a hard time getting the Indian health bill to the floor, I hope my colleague would acknowledge the fact that one of the people central in getting that bill to the floor and getting it passed was the Senator from Arizona. It was because of my strong commitment to get that done. I will work with anybody, not only to deal with the Indian health matter but also local law enforcement and the water development problems that we talked about with Native Americans. I know my colleague understands that is my position.

Mr. KYL

Mr. KYL. The following Senators are necessarily absent: the Senator from Tennessee (Mr. Alexander), the Senator from Colorado (Mr. Allard), the Senator from Missouri (Mr. Bond), the Senator from Kentucky (Mr. Bunning), the Senator from Georgia (Mr. Chambliss), the Senator from Oklahoma (Mr. Coburn), the Senator from Minnesota (Mr. Coleman), the Senator from Tennessee (Mr. Corker), the Senator from Texas (Mr. Cornyn), the Senator from Idaho (Mr. Craig), the Senator from South Carolina (Mr. DeMint), the Senator from Nevada (Mr. Ensign), the Senator from New Hampshire (Mr. Gregg), the Senator from Nebraska (Mr. Hagel), the Senator from Texas (Mrs. Hutchison), the Senator from Oklahoma (Mr. Inhofe), the Senator from Florida (Mr. Martinez), the Senator from Arizona (Mr. McCain), the Senator from Alaska (Ms. Murkowski), the Senator from Alabama (Mr. Shelby), the Senator from Alaska (Mr. Stevens), and the Senator from Lousiana (Mr. Vitter). Further if present and voting, the Senator from Minnesota (Mr. Coleman) and the Senator from Tennessee (Mr. Alexander) would have voted ``yea.'' Further, if present and voting, the Senator from Kentucky (Mr. Bunning), the Senator from South Carolina (Mr. DeMint), and the Senator from Texas (Mr. Cornyn) would have voted ``nay.''

Mr. KYL

Mr. KYL. The following Senators are necessarily absent: the Senator from Tennessee (Mr. Alexander), the Senator from Colorado (Mr. Allard), the Senator from Missouri (Mr. Bond), the Senator from Kentucky (Mr. Bunning), the Senator from Georgia (Mr. Chambliss), the Senator from Oklahoma (Mr. Coburn), the Senator from Minnesota (Mr. Coleman), the Senator from Tennessee (Mr. Corker), the Senator from Texas (Mr. Cornyn), the Senator from Idaho (Mr. Craig), the Senator from South Carolina (Mr. DeMint), the Senator from Nevada (Mr. Ensign), the Senator from New Hampshire (Mr. Gregg), the Senator from Nebraska (Mr. Hagel), the Senator from Texas (Mrs. Hutchison), the Senator from Oklahoma (Mr. Inhofe), the Senator from Florida (Mr. Martinez), the Senator from Arizona (Mr. McCain), the Senator from Alaska (Ms. Murkowski), the Senator from Alabama (Mr. Shelby), the Senator from Alaska (Mr. Stevens), and the Senator from Louisiana (Mr. Vitter). Further, if present and voting, the Senator from Kentucky (Mr. Bunning) and the Senator from Texas (Mr. Cornyn) would have voted ``nay.'' Further, if present and voting, the Senator from Tennessee (Mr. Alexander), the Senator from Minnesota (Mr. Coleman), and the Senator from Tennessee (Mr. Corker) would have voted ``yea.''

Mr. KYL

Mr. KYL. The following Senator is necessarily absent: the Senator from Arizona (Mr. McCain).

Mr. KYL. The following Senator is necessarily absent: the Senator from Arizona (Mr. McCain).

Mr. KYL

Mr. KYL. The following Senator is necessarily absent: the Senator from Arizona (Mr. McCain).

Mr. KYL

Mr. KYL. I think the majority leader will agree with this. When the majority leader speaks of accepting amendments, it is not a matter of accepting an amendment to the bill.

Mr. KYL. But rather agreeing to allow an amendment to be offered, debated and voted on.

Mr. KYL. Mr. President, I do object on behalf of Senator DeMint. Let me make a very brief statement. The distinguished majority leader is correct. It is almost 11:30 this evening, and we have been working since about 3 o'clock this afternoon to try to reach agreement on how to proceed with this very important bill. We have made a lot of progress. A lot of Members have been willing to make concessions to try to limit the number of amendments that would be considered so this bill could be completed sometime next week. But we haven't worked out everything. Unfortunately, because everything hasn't been worked out at this late hour tonight, it wasn't possible for us, one of our Members, to agree to this particular request. The majority leader is correct about how we will have to proceed as a result. It is my strong hope that because this is a very important piece of legislation--Members have different views about aspects of it--an agreement could be reached by which an appropriate number of amendments could be considered and debated and voted on next week and the bill finally disposed of at a point next week. There is a fairly constructive way to do this, and then there is a way to do it that isn't as constructive. So I appreciate the effort the majority leader and others have put into this tonight. It would be my hope that in that same spirit, we can continue to talk about this tomorrow and hopefully reach an agreement we would be able to proceed with in order to complete the bill sometime next week.

Mr. KYL. Mr. President, might I make a point of clarification?

Mr. KYL. No, No. I knew the Senator would want to be clear on that. There are some nonrelevant or nongermane amendments that have been proposed. It is certainly understandable that the majority would not want to have those amendments considered as a part of the debate. For those amendments, however, that are relevant to the subject matter at hand, that is what most of the discussion has been about, and we are hoping at the end of the day an arrangement can be agreed to where those amendments could be considered by the Senate, debated, voted upon, maybe rejected, but at least the Members would have had an opportunity to vote on the amendments, and, as I said before, and, as the majority leader said, to conclude the bill then sometime next week.