Further Changes To S. Con. Res. 13 Pursuant

Floor Speech

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Mr. McCAIN. If the Senator will yield, on that map, I wonder should there not be a sticker for the State of Florida? According to a published report by one of my favorite columnists, Dana Milbank, of the Washington Post:

Gator Aid: Senator Bill Nelson inserted a grandfather clause that would allow Floridians to preserve their pricey Medicare Advantage program.

So maybe we should have one of those stickers for Florida there. By the way, that will cost my constituents more money because they will not have that same deal. Should there be a sticker for Montana?

Again, according to Dana Milbank:

Handout Montana: Senator Max Baucus secured Medicare coverage for anybody exposed to asbestos--as long as they worked in a mine in Libby, Montana.

Should there be a sticker there?

Continuing, Dana Milbank says:

Iowa pork and Omaha Prime Cuts: Senator Tom Harkin won more Medicare money for low-volume hospitals of the sort commonly found in Iowa. .....

Maybe there should be a sticker for that. I don't know if you have North Dakota in there. Dana Milbank says:

Meanwhile, Senators Byron Dorgan and Kent Conrad, both North Dakota Democrats, would enjoy a provision that would bring higher Medicaid payments to hospitals and doctors in ``frontier counties'' of states such as--let's see here--North Dakota!

Should there be one for Hawaii? Mr. Milbank goes on to say:

Hawaii, with two Democratic senators, would get richer payments to hospitals that treat many uninsured people.

Should there be a sticker there for Michigan? Mr. Milbank says:

Michigan, home of two other Democrats, would earn higher Medicare payments for some reduced fees for Blue Cross/Blue Shield. Vermont's Senator Bernie Sanders held out for larger Medicaid payments for his state. (neighboring Massachusetts would get one, too).

I guess there are a number of States that maybe should have stickers on them so that the American people can see where these special deals were cut out, and the majority of the population of this country can see where they were not. They are going to pay while those States pay less because of not just their location but because they happen to have been behind closed doors and cut special deals.

Mr. BAUCUS. I wonder if the Senator would yield briefly.

Mr. McCAIN. Sure. I ask that Senator Baucus be recognized.

Mr. BAUCUS. I am pointing out, as the Senators know, for example, under this legislation, the Federal Government pays all the costs of eligible enrollees through 2016. In this legislation, we are talking about the so-called expansion population. That is those between 100 percent of poverty on Medicaid and 133 percent of poverty, and under the underlying statute----

Mr. McCAIN. Does that mean all these States are being treated the same?

Mr. BAUCUS. In 2016, all States are treated the same.

Mr. McCAIN. This happens to be 2009. What happens between now and 2016?

Mr. BAUCUS. Beginning next year, when this goes into effect, 2010 through 2016, all States will get 100 percent payments for that expansion coverage.

Mr. WICKER. What would happen, then, after 2016 under current legislation?

Mr. BAUCUS. Afterward, under current legislation--one sentence of background. Today, as the Senator well knows, different States receive different Federal contributions to Medicaid. It varies according to States. The average is about 57 percent Federal. The average for all States on average is 57 percent of the cost of Medicaid is paid for----

Mr. McCAIN. If that is the case----

Mr. BAUCUS. Let me finish.

Mr. McCAIN. If that is the case, we will be glad to have the same provision inserted for the State of Arizona that was inserted for the State of Florida. You don't have a problem with that, do you?

Mr. BAUCUS. Let me answer the question.

Mr. McCAIN. Do you have a problem with that?

Mr. BAUCUS. I can answer only one question at a time. The first question is from the Senator from Mississippi. Then, after 2017, all States get 90 percent--we are talking about expansion of population.

Mr. WICKER. The Senator yielded to me the other day, and I appreciate that. We have a number of Republicans who want to speak during our hour.

The fact is, after 2016, every State in red has to tax their own citizens and pay their State share, except Vermont, Massachusetts, and Nebraska. And I still challenge any colleague in this Senate to come before this body and say that is fair. I do not believe they will say that is fair.

Mr. McCAIN. My question to the Senator from Montana is this: Would the Senator from Montana be willing to have the same provision that Senator Nelson, according to these reports, inserted, a grandfather clause that would allow Floridians to reserve their price in the Medicare Advantage Program? Would he accept a unanimous consent request right now that same provision apply to every State in America?

I ask unanimous consent that the same provision that was put in for the State of Florida by Senator Nelson would apply to every State in America.

The PRESIDING OFFICER. Is there objection?

Mr. BAUCUS. Reserving the right to object, I think it would be highly imprudent for me not to object, so I will object to that request. I also point out that on average, Uncle Sam pays 90 percent of the Medicaid payments for this expansion of population after the year 2016.

The PRESIDING OFFICER. Objection is heard.

Mr. McCAIN. I think the fact that an objection was heard resolves the case. Those are comforting words on the part of the Senator from Montana, whom I appreciate, but the fact is, there are special deals for special people. It is well known. It is very well known.

May I mention to my colleagues--sort of a personal privilege here--the Senator from Louisiana came to the floor this morning and said:

Recently, just yesterday, Senator John McCain, our colleague from Arizona, has claimed that the American people are opposed to reform and he speaks about the will of the majority. I would like to remind, respectfully, my colleague from Arizona that the will of the majority spoke last year when they elected President Obama to be President and they decided not to elect him, and the President is carrying out the will of the majority of the people to try to provide them hope and opportunity.

I say in response to that, I really did not need to be reminded. I had not forgotten. Sometimes I would very much like to. But I appreciate the reminder.

The fact is that the Senator from Louisiana and other Senators should know that poll after poll, public opinion, partially because of what the Senator from Mississippi is pointing out--the latest being ``U.S. Voters Oppose Health Care Plan by Wide Margin.'' A Quinnipiac poll finds 3 to 1 that the plan should not pay for abortion. And it says American voters mostly disapprove of the plan 53-36 and disapprove 56-38 percent President Obama's handling of the health care issue.

If I can remind my friend and colleague from Louisiana, I did carry her State.

Mr. BAUCUS. The Senator carried my State too.

Mr. McCAIN. And the State of the Senator from Montana.

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Mr. McCAIN. But also, doesn't this bring up a larger issue--I ask all my colleagues to comment on this--whether our job here is to do whatever we can to just simply help our State, even if it is at the expense of other States, as the Senator from Mississippi pointed out, or is our title U.S. Senator, Arizona, Nebraska, Mississippi, et cetera? My title is not Arizona Senator, U.S.; it is U.S. Senator, Arizona. So of course I am here to represent the people of my State. But is a U.S. Senator's job to go out and do something which would then be at the expense of the citizens of another State simply by virtue of their clout and influence? Is that what we were sent here by our constituents to do?

Is it true what the majority leader said yesterday:

"I don't know if there is a Senator that doesn't have something in this bill that was important to them,'' Senate Majority Leader Harry Reid reasoned when asked at a news conference Monday about the cash-for-cloture accusation. ``And if they don't have something important in it to them, then it doesn't speak well of them.''

Does it speak well of us when we do something like the Senator from Mississippi pointed out, that favors Libby, MT, and not the rest of the country, that helps the seniors in Medicare Advantage in Florida and not in Arizona? Is that what we were sent here to do? That has never been my view of what our obligations to our citizens are, but also to the citizens of this country.

I ask my colleagues to comment.

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Mr. McCAIN. A Senator from Colorado came to the floor and proudly stated that he had not asked for anything or gotten anything, and I will ask the Senator from Nebraska a question because his State seems to be at the center of a lot of attention. But, first of all, there is a little booklet that is put out by the Government Printing Office that talks about how our laws are made. We give it to our constituents and send it to schools all over America. I have never seen anything in that little booklet--it is a very interesting booklet--that says you get behind closed doors and you cut deals.

I know we are all a little cynical about politics and campaign promises, but the negotiating behind closed doors is especially so, particularly after your President says during the campaign, time after time: I am going to have all the negotiations around a big table. We will have doctors and nurses, hospital administrators, insurance companies, drug companies, they will get a seat at the table. They just would not be able to buy every chair. But what we will do, we will have negotiations televised on C-SPAN so that people can see who is making arguments on behalf of their constituents and who is making arguments on behalf of the drug companies.

Of all people he recognized, the drug companies--who got the best deal of all? PhRMA. Who has spent the most money lobbying? Who has spent the most money on advertising? PhRMA. Who is going to cost the American consumer $100 billion, that could have been saved by the consumer if we had been able to reimport prescription drugs?

But I would ask my friend from Nebraska because along with the ``Louisiana purchase'' and probably the Florida deal this Nebraska deal has probably gotten the most publicity and visibility. Maybe because it was the 60th vote. I don't know if it is the biggest or not, in terms of money, because we will be finding deals in this 2,700-page bill for months. For months, we will be finding provisions, even though our staffs have carefully read it. It is not 2,700 pages for nothing.

So I would ask the Senator from Nebraska: How does this go over in the heartland of America? How do the people in Nebraska, who see that they have gotten some kind of special deal, a special provision--certainly reported as so in the media--that would come at the expense of other taxpayers in America? I am curious about the reaction the Senator from Nebraska gets.

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Mr. McCAIN. Let me make one additional comment. I have seen reform go through the Congress of the United States. The first one I saw was when we saved Social Security--a major reform of Social Security.

There was no backroom dealing. It was a straightforward proposal as to how to fix Social Security. We fixed welfare, it was welfare reform--again, open, honest, bipartisan negotiations and bipartisan agreement. Welfare reform, Social Security reform, the efforts we made at tobacco reform, at campaign finance reform, at immigration reform and many others--the Patients' Bill of Rights. Every reform I have ever been involved in has had two major and sole components: No. 1, it is bipartisan; No. 2, there were no special favors or deals cut, provisions in thousands of pages of legislation.

Again, we know where the train is headed. We know what is going to happen a short time from now, but they will make history. You will make history. You will have rammed through ``reform'' on a strictly partisan basis, without the participation of the other party, over the objections of a majority of the American people, done in closed negotiations, with results that are announced to the American people without debate or discussion and to this side without debate or discussion.

The American people do not like it. They do not like for us to do business that way. I am sure this peaceful revolution that is going on out there already--because as the Senator from Idaho pointed out, because of the involvement of the car companies, the stimulus, the bonus, the generational theft we are committing, this, all on top of that, is going to give great fuel to the fire that is already burning out there, where they want real change, real change which they were promised in the last Presidential campaign and certainly did not get.

Mr. RISCH. I say to Senator McCain, probably one of the great ironies of all this is going to be at 8 o'clock on December 24--when this bill passes with the 60 votes, all Democrats--immediately following that vote is going to be a vote, again all 60 Democrats and only Democrats, raising the national debt. What an irony, to put $2.5 trillion in spending of a new social entitlement program, adding it to the three already huge entitlement programs that are in the process of bankrupting America, adding this to it and then turning right around and increasing the debt ceiling. When they increase it, it is going to be--nobody knows exactly how much it is going to be, hundreds of billions. But that is only in the last 2 months. They are going to have to come back again in February and increase the national debt ceiling again. What irony.

Mr. McCAIN. Of course, this legislation turns everything we know about budgeting on its head, although it has been done before and it has been done by Republicans, to our shame. Today, if you go out and buy an automobile, you can drive it for a year before you have to pay for it. Under this bill, it is the opposite. You pay the taxes, you have the reductions in benefits, and then 4 years later you start having whatever benefits would accrue from this legislation. So for 4 years small businesspeople, people all over America, will see their health care costs increased before there is a single, tangible result from it--remarkable.

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Mr. McCAIN. Can I say, I appreciate the Senator from Mississippi bringing this important aspect to this issue and continuing to do so.

I would like to pick up on what Dr. Barrasso mentioned about the Kennedy family. It is well known I had a very close relationship, developed over the years, with Senator Ted Kennedy and that we worked together on a variety of issues. So there is a great irony in the constant, over there on the other side of the aisle, references to Senator Kennedy, who always began legislation by getting bipartisan, by getting Members of the other side of the aisle committed and working together--whether it be on immigration reform, whether it be on health care reform, whether it be on one of the great achievements of President Bush 2, No Child Left Behind.

In other words, every dealing I ever had with Senator Kennedy was to reach out, establish a fundamental base for agreement, and then move forward with legislation in a bipartisan fashion, which I think was one of the major reasons why he had such an impressive legislative record.

How did the other side do it? Without a bit of serious negotiation, without bringing anyone on board before moving forward--no one--which ends up, now, with a 60-to-40 vote, which is a pure partisan vote and outcome when there has never been, in history, a single reform that was not bipartisan. That is why the American people are rejecting this. That is why the American people are seeing through it. To hear the constant refrain that the American people want this: Read any poll. It is just a matter of difference because the American people have figured this out. It is going to be one of the great historic mistakes--not historic--but historic mistakes made by the Congress of the United States.

Mr. McCONNELL. If I may say to my friend from Arizona, he is absolutely right. I have had an opportunity to observe Senator Kennedy over the years. That is exactly the way he operated.

If I may, just to make a point with regard to the observation of the Senator from Mississippi about Congressman Stupak, as I understand it, Congressman Stupak was not asking for some special deal for Michigan in return for his vote. He was, rather, trying to establish a principle that would apply to all Americans. Is that not the case?

Mr. WICKER. That is exactly correct. I commend my former House colleague for taking that principled stand.

Mr. McCONNELL. Could not be same thing be said for our colleague, Senator Lieberman from Connecticut? I am sorry he ended up voting for this 2,700-page monstrosity, but you have to stay, as I understood his position--and Senator McCain certainly knows him very well--his position was, if the government goes into the insurance business, I can't support this bill, not: I am open for business and what you can you do for Connecticut.

Mr. McCAIN. There may be on the floor a unanimous consent request to remove the Nebraska Medicaid deal. I would hope, if there is any unanimous consent agreement at any time, that the whole bill will be fixed, which means every special provision would be removed, whether it be from Nebraska or any other State. We still have the Louisiana Purchase of $300 million. We still have the Florida Medicare grandfather clause, $25 to $30 billion. The list goes on and on. The Connecticut hospital--I guess it is the Connecticut hospital. It is always in legislation, so you have to do research to see who qualifies. I would hope we could have, again, agreement that all these special provisions that affect certain specific States would be removed as well. That would go over rather well with the American people.

I want to say to my colleagues, thank you for your passion. I know a lot of people don't watch our proceedings on the floor. It has played a role in educating the American people as to what we are facing. The media played a role, advocacy groups, grassroots organizations all over America. But I have had the great privilege of engaging in these colloquies with my colleagues. To me, it has been both helpful to my constituents, and, frankly, it has also been helpful to me to work with people who have been involved in these issues, former Governors and others. We have made some kind of contribution, which I think is what we are all sent here for.

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