Lisa Murkowski

Ms. MURKOWSKI

Ms. MURKOWSKI. Is that better?

Ms. MURKOWSKI. Mr. President, I want to start my comments by acknowledging my colleague from Maryland and accept her gracious offer to continue to work on this issue as it relates to women's health and women's health services. As has been noted by the Senator from Maryland and the Senator from Washington, this is an issue that we women of the Senate have come together on repeatedly, to work cooperatively. While we do have, some would say, somewhat dueling amendments here, I think it is important to recognize the goals we are both seeking to attain here are certainly right in alignment. We are just choosing different means to get there. But I appreciate, again, the civility and cooperation from not only Senator Mikulski but the other women of the Senate on this very important issue. I wish to reiterate a couple of points about my amendment that I made yesterday.

Ms. MURKOWSKI. I ask unanimous consent that further reading of the amendment be dispensed with.

Ms. MURKOWSKI

Ms. MURKOWSKI. I thank the Senator for the dialog here today. I think this is an important part of our discussion as we debate health care reform on the floor. We have had good conversations already yesterday and today about the cuts to Medicare, the impact we will feel as a nation if these substantive cuts advance. But I think this discussion-- and we are narrowing it so much on what the recommendations have been from this task force, but I think it is a good preview of what the American people can expect if we move in the direction of government- run health care, of bureaucrats, whether it is the Secretary of Health and Human Services or whether it is task forces that have been appointed by those in the administration, who are then able to make that determination as to what is best for you and your health care and your family's health care. I think the discussion we have had today about ensuring that it is not best left to these entities, these appointed entities to make these determinations, but let's leave it to--or let's allow the information to come to us from the medical professionals. Senator Coburn has spoken so eloquently on the floor about relying on those who really know and understand, who live this and who practice this, rather than us as politicians who want to be doctors. I don't want to be a doctor. I want to be able to rely on the good judgment of a provider I trust, and I want him or her to be able to make those decisions based on their understanding of me and my health care needs and what is best for me and what the best practices are that are out there, rather than having a task force telling them: That is the protocol for Lisa. She is 52. She is able to get a mammogram every other year now. I want to know that it is me and my doctor who are making these decisions. I hope Members will take a look at the amendment I will offer and consider how it allows for truly that kind of openness, that kind of transparency, and gives individuals the freedom of choice in their health care that I think we all want. With that, I thank my colleague from Wyoming, and I yield the floor.

Ms. MURKOWSKI. I am glad the Senator mentioned the issue of the abortion services. I think there is a vagueness in the amendment Senator Mikulski has offered. Some have suggested that it would allow those in the Human Resources Services Administration, HRSA, to define abortions as a preventive test, which could provide that health insurance plans then be mandated to cover it. That has generated some concern, obviously. Some have opposed the amendment, saying that if Congress were to grant any executive branch entity sweeping authority to define services that private plans must then cover, merely by declaring a given service to constitute preventive care, then that authority could be employed in the future to require all health plans to cover abortions. So all we are doing with my amendment is just making very clear there are no vagaries, there is no second-guessing. It just makes very clear that the Secretary cannot make that determination that preventive services are to include abortion services.

Ms. MURKOWSKI. It states very clearly on the second page that the Secretary shall not use any recommendation made by the U.S. Preventive Services Task Force to deny coverage and items serviced by a group health plan or a health insurance issuer. So, yes, we make it very clear that these recommendations from the USPSTF cannot be used to deny coverage. I think the opportunity to have medical professionals, as this USPSTF is comprised of--we should have an entity that is kind of looking out and seeing what best practices are. But then that entity should not be the one that causes a determination as to whether coverage is going to be offered. You can use that as a resource, most certainly, just as we use as a resource the recommendation from, say, for instance, the American Congress of Obstetricians and Gynecologists, the American College of Surgeons, the American Society of Clinical Oncology, but it is not going to be the determining factor. I think that is where we need to make that separation, where my amendment separates from Senator Mikulski's.

Ms. MURKOWSKI. If I may comment on the Senator's last statement, this is very important for people to understand. There has been much said about the Mikulski amendment and what it does or does not do. But it is very important for women to understand the Mikulski amendment will not provide for those mammograms for women who are younger than age 50. Her amendment specifically provides that it is ``evidence-based items or services that have in effect a rating of `A' or `B' in the current recommendations of the United States Preventive Services Task Force.'' So you go to the task force report, and as the Senator has noted, women who fall between the ages of 40 and 49 receive a grade of a C, and the recommendation is, specifically: Do not screen routinely. Individualized decision to begin biannual screening, according to the patient's context and values. But they have received a C designation by USPSTF. According to the Mikulski amendment, those women who are younger than 50 years of age will not be eligible or will not be covered under the mandatory screening requirement she has set forth in her amendment. I think where she was trying to go was to ensure that these recommendations would not be used to deny coverage. She adds a paragraph stating that nothing shall preclude health plans from covering additional services recommended by the task force that are either not an A or a B recommendation. But the amendment does not require plans to cover services that are not an A or a B. In other words, if you are 45 years of age, you are in this C category, and the amendment does not require, then, that your preventive screening services be covered. So for those women who are in this age group-- Congresswoman Debbie Wasserman Schultz just went through a recent bout of cancer, and I think that was diagnosed at age 41. For those women who fall into this category, this amendment the Senator from Maryland has introduced does not address the concerns that have been raised by these recommendations coming out of this preventive task force. Again, I think we need to understand that what this amendment specifically allows for is first-dollar coverage for immunizations for children, children's health services as outlined with the HRSA--Human Resources Services Administration--guideline. But, in fact, the requirement to provide for screening coverage for women who are not in this A or B category--in other words, anybody younger than 50--we need to understand is not covered through this. Our amendment, through allowing for a level of transparency, ensures that when you go to obtain your insurance, you can see very clearly what the professional medical organizations recommended are the guidelines and then what your insurer is proposing to offer you for your coverage. If it is not coverage you like, then shop around. This is what this insurance exchange is supposed to be all about.

Ms. MURKOWSKI. I appreciate the question from my colleague from Wyoming. The Senator knows, coming from a rural State, that our health care costs are typically higher, and it is not just an issue of cost, but it is an issue of access, and particularly in my State, where most of our communities are not connected by roads, it is very difficult to gain access to a provider. It is even more difficult to gain access, for instance, to mammography units. I have been involved in this issue, in terms of women's health and cancer screening, for many decades now, primarily because my mother got started in it back when I was still in high school and saw a need to provide for breast cancer screening for women in rural areas, where they could not afford to fly into town, as we would call it, for the screenings. So she engaged in an effort--and continues to this day--to raise money for not only mobile mammography units but to figure out how we move those units from village to village. Essentially, what they have been able to do, over the years, is you put that mobile mammography unit on the back of a barge and you take it up and down the river and you stop in every village and offer free screenings for women. You fly it into a village, where you are not on a river. We have been making this effort, again, for decades, working, chipping away slowly at the issue of breast cancer. We recognize it in our State. Particularly with our Alaska Native populations, we see higher levels of breast cancer than we would like. We are trying to reduce that. But when these recommendations came out several weeks ago from the USPSTF, I will tell you, there was a buzz around my State amongst women about: Well, now what do I do? Where do I go? Do I need to go in for my screening? What should I do? There is an article that was actually in the news just, I guess, a couple weeks ago, and it cites a comment from a doctor. Her comment was, the new recommendations were confusing patients who usually come in for their annual screenings. She said: My schedulers have called to schedule patients to come in for their followup mammogram, and they have been told: Well, I don't have to do that now. This government group says I don't have to do that. Mr. President and my colleague from Wyoming, maybe some do not. But what about those who are at risk? These are the ones whom I think we are continuing to hear from who say: Please, add some clarity to this.

Ms. MURKOWSKI. Mr. President, there has been a great deal of discussion this week certainly, and last week, with the announcement from the U.S. Preventive Services Task Force, the USPSTF, of their recommendations as they relate to mammograms and recommendation that women under the age of 50 do not need to be screened until they reach age 50, and then on attaining the age 50, every other year after that. When these recommendations came out on November 16, it is fair to say they generated a level of controversy, a level of discussion and a level of confusion around the country by women from all walks of life. For many years now, women have operated under what we knew to be the standards, the protocols. If you had a history of breast cancer in your family, you took certain steps earlier, but the general recommendation was out there. Certainly, the guidelines we had been following, the assurances we were seeking as women were that we would be encouraged to engage in these screenings on an annual basis. They gave us all a level of confidence. When these new recommendations, these new guidelines came out just a couple weeks ago, I do think the level of confusion, the level of anxiety that was raised because of this announcement brought a focus to some of what we are talking about when we discuss health care reforms and should the government be involved in our health care. I know I have received e-mails from friends, from relatives, girlfriends I haven't heard from in a while, talking with women, generally, about what do they think about this. I would hear story after story of the woman who discovered, at age 39, a lump, something that was off, something that was not right, and then the stories subsequent to that, the steps she took as an individual with her doctor. Again, the announcement that we now have these guidelines that this preventative screening task force has put in place and everything we thought we knew and understood about what we should be doing with our health has been unsettled brings us to the discussion today. We have an amendment offered by the Senator from Maryland. I would like to offer a little bit later an amendment, but I would like to speak to the amendment now, if I may. I am proposing this as a side-by- side to the Mikulski amendment. This is designed to allow for an openness, a transparency on preventative services, not just mammograms. I don't want to limit it to only mammograms, because we know that preventive services in so many other aspects of our health are also equally key and also equally important. What I am looking to do with my amendment is to rely on the expertise, not of a government-appointed task force but to rely on the expertise of medical organizations and the experts, whether they are within the college of OB/GYNs or surgeons or oncologists, rely on them and their expertise to determine what services, what preventive services should be covered. What we are seeking to do is allow for a level of information so an individual can select insurance coverage based on recommendations by these major professional medical organizations on preventative health services, whether it is mammography or for cervical cancer screening. I think we learned from the announcement from the USPSTF, the Preventive Services Task Force, that when we have government engaging in the decisions as to our health care and what role they actually play, there is a great deal of concern and consternation. I have heard from many colleagues on both sides of the aisle: That task force was wrong. We think they have made a mistake in their recommendations. What we are intending to do with this amendment is keep the government out of health care decisionmaking and allow the spotlight to be shown on the level of prevention coverage that patients will get under their health care plan, rather than relying on unelected individuals, basically individuals who are appointed by an administration to serve as part of this panel of 16, on the Preventive Services Task Force. My amendment specifies that all health plans must consult the recommendations and the guidelines of the professional medical organizations in determining what prevention benefits should be covered by all health insurance plans. I know at least those of us who are on the Federal employees health benefits have an opportunity to subscribe to the Blue Cross/Blue Shield plan. This is their booklet that is out for 2010. This is under their standard basic option plan. Turn to preventive care for adults that is covered. They provide, under this particular plan, for cancer diagnostic tests and screening procedures for colorectal cancer tests, for prostate cancer, cervical cancer, mammograms, ultrasound, abdominal aneurysm. There is a list we can look to. What we don't see laid out in this booklet or any of the other pamphlets that outline given plans out there is, OK, for instance, the breast cancer test, is there an age restriction. I am told under Blue Cross there is not. But it doesn't indicate that there. What do the experts recommend? It is not clear from what we receive. So what my amendment would do, in part, is to allow for this information to be directly made available to patients, to individuals who are looking at the plans, to make a determination as to what they will select. If you go to the Web sites of these professional medical organizations, for instance, the American Congress of Obstetricians and Gynecologists, they recommend that cervical cancer screening should begin at age 21 years, regardless of sexual history. Cervical cytology screening is recommended every 2 years for women between the ages of 21 and 29. The American Society of Clinical Oncology, as to the recommendations for mammography, urges all women beginning at age 40 to speak with their doctors about mammography, to understand the benefits and potential risks. By age 50, at the latest, they should be receiving mammograms. The American College of Surgeons, in their recommendations, recommend that women get a mammogram every year starting at age 40. As an individual who is looking to make a determination as to what the experts are saying out there, what is being recommended, I would like to know that this information is made available to me to help me make these decisions. What our amendment would require is the plans would be required to provide this information directly to the individuals through the publications they produce on an annual basis. What we are talking about now is the doctors. It is the specialists who will be recommending what preventative services to cover, not those of us here in Washington, DC, in Congress, not the Secretary of Health and Social Services, who may or may not be a doctor or a medical professional, not a task force that has been appointed by an administration. We are trying to take the politics out of this and put it on the backs of the medical professionals who know and understand this. This is where I think we want to be putting the emphasis. This is where we want to be relying on the professionals, not the political folks. Additionally, my amendment ensures that the Secretary of Health and Human Services shall not use any recommendations made by the U.S. Preventive Services Task Force to deny coverage of any items or services. This is the crux of so much of what we are discussing right now with these latest recommendations that came out by USPSTF. The big concern by both Republicans and Democrats and everyone is the insurance companies are going to be using these recommendations now to deny coverage to women under 50 or to a woman who is over 50, if she wants to have a mammogram every year; that she would only be allowed coverage for those mammograms every other year rather than on an annual basis. We want to take that away from the auspices, if you will, of the government. To suggest that we will deny coverage based on the recommendations of this government task force is not something I think most of us in this country are comfortable with. We specify very clearly that the Secretary cannot use any recommendations from the USPSTF to deny coverage of any items or services. We also include in the amendment broad protections to prevent, again, the bureaucrats, the government folks at the Department of Health and Human Services, from denying care to patients based on the use of comparative effectiveness research. Finally, we include a provision that ensures that the Secretary of Health and Human Services may not define or classify abortion or abortion services as preventative care or as preventative services. This amendment is relatively straightforward. It relies, essentially, on the recommendation of practicing doctors, as opposed to the bureaucrats, to the politicians, to those in office. My amendment addresses the concern that the government will make coverage determinations for your health care decisions. What we are doing here, quite simply, is making it transparent, making clear that the preventive services recommended by the professional medical organizations are visible, are transparent. We require the insurance companies to disclose that information that is recommended and, again, recommended by the professionals. This is a good compromise. It basically keeps the government out, and it keeps the doctors in. It requires the insurance companies to disclose the information to potential enrollees and allows for, again, a transparency that, to this point in time, has been lacking. It has been suggested by at least one other Member on the floor earlier that my amendment would cost somewhere in the range of $30 billion. I would like to note for the record, we have not yet received a score on this. We fully believe it will be much less than has been suggested. When the statement was made, it was not with a full view of the amendment we have before us and is not consistent with that. I did wish to acknowledge that as we begin the discussion on my amendment.

Ms. MURKOWSKI. Mr. President, I ask unanimous consent I be permitted to engage in colloquy with my Republican colleagues on an amendment I will be discussing.

Ms. MURKOWSKI

Ms. MURKOWSKI. I thank my colleagues and I thank particularly the senior Senator from Maine for her long, arduous work as part of a small group of Senators who did try, honestly and with great integrity, to advance this process so we would have a bipartisan product to deal with. I appreciate her efforts. I heard a little bit of her frustration as she spoke on the floor this evening. I thank her for her leadership. I concur with my fellow Senator from Oklahoma that we all agree reforms are needed in the health care world. We all agree that the status quo is not acceptable. But where we differ is certainly what leads us to the discussion this evening, and tomorrow, and up to the vote tomorrow evening at 8 o'clock. Typically, this time of year, going into Thanksgiving and then the holidays that follow in December, we consider this the season of giving, where we give thanks and do a lot of giving back. Unfortunately, what we are looking at this particular November, with this particular bill, kind of makes it a season of taking--taking away your ability to choose the health insurance you want, taking away nearly $\1/2\ trillion by cutting from Medicare--a program that is already strapped, a program that provides so much for our seniors and the disabled. But we recognize that program is seriously underfunded and looking to literally go off a cliff by 2017--by taking more of your salary and increasing the Medicare payroll tax for government intrusion into your health care decisions. This health care bill is a massive overreach by the Federal Government that will result in our government having more involvement in your family's health care decisions and greater government intervention, cutting into 16 percent of our economy. Before we get into the policy debate on the health care bill, I asked one of the interns in my office to go down to the Dirksen post office. We had gotten an inquiry from a constituent from Alaska wanting to know if we could send a copy of the bill. The bill, as you can see on some of the Members' desks, is large. When it was weighed at the post office in the Dirksen building, it weighed in at 20 pounds 5.5 ounces. That is probably close to the size of the turkey my family and I will purchase for Thanksgiving. It is going to take about $45 to mail that by priority mail to Alaska. So we suggested that perhaps the Internet is a better option. In this 2,000-plus page bill, you will find the government requiring that you comply with an individual mandate where the Federal Government is going to tell you you have to buy health insurance, regardless of whether the premiums are affordable. This goes back to the concerns of the Senator from Maine. So much of this is about the affordability. If we require individuals to purchase health care insurance but we have not done anything, or enough, to make it more affordable for them, all we are doing is setting them up for additional penalties. Failure to comply will result in a $750 penalty per person to a family. We also know in this bill our government is going to be telling employers they have to comply with employer mandates, which place onerous penalties on a large number of our small businesses. These are businesses that have 50 or more employees. I think it is important to recognize that the SBA, Small Business Administration, defines a small business as one with 500 or fewer employees. But for the purposes of the employer mandate, we are going to say that if you have over 50 employees, you will be required to provide for that insurance. Let's use an example here. Say you have a small business, you employ 51 employees, and one of those employees receives a Federal subsidy for health insurance. Under this Democratic health care reform bill, the employer will be fined $750 for each of its 51 employees--not just the one employee who receives a subsidy but for all of them. So if you are a small business owner in Alaska, in Anchorage, or Fairbanks, or Juneau, who runs a restaurant or a small hotel, that employer needs to know he could be subject to a total of over $38,000 in penalties if only one of his employees seeks a government subsidy. This penalty provision alone in the bill is estimated to raise $28 billion to pay for the Democratic health program. The bill before us today also subjects Americans to health insurance that the Federal Government is going to define that this is what you have to have. What the drafters of this 2,000-plus page bill declare is it is an insurance plan with a 60-percent actuarial value. In other words, all of the discussion about ``if you like the health care plan that you have, you can keep it''--yes, in fact, you can, but only if it meets the definitions we are setting forth within this, and the requirement is that it is 60 percent of actuarial value. In Alaska, we have over 88 percent of the health benefits that are provided to individuals and small businesses by the largest insurance company operating there, Premera Alaska Blue Cross/Blue Shield. We are told that 88 percent will not meet this 60-percent threshold requirement. So what does that mean? You have had your insurance plan through Premera and your employer provided it. But if it doesn't meet this threshold requirement, what then happens is that those small business employees will not be in compliance with the provisions of the bill, so you are going to see penalties assessed. Many of my constituents will see those penalties assessed. They may lose the insurance they have, which they like, but the penalty will be a massive increase in health care insurance premiums. When we talk about the promises of health care reform and what we are going to make available to you, I think most people believe that with health care reform would come a reduction in premiums, or at least not incredible increases in premiums. In this bill, we raid the strapped Medicare Program to pay for expanding the role of government in health care reform. We raid future payments to the Medicare patients through increased payroll taxes. I think it is important to recognize that this is an unprecedented and dangerous step that plays a shell game with Americans. We are going to increase your taxes through the Medicare payroll tax, but then we are going to divert that money to pay not for keeping Medicare solvent--I mentioned earlier the insolvency cliff out there--and we are going to divert that money not to keep Medicare solvent, not to increase funds to Medicare, not to increase patient access to doctors and nurses, which so many of my constituents are suffering from but, instead, we institute a new Medicare payroll tax that is used to pay for expanding the size of the Federal Government and creating yet another federally run health plan. We recognize that the insolvency of Medicare is real. The Medicare trustees report from 2009 said that Medicare is going to be insolvent by the year 2017. But the drafters of the bill don't write a reform bill to fix Medicare insolvency. Rather, they are using this as an opportunity to tax Medicare funds to pay for the creation of another Medicare-like system. This is truly the height of hypocrisy. It is working against what is right and what should be done for Medicare. The inclusion of a 5-percent Medicare payroll tax is bad enough, but when one realizes that the tax is not indexed to inflation, one can only cringe at the financial pain that is ahead for America's middle class. There may be many people out there saying, oh, you are increasing taxes on the rich and individuals earning $200,000 or more, and couples earning $250,000 or more, but you need to put this in context and recognize how far from the truth this can be. Back in 1969, Congress enacted the alternative minimum tax, the AMT, to ensure that fewer than 200 individuals paid their fair share of taxes. Unfortunately, the AMT was not indexed to inflation, and today we have nearly 30 million taxpayers who face the long hand of the AMT tax, with many of them falling squarely in the middle of the middle class. Congress has consistently taken action to protect the middle class from the AMT. We do this, as we know around here, on a year-by-year basis, and each year it is costing more than the previous year with the number of people who face the tax growing each year. The recent 1-year patch cost $70 billion. A 10-year fix is expected to cost $447 billion. Sadly, history has a habit of repeating itself, and Congress has demonstrated a consistent inability to learn from its mistakes. My prediction is if the Medicare payroll tax increase becomes law, Congress will, once again, need to spend large sums of money to protect the middle class from this onerous new tax. Let's delve into the Medicare and Medicaid restrictions on doctors and nurses under these government health programs. In my State of Alaska, in our most populated city, Anchorage, we have very few general care doctors who are willing to accept Medicare patients. We had a study done not too long ago, and the number given in that study is there are 13 providers, 13 doctors who are taking on new Medicare- eligible individuals. In Alaska, if you are about to hit the magic age of 65, going on Medicare, you have Medicare as your primary insurance whether you like it or not. What you learn when you are on Medicare is you have very few doctors willing to see you. Eighty-three percent of the primary care doctors in Alaska's largest city will not see Medicare patients. These individuals, who before they were 65 enjoyed unfettered access to care when on private health insurance, whether they had it through the municipality, Anchorage, or they worked for a private employer, they are now realizing the harsh realities of Medicare and that they are going to face some severe restrictions in access to a primary care doctor. We are seeing it on a very accentuated basis in Alaska, but we are seeing it in many parts of rural America. It is almost unthinkable to me. A number of constituents have come up to me and have said: Look, just get us out of the Medicare system. Let us go out to the private market and purchase health insurance like we were able to do before we were on Medicare because, regardless of the contributions I make, regardless of how much I have paid into the Medicare system, it doesn't mean anything to me if I don't have access to care. They are saying: I know I have worked all these years to pay in, but I want my old insurance back. It is because what we have done is restricted their access to services, and it is something they have never dealt with before. This problem is not just in my State. According to GAO, we have States such as Colorado, Oregon, and New Mexico that are facing these major restrictions in access to primary care doctors. Senator Daschle, when he was doing his health care tour last year, when he was in Dublin, IN, and talking to doctors about how best to reform our health care system, the doctors in Dublin told the Senator that the Medicare reimbursement rates are not keeping pace with the costs of a medical practice. So if we know that private insurance pays significantly more than government insurance, then access under a government plan will undoubtedly be reduced. We have seen this both in the Medicare and the Medicaid Programs. Under the Medicaid expansion program in this health care bill, we know that Medicaid is now going to include individuals up to 133 percent of poverty. Under the Democrats' health bill, the Federal Government pays all the costs covering newly eligible enrollees through 2016. This is good for the States. It will allow Alaska, for example, to expand the roll of the Medicaid Program and include more Alaskans on the State's Medicaid Program. CBO said after 2016, the share of the Federal spending is going to vary somewhat from year to year but ultimately would average about 90 percent. If you are responsible for your State's budget and your State can no longer afford the Medicaid Program in the year 2017, when the Federal Government drops that coverage to somewhere around 90 percent, if your State is a balanced budget State such as Alaska and your State revenues are going down because of what is happening with tourism or a bad fishing season or the price of oil, what then do the States do to continue the Medicaid Program? It seems to me there are a couple options. They can either drop the expanded Medicaid population or they could reduce reimbursements rates and place the Medicaid enrollees who once had decent care in Alaska in the same predicament as my Medicare constituents are currently in. There is a reason why Democratic and Republican Governors have said this Medicaid expansion is the mother of all unfunded mandates. While all these provisions I mentioned are certainly enough for me to decide not to support this health care bill, the most troubling aspect we are seeing played out in the news right now is the impact of government rationing, which will allow the government to deny access to health care services. This is something Republicans have been speaking about all summer with regard to various health care bills. We have all seen throughout the news a great deal of concern over the announcement from the U.S. Preventive Services Task Force that it no longer recommends routine mammogram screening for women between the ages of 40 and 49. This task force's recommendation is just a look behind the curtain of what we can expect if the government runs your health care. Under this bill, we are going to provide one person, the appointed position of the U.S. Secretary of Health and Human Services. We are going to give her the ability to make a wide variety of determinations, both on the health exchanges as well as in the government-run plan. I am very concerned about what we are finding from this task force and what it means for both men and women who suffer from this deadly disease. I can tell you, without a doubt, what this has caused is great confusion. The task force came out with their recommendations and then, shortly thereafter, Secretary Sebelius came out saying women in their forties should continue to get mammograms. The task force is saying women should not even conduct self-breast exams. We have constituents who don't know what they should or what they should not be doing. This is why we need a hearing to better understand how this task force came to their conclusions. But the bigger picture is, what we need to appreciate is this ordeal we have been dealing with this week is a glimpse into the chaos of what we could see with a federally run health plan and a massive expansion of the Federal Government's role in your health care. I wish to mention, because there have been multiple accounts in the media about, no, we are not intending that this task force recommendation is going to change in any way what coverage might be available to women. I know that some of my colleagues on the other side of the aisle have recognized, in fact, that these recommendations do hold great weight with the policymakers and the insurance companies. One of my colleagues from Maryland has said she plans to offer an amendment that would address or limit the cost of breast cancer tests for women 40 and older. She said otherwise insurance companies may use this new recommendation as yet another reason to deny women coverage for mammograms. In fact, in the bill, there are at least 14 references to the U.S. Preventive Services Task Force. In section 4105 is a provision that would authorize the Secretary to modify benefits under Medicare if consistent with task force recommendations and deny payment for prevention services the task force recommends against. This could be a situation we should be very concerned about how, with recommendations such as we are seeing come out of the task force, they inadvertently or perhaps advertently will impact a woman's access to care. I know I have probably gone over my time, and the Senator from Oklahoma is waiting. I will close my comments by saying we do need health care reform. I echo the remarks of the Senator from Maine. We need to do it the right way. Setting an arbitrary timeline, saying we have to get it done by this holiday or that holiday or moving down the calendar--we have to take the time to do it right. We have to bring down the premium costs so everyone can have access to affordable health care. Imposing mandates on individuals or on employers, if we haven't done anything to provide for greater affordability, we haven't helped the situation. Unfortunately, this bill does not help us with the affordability piece. I am focused, as many of my colleagues are, on an alternative, a step-by-step approach to reduce our health care costs to allow businesses to buy across State lines, allow co-ops to be formed so that fishermen in my State or other coastal States or employees of a small business can pool together to purchase affordable comprehensive coverage. Just as important is certainly the need to preserve the rights of patients to see the doctors of their choice. We must make sure we are protecting Medicare coverage for seniors. We have to eliminate the discrimination based on preexisting conditions, ensure that expansion of government health programs will not result in restrictions in access to care because of reduced reimbursements to doctors and hospitals. While this bill does attempt to address several of these issues--for instance, the one about eliminating discrimination based on preexisting conditions--it delays the implementations of some of the more worthwhile provisions until the year 2014. We have bipartisan support on many of these pieces individually. So why would we not try to work on those areas where we do have agreement, where we do have consensus rather than waiting until 2014? I held a townhall meeting in Chugiak, AK, last week. It was a pretty tough night. We had winds that were howling off the mountains, snow all over the place, and real slick and icy roads. Over 200 people decided to brave the weather to come and speak out on the issue of health care reform and what is happening in Washington, DC. I will tell you, the one thing those constituents stood and repeated over and over was: Don't pass health care reform that is going to raise our taxes, that is going to increase our premiums, and that will cut Medicare. We need to listen to these folks. We need to listen to the American people. We have an opportunity to do it right. There is a lot of good work that goes on by a lot of good people in this body and outside this Chamber. But we are at a point now where because of deadlines-- artificial deadlines--we are forced to a process tomorrow evening where we are going to have a vote on a cloture motion on the motion to proceed. As my colleague from Oklahoma pointed out, it is a bit of a shell. We think we are going to this health care bill that is 2,000- some-odd pages, but, in fact, the vehicle we will be using on the motion to proceed is not what this is. I am not going to suggest it is bait and switch, but it could be bait and switch. I do believe our opportunity to share our concerns about what is contained in this legislation is now. We need to take the time to explain to our constituents the concerns we have, the problems we have, the unintended consequences we believe are part and parcel of this legislation. I thank the Presiding Officer for the time this evening and thank all my colleagues for their coordinated efforts to help provide a little bit of insight to the American people on what we are dealing with in the proposed legislation from the Democratic leader. I yield the floor.

Ms. MURKOWSKI

Ms. MURKOWSKI. Madam President, when the Senate considers the nomination of David Hamilton to the Seventh Circuit U.S. Court of Appeals later this afternoon, I intend to vote no. Some may regard this as perhaps inconsistent with my vote yesterday when I joined with a number of my colleagues on this side of the aisle in voting for cloture on the nomination. I certainly do not regard the two positions as inconsistent. While I do not believe this nominee should be confirmed, I do believe judicial nominees deserve a straight up-or-down vote. I have come to the Chamber today to explain my views on the Hamilton nomination and expand upon why I voted as I did yesterday. Our process for consideration of judicial nominees is broken. It has been broken since I came to the Senate in 2003. In fact, on April 30, 2003, I was among 10 freshman Senators, bipartisan, who wrote our respective leaders to say the confirmation process needed to be fixed. For reasons I can't fathom, we still seem to be light-years away from a process in which a President's judicial nominees come to the floor expeditiously for a straight up-or-down vote. This is a far cry from the process I am told the Senate adhered to prior to 2001 when there existed a strong presumption against the filibuster of judicial nominees. A cloture vote on a nomination was virtually unprecedented. I understand all of that changed in February of 2001 when our colleagues on the other side of the aisle decided they would engage in the regular practice of blocking the confirmation of courts of appeals nominees with whom they had ideological disagreements through the use of the filibuster process. Miguel Estrada, deemed ``well-qualified'' by a unanimous vote of the American Bar Association, had to suffer through seven failed cloture votes. This was in his bid to serve on the DC Circuit. Finally, he decided to move on with his life. Priscilla Owen, also a recipient of a unanimous ``well-qualified'' rating by the ABA, suffered through four failed cloture votes before ultimately being confirmed to the Fifth Circuit. David McKeague, a Sixth Circuit nominee, unanimously deemed ``well- qualified'' by the ABA was filibustered. I could go on. In the 2003 letter, my cosigners and I noted that in some instances when a well-qualified nominee for the Federal bench is denied a vote, the obstruction is justified on the ground of how prior nominees, typically the nominees of a previous President, were treated. Without doubt, a number of President Bush's nominees to the U.S. court of appeals were treated unfairly by this body. Off the top of my head, I can probably count 11 nominees to the courts of appeals, each of whom was deemed qualified to serve by the American Bar Association raters, many ``well-qualified'' in that rating, who had to suffer the filibuster. It would not be my place to venture an opinion whether this entered into the cloture debate yesterday. However, I wish to make clear this is not how I evaluate judges for confirmation. In voting to end debate on the nomination of Judge Hamilton, I wanted to make the point that the qualified nominees of a President to the Federal bench deserve a straight up-or-down vote. This is what I believe the Constitution expects of this body in most cases. Having said that, I have substantial concerns about the elevation of Judge Hamilton. I have considered his record on the Federal district court in Indiana as well as criticisms of his record. I regard it as my personal responsibility to consider these matters. My confirmation votes reflect my personal judgment as to the qualifications of the nominee. As a Senator and as a mother, I have grave concerns about Judge Hamilton's judgment in recommending executive clemency for a 32-year- old police officer who was convicted of violating Federal child pornography laws. The defendant pled guilty to Federal charges that he photographed in one case and videotaped in the other sexual encounters with two women, one age 16 and the other age 17. Although it may have been lawful for the defendant to engage in these encounters under the laws of Indiana, it is not lawful to photograph them under the laws of the United States. Judge Hamilton went out of his way to argue that the 15-year mandatory minimum sentence imposed by Congress for such violations was a miscarriage of justice in this case. He argued vociferously that executive clemency is warranted. This Senator does not understand why Judge Hamilton would choose this cause to champion. While I understand Judge Hamilton has imposed substantial sentences in other child pornography cases, I do not agree with his reasoning in this matter and cannot, in good conscience, support his confirmation. With that, Madam President, I appreciate the attention of the Chair. I yield the floor. I suggest the absence of a quorum.

Ms. MURKOWSKI

Ms. MURKOWSKI. I ask unanimous consent that the order for the quorum call be rescinded.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to take advantage of a unique opportunity to recognize and thank those who hold the distinguished title of ``veteran.'' It is because of their service, their commitment, and their sacrifice, that our country is what it is today, a great nation which stands for freedom and which shines as a beacon of hope and opportunity to the rest of the world. Ninety-one years ago today, on the 11th hour, of the 11th day, of the 11th month of 1918, the hostilities of World War I between the Allied nations and Germany, ceased. While the commemoration of this day was originally known as Armistice Day, later being renamed as ``Veterans Day,'' the purpose and intent has never changed. President Woodrow Wilson, in 1919, expressed his thoughts of this day, and they ring as true today as they did nine decades ago: To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country's service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations. In Alaska we have the distinct pleasure and honor of having the largest per capita percentage of veterans of any State in the Union. We call them our neighbors, our coworkers, and our friends. Our communities benefit from the experience and expertise which they have brought home with them from their time in the service of our Nation. Today, while they may wear different clothing in place of a uniform, their service continues as they provide leadership and skill within the State of Alaska. As we reflect on the service of heroes who have served our country in conflicts past such as World War I, World War II, Korea, Vietnam, the Persian Gulf war and others, we would be remiss if didn't also pause to honor the dedication of the men and women who are putting their lives on the line today to protect our freedom. This includes not only those serving in Southwest Asia but also those still in Kosovo, those still standing watch of the Korean demilitarized zone, and those serving and sacrificing in countless other countries and regions around the world. Today, we also mourn. We mourn those veterans who made the ultimate sacrifice in the defense of freedom. This year, Alaska lost several members of our military community in the Afghanistan and Iraq conflicts. I extend my heartfelt sympathy to the families of our fallen service members. Finally, I would like to recognize a group who often isn't honored enough: the families and loved ones of America's veterans. These are the folks who have had to see their loved ones sent away to war zones and who worried about their well being every second, of every minute, of every day until they returned. These are the folks who have had to singlehandedly manage the household and deal with the car, the washing machine, or the heater invariably breaking the second that their spouse departed. These are the folks who firsthand deal with the invisible scars and injuries of war, such as PTSD, when their loved one comes home. The family members of our veterans are heroes who bravely serve our Nation and rightfully deserve our recognition. I am honored to have the opportunity to stand among my colleagues here on the Senate floor and proudly state that while we know that words cannot express the gratitude that a grateful nation has for its veterans, with a common voice we want to say thank you.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to acknowledge the life of one of Alaska's most dedicated public servants. Representative Richard Neal Foster served as a member of the Alaska House of Representatives for nearly 21 years. Since his election in 1988 he represented the residents of Nome and 28 villages with great love and dedication. Alaska will remember him this Friday at a memorial service in Anchorage. A lifelong Alaskan, Representative Foster was born and raised in Nome. He received a business administration degree from the University of Alaska. He managed Foster Aviation, a family-run air service started by his father in 1946. He was a civic leader in the community of Nome serving on the boards of the Bering Straits Native Corporation, the Sitnasuak Native Corporation, Nome Eskimo Community, and the Northwest Campus of the University of Alaska. Representative Foster will be remembered for a lifetime of public service. After serving two tours in Vietnam as a captain in military intelligence he was awarded the Bronze Star. He received a commission as a second lieutenant in the Army through the University of Alaska, Army ROTC program. As a man with passion for Alaska, he later served with the Alaska Army National Guard in Nome. During his tenure in the Alaska State legislature, he served as majority whip from 1993 to 2007. Showing his commitment to address the challenges of rural Alaska, he was a member of the Bush Caucus as well as the Alcohol and Substance Abuse Task Force Committee. And, in 2009, he was honored as a University of Alaska Distinguished Alumni because of his dedication to public service. As one of the longest serving members in the Alaska legislature, it saddens me to acknowledge that Alaska has lost one of our truly great leaders. I had the honor of serving in the legislature with Representative Foster. He was a man with an infectious laugh and he had a great love for the Seward Peninsula and the State of Alaska. Never letting divisive politics come between friendships, he was known for his humility and friendliness to both Republicans and Democrats. His ``Friday at Fosters'' events, where he hosted legislators, staff, administration officials, friends, and visitors for a Friday evening jam sessions for over 17 years, will be sorely missed. Foster loved the outdoors of the Seward Peninsula, a region with a rich mining history. He spent his summers at Hannum Creek, working on his family's mining claims. One time, he and his sister Iris and son Neal walked 80 miles of the historic mining trail from Quartz Creek to Hannum Creek to experience the journey of ``Old Timers.'' In addition, Foster was known for his love of military history including the Civil War and World War II and was a collector of military weapons. He is survived by his wife Cathryn of Eatonville, WA; seven sons, Neal Foster of Nome, AK; James Foster of Anchorage, AK; Nathan Foster of Ellendale, ND; 1st Lt. Jason Weber, LCpl Richard Foster, Ramsey Foster, and Chandler Foster, all of Eatonville, WA; and two daughters, Maria Stevens of Tacoma, WA, Tiffany Sanchez of Miami, OK; and sister Margaret ``Iris'' Magnell of Laguna Hills, CA. Foster's public service to the State of Alaska will continue to positively impact the lives of Alaskans for decades to come.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I wish to remember one of the great public officials in the history of the State of Alaska, the former mayor of Anchorage, George M. Sullivan, who died peacefully in his sleep last month at age 87. George served Alaska during a time of transition in our State's history. A lifelong Alaskan who was born and raised in Valdez, George worked for the U.S. Army's transportation corps during World War II in the Aleutians. He later won a seat in the Alaska House of Representatives in 1964 and 1965, being an excellent representative for Anchorage to represent the city's vast economic needs in the State legislature. He was a convincing spokesman for Anchorage in securing the aid that the city so desperately needed to rebuild. George became the mayor of the city of Anchorage in 1967, just 8 years after statehood, but more importantly just 3 years after the Good Friday earthquake of 1964 that destroyed most of downtown Anchorage. The city was still in the early phases of rebuilding when George became the leader of city government. He guided the city through crafting new building and zoning codes as well as implementing land use planning to prevent further earthquake damage from occurring in the future. Meanwhile, an economic earthquake struck Alaska--the discovery of oil on Alaska's North Slope in December 1968. That discovery did more than any other event, even the earthquake, to turn Anchorage from a small port city to Alaska's largest city and the center of business, commerce, and supply in the State. In preparation for the construction of the Trans-Alaska pipeline and the subsequent economic boom, Sullivan had the vision to see that municipal government needed to have greater authority to regulate and supervise growth. He led the effort to bring about the merger of the city of Anchorage with the surrounding borough to build a unified government, helping to write the city-borough's first charter in 1975. He then stayed on to guide the young unified city-borough government, serving as mayor for 14 years, longer than any other person before or since. While guiding Anchorage to become the State's largest city, he also found time to represent Alaska as the State's first member of the executive board of the National League of Cities in 1972. He also served as the president of the Alaska Municipal League. George also worked tirelessly to represent Alaska's needs during congressional consideration of the Alaska lands act that eventually passed in 1980. It was then that I first met him since I was working as an aide for the Alaska Legislature. George truly was an inspiration. He could light up a room in Juneau just by entering it and could influence legislation simply with a few words of wisdom. George did not speak to hear himself talk, but everyone listened when he did talk. That was because everyone who knew George knew he was a straight shooter, a totally honest, fair, dedicated and hard-working man of outstanding judgment. He was a gentleman in every sense of the word. He worked tirelessly to develop a complete city, one with services for the young which is why the town's sports center the the Sullivan Arena--is named after him. He also worked to build facilities for senior citizens and low-income individuals and he worked to build the infrastructure necessary for a modern city in a cold climate. While we had known of his ill health and his battle with cancer for some time, there is still a great emptiness at his passing. While his wife Margaret passed away 2 years ago, George is survived by nine children, one of which, Dan, is Anchorage's current mayor. As much as George was known for his leadership in the community and State, he was also known to be a family man. He and his wife Margaret were married for 59 years and raised nine children. I offer my deepest condolences to all of his children and grandchildren. George was truly one of Alaska's original pioneers, a giant who will be sorely missed. His many accomplishments will live on in Alaska's history. Many Alaskans, including myself, will continue to remember the good humor, wisdom, and selflessness of the man who will always be called Mr. Mayor.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to talk about the hidden taxes that American families could be forced to pay under the Baucus proposal if Congress doesn't cut half a trillion dollars in Medicare services. Despite the score we saw last week by the CBO that there would be an estimated $81 billion in savings to the Federal Government, the fine print of that CBO letter paints a different picture and raises some real concerns about whether Congress has the stomach to cut $500 billion in services to the elderly and the disabled on Medicare. This point was raised over the weekend. There were several editorials that ran in the Washington Post, Reuters, the Salt Lake Tribune, and the Colorado Springs Gazette, and they criticized the Baucus bill for unrealistically relying on $500 billion in savings in Medicare. These articles conclude that Congress is unlikely to enact Medicare cuts based on their annual action--our annual action--since 2003 that has stopped cuts to the doctors' reimbursement rates under the sustainable growth rates formula. This is what we call the SGR. In 1997, Congress enacted the SGR formula, which automatically cuts Medicare reimbursement rates when annual spending for doctors' visits exceeds the SGR target. Every year since 2003, Congress has stepped in to prevent these cuts from going into effect. The question should be asked whether it is wrong for Congress to prevent these cuts. I suggest no, absolutely not. In fact, there is virtually unanimous agreement among Republicans, Democrats, and the President that the fixes must happen because the SGR is a flawed formula that doesn't accurately account for Medicare practice costs. The SGR, however, is just one example of how Congress has been unwilling to not only prevent cuts to the Medicare Program but also unwilling to fix the flawed SGR formula. Except for 1 year, in 2002, when Congress allowed the 5.4-percent cut to go into effect, every year since then Congress has ``fixed'' the Medicare cut by affixing a Band- Aid, which has resulted in artificially adjusting the Medicare reimbursement rates and pushing larger ``phantom cuts'' into future years. Will this year's 21-percent cut to Medicare provider reimbursement rates go into effect? It is highly unlikely. In fact, the Baucus bill contains another Band-Aid measure that pushes this year 21- percent cut into 2010, with the notion that next year doctors will face an even larger, 25 cut under the Finance Committee proposal. While the past is not always indicative of the future, I believe it is highly unlikely that we in Congress will witness any willingness to make a game-changing ``audible'' that forces half a trillion dollars in cuts to services for our seniors and for the disabled. The CBO has acknowledged this in a letter to Senator Baucus when they discussed the budgetary impact of the health care bill. CBO said: The mechanism governing Medicare's payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments. . . .The long-term budgetary impact [of the Finance Committee proposal] could be quite different if those provisions were ultimately changed or not fully implemented. If, since 2003, Congress had stepped in to prevent Medicare cuts from going into effect, why should we expect Congress to now take the unprecedented step of cutting nearly half a trillion dollars from the Medicare Program? In fact, there was an editorial in the Washington Post last month talking about CBO's assumption of Medicare savings. They said: Many Medicare ``savings'' are probably phony. Congress is likely to reverse them, as in the past. Put in that category about $200 billion in ``savings'' over 10 years from lower reimbursement rates for doctors, which Congress has repeatedly prevented from occurring. A separate $180 billion in ``savings'' from lower reimbursement for hospitals and other providers are similarly suspect. Together, these items provide about half the [Baucus plan's] financing. If half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn't he gotten started on the painless billions in ``waste and fraud'' savings? That was in the Washington Post last month. Just today, on the front page of the Washington Post, it was reported that the SGR fix included in the House bill, H.R. 3200, was stripped out of the health care reform bill that passed in three House committees of jurisdiction. Leaders in the House are citing the $240 billion cost of the SGR fix as the main reason for removing this provision. I believe Congress is being shortsighted in not addressing a major concern in the Medicare Program--a concern that not only would address reimbursement decreases that doctors have faced every year since 2002, but also the concerns about access to doctors that is worrying more and more Medicare patients every day. By stripping this important provision out of the House bill, Medicare patients are left crossing their fingers in the hopes that the SGR fix will ultimately be included in the health reform bill. I believe removal of this essential and important provision, not only because of policy concerns but, rather, because House leaders want to stay below an arbitrary pricetag, simply shows Congress's unwillingness to address significant failures in a government health program that impacts the lives of some 44 million elderly and disabled Americans. We know the government has been promising to cut from the Medicare Program, particularly in the areas of waste, fraud, and abuse, since the Reagan administration. Yet spending continues to rise. There is no reason to believe this is going to ever change. I will not support cuts in services under the Medicare Program. I will ask my colleagues to give weighted consideration to whether they would be willing to tell their Medicare seniors and disabled constituents that they voted to cut $500 billion from their Medicare insurance. Inevitably, if the Congress cannot pass a measure to cut from Medicare, then the money will have to be made up either through increased taxes on average American families or in the form of additional deficits that will burden future generations of Americans. Mr. President, with over $2 trillion spent on bailouts, stimulus, and cash for clunkers in just the past 22 months, we must be better stewards and more vigilant of the potential for additional costs to working families for expanding government services and creating more mandates for health insurance. With that, I thank the Chair and suggest the absence of a quorum.

Ms. MURKOWSKI

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

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to remember a good friend who is leaving the Senate after a career of public service, Senator Mel Martinez. Mel Martinez came to the Senate in 2005 after serving as Secretary of Housing and Urban Development under President George W. Bush. Senator Martinez was the first Cuban American to serve in the U.S. Senate. Born in Cuba, Senator Martinez arrived in the United States at age 15. During his tenure as Secretary of Housing and Urban Development, Mel Martinez addressed the National Congress of American Indians, pledging to strengthen the government to government relationship with tribes in the Federal Indian programs administered by his agency. He was keenly interested in ameliorating the third world housing conditions that exist in the Native villages of rural Alaska. Alaska's tribe and tribal housing authorities benefit greatly from Federal funding available under the Native American Housing Assistance and Self Determination Act and other Federal housing programs, which were strengthened under Senator Martinez' leadership at HUD. Despite the fact that the States we represent are as far away geographically as States can be, we have always been good friends. I was proud to serve with Senator Martinez on the Energy and Natural Resources Committee. Senator Martinez was a close ally on energy issues, and he was always a fierce advocate for the interests of his Floridian constituents. We shared a common interest in promoting Federal energy efficiency standards, responsible nuclear waste storage, and we worked together on the 2005 Energy Policy Act. He was a tough bargainer on the more recent 2007 Energy Independence and Security Act as he aggressively pursued the interests of his constituents with respect to Federal Outer Continental Shelf energy development. I wish Mel Martinez and his wife Kitty the best of luck in their future endeavors.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I was deeply saddened by the passing of Senator Edward M. Kennedy in August, my colleague on the Health, Education, and Labor Committee, a statesman in every sense of the word, and a Senator not just for the people of Massachusetts but for every corner of the Nation. I am grateful for the time I shared with him as a colleague and as a friend. Senator Kennedy may be best known in this body for his consistent leadership on the big national issues. Whether you agreed with him or not Senator Kennedy was ``all in'' on the issues he cared about, like health care and education, and a formidable force to be reckoned with. While Senator Kennedy was firm in his convictions, he was open to the ideas of other Senators, regardless of party affiliation. As most Senators who worked with him know, Senator Kennedy had an unequaled reputation for compromise and negotiation. As legislation was being written and developed, he recognized the importance of other Senators' perspectives on an issue, including mine, and was therefore willing to alter legislative proposals for the sake of cooperation and finding middle ground with Senators from any political party. The two years I spent on the HELP Committee with him as my chairman were truly a blessing. There was so much to admire about Senator Kennedy's career. But the thing I really admired about Senator Kennedy was his ability to look beyond the beltway to take up causes that might seem obscure to many in this body--causes that offended Senator Kennedy's sense of justice. Let me offer a few examples from my State of Alaska. Federal law requires agencies to reinstate civil servants who go on active duty in the National Guard and Reserves when their service is complete. The law goes by the acronym USERRA. When Bob Traut of Palmer, AK, completed his active duty service with the Alaska National Guard, he was not reinstated to his position in the Indian Health Service. His position had been eliminated and he was not offered another. He filed a USERRA complaint with the Department of Labor, which was passed around among investigators and ultimately lost. Several years after he started this process he was offered a Federal position at a U.S. Coast Guard base hundreds of miles from his home. He couldn't drive to his new workplace--he had to fly there because Kodiak is an island not connected by road to the rest of Alaska. Even then his back pay claims were lost in a morass of bureaucracy, in spite of repeated inquiries from my office. Bob Traut's fortunes changed when Senator Kennedy decided to hold an oversight hearing about USERRA focused on Bob Traut's case. The Alaska Native Claims Settlement Act, the 1971 law which resolved the aboriginal land claims of Alaska's first peoples, is truly one of the landmark pieces of federal Indian legislation. The administration offered Alaska's Native people 10 million acres of land. Senator Kennedy came to the floor on several occasions to argue that the number of acres should be no less than 40 million. The ultimate settlement was 44 million acres. A settlement which might not have been possible without Senator Kennedy's leadership. As the chairman of the Subcommittee on Indian Education, Kennedy joined a few other Senate colleagues on a trip to several Alaska Native villages in April 1969. Kennedy recalls being stunned by the poverty and despair in the villages, many of which still lack basic sanitation and are plagued by high rates of sexual assault, domestic violence, and suicide. It affected Senator Kennedy so deeply that he found it difficult to ``numb the pain.'' The course of Senator Kennedy's life brought him many blessings and accomplishments. He was a father of three beautiful children and two stepchildren, a Harvard graduate, a nine-term Senator with the third longest time serving in the U.S. Senate in American history, a veteran of the Army, a talented football player who almost went pro but opted instead for a life of public service . . . the list goes on. My condolences and blessings go out to his family, especially his wife and children. Despite Ted's passing, his spirit lives on. There is little doubt in my mind that this spirit will inspire generations of our colleagues in the years ahead to take up his causes and ensure that the vulnerable in America, the often forgotten Americans who live in remote places like rural Alaska, are never forgotten. Ted, thank you for your service.

Ms. MURKOWSKI

Ms. MURKOWSKI. Madam President, I also wish to recognize my friend and colleague, Senator McCain, who was there at the end to help us with this issue. The people of Alaska thank our colleagues, Senator Inouye, Senator McCain, and so many others for the consideration that was given these Alaska Territorial guardsmen. Last Friday, we were disappointed to learn that some in the administration might not share our enthusiasm for putting this matter to bed and restoring the retirement benefits for the 26 elderly Alaska Native veterans. The statement of administration position on the Defense appropriations bill contains two sentences that read as follows: The administration objects to a new General Provision that would count as ``active duty'' service the time the Alaska Territorial Guard members served during World War II. This provision would establish a precedent of treating service performed by a State employee as active duty for purposes of the computation of retired pay. The notion that restoring these benefits establishes a precedent of treating service performed by a State employee as active-duty service defies logic and it defies history. Not only is it inconsistent with the letter of Congress's finding in section 8147 of the 2001 Defense Appropriations Act that the service was indeed Federal service, it is inconsistent with the facts, and I believe it is inconsistent with the law. When our Lieutenant Governor--retired LTG Craig Campbell--heard this, he remarked: The administration doesn't understand what the territorial guard is. This was an initiative of the Federal Government. They provided a federal service. General Campbell recently retired as Adjutant General of the Alaska National Guard, and he is absolutely correct on this. The Alaska Territorial Guard was created back in 1942 to protect Alaska from invasion by the Japanese. The notion that Japan had an interest in Alaska was far from speculative, as we know. The Japanese bombed Dutch Harbor and landed in Attu and Kiska in the Aleutian Chain. Enemy submarines lurked in the Bering Sea. The ATG was organized by U.S. Army MAJ Marvin Marston under the leadership of a territorial Governor who reported to Washington. These were Uncle Sam's men. All who served were volunteers. They were not State employees. It was organized in the name of the President of the United States, and it was armed by the U.S. Army. The operations of the units were inspected by the U.S. Army, and the unit was disbanded in 1947 by order of the U.S. Army. The unit was well known for its skill in protecting Alaska. These gentlemen were Native hunters and fishermen, but they knew the land better than any soldier that the army might have sent up from the lower 48. They kept watch over 5,000 miles of coastline for enemy vessels and submarines, shooting down Japanese balloon bombs, protecting the Lend-Lease Route between Alaska and Russia and recovering downed airmen. These were the core missions of the territorial guard. It is very disappointing that 62 years after the Alaska Territorial Guard was disbanded the value of their service to our Nation and to our success in World War II has been drawn into question. When I came to the floor on January 22 of this year, I gave the Defense Department the benefit of the doubt. I believe, as did General Campbell and his staff judge advocate, that the 2000 legislation entitled members of the ATG to all the military benefits merited by their service. The military at one time held that position, but then on January 22, they didn't. I called upon the Department of Defense to work with me, to work with Senator Begich, to make things right. The Alaska congressional delegation wrote to the President to enlist his personal support for this effort. Nine years now have passed since Congress determined that service in the Alaska Territorial Guard during World War II was Federal service. Nine years have passed since the Secretary of Defense ordered that these brave members of the tundra army who remain alive are entitled to discharge certificates from the U.S. Army; 9 years since they were granted full Federal veterans benefits. I would suggest it is 9 years too late for the Defense Department to reopen the question of whether service in the ATG was Federal service. The Congress has answered this question with finality. I mentioned that many Americans have registered their opinions on the Internet over the administration's position on territorial guard retirement benefits. Many think it is cruel to continue to deny these benefits. And many believe the administration's position denigrates the service of the Alaska Territorial Guard. Some have suggested the men who served deserve an apology. But one perceptive individual suggested, I doubt that President Obama actually made this decision or even knows about it. So once again, I ask that President Obama personally support us in our quest to obtain justice for a few elderly Alaska Natives who once served our Nation with patriotism, with pride, and with distinction. President Obama, show some heart, do the right thing, and support our efforts to restore military retirement benefits for these 26 individuals. With that, Madam President, I yield the floor.

Ms. MURKOWSKI. Madam President, I do have additional comments I wish to make. I ask unanimous consent that I have 5 minutes to conclude these remarks, if that is acceptable.

Ms. MURKOWSKI. Madam President, it was my understanding that I was to have 15 minutes under this time agreement; is that correct?

Ms. MURKOWSKI. Madam President, on January 22 of this year, I came to the floor to inform our colleagues in the Senate about a decision by the Department of Defense that service in the Alaska Territorial Guard during World War II would not be regarded as Active-Duty service for purposes of military retirement. That decision reversed the position that had previously been taken by the Army that this service did count toward military retirement. As a consequence, 26 elderly Alaskans, descendants of the aboriginal people who originally inhabited Alaska, 26 Native people, predominantly Eskimo, were about to see a substantial reduction in their military pensions, this all happening in the dead of an Alaska winter when we were paying extraordinarily high fuel prices. At that time when I came to the floor, I wondered out loud what kind of government, what kind of ``Cruella'' would cut the pensions of 26 elderly people who stood up to defend Alaska and our Nation during World War II with absolutely no prior warning, no advanced notice? The answer was our government, on advice of the lawyers. In the Defense Appropriations Act for fiscal year 2001, Congress recognized service in the Alaska Territorial Guard as Active-Duty service. Section 8147 required the Secretary of Defense to issue discharge certificates to each member of the Alaska Territorial Guard under honorable conditions if the Secretary determined the nature and duration of the service of the individual so warrants. The military first concluded that included retirement benefits and then abruptly reversed that position with immediate effect. As Lieutenant Colonel McNorton explained in a story carried by the Associated Press, section 8147 applies to military benefits, including health benefits, but it does not make members of the Territorial Guard eligible for retirement pay. I must emphasize, at this point, that no Alaska Territorial guardsman claimed a military pension solely because of his service in the Territorial Guard. The Alaska Territorial Guard was created in 1942 and disbanded in 1947. Many members of the ``Tundra Army,'' as some called it, continued to serve in the Alaska National Guard and other units of the military. That service, combined with service in the Territorial Guard, forms the basis for the claim. I have come to learn that when you use the term ``Cruella'' on the Senate floor, people sit up and take notice. My remarks were telegraphed across the blogosphere and national media outlets. The response that came from across the country to the plight of the 26 elderly Alaskans was truly heartwarming. Across the ideological spectrum, the response from the American people was outrage over this situation. The high level of national interest in the plight of these Alaska Territorial Guard members was not lost on the senior leaders of the Army. The Secretary of the Army rose to the occasion. He reached into his emergency and extraordinary expense fund--the triple E fund-- to continue the payments to those elders for 60 days, in the hope that Congress would have an opportunity to address the issue by then. My colleague, Senator Begich, and I promptly introduced legislation to correct that situation, but the legislation was not considered before the 60 days of temporary payments ran out. The Alaska Legislature stepped up to fill the gap, and they enacted legislation to continue the payments from State funds until February of 2010 in order to, again, give Congress the time to fix the problem. With the support of our colleagues--and I especially appreciate the leadership and support from Senator Levin, my colleague and friend Senator Inouye, and Senator Cochran--language to clarify that service in the Alaska Territorial Guard counts toward eligibility for retirement pay that was included in that 2010 Defense authorization bill----

Ms. MURKOWSKI

Ms. MURKOWSKI. Madam President, I ask unanimous consent that a military fellow in my office, MAJ John Vargas, be granted the privilege of the floor for the duration of the debate on the fiscal year 2010 Defense appropriations bill.