Jack Reed

Mr. REED

Mr. REED. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I rise today to introduce the Transitional Federal Medical Assistance Percentage, FMAP, Act, and I am pleased to do so with the support of Senators Brown, Whitehouse, Akaka, Durbin, Klobuchar, and Begich. This bill is an important step in continuing the conversation about how we can help our States, businesses, and individuals as our economy recovers. In my State of Rhode Island, the economic downturn has been particularly hard hitting on families and businesses. As a result, the State has seen a decline in tax revenue and an increased enrollment in safety net programs like Medicaid. Revenue from the sales tax is down over 7 percent, income tax receipts are down 2.3 percent, and corporate tax revenue is down nearly 10 percent. At the same time, unemployment rates have soared to new heights, topping 13 percent earlier this year. In the past 2 years, 40,000 Rhode Islanders have lost their employer- sponsored health insurance. Many of these individuals have come to rely on Medicaid for health coverage. This has caused great strain on the State's resources and its Medicaid program. In November, we learned that the estimated Medicaid caseload for the year will cost over $40 million more than what the State had initially estimated in its budget. The American Recovery and Reinvestment Act, which I supported, provided States with additional Federal assistance through 2010. States have used these funds to help balance their budgets, minimize harmful cuts in public services, and, very importantly, to prevent tax increases in many cases. However, even with the funding from the Recovery Act, Rhode Island will close the current fiscal year $219.8 million in the red. A total of 38 States have looked ahead to fiscal year 2011, and they have estimated $92 billion in combined deficits in the coming year. As the State fiscal year nears, and more States have had ample time to analyze their fiscal health it is expected that the total shortfall will likely equal $180 billion. As Congress debates health reform and works to ensure that every American has access to health insurance in 2014, we must not forget about ensuring that Americans have access to health insurance between now and then, as the economy slowly recovers and as state budgets begin to heal. During this tough time we need to help individuals, businesses, and States, and I am particularly concerned with making sure our States have the resources to provide adequate health care. Unless Congress acts on FMAP legislation, States will be forced to use their limited resources to cover an expanded Medicaid population beginning in January 2011. Since States are planning their fiscal year 2011 budgets, which will begin in July, many Governors are requesting Congress act now to provide States with additional Federal support. The Transitional FMAP Act would extend the enhanced FMAP funding which we passed in the Recovery Act for two additional quarters. This extension accounts for the prolonged recession and ensures that the pressure of Medicaid needs do not overwhelm the States. The bill would also begin a slow decrease of enhanced FMAP funding from July 2011 through December 2013. This will help States as they recover and ensure that States do not experience a gap in assistance prior to health reform-related FMAP levels beginning in January 2014. Mr. President, this additional funding is important for States, businesses, and individuals. I know that Chairman Baucus and Leader Reid are well aware of the importance of FMAP and have a history to working to aid our States. I look forward to working with them and my other colleagues to provide States with necessary additional Federal Medicaid assistance. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I think it is important to focus on the fiscal difficulties we have today, but I think it is also important to recognize the probable causes of these huge deficits: two wars, unfunded, no attempt to fund them, spent simply by running up the deficit; tax cuts, which were unfunded and which did not ultimately generate the kind of sustained economic growth and job growth that their supporters advertised, and then the Medicare Part D program, an entitlement program which was also completely unpaid for. Today we have people talking about entitlement reform, how that is a key aspect of health reform. But so many of my colleagues on the Republican side supported President Bush when he proposed the Medicare Part D program, a worthy program in concept, but in the context of not paying for it, it is a concept that is costing us greatly today. Additionally, it is particularly ironic at this moment, because we are considering a McCain motion that would report this health care bill back to the committee with the instructions to restore $400 billion in spending, roughly, over 10 years. I cannot think of anything more contrary to the notion of entitlement reform. What we have tried to do in this bill is to restructure Medicare so that it will continue providing quality health care, but also recognize the high costs we are facing going forward and the general economic climate we face today. Again, let me remind you, in January 2001, the unemployment rate was about 4.6 percent. When President Obama took office, it was double that and growing and continuing to grow. We have seen some effects to limit this growth, but it is still a critical issue. Again, this reform package is designed not only to deal with the quality of health care, accessibility to health care, and affordability of health care, but it is designed to, over the long term, begin to rein in costs that are absolutely out of control. Those suffering the most from this course are the American people and, in some respects, small business men and women. Their health care costs are going up faster than any other costs, and in many instances faster than wages, and it is unsustainable. If in my State of Rhode Island we do not take effective action, we will see within several years premiums reaching $24,000 to $30,000 a year for a family of four. We cannot sustain that. If someone is interested in taking the very difficult step of entitlement reform, they would reject the McCain motion. But there are other reasons to reject the amendment, as well. First, the funding that has been eliminated from the current health care system and the system going forward, has been eliminated because it does not improve care. This is particularly true in Medicare Advantage. This was a program that was developed and sold essentially to the American people as cost containment for Medicare. This was one of the proposals that would rein in out-of-control health care costs by giving insurance companies the ability to manage more effectively. Of course, what we have seen is a significant increase in payments to Medicare Advantage payments over traditional Medicare. Of course, these insurance companies can manage health care very well as long as they are receiving very significant premium payments from beneficiaries. But, those premiums do not essentially go to better health care. It certainly goes, however, to better profits for the insurance companies. Indeed, with Medicare Advantage there is a rebate given to each insurance company. This is not the case with traditional Medicare. The rebate was designed essentially to provide, again, lower cost access to health care benefits for the consumers of Medicare Advantage. The GAO found that 19 percent of Medicare Advantage beneficiaries actually pay more than traditional Medicare for home health care and 16 percent pay more for inpatient services. Here is the irony. We are paying the insurance companies more, but the beneficiaries of Medicare Advantage are, indeed, are also paying more. So there is no cost savings in this regard, in this program at least. The other point, which is I think critical and I alluded to, is that for the same services you receive in Medicare Advantage, there is, on average, a 14-percent increase overall for those similar services in traditional Medicare. We have to, I think, take tough steps to eliminate these over- payments, but steps that will enhance the quality of care for seniors, and that is what is being done in this bill. While some of these resources are being used to help redesign a system for all Americans, there will also be significant improvements for seniors, for care that is more effective and efficient, and less costly. Let me suggest something else. We are all paying right now for the cost of uninsured Americans. It has been estimated that every private insurance plan in this country is paying--every individual payer, businesses or individual--about $1,000 a year for uncompensated care. That is the cost hospitals shift from their uncompensated care on to the insurance providers, the carriers, and that is translated into higher premiums for all Americans. Under this legislation, the hospitals will now see patients presenting themselves with an insurance card. Mr. President, over 94 percent of Americans, it has been estimated, will be covered under our proposal. So instead of showing up for free care, they will be under an insurance plan. The hospitals will benefit. Medicare, Medicaid, and the whole health care system will benefit. Again, this is one of the changes that would be reversed by the McCain motion. Also, we have taken steps so that hospitals will be much more effective in managing their patient flow. Readmissions will hopefully be reduced by some of the provisions in this legislation. There are many things we should do and will do, but I believe we can successfully balance expanding our coverage system, protecting quality of care, but also recognizing, as has been suggested, the fiscal implications not just for the moment but going forward. I suggest if someone is serious about entitlement control, serious about the fiscal implications of this legislation or any other legislation, they will not simply order the committee to restore these cuts. They would do something much more proactive and, indeed, support what I believe are sensible, sound proposals to provide quality, to ensure that over the long run, Medicare is more solvent. In fact--the final point--the legislation before us would extend the life of Medicare, the solvency of Medicare over at least 5 years. So for those people who say we are trying to end Medicare, their solution is simply to let it go bankrupt apparently in 2017 or to simply ignore it and let it find its own fate. We can do better. I urge rejection of the McCain motion. I yield the floor.

Mr. REED

Mr. REED. Mr. President, I thank the Senator from Minnesota. I want to add my comments to that of the Senator from Maryland and the Senator from Delaware to commend the new Senator from Massachusetts. He not only carries on the great work of Ted Kennedy, but he does it with the same passion and eloquence. What struck me in this legislation--and reminiscent of Senator Kennedy--is that this legislation will provide real help to real people. It is about solutions, not slogans. Let me illuminate, if I may. Premium relief. What is troubling so many middle-class families? They are too wealthy to qualify for direct public assistance in terms of the Medicaid Program, but they are not wealthy enough to pay for insurance. This legislation will cap family outlays on medical insurance premiums. Families making under $88,000 will pay no more than 10 percent of their income on premiums. They will be given direct assistance through the tax system. There will be a rebate. So people now, rather than staring at 20 percent, 15 percent, 18 percent increases, will at least know there is a cap. And perhaps if we do our work well enough, the whole system will begin to reduce below the 10- percent mark, and everyone will benefit. It is also notable that real families worry about many things. They worry about educating their children. They want them to be educated, but they also recognize as full-time students in higher education, they can stay on the family health care plan. It is interesting to note that decisions made about education are tied into health care, and also, in fact, as to where you work, if you should keep your job you do not like because you have health care or go on, whether you strike out to start a new business because you have this brilliant idea or stay in your current position because there is health care there. But what this bill does, again, is provide real help for real people and allows families to keep their children on their health care plan until they are 26 years old. It also reforms dramatically the insurance system. Again, we listen to many of the complaints: Oh, we don't want a government-run health care system; we don't want bureaucrats telling us what to do. The irony, of course, as you mentioned, and Senator Schumer did, too, is that one of the most popular health care programs in this country is Medicare, which is government run. One of the other most popular health care programs in this country is run through the Veterans' Administration, which is a government agency. The least popular programs are private health insurance, where everyone has complaints-- doctors, patients, providers. This legislation will prevent lifetime limits that insurance companies dictate. It will also do many other things. So let me conclude because I appreciate very much--and if the time allows, I have a question for the Senator from Massachusetts. But this is a bill that when you move past all of the rhetorical smokescreens-- because, frankly, most of our colleagues on the other side don't want to do anything. They didn't want to do it in 1993 and 1994; they didn't want to do it in 1933 and 1935; and they still don't want to do it-- this legislation helps real people with solutions not slogans about nationalization and bureaucrats.

Mr. REED

Mr. REED. I thank Senator Udall. Senator Kaufman has made an excellent point. What we have seen over the last several years, actually more than a decade, is increasing costs shifted to small business. Just this year, a 15-percent increase in small business premiums is anticipated, much higher than inflation. That is because there is no real competition. Rhode Island is on that map, where two companies control 8 percent of the market. There are forces, which have been illuminated, that drive up this constant increase in cost. One is profits. That is what private companies are organized to achieve. If we were directors of those companies, we would be trying to do that. But those profits drive two things: One, shareholder return, profitability of stock, and also compensation for executives. Those two phenomena will not be in place in a public option. It will be a not-for-profit cooperative arrangement. So the response will not be to shareholders or to self-aggrandizement of executives; it will be to delivering service. That is going to be a check. What I find ironic in this discussion is the bold proponents of free markets who believe the free market can solve it are afraid of competition. They are afraid of a public option because they say: We can't compete with the Government. Their definition of competition is any competition. They are probably worried about 80 percent shared between two companies. This is a managed environment. Year in and year out, the insurance companies do great and small business does worse and worse. I thank the Senator for yielding.

Mr. REED

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Commerce, Science, and Transportation be authorized to meet during the session of the Senate on November 18, 2009, at 2:30 p.m. in room 253 of the Russell Senate Office Building. The PRESIDING OFFICE. Without objection, it is so ordered. committee on environment and public works

Mr. REED. Mr. President, I ask unanimous consent that the Subcommittee on Public Lands and Forests be authorized to meet during the session of the Senate to conduct a hearing on November 18, 2009, at 2:30 p.m., in room SD-366 of the Dirksen Senate Office Building.

Mr. REED. Mr. President, I ask unanimous consent that the Ad Hoc Subcommittee on Contracting Oversight of the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on November 18, 2009, at 2:30 p.m., to conduct a hearing entitled, ``Accountability for Foreign Contractors: The Lieutenant Colonel Dominic `Rocky' Baragona Justice for American Heroes Harmed by Contractors Act.''

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Veterans' Affairs be authorized to meet during the session of the Senate on November 18, 2009. The Committee will meet in room 418 of the Russell Senate Office Building beginning at 9:30 a.m.

Mr. REED. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on November 18, 2009, at 2:30 p.m., in room SD-226 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Nominations.''

Mr. REED. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on November 18, 2009, at 9:30 a.m., in room SD-G50 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Oversight of the U.S. Department of Justice.''

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on November 18, 2009.

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Health, Education, Labor, and Pensions be authorized to meet during the session of the Senate on November 18, 2009, at 10 a.m., in room 430 of the Dirksen Senate Office Building.

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on November 18, 2009, at 10:15 a.m.

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Agriculture, Nutrition, and Forestry be authorized to meet during the session of the Senate on November 18, 2009, at 9:30 a.m. in room 106 of the Russell Senate Office Building.

Mr. REED. Mr. President, I ask unanimous consent that the Committee on Environment and Public Works be authorized to meet during the session of the Senate on November 18, 2009, at 9:30 a.m. in room 406 of the Dirksen Senate Office Building. The RESIDING OFFICER. Without objection, it is so ordered. committee on foreign relations

Mr. REED

Mr. REED. Mr. President, today I have the great privilege of rising to pay tribute to my chairman, the longest serving Senator in the history of this country, the senior Senator from West Virginia, Robert C. Byrd. He has reached a milestone among many in his career. It is an extraordinary record of service and dedication and patriotism to the country, and it reflects the values of the people of West Virginia and of this great Nation. Senator Byrd's extraordinary service is measured not just in length but accomplishments, but the length is impressive, indeed. He has 20,744 days of service as a Member of Congress--over 56 years, 10\1/2\ months. Over that time, Senator Byrd has cast over 18,500 rollcall votes, witnessed the inauguration of 11 Presidents, and he has been successful in 15 out of 15 elections. For over 60 years, Senator Byrd has represented the people of West Virginia tirelessly, with a great deal of energy and a great deal of success. He started in the West Virginia House of Delegates and then was elected to the West Virginia State Senate. Then he went to the U.S. House of Representatives. Finally, he came here to the U.S. Senate, where he is currently serving in an unprecedented ninth full term. I think Senator Byrd's success is a reflection of his steady progress, learning first about the people of his home State as he worked among them, knowing them well because they were his friends and neighbors; and then going on into local government and dealing with the concerns as a State representative and then as a State senator; and then coming to the House of Representatives, understanding the operation of the House and how he could help the people of West Virginia; and finally, he coming here to the U.S. Senate. What is incredibly impressive about Senator Byrd is that he is not only the longest serving Senator in the history of this country, he is the most knowledgeable Senator with respect to the history of our body. He is the author--he literally wrote the book on the U.S. Congress and the Senate, among so many others that he has written. This reflects his incredible talent and intellect but also his incredible hard work and tenacity, and it reflects the range of experience he has had. No one knows this body better than Robert Byrd. No one has served it longer. Nobody has served it with the same kind of energy, insight, and dedication. It has been reflected in West Virginia, across the Nation, and across the globe. For example, in 1947, shortly before Senator Byrd first came to Washington D.C. as a U.S. Congressman, there were only four miles of divided four-lane highway, in West Virginia. Today, as a result of Senator Byrd's work, the expansive Appalachian Development Highway System is nearing completion. He understood, as we must today, that economic development is not only a fundamental need, but that it results largely from the infrastructure improvements that speed commerce and literally connect people to one another. Senator Byrd also is a tireless advocate for miners, those men and women--principally men--who go down and literally risk their lives in the coal mines. He knows this firsthand. As a result, mining-related injuries in West Virginia have significantly declined since Senator Byrd came here--the results of his actions, the results of his understanding, and the results of his commitment to the people he served. He worked hard each and every day for those who risk their lives in a dangerous occupation and deserve the attention and respect of this body and our country. He has done much more than help the people of West Virginia. As I indicated before, as the greatest scholar in our body, he has demonstrated a profound understanding and respect for the Constitution of the United States. He has shown that not just in words but in deeds. He has been prepared to stand up when he thought constitutional values were being impaired. Indeed, no commitment is greater to Senator Byrd than his commitment to the Constitution and the values therein. He has stood up forcefully and persuasively on so many occasions to defend the Constitution and to serve truly the oath we all take to preserve, protect, and defend the Constitution. On Friday, Senator Byrd will celebrate his 92nd birthday. He will celebrate that in his usual fashion: He will work, I am sure. He will work for the people of West Virginia, for the people of this country, and for the people of the world. He will reflect back on his dearest partner, his wife, who was his support, comfort, and inspiration. He will reflect upon his children, grandchildren, and great-grandchildren. He will reflect upon a life well lived in service to his country. But more important, he will look ahead to the work he will do as he finishes this term and prepares for his next election to represent the people of West Virginia.

Mr. REED

Mr. REED. I suggest the absence of a quorum.

Mr. REED. Mr. President, I ask unanimous consent that upon disposition of the nomination of Judge David Hamilton and the Senate resuming legislative session that the Senate then proceed to the consideration of Calendar No. 190, S. 1963, Veterans Health Care Initiatives, and that the bill be considered under the following limitations: that general debate on the bill be limited to 30 minutes equally divided and controlled between Senators Akaka and Burr or their designees; that the only amendment in order be a Coburn amendment regarding funding priorities which is at the desk and that it be printed in the Record once this agreement is entered; that debate on the amendment be limited to 3 hours, with 2 hours under the control of Senator Coburn and 60 minutes under the control of Senator Akaka or his designee; that upon the use or yielding back of all time, the Senate proceed to vote in relation to the Coburn amendment; that upon disposition of the Coburn amendment, the bill, as amended, if amended, be read a third time, and the Senate then proceed to vote on passage of the bill.

Mr. REED

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

Mr. REED

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

Mr. REED. Mr. President, I come to the floor today, as so many of my colleagues have, to reflect on the extraordinary tragedy that took place at Fort Hood, TX, yesterday. It is almost inconceivable such an event could take place. As we sort through the motives and the rationale, which may take weeks, I think we, obviously, have to extend our deepest, sincerest condolences to the families of these men and women. They were there because they wanted to serve their country. They were there because they were willing to risk their lives in service to this Nation. Tragically and inexplicably, it happened on a post in the United States not in a faraway land. I think this is a moment where we all have to stop, not only to extend our warmest condolences to the families, but also to reflect on the service and sacrifice of all the troops. Their continued willingness to serve and expose themselves to risk, to leave their families behind--all of this creates the pressure, the tension, the burden of soldiering in this moment in our history. We owe them more than we can repay them. At this moment, I express my deepest condolences to the families and also to those soldiers who came to the aid of their comrades, who exposed themselves in a dangerous manner to try to get people to safety, to try to provide first aid to the wounded. They continue to be our heroes, and they always will be. Mr. President, I would now like to speak on the military construction bill before us. I want to commend, obviously, my colleagues, Senator Johnson and Senator Hutchison, for their great work. I had the privilege for a short time to serve as the acting chairman of the subcommittee and worked very closely with both Senator Johnson, our chairman, and Senator Hutchison, the ranking member. They are both very committed and dedicated colleagues, and they have done a remarkable job. This bill provides $134 billion for military construction, military family housing, and veterans affairs programs, an increase of approximately $429 million over the President's request. This bill provides a total of $109 billion for the VA and increases funding for medical care by $4.2 billion over last year's funding. For the first time, the bill includes advance appropriations for the VA's medical programs to ensure a stable and uninterrupted funding stream. This bill also provides funding to combat homelessness among veterans. This is a priority of both Secretary Gates and Secretary Shinseki, and also Admiral Mullen, the Chairman of the Joint Chiefs of Staff. This bill includes $3.2 billion for health care, support services, and housing assistance for homeless veterans. I hope, again, the Senate will act before Veterans Day to pass this measure. I think it would be a fitting tribute to our veterans, whom we honor in words, and I think we have the chance, early next week, to honor them in deeds. Mr. President, I ask unanimous consent that my following remarks be printed elsewhere in Morning Business.

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

Mr. REED

Mr. REED. Mr. President, I have been very fortunate in my life. One of the great opportunities I received from Senator John O. Pastore of Rhode Island was the opportunity to attend West Point. At West Point, it was not just a great education, it was not just an opportunity to serve the Nation. The most important opportunity I had was to meet an extraordinary group of my colleagues and classmates who have served this Nation with great distinction now for over 30 years. Recently, some of my colleagues who have reached general officer ranks have retired: GEN Bill Dailey, who was one of the chiefs of our special operations forces, someone whose heroism and courage would be well renowned if it could be revealed, but because of his special operations missions, much of what he has done will be classified for many years; GEN Mike Maples, who was the head of the Defense Intelligence Agency--two valued friends and classmates who have retired. In a few days, another of my classmates will join that distinguished roster: LTG Tom Metz. Tom Metz is someone who personifies the values of duty, honor, and country, and who has spent his entire life in service to the Nation. He joined the Army as an enlisted man in 1966. He went to the Army's West Point preparatory school, and then he joined the class of 1971 in the summer of 1967. Even then, back in the late 1960s, it was quite obvious that Tom Metz was going to be a leader in our Army, that he was going to command great responsibilities. It was a function of his skill but, most importantly, it was a function of his character, his commitment to those he led and to the Nation he chose to serve. Tom Metz's career has been an extraordinary one. He started as a lieutenant in the 1st Battalion of the 509th Parachute Infantry Regiment in Germany in the 1970s. He rose through the ranks to hold command at every level: platoon, company, battalion. He concluded his command responsibilities in Iraq as the commander of Multi-National Corps-Iraq during Operation Iraqi Freedom. There he led our forces from January 2004 to February 2005. In a difficult moment, he provided the leadership and the example that our forces needed. His previous assignments included being the assistant division commander of the 4th Infantry Division, where he was able to begin the technological improvement of our Army by introducing new digital technology for our armored forces. He also served in several staff positions of great responsibility. Presently, he is the head of the Joint Improvised Explosive Device Defeat Organization. This is the weapon--the IED--of choice of our opponents, and the Department of Defense chose one of the most capable and most caring individuals to lead our effort to defeat these devices. Tom will conclude a distinguished career. He was bolstered, supported, encouraged, and sustained throughout his career by his wife Pam and his family. They, too, served and they, too, deserve our great commendation and respect. I am extraordinarily proud of his service as a classmate, as a friend, as someone who admires his character, his courage, and his unstinting commitment to the soldiers he led and the Nation he served. I thank him for his great service. Mr. President, I suggest the absence of a quorum.

Mr. REED

Mr. REED. Mr. President, I ask unanimous consent that the Senate proceed to a period of morning business, with Senators permitted to speak for up to 10 minutes each.