Debbie Stabenow

Ms. STABENOW

Ms. STABENOW. Mr. President, I would like to discuss with the chairman of the Financial Services and General Government Appropriations Subcommittee, Senator Durbin, as manager of the Financial Services Subcommittee section of the bill before the Senate, language included in the bill that creates a binding arbitration process for auto dealers associated with General Motors and Chrysler whose contracts were terminated as part of the manufacturers' restructuring efforts this year. The difficult decisions made during the last year have highlighted the interconnectedness of the industry and have shown the impact that these companies have in every State in the country. I particularly understand how difficult this situation has been for Michigan auto dealers. My father and grandfather ran the Oldsmobile dealership in Clare, MI, where I grew up. My very first job was washing cars on that lot. Thousands of employees, either directly employed by the companies or through the thousands of dealerships and suppliers, depend on the viability of the auto manufacturers. Without the manufacturers, there is no dealer network, and small businesses across the country would close, adding more devastating job losses as our economy is trying to recover. What we do here must continue to ensure a healthy future for the auto companies as they work towards a profitable future. When negotiating an agreement for arbitration was it the Chairman's intent that the dealers entitled to this arbitration process would only be the dealers that were terminated as a result of the bankruptcy?

Ms. STABENOW

Ms. STABENOW. So we have over 300 pages of the bill which contain Republican amendments, and that is fine. There is no ownership in the sense of who has the better ideas. In fact, what I find interesting is the insurance exchange we have in the bill for small businesses--which is at the heart of coverage of small businesses and individuals--has been offered by Republicans and Democrats. I believe distinguished former Senator Bob Dole offered some form of an exchange back during the debate when President Clinton was in office. So we are not trying to claim a corner on ideas. There are many ideas that have been available and talked about for years. It is a matter of having the will, the commitment to actually do the hard work people expect us to do in order to get this done. I think that is what is so important about this time, when the average family is finding themselves unraveling, with not knowing if their job is going to continue to be available or if there will be a cut in wages. They are paying more out of pocket for everything under the Sun and then worrying if the employer is thinking: Well, you can have your job or your health insurance because the employer can't keep both going. The fact is, we have lost so many middle-class jobs--and I will spend another time talking about the loss of manufacturing jobs in this country. We have lost a lot of our middle class in terms of good-paying jobs. So people are now saying: Wait a minute, just being the party of no, that is not going to be enough. That is not good enough--just saying no for political reasons. That is not enough. We want to know what you are going to say yes to. We want to know how you are going to work together. We want to know how are you going to actually solve a problem. When someone such as Joe, from Rockford, MI, says he served in the Marines for 4 years and their motto is: ``We take care of our own,'' my question is: When are we going to come together and take care of our own Americans? I don't mean literally taking care of every person but creating opportunity for people, creating the climate for people to have a job, to have health insurance, to send the kids to college, to be able to afford to keep their lights on, and to be able to know that their country is on their side. That is what this is about. They do not want us to wait more, they want us to move quickly--move quickly on health care and jobs and all the other issues that are so important to their families. So I thank my friend from Rhode Island for joining me, because there is a sense of urgency that people have, and we need to have that sense of urgency to get things done--to work together and to get things done. Frankly, one of the things our colleagues on the other side of the aisle have successfully done is united our caucus in its determination to not let this kind of stalling and objections and tactics, which are slowing things down, stop us from actually solving a huge problem that has gone too long unsolved for the American people. I thank the Chair.

Ms. STABENOW. I would like to think there would be a likelihood of that happening, but I can't imagine it. Frankly, and I think unfortunately, they view it in their self-interest, whether it is a business decision, as a radio host, or whether it is a decision of the other party. I appreciate the fact that it is hard to lose elections. We have all been in those situations. I appreciate the fact that folks don't want to be in the minority. Most of us have been in that situation. So I appreciate that. But I think all of us were hoping this year, with two wars, with the deficit we have, with the challenge on health care, with the need to create jobs, and with the financial crisis we are in, that somehow it would be different for a while. I would ask my colleague if he had the same sense of hope coming in; that this year maybe there would be a moratorium on the partisanship; that we could actually come together in the interest of the country and solve problems before going back to the elections. I would ask my friend if he was as surprised as I was that there was not only no stopping after the election but that the same folks who led things during the election are leading them right here on the floor.

Ms. STABENOW. If I might interject with my friend, I have been handed a note that says, in fact, there have been over 150 amendments offered by Republicans, and so our attempts have been ongoing to reach out.

Ms. STABENOW. Mr. President, before my good friend from Iowa leaves the floor, I thank him for his wonderful leadership on the health care reform bill, on the appropriations that he chaired--formerly on Agriculture. It has been a pleasure to partner with him on so many things. Mr. President, I ask unanimous consent that I be allowed to speak as in morning business for up to 20 minutes.

Ms. STABENOW. Mr. President, I want to talk about health care. I have to say that if 20 percent of what was being said by our Republicans friends was true about this bill, I could not vote for it either. I keep hearing things described that have no relationship to the reality of the bill that I helped to write in the Finance Committee, or my friends helped to write in the HELP Committee or the bill that is on the floor now. I see all kinds of comments that, frankly, concern me because I don't see them reflected in the reality of the legislation in front of us. I encourage people to take the opportunity to read the bill or the summaries. For the people in Michigan, we have had it up on our Web site, and we have had every bill, as it is introduced and passed, on the Web site, so people will have an opportunity to look at the information available. I do know this: What we have been hearing from our colleagues is not good enough, when we think about the fact that we had a Congress and a White House for 6 out of the last 8 years that was controlled the by Republican Party and yet nothing was done. Proposals have come forward now about all these things that should be done. But they weren't done when they were in charge. What we saw was a lot of tax cuts for the wealthy people and a lot of no-bid contracts for friends of people in the administration. We saw a lot of things that didn't affect people in my State very positively and didn't help the working people in my great State of Michigan. But now, as we are trying to move forward and do something for people, for small businesses and large businesses, and bring down costs and provide health care for people, there are all kinds of suggestions about why we should wait and do it over. What I heard in committee and what I am hearing now on the floor, as a proposal--because we don't have a Republican bill in front of us or one that has been offered--is this: Wait, wait, wait. We don't need to do this. That doesn't have to be done right now. There is no sense of urgency. We should wait, wait, wait. That is what we hear. We hear that business as usual for the insurance companies is OK. Let them decide what is covered--if you can find insurance--and how much it should cost, whether or not they are going to be able to provide a test for you or an operation for you. That is OK. Let the insurance companies continue to be the ones between you and your doctor. That is what we have seen over and over. We saw it in committee. Every time we were trying to lower costs for families and small businesses, they were on the side of helping the insurance companies. They were willing to take tax cuts we put in the bill, and they offered amendment after amendment that would have had higher costs for middle-class families and small businesses, in order to help the insurance industry. I will share a few stories from people who have become part of our health care people's lobby through my Web site, who have been willing to share stories. David is from Sutton's Bay, which is a beautiful part of Michigan. We would love to have you come visit. It is a gorgeous part right on the water. David says: I'm a 61-year-old cancer survivor with diabetes and high blood pressure. I am self-employed, and lately, uninsured. I worked all my life to build a stake here in farm country and almost lost it last fall to foreclosure because of a medical emergency. This farm is all I have . . . the savings and cash are gone. I continue to work with no retirement in sight. I have put everything I had for retirement into my farm. Please, help me keep it. I know that David is not saying wait, wait, wait. He wants us to act, and to act now, on something that will be meaningful and makes sense to bring down costs, to give him a chance to find affordable insurance that doesn't bankrupt him and his family. I want to share also another story from Jeff from Rockford, MI: It has been over five years since death stared me down. I was diagnosed with testicular cancer. Losing my job to a layoff, mortgage to pay, among other things--and my options were minuscule. I had no insurance then because there was none that I could afford. I thank God and the staff at Grand Rapids Spectrum Health for my life today. Unfortunately, I am still $25,000 in debt because of lack of coverage. I served in the Marines from 1984-1988. One of their mottos is, ``We take care of our own.'' Imagine what this country would be like if we all thought like that. Jeff is right. We are in this together and, just as we have dramatically increased our support for our veterans and their health care, we need to make sure we are taking care of our own American families and American businesses. Wait, wait, wait? I don't think so. I don't think that is what Jeff is asking us to do. Jennifer from Hollow, MI: I am married and have one beautiful little girl. But about 6 months ago, my husband's work informed us they would no longer be able to carry health insurance for their workers. A very common story, having to choose between keeping people employed and paying for health care. We could have gone on COBRA but it would have cost double what we were paying and we couldn't meet that cost. Mr. President, as you know, we have worked to lower the cost of COBRA, and we hope to be able to continue that lower cost in legislation that will be coming up shortly. But it is still very expensive. We are lucky because Michigan has a program for children, so we didn't have to worry about our daughter's coverage. When we went to look for insurance for my husband and me, the prices were steep or we were denied because of my preexisting condition. That is one of the things we are going to change. Right now going to the doctor is next to impossible, but to see a specialist is like asking for the Moon. We know that we are highly blessed. My husband has a job. That is more than a lot of people have. We just want affordable health insurance, and we don't mind paying for it. It just doesn't seem like too much to ask, does it? No, Jennifer, it is not too much to ask, and that is what we are all about. We are all about putting together a plan--and that is what is in front of us--that will lower costs, that will save lives, save Medicare, that will focus on making sure each American has a health care bill of rights, has protections they know will allow them to make sure their health insurance will be available if they pay for it; that they cannot get dropped because of a technicality; that if they have a preexisting condition, they can still find affordable insurance; that there will no longer be lifetime caps on insurance policies; that we will allow our young people to stay on mom's or dad's insurance until age 26. We have a number of changes we are making for people in the insurance exchange, for policies that take effect after the effective date of this act, and it is about making sure people have affordable insurance and they are getting what they are paying for. That is what this is about. What happens if we do nothing--if we do nothing; if we wait, wait, wait, like the Republicans are saying? Every single day 14,000 Americans lose their health insurance; 14,000 people got up today with health insurance and they will go to bed without it. That happens every single day. Insurance rates are going to double in the next few years, by 2016. Business costs are going to double. Increased premiums are going to cost us, it is expected, 3.5 million more jobs. I don't know about any of my colleagues, but we cannot afford to lose any more jobs in Michigan. Health care is directly related to jobs and our international competitiveness. We know incomes of families will be reduced. We know every 5,000 homes will be foreclosed as a result of a health crisis, and 62 percent of the bankruptcies are as a result of a health care crisis. Wait, like our Republican colleagues say? No, we cannot wait. The families, the people I talked about and read their stories, they cannot wait. Families cannot wait. Businesses cannot wait. Small businesses that cannot find insurance cannot wait. Large businesses that are finding themselves in difficult situations, considering pulling up shop and going to another country because of lower health care costs cannot wait. People expect us to solve this problem. They expect us to come together and work together, without all the stalling and the objections and the partisan politics. They expect us to come together and solve what is a huge American problem by bringing down costs and creating access to affordable health care where people know that the insurance company will not be the one that is standing between them and their doctor. This is about saving lives, saving money, saving Medicare. Mr. President, 45,000 people will lose their lives in the coming year. And 45,000 families will have one less chair or an empty chair at the holiday dinners that are coming up because 45,000 people could not find affordable insurance in this country--Americans, in America. Saving money--this is about making sure small businesses get the tax cuts they need to help them buy insurance, to make sure that families who are buying through the new insurance pool get the tax cuts they need to afford to buy insurance. This is about making sure large businesses begin to see costs come down over time because when they are providing insurance already, they are not going to pay the extra costs of folks walking into an emergency room uninsured who are treated and then the costs get rolled over on to everybody with insurance. We as a country are going to save dollars, save money over time for taxpayers and strengthen Medicare to bring down costs. And, yes, we are going to save Medicare. We are going to lengthen the Medicare trust fund solvency. We are going to make sure overpayments to for-profit insurance companies are reined in so that the majority of seniors do not see their premiums go up under Medicare to pay for those excess profits. We are going to make sure we are closing that gap in coverage for prescription drugs that has now been called the doughnut hole, where too many seniors or people with disabilities fall into that hole, cannot afford their medicine, and are not able to get the care they need. We are going to make sure preventive care does not have an extra cost of a copay or deduction because we know it saves money and saves lives. Under Medicare, we are going to make sure that is there as well. That is what this is about. It is not about waiting. It is not about all the other stuff we have heard that are scare tactics. This is about tackling and solving a problem for the American people that we cannot afford to wait to do any longer. Coming from Michigan, I have to say everything I do, everything I care about is about saving jobs. We know in addition, we truly are saving jobs. We are saving jobs for our large employers right now that provide insurance, have been doing the right thing for years but have seen their costs go up 10 percent, 20 percent, 30 percent every year and cannot sustain it anymore. They are cutting health care benefits, raising premiums, or laying people off because they cannot afford it. We know our small employers under our package will save 25 percent. I believe we are going to be doing even more for small businesses. We have tax credits to help companies, and, as I indicated before, our plan is going to save 3.5 million jobs that would otherwise be lost because of the increased health care costs that cause employees to be let go or companies to move overseas. We are talking about saving lives, saving money, saving Medicare. We are talking about saving jobs. What we are not talking about is waiting. We are not talking about stall tactics or politics. We are way beyond that. I understand there is a big strategy to make sure the President of the United States is not successful. There is a big strategy to make sure we are not successful in the Senate. We have seen more filibusters and more objections than ever before. The vast majority of the days we have been in session--I believe it is 39 weeks now--all but 4 of those we have seen filibusters. It has never been done before--filibusters and objections over and over again. We are committed to getting beyond that and focusing on the reality of what is happening in people's lives. People are waiting for us to step up and to solve this problem and to give them the ability to have access to affordable health insurance for themselves and their families. We are not proposing something radical. We are proposing that we fill in the gaps for the folks who do not have insurance today, most of whom are in a small business, most of whom are working maybe one, two, three part-time jobs but they are working and they don't have access to health insurance, or they are self-employed, as the gentleman I talked about, David, in Suttons Bay, maybe a farmer, maybe a realtor, maybe the next Bill Gates in their garage coming up with the next great invention. They don't have access to the same big insurance pool that a big business has to bring down costs. What we are talking about for those folks who are working or have recently been laid off and cannot find insurance is giving them a way, a competitive way to buy insurance from an insurance pool. I cannot imagine a more important Christmas present to give to American families than the ability to know going forward that when they lose their job, they are not going to lose their health insurance; that they have an opportunity, a way to get affordable insurance, and that we have come together as a Senate to focus on saving lives, saving money, and saving Medicare. Mr. President, I yield the floor.

Ms. STABENOW. Mr. President, I thank my friend from Rhode Island for the question and for his advocacy and understanding of how we bring down costs and what we should be doing in so many areas for families and for businesses in the country. I will just say that we have, first of all, attempted to get something done for years. In the last couple of years, reaching out to Republicans in an unprecedented way, our distinguished chairman of the Finance Committee, as everyone knows, went to unparalleled lengths in reaching out and spending months and months putting together a work group of three Democrats and three Republicans to work in good faith to get something done. We have accepted Republican ideas. I know on the HELP Committee there were many amendments accepted from Republican colleagues. We have continued to reach out and look for ways to work together. But what we are seeing is a lack of desire to work together and more than just a lack of desire, as the Senator indicated, but simply to attempt to embarrass the President of the United States, to stop him from being successful, and to stop us politically, when the reality is very serious. This is not about a President. We have had 100 years of Presidents trying to do this. This is not a particular Senate. We have had Senates for years that have been trying to do this. This is about when are we going to get beyond all this? When are we going to actually get beyond this and focus on the reality of what is going on in people's lives, what is going on in every small business that is trying to figure out how to pay the bills and hold it together or every manufacturer in my great State that is trying to figure out how they are going to hold it together. At one point, the American people will have every right to say to us: When are you guys going to get beyond this stuff? The good news is, we have a President who has said now is when we are going to put it behind us and the Senate has said now is the time and we will work in good faith with anyone who wants to work with us. But we will not wait, which is what we are being asked to do--wait until another time, when 45,000 more people will have died next year, when another 5,000 people a day will have lost their homes to foreclosure.

Ms. STABENOW

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m., to hold a hearing entitled ``Strengthening the Transatlantic Economy: Moving Beyond the Crisis.''

Ms. STABENOW. 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 December 9, 2009, at 10 a.m., to conduct a hearing entitled ``Five Years After the Intelligence Reform and Terrorism Prevention Act (IRTPA): Stopping Terrorist Travel.''

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

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs' Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m. to conduct a hearing entitled, ``The Diplomat's Shield: Diplomatic Security in Today's World.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Banking, Housing, and Urban Affairs, Subcommittee on Economic Policy, be authorized to meet during the session of the Senate on December 9, 2009, at 2 p.m., to conduct a hearing entitled ``Weathering the Storm: Creating Jobs in the Recession.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on December 9, 2009, at 10 a.m., in room SH-216 of the Hart Senate Office Building, to conduct a hearing entitled ``Oversight of the Department of Homeland Security.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate, on December 9, 2009, at 2 p.m., in room SD-226 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Mortgage Fraud, Securities Fraud, and the Financial Meltdown: Prosecuting Those Responsible.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Indian Affairs be authorized to meet on December 9, 2009, at 9:30 a.m., in room 628 of the Dirksen Senate Office Building.

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Finance be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m., in room 215 of the Dirksen Senate Office Building, to conduct a hearing entitled ``Exports' Place on the Path of Economic Recovery.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on December 9, 2009, at 10 a.m., to hold a hearing entitled ``The New Afghanistan Strategy: The View from the Ground.''

Ms. STABENOW. Mr. President, I ask unanimous consent that the Subcommittee on Science and Space of the Committee on Commerce, Science, and Transportation be authorized to meet during the session of the Senate on December 9, 2009, at 2:30 p.m. in room 253 of the Russell Senate Office Building.

Ms. STABENOW

Ms. STABENOW. Mr. President, I thank the Presiding Officer and the chairman of the committee. Mr. President, I rise today to speak concerning an amendment on which I am proud to join the Senator from North Dakota, Mr. Byron Dorgan, and other colleagues in an effort to lower the cost of prescription drugs. But I do want to make one comment on Medicare before I do that. We know our plan, overall, is about saving lives, saving money, and saving Medicare. That is what this is about overall. That is what we are doing in our health care reform proposal for American families. But I do want to mention and stress again this is about saving Medicare. It is about strengthening Medicare and our commitment. I do have to say, we have been hearing from colleagues, and the distinguished Republican leader has said over and over again that, in fact, cutting Medicare is not what Americans want. Then last night he said here on the floor that expanding Medicare was a plan for financial ruin. So they do not want to cut, they do not want to expand. I am not sure where our colleagues on the other side are in terms of Medicare. But I know where we are. I know we are the party that created Medicare, with President Johnson at the time. We are the party that has continued to promote and to expand and to strengthen Medicare. We are the party that intends to make sure we save Medicare for the future, expanding prescription drug coverage, to be able to close the doughnut hole, to be able to expand the ability of seniors to have preventive care, and to extend the life of the Medicare trust fund, which is critically important. And to that, I want to speak now to the other two provisions we have as our priorities: saving lives and saving money. The Dorgan-and-others amendment, which I am proud to join Senator Dorgan on, does exactly that. It will save lives and save money. As a Senator from Michigan, I know that very well. We can look across the Detroit River into Windsor and know that the people of Michigan, by going across the bridge, would be able to drop their costs 30, 40, 50 percent. There is something wrong with the system where Americans are paying so much more than those in other countries for the same drug. The safety provisions are the same. The difference is there have been protections put up at the American border to stop Americans from getting the benefit of having our hospitals, our pharmacies, our schools of medicine, and others who use prescription drugs to be able to bring that back, to do business across the border. Everybody is always talking about open borders, open trade. Well, this is a trade issue about bringing back FDA-approved prescription drugs across the border to the American side, so Americans have access to lower priced medicines. It has been about 10 years now since I did my first bus trip to Canada with seniors. I have been doing that for a long time. I have been focused on this issue both in my days in the House of Representatives, where I took the lead on this issue, as well as now working with colleagues in the Senate. It is time to get this right in the context of health care reform because this is about saving lives and saving money. I want to share one story. I have heard so many over the years from people in Michigan. But here is one recent story of someone who has written to me. Joe is a 40-year-old father with heart disease. His family says despite his heart condition, he is doing well. He loves to work. His medicines cost over $4,800 a month. Can you imagine that? But his insurance has a family cap of $10,000 a year. In other words, after basically 2 months, he hits the cap, and he has to pay for everything out of pocket. By going over the bridge to Canada--and we have three bridges: up in the Upper Peninsula, we have a bridge; in Port Huron we have a bridge; and in Detroit we have a bridge, the largest cross-border bridge in terms of volume of goods and services on the northern border--but by simply going across the bridge, Joe would be able to save $2,000 a month. We should be able to do better for Joe and his family. He could save $2,000--almost half of his cost--by simply buying the same drug, FDA approved, from one side of the bridge instead of the other. We also know that the cholesterol-lowering drug Lipitor is about 40 percent less, also the ulcer medication Prevacid is about 50 percent less, according to a search on Pharmacy Checker. I have to say that again. This is a trade issue and whether we are going to continue to have trade barriers. Because, for instance, Lipitor is made in Ireland and Pfizer is able to bring that back to America, they can bring it back. But if someone wants to go to Windsor, Canada, right across the bridge, and purchase a lower priced version of the very same drug, Lipitor, and bring it back as an individual or a business or a pharmacy or a hospital, it is illegal. It is illegal. That makes absolutely no sense. This amendment is about opening the border, allowing our pharmacies, allowing our wholesalers, allowing hospitals--I have gotten calls from medical schools at universities wanting to do business, to lower their cost, with wholesalers in other countries where it is FDA approved, safe to do that. That is what this bill is about. Right now, we are in a situation where if we do not pass the Pharmaceutical Market Access and Drug Safety Act, which we have introduced on a bipartisan basis, we are going to continue to have a situation where people such as Joe, a 40-year-old father with heart disease, is going to be paying $4,800 a month out of his own pocket, when we could cut that down. It still would be tremendous, but we could cut that by $2,000 for him, by passing this legislation. The drug importation bill is supported conceptually. We have been working over time with many different groups such as AARP, the Alliance for Retired Americans, Families USA, and Cato Institute--very different groups philosophically, but they all agree we need more competition, we need to open the border to safe--and I emphasize and underline ``safe''--FDA-approved prescription drugs so we are focused not on what is best for the pharmaceutical industry, the brand-name companies, but what is best for American citizens who are struggling, who see their prices go up 8 percent, 9 percent, 10 percent, 15 percent every year. Families cannot sustain that. How many of us have stood on this floor and talked about the fact that people are choosing between food and medicine? That is not just rhetoric. It is not rhetoric. It is real. It is real for people right now today. It is getting cold. It is getting very cold. People are deciding: Am I going to keep the heat on or am I going to be able to get my medicine? Am I going to be able to get my food? Am I able to get my medicine? Am I able to pay the rent, the mortgage, or get the medicine I need for my life or for my child's life or for my husband's or wife's ability to continue to live a healthy, successful life? That is what this is about. We have an easy, straightforward way to increase competition, to bring down prices, with safe, strong safety standards. This is something that makes sense. It will help seniors. It will help people with disabilities who are in the doughnut hole before we get that all closed under Medicare. It will help every family and every individual right now who needs medicine and is paying more and more, higher and higher prices every single year. I hope we will have a very strong bipartisan vote. This is a very important addition to what we are doing here. This truly will save lives and save money; and that is what we are all about: creating competition to bring prices down so the American people have access to the medicine and to the health care they need and deserve. Thank you, Mr. President.

Ms. STABENOW

Ms. STABENOW. Mr. President, first, I thank the Senator from California for her passionate advocacy and standing up for all of us, the women of this country. She is a mom, as she said. I, too, am a mom. As hard as it is for me to believe, I am also a grandmother with wonderful 2-year-old Lily and a little grandson Walter, who was born on his daddy's--my son's--birthday in August. Obviously, they are the light of my life, as well. One of the reasons I feel so passionate about the broader bill on health care reform is that this is about extending coverage to babies so they can be born healthy, and about prenatal care; it is about making sure that in the new insurance exchange we have basic coverage for maternity care. I was shocked to learn that 60 percent of the insurance policies offered right now in the individual market don't offer maternity care as basic care. We happen to think that is incredibly important. We are 29th in the world in the number of babies--below Third World countries--that survive the first year of life. This health care reform bill is about making sure we have healthy babies, healthy moms, and it is about saving lives and moving forward in a way that is positive, expanding coverage, not taking away important coverage for women who, frankly, find themselves in a crisis situation. That is what we are doing, unfortunately, through the Nelson-Hatch amendment. I have great respect for both of my colleagues who have offered this amendment, and for others who feel deeply about this issue. In the bill that has come before us, I think we respect all sides and keep in place the longstanding ban on Federal funding for abortion services, and no one is objecting to that. No one is trying to change that. As my friends have said, this is about whether we cross that line into private insurance coverage--whether we say to a woman, to a family: You are going to have to decide whether, when you have a child and you are having a crisis in the third trimester and might need some kind of crisis abortion services--whether you are going to find yourself in a situation where you are going to need abortion services, and you are going to have to publicly indicate that and buy a rider on insurance because you can't use your own money to buy an insurance policy. Here is what we know now. We know five States have riders right now-- Idaho, Kentucky, Oklahoma, Missouri, and North Dakota. There is no evidence there are any riders available in the individual market. So even though, technically, they say you can buy additional coverage, it is not offered or available. We are told by the insurance carriers that, in fact, it probably will not be available. We all know what this is about. This is about effectively banning abortion services coverage in the new insurance exchange we are setting up, which could, in fact, have a broader implication of eliminating the coverage for health plans outside the exchanges. So that is what this is about, which is why it is so important. Again, we are agreeing on the elimination or banning of Federal funding for abortions, other than extreme crises circumstances. We have done that in Federal law. This is about whether we go on to essentially create a situation where effectively people cannot get that coverage with their own money. The Center for American Progress noted that because approximately 86 percent of the people who are going to be offered new opportunities for insurance--small businesses, individuals, in the private market--that because 86 percent of them will, in fact, receive some kind of tax credit or tax cut, in fact, again, we are talking about eliminating this option altogether because the majority of people will get some kind of a tax cut during this process. I think there are also some broader implications around the tax policy. If we are saying that someone can't purchase an insurance policy of their liking if they are getting a tax credit to help with health insurance, the fact is, what about other tax credits? What about other kinds of ways in which people get tax credits or tax cuts today? The implications of this are extremely broad. I urge a ``no'' vote. Let's keep Federal policy in place that doesn't allow Federal funding for abortion but respects the women of this country.

Ms. STABENOW

Ms. STABENOW. Mr. President, I want to specifically respond to the Senator from Nevada who was talking about the Canadian health care system a little earlier. I appreciate the information, the education. Of course, it has nothing to do with this debate, but it was nice to hear. We now understand a little bit more about the Canadian health care system. The great news for us is that what we are designing is a uniquely American health care system. I want to walk through the elements. About 60 percent of the folks of the great State of Michigan get their health insurance through their employer. That will continue. We are told that either their premiums will stay the same or go down, according to the Congressional Budget Office. And we believe many of the efforts in this bill will actually bring costs down. One of the reasons that costs will come down is those of us with insurance will no longer be paying through the back door for people who use the emergency room who are sicker than they otherwise would be. They use the emergency room and then the costs are shifted on to people with insurance. We know there is about a $1,100 hidden tax we each pay on our premiums to pay for people right now who do not have insurance and use the emergency room inappropriately. Those with insurance now will not see their insurance change in terms of how they relate to their employer and their insurance company, but they will see costs go down because others will actually have insurance and not be using emergency rooms inappropriately. We also put in place protections for consumers, basically those, as the Senator from Minnesota was talking about, who have a preexisting condition and cannot find insurance now. Or somebody who has insurance. I don't know how many times I have heard from constituents of mine who have paid all their life and said, I don't have a problem, I have insurance, and then somebody gets sick and somebody gets dropped. They get dropped from their insurance because the insurance company does not want to pay for it. People with insurance now will keep the system they have but will benefit from consumer protections and from gradually seeing costs come down because we are not paying for people who are using other health care services inappropriately. We have about 80, 85 percent of the public right now who are covered with insurance, either through their employer or through Medicare, the great American success story we have been talking about, or through Medicaid, the VA, and so on. For the 15 to 20 percent of the public we are trying to provide options for affordable insurance, those are mainly people working. A vast majority of the people we are talking about work for a small business, they work part time, they work two part-time jobs, they work three part-time jobs. I have been hearing from small businesses for years: We wish we had the same clout as big business. We wish we could pool all the small businesses and the individuals, that entrepreneur working out of their garage, that realtor who does not have a pool. Pool us and give us the same clout as big business. That is what we are doing in this bill. Versions of this have been proposed by the distinguished Senator from Wyoming. I know back during the Clinton years during the debate, Senator Bob Dole proposed something similar. This has been a Democratic idea and a Republican idea for years. We are calling this an insurance exchange where basically if somebody right now cannot find affordable insurance by going out by themselves in the individual market, they are going to be able to go to a place where companies will bid on the large pool of everybody who does not have affordable insurance now. Just like what we do for the Federal Government, like our insurance plan, our Federal employee insurance plan, which is an insurance exchange, someone will be able to go to a Web site or be able to get information and be able to find out about the private insurance companies that want to offer insurance to them through this insurance pool. One of the things we are debating is whether there should be a public insurance choice for people. I believe there should be. I believe that in order to provide competition for the for-profit companies, we should have that. But the exchange is set up basically for small businesses and individuals to purchase--and we are told that people will see cheaper rates being able to do that. And to be sure they are able to do that, we are including tax cuts, refundable tax credits for individuals, for small businesses that cannot afford insurance today, to help them afford insurance. That is what the exchange is about. That will affect 15 to 20 percent of the public who do not have insurance today. We also have in the bill another option where a State could choose to take the tax credits available to people in the exchange and could decide to pool those and do a basic health insurance plan and negotiate with an insurance company to get a better deal for people in their State. We also have something I wish had been in place a couple of years ago for my own children, and that is, we are going to say to young people that you can stay on your parents' insurance until your 27th birthday. We also have a policy that is more geared to young people within the exchange that will be less cost to them. Can you imagine all of the young people today, college or not, who come out, get the first job, like my children, no health insurance, who will benefit by saying you can stay on your parents' insurance until your 27th birthday? That is in this bill, and it is very important. Also basically make Medicaid for low-income individuals a safety net so that anyone below 133 percent of poverty can qualify. What that says is--and this is very important to people in my State where we have the highest unemployment rate in the country--if you lose your job, you are not going to lose your insurance. It is a very important right for Americans. We are improving the Medicare system. We have certainly talked about that for a long time on the floor. A lot of time has been spent on the Medicare Program. We are cutting out overpayments to insurance companies, the for-profit companies right now that are being paid more than they should be and putting that back into the Medicare system to make it stronger for the future, to help pay for prescription drugs and to create more preventive care for seniors. Then another very important piece I was very proud to coauthor with Senator Kerry relates to early retirees. We have a lot of folks who are retiring early not by choice. They are being told they are going to have to retire early at age 55 or age 58 or 59. They may or may not have insurance. If they do, they are a higher cost for their employer, and if they do not, it is extremely difficult to find affordable insurance for somebody more likely to be using health care at that point. We have a provision where the Federal Government will partner with a business, with an insurance plan to make sure the costs are lower for the early retiree. It is called reinsurance. But for higher cost procedures or episodes, the Federal Government will come in above a certain level and cover the costs. It is a partnership between the private sector and the Federal Government to make sure early retirees, who are already being hit with a thousand different challenges as a result of early retirement, can afford insurance. This is a snapshot of what we are doing. Again, the vast majority of people are in private employer-based insurance today. That will not change, other than this will over time bring their costs down and it will give them new protections because if something happens--and it is happening every single day where an employer has to decide, Do I pay the 30 percent increase in premiums or do I keep people employed? If people find themselves in a situation where their employer drops insurance or drops employees as a result of costs, they have another option. They have someplace to go where they cannot today. They can go into the insurance exchange. They can get tax cuts that will help them purchase more affordable insurance from a large group pool as a big business does. Let me say that bottom line for all of this for us, despite everything that is being said, is that this is about saving lives, it is about saving money, and it is about saving Medicare. Every year we are losing 45,000 Americans who are dying prematurely because they cannot find health insurance and cannot get the health care they need. We have a variety of ways in this bill in which we are saving dollars. We have analysis from the Congressional Budget Office and Joint Tax showing that. And finally, we are saving Medicare for the future.

Ms. STABENOW. I yield the floor.

Ms. STABENOW. May I ask my friend a question. Do I understand it would be the Senator from New Jersey and then the Senator from Arizona and then myself?

Ms. STABENOW. Madam President, I thank the distinguished Senator from Montana, who has been here morning, noon, and night counteracting falsehoods and scare tactics on the floor and putting forward what is really in this legislation that is so important to millions of people around the country. Everyone benefits, in one way or the other, by either costs coming down or by direct access to more affordable insurance. I thank our distinguished leader from Montana. We have talked so much about Medicare and Medicare Advantage, but I do have to take a moment to respond to what has been said over and over on the floor. It is very difficult for me--and I know for others around the country--to listen to our friends from the other side of the aisle lamenting that they want to protect Medicare, when it was a Democratic Congress and a Democratic President who created Medicare, over the same objections, by the way. You can take a look at the objections in 1965, the debate: The world was going to come to an end if, in fact, we passed Medicare. Of course, Medicare has become a great American success story for tens of millions of seniors and people with disabilities. Our friends now talk about how they are going to protect Medicare, at the same time that just a couple weeks ago, on the House side, 80 percent of Republicans voted to do away with Medicare as we know it today and make it a voucher system and put insurance companies back in control. One of the frustrations for me is to hear the unfortunate negative comments that have been made about a very distinguished organization that represents senior citizens across the country, the American Association of Retired Persons, that I might add, when we were doing the prescription drug bill, my colleagues on the other side of the aisle used in every single speech because they were supporting them at that time. Now they are supporting our position. They disagree with them. They have said: Most importantly, the legislation does not reduce any guaranteed Medicare benefits. Now we are hearing how horrible they are, which I think is a real disservice to a very important national organization. I think it is important, in the name of truth and in the name of fairness, to look at quotes that have been made about AARP that are different from what we have heard on the floor today and since this debate began. Our distinguished colleague from Arizona, who sponsored an amendment related to Medicare Advantage and has been on the floor numerous times, including today, disparaging AARP, said at an AARP convention: I say God bless AARP-- This is the senior Senator from Arizona. I say God bless AARP for everything they are doing, not only for the present generations of Americans, but for future generations. That's your duty, that's your strength, and that's why I love to see you at every town hall meeting. The unfortunate thing is now our colleagues on the other side of the aisle don't want to see AARP at every townhall meeting because they are not saying what they want them to say. I also have to express concern that we had 6 years of our colleagues in full control of the Federal Government--the Presidency, House, and Senate--and we did not get legislation to bring down health care costs or legislation to make sure every American, small business, and family could afford insurance as we are doing today. So it is a little difficult, even though we have come together on other issues on health care, on this particular one it is difficult now to hear all the criticisms that are flying and all the things we should be doing, but they were not brought forward a number of years ago, when they actually were in charge and could have done something about it. That is concerning to me. This legislation is about saving lives, it is about saving money, and it is about saving Medicare. I wish to share one story because not too long ago--it seems like a long time since we have been working so diligently this week--it was just Thanksgiving, and families all across America came together to reminisce around the dinner table, to watch football, and share a family meal. Even in tough times we stop, reflect, and give thanks for our many blessings. I know that is true for my family, and I am sure all our families. This year, there were 45,000 empty place settings at tables across the country for men and women whose lives were cut short because they did not have health insurance. I wish to share one story.

Ms. STABENOW. I ask for an additional minute.