Debbie Stabenow

Ms. STABENOW

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Rules and Administration be authorized to meet during the session of the Senate on Wednesday, February 11, 2009, at 10:30 a.m.

Ms. STABENOW. Mr. President, I ask unanimous consent for the Committee on Veterans' Affairs to be authorized to meet during the session of the Senate on Wednesday, February 11, 2009, to conduct a hearing to review veterans' disability compensation and the appeals process. The Committee will meet in 418 Russell Senate Office Building, at 9:30 a.m.

Ms. STABENOW. Mr. President, I ask unanimous consent that the Committee on Energy and Natural Resources be authorized to meet during the session of the Senate on Wednesday, February 11, 2009, at 11:30 a.m., in room SD366 of the Dirksen Senate Office Building.

Ms. STABENOW

Ms. STABENOW. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 274, As Modified

Ms. STABENOW

Ms. STABENOW. I would like to thank my distinguished colleague from Washington. I look forward to working with her in the future to ensure that investing in America's workers remains a critical component of our national economic recovery and growth strategy. Long-Term Care

Ms. STABENOW. Is it also the Senator's understanding that the most effective strategies in helping workers maintain and secure new jobs in emerging and viable industries, including the energy efficient and advanced drive train vehicle industry, the biofuels industry, the energy-efficient building, construction, and retrofits industries, and the aerospace industry are those supported by strategic partnerships among State and local workforce boards; institutions of higher education, including community colleges and other training providers; labor organizations; industry; and economic development entities that use sector or cluster-based training approaches for developing job training strategies and career pathway initiatives that lead to economic self-sufficiency?

Ms. STABENOW. Mr. President, I would like to engage my friend and colleague, the Senator from Washington State, in a colloquy. I want to commend my good friend's work on behalf of America's workers, including the growing number of workers who have lost their jobs and need skill training and other services to secure good jobs in new or viable industries, including those that are retrofitting themselves to improve longer term global competitiveness. These industries promote energy efficiency, energy conservation, and environmental protection in such industries as advanced manufacturing, auto, aerospace, health care, and others. As Senator Murray has rightly stated during conversations on this recovery bill, investing in job creation should be accompanied by investments in workers, an essential component to strengthening our Nation's productivity and long-term competitiveness. These workers include the increasing number unemployed or underemployed individuals across the country and the thousands of manufacturing workers who have lost their jobs, such as those in the aerospace industry and the automotive industry. In her role as chairman of the Senate Subcommittee on Employment and Workplace Safety, we have worked together to help workers, particularly those in distressed industries, acquire the skills they need to secure family-supporting jobs in viable and emerging industries including the energy efficient and advanced drive train vehicle industry, the biofuels industry, and the energy-efficient building, construction, and retrofits industries. That is why I would like to clarify several provisions contained in the bill before us today that pertain to job training for workers. As the Senator knows, my home State of Michigan has experienced major economic dislocations from manufacturing plant closures and industry layoffs. I would like to first ask the esteemed Senator from Washington State if it is her understanding that worker training in these industries would be eligible for consideration by the Secretary of Labor under the national emergency grant and competitive grant funding sections of the workforce provisions of this bill?

Ms. STABENOW. Mr. President, I thank the distinguished chairman of the Finance Committee who I know is working so hard. There are so many different pieces of this that are so important to the American people. I want to take a moment, after listening to colleagues--today and throughout the week--on the other side of the aisle, to talk about the fact that this package is strongly supported by the majority of our caucus and I believe the majority of the American people who know we have to do something different than what has been done for the last 8 years. We have been debating whether to go back to policies that have been in place for 8 years--tax policies that have been passed on a number of occasions, over the last 8 years, under President Bush and when our colleagues were in the majority. We have seen those policies in place. We have seen the results of those, and they didn't work. I wish they had. My State of Michigan has the highest unemployment rate in the country, over 10.6 percent, heading up to 11 very quickly. I wish they had worked because people in my State then would be working. But that is not what has happened. The American people know that. The American people understand we have to do something different. I remember in those debates in the last 8 years when we came forward saying we need to put people to work by focusing on jobs directly, jobs rebuilding America, making sure we are focusing on jobs for roads and bridges and rebuilding water and sewer systems and rebuilding our schools and doing things that would directly stimulate the economy. But those were rejected with the same arguments we are hearing now, the same arguments. We have talked over the last 8 years about the need to aggressively move to the new green economy so we are not only tackling our dependence on foreign oil but creating jobs in this new green energy revolution. There were the same arguments in opposition, on the other side of the aisle. We have put forward proposals to invest in our people, proposals to make sure that people who are hurt by this devastating financial and economic crisis--those who are unemployed or fearful of being unemployed, who cannot put food on the table and pay the bills and pay their mortgage--can get help. Too many times that has been rejected. We now find ourselves here. There was an election where those policies were debated for a long time--not 1 year but 2 years. Those policies the American people took a look at, both sets of policies, and they said no. They said no to the policies of the last 8 years. They said no to inaction. We all know we were talking 2 years ago about the fact that we had to address the housing problem, subprime lending, or we were going to see a rippling effect in the financial markets. There was inaction. Nothing happened. We find ourselves in a position today where we are seeing some 600,000 people now--that is the unemployment number for January; 500,000 the previous month, 500,000 the previous month. It is only getting worse and worse. Eleven million people in this country do not have a job and that is only the people we are counting. We come to this point where, yes, there is a difference. I commend colleagues who are working together to get to the necessary 60 votes and are working in good faith. But fundamentally we have a difference in philosophy of how our economy should operate and, frankly, whom it should help. Our proposal, this President's proposal, is to make sure the majority of Americans, the overwhelming number of Americans who have been left out of this economy in the policies of the last 8 years get an opportunity to participate with job, jobs rebuilding America, jobs in the green economy, keeping our police officers on the streets, our teachers in the schools, retraining for the new economy and making sure people who have been hurt, devastated so much, get the help they need. I urge us to join together in a new direction.

Ms. STABENOW

Ms. STABENOW. I thank the Chairman and look forward to working with him on this important issue. Investing in Home and Community-Based Services

Ms. STABENOW. Thank you. Madam President, I want to ask a question of the Senator from Washington State. But I first want to thank her for her vision. She has been the person who has understood this is more than just about research and development, that this is about actually putting assets in America, in jobs here in America through manufacturing. I thank her for her vision. It has been my honor and pleasure to work with you on this issue. But I am wondering if the Senator is aware, in fact, of other countries such as South Korea which certainly has been investing in this. But Germany, last summer, developed what they call the Great Battery Alliance. Japan created the first batteries. Ford Motor Company, in doing their first Ford Escape Hybrid, their first Escape HUV, while we are proud that was done in America, in fact, the battery came from Japan. So China, Japan, South Korea, Germany--India now has announced a manufacturing strategy. So I ask, as you look at this, if she has looked at those other countries as well?

Ms. STABENOW. Madam President, will my friend be willing to yield for a question?

Ms. STABENOW. Madam President, I wonder if my colleague will yield for one more question.

Ms. STABENOW. I just came from a very large conference called the Blue Green Conference with about 2,500 people who are in town from environmental groups, labor organizations, business organizations, focused on exactly what the Senator is talking about. I wonder if the Senator is aware we have had people on the Hill actually supporting this wonderful amendment and arguing that, in fact, there are jobs, good-paying jobs, available from doing exactly what she is talking about? I wonder if my colleague is aware of the extent to which there is such a broad coalition of people across this country now supporting exactly what she is talking about?

Ms. STABENOW. Mr. President, before talking about a very important amendment introduced by Senators Cantwell and Hatch--and I commend them for their leadership on this very important amendment about jobs in the future--I believe we are at a critical point. We have seen job loss within the last 8 years like we have never seen before. In fact, in the last year, we lost 2.589 million jobs. It is accelerating every month-- 500,000 last month, 500,000 the month before. We are seeing new numbers that show acceleration of job loss. Unfortunately, that has come as a result of action and inaction in the last 8 years. We are at a pivotal point. Do we use the same policies of the last 8 years or similar ones or do we do something new? Do we focus on a different strategy of investment, focusing on the demand side of supply and demand, creating jobs, putting money in people's pockets to pay the bills, and grow the middle class of this country? That is what this package is about. It is a change. I understand there is a disagreement and an honest debate of philosophies that occurs in the Senate. I totally understand that colleagues who have been promoting an approach for 8 years with President Bush would come forward with the same kinds of proposals on tax cuts and other approaches, most of those around tax cuts that are very supply-side oriented. I understand that is their philosophy, that is their approach. They believe that is what should happen. With all due respect, that has not worked. We are talking about over 2.5 million jobs lost last year. Critically important to me in Michigan, we have lost over 4.1 million manufacturing jobs in the last 8 years. We have had no manufacturing strategy, no focus on good-paying middle-class manufacturing jobs. In this package, we are going to change that. One of the important ways--and there are multiple items in the bill I will mention--relates to an amendment that will be coming before the body, hopefully today. It was offered by Senators Cantwell and Hatch, and it speaks to the future. I am proud to be a cosponsor. It focuses on manufacturing the vehicles, the plug-in electric vehicles that we know we need to get us off our dependence on foreign oil, to address global warming, and to create jobs. We have done a great job on R&D. We are investing in this package as it relates to battery development and research and development. We are doing a better job all the time on demonstration projects. We have passed tax incentives for consumers. The question is, Where will the vehicles be made? Where will the battery technology be made? That is the piece that has not been happening. I am proud that the first hybrid SUV was made by an American company, Ford Motor Company. They made the Ford Escape hybrid. But they had to buy the battery from Japan. Now we see batteries coming from Korea. We want the jobs making those batteries in America. That is what this amendment is about. A123, which is a leading battery company, asserts that an investment of $4.6 billion over the next 5 years in batteries and electric vehicles will create 29,000 direct jobs and 14 million square feet of new U.S. plant capacity. Of the newly created jobs, it is estimated that about 80 percent would be in the advanced battery industry or in the supply chain. I am extremely supportive and pleased to be involved in this particular amendment. I also appreciate the fact that it does something incredibly important. In this horrible economy we find ourselves, where capital is not available for startups or for mature manufacturing companies that are turning to a green economy, this makes sure that companies in a loss position, that we need to grow the economy and create jobs, will also participate in creating the new electric vehicles. This is the future. Shame on us if we do not make these investments now and we go from dependence on foreign oil to dependence on foreign technology, which is, frankly, where we have been headed in the last 8 years. This recovery package changes that. The Cantwell-Hatch-Stabenow amendment is a very important addition to it. More broadly, let me say that we know we need a change, and we need action now from the policies that have put us where we are. We have over 11 million people who want to work and who are out of work. Right now, we have more people out of work than there are jobs available. We are in a situation where we have to focus on creating jobs. That is what this recovery package does. What we are talking about is making sure we are rebuilding the middle class. That is not a slogan; that is a reality. We have been losing the middle class because we have been losing good-paying jobs. Too many families find themselves in the middle of this economic tsunami, and they are asking us to focus on jobs and those things that will allow them to pick themselves up, to work, pay the mortgage, put food on the table, send the kids to college, and have the American dream we all want for ourselves and our children. That is what this is about. This package is about jobs rebuilding America, jobs that leave something behind for the taxpayer--a safer bridge, better roads, better water and sewer systems, the ability for small businesses to connect with high-speed Internet so they can sell their products around the world, the ability for hospitals to cut the cost of health care by new technology and to move ahead for the future. Jobs rebuilding America are essential to this package. Secondly, it is jobs and a new green economy. We know that one of the next things we will have to tackle is what we do about the incredibly serious threat of global warming. There is a way to do that that creates good-paying jobs in America by focusing on the new green economy. That is the new green revolution. It was 101 years ago when the Model T Ford rolled off the line. At that time, we created a revolution, people being able to move, to be more mobile with vehicles. We started a revolution that created the middle class. This is now a time for that next revolution. When Henry Ford created the Model T, he also started another revolution, which was paying his workers enough so they could buy the vehicle. He knew that good-paying jobs were part of the equation. You could build automobiles, but if nobody could buy them, it wouldn't matter. He understood the demand side of supply and demand. He doubled wages to $5 a day so his workers could buy the vehicles. This package focuses on workers having money in their pockets so they can buy things to get this economy going again. In the green economy, it is exciting to see what we have been able to do. Last year on the floor we passed in our budget resolution a green- collar jobs initiative which I was proud to author. Other than the retooling loans, we were not able to fund the rest of it. This package funds the green-collar jobs initiative with $2 billion for grants for advanced batteries. It focuses on green-collar job training. It focuses on weatherization and energy efficiency for buildings, which we know create 40 percent of energy usage. It focuses on creating a smart grid to improve the security and reliability of the electricity grid. If everybody in the United States had an electric vehicle made in America and they plugged it in, we would totally destroy the electric grid. We don't have the capacity. In this bill, we look to the future and say: We want the vehicles. We want the fuel efficiency. We want to stop those carbon emissions. And we better make sure we have a grid that allows that to work. So that is in here as well. So it is about right now, and it is about where we want to go in terms of jobs in so many different areas. We are talking about loan guarantees and grant programs and tax incentives that combine to create a picture of a future that is based on a green economy and is based on good-paying jobs in America. I wish to make sure the 8,000 component parts that go into a wind turbine--somebody told me it was 1,200 parts, and then somebody said, no, it is 8,000 actually--8,000 different parts in one wind turbine. I wish to make sure those are manufactured in this country, not just that we use the wind energy, which is important, but 70 percent of the economic activity in using wind energy comes from manufacturing the parts. We do that pretty well in Michigan, as well as, I know, around the country. But we are pretty proud of our skilled workforce which knows how to make things, manufacture things, develop things, engineer things. The green economy and the incentives in this recovery bill focus on creating those kinds of jobs, and it is very exciting to see where we can go. We also know there are people who right now we need to be focusing on to make sure we have support for our States and communities so they can keep police officers on the beat, schoolteachers in the classroom, and keep jobs--very important jobs--in public service we all benefit from every day. That is in this package. There are a tremendous number of people who are hurt, and certainly I speak for people in our great State who work hard every day and have been caught in the middle of this economic crisis. We have not seen much in the last 8 years to recognize the hurt families are going through and to help them through what we hope will be a temporary situation. Unemployment compensation benefits are increasing as well. Help for families to be able to keep their health insurance is in this bill. Job training and help for people who have lost their jobs because of unfair trade practices is in this bill. Help to put food on the table for families is in this bill. This is a very important economic recovery package that focuses ultimately on making sure we are creating jobs in America. That is what this is about. It is all kinds of jobs, that is for sure. There is not one silver bullet. It is all kinds of jobs. But it is about creating jobs, creating opportunities, looking to the future, disregarding the policies that have not worked, saying: Do you know what. We are not going to do that anymore. The same things that have been proposed that relate to what has happened in the last 8 years, we are not going to do that anymore. We cannot afford to do that. We are in a crisis. We need to act boldly, smartly, and now. This bill does that. This is about creating jobs in America. I hope we will join together in a strong bipartisan vote to get it done. I thank the Chair.

Ms. STABENOW. Mr. President, as you know, H.R. 1 provides critical incentives for the adoption of meaningful EMR technology. Adoption of this technology is essential to improving care and reducing costs. Michigan hospitals have been at the forefront of critical advances in health information technology such as e-prescribing and developing an Electronic Medical Record. In fact, its ambulatory sites have been paperless for almost 5 years. Many of my hospitals are spending significant resources in this difficult economic environment to convert their hospital records to electronic format and upgrade EMRs to contain Clinical Practice Guidelines. Section 4201 (a)(1)(C) of the bill seeks to prevent double payments by excluding certain physicians who practice substantially in hospital settings and use hospital-owned EMR equipment. To clarify the intent of this section, the bill lists specific examples of hospital-based professionals to be excluded. This makes sense. But I am concerned that this language may also inadvertently exclude many physician group practices associated with hospitals may not qualify for EMR incentives under H.R. 1. The way the provision is drafted may many outstanding medical groups such as the Billings Clinic in your great state from receiving incentive payments because they are classified as ``provider-based'' entities. Because of this designation, I am concerned that HHS may consider such professionals as ``Hospital- Based Eligible Professionals'' who are prohibited from receiving incentive payments under this section of the bill. I am sure it is not our intent to exclude such physician group practices from incentives. I hope the Chairman will work with me and my staff to ensure that Congressional intent will be carried out and early champions of HIT are eligible for EMR incentives in the H.R. 1.

Mrs. STABENOW

Mrs. STABENOW. Mr. President, I commend Senator Murray for her amendment. I am proud to be a cosponsor, and I strongly support the motion to waive the Budget Act. When my friend from South Dakota said we should not spend money on things we don't need, we need jobs. We need jobs, and that is exactly what this amendment does. The additional resources in this amendment of $25 billion, according to the normal formulas used, by my calculation would create over 1,187,500 new, good- paying jobs. That is exactly what we need to do to get this economy going again. With all due respect to my colleagues on the other side of the aisle, the reality is, we have had 8 years of their philosophy, 8 years of a philosophy focused on the supply side of supply and demand. Start at the top, it will trickle down. What has that gotten us? In the last year alone, what that has meant to us is 2,956,000 good-paying American jobs gone, in 1 year. Over the last 8 years in manufacturing, which is the backbone of the middle class, we have lost over 4.1 million manufacturing jobs. What this amendment is about, what this recovery plan is about, is changing the way we do business, changing priorities, focusing on middle-class workers, communities, folks working hard to stay in the middle class or get into the middle class, the people who need money in their pocket to buy things so we can have a strong economy again. We are talking about, in this proposal, creating jobs. That is what this is about. The philosophy that has been operating for the last 8 years has put us in a situation where we lost more jobs last year than any other time since 1945: Eleven million people are out of work. Something has to change. I commend our committee chairmen for their leadership, Senators Baucus and Inouye, and all of the good work that has gone into changing direction. The reality is, we are at a point in time where we have to focus on the folks who want a job, who want to go to work in the morning, to be able to pay the bills and keep the mortgage and put the kids in college and put food on the table. That is what this amendment does. This is about rebuilding America. At the end of it, we as taxpayers get something for it. We know a quarter of our bridges are in dangerous condition. We know we need to focus on roads and bridges and water and sewer systems, building 21st century schools for children, more focus on public transportation. We need to focus on creating good-paying jobs. That is what this amendment is all about. We have had enough of policies that only focused on a few. We have had enough of policies that asked the majority of Americans to sit and wait for something to trickle down to them and their families. This recovery plan rejects a philosophy that has not worked. Frankly, it is a philosophy that was rejected last November. People are saying they want to change the focus. What have we done? We have put together a recovery plan that focuses on jobs and rebuilding America. That is what the Murray amendment does. We focus on green manufacturing and green technologies, which are so important to our future, because as manufacturing was the backbone of the middle class for the last century, a green economy will build on manufacturing, will build on the middle class of the future. We have significant investments that move us in that direction, that not only make sure we are growing fuels and that we are operating in a more efficient manner, but that we are building the green technologies here so the jobs are here. That is what this is about. I believe strongly that we need to waive the Budget Act. We need to get on with the Murray amendment, because the bottom line of all of this is rebuilding the middle class. I yield the floor.

Ms. STABENOW

Ms. STABENOW. Mr. President, I move to reconsider the vote.

Ms. STABENOW

Ms. STABENOW. Mr. President, I move to reconsider the vote, and I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 46

Ms. STABENOW. Mr. President, I rise today in strong support of the Children's Health Insurance Program, and the fact that we will be adding 4 million children for a total of 10 million American children from families predominately who are low income, who have parents who are working but do not have insurance, and have a very difficult time going into the private sector and paying very high premiums to try to be able to cover their children. We do not want families choosing between keeping the lights on and keeping the heat on, food on the table, and whether their children can get health care. And for too many families in America right now, that is what is happening. So I am pleased to be a part of this, to know we have a President who will enthusiastically and quickly sign this bill as one of his first actions. I think it will be very exciting to see that, after having worked so hard on a bipartisanship basis with colleagues to pass not once but twice children's health insurance, and to have it vetoed by the former President. This is a real opportunity for us. I certainly thank Chairman Baucus and his staff for all of the work, and also the work of Senator Rockefeller and Senator Grassley and Senator Hatch, who are expressing concerns, but there has been a tremendous amount of bipartisan work that has gone on. Frankly, the bill we have in front of us is very much the bill that we worked on together in a bipartisan way and brought to the floor in the past. It was a compromise. There are things that, frankly, if I were doing this by myself, I would want to go back and change if we were not keeping to the bipartisan agreement. We were originally talking about adding more children, a larger pricetag of $50 billion. I would have been very happy to go back to that number. But, again, in agreeing to work within the confines of the bipartisan agreement from last session to be able to move it quickly, we did not do that. Also, there are certainly elements relating to low-income adults that I would like, coming from Michigan, to revisit. But we have not done that. So I think there has been a tremendous good-faith effort to operate within the framework of the bill that was passed, worked on by leaders on both sides of the aisle. We have a wonderful opportunity right now to do something very important for the children of Michigan, the children of Oregon, the children all across this country. There are very important changes from the current program that we are adding in this bill, making improvements in outreach and enrollment. Our colleagues on the other side of the aisle have talked about concerns about not having enough outreach to low-income children. Dollars are placed in this bill that would allow more of that to occur. I think that is very important. Dental coverage. Mental health coverage. We have all heard the horror stories of children who had tooth problems or an abscess turning into a situation that in certain cases has caused death, tremendous tragedies. It is inexcusable that in the United States of America we would have children who could not get the dental care they needed or the mental health care they needed. I am very pleased to have worked on the areas of health information technology where we are adding the ability to pilot a pediatric electronic medical record to make it easier to track children and to be able to have a more efficient way to gather the information about children's health records and to have it available for providers. This bill is a huge step forward in so many areas. The Children's Health Insurance Program has been a success story since its beginning. I was pleased as a new House Member from Michigan in 1997 to have voted to pass the original Children's Health Insurance Program, and the companion program with it under Medicaid, which has reduced the number of uninsured children by over one-third. I think that is something we should feel very proud about. These gains have occurred even as health care costs have risen, skyrocketing in many places, and employer-based coverage has, unfortunately, been declining because of the cost. I know in my home State of Michigan, the Children's Health Insurance Program and the partner program of Medicaid have made a huge difference in people's lives, a huge difference in a family's ability to care for their children, to be able to sleep at night and not worry about what happens if their children get sick. Working families in Michigan have been losing their employer- sponsored coverage for over a decade now, unfortunately, increasing the need for an expansion of affordable health insurance options for children. A report recently released from the University of Michigan and Blue Cross-Blue Shield of Michigan found that between 2000 and the year 2006, employer-sponsored insurance decreased over 10 percent, meaning that we are talking about families who otherwise had insurance through their employer and now they do not. They then turned to the private individual marketplace. It is extremely expensive. And for many families, that is not an option. So they have turned to this wonderful public-private program called the Children's Health Insurance Program. In Michigan it is known as MIChild. This is a wonderful partnership that has helped families of working parents, folks who are working hard, but who are not poor enough to be able to qualify for health care under Medicaid for low-income individuals. They are not in a job or wealthy enough to be able to purchase health care themselves in the private sector, but they are working. They are working hard every day, maybe one job, maybe two jobs, maybe three jobs. But they do not have health insurance. That is who we are focused on when we talk about the Children's Health Insurance Program. It is not about rich kids, as we have heard some discussion about. In Michigan, a family of four cannot make more than $40,000 a year to qualify for MIChild. Those families are working very hard, and that is not a lot of money to try to hold together a family of four and pay the mortgage, put food on the table, and then find some way to pay big insurance premiums. Let me share a few stories from families in Michigan who have contacted me. Five-year-old Ryland has a heart condition that causes his heart to race. He had two unsuccessful surgeries for his condition when the family lived in Canada. When they returned to Michigan, there was no insurance company that would cover Ryland because he had a preexisting condition--a very common story for families. Michigan used a portion of its funding to expand what we call Healthy Kids. Through that program, Ryland was able to receive a successful surgery. Six-year-old Ethan has a serious heart condition called long QT syndrome, which causes seizures and blackouts and makes the heart race until it stops completely. Ethan had received insurance through his father's employer, but when his father died, his mother did not know what to do. Luckily, Ethan's mother was able to enroll him in the Michigan program MIChild. He was then able to get the care he needed to get help for his heart condition early on. It has made a tremendous difference in his life and in his mother's life. This is not only the right thing to do, the moral thing to do; treating illnesses and chronic conditions early also is the economical thing to do. I do not want to put it in dollar terms because what is most important is the ability for children to be able to be healthy and live long lives and have opportunities for the future of this great country. But we all know that if a parent is forced to wait until it is an emergency situation and use the emergency room, or worse, in terms of waiting until a child is in a very serious illness, we are talking about huge costs. So this is the one time where we save money and save lives. We save money and we improve the quality of life for 10 million children in America through this program. Sharing another story: Chad and his wife have two young children. He works for a small landscaping business with an off-season of 3 to 4 months. Sometimes the winter can be pretty long in Michigan. If they, Chad and his wife, purchased insurance through their employer, it would be an additional $300 a month which, unfortunately, was not affordable for them. But through MIChild children's health insurance, both of their sons were able to get the inhalers they needed for their asthma. That significantly changed their life, their qualify of life. Pam is a full-time preschool teacher and mother. Her monthly premiums of $384 a month would have taken up over 20 percent of her pay. She was not able to do that. Through MIChild she was able to get the specialized care she needed for her youngest daughter, who suffers from a rare seizure disorder. Pam's story, in particular, illustrates the problems facing working families. According to the Commonwealth Fund, nearly three-quarters of people living below 200 percent of poverty found it difficult or impossible to afford coverage. That is what is happening to families all across the country. The situation is even worse for individuals with chronic conditions such as asthma or diabetes. If they are able to purchase coverage in the private individual market--if--then costs are much higher. I would like to remind my colleagues that reauthorizing the Children's Health Insurance Program is about all children--no matter where they live, whether they live in the city, the suburbs, or in rural Michigan or rural America. The nonpartisan Carsey Institute found that in the vast majority of States a higher percentage of rural children live in poverty today than they did 5 years ago. This fact has translated into a higher need for health care like children's health insurance in rural areas. In fact, 32 percent of all rural children rely on the Children's Health Insurance Program and Medicaid compared to 26 percent of urban children. So this is something that certainly affects every part of my State--from the cities, to northern Michigan, to southwest Michigan, and every part of this great country. Because of the importance of the children's health program, I urge my colleagues to put aside negative attacks and join to support a bill that is basically the same bill we worked on together in a bipartisan way that we brought to the floor in the last Congress that, unfortunately, was vetoed. But we now are in a position, using this document that was worked on with leaders across the aisle, to do something about which we can all be very proud. This bill will make a real difference in the lives of children and families across America, and it is a great way to start the new year. Thank you, Mr. President.

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise today to introduce the E-Centives Act, which will help ensure safety-net providers serving our most vulnerable citizens can acquire Health Information Technology, HIT. As I have spoken about many times, HIT promises to transform the delivery of health care in the United States, improving the overall efficiency and effectiveness of healthcare. Some specific quality improvements that result from HIT include reduction in errors that come from illegible handwriting; electronic systems that prompt prescription of generic rather than brand-name drugs; reduction in duplicate diagnostic tests; physician reminders regarding appropriate preventive care; clinical decision support systems that encourage use of evidence- based medicine; identification of drug interactions and patient allergies; and assistance to physicians to manage patients with complex, chronic conditions. While HIT holds great promise for transforming health care, unfortunately not all providers have the financial means to adopt and use this technology. In fact, the cost of acquiring technology is a major barrier to adoption among health care providers. Cost is particularly burdensome to small practices and safety-net providers that often operate with low financial margins. Several organizations, including the Kaiser Commission on Medicaid and the Uninsured and the Healthcare Information and Management Systems Society, recognize the essential role that the Federal Government must play to assist providers in the Medicaid and Children's Health Insurance Program, CHIP, to acquire HIT. But absent Federal funding, we could see a ``digital divide'' in health care. The bill that I am introducing today will help accelerate investment in certified HIT by providers predominantly serving Medicaid and CHIP beneficiaries. The bill accomplishes this by providing authority to State Medicaid programs to reimburse providers at the enhanced SCHIP FMAP rate for the costs associated with the meaningful use of a certified electronic medical record. This bill also helps streamline the administration and enrollment process for the Medicaid program by modifying the current regulation that governs the Medicaid Management Information System to include funding for electronic information and eligibility systems, patient registries for disease screening, and office staff training on electronic information and eligibility systems. I look forward to working with my colleagues to ensure that all health care providers and all Americans can see the benefit of health information technology. Widespread diffusion of HIT is a critical step in health care reform and making sure every American has the most efficient, optimal quality care.

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise today to introduce the E-Centives Act, which will help ensure safety-net providers serving our most vulnerable citizens can acquire Health Information Technology, HIT. As I have spoken about many times, HIT promises to transform the delivery of health care in the United States, improving the overall efficiency and effectiveness of healthcare. Some specific quality improvements that result from HIT include reduction in errors that come from illegible handwriting; electronic systems that prompt prescription of generic rather than brand-name drugs; reduction in duplicate diagnostic tests; physician reminders regarding appropriate preventive care; clinical decision support systems that encourage use of evidence- based medicine; identification of drug interactions and patient allergies; and assistance to physicians to manage patients with complex, chronic conditions. While HIT holds great promise for transforming health care, unfortunately not all providers have the financial means to adopt and use this technology. In fact, the cost of acquiring technology is a major barrier to adoption among health care providers. Cost is particularly burdensome to small practices and safety-net providers that often operate with low financial margins. Several organizations, including the Kaiser Commission on Medicaid and the Uninsured and the Healthcare Information and Management Systems Society, recognize the essential role that the Federal Government must play to assist providers in the Medicaid and Children's Health Insurance Program, CHIP, to acquire HIT. But absent Federal funding, we could see a ``digital divide'' in health care. The bill that I am introducing today will help accelerate investment in certified HIT by providers predominantly serving Medicaid and CHIP beneficiaries. The bill accomplishes this by providing authority to State Medicaid programs to reimburse providers at the enhanced SCHIP FMAP rate for the costs associated with the meaningful use of a certified electronic medical record. This bill also helps streamline the administration and enrollment process for the Medicaid program by modifying the current regulation that governs the Medicaid Management Information System to include funding for electronic information and eligibility systems, patient registries for disease screening, and office staff training on electronic information and eligibility systems. I look forward to working with my colleagues to ensure that all health care providers and all Americans can see the benefit of health information technology. Widespread diffusion of HIT is a critical step in health care reform and making sure every American has the most efficient, optimal quality care.

Ms. STABENOW

Ms. STABENOW. Mr. President, I wish to take a few minutes this evening to respond to some of the comments that we have been hearing from colleagues on the other side of the aisle expressing great concern about the spending of a recovery package for America, as we are talking about today. I find it quite extraordinary when I hear colleagues talking about objecting to spending Federal dollars right now--Federal dollars that would add to the deficit--given where we have come from in the last 8 years. I find it quite extraordinary. I remember back when I was in the House of Representatives, serving with the distinguished Presiding Officer, when in 1997 we took some very tough votes and did a lot of hard work under President Clinton. Actually, we balanced the budget for the first time in 30 years. That put us on a course to eliminate the deficit, to strengthen the country, to create the right kinds of priorities for the American people. As a result of that action, in 2001, when I came into the Senate as a new member of the Budget Committee, we were debating what to do with the biggest surplus in American history, $5.7 trillion. How should we address the largest surplus we had seen in the Federal budget. At the time, the Democrats on the committee proposed that we divide that surplus into three parts: one, for tax cuts geared to the middle class; two, for investments to create jobs, invest in education, and future opportunities; and three, to help strengthen Social Security. That was rejected. Instead, as we all know now, a very large supply-side tax cut, trickle-down economics, was passed. My constituents, in January 2009, are still waiting for it to trickle down to their pockets. But that was put in place, which began a process that has now led us to the highest deficits in the history of the country in just 8 years. That was coupled with a war that was not paid for, over $10 billion a month, and certainly the most important thing has been the loss of life. Then we saw just at the end of the year an effort to provide $700 billion in what has been dubbed the bailout of Wall Street--to date, I suggest, not very effective and at times outrageous in terms of what has happened with that money. So it is not that the Federal Government has to spend money, it is not that colleagues on the other side of the aisle have not supported spending. They supported spending for 8 years. The question is, What are we going to spend it on and for whom? Many Americans have seen their standard of living go down, their jobs go away, their houses go away, their opportunities go away, while some have done very well under a particular kind of spending over the last 8 years. What I suggest is this is not about whether we spend or invest or use Federal dollars; it is about our values and priorities. In whom are we going to invest? Where are we going to spend the dollars? I have had so many people in Michigan say to me, with all the debates going on: Where is my bailout? I am sure you heard that, Mr. President: Where is my bailout? Small business owners: Where is my bailout? Individuals. I suggest what we are debating is the American people bailout, the investment in America. The people of this country have resoundingly rejected the policies of the last 8 years that have gotten us to where we are today. That is what elections are about. People have said very loudly: We don't want the same policies; we don't want the same people espousing the same policies going forward as we have seen in the last 8 years. Where have those policies over the last 8 years gotten us? Over the last 8 years, we have not seen a commitment to manufacturing in this country. Some people say that is only a narrow special interest for a certain number of States in the country. I suggest it is a foundation of the middle class in this country. The fact that we have lost 4.1 million manufacturing jobs due to the policies of the last 8 years-- 750,000 of those jobs just last year--that totally relates to where we are in terms of jobs in this country, what is happening in this country, and what is happening to middle-class people. The economic activity in the manufacturing sector has fallen to its lowest level in 60 years. That absolutely equates to the challenges we are currently having in this economy. In 2008, 2.6 million jobs just in general were lost, the worst year since 1945--8 years of policies put forward by the current administration and supported by many people who have been on the floor since we came back into session arguing we should not do something different; we should not try a different kind of investment policy; we should not focus on jobs in America, the middle class, and so on; we should keep doing it the way we have been doing it. That is basically what we are hearing on the floor, the same kinds of things that have gotten us to these numbers--1 million jobs lost last month. Last month, 1 million Americans. As of December, 11.1 million people were unemployed. And we wonder why they cannot pay their mortgages and their homes are going into foreclosure. The jobless rate is the highest in 16 years, and we know it is not going to get better quickly. We know at least the first half of this year--possibly the entire year--is going to be very tough. We know that. But common sense would say that we do not embrace the same policies that have gotten us to this point if we want to get out of the hole. It is exciting that next week we are going to swear in a wonderful new President who has policies, working with us, working with all of us together, that will stop digging the hole and begin to bring us out of the hole, even though we know it is a deep hole, and he has certainly stressed that, wisely, with the American people. We are going to begin to come out of this hole. Over and over again in the last week, we have been hearing colleagues objecting to a change in economic policy and proposing the same old thing. The same old thing has put us in a situation where the U.S. median home price fell 13 percent in the last year, which is the fastest pace since the 1930s. That is what the kinds of policies we are hearing on the other side of the aisle have achieved. Mr. President, 3,100 foreclosures happen every day. Today, as we have been in session, 3,100 families have seen their homes foreclosed upon. Tomorrow, there will be another 3,100 families; the next day, 3,100 families. That is what the policies--action and inaction--of the last 8 years have done. One in ten homeowners with a mortgage is either in foreclosure or delinquent on payments. Pension plans, if you are fortunate enough to have had a job, worked hard all your life, and put money into a pension--maybe you did not take a pay raise in order to make sure you had that pension--have suffered their steepest 1-year drop in 20 years. The average pension fund now is holding assets that would cover only about 75 percent of what had been promised to workers. I could go on and on with the numbers, and you know them as well. The good news is the American people have looked around at what has happened, the trickle-down economic policies of the last 8 years--the idea that we can't afford to invest in education for the future or health care or focus on jobs for the future--they have looked at those policies and said, no more, no more, We have had enough. So that brings us to this point, and we will have the opportunity in the next few weeks to bring forward an economic recovery plan that focuses in a very different way. If we are going to do tax cuts, we want tax cuts for middle-class families and those working hard to get into the middle class to benefit from those and that is the policy we will see coming forward. We are going to see policies that will create jobs rebuilding America. I have heard colleagues on the other side of the aisle saying: Oh, my gosh, they want to not only talk about roads and bridges and water and sewer systems, but they want to talk about broadband--the idea of connecting rural communities and small businesses to the Internet so they can sell around the world, just like big business does. Oh, my goodness, you mean they want everybody to have access to the Internet, not just some people? Yes, that is true. We believe the new highway, the information highway, that power needs to be available to every child, to every small business, to every farmer at the end of the road. Just as we built the electricity systems, the telephone systems of the past, we need to make sure we are building for the future in America so everyone has access to these new technologies to have opportunity for jobs and income and education. I am also very involved in making sure we can computerize our health care system so we can cut costs from unnecessary paperwork; that we can also provide the very best quality of health care in every hospital, large and small, whether you live in a small rural area or an urban hospital is where you would go or a suburban hospital. We need to focus on jobs rebuilding America and reinvesting not only in the upfront construction jobs but in what that will mean to the assets that will be there afterwards, which is very much a part of this recovery plan. We know we want to see alternative energy jobs, and certainly I am very involved in the whole effort to create green jobs. I am very proud that last year in the budget resolution we included my green-collar jobs initiative, which now our new President-elect and his team are working to fund as a part of what we need to do to create the new battery technology. This is not just the research but to build the batteries here in the United States; and not only to have wind energy but to build the wind turbines here and create the jobs; and not only to have the solar power but to build the solar units or the solar panels, to have the equipment, to have the storage from the batteries all done here. That is a part of our vision for a recovery package for the future. Because I have been working so closely with advanced manufacturing in the auto industry, I know an interesting statistic is that if everyone had an electric car today--and we would certainly like that to happen from an environmental standpoint--we would blow up the electrical grid in this country, poof. We would be in deep trouble. So part of what we need to have happen is to upgrade so we have a better electric system to be able to handle those new vehicles. We need to create a new kind of infrastructure so that when you pull up in your vehicle, which would get 40 miles per--what shall I say? It is not 40 miles per gallon because it is not a gallon. It is 40 miles on the road to a charge. Wouldn't it be great to be able to pull up and charge it in a parking lot or at a parking meter as you went into the store? There are so many ways we need to build and rebuild America for this new technological world we are in, this new green alternative energy world we are in. That is our hope: Jobs, rebuilding America, and building for the future. We not only can achieve very important goals of energy independence and tackling in a real and meaningful way the serious issue of global warming, but we can create jobs in America, good-paying jobs in America. That is what this recovery plan does, and I am very excited to work with the incoming administration and to see their vision and their commitment to working with us. There are so many pieces of this that will be addressed. I will mention one other, and that is when I talked earlier about the numbers regarding unemployment and housing and pensions and what is happening to people, we have seen now close to a decade--8 years--of neglect, of not paying attention to those who have been hurt by the policies that have been in place. So it is very important that we, in fact, recognize that we have more people out of work than there are currently available jobs--people who have worked all their lives, people who want to work, who recognize the dignity of work but in the short run need some help. Part of this package needs to address this as well, whether it is unemployment insurance, whether it is food assistance, whether it is help with health care during a transition or whether it is addressing those who have lost their jobs because of trade. Those priorities represent the best of America and who we are, our real values and priorities as Americans, understanding that we are in a global economy and that transition, at best, even if everything was going well, even if every policy was going well, has created pain and suffering for those caught in the middle. Unfortunately, because of a series of policies, whether it is not enforcing our trade laws fairly, whether it is not addressing health care or seeing the cutbacks in education, and so on, too many people have been hurt and need some help. Too many people have been hurt in the last 8 years. So a very important part of this recovery plan as well is to make sure those families know we see them, we hear them; that, as Americans, we care about them and want to make sure they have the temporary assistance they need while we are creating these jobs in the new economy. There is a lot of work to do, as we all know, and I would conclude by saying that while we may not know how long it will take for us to move out of this deep hole we have been placed in, in terms of job loss and deficits, and so on, here is what we do know: The same thing has been tried for 8 years and things have only gotten worse every year. So those who would argue that we should have more of the same I think find themselves in a difficult position because the American people want change. They have voted for change, and they expect us to change the values and the priorities of this country so that we are, in fact, investing in our people and in a strong America again. I yield the floor, and I suggest the absence of a quorum.

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

Ms. STABENOW

Ms. STABENOW. I am very pleased to introduce the Health Information Technology Act with my friend and colleague from Maine, Senator Snowe. As co-chairs of the Senate Health Care Quality Improvement and Information Technology Caucus, we have seen first-hand the transformative power information technology has on the delivery of health care. Our legislation is a substantial down-payment in building up our Nation's health information network and an important step in reforming health care. In doing so, we will reduce costs for our businesses, improve the quality of care for patients, and ensure health providers have access to the most accurate information. And I am very excited that President-elect Obama identified health IT as an important part of investing in our Nation's economy. The result of using 19th century technology in a 21st century health care system is higher costs, increased errors, and decreased quality of care. Too often, care is duplicated or the best and most appropriate care isn't given. Our health care professionals can't possibly provide the best care if they don't have complete and accurate information about the patient sitting in front of them. Many studies have found that as much as $300 billion is spent each year on health care that does not improve patient outcomes on treatment that is unnecessary, inappropriate, inefficient, or ineffective. For example, in last year's series of health reform hearings in the Senate Finance Committee, we heard testimony from Elizabeth McGlynn of the RAND Corporation that we only receive 55 percent of recommended preventive care services, 54 percent of recommended care for acute health problems, and 56 percent of the care that doctors agree is necessary for people with chronic conditions when we seek medical treatment. It's long past time that we fully utilize technology to make health care accessible and affordable for every family and business. However, most of our Nation's health care providers don't have access to capital in order to purchase information technology and service updates. Too many providers, especially our safety-net providers, are having a hard enough time just keeping up with their daily costs, much less to invest in something new. A March 2001 Institute of Medicine study concluded that in order to improve quality, there must be a national commitment to building an information infrastructure. An October 2003 Government Accountability Office report found that the benefits of an electronic healthcare information system included improved quality of care, reduced costs associated with medication errors, more accurate and complete medical documentation, more accurate capture of codes and charges, and improved communication among providers enabling them to respond more quickly to patients' needs. By providing the most appropriate care at the most appropriate time in a safe, secure way, we can reap huge savings. A January 2005 Report by the Center for Information Technology Leadership found that moving to standardized health information exchange and interoperability would save nearly $80 billion annually in the United States. The benefits of adoption and use of health care information technologies, systems and services will be widespread: employers will realize cost savings, clinicians will gain new electronic support tools and patient information to help guide medical decisions, and patients will benefit from a more efficient health care system and from a safer health care system with fewer unnecessary treatments and more attention to preventive care. We know that adoption of health information technology can play a critical role in improving patient outcomes and at the same time greatly reduce costs. But it can't happen without the federal government playing a role. The members of the Health Information Technology Leadership Panel concurred that without federal leadership, neither their individual companies nor the industrial sector as a whole can achieve the breadth of HIT adoption that would be required to realize the needed transformation of health care. Our country must have a national commitment to building an information infrastructure, and the Federal Government needs to step up to the plate and provide much-needed funds to get the ball rolling. Without health IT, we are not going to be able to accomplish other reforms necessary to improve our health care system. That is why I am fighting for funding similar to the legislation we are introducing today, will be included in the economic recovery act we will soon be debated. The sooner we get them into our hospitals, physician offices, nursing homes, community health centers, community mental health centers, and other health care providers, the sooner our patients, providers, and pocketbooks will see the rewards.

Ms. STABENOW

Ms. STABENOW. Mr. President, first let me say that this is not a bailout this evening, this is a bridge loan of $14 billion to stop us potentially, if one of the companies goes under, from over $150 billion in taxpayer funds that we will be spending, including assuming the taxpayers' cost for 775,000 pensions in a bankruptcy that will go into the pension guarantee fund. So we are talking about a small bridge loan in a global credit crisis where every other country in the world has stepped up to help their auto industry because they understand it is critical to their national defense, they understand it is critical to their economy, and they are trying to create the middle class we have had in America. In America, if this goes down tonight, we are saying we do not care about the backbone of the economy which has been and will continue to be manufacturing. Somebody has to make something in this country. We cannot all push paper on Wall Street. Somebody has to make something. The reality is, this is a tough bill. I wish to thank our leaders, Senator Reid for his patience and diligence and leadership, and Senator Dodd for his incredible patience, his staff being involved. It placed one more crisis on the doorstep of Senator Dodd to have to deal with. I appreciate Senator Corker stepping up to try to work this out and certainly Senator Voinovich and Senator Bond. Senator Levin and I have worked closely with them. But the reality is this: If we walk away this evening and do not vote to proceed with this bill, we are saying it is okay for a major auto company in America to go bankrupt, for 2.5 million people in this economy to lose their jobs. Over what? We have a tough bill that creates a restructuring mechanism where everybody comes to the table to restructure. We give them until March 31. If they are not moving in good faith, the $14 billion can be rescinded. If they do not have a viable plan by March 31, there is no more assistance. Unfortunately, what my Republican colleagues have said is that the only way we are going to do this, the only way we are going to do this, is the workers have to negotiate first with the Republican Party, with the Republicans. As long as the workers were willing to take all of the cuts the Republican Party thinks they should before the negotiation, they would be willing to step up and save the backbone of manufacturing in this country and 2.5 million jobs. We have tried everything. We have negotiated with the White House in good faith. I appreciate that. They have kept their deal. We have negotiated with every party that wanted to come forward, including today, all day, focusing with Senator Corker. But the reality is, we are in a position where evidently the only thing that matters to the majority of those on the other side of the aisle is that workers get paid too much in this country--somehow, workers get paid too much in this country--and unless we sock it to the workers, they are not willing to allow a $14 billion bridge loan to be able to save an industry and save an--