Jim Talent

Mr. TALENT

Mr. TALENT. Mr. President, today I rise on behalf of myself and my colleagues, Senators Charles Schumer and Lindsey Graham, in support of the Sickle Cell Treatment Act of 2003, which will help hundreds of thousands of people who suffer from Sickle Cell Disease. SCD, a genetic disease that affects red blood cells. This bill has bipartisan and bicameral support, as Representatives Danny K. Davis, a Democrat, and Richard Burr, a Republican, will introduce the companion bill today. Sickle Cell Disease is an inherited blood disorder that is a major health problem in the United States, primarily affecting African Americans. People with sickle cell disease have red blood cells that contain an abnormal type of hemoglobin. Sometimes these red blood cells become sickle-shaped--crescent shaped--and have difficulty passing through small blood vessels. When sickle-shaped cells block small blood vessels, less blood can reach that part of the body. Tissue that does not receive a normal blood flow eventually becomes damaged. This is what essentially causes the potentially life-threatening complications of sickle cell disease. There is currently no cure. More than 2,500,000 Americans, mostly African Americans, have the sickle cell trait. Among newborn American infants, SCD occurs in approximately 1, in 300 African Americans. The most feared complication for children with SCD is a stroke, which may affect infants as young as 18 months of age. While some patients can remain without symptoms for years, many others may not survive infancy or early childhood. Many adults with SCD have severe physical problems, such as acute lung complications that can result in death. Adults with SCD can also develop chronic problems, including pulmonary disease, pulmonary hypertension, and kidney failure. The average life span for an adult with SCD is the mid-40s. Stroke in the adult SCD population commonly results in both mental and physical disabilities for life. The Sickle Cell Treatment Act of 2003 helps combat SCD by providing Federal matching funds for SCD-related services under Medicaid, and by allowing States to receive a Federal 50-50 match for nonmedical expenses related to SCD treatment such as genetic counseling. This bill also authorizes a grant program in the amount of $10 million per year for 5 years to fund 40 health centers nationwide. Although I will go into detail about the bill, its focus is to encourage States to partner with SCD providers, who have historically been on the frontlines of this issue, to treat and find a cure for SCD patients. With regard to the Federal matching funds, this bill allows states to reimburse SCD services beyond current Medicaid law, which only covers physician and laboratory services. For example, if a State wanted to increase reimbursement rates for SCD blood transfusions, it could do so through rate setting for the new SCD benefit without having to increase reimbursement for all Medicaid blood transfusions, therefore, making it easier for a State to reimburse at a higher rate for SCD-related treatment. The bill also provides Federal reimbursement for education and other services related to the prevention and treatment of SCD. This will allow States to get a Federal 50-50 match for nonmedical, administrative expenses to include outreach and genetic counseling about SCD and its treatment for SCD patients of any age. This is critical to helping this historically underserved population, many of who may not know about SCD or its symptoms until it is too late. This bill also allows hospitals and clinics to do outreach with non- medical personnel to educate high-risk communities about recognizing SCD. It would also allow nonmedical personnel like counselors to spend time with SCD families to discuss how to manage the disease. Providing this one-stop shop will centralize SCD-related treatment and counseling services to better serve those with SCD. In addition to the diagnosis and treatment components, this bill creates a grant program for 40 health centers nationally. Specifically, the U.S. Department of Health and Human Services is authorized to distribute grants to up to 40 eligible health centers nationwide for $5 million for the next 5 fiscal years. Grants may be used for purposes including the education, treatment--i.e., genetic counseling and testing--and continuity of care for individuals with SCD, for training health professionals, and to identify and secure additional Federal funds to continue SCD treatment. This bill also creates a National Coordinating Center to collect, monitor and distribute information on new and innovative practices to prevent and treat SCD, establish a model protocol for the grant recipients to follow as a quality control mechanism, develop educational materials regarding the prevention and treatment of SCD, and submit a report to Congress to ensure fiscal accountability and provide information of recent developments towards a cure for SCD. The Sickle Cell Treatment Act of 2003 provides tremendous benefits to States. The approach taken in this bill is to add services related to SCD to the list of services covered by Medicaid for those people who are eligible for Medicaid under current eligibility rules. For example, the bill allows States to use Medicaid funds to work with providers to better serve areas with a high prevalence of SCD in fields such as education and counseling,which are currently not reimbursed by Medicaid. This bill also allows the States to create opportunities to partner with providers to determine ``best practices'' to encourage the most effective and efficient use of medical resources toward SCD treatment and education. In introducing the Sickle Cell Treatment Act of 2003, we are trying to help thousands of Americans who live with this disease. This legislation will provide many of these patients with access to the essential treatments that they need. It has the support of many important groups representing the SCD, African-American and children's health care communities as well as the providers and researchers who are working to treat and find a cure for this disease. For example, Allan Platt, Program Coordinator, The Georgia Comprehensive Sickle Cell Center at Grady Health System in Atlanta, GA has written me the following letter, which states in part, ``You did a wonderful thing for sickle cell patients and for those who are caring for them. Let us know how we can rally support for this.'' I want to offer my appreciation to the Sickle Cell Disease Association of American Inc., SCDAA, for its vigilant efforts to help find a cure for SCD, and working with my office to help craft this critical piece of legislation. SCDAA President and Chief Operating Officer, Lynda K. Anderson, has provided tireless support on behalf of this effort. Also I would like to acknowledge the efforts of SCDAA Board Member Michael R. DeBaun, M.D., M.P.H, Assistant Professor of Pediatrics and Biostatistics at the Washington University School of Medicine in St. Louis, MO. Lynda and Michael have brought the issues addressed in this bill to my attention and helped to bring the introduction of this bill to fruition. The SCDAA was founded in 1971 to provide an effective coordinated community-based approach to developing and implementing strategies to resolve issues surrounding sickle cell disease. Through three decades, SCDAA and its member organizations have demonstrated how community- based organizations and comprehensive health and research centers can work with local, State and Federal agencies in furtherance of national health care objectives. To this day, SCDAA continues to pursue legislative initiatives to secure additional government funding for research and community-based services. Moreover, it has demonstrated its capacity to provide continued leadership in this area as a potential national coordinator center, and I look forward to the organization applying for such a designation, once this measure has been enacted into law. My colleagues and I on both sides of the aisle and in both legislative bodies look forward to working with SCDAA to fight this good fight and to secure the resources required to address the very unique needs of patients, families and communities affected by SCD. I ask that my colleagues in the Senate join Senators Schumer and Graham, and Representatives Davis and Burr in helping us to find a cure to help the approximately 70,000 Americans who have SCD and the approximately 1,800 American babies who are born with this disease each year in supporting the Sickle Cell Treatment Act of 2003. I ask unanimous consent that the text of the bill printed in the Record.

Mr. TALENT

Mr. TALENT. Mr. President, today I rise on behalf of myself and my colleagues, Senators Charles Schumer and Lindsey Graham, in support of the Sickle Cell Treatment Act of 2003, which will help hundreds of thousands of people who suffer from Sickle Cell Disease. SCD, a genetic disease that affects red blood cells. This bill has bipartisan and bicameral support, as Representatives Danny K. Davis, a Democrat, and Richard Burr, a Republican, will introduce the companion bill today. Sickle Cell Disease is an inherited blood disorder that is a major health problem in the United States, primarily affecting African Americans. People with sickle cell disease have red blood cells that contain an abnormal type of hemoglobin. Sometimes these red blood cells become sickle-shaped--crescent shaped--and have difficulty passing through small blood vessels. When sickle-shaped cells block small blood vessels, less blood can reach that part of the body. Tissue that does not receive a normal blood flow eventually becomes damaged. This is what essentially causes the potentially life-threatening complications of sickle cell disease. There is currently no cure. More than 2,500,000 Americans, mostly African Americans, have the sickle cell trait. Among newborn American infants, SCD occurs in approximately 1, in 300 African Americans. The most feared complication for children with SCD is a stroke, which may affect infants as young as 18 months of age. While some patients can remain without symptoms for years, many others may not survive infancy or early childhood. Many adults with SCD have severe physical problems, such as acute lung complications that can result in death. Adults with SCD can also develop chronic problems, including pulmonary disease, pulmonary hypertension, and kidney failure. The average life span for an adult with SCD is the mid-40s. Stroke in the adult SCD population commonly results in both mental and physical disabilities for life. The Sickle Cell Treatment Act of 2003 helps combat SCD by providing Federal matching funds for SCD-related services under Medicaid, and by allowing States to receive a Federal 50-50 match for nonmedical expenses related to SCD treatment such as genetic counseling. This bill also authorizes a grant program in the amount of $10 million per year for 5 years to fund 40 health centers nationwide. Although I will go into detail about the bill, its focus is to encourage States to partner with SCD providers, who have historically been on the frontlines of this issue, to treat and find a cure for SCD patients. With regard to the Federal matching funds, this bill allows states to reimburse SCD services beyond current Medicaid law, which only covers physician and laboratory services. For example, if a State wanted to increase reimbursement rates for SCD blood transfusions, it could do so through rate setting for the new SCD benefit without having to increase reimbursement for all Medicaid blood transfusions, therefore, making it easier for a State to reimburse at a higher rate for SCD-related treatment. The bill also provides Federal reimbursement for education and other services related to the prevention and treatment of SCD. This will allow States to get a Federal 50-50 match for nonmedical, administrative expenses to include outreach and genetic counseling about SCD and its treatment for SCD patients of any age. This is critical to helping this historically underserved population, many of who may not know about SCD or its symptoms until it is too late. This bill also allows hospitals and clinics to do outreach with non- medical personnel to educate high-risk communities about recognizing SCD. It would also allow nonmedical personnel like counselors to spend time with SCD families to discuss how to manage the disease. Providing this one-stop shop will centralize SCD-related treatment and counseling services to better serve those with SCD. In addition to the diagnosis and treatment components, this bill creates a grant program for 40 health centers nationally. Specifically, the U.S. Department of Health and Human Services is authorized to distribute grants to up to 40 eligible health centers nationwide for $5 million for the next 5 fiscal years. Grants may be used for purposes including the education, treatment--i.e., genetic counseling and testing--and continuity of care for individuals with SCD, for training health professionals, and to identify and secure additional Federal funds to continue SCD treatment. This bill also creates a National Coordinating Center to collect, monitor and distribute information on new and innovative practices to prevent and treat SCD, establish a model protocol for the grant recipients to follow as a quality control mechanism, develop educational materials regarding the prevention and treatment of SCD, and submit a report to Congress to ensure fiscal accountability and provide information of recent developments towards a cure for SCD. The Sickle Cell Treatment Act of 2003 provides tremendous benefits to States. The approach taken in this bill is to add services related to SCD to the list of services covered by Medicaid for those people who are eligible for Medicaid under current eligibility rules. For example, the bill allows States to use Medicaid funds to work with providers to better serve areas with a high prevalence of SCD in fields such as education and counseling,which are currently not reimbursed by Medicaid. This bill also allows the States to create opportunities to partner with providers to determine ``best practices'' to encourage the most effective and efficient use of medical resources toward SCD treatment and education. In introducing the Sickle Cell Treatment Act of 2003, we are trying to help thousands of Americans who live with this disease. This legislation will provide many of these patients with access to the essential treatments that they need. It has the support of many important groups representing the SCD, African-American and children's health care communities as well as the providers and researchers who are working to treat and find a cure for this disease. For example, Allan Platt, Program Coordinator, The Georgia Comprehensive Sickle Cell Center at Grady Health System in Atlanta, GA has written me the following letter, which states in part, ``You did a wonderful thing for sickle cell patients and for those who are caring for them. Let us know how we can rally support for this.'' I want to offer my appreciation to the Sickle Cell Disease Association of American Inc., SCDAA, for its vigilant efforts to help find a cure for SCD, and working with my office to help craft this critical piece of legislation. SCDAA President and Chief Operating Officer, Lynda K. Anderson, has provided tireless support on behalf of this effort. Also I would like to acknowledge the efforts of SCDAA Board Member Michael R. DeBaun, M.D., M.P.H, Assistant Professor of Pediatrics and Biostatistics at the Washington University School of Medicine in St. Louis, MO. Lynda and Michael have brought the issues addressed in this bill to my attention and helped to bring the introduction of this bill to fruition. The SCDAA was founded in 1971 to provide an effective coordinated community-based approach to developing and implementing strategies to resolve issues surrounding sickle cell disease. Through three decades, SCDAA and its member organizations have demonstrated how community- based organizations and comprehensive health and research centers can work with local, State and Federal agencies in furtherance of national health care objectives. To this day, SCDAA continues to pursue legislative initiatives to secure additional government funding for research and community-based services. Moreover, it has demonstrated its capacity to provide continued leadership in this area as a potential national coordinator center, and I look forward to the organization applying for such a designation, once this measure has been enacted into law. My colleagues and I on both sides of the aisle and in both legislative bodies look forward to working with SCDAA to fight this good fight and to secure the resources required to address the very unique needs of patients, families and communities affected by SCD. I ask that my colleagues in the Senate join Senators Schumer and Graham, and Representatives Davis and Burr in helping us to find a cure to help the approximately 70,000 Americans who have SCD and the approximately 1,800 American babies who are born with this disease each year in supporting the Sickle Cell Treatment Act of 2003. I ask unanimous consent that the text of the bill printed in the Record.

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that further reading of the amendment be dispensed with.

Mr. TALENT. Mr. President, I send an amendment to the desk.

Mr. TALENT. Mr. President, I will speak briefly. First, I commend my friend and colleague from Missouri for his work on this issue for several years and his consistent advocacy for fairness to all the employees of American Airlines. I also express my deep gratitude to our friend and colleague from Texas for how she has worked with us on this amendment and indeed on this whole issue within, of course, the limits of her convictions. Briefly, this situation is not easy for anyone and I recognize that. I emphasize that there are thousands of people who are in a uniquely difficult situation, people with 10, 15, 20 years seniority with a company. When you get that kind of seniority with a company, you order your life so far as it is job related, on the assumption that unless the company goes down--in this case, stops flying--you are not going to be laid off. You do that in terms of your financial affairs; you get mortgages; you make arrangements with your kids and their college education. Thousands of people worked for TWA for years and years and years and did that. Then something happened. I don't know what happened; I was not there. The people who were supposed to represent their interests in this process--management, the union, the government--for some reason did not. Their interests were not represented. As a result, they are now facing layoffs contrary to all their expectations. I support the Senator's sense-of-the-Senate amendment. I hope it means as we continue to represent those interests we will have some chance along the process to get fairness for these people who expect better and deserve better and who have worked so hard in giving so much to this company for so long.

Mr. TALENT. Mr. President, I rise, along with my colleagues, Senators Bond, Clinton, and Schumer, to offer the Airline Workers Fairness Act, with the hope of ensuring the fair and equitable resolution of labor integration issues surrounding American Airlines and the former TWA. I want to give the Senate a brief history of these issues. American Airlines acquired TWA in April of 2001. We all thought that was a good thing. We still hope it is a good thing. We supported it. At the time, American Airlines promised TWA employees that they would be treated fairly as a result of the buyout, and in fact that promise was one of the conditions of Federal approval of the buyout. Certainly, our expectation was that when the representative employee groups merged, their seniority lists would be dovetailed in the normal fashion. In other words, the years of service for TWA employees would count in the merged company, and years of service for former American Airline employees would count as well. For whatever reason, that didn't happen. In fact, nothing even close to it happened. The former TWA flight attendants were stapled to the bottom of the merge seniority list, and most of the TWA pilots were stapled to the bottom of the seniority list. In all my years in public office and in the years when I practiced labor law, I have never seen a merger that was as disadvantageous to one of the former employee groups as this one. The effect of it is that employees who have been working for TWA for decades are placed behind on the seniority list employees working for American Airlines only a year or two. All you have to do is fly American Airlines and be recognizable as a Member of Congress to see what the implications of this have been for real people. I do not think I go on a flight where a flight attendant does not come up to me and tell a story, such as she is a 28-year flight attendant for TWA who is now going to be laid off while people who have been working for American Airlines for only a year or two will be still flying. A specific example: Sally Young, a former TWA captain who now works for American Airlines whom I have met and talked with, is a 15-year veteran of TWA. She was demoted, because of seniority, from being a captain to a first officer, and now, after the recent layoffs were announced, is scheduled to be laid off even though pilots who have been working only a short time for American Airlines will continue to fly. The result of this for the flight attendants is that there were 4,000 flight attendants who worked for TWA. By midsummer, all of them will be gone. These are people who have given their life to this company, people who have mortgages, people who are at a stage in life where it is very difficult for them to retrain and find other employment. People who were promised better, who clearly understood that in some way, shape, or form they would be protected in this buyout are going to be gone, and most of the pilots will be gone as well. I am not here to blame anybody for this. It is an extraordinarily, uniquely disadvantageous situation. I do not know how it happened, but I know it is not right, and this amendment is designed to fix it in a fair and equitable fashion. It applies only to this merger. It says that the parties will bargain for several weeks after this amendment becomes effective, and if they cannot reach an agreement, they will go to a neutral expert binding arbitration, and the arbitrator can then decide what result will be fair in light of the situation they are in now. These people who have worked for so long and given back so much over the years to keep this company afloat will have the consideration that we all thought they would have had. Those of us who are offering this amendment and supporting this amendment would rather not do it on this vehicle. We would not have done it on this vehicle, but the underlying bill provides several billion dollars of extraordinary relief for the airline industry. We support that. In addition, American Airlines announced several thousand more layoffs earlier this year. If we do not do something soon, it will be too late to do anything. Certainly it will be too late to do anything as conveniently as it will be if we adopt this amendment. Again, our amendment does not impose any Government solution on the parties. It costs no money. It affects no other airline and no other situation. We are offering it now to provide some relief to a group of people who expected and deserve better and who, unless we do something, are going to be out on the street. That is the reason we are offering the amendment at this time.

Mr. TALENT

Mr. TALENT. If there is no further business to come before the Senate, I ask unanimous consent that the Senate stand in adjournment under the previous order.

Mr. TALENT

Mr. TALENT. Mr. President, for the information of all Senators, the Senate will be in a period for morning business tomorrow morning until 11 a.m. to allow Members to continue to make statements in support of our troops. This is, of course, according to the majority leader. At 11 a.m., the Senate will begin consideration of the supplemental appropriations bill. Amendments are anticipated on that measure. The majority leader would encourage Members to notify the managers if they intend to offer any amendments. At 2, the Senate will conduct the fourth cloture vote in relation to the Estrada nomination. Following that cloture vote, the Senate will resume consideration of the supplemental appropriations bill. The Senate will complete action on the supplemental this week so we can get the necessary funds flowing to our brave men and women who are serving in Iraq. Therefore, the leader would inform all Senators to expect a busy day tomorrow with rollcall votes throughout.

Mr. TALENT

Mr. TALENT. Mr. President, I further ask unanimous consent that at 11 a.m., the Senate proceed to the consideration of the supplemental appropriations bill as reported by the Appropriations Committee. I further ask consent that at 1:30 p.m., the Senate then proceed to executive session and there then be 30 minutes of debate equally divided in the usual form prior to the cloture vote on the nomination of Miguel Estrada to be a circuit judge for the DC Circuit; provided further that if cloture is not invoked, the Senate then return to legislative session.

Mr. TALENT. Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 10 a.m., Wednesday, April 2. I further ask that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and the Senate then begin a period for morning business until 11 a.m., with the time equally divided between Senator Hutchison and the minority leader or their designees.

Mr. TALENT

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

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that the Senate proceed to a period for morning business.

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of the following calendar items en bloc: Calendar No. 54 and Calendar No. 55.

Mr. TALENT. Mr. President, I ask unanimous consent that the bills be read a third time and passed, en bloc; that the motions to reconsider be laid upon the table, en bloc; and that any statements relating to the bills be printed in the Record.

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of S. Res. 102, which was submitted earlier today by Senator Sununu.

Mr. TALENT. I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, the motion to reconsider be laid upon the table, and that any statements relating thereto be printed in the Record.

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that the Armed Services Committee be discharged from further consideration of S. 704 and that the Senate proceed to its immediate consideration.

Mr. TALENT. Mr. President, I ask unanimous consent that the bill be read a third time and passed; that the motion to reconsider be laid upon the table; and that any statements relating to the bill be printed in the Record.

Mr. TALENT

Mr. TALENT. Mr. President, this is ``Cover the Uninsured Week'' and there have been press events--and I guess you can call them rallies-- around the country designed to inform America about the problem of the uninsured. I guess I am glad that is happening. It seems as though it happens a lot. We have been talking about the uninsured for a long time. I think it is time we do something about the uninsured instead of just telling everybody that we have. And we can do that. I would suggest we are on the brink of doing it. We in the Senate just have to choose between the employees of the small businesses around the country, who are most of the uninsured, and the big insurance companies that have them under their thumb currently. There are about 41 million uninsured people in the country at any given time. About 60 percent of those uninsured people are either owners of small businesses or employees of small businesses, or dependents of somebody who owns or works for a small business. Most of the people who are uninsured are working people. The reason they are uninsured and the reason they are not getting health insurance through their small business is that the small businesspeople are caught. They are stuck on a dysfunctional market. They are caught because all they bring to that market is a unit of 4 or 5 people, or maybe 20 or 30, or maybe 60 or 70. And they have very few choices. They consistently pay higher costs for health insurance premiums, and they get lower quality insurance than people who work for big businesses or people who work for the Federal Government, as we do. I have seen this all over the State of Missouri and, indeed, all over the country. I chaired the Small Business Committee for two terms in the House. In that capacity and since then, I have visited personally with hundreds and hundreds of small businesspeople and with thousands of their employees. This is their No. 1 issue. It is not fair for them to be laboring under impediments that the rest of us do not have. I was in Farmington, MO, over the weekend. I stopped by an optometrist's office run by a couple of optometrists, and a couple of their employees were there. They gathered around and told me a very familiar story. In 1999--I think it was--they said, we just felt we had to start providing health insurance to our people, as expensive as it was and as difficult as it was. They had to spend hours and hours soliciting bids, maneuvering, and trying to get insurance for their people. So they started it. They said: When we started, it was a little over $200 a month per employee. Now, 4 years later, it is over $500 a month per employee. They are not able to give wage increases to their people because health insurance costs are increasing so fast. Everywhere I go, small business health insurance costs are going up 20 or 25 percent a year. There is a further human side to this story. One of their employees-- a really neat lady--I talked with for a while. She is a single mom and a cancer survivor. She is trapped, and the small business is trapped with her, because if they drop the insurance, she will never get reinsured anyplace else. They feel a moral obligation to continue that insurance for her. The other employees are doing without wage increases and dealing with substandard insurance in order to help their fellow employee. I have seen this story over and over again. And it is not necessary. We can do something about it, and we need to. Here is what we can do. The House passed several times in the 1990s--and the President now supports the plan--a plan that would simply allow small businesses to pool through their national trade associations or their professional associations and get health insurance on the same terms and under the same regulatory apparatus as the big businesses, the unions, and the Government currently do. That is all we need to do, just empower the small businesspeople. It will not cost the taxpayers a dime because it is not a Government program. It is just allowing people to do what is already happening all over the United States. So here is how it would work: Let's say the National Restaurant Association would sponsor national health insurance plans. They would start an employee benefit side, just like the big companies do. They would contract with national insurance companies. They would have a self-insured side. And then, if you are a restaurant employee, by joining the restaurant association, you would automatically be entitled to get this insurance. They would have to offer it to you. They could not tell you you could not have it. And you would be part of a pool of 20,000 or 30,000 people instead of in a unit by yourself with two or three or five or ten people, like my brother's situation. He has a little tavern kind of restaurant in St. Louis. Actually, it may be more of a saloon. But, in any event, he could join the National Restaurant Association to get coverage. It is just him and my sister-in-law who run this place. Apart from the money, which is impossible for him, he does not have the time and does not want to incur the risk of going out two or three times a year and soliciting bids. And then, all of a sudden, what often happens to small businesspeople is they get called up because somebody actually filed a claim. The big insurance company tells them their rates went up astronomically. They have no power in this market. They are caught with few choices, with small groups, with high administrative costs. It is not necessary, and it does not even cost anything for us to fix it. I was talking about this at a dinner the other day with six or seven people who were there to talk about how we could serve the underserved better with health care. This is part of the answer to it. We had a real good dialog with these folks. Many of them are operating a charitable enterprise where they are helping people get health care. I laid this out for them, and one of the men said to me: Well, who wouldn't support that? Indeed, who wouldn't support it? I will tell you who doesn't support it: the big insurance companies, who control this small group market now. They are operating like monopolists. Monopolists ratchet down their output and raise their prices. That is what is happening. Fewer and fewer people are covered, and prices are going higher and higher. They are making money, and people around this country do not have health insurance. It is wrong, and it ought to stop. One argument I hear about this is: Look, if we do this, the association health plans will engage in cherrypicking. What that means is, the healthy small business groups will go into the big plans, the sicker small business groups will prefer to stay out there in the small business market. This is actually an argument that the big insurance companies are raising. It is the exact opposite of the truth. Common sense tells you if you have a history of illness, if you have cancer or had cancer or diabetes or kidney problems, or something similar to that, and somebody says to you, look, you can be in a small group market, you can work for a small business and be part of a group of 4 or 5 people or 40 or 50 people, or you can work for a big business and be part of a group of 10,000 people, which would you choose? I have asked that question in small business groups around the country. I have not had a single person say: If I were sick, I would rather be part of the small group. Of course you would rather be part of the bigger group. This is a haven for small business people who want to help themselves and their employees, and particularly the ones who are sick and need the insurance, such as that lady in the optometrist shop in Farmington. It is a haven for them. And it will cut the cost of their health insurance, on average, 10 to 20 percent and make insurance available to millions of people who currently do not have it. It does not cost the taxpayers anything. It is just like a big co-op. We have a lot of support in the Senate. I am very pleased about our progress. The chairman of the Small Business Committee, the senior Senator from Maine, Ms. Snowe, is a strong supporter and is leading the fight. Senator Bond is supportive. The Senator who is presiding over the Senate today is supportive. Senator McCain is supportive. I have been talking with a number of my friends and colleagues on the other side of the aisle. I am hoping to get support there. In the House, it passed on a strong bipartisan basis. I believe we can do the same. It is just a question of the choices we want to make. We can choose these small businesspeople and their employees who have been telling us, year after year after year: We are working full time; We care about our jobs; We care about our fellow employees; Let us help ourselves, or we can choose the big insurance companies that have a monopoly on this market and are charging higher and higher prices and providing fewer and fewer policies of insurance for people who need it. I think the choice is clear. I urge the Senate to look at this bill, the association health plans. We can get it passed. We can make a difference, and we can do it now. I yield back the remainder of my time.

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that I be recognized in morning business for a period of up to 15 minutes.

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

Mr. TALENT

Mr. TALENT. I appreciate it. Sometimes I go down to our little rumpus room and they are arguing about something, and the one thing I tell them I don't want to hear is: They started it. He started it. There is a code of conduct to which you should adhere. Let's adhere to it. That is in the interest of this Senate. It is in the interests of the Constitution and the interests of the people. What must the people think when they see us doing this on an appellate court nomination? I ask my friends from the other side of the aisle, I know it was done--not to this extent but from this side of the aisle--to some of President Clinton's nominees. Let's go back to the standard we always followed. Let's make the Senate work. Let's keep it from being broken. I thank the Senator for yielding.

Mr. TALENT. Mr. President, I want to place this debate in historical context. The tradition of the Senate has been to confirm judicial nominations of the President if the nominees were competent, if they were qualified, if they were honest, if they had a record and background in the law, in the practice of law or on the bench or in academia, that suggested they could live up to the standards of the judiciary. If they did, they were confirmed and confirmed without having to answer questions that nobody ever has had to answer and would usurp and undermine the executive branch and the Solicitor General's Office if they had to answer it. Under those standards, hundreds of people in Miguel Estrada's circumstances have been confirmed without even any controversy, much less a filibuster, and everybody here knows it. You can always invent a reason to be opposed to somebody. Senators on the other side have been good at doing that with regard to Miguel Estrada, but he ought to be confirmed. At least he ought to have a vote, if we are going to follow the traditions of the Senate. Now those traditions have broken down to the point we not only are voting not to confirm people, we are not even allowing a vote. We have Senators conducting a filibuster on somebody because they suspect they might disagree with his jurisprudence. What is it we are so afraid Miguel Estrada might believe; a man who went to Harvard Law School, was an editor of the Law Review, served in the Solicitor General's Office, has been given high marks by everybody who has ever supervised him? Of course he is in the mainstream. In the past, we gave people the benefit of the doubt. We don't have time, with every judicial nominee, to go through everything they might believe about every particular judicial issue. The fact is, if we were applying the traditions of the Senate, or anything close, this man would be confirmed and we could move on. Now we cannot even get a vote, and everybody here knows that. The Senate is broken. It is broken at a time where we may be going to war. The economy is in trouble. Of course we need to move on. I hear Senators from the other side saying we should not be debating this, we should be moving on. Yes. Exactly. But you can't stand up and conduct a filibuster and then say you are not obstructing. You are. Let us have a vote on this man. He will probably carry. Other nominees we have votes on may not carry. Let's get the Senate working together. It is not the end of the world if somebody gets on the court of appeals that you don't like. He is not going to change the Constitution. He is on the court of appeals. Let's vote on him and let's move on. What concerns me is something to which the Senator from New York referred. I am concerned that a few years from now a Democratic President may get elected and he is going to start nominating people and we are going to get back on this, except from this side of the aisle. It would be wrong. I have three kids. They are 12, 10, and 6.

Mr. TALENT. Can I have another minute to talk about my family?

Mr. TALENT

Mr. TALENT. Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 9:30 a.m., Wednesday, February 26. I further ask unanimous consent that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and the Senate return to executive session and resume consideration of the nomination of Miguel Estrada to be a circuit judge for the DC Circuit.