Barbara Mikulski

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, today I wish to thank LTG Emerson Gardner, Jr. for his outstanding service to our great Nation and to congratulate him on the occasion of his retirement. Lieutenant Genera Gardner hails from the great State of Maryland and next week he will retire from the U.S. Marine Corps after 37 years of faithful and superb service. Duty, honor, country--the Marine Corps motto--are not just words to him. I am so proud of General Gardner's accomplishments and service and would like to share a bit more about this great marine. Lieutenant General Gardner is a 1973 cum laude graduate of Duke University. He was named an Olmsted Scholar in 1978 and studied history and political science for 2 years at Goettingen, Germany. He is a graduate of The Basic School, Defense Language Institute, Marine Corps Command and Staff College, Armed Forces Staff College, the Norwegian Defense College and the National Security Leadership Course at the Maxwell School of Citizenship and Public Affairs at Syracuse University. As a distinguished naval aviator, Lieutenant General Gardner served as a helicopter pilot in all three Marine air wings. He was hand-picked to serve as a White House liaison officer and Presidential helicopter command pilot for President Ronald Reagan. As commanding officer of HMM-261, Lieutenant General Gardner led the Raging Bulls in Operation Sharp Edge, the evacuation of Liberia, and into major combat operations during Operations Desert Shield and Storm. It is also important to note that during his career, he has accumulated more than 4,300 flight hours in most of the aircraft currently in the Marine Corps inventory. Lieutenant General Gardner also served as one of seven Marine Expeditionary Unit commanders in the world. As the commanding officer of the 26th Marine Expeditionary Unit, Special Operations Capable, he led Operation Silver Wake, the noncombatant evacuation, NEO, of Albania, Operation Guardian Retrieval, contingency support for a NEO of Kinshasa, Zaire and Dynamic Response, the first employment of SACEUR's Strategic Reserve into Bosnia. Lieutenant General Gardner has served as G-3 current ops officer with the 9th Marine Amphibious Brigade in Okinawa, deputy G-3 for II Marine Expeditionary Force and as the J-3, operations officer, for the Standing Joint Task Force, MARFORLANT. He was also the assistant chief of staff for operations and logistics at Allied Forces Northern Europe at Kolsas, Norway and at Allied Forces Northwestern Europe, in High Wycombe, England. Soon after this assignment, he served as assistant deputy commandant for aviation at Headquarters Marine Corps, Washington, DC. His tour as the deputy commander of U.S. Marine Corps Forces, Atlantic included extended temporary additional duty as the deputy J-3 for current operations at U.S. Central Command in support of Operation Enduring Freedom. General Gardner served as the director for operations, J3 at U.S. Pacific Command, the deputy commandant for programs and resources at Headquarters, Marine Corps and currently as the director for cost assessment and program evaluation for the Secretary of Defense. With such an honorable and distinguished career, it is only fitting that I share with you his long list of military awards and decorations which include the Defense Distinguished Service Medal, multiple awards of the Defense Superior Service Medal, Legion of Merit, Defense Meritorious Service Medal, Meritorious Service Medal, Air Medal, Navy Commendation Medal and the Presidential Service Badge. Under Lieutenant General Gardner's guidance, the Marine Corps expanded its personnel and strengthened its readiness. He led the Marine Corps' efforts to acquire MRAPs and other vital equipment so needed by our marines, soldiers and airmen in Iraq and Afghanistan. As a result of his work, the force has never been stronger and it is his honesty and integrity which both his subordinates and superiors admire. Anyone who knows General Gardner knows of his commitment to lead and mentor young marines, his dynamic and persuasive personality, his careful, thoughtful and precise preparation of all things--mission or brief--and of course, his steadfast and unwavering dedication to the men and women serving in the U.S. Marine Corps. The history of our great Nation is comprised of men, just like General Gardner, who have so bravely fought for the ideals of freedom and democracy. It is humbling for those of us who, far from the dangers they have faced, live our lives in relative comfort and ease. Today our country owes General Gardner, as well as his wife Vivian, and children Phil, the oldest Nick, a corporal in the Marine Corps who served in Iraq, Christian, a lance corporal who will deploy to Afghanistan in June as a Marine Corps sniper, and Marc who wants to be an engineer, our warmest of thanks and deepest appreciation for all that they have done. I offer my sincerest gratitude for his decades of service and I salute LTG Emerson Gardner as he retires from the U.S. Marine Corps. Semper Fi!

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise today to submit a resolution urging the U.S. Postal Service to issue a semipostal stamp to help raise money for Alzheimer's research. A semipostal stamp will fund new research while also raising public awareness about this devastating disease. Finding new ways to treat Alzheimer's should be a national priority. The disease not only harms patients and their families, it strains our health care system as well. Every 70 seconds, someone in America develops Alzheimer's. An estimated 5.3 million Americans have Alzheimer's disease, including one in eight people over 65. The direct and indirect costs of Alzheimer's and other dementias to Medicare, Medicaid and businesses amount to more than $148 billion each year. By 2050, this disease is likely to affect more than 11 million people 65 and older--unless we can find a medical breakthrough. In addition to this resolution, I am also the sponsor of the Alzheimer's Breakthrough Act. The act would increase overall funding for Alzheimer's research at NIH, establish a national summit to identify priorities and maximize resources in our fight for better treatments and a cure, and expand the Alzheimer's State Matching Grant Program. I am hopeful the Senate will pass the Breakthrough Act this year in addition to the resolution I am introducing today. A semipostal stamp is one more way each of us can help in the fight against Alzheimer's. Proceeds from the stamp's sales would fund Alzheimer's research at the National Institutes of Health. By paying more than the normal postage rate for this stamp, the public could contribute directly to the search for a new treatment or even a cure. I ask my colleagues today to join me in the fight against Alzheimer's and support this resolution.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, I come to the floor of the Senate to say to my colleague from Kentucky: Let the unemployment bill go. Let's free the unemployment compensation bill, the bill that will fund COBRA health insurance benefits and put people back to work building highways, and let's pay doctors the fees they deserve for saving lives and improving lives. Of all of the bills in the United States of America, why are we holding up this one? I think it is outrageous, and I think it is egregious. My Lord, look at this. Right now in the United States of America, 400,000 American citizens are not receiving their unemployment benefits. They have been laid off. They have been pushed around. They have been pushed out. And now the Senate will not act to extend their benefits. Then there are the health insurance benefits called COBRA, and 500,000 Americans are not getting that. Who gets COBRA benefits? No, it is not a snake--although there are a lot of snakes around. It means that if you were laid off from a company, you have the opportunity to, with your own money out of your own pocket, be able to buy insurance and get a modest subsidy to help you through this. My gosh, why can't we do this? Then there are the thousands of doctors who are not being paid. There are the highway people who are not being paid. I gave you national statistics, but I am a Senator from Maryland. I want you to know that tonight there are 4,700 unemployed workers in my State who are not going to get their unemployment benefits--4,700 unemployed workers. That is money they could use to provide their families with a safety net for food, housing, heat, and for the expenses and activities of daily living. This isn't just a number. It is not a statistic. We are talking about 4,700 families who won't have a source of income to get them through this very difficult time. Then there is COBRA. Again, COBRA pays 65 percent of the cost of health insurance for people who have lost their jobs. In Maryland, there are 9,282 people--close to 10,000--who have lost their benefits. COBRA makes sure they have health care. We are talking about someone, for example, who worked for a company all of his life, and then he was laid off because it was part of the great layoff that is going on in my State. He went to buy health insurance, and he is buying it through COBRA. It costs almost four times what it cost where he worked. At the same time, he has health problems. He is a diabetic. He is a father. He wants to work and, most of all, he wants to have health insurance for himself and his family. But, oh, no, we are holding it up because of something called pay-go. Then what else are we doing? We are not paying our doctors. Regardless of how one feels about health insurance reform, you can't have health reform without doctors. The opposition to health care reform, like Mr. Boehner, says we have the best health care system in the world. If we have the best health care system, why aren't we paying our doctors what they deserve? These are highly skilled people who work sometimes day and night to be able to save lives or improve lives. They assume the risks of medical management of highly complex cases. Why are we cutting their pay by 21 percent? I don't see those guys over there cutting their pay 21 percent until we figure out how to pay for our salaries. Why are we cutting doctors 21 percent? I am so frustrated about this. Whether it is job reform, health care reform, mortgage reform, in this body, when all is said and done, more gets said than gets done. The American people are as mad as they can be, and they don't want to take it anymore. I feel the same way. I am sick and tired of all these obstruction tactics that prevent people from getting the benefits they need to take care of their families or fund the programs that create jobs. If we are going to have job reform and health reform, I think we need Senate reform. I am old-fashioned. I believe the majority rules. I think 51 ought to be a magic number. I am so tired of the tyranny of the 60. Oh, we need 60 votes--60 votes, a supermajority every time, except for the Pledge of Allegiance. I come back to wanting the majority rule. This is why I stand four square for filibuster reform. I am heart and soul a reformer, sometimes a little too mouthy. Some people say I am a little too feisty. But I want to get the job done. I am ready to duke it out in the arena of ideas, present our best arguments, present our best cases, take a vote, and see how it turns out. I hope when I offer amendments I win, but if I lose because I get less than 51, I feel I have gotten a square deal. But if I have to go after 60, I feel I am inhibited by the tyranny of 60. I believe the filibuster is a dated, arcane tactic that belongs to another century and another Senate. I wish to see the filibuster rule either ended or modified. There are those on our side of the aisle who say: Don't do that. What happens if we lose control, we might need it. Maybe if majority ruled, we would not lose control. Most of all, maybe the American people would see us actually debating, discussing, amending, and voting on ideas. Right now, the other side hides behind procedure. It hides behind process, it muddies the water, and the people are starting to catch on. I am calling on our institution to seriously consider Tom Harkin's legislation. I think Senator Harkin is on to something. Senator Harkin and I are great respecters of the Senate and its traditions. We understand the filibuster and when it was used for great and grand debates on, for example, the expansion of civil rights in our country. Under the Harkin proposal, you would get four shots at it. I think my colleague from Kentucky would like it. He is a baseball icon. You get three strikes and you are out. Maybe we would get four bites at the apple. The first time you vote if you don't get 60, it would fail. The second time you would need 59 votes or it would fail. The third time you would need 57 votes or it would fail. The fourth time, 53 votes and then we would come back to 51. We are not for throwing away the filibuster, but we are for modifying it. Hopefully, it will bring us to a Senate that wants more function as the greatest deliberative body in the world. Now we are the greatest delayed body in the world. We don't deliberate; we delay. We don't do constructive things; we do obstructive things. This is not the Senate the American people want. They want us to debate ideas. They want us to do due diligence on those ideas, to make sure they are sensible, that they are affordable, that we are doing something that accomplishes the great missions of our country. I want, again, majority to rule. I call upon the Senator from Kentucky and the other party: Let this bill go. Bring it out. Please, let us have a vote on it so tonight, when the families in Maryland go to bed, they can be sure that tomorrow when they awaken, their safety net of unemployment compensation is there; that they can buy their health insurance through COBRA, that gifted and talented doctors will know they will be paid and reimbursed and acknowledged for the great services they are performing. That is what the United States should be doing. There is plenty of money for other things. When they talk about how they want this to be pay as you go--I voted for pay-go. I did. But we are in an emergency situation, and I believe this calls us to act now, and I hope we act tonight. I hope we can all work together, and when more is said, the less gets said and more gets done. I yield the floor.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, today I wish to commend and congratulate the League of Women Voters, in honor of the league's 90th anniversary. This nonpartisan political organization encourages informed and active participation in government, works to increase understanding of major public policy issues, and influences public policy through education and advocacy. The League of Women Voters was founded by Carrie Chapman Catt in 1920--just 6 months before the 19th amendment to the U.S. Constitution was ratified, giving women the right to vote after a 72-year struggle. It was designed to help 20 million women carry out their new responsibilities as voters. It encouraged them to use their new power to participate in shaping public policy. Today, there are 900 State and local Leagues in all 50 States. While the league neither supports nor opposes candidates for office at any level of government, it works to influence policy through advocacy on issues such as voting rights, health care reform, global climate change, and election administration. This grassroots citizen network is directed by the consensus of its members nationwide. In honoring the league, we commemorate the past achievements of women and highlight the successes of women today. From the suffragists who founded the league 90 years ago to the incredible women who work today to improve our communities and our country as elected officials and as volunteers, the league's women are making a profound and lasting civic impact. I wish the League of Women Voters continued success as they bring more women into the political arena as candidates, informed voters and advocates.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I ask unanimous consent to speak as in morning business.

Ms. MIKULSKI. Mr. President, I rise to speak about the current state of affairs in the Washington Metro and why we need to bring about change. The Washington Metro, America's subway, is in trouble. I fear for its safety. I fear for its operational reliance. I fear for the well-being of both the passengers and the workers who ride Metro. Every morning, I am afraid to wake up and find out that there has been another accident or death on the Washington Metro. Most recently, a Metro train carrying 345 passengers derailed underground in the heart of downtown. It was Friday when the Federal Government reopened after our big No. 2 blizzard. The train somehow managed to get on the wrong track as it was leaving the station. Thank God a safety device actually worked and pushed the train off of the wrong track to prevent it from crashing into another train. Thankfully, a near miss. In June, there was a terrible crash of the Metro, cars upon cars upon cars. Since that time, 13 people have died on the Metro, and there have been countless injuries. That is why that terrible day after our No. 2 blizzard, many sat in the dark, scared to death. They were afraid of being crashed into, which had happened before. They were afraid of fire. They were afraid of smoke. They were afraid of being trapped and, most of all, they were afraid that Congress would fail to act. I wish to salute the Subcommittee on Housing, Transportation, and Community Development chaired by my good colleague Senator Bob Menendez, for taking a great interest in this and introducing legislation that the administration sanctions to begin to get Metro on the right track. We need to do this. Last year, after the nine people were killed, I introduced legislation to give the Transportation Secretary the authority to establish Federal safety standards for Metro systems around the country. There had been none. It would require the Transportation Secretary to implement the National Transportation Safety Board's most wanted safety recommendations. After accidents on subways, after accidents on our Metro, the NTSB comes in and investigates. Gee, are we glad to see them. They are the CSI meets Metro. At the end, they not only tell us what went wrong, but what we have to do to get it right. Well, guess what. We don't listen to them. After every accident, there is press--we are going to make changes--but nothing happens. So, for example, the issues they have recommended relating to crashworthiness standards for cars, emergency entry and evacuation standards, data event recorders, often go unheeded. We have to make those changes, and we need to take another step. Today, I take another step by joining Senator Menendez, Senator Dodd, and Senator Cardin on the Public Transportation Safety Program Act. This is an idea that we have worked on, along with the administration, to give the Transportation Secretary the authority to establish Federal safety standards. It also strengthens State oversight programs that inspect and regulate the Metro systems. Because Washington Metro is in two States and in the District of Columbia--Maryland, Virginia, and DC--it has the Tri-State Oversight Committee. But you know what. The Metro board doesn't have to pay any attention. In fact, we had to raise cane and pound the table to allow them to work with the safety inspectors and actually walk the tracks to try to get some action. We had to muscle our way in, just trying to get the Tri-State folks involved in safety. Well, for me, right now, the spotlight is the Washington Metro. My obligation is here. There are other Metro systems around the country that this bill will also deal with, but right now, myself and Senator Cardin, John Warner--Mark Warner--John Warner in his time--Jim Webb, and Congresswoman Eleanor Holmes Norton want to work together. We want to work with the Banking Committee to pass legislation that would bring about change. We want to make sure that when we make recommendations, the FTA--the Federal Transit Authority--has the authority to implement the changes and to make sure that Metros both here and around the country implement them. We also want to require that the implementation of the NTSB's most wanted list is absolutely done so when we say let's have crashworthy standards for our cars, it is actually implemented. Did you know we have standards for everything that is involved in transportation but not standards for the safety or the crashworthiness of these cars? These two bills are important because there are no Federal safety standards for Metro systems. Rail transit is the only transportation mode without safety standards oversight or enforcement. As I said, we have safety standards for airplanes, commuter rail systems, even buses, but Metro systems do not have standards, even though the rail transit has 14 million daily riders. Up until now, safety has been left to the States. Each State has its own safety enforcement practices, but in our case of the Washington Metro, which travels in two States and the District of Columbia, we need to make sure we have a system that is appropriately regulated. The bill that was introduced by the Banking Committee and Senator Menendez yesterday, which I support, does two things. It gives the Transportation Secretary authority to establish safety standards for Metro, light rail, and bus systems nationwide. It provides a framework for developing and enforcing those safety standards, and it will look at existing industry standards and best practices. It would also have to consider the NTSB's recommendations. I think about those 13 people a lot. I think about the people who ride the Metro. I think about the people who work on the Metro. So when we talk about this legislation, we have to think of it not in terms of rail cars and money but in terms of people and in terms of safety. That is why I introduced the National Metro Safety Act in July after the accident, joined by my colleague Senator Cardin. It enables the Transportation Secretary to develop, implement, and enforce those national safety standards, and it requires DOT to implement the NTSB, the National Transportation Safety Board's, most wanted safety recommendations. They have what they call their top 10. It would have standards for the crashworthiness of cars. It would mandate evacuation standards so that people could get out of these cars in the event of an accident. It would have the black box data recording device so we could trace what happens on a car and have the lessons learned. It would also deal with the hour of service regulations for train operators. It requires that we do these actions. So for these issues--the crashworthiness, the train cars, the emergency entry and evacuation, data--all of this has been recommended in the past by the NTSB. In 2002 they recommended data event recorders. Nothing happened. They recommended emergency evacuation standards in 2006. Nothing happened. They recommended hours of service to make sure our people were fresh and fit for duty. Nothing happened. We know what happens: accidents in which people die, are maimed, burned, or injured. It is time we listened to the experts who advise us. It is time that we ensure the safety of the people who ride the Metro here. It is time that we take action and be able to bring this under the Federal Transit Authority. The people who count on us when they get on a subway should be able to count on us to do all we can to ensure their safety.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, people are angry and they are anxious. They are worried their middle class way of life is slipping by. They are worried about their jobs. They are worried about their pensions. They are worried about the cost of everything from health care to housing to higher education. They have to make tough decisions. They are sitting at their kitchen tables balancing their checkbooks and being careful about spending. They want to know we are being careful too. They want an administration and a Congress that do two things: create jobs and spend money frugally and wisely. I am angry too. I was told that TARP was needed to get money to Main Street. I didn't care if every firm on Wall Street went bankrupt. But I did care about jobs, small businesses, and families' mortgages. That's what I was told TARP was about. Instead--ungrateful bankers got an astonishing amount of money from taxpayers who used it to pay themselves bonuses. Chairman Bernanke made four big mistakes: he let banks take on too many risks, he ignored the housing bubble, he failed to protect homeowners, and he gave too much taxpayer money away for too little in return. It is not just Mr. Bernanke though. The entire economic policy team for the last two administrations deserves blame So I had questions about this nomination. I spoke with Maryland business leaders, looked into Mr. Bernanke's record, and I met with him at the end of last year. I let Mr. Bernanke know that I am focused on three things to get our economy going again: creating jobs, getting more lending to the middle economy and small businesses, and helping people get out from under the threat of foreclosure. I know that people's top priority is jobs. Mr. Bernanke needs to realize that too. When Bernanke thought Wall Street was on the verge of a crisis, he acted dramatically. He used new powers for new programs. Well, the job market is in a crisis now. But the Fed's response has just been tame and tepid. We need the same urgency from Mr. Bernanke to jump-start the job market as he gave to Wall Street to jump-start the financial markets. The Fed has pumped trillions of dollars into the financial system. Congress has approved billions more. Money went to the banks and because we thought they'd lend it out to help small businesses and help community banks, and community pillars. But what I have heard since then is that companies' credit is being withdrawn and responsible applicants are being rejected for reasonable loans. We need to try something different to make sure money goes where we want it to--and doesn't get used by banks to pay bonuses. I am also angry that economic policy-makers went all out to help Wall Street and only halfway to help homeowners. In his second term Mr. Bernanke needs to do much more to help them, and help communities ravaged by too many foreclosures. Mr. Bernanke needs to realize that ``Crisis Averted'' doesn't mean ``Mission Accomplished.'' There have been too many missed signals-- misplaced priorities. But I am voting to confirm Mr. Bernanke because he is not a man of ideology and when we needed him most his expertise and level head probably helped stop a catastrophe. He didn't panic, and learned from history, which he has studied closer than anyone else. No one understands the risks the economy faces better than he does. That does not mean we shouldn't rock the boat. We need bold new approaches-- and I'll fight for them. I was advised that rejecting his nomination would cause markets to nose-dive--which would hurt retirees and families saving for their future. I am not enthusiastic in my support. But I think Mr. Bernanke understands the job that he still has to do. And that in his second term he will focus better on jobs, getting lending going to the middle economy, and mortgages. So I will vote to confirm him for a second term.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, people are angry and they are anxious. They are worried their middle class way of life is slipping by. During the last several months as I listened to people they had very clear messages. First, ensure the solvency and stability of Medicare and, they said, no Medicare rationing. Second, they said to get the government's fiscal house in order. They said to be as frugal as they have to be in their own homes. I absolutely agree the government has to get its fiscal house in order. And I am unrelenting in making sure that Medicare is there when people need it, and is there in the way their doctor says they need to have it. I fear this commission is a back door to rationing Medicare. I pledged during health care reform, and I pledge now, I will not ration Medicare. I agree that Congress needs a gut check on spending, but we don't need a gutless vote. I worry that this commission will be a fast track process to ration Medicare run by a group with limited accountability selected by the very same politicians who were incapable of making the tough decisions. I will not vote for a commission to ration Medicare. Social Security is not the real cause of the debt crisis. It has never added to the debt. It can be fixed through regular order with small tweaks that don't cut benefits. I believe tough decisions on the budget and revenue should be made in the full light of day and through regular order with full accountability, and without subcontracting responsibility to a commission. I support the goal of fiscal responsibility. We need urgent action. We must clean up the mess of many years of failed economic policies while ensuring the long-term health and economic security of Americans through the protection of Medicare and Social Security and at the same time, be aware that we must deal with job creation and the wrenching problem of home foreclosures. I have made tough budget decisions in the past. I opposed tax cuts that went to the lavishly wealthy and cuts that let hedge fund managers pay lower taxes than their secretaries. I opposed tax cuts for corporations that shipped jobs overseas. I have used the powers of both my office and of other institutions to fight waste, fraud and abuse. In the late 1990s, I was one of nine votes against repealing the Glass-Steagall Act which allowed banks to make risky bets with families' checking accounts with little regulation and no accountability, leaving taxpayers to clean up the mess with TARP. And it created the go-go permissiveness that got our economy into a ditch with a big recession that is part of the debt problem. During the prescription drug debate I voted against the bill because Bush and the Republican Congress refused to allow the government to negotiate with drug companies for lower prices. It was just one more give away for drug and insurance companies so they could charge seniors and the government more for prescription drugs. I have stood for strong and independent inspectors general at Federal agencies so they have power to ensure fairness and accountability. I asked the Department of Justice IG to investigate when political appointees were awarding grants to their friends. And IG made recommendations to reform the grant process. I asked the Government Accountability Office to recommend reforms for the Chesapeake Bay Program to focus the bay program on results because the bay program was fudging its data to overstate progress in cleaning up the bay. I have fought on my own committee against botched government boondoggles--lavish conferences with $4 meatballs at the Department of Justice, satellite construction contracts that have run billions over budget and years behind schedule, and Enron-like accounting in the AmeriCorps Program. And I have supported strong protections for whistleblowers, so talented civil servants can come forward about wrongdoing without fear of retribution when they uncovered corrupt practices. I believe some commissions can work, like the Bipartisan Policy Center's Debt Reduction Task Force headed by Pete Domenici and Alice Rivlin that will issue tough recommendations on revenue and spending. I look forward to their findings and I want to hear recommendations from others. I would support a commission like the one proposed by Senator Baucus where there could be amendments and full debate so we could vote to stop the rationing of Medicare and raising taxes on the middle class. I support the goal of fiscal responsibility. I don't support this process with its fast-tracking, muffling of amendments and limited debate. This is not the way to address programs touching every American family. I don't support shifting the burden and risks to seniors and their families. I will not support this commission or rationing Medicare, raiding Social Security or any backdoor way of raising taxes on the middle class.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, today is a historic day. After decades of discussions and promises, we have taken a giant step forward in providing universal access to health care. I was proud to vote for the Patient Protection and Affordable Care Act. It extends coverage to 31 million Americans who don't have health insurance now. Our bill is a step forward in achieving my four principles of health care reform: saving and strengthening Medicare; ending punitive insurance company practices that deny coverage based on preexisting health conditions, age and gender; providing universal access; and emphasizing quality, prevention and integrative health to save lives and save money. I like the Patient Protection and Affordable Care Act because it saves and strengthens Medicare. The bill extends Medicare solvency; promotes care based on value not volume; closes the prescription drug coverage gap with a 50-percent discount on brand-name medications for seniors who fall into the gap; stops insurance companies from charging seniors four or five times more for insurance than young people; and removes the cost barrier to preventive care by eliminating deductibles, copayments and other cost sharing for seniors. This bill helps the good guy businesses that want to provide insurance, but can't because it costs too much. I come from a small business family. My father was a grocer and my grandmother ran a small bakery. So I grew up in a family that knew what it was to face a weekly payroll. The Patient Protection and Affordable Care Act protects small businesses with fewer than 50 employees. It gives them tax credits to be able to afford insurance for their employees. The Senate bill creates new insurance exchanges for small businesses and individuals who don't get insurance through work. It is like an online shopping mall for insurance. It provides individuals and businesses the same bargaining power as if they were a large group. It gives them the choice and the opportunity to select the best plan they can afford with the care that best meets their needs. The Senate bill promotes cost savings and greater doctor-patient satisfaction through administrative simplification. The bill creates single standards for electronic transactions that will mean less paperwork and more doctor-patient time. The Patient Protection and Affordable Care Act will control costs through a new emphasis on integrative health, prevention, and quality. New funding for wellness and prevention programs will support innovative approaches. That includes local initiatives using grassroots strategies to create healthier communities. The Patient Protection and Affordable Care Act also improves the quality of care. As a member of the Senate Health, Education, Labor, and Pensions Committee, I was charged with establishing our bill's section on improving quality and delivery systems in health care. This section creates a national strategy to improve lives, save lives and reduce costs. This is achieved by promoting best practices like simplifying drug labels, and promoting discharge planning and medication management. These practices save money and improve patient outcomes through reduced hospital readmissions, improved patient safety, and better care coordination. For example, the Senate bill creates grants to identify, disseminate, and implement innovative best practices to local providers and patients. One such practice is the Pronovost Checklist from Dr. Peter Pronovost at Johns Hopkins University. He developed simple steps to properly insert a catheter and eliminate line infections. When used in Michigan for 1 year, it saved 2,000 lives and $200 million. We make his checklist--and others like it--available to hospitals across the country We also expand the use of medical homes by establishing community health teams. These teams include providers from the primary care physician to specialists and nutritionists. In North Carolina, medical homes save $175 million each year. Our bill makes medical homes available across the country. These provisions--and more like them--not only save lives, they save money. I am particularly proud of my women's preventive health amendment included in this bill. Right now, women pay more and get less in health care. For far too long, many insurance companies have treated simply being a woman as a pre-existing condition. They have used every trick in the book to deny coverage to women. The Mikulski amendment guarantees access to preventive tests that save money and save women's lives. It requires insurance companies to cover preventive care and screenings at no added cost to women. Without my amendment, there would be no guarantee that women under 50 would be covered for mammograms, no guarantee of an annual women's health exam that would include screenings for heart disease, and no guarantee that women would have access to this preventive care at no cost. In the Patient Protection and Affordable Care Act I stood up for Maryland. I preserved the Maryland Medicare waiver, which I authored more than 30 years ago. This Maryland waiver is crucial in allowing hospitals to provide uncompensated care without jeopardizing their own financial stability. What else does this health care reform bill mean for Maryland? It means that more than 1 million Marylanders who aren't covered now will have access to affordable insurance. It gives a helping hand to 50,000 small businesses in Maryland. It means lower costs for the 130,000 Marylanders who fall into Medicare's prescription drug coverage gap. It means that young adults in Maryland can stay on their parents' policies until they are 26 and that they'll have access to affordable coverage after that. It means that families who are just a layoff, a job switch or an illness away from losing coverage will have health care stability and security. It means that if you like the insurance you have now, you can keep it. Or if you don't have it, you can get it. And it means that health care reform will be affordable to families and to the nation. We can't let health care bankrupt our families or the government. The non-partisan Congressional Budget Office says the Senate bill will reduce the deficit by $132 billion over the next 10 years. And while I support the Patient Protection and Affordable Care Act, I have some serious yellow flashing lights. I hope these issues will be resolved in a more favorable way in conference. I am for a more robust and transparent public framework to ensure competition and choice in the marketplace. I like public options. Two of my favorite public options are Social Security and Medicare. The Senate bill creates a lot of new customers for insurance companies by mandating insurance coverage. But like big banks, insurance companies don't show remorse for past transgressions. We can't simply trust them to do the right thing. The Senate bill relies heavily on regulation to achieve what could be done with a public framework. I prefer the House public option. I also continue to oppose the excise tax included in the Senate bill. I am not for taxing the health care benefits of retired public employees and union members to pay for health reform. Some call them Cadillac plans. I call it a ``Clunker Idea.'' The excise tax will just shift costs onto workers through higher deductibles, copayments, and less generous coverage. I am against this back-door tax on middle America & retirees. Again, I prefer the House version on this. So we have some work to do. I will keep fighting for health care reform. Because it is absolutely terrible when you hear--I am sorry your insurance doesn't cover that. It is horrifying when you have no insurance at all because you lost your job or your benefits and you face losing your life savings to pay for the care you need. I can assure you I will be fighting on the side of Maryland and the American people to complete health care reform in early 2010.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, my top priority is jobs--to help those who have one, keep it and to help those who don't have one, find one. That is why I have always supported the automobile dealers in Maryland and across the country, which each employ on average about 50 people and are also economic pillars in large and small communities throughout the United States. Dealers don't just provide jobs for people who sell cars they also provide them to people who service the cars and for managers and office workers who make dealerships run smoothly. I have fought for the auto dealers in several ways over the past year, first on the Recovery Act, where we passed tax incentives to help consumers purchase new cars, and then again this summer when I worked with my colleagues to pass cash for clunkers, which saved jobs in the auto industry, promoted energy efficiency, and helped the middle-class afford a car, which is most families' second largest purchase behind their home. Dealers are not only critical to their local economies; they also make the auto industry work by distributing, selling, and servicing the cars at practically no cost to the manufacturers. That is why I cosponsored S. 1304--to give car dealers a chance to contribute to our economic recovery and to provide jobs as the domestic auto industry restructures and retools. Today, I am proud to support a provision in section 747 of the Financial Services appropriations conference report that shows dealers that Congress is on their side and on the side of creating and protecting jobs as our economy struggles toward recovery. This provision will give automobile dealers around the Nation a fair shot at getting back into business by setting up a neutral and fair arbitration process. First, it requires that manufacturers make all pertinent information available to dealers. I expect all parties to fully comply with this requirement and for all relevant information to be made available in a transparent and easily understandable form to dealers and to the arbitrators. Also, I support section 747 because it requires arbitrators to consider all the relevant factors that affect whether a dealer is and can be successful, and that demonstrate how dealers contribute to the viability of the manufacturing companies whose cars they sell. I also expect and encourage arbitrators to consider the rights that dealers are guaranteed under all applicable Federal and State laws when making their decisions. Our economy is struggling to recover because there aren't enough jobs. Auto dealers are a major employer across the country, and they also are essential to reviving a healthy American auto industry. As the American auto industry looks to the future, we can't forget the essential role that dealers play, providing both thousands of jobs and also the affordable cars and auto related services that American families need.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to pay tribute to the life and legacy of my friend Abe Pollin. He was a businessman, community leader, philanthropist, familyman. He was someone who simply made our community and our Nation a better place. Abe was a great man who did great things. But he did it without a lot of fanfare. He was a team owner who thought first about the community that supported his teams. He was an employer who didn't treat his athletes or his employees as commodities--but as members of his team. Abe Pollin was also a developer. But he didn't just invest in buildings, he invested in communities. He built one of the first big apartment buildings in Bethesda, named after his beloved wife Irene, long before Bethesda became the vibrant downtown that it is today. He never lost faith in Washington--building the MCI Center, now the Verizon Center, in the mid 1990s--which led to the revival of downtown Washington. Here in the DC Metro area, there are few community organizations that did not benefit from his advice, his philanthropy or his leadership. Abe made our region a better place, and will be greatly missed. My thoughts and prayers are with the Pollin family--his wife Irene, who is a founding mother of the effort to empower women to fight heart disease, and his children and grandchildren. I will be forever grateful for the Pollin family's early support of a young city council woman from Baltimore who wanted to run for Congress. Abe Pollin was one of my earliest supporters, and his faith in me meant a great deal. Last night, thousands of people gathered at the Verizon Center to celebrate Abe Pollin's life. His legacy is a community that is stronger, more vibrant--and simply a better place to live.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, I rise to speak on the bill as well as in opposition to the Nelson of Nebraska amendment on the subject of abortion. First of all, I truly believe health care reform is the most important social justice vote we will cast in this decade. Why? Because we are talking about providing universal access to health care, which I believe is a basic human right and should be a fundamental American right. That is why health care reform is so important: To provide universal access to health care and, in this bill, ending the punitive practices of insurance companies against women, particularly in the area of gender discrimination, where we pay more and get less in our benefit package, as well as where simply being a woman is often treated as a preexisting condition. Eight States consider domestic violence a preexisting condition and you can't get insurance. One woman who had a medically mandated C- section was told she couldn't get insurance again unless she had a sterilization--coerced sterilization in the United States of America. I thought that is what they did in Nazi Germany or in old Communist China. The other thing this bill does is strengthen and stabilize Medicare to make sure seniors have access to health care at all ages and all stages. I consider these principles to be pro-life. I think the health care bill we are debating is as pro-life as can be because what other thing helps maintain, protect, save, or deal with impaired life better than providing universal access to health care? A famous pastor by the name of Rick Warren, who has written the great book that has inspired so many, ``The Purpose Driven Life,'' talks not about pro-life but whole- life principles. I think being able to see a doctor or an appropriate health care professional saves lives, and I view this vote on health care reform as the most important pro-life or whole-life vote anyone can cast. I agree with Pastor Rick Warren when he uses that principle. I believe in seeing a doctor when you need one, in saving a life, or in getting the health care you need so you don't lose an eye from diabetes, you don't lose your kidney, you don't lose your foot or, if you are pregnant and diabetic, you don't lose your child. We want to make sure women have access to mammograms, that the men we love and who love us have access if they have high blood pressure--and sometimes they have it because they don't have health care for their family--or prostate cancer. I believe that is what whole life is. So with this bill, I believe supporting screening for diabetes is pro-life, cervical cancer screening is pro-life, but, most of all, if you want people to have healthy pregnancies, healthy childbirth, healthy babies, they need access to health care. So that is why I say voting for universal access to health care is as pro-life as you can be. Making this debate about abortion, I believe, is misguided and wrong. First of all, in the bill, we already deal with this topic. In the interest of passing health care reform, I believe we deal with this sensitive topic in a sensitive way. We rejected shrill and strident amendments on both sides. For example, we did not seek to change the settled language regarding abortion that is the Hyde amendment. There were those in the exuberance of last year's election who said: Oh, let's get rid of Hyde. Many of us took that position, trying to find that sensible center. We are principled and whole-life people as well. We said: Let's keep the Hyde amendment. It is settled language. I don't use the term ``settled law'' because that is a precise legal term, and I know my colleague from Pennsylvania and others can argue that, but Hyde is settled language. What does the Hyde amendment that has been around for almost 30 years do? It prohibits any Federal funds to be used directly for abortions, except in the case of rape, incest, or when the life of the mother is at risk. It has additional provisions that provide a conscious clause to protect providers who do not want to provide abortions. This bill does not seek to change the underlying premise of the Hyde amendment which, as I said, I regard as settled language of 30 years ago. The pending Senate bill goes even further than Hyde. It was legislation that came out of the Finance Committee, and I salute them for, once again, trying to find a sensible center, engaging in civil and rational dialogue. I wish to compliment them on their efforts. However, the other side keeps changing the midpoint. By seeking a greater good, many of us agreed to what was in the Finance bill. Quite frankly, it went further than I would have liked if I were writing the bill, but, again, in the interest of comity we would keep this debate on the issue of providing health care and not turn it into an abortion debate. What does what came out of the Finance Committee and what is in the merged bill do? It says loudly, clearly, and consistently: No Federal funds can be used to pay for the coverage of abortion, and it does it by separating out funds so no public money from Federal credits or subsidies would be used for abortions. What more can we ask anyone to do? Under the pending bill, health care plans cannot be required to cover abortion. Health care plans can choose to cover or not cover it, and State laws regarding abortion are not preempted. It, again, includes the longstanding practice of a strong conscience clause for either individual providers or institutions--for example, Catholic hospitals--from performing abortions if it is against their conscience. I believe what we have done is found the sensible center, and it leaves the decision in the hands of patients and doctors, not politicians or insurance executives. So the question is not what is decided but who decides. I believe it should be in the hands of patients and doctors, not politicians or insurance executives. Let's go to Nelson, which is a Senate version of Stupak. I reject the Ben Nelson amendment. I believe it is unnecessary. I believe it is unneeded. I believe it is uncalled for. It goes further than Hyde because it prohibits the public option from covering abortions and it prohibits individuals receiving Federal insurance subsidies from purchasing a plan that covers abortion and, even if you use your own money, it cannot be used for abortion. It also allows women to purchase an abortion rider. Oh, boy. Is this supposed to be a big deal? Is this supposed to be the kind of thing that is supposed to make us happy? What an insulting, humiliating thing to say: If you want an abortion, go buy a rider. I think it demonizes women. Why don't you go into the workplace and paint a scarlet letter on your head. Hawthorne still lives in the Nelson amendment. Lets paint the ``A word'' on your forehead. Can you believe this? I don't know of any individual woman or any woman in consultation with the man she loves and who loves her saying: Yes, you know, we might have an abortion. Why don't we buy that rider. Nobody plans to have an abortion. It is not the subject of intimate conversations that families talk about as they plan their lives together. Do you realize the intense discrimination a woman would face? How about: Why don't we have men buy an abortion rider for the women they get pregnant? Let them buy the abortion rider. Maybe we can even give them a discount. We are hot about this, and we are cranky about it because there is no need to do it like this. We have tried, at every step of the way, to handle this topic with great respect because there are people with principles. We are all people of principle. Some use the term ``pro- life.'' I use the term ``whole life.'' What are the rest of us? Do you think I am anti-life? All my life as a social worker, I have fought for social justice. I fought for access to health care. And to say I am going to support a bill that denies access to services for most women in the exchange-- anyway, I think this thing goes further than Hyde, and we should be debating health care, not abortion. This legislation on the Senate floor should be about women's health, like the debate we had last week about prenatal health care, how to improve delivery systems for greater survival and how to minimize birth defects. That is what it should be. Women's health care decisions should be made by the women, in consultation with their doctor. The Patient Protection and Affordable Care Act is what we believe is a wonderful compromise, and it rejects these strident viewpoints. The most pro-life thing we can do is pass universal access to health care. The most pro-life thing we can do is stabilize Medicare so people have health care at all ages and all stages. So reject the Nelson amendment, and if you are pro-life, vote for the Senate merged bill. I yield the floor.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, I yield myself a firm 10 minutes.

Ms. MIKULSKI. Madam President, health care is a woman's issue. Health care reform is a must-do woman's issue, and health insurance reform is a must-change issue. So many of the women and men of the Senate are here today to fight for change and to make sure we have universal access to health care. When we have universal access, it makes a difference in our lives, which means we have to have universal access to preventive and screening services. My amendment--and, by the way, it is a bipartisan amendment--makes universal access to preventive and screening services for women available. There is much discussion about whether women should get a particular service at a particular age. We don't mandate that women get a service; we leave that up to a decision made with the woman and her doctor. But, first of all, they need to be able to have a doctor. So we are for universal access, and this is why the underlying bill is so important. Then, when you have that, there should also be universal access to preventive and screening services, particularly to the top killers of women, those things that are unique to women. We think about cancer: breast cancer, ovarian cancer, and cervical cancer. Also, women are dying at an increased rate of lung cancer. Then there are these other silent killers that have had a lethal effect on women, and that is cardio and vascular disease. So we want to guarantee universal access to medically appropriate or medically necessary screening and preventive services. Many women don't get these services because, first of all, they don't have health insurance; and, No. 2, when they do have it, it means these services are either not available unless they are mandated by States or the copayments are so high that they avoid getting them in the first place. The second important point about my amendment is it eliminates deductibles and copayments. So we eliminate two big hurdles: having insurance in the first place, which is the underlying bill, as well as copayments and deductibles. I know of no one in this room who would not want to be on our side on this issue. I wish to acknowledge the role the Senator from Alaska has played, Ms. Murkowski, as well as Senator Kay Bailey Hutchison, Senator Snowe, and Senator Collins. We, the women of the Senate, have worked on a bipartisan basis for years making sure we were included in the protocols at NIH, increasing funding for important research areas to find that cure, to race for that cure and, at the same time, to be able to have mammogram standards. What the Murkowski amendment--and by the way, she is Murkowski, I am Mikulski. We sound alike, and the amendments might sound alike, but, boy, are they different. The Murkowski amendment offers information. I think that is important. That is a threshold matter. You have to have information to make an informed decision. But it does not guarantee universal access to these services, and, of course, it does not eliminate the high payments and deductibles. So her amendment is flawed. My amendment is terrific. My amendment offers key preventive services, including an annual women's health screening that would go to a comprehensive assessment of the dangers to women, including heart disease and diabetes. We hope when the Senate makes its decision today, it deals with the fact that for we women, the insurance companies take simply being a woman as a preexisting condition. We face so many issues and hurdles. We can't get health care. We can't get health insurance because of preexisting conditions called a C-section. I am going to be meeting with an insurance company executive later where his company denied health insurance to a woman who had a medically mandated C-section, and a letter from this insurance company said: We are not going to give you insurance unless you have a sterilization--a coerced sterilization in the United States of America. That is going to be an amendment for another day. But I just wish to give the flavor and the power of what women face when we have to cope with the insurance companies or where there are barriers to our getting these health care screening services. So we want to be able to save lives, and we want to be able to save money. We believe in universal access, and if you utilize the service it is because you have had the consultation with your doctor. We do know early screening and detection does save lives, and, at the same time, it saves money. I will conclude with this: When we look at heart disease and diabetes, not only cancer but early detection of diabetes means, in a well-managed program, under appropriate medical supervision you very likely will not lose that eye, you will not lose that kidney, you will not lose that leg and, most of all, you will not lose your life. So let's not lose the Mikulski amendment. Let's go with Mikulski and thank Murkowski for her information, but hers is too tepid and too limited. Madam President, I ask my colleague, one of the great guys who supports us, Senator Cardin, how much time he needs. I yield 5 minutes to Senator Cardin.

Ms. MIKULSKI. Madam President, I yield 3\1/2\ minutes to the junior Senator from Minnesota, Mr. Franken.

Ms. MIKULSKI. Madam President, how much time does our side have?

Ms. MIKULSKI. I yield 5 minutes to the Senator from Michigan.

Ms. MIKULSKI. Madam President, I yield 4 minutes to the Senator from the State of Washington, who has been a real leader on these issues. By the way, Madam President, before the Senator speaks, I want to thank Senator Stabenow for a unique courtesy. This is her desk, and as many of my colleagues know, I broke my ankle and I can't get up to where my desk is at this point. I will, however, in a matter of another few weeks. But she has given me this desk on loan so that I could stand on my own two feet to debate this amendment, and I wanted to thank her for the courtesy. Madam President, I also want to note something while the senior Senator from the Republican leadership is here, and the author of the amendment. We, the women of the Senate, on a bipartisan basis, have worked for women's health. Today, we disagree on what is the best way to achieve it by these two amendments. I want to thank my colleagues for setting a tone of civility. I think this has been one of the most rational, civilized conversations we have had over this, and I would like to thank them. As the leader on this side of the aisle, in terms of seniority, I would like to extend my hand in friendship and suggest when this bill is done, and this amendment is done, we continue to focus on this wonderful work that we have done together. We have done things that have saved millions of lives, and so I look forward to continuing that. Madam President, I now yield 4 minutes to the Senator from the State of Washington, Mrs. Murray.

Ms. MIKULSKI. Of course.

Ms. MIKULSKI. I thank the Senator.

Ms. MIKULSKI. That is correct.

Ms. MIKULSKI. Yes, that is correct. This amendment does not cover abortion. Abortion has never been defined as a preventive service. This amendment is strictly concerned with ensuring that women get the kind of preventive screenings and treatments they may need to prevent diseases particular to women such as breast cancer and cervical cancer. There is neither legislative intent nor legislative language that would cover abortion under this amendment, nor would abortion coverage be mandated in any way by the Secretary of Health and Human Services.

Ms. MIKULSKI. Mr. President, we are waiting for Senator Boxer to come to the floor, so if the other side of the aisle has another speaker, I know at the end we hope that Senator Lisa and Senator Barb--I say that because our last names sound so much the same--could wrap it up. How would the Senator from Wyoming like to proceed? We are waiting for Senator Boxer or for Senator Baucus.

Ms. MIKULSKI. Then I will wrap up.