Indian Health Care Improvement Act Amendments of 2007

Floor Speech

INDIAN HEALTH CARE IMPROVEMENT ACT AMENDMENTS OF 2007 -- (Senate - February 14, 2008)

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Mr. SANDERS. Madam President, I rise in strong support of the Indian health care package being put together by Senator Dorgan. As Senator Reid indicated, these are a group of people who have been the most neglected in our country, and it is imperative we move rapidly to address longstanding concerns.

I have an amendment pending to provide $800 million in emergency funding for the LIHEAP program. The reason I am offering this amendment is simple and obvious. At a time when home heating fuel is skyrocketing, millions of senior citizens on fixed incomes, millions of low-income families with kids, and persons with disabilities are desperately trying to keep their homes warm this winter. Without this additional source of immediate funding, there is a major risk that old people and lower income people all over America will go cold. In the richest country on the face of the Earth, we have a moral responsibility not to allow that.

Over the past week, as everybody knows, in many parts of America, temperatures have been going well below zero. In my State of Vermont, in Lincoln, VT, was 21 below zero. In Nome, AK, the high temperature was 15 below; Grand Forks, ND, 12 below zero; Eureka, SD, 3 below zero. On and on all across the country, temperatures are getting cold. The cost of home heating oil is outrageously high. LIHEAP funding is being depleted. People are unable to afford to keep their homes warm. That, in a nutshell, is what we are discussing.

The amendment I am offering has been endorsed by many organizations and many Members of the Senate. Some of the endorsees include the National Governors Association, the AARP, the National Conference of State Legislatures, many others. Let me briefly excerpt from a letter I received from the National Governors Association in support of the amendment:

Additional funding distributed equitably under this amendment will support critically needed heating and cooling assistance to millions of our most vulnerable, including the elderly, disabled, and families that often have to choose between paying their heating or cooling bills and food, medicine and other essential needs.

That is from the National Governors Association. The AARP also has come out in support of the amendment, indicating that some of the most significant victims of what happens when it becomes cold are senior citizens who suffer from hypothermia. They are very much in support of this amendment, and we thank them for their support.

This bipartisan amendment is also cosponsored by many of my colleagues, including: Senators Clinton, Obama, Snowe, Collins, Leahy, Sununu, Kennedy, Gordon Smith, Coleman, Kerry, Stabenow, Schumer, Lautenberg, Lincoln, Klobuchar, Murray, Cantwell, Menendez, Durbin, and Whitehouse. I thank them.

Yesterday, Senator Gregg offered a second-degree amendment to my amendment. In my view, his amendment is a poison pill which, if passed, would either kill or slow down all our efforts to increase emergency funding for LIHEAP. The Gregg amendment would pay for the $800 million increase in LIHEAP by cutting overall discretionary nondefense spending by about .2 of 1 percent. I am opposed to the Gregg amendment for a number of reasons. First, it is an extremely irresponsible way to do budgeting. There are some agencies that need to be cut a lot more than .2 of 1 percent. And there are, in fact, programs and agencies that need significantly more funding. An across-the-board cut, regardless of the needs of a program or agency, is irresponsible.

Secondly, Senator Gregg excludes from his cuts the department that receives over half the discretionary funding, and that is the Department of Defense. If Senator Gregg thinks all of the $500 billion-plus that goes to the Department of Defense is well spent and well accounted for, he is mistaken. You cannot exclude the largest recipient of discretionary funding from examination.

In the real world, what would be the impact of the Gregg amendment if it were to pass? I know that .2 of 1 percent may not seem like a lot of money at first blush, but let's take a look at what this cut would mean. It would mean a $54 million cut for veterans medical care, and overall veterans funding would be reduced by $86 million. I don't think any Member of the Senate supports that. While we are trying to fight and come up with an understanding of various cancers, Alzheimer's disease, Parkinson's disease, the National Institutes of Health would be cut by over $58 million by the Gregg amendment. The Gregg amendment would cut special education by $22 million. People are paying higher and higher property taxes because this Congress, for many years, has not kept the promise it made by adequately funding special education. The Gregg amendment would cut funding for special ed by some $22 million. Head Start would be cut by $14 million. We are grossly underfunding Head Start right now. We have a major early education crisis from one end of America to the other. This would only make that problem worse. The Gregg amendment would cut community health centers by over $4 million at a time when 47 million Americans have no health insurance, creating a process by which even fewer Americans can access primary health care. Homeland security would receive a cut of $70 million. Education would be cut by over $100 million.

I certainly share Senator Gregg's concerns about the national debt. I look forward to working with him and other members of the Budget Committee to discuss how we should reduce our $9.2 trillion national debt, which increased by $3 trillion under President Bush. It is a real issue, one we have to get a handle on. But maybe we will discuss in the Budget Committee the absurdity of trying to eliminate the estate tax which would add $1 trillion to our national debt over 20 years by giving tax breaks exclusively to the wealthiest .3 of 1 percent.

We are debating whether we should help senior citizens who are going cold this winter. But there are many, including the President, who say: No problem, a trillion dollars in tax relief for the wealthiest .3 of 1 percent.

We should be discussing why we are providing other tax breaks to some of the wealthiest people in this country. Perhaps we can discuss the appropriateness of spending $12 billion a month on the war in Iraq, with most of that sum being budgeted as emergency spending. It is not an emergency. We know what is going on. Yet we are not prepared to pay for the war. We are leaving that cost to our kids and grandchildren. That is emergency spending. We can pass that $12 billion a month. Yet there are those who balk at spending $800 million on a real emergency, and that is keeping senior citizens and families all over America warm this winter.

Providing a mere $800 million for LIHEAP would primarily benefit senior citizens, families with children, and people with disabilities earning between $10 and $15,000 a year. At a time when gasoline and home heating oil prices in the State of Vermont and throughout the country are well above $3 a gallon, we should not be forcing seniors and others to make a choice about whether they are going to buy the medicine or food they need--hunger is increasing--or keep warm this winter.

There is no great secret that the American people are increasingly disenchanted with what is going on in Washington, whether in the White House or in Congress. They wonder what planet we are living on. They are struggling, millions, every single day to keep their heads above water to pay for the food they need, to fill up their gas tanks in order to go to work, to keep warm in the winter. They wonder why we are not responding to their needs. We have people here talking about more tax breaks for billionaires, when workers are losing their jobs.

Passing the Sanders amendment certainly is not going to solve all those problems.

But maybe at a time when people are going cold and others know that people are going cold, maybe--maybe--it will make the American people understand some of us are aware of the reality of American life as it exists in cities and towns all across this country, that maybe we know what is going on, and we are prepared to respond in a proper way.

Madam President, having said that, I ask unanimous consent that the Senate now resume the Gregg amendment No. 4022 and that it be modified to be a first-degree amendments and that the Senate then debate concurrently amendments No. 3900 and No. 4022, as modified, with 40 minutes of debate prior to a vote in relation to each amendment, with the time equally divided and controlled between Senator Sanders and Senator Gregg or their designees; that each amendment be subject to a 60-affirmative vote threshold, and that if the amendment does not achieve that threshold, it be withdrawn; that if either amendment achieves 60 affirmative votes, then the amendment be agreed to and the motion to reconsider be laid upon the table; that the vote in relation to the Gregg amendment No. 4022, as modified, occur first in the sequence and that there be 2 minutes of debate, equally divided, prior to each vote; provided further that no intervening amendment be in order to either amendment; that upon the use or yielding back of time, the Senate proceed to vote in relation to the Gregg amendment, to be followed by a vote in relation to the Sanders amendment.

The PRESIDING OFFICER. Is there objection?

Ms. MURKOWSKI. Madam President, reserving the right to object--and I will object--I am certainly a supporter of LIHEAP, but I object at this time.

The PRESIDING OFFICER. Objection is heard.

The Senator from Vermont.

Mr. SANDERS. Madam President, I am kind of new to the Senate, but I would ask my friend from Alaska or my friend from New Hampshire: Why? Why the objection? If we are sympathetic to LIHEAP----

The PRESIDING OFFICER. To the Senator from Vermont, it is not in order to propound questions to other Senators who do not have the floor.

Mr. SANDERS. Madam President, I wonder why it would be that when we face a dire crisis all across this country, we cannot move forward vigorously in providing relief to seniors and low-income people who need this help. I would love to have a response to that, Madam President.

Mr. GREGG. Madam President, is the Senator yielding the floor?

Mr. SANDERS. Madam President, I yield to my friend from New Hampshire.

The PRESIDING OFFICER. The Senator from New Hampshire.

Mr. GREGG. Madam President, obviously, I have an amendment which is caught up in this effort. I would hope we could vote on it. I think it is the right approach that we fund LIHEAP but that we also pay for that funding so we do not pass the bill for LIHEAP on to our children, so we do not put ourselves in a position where we are paying today's energy bills with our children's dollars 10 years from now, plus interest.

But I understand, having heard the majority leader come to the floor earlier and say he did not want this bill filibustered or slowed down, that this is sort of part of an exercise by the leaders of this bill on this bill--because this is the Indian health bill--to try to, I guess, clear the table so amendments which are not directly relevant to Indian health do not end up slowing down this bill.

I do not think this decision can be laid at the feet of either party. It appears it is a joint decision by the leadership of the committee of jurisdiction on Indian health. That is why this proposal, which Senator Sanders has laid out, which I am perfectly amenable to--and I would actually support the unanimous consent request that he propounded. It has been objected to.

I understand an amendment from our side dealing with the fact that the city of Berkeley has said the Marines there are unwelcome and has offered protesters a free parking site in front of the Marine recruiting headquarters, with a megaphone to yell at the marines--men and woman who have served us in war in Iraq--that proposal, which would have basically laid out the objection of the Senate to that despicable act by the city council in Berkeley relative to the treatment of our marines, is also not going to probably be offered because there is an attempt to move this bill forward.

I guess I appreciate the fact that the Indian health bill is a good--I don't know if it is a good bill; I don't know enough about it, but it appears to be supported by both sides here, and they want to move it forward. It is unfortunate the LIHEAP issue, which I think should be addressed in the context I am proposing, which is that it be paid for, will not be able to be addressed at this time. But I understand the situation, and I understand why it has happened. But I do not think it can be laid at the feet of either party.

Mr. SANDERS. Madam President, reclaiming my time, to the best of my knowledge, I heard the objection coming from the Republican side, not the Democratic side.

Mr. GREGG. Madam President, if I may seek the floor, I think it is pretty obvious what is happening. I want the Record to show that prior to the objection being made--it is not my fight--but as a practical matter, the majority leader came to the floor and castigated the fact that the bill was being slowed down by amendments, one of which would be the LIHEAP amendment.

Mr. SANDERS. Madam President, reclaiming my time, it is absolutely not my intention, as I indicated to Senator Dorgan, to slow this down. This is important legislation we want to pass. I would limit my time to 20 minutes, to 10 minutes. I think most people here know what the issue is. I would like an up-or-down vote, and let's move on to Indian health.

Mr. GREGG. Madam President, if the Senator is going to allow the bill to be open to LIHEAP, then I presume it should be open to all extraneous amendments. I suspect the amendment of the Senator from South Carolina relative to the city of Berkeley is an extraneous amendment but one that is worth debating and should be discussed.

Mr. KYL. Madam President, will the Senator from Vermont yield?

Mr. SANDERS. Yes, I yield.

The PRESIDING OFFICER. The Senator from Vermont yields to the Senator from Arizona.

Mr. KYL. I thank the Senator.

Madam President, if I could further explain, first of all, I appreciate that the Senator from Vermont has offered an amendment that is very important to his State. It is not germane to the Indian health bill. I also understand how both Senators from New Hampshire are supportive of the LIHEAP approach. Whether it is paid for or not paid for is another question. But the point is, that amendment is not germane to the Indian health bill, and if there is a vote on the LIHEAP amendment, the amendment of the Senator from Vermont, there will be requests, I know, from this side of the aisle and perhaps other requests to consider other nongermane amendments to the bill.

I think what the majority leader was saying is something that I subscribe to on this side, which is that the Indian health bill is an important bill to get done. If we begin consideration of a lot of extraneous or nongermane amendments to the Indian health bill, it may well jeopardize our ability to conclude work on the Indian health bill. That is the only reason for the objection, and I hope the Senator can appreciate that.

Mr. SANDERS. Reclaiming my time, Madam President, I would ask my friend from Arizona--and I understand that. We want to move to the Indian health bill. There is a real solution to that in the real world if we are serious; that is, limiting the amount of time and reaching a unanimous consent agreement about a few amendments that might be offered so we can vote on them and move on to Indian health.

Would the Senator from Arizona be prepared to do that?

Mr. KYL. Madam President, I would be happy to respond to the Senator from Vermont but in this way: There are people on my side of the aisle who have already attempted to propound nongermane amendments that they would like to have a time agreement on as well. I suspect that before we begin to get into that kind of a negotiation, the leaders will want to consider what that is going to be doing to the time schedule for the bill, and the managers of bill are going to want to do the same because we would like to try to conclude the bill as soon as we can; and that will open up a process that could delay matters.

Mr. SANDERS. Reclaiming my time, Madam President, I think, again, we want to move and pass, I hope, the Indian health bill. But I think if we are honest--obviously, if people want to bring up 30 amendments, that would kill the Indian health bill, but if that is not the desire, if there are very few amendments and leadership can agree on a time limit on them, we can move forward on some serious amendments, have votes, and pass--at least vote on--the Indian health bill.

Again, I ask my friend from Arizona if that is something he would entertain. It does mean that not everybody can offer every amendment they want. There would have to be a limitation and a time limitation.

Mr. KYL. Madam President, I will respond again to the Senator from Vermont: There are nongermane amendments--at least one of which has already been brought up--that I doubt the leaders and certainly the managers of the bill would like to see embroiled into the Indian health care debate. Once the process begins, it is hard to control it. So it is not as simple as asking, would I be agreeable to a time agreement on perhaps the amendment of the Senator from Vermont and the amendment of the Senator from South Carolina--because that would undoubtedly get brought into this. But there may be others as well.

So it is not a question we can answer when one cannot see where the end of it might be. I think that is the concern we have with beginning this kind of process. But I suggest that the Senator from Vermont continue to consult with his leader, with the managers of the bill, and see if we can move the process forward.

The PRESIDING OFFICER. The Senator from Vermont.

Mr. SANDERS. I yield the floor.

The PRESIDING OFFICER. The Senator from North Dakota.

Mr. DORGAN. Madam President, it is more than a little frustrating. We have been here for 3 hours this morning. We have amendments on this bill dealing with Indian health care. We have nongermane amendments that have been offered: Medicare, LIHEAP, earmarks for Berkeley, abortion.

This is a very serious issue. We have people dying in this country with respect to this health care question about American Indians. I spoke earlier this morning that the U.S. Government has a responsibility for health care for Indians. If you ask the question: Why? Because we signed up for it. We signed the treaties. We said: We promise, and we have a trust responsibility for it.

So we spend twice as much money to provide health care to Federal prisoners as we do for American Indians. We are not meeting the needs. We have people dying. So it takes 10 years to get a bill to the floor of the Senate--10 years to get a bill to the floor--to try to improve health care for Indians, and we get here, and we have unending appetites for amendments that have nothing to do with Indian health.

Look, I support low-income energy assistance. I support that. I support a lot of these issues. Many of them have nothing to do with Indian health. We are just trying to get a bill passed here.

Let me describe something I heard about a month ago to describe the urgency. I was at the Standing Rock Indian Reservation in North Dakota. It straddles the North Dakota-South Dakota border. The husband of Harriet Archambault came to a meeting I had--a listening session on Indian health care--and he described his wife Harriet and her battle to try to deal with this health care dilemma. They lived nearly 20 miles from a clinic in South Dakota. It was an Indian health care clinic. She would get up in the morning and drive 18 miles to the clinic because that clinic can take only 10 people in the morning and 10 people in the afternoon. So five times, she got up in the morning to drive to that clinic. All five times she got there, there were 10 people ahead of her.

Her medicine ran out on October 25, 2007, her husband said. Five times for the next month, she got up and drove to that clinic. She could not stay there, because she was also a day care provider for her grandchildren. So this woman went, tried to sign up, but there were 10 people ahead of her--that is all they would take--and she had to go home.

Five times she did that in a month. A month later, she died. Her medicine ran out October 25. She died November 25. She had called her sister about 3 weeks before, and she said: ``What do I have to do here to get the medicine I need? Die?'' Well, she did die because she could not get service in this Indian health system.

The fact is, people are dying. All we are asking is that we maybe have somebody come over and offer an amendment on Indian health care and start a debate on these amendments. If we have people who have these amendments, come over and offer them. We have some that are filed. Let's have some votes and try to get through this piece of legislation.

This is the third day we are on the floor of the Senate with this bill. I said earlier, it has taken 10 years to get here. Every single year we have worked on this. Senator McCain, who was chairman of the Indian Affairs Committee, worked on it with me--Senator Murkowski. We work on it and never get it to the floor. We finally get it to the floor of the Senate, and this is like a root canal, except a root canal hurts less, because at least you are accomplishing something.

Here we come to the floor of the Senate, and we cannot get amendments up. We cannot get amendments voted on. So my hope would be we can find a way to move through this legislation.

Mr. SANDERS. Madam President, will the Senator yield?

Mr. DORGAN. Madam President, I am happy to yield for a question.

Mr. SANDERS. Madam President, I thank my friend from North Dakota.

AMENDMENT NO. 3900 WITHDRAWN

Madam President, I ask for the regular order with respect to the Sanders amendment No. 3900.

The PRESIDING OFFICER. Does the Senator from North Dakota yield for that purpose?

Mr. DORGAN. Madam President, I yield for that purpose. I believe I understand what the Senator from Vermont is doing.

The PRESIDING OFFICER. The amendment is now pending.

Mr. SANDERS. Madam President, given the objection, I withdraw my amendment.

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