E PL UR UM IB N U U S Congressional Record United States th of America PROCEEDINGS AND DEBATES OF THE 110 CONGRESS, SECOND SESSION

Vol. 154 WASHINGTON, THURSDAY, FEBRUARY 14, 2008 No. 25 Senate The Senate met at 9:30 a.m. and was Senator from the State of Arkansas, to per- have been longer days, as I indicated called to order by the Honorable MARK form the duties of the Chair. last night. L. PRYOR, a Senator from the State of ROBERT C. BYRD, I hope people will come and offer Arkansas. President pro tempore. amendments. That is what we need to Mr. PRYOR thereupon assumed the do. We need to move through this legis- PRAYER chair as Acting President pro tempore. lation. We have been told that Mem- The Chaplain, Dr. Barry C. Black, of- f bers who have amendments are waiting fered the following prayer: to offer them. I hope they will do that. RECOGNITION OF THE MAJORITY Let us pray. We are going to finish the bill this LEADER Almighty God, who desires truth in week. We have a break coming next the inward parts, keep our lawmakers The ACTING PRESIDENT pro tem- week. We really would like to get the in Your care. As they dedicate their pore. The majority leader is recog- work done. We could finish it today. I talents to the Nation’s well-being, nized. hope we can do so. Mr. President, I suggest the absence make our Senators faithful to each f challenging duty, loyal to every high of a quorum. claim, and responsive to the human MEASURES PLACED ON THE The ACTING PRESIDENT pro tem- needs of this suffering Earth. Set a seal CALENDAR—S. 2633, S. 2634, S. 2636 pore. The clerk will call the roll. The legislative clerk proceeded to upon their lips that no thoughtless Mr. REID. Mr. President, there are call the roll. words shall sting or harm another. three bills at the desk due for their sec- Mr. REID. Mr. President, I ask unan- Strengthen them to meet this day’s ond reading. imous consent that the order for the waiting tasks with kindness and good The ACTING PRESIDENT pro tem- quorum call be rescinded. will. Lord, give them strength of will, pore. The clerk will report the bills by The ACTING PRESIDENT pro tem- steadiness of purpose, and power to do title for the second time. pore. Without objection, it is so or- good for the glory of Your Name. The legislative clerk read as follows: dered. We pray this in the Name that is A bill (S. 2633) to provide for the safe rede- f above every name. Amen. ployment of United States troops from Iraq. A bill (S. 2634) to require a report setting RESERVATION OF LEADER TIME f forth the global strategy of the United The ACTING PRESIDENT pro tem- PLEDGE OF ALLEGIANCE States to combat and defeat al Qaeda and its pore. Under the previous order, the affiliates. The Honorable MARK L. PRYOR led A bill (S. 2636) to provide needed housing leadership time is reserved. the Pledge of Allegiance, as follows: reform. f I pledge allegiance to the Flag of the Mr. REID. Mr. President, I object to INDIAN HEALTH CARE IMPROVE- United States of America, and to the Repub- any further proceedings with respect to MENT ACT AMENDMENTS OF 2007 lic for which it stands, one nation under God, these bills, and I object en bloc. indivisible, with liberty and justice for all. The ACTING PRESIDENT pro tem- The ACTING PRESIDENT pro tem- pore. Under the previous order, the f pore. Objection is heard. The bills will Senate will resume consideration of S. APPOINTMENT OF ACTING be placed on the calendar. 1200, which the clerk will report. PRESIDENT PRO TEMPORE f The legislative clerk read as follows: The PRESIDING OFFICER. The A bill (S. 1200) to amend the Indian Health SCHEDULE Care Improvement Act to revise and extend clerk will please read a communication Mr. REID. Mr. President, following that Act. to the Senate from the President pro my remarks and any the Republican Pending: tempore (Mr. BYRD). leader wishes to make, we will resume The legislative clerk read the fol- Bingaman/Thune amendment No. 3894 (to consideration of the Indian Health Care amendment No. 3899), to amend title XVIII of lowing letter: Improvement Act. Senator DORGAN and the Social Security Act to provide for a limi- U.S. SENATE, Senator MURKOWSKI are here. I believe tation on the charges for contract health PRESIDENT PRO TEMPORE, this is our fourth day. Someone told services provided to Indians by Medicare pro- Washington, DC, February 14, 2008. viders. To the Senate: me yesterday: But they were short Vitter amendment No. 3896 (to amendment Under the provisions of rule I, paragraph 3, days. The only reason they were short No. 3899), to modify a section relating to lim- of the Standing Rules of the Senate, I hereby is because nobody has been here to itation on use of funds appropriated to the appoint the Honorable MARK L. PRYOR, a offer any amendments. They would Service.

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

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Because they are so tions bills to try to pass them before ceived policies by the Federal Government far behind, all the bills are cobbled to- October 1. regarding Indian tribes and offer an apology to all Native peoples on behalf of the United gether in an omnibus bill and moved at Last year, it took 325 days from the States. one time, which creates so much mo- release of the President’s budget until Dorgan amendment No. 3899, in the nature mentum that it is difficult to stop a the appropriations process was com- of a substitute. bill such as that. It is certainly almost pleted on December 26. Now, only 40 Sanders amendment No. 3900 (to amend- impossible to read and know what is in days later, the process has begun again ment No. 3899), to provide for payments it. On average, these spending packages with the submission of the President’s under subsections (a) through (e) of section have combined 7.6 regular appropria- new budget on February 5. 2604 of the Low-Income Home Energy Assist- By limiting budget decisions to every ance Act of 1981. tions bills. So the average omnibus bill Gregg amendment No. 4022 (to amendment is 7.6 of the 12 appropriations bills piled other year, Congress would have con- No. 3900), to provide funding for the Low In- all together in 1 bill and passed, basi- siderably more time to spend passing come Home Energy Assistance Program in a cally rammed through the Senate and critical legislation. Whether it be im- fiscally responsible manner. the House. migration reform, which we need to do, Barrasso amendment No. 3898 (to amend- Last year, Congress enacted a $555 tax cuts, or legislation addressing our ment No. 3899), to require the Comptroller billion, 1,600-page omnibus package Nation’s housing problems, Congress General to report on the effectiveness of co- that combined 11 of the 12 required ap- could focus more on important legisla- ordination of health care services provided propriations bills in 1. It was passed in tive matters rather than just always to Indians using Federal, State, local, and tribal funds. late December, not long before Christ- every year backed up, jammed up with mas, when people were anxious to go appropriations debates, arguing over Mr. REID. I suggest the absence of a home. I am sure that is part of the pork and earmarks, among others. quorum. plan. It all moved forward. Mr. Presi- Some will argue that 2-year budg- The ACTING PRESIDENT pro tem- dent, 1,600 pages—it is unlikely many eting would increase the need for en- pore. The clerk will call the roll. Members of this Senate read it. Basi- acting supplemental spending. They The legislative clerk proceeded to cally, what they would do is send out say we will have more supplemental call the roll. their staff to determine if something emergency spending. As such, we will Mr. SESSIONS. Mr. President, I ask they especially cared about was in it, not save a lot of time, and it still will unanimous consent that the order for and if what they wanted was in it, they not be a healthy process. the quorum call be rescinded. would vote for the bill. That is the way I ask this: How much more supple- The ACTING PRESIDENT pro tem- things have gone around here. It is not mental emergency spending can Con- pore. Without objection, it is so or- a good policy. The package we passed gress do? dered. last December was the largest omnibus Over the last 10 budget cycles, even Mr. SESSIONS. Mr. President, I ask bill since 1988, when we enacted a $598 though we are passing regular appro- unanimous consent that I be allowed to billion package that included all 13 priations bills every single year, Con- speak as in morning business. bills. gress has enacted at least 25 supple- The ACTING PRESIDENT pro tem- Finally, this broken budget process mental emergency appropriations pore. Without objection, it is so or- has resulted in almost $1.7 trillion in packages. These packages have ap- dered. deficit spending over the past 13 budget proved almost $884 billion in additional 2-YEAR BUDGET PROCESS cycles. emergency spending. That is a shock- Mr. SESSIONS. Mr. President, the There is no single cure, I will cer- ing number. congressional budget process, which we tainly admit, for all of what ails Con- But I will add this. When someone will begin again soon, is clearly bro- gress and the way Congress spends the does bring up an emergency spending ken. Since fiscal year 1980, only three people’s money. However, a biennial, 2- bill—and there may be a number of times has Congress enacted all its ap- year budget, 2-year appropriations times that it is quite legitimate—and propriations bills by the start of the would be, I am convinced and have asks that it be brought up and spent next fiscal year, which is October 1. been for quite a number of years, a tre- above the budget—and that is what During that same time, 138 continuing mendous step in the right direction. It emergency spending does; we approve a resolutions have been needed to keep is a good-government reform. I wish to budget, we should stay within the the Government running. In other talk about biennial budgeting a bit. budget—we pass an emergency bill and words, if Congress does not appropriate Biennial budgeting has been sup- it busts the budget. It goes above the money, it cannot be spent by the exec- ported by the last four Presidents. It is budget. We say it is emergency spend- utive branch. It cannot be spent by the a very simple concept. Under current ing that is so important that we don’t Government, period. So when we do not budget law, Congress must pass the adhere to the budget and we are going pass an appropriations bill to fund the twelve 1-year appropriations bills each to spend the money anyway. Of course, Department of Defense or the Depart- year to fund the Federal Government. all of that goes straight to the debt, ment of Housing and Urban Develop- With biennial budgeting, twelve 2-year since we are already in deficit. Any ad- ment, they cannot operate. They shut appropriations bills would be enacted ditional spending over our budget is down. As a result, we come through instead of 1-year bills. A change from a even more monies that go to our debt. with continuing resolutions to allow 1-year to 2-year budget cycle would But it takes 60 votes, at least. A person funding to continue at the previous have many great benefits. is able to come to the floor and object year’s level while we debate and argue I emphasize, this is not a partisan and create a discussion and demand a over the appropriate appropriations for matter. This is a matter that I believe supermajority of 60 votes to have emer- that next fiscal year. will strengthen the Congress and help gency spending. I think that in itself Repeatedly, we have been late. On av- us increase some of those very poor should deter some frivolous use of erage, there have been 4.8 continuing ratings we have with the American emergency spending, I really do. resolutions each fiscal year. On aver- people. I think we would be better off, even age, we have been almost 3 months late A change from a 1-year to 2-year though I am sure we will have emer- passing the appropriations bills, put- budget would deal with this problem gency spending packages with a 2-year ting us well into the next fiscal year. that is a reality for us: that under the budget, because we certainly have had For fiscal year 1996, 10 years ago, the current system, the budget process, the them even with a 1-year budget cycle. final appropriations bill was signed al- appropriations process is never-ending. I do think the taxpayers won’t be de- most 7 months late. We should have completed this process fenseless when those emergency bills Over the past 13 budget cycles, Con- last year before October 1, the start of come up. gress has passed 10 omnibus spending the new fiscal year, the appropriations Another big thing. All of us in the bills. These omnibus bills occur when, funding for the next fiscal year. We did Congress, and I think all of us in the instead of passing each of the 12 appro- not get that done until late December. Senate, know in our hearts, know in

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But they are not able hope to take 5 minutes on the 2-year don’t do oversight in an effective way to do it oftentimes because all the time budget and how I hope, and many of us is because we have to pass the funding on the floor of the Senate is spent on hope, that it will be something the bills. We are always arguing over how trying to pass appropriations bills. So Democrats and Republicans can agree much should be spent on this or that whether it helps the majority or the on to change the way Washington program, how much should be spent on minority party, I am not sure, but it works. this or that pet project, and we spend will help the taxpayers. It is good gov- I will be glad to defer that, knowing our time doing that and not going out ernment reform. the importance of moving ahead on In- and looking at agencies and depart- It is not a partisan thing we are talk- dian affairs. ments with a fresh view. ing about. We are talking about a his- Mr. DORGAN. If the statement is 5 The Office of Management and Budg- toric change in the way we do business minutes, I would not object to that, et has made a long list of agencies that that will help every agency and depart- but I do want, at the end of that 5 min- are poorly performing, that they ques- ment of government because they will utes, to begin the bill. Again, Senator tion the legitimacy of. If we would have at least 2 years of a solid budget COBURN has arrived, and we have a lot focus on that effectively, I think we from which to work. They will only of work to do. But I know Senator could do a much better job. have to put together their proposals ALEXANDER has worked on budget Also, I would suggest that with a 2- every 2 years instead of every year. issues for a long while, so I ask unani- year budget, Federal agencies could Congress will be able to deal with it mous consent that Senator ALEXANDER focus more on their core missions. The one time, and then during the off year, be recognized for 5 minutes, and after Department of Defense, for example, we would be able to examine how we that I will make some comments, Sen- spends untold hours preparing their are spending money and make new pro- ator MURKOWSKI then will make some budget every year, and it creates a lot posals and new ideas for improving the comments, and we will begin a discus- of uncertainty because they are never health care system of America, the sion with Senator COBURN. sure whether this or that program will savings system of America, and the de- The ACTING PRESIDENT pro tem- be continued. It causes quite a bit of fense of America. pore. Without objection, it is so or- stress and uncertainty. Agencies are I thank the Chair, and I note my col- dered. spending thousands of hours on their league Senator ALEXANDER from Ten- The Senator from Tennessee is recog- annual budget process. nessee is here. I know he strongly nized for 5 minutes. Constituent groups and organizations shares this view. We have both worked Mr. ALEXANDER. Mr. President, I could save a lot of money. They come with and met with Senator PETE greatly appreciate the courtesy of the up every year. We see them. They are DOMENICI, long-time former chairman Senator from North Dakota. He him- some of the best people we know, and of the Budget Committee and a mem- self is an expert on appropriations and those people come up every year. They ber of the Appropriations Committee in budget matters, both at the Federal wouldn’t have to come up but every 2 the Senate, who has championed this level and at the State level. It would be years with biennial budgeting. Save battle. Frankly, I think it would be a my hope that as this subject I am some money for those agencies and de- nice tribute to Senator DOMENICI if, about to talk about moves ahead, it partments that are worried about their when he completes his tenure, distin- would be something that would inter- budgets and maybe even save our con- guished as it has been in the Senate, est him as well. stituents a little money on air travel. we were to pass a 2-year budget. 2-YEAR APPROPRIATIONS Finally, a 2-year budget would create I thank the Chair, and I yield the I can make my point quickly and a more stable system of government floor. simply. We have heard a lot this year because Congress has proven it cannot The ACTING PRESIDENT pro tem- that the people of this country would complete its budget process each year. pore. The Senator from North Dakota. like a change in the way we do business It can’t do it. Funding delays would Mr. DORGAN. Mr. President, Senator in Washington, DC. One way to do that surely occur less often and less fre- ALEXANDER has not indicated to me the is change how we go about our busi- quently with a 2-year budget, and the purpose of his presence on the floor, ness. That means I would prefer, and I Federal agencies could function more but we are most anxious to get started believe almost all of us would prefer, effectively. on the Indian Health Care Improve- and I know the people would prefer, Process often does drive policy. The ment Act. That was scheduled for 9:30 that we focus on big issues and we current budget process, the current ap- this morning. I wish to begin an open- come up with good principled ideas. propriations process, we know, is not ing statement at some point, and I And then we debate those principles, working. It is an embarrassment to us. know Senator MURKOWSKI would, and and then we reach across the aisle, be- It embarrasses us every year, not just we want to do a managers’ package. cause it takes 60 votes to get anything because the Democrats failed last year Senator COBURN is here, because I done here to come to a result. in their first year in the majority, but asked if he would be here at 9:30, and We did that on the economic stim- because Republicans failed too, con- he has a number of amendments. I ap- ulus, we did that on energy, we did that sistently, to pass budgets in an effec- preciate very much his work and his ef- on terrorism, and it didn’t mean we tive way. It is a bipartisan problem. We forts on Indian health care. I am hop- didn’t have debates. We had big de- need to look no further than the $400 ing we can work with Senator COBURN bates. That is why we are here. But we billion deficit projected for this year, this morning to deal with some of his came to a result and the result had to or our Nation’s $9 trillion debt to know amendments. I know he has filed a be bipartisan. I am not so interested in we are not being effective in managing number of them, and he and I have had the bipartisanship as I am interested in the taxpayers’ money. many discussions about it. I appreciate the result. I heard Rick Warren speak By itself, a 2-year budget will not end his attendance. He has just walked into the other day, and he said he wasn’t so the profligate spending of Congress, the Chamber. interested in interfaith dialog as he that is for sure. But a 2-year budget Our interest is in getting a lot of was interested in good works. cycle would be a huge improvement. I work done this morning and this after- I think that is what the people want have no doubt about it. Twenty-one noon in order to try to see if we can to see from us. My suggestion for good States currently operate with a 2-year finish this bill. This will be the third works and for results is that we adopt budget cycle. I think it is time for Con- day that the Indian Health Care Im- a 2-year appropriations budget process, gress to do the same. provement bill has been on the floor, so as described by the Senator from Ala- When I was working on this the last I wish to begin on that. I know Senator bama and as advocated by the Senator several years, when the Republicans ALEXANDER has appeared, though I from New Mexico, Senator DOMENICI. had a majority in the Senate, I felt as don’t know for what purpose, and per- This is not a Republican idea, this is

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00003 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S996 CONGRESSIONAL RECORD — SENATE February 14, 2008 not a Democrat idea, this is a good adopt a 2-year budget for spending. We Regrettably, it has not been ade- idea. It has the support of Senator are going to spend every other year re- quately delivered. So I am going to FEINGOLD from the other side, and it vising and repealing laws and make the talk a little bit later. I know my col- has the support of the independent Government run efficiently. And we league, Senator COBURN, is on the Sen- Senator, Senator LIEBERMAN, so I are going to get our appropriations and ate floor, and he has amendments. I am would hope it has strong support all budgeting done on time. We can save going to give him an opportunity to across the aisle here. the taxpayers dollars so that States, speak. I am as well, but I will have an Let me give an example or two of cities, companies, and countries that opportunity later this morning to de- why it would make a difference. When deal with the United States of America scribe in much greater detail why there we debate the higher education bill in can do so in a timely and efficient way. is an urgency and why this system a few weeks, I am going to ask permis- I thank the President, and I thank must be improved. We cannot wait any sion to bring on the floor several boxes again the Senator from North Dakota longer. containing all the rules and regula- and the Senator from Alaska for allow- I yield the floor. tions that 6,000 higher education insti- ing me this time. The ACTING PRESIDENT pro tem- tutions in this country must wade Mr. DORGAN. Mr. President, we are pore. The Senator from Alaska is rec- through in order to accept students going to turn now to the Indian Health ognized. who receive a Federal grant or a loan. Care Improvement Act, and I am going Ms. MURKOWSKI. Mr. President, I The stack of boxes is about that high— to be very brief, and I know my col- thank the chairman of the Indian Af- that many rules and regulations. But league will as well because we will fairs Committee for his leadership on this new higher education bill that we have a chance later to speak at greater this very importation reauthorization will likely pass doubles the number of length. bill. As he has indicated, this work is a rules and regulations. Maybe some of The Indian Health Care Improvement long time in coming, and it is a col- them are needed, but what we haven’t Act has been the subject of reauthor- laborative effort not only of those on had time to do is go through that stack ization for many years, and the Con- the committee, those of us who rep- of boxes as tall as I am to see if we can gress has not been able to do it. The resent so many in Indian country cut the regulations in half. We don’t fact is we have very serious problems across the Nation, but truly for so with respect to Indian health care. The have time to do that. many who have put so much work into If we spent every other year drawing Indian Health Service is a very impor- this reauthorization, this very impor- up a budget and our appropriations tant Federal agency. We have some tant health care reform. bills, and then, in the odd year, going people who work in that area who do We do have amendments we have re- back through rules, laws, and regula- important work and are good and dedi- ceived and are looking forward to hav- tions already on the books, I think we cated people, but the fact is the system ing discussion on them. As Chairman isn’t working very well. We have Amer- would have a strong force for fewer DORGAN has noted, Senator COBURN ican Indians—the first Americans, by rules, fewer regulations, and fewer will have an opportunity to offer some the way—who are supposed to get laws. And also more effective, if not of those this morning. But in the spirit health care as a result of treaties and less, spending. of focusing on what we have in front of A second example. The State of Mis- trust responsibilities who are not get- us today, I think it is important that souri has told the Department of ting the health care they deserve. we keep in mind we have an obligation I will again, later today, describe the Transportation that with the Federal to advance a health care system that horrors of Indian health care that does money we already give the State of has been left behind the times in terms not work. People are dying, people are Missouri, they can repair every broken of any updates, whether it is in the routinely being denied the health care bridge they have in 5 years. They can that every one of us would expect for area of behavioral health or telemedi- do this as long as we let them do it ourselves and our family. We are trying cine or substance abuse or what we are first under their rules and regulations, to reauthorize the Indian Health Care doing with diabetes treatment or how without waiting for our appropriations Improvement Act after 8 years. Eight we are moving forward with construc- process. In other words, if we let them years ago, it was supposed to have been tion of facilities. We recognize that we build the bridges and then we buy the reauthorized. Eight years later, we are have a ways to go in updating the sys- bridges to reimburse them, according still on the floor of the Senate, strug- tem. This is important and is nec- to specifications, we don’t have to gling. essary. spend any more money to fix all the So my hope is, perhaps we will now Recognizing the limitations on Sen- broken bridges in Missouri. succeed. Senator MURKOWSKI and the ator COBURN’s time at this point, I What that should indicate to us is Indian Affairs Committee have worked yield to the Senator so he can offer his the gross inefficiency of our appropria- on a piece of legislation that is not amendments. We will continue our con- tions and budget processes when it giant reform, it is not a huge step for- versation later in the morning. comes to building roads, when it comes ward, but it is a step forward in the The ACTING PRESIDENT pro tem- to making contracts, when it comes to right direction. pore. The Senator from Oklahoma. waging war. Our process wastes billions Some of my colleagues—I believe my Mr. COBURN. Mr. President, first of of dollars a year. No wonder the people colleague, Senator COBURN—will say all, let me thank the chairman and of this country are upset with us. we need much larger reform. I do not ranking member, Senator MURKOWSKI, Final action on appropriations meas- disagree with that. I am going to be for their work on this effort. ures has occurred, on average, 86 days supporting much broader reform in In- AMENDMENTS NOS. 4024 THROUGH 4037 TO after the start of the fiscal year. And dian health care. But if you cannot get AMENDMENT NO. 3899 our fiscal year starts when? On October a modest step in the right direction, Oklahoma is the No. 1 State in the 1. I mean, who else begins their year on how on Earth can you get big, bold re- country as far as tribal members. In- October 1? That is not the Chinese cal- form? dian health care is an issue on which endar, it is not most Americans’ cal- This is the first step in a two-step we are struggling, and there are all endar, but it is our fiscal calendar. So process to fix what is wrong. I think sorts of components for it. I am going everybody has to adjust their business this Indian Health Care Improvement to ask unanimous consent now to bring to a strange year, and then we never Act will give us substantial oppor- up my amendments numbered 4024 meet it. tunity to improve the health care in through 4037 as if brought up individ- My hope is that this year we can the lives of American Indians. ually and ask that each be set aside so honor Senator DOMENICI and ourselves. Let me make the point that is impor- they will be considered pending. I ask We can add a Democratic name right tant. We owe this health care through unanimous consent that be carried out up there with his, as prominently, and treaties, through a trust responsibility. at this time. we can say to the country: We are We have made commitments. We owe Mr. DORGAN. I have no objection to going to change the way Washington this health care to American Indians that. The Senator and I have talked does business. We are going to do it in through promises the Federal Govern- about this. He wants to get all of his a bipartisan way. We are going to ment has made. amendments pending. But he will be

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00004 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S997 asking for discussion and votes on a ‘‘(B) creating any new privilege concerning ‘‘(4) the overall health outcomes in Indi- number of them. disclosure. ans, as compared to the overall health out- Mr. COBURN. Far less than what I AMENDMENT NO. 4028 TO AMENDMENT NO. 3899 comes of other residents of the United bring up. (Purpose: To provide a blood quantum re- States; Mr. DORGAN. I have no objection. quirement for Federal recognition of In- ‘‘(5) patient satisfaction of Indians receiv- dian tribes) ing health care services through the Service; The ACTING PRESIDENT pro tem- ‘‘(6) the total amount of funds of the Serv- On page 347, after line 24, add the fol- pore. Without objection, it is so or- ice expended for— lowing: dered. ‘‘(A) direct medical care; and The amendments are as follows: SEC. 104. BLOOD QUANTUM REQUIREMENT FOR ‘‘(B) administrative expenses; FEDERAL RECOGNITION OF INDIAN ‘‘(7) the health care coverage options avail- AMENDMENT NO. 4024 TO AMENDMENT NO. 3899 TRIBES. (Purpose: To ensure that tribal members re- Effective beginning on the date of enact- able to Indians receiving health care services ceive scientifically effective health pro- ment of this Act, in determining whether to through the Service; motion services) extend Federal recognition to an Indian tribe ‘‘(8) the health care services options avail- At the appropriate place in title VIII of the or other Indian group under part 83 of title able to Indians; and Indian Health Care Improvement Act (as 25, Code of Federal Regulations (or successor ‘‘(9) the health care provider options avail- amended by section 101), insert the fol- regulations), the Secretary of the Interior able to Indians. lowing: shall require that each member of the Indian AMENDMENT NO. 4032 TO AMENDMENT NO. 3899 ‘‘SEC. 8ll. SCIENTIFICALLY EFFECTIVE HEALTH tribe or group possess a degree of Indian (Purpose: To protect rape and sexual assault PROMOTION SERVICES. blood of not less than 1⁄512. victims from HIV/AIDS and other sexually ‘‘Notwithstanding any other provision of AMENDMENT NO. 4029 TO AMENDMENT NO. 3899 transmitted diseases) this Act, coverage of health promotion serv- (Purpose: To require a study of membership At the appropriate place in the Indian ices under this Act shall only be for medical criteria for federally recognized Indian Health Care Improvement Act (as amended or preventive health services or activities— tribes) by section 101), insert the following: ‘‘(1) for which scientific evidence dem- ‘‘SEC. lll. TESTING FOR SEXUALLY TRANS- On page 347, after line 24, add the fol- onstrates a direct connection to improving MITTED DISEASES IN CASES OF SEX- lowing: health; and UAL VIOLENCE. ‘‘(2) that are provided in accordance with SEC. 104. GAO STUDY OF MEMBERSHIP CRITERIA ‘‘The Attorney General shall ensure that, applicable medical standards of care. FOR FEDERALLY RECOGNIZED IN- with respect to any Federal criminal action DIAN TRIBES. involving a sexual assault, rape, or other in- AMENDMENT NO. 4025 TO AMENDMENT NO. 3899 Not later than 1 year after the date of en- cident of sexual violence against an Indian— (Purpose: To clarify the absence of author- actment of this Act, the Comptroller General ‘‘(1)(A) at the request of the victim, a de- ization of racial preference in employment) of the United States shall conduct a study of fendant is tested for the human immuno- At the appropriate place in title VIII of the membership criteria for federally recognized deficiency virus (HIV) and such other sexu- Indian Health Care Improvement Act (as Indian tribes, including— ally transmitted diseases as are requested by amended by section 101), insert the fol- (1) the number of federally recognized In- the victim not later than 48 hours after the lowing: dian tribes in existence on the date on which date on which the applicable information or ‘‘SEC. 8ll. NO RACIAL PREFERENCE IN EMPLOY- the study is conducted; indictment is presented; MENT. (2) the number of those Indian tribes that ‘‘(B) a notification of the test results is ‘‘Notwithstanding any other provision of use blood quantum as a criterion for mem- provided to the victim or the parent or this Act, nothing in this Act authorizes any bership in the Indian tribe and the impor- guardian of the victim and the defendant as racial preference in employment. tance assigned to that criterion; soon as practicable after the results are gen- AMENDMENT NO. 4026 TO AMENDMENT NO. 3899 (3) the percentage of members of federally erated; and recognized Indian tribes that possesses de- (Purpose: To modify a provision relating to ‘‘(C) such follow-up tests for HIV and other grees of Indian blood of— child sexual abuse and prevention treat- sexually transmitted diseases are provided as (A) 1⁄4; ment programs) are medically appropriate, with the test re- (B) 1⁄8; and sults made available in accordance with sub- Strike paragraph (5) of section 713(b) of the 1 (C) ⁄16; and paragraph (B); and Indian Health Care Improvement Act (as (4) the variance in wait times and ration- ‘‘(2) pursuant to section 714(a), HIV and amended by section 101) and insert the fol- ing of health care services within the Service other sexually transmitted disease testing, lowing: between federally recognized Indian Tribes treatment, and counseling is provided for ‘‘(5) To identify and provide behavioral that use blood quantum as a criterion for victims of sexual abuse. health treatment to Indian perpetrators and membership and those Indian Tribes that do AMENDMENT NO. 4033 TO AMENDMENT NO. 3899 perpetrators who are members of an Indian not use blood quantum as such a criterion. household making efforts to begin offender (Purpose: To allow tribal members to make AMENDMENT NO. 4030 TO AMENDMENT NO. 3899 and behavioral health treatment while the their own health care choices) perpetrator is incarcerated or at the earliest (Purpose: To ensure tribal members have ac- On page 336, between lines 13 and 14, insert possible date if the perpetrator is not incar- cess to the highest levels of quality and the following: cerated. safety in the Service) ‘‘SEC. 817. TRIBAL MEMBER CHOICE DEMONSTRA- At the end of section 713 of the Indian Strike section 221 of the Indian Health TION PROJECT. Health Care Improvement Act (as amended Care Improvement Act (as amended by sec- ‘‘(a) IN GENERAL.—The Secretary shall es- by section 101), add the following: tion 101) and insert the following: tablish a demonstration project in not less ‘‘(d) LIMITATION ON FUNDING.—Treatment ‘‘SEC. 221. LICENSING. than 3 Service Areas (chosen by the Sec- shall be provided for a perpetrator pursuant ‘‘Nothing in this Act preempts any State retary for optimal participation) under to this section only if the treatment is sci- requirement regarding licensing of any which eligible participants shall be provided entifically demonstrated to reduce the po- health care personnel. with a risk-adjusted subsidy for the purchase of qualified health insurance (as defined in tential of the perpetrator to commit child AMENDMENT NO. 4031 TO AMENDMENT NO. 3899 sexual abuse again, and shall not provide the subsection (f)) in order to— (Purpose: To promote transparency and ‘‘(1) improve Indian access to high quality basis to reduce any applicable criminal pun- quality in the Service) ishment or civil liability for that abuse. health care services; At the appropriate place in title VIII of the AMENDMENT NO. 4027 TO AMENDMENT NO. 3899 ‘‘(2) provide incentives to Indian patients Indian Health Care Improvement Act (as to seek preventive health care services; (Purpose: To clarify the effect of a title) amended by section 101), insert the fol- ‘‘(3) create opportunities for Indians to At the appropriate place in title VII of the lowing: participate in the health care decision proc- Indian Health Care Improvement Act (as ‘‘SEC. 8ll. GAO ASSESSMENT. ess; amended by section 101), insert the fol- ‘‘Not later than 1 year after the date of en- ‘‘(4) encourage effective use of health care lowing: actment of the Indian Health Care Improve- services by Indians; and ‘‘SEC. 7ll. CRIMINAL CONDUCT. ment Act Amendments of 2008, the Comp- ‘‘(5) allow Indians to make health care cov- ‘‘Nothing in this title— troller General of the United States shall erage and delivery decisions and choices. ‘‘(1) establishes any defense, not otherwise conduct, and submit to Congress a report de- ‘‘(b) ELIGIBLE PARTICIPANT.— applicable under law, for any individual ac- scribing the results of, an assessment of— ‘‘(1) VOLUNTARY ENROLLMENT FOR 12-MONTH cused of any crime, including physical or ‘‘(1) the average wait time of patients in PERIODS.— sexual abuse of children or family violence; the Service; ‘‘(A) IN GENERAL.—In this section, the term or ‘‘(2) the extent of rationing of health care ‘eligible participant’ means an Indian who— ‘‘(2) preempts or otherwise affects any ap- services in the Service; ‘‘(i) is a member of a federally-recognized plicable requirement for— ‘‘(3) the average per capita health care Indian Tribe; and ‘‘(A) reporting of criminal conduct, includ- spending on Indians eligible for health care ‘‘(ii) voluntarily agrees to enroll in the ing for child abuse or family violence; or services through the Service; project conducted under this section (or in

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the case of a minor, is voluntarily enrolled ‘‘(2) EXCLUSION OF CERTAIN OTHER CON- later than the date that is 1 year after the on their behalf by a parent or caretaker) for TRACTS.—Such term shall not include insur- date of enactment of this section and shall a period of not less than 12 months in lieu of ance if a substantial portion of its benefits be conducted for a period of at least 5 years. obtaining items or services through any In- are excepted benefits (as defined in section ‘‘(B) EXTENSIONS.—The Secretary may ex- dian Health Program or any other federally- 9832(c) of such Code).’’. tend the program for such additional periods funded program during any period in which AMENDMENT NO. 4034 TO AMENDMENT NO. 3899 as the Secretary determines appropriate, un- the Indian is enrolled in the project. (Purpose: To allow tribal members to make less the Secretary determines that the pro- ‘‘(B) VOLUNTARY EXTENSIONS OF ENROLL- their own health care choices) gram is unsuccessful in achieving the pur- MENT.—An eligible participant may volun- On page 336, between lines 13 and 14, insert poses described in subsection (a), taking into tarily extend the participant’s enrollment in the following: account cost-effectiveness, quality of care, the project for additional 12-month periods. and such other criteria as the Secretary may ‘‘SEC. 817. TRIBAL MEMBER CHOICE PROGRAM. ‘‘(2) HARDSHIP EXCEPTION.—The Secretary specify. ‘‘(a) IN GENERAL.—The Secretary shall es- shall specify criteria for permitting an eligi- tablish a program in geographically feasible ‘‘(2) REPORTS TO CONGRESS.—During the ble participant to disenroll from the project Service Areas (as determined by the Sec- initial 5-year period in which the program is before the end of any 12-month period of en- retary, taking into account those Service conducted, and during any period thereafter rollment to prevent undue hardship. Areas that are likely to have optimal par- in which the program is extended, the Sec- ‘‘(c) SUBSIDIES REQUIREMENT.—The average ticipation) under which eligible participants retary shall periodically submit reports to amount of all subsidies provided to eligible shall be provided with a risk-adjusted sub- Congress regarding the progress of program. participants enrolled in the demonstration sidy for the purchase of qualified health in- Each report shall include information con- project established under this section for surance (as defined in subsection (f)) in order cerning the populations participating in the each 12-month period during which the to— program, participant satisfaction (deter- project is conducted shall not exceed the ‘‘(1) improve Indian access to high quality mined by indicators of satisfaction with se- amount equal to the average of the per cap- health care services; curity, affordability, access, choice, and ita expenditures for providing Indians items ‘‘(2) provide incentives to Indian patients quality) as compared with items and services or services from all Indian Health Programs to seek preventive health care services; that the participant would have received for the most recent fiscal year for which ‘‘(3) create opportunities for Indians to from Indian Health Programs, and the im- data is available. participate in the health care decision proc- pact of the program on access to, and the ‘‘(d) SPECIAL RULES.— ess; availability of, high quality health care serv- ‘‘(1) TREATMENT.—The amount of a subsidy ‘‘(4) encourage effective use of health care ices for Indians. provided to an eligible participant in the services by Indians; and ‘‘(f) QUALIFIED HEALTH INSURANCE.— project shall not be counted as income or as- ‘‘(5) allow Indians to make health care cov- ‘‘(1) IN GENERAL.—In this section, the term sets for purposes of determining eligibility erage and delivery decisions and choices. ‘qualified health insurance’ means insurance for benefits under any Federal public assist- ‘‘(b) ELIGIBLE PARTICIPANT.— which constitutes medical care as defined in ance program. ‘‘(1) VOLUNTARY ENROLLMENT FOR 12-MONTH section 213(d) of the Internal Revenue Code ‘‘(2) BUDGET NEUTRALITY.—In conducting PERIODS.— of 1986 without regard to— the demonstration project under this sec- ‘‘(A) IN GENERAL.—In this section, the term ‘‘(A) paragraph (1)(C) thereof, and tion, the Secretary shall ensure that the ag- ‘eligible participant’ means an Indian who— ‘‘(B) so much of paragraph (1)(D) thereof as gregate payments made to carry out the ‘‘(i) is a member of a federally-recognized relates to qualified long-term care insurance project do not exceed the amount of Federal Indian Tribe; and contracts. expenditures which would have been made ‘‘(ii) voluntarily agrees to enroll in the ‘‘(2) EXCLUSION OF CERTAIN OTHER CON- for the provision of health care items and program conducted under this section (or in TRACTS.—Such term shall not include insur- services to eligible participants if the project the case of a minor, is voluntarily enrolled ance if a substantial portion of its benefits had not been implemented. on their behalf by a parent or caretaker) for are excepted benefits (as defined in section a period of not less than 12 months in lieu of ‘‘(e) DEMONSTRATION PERIOD; REPORTS TO 9832(c) of such Code).’’. obtaining items or services through any In- CONGRESS.— AMENDMENT NO. 4035 TO AMENDMENT NO. 3899 dian Health Program or any other federally- ‘‘(1) DEMONSTRATION PERIOD.— funded program during any period in which (Purpose: To prioritize patient care over ‘‘(A) INITIAL PERIOD.—The demonstration administrative overhead) project established under this section shall the Indian is enrolled in the program. At the appropriate place in title VIII of the begin not later than the date that is 1 year ‘‘(B) VOLUNTARY EXTENSIONS OF ENROLL- Indian Health Care Improvement Act (as after the date of enactment of this section MENT.—An eligible participant may volun- amended by section 101), insert the fol- and shall be conducted for a period of 5 tarily extend the participant’s enrollment in lowing: years. the program for additional 12-month periods. ‘‘(2) HARDSHIP EXCEPTION.—The Secretary ‘‘SEC. 8ll. REQUIREMENT. ‘‘(B) EXTENSIONS.—The Secretary may ex- tend the project for such additional periods shall specify criteria for permitting an eligi- ‘‘Not less than 85 percent of amounts made as the Secretary determines appropriate, un- ble participant to disenroll from the program available to carry out this Act shall be used less the Secretary determines that the before the end of any 12-month period of en- to provide the medical services authorized project is unsuccessful in achieving the pur- rollment to prevent undue hardship. by this Act. ‘‘(c) SUBSIDIES REQUIREMENT.—The average poses described in subsection (a), taking into AMENDMENT NO. 4036 TO AMENDMENT NO. 3899 amount of all subsidies provided to eligible account cost-effectiveness, quality of care, participants enrolled in the program estab- (Purpose: To prioritize scarce resources to and such other criteria as the Secretary may lished under this section for each 12-month basic medical services for Indians) specify. period during which the program is con- On page 121, strike line 15 and insert the ‘‘(2) PERIODIC REPORTS TO CONGRESS.—Dur- ducted shall not exceed the amount equal to following: ing the 5-year period described in paragraph the average of the per capita expenditures ‘‘(c) PRIORITIZATION.—Before providing any (1), the Secretary shall periodically submit for providing Indians items or services from hospice care, assisted living service, long- reports to Congress regarding the progress of all Indian Health Programs for the most re- term care service, or home- or community- demonstration project conducted under this cent fiscal year for which data is available. based service pursuant to this section, the section. Each report shall include informa- ‘‘(d) SPECIAL RULES.— Secretary shall give priority to the provision tion concerning the populations partici- ‘‘(1) TREATMENT.—The amount of a subsidy of basic medical services to Indians. pating in the project, participant satisfac- provided to an eligible participant in the ‘‘(d) DEFINITIONS.—For the purposes of this tion (determined by indicators of satisfac- program shall not be counted as income or section, tion with security, affordability, access, assets for purposes of determining eligibility AMENDMENT NO. 4037 TO AMENDMENT NO. 3899 choice, and quality) as compared with items for benefits under any Federal public assist- and services that the participant would have ance program. (Purpose: To prioritize scarce resources to received from Indian Health Programs, and ‘‘(2) BUDGET NEUTRALITY.—In conducting basic medical services for Indians) the impact of the project on access to, and the program under this section, the Sec- On page 121, strike line 15 and insert the the availability of, high quality health care retary shall ensure that the aggregate pay- following: services for Indians. ments made to carry out the program do not ‘‘(c) EFFECTIVE DATE.— ‘‘(f) QUALIFIED HEALTH INSURANCE.— exceed the amount of Federal expenditures ‘‘(1) EFFECTIVE DATE.—This section takes ‘‘(1) IN GENERAL.—In this section, the term which would have been made for the provi- effect on the date on which the Secretary ‘qualified health insurance’ means insurance sion of health care items and services to eli- makes the certification described in para- which constitutes medical care as defined in gible participants if the program had not graph (2). section 213(d) of the Internal Revenue Code been implemented. ‘‘(2) CERTIFICATION.—The certification re- of 1986 without regard to— ‘‘(e) IMPLEMENTATION; REPORTS TO CON- ferred to in paragraph (1) is a certification ‘‘(A) paragraph (1)(C) thereof, and GRESS.— by the Secretary to Congress that— ‘‘(B) so much of paragraph (1)(D) thereof as ‘‘(1) IMPLEMENTATION.— ‘‘(A) the service availability, rationing, relates to qualified long-term care insurance ‘‘(A) INITIAL PERIOD.—The program estab- and wait times for existing health services contracts. lished under this section shall begin not within the Service are—

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00006 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S999 ‘‘(i) acceptable to Indians; and that have to happen for us to live up to and this is an important thing—the ‘‘(ii) comparable to the service availability the commitment that we have made to conservation of health; in other words, and wait times experienced by other resi- Native Americans. the prevention of disease, which Chuck dents of the United States; and The myriad of problems facing Indian Grim was just starting to get into, but ‘‘(B) the provision of services under this we do not have the funding to do it the section will not divert resources from or neg- health care in Indian country are many atively affect the provision of basic medical of the same issues that are facing way we need to do it. We know the and dental services by the Service. health care delivery throughout rural manifestation of diabetes and addic- ‘‘(d) DEFINITIONS.—For the purposes of this America. They are compounded, how- tion and hypertension and heart dis- section, ever, in this system by a system that ease among our tribal members is high- Mr. COBURN. Let me start by say- refuses to recognize its own role in er than any other group in our country. ing, improving the health care of Indi- holding back health care delivery for Yet the conservation of health has not ans in this country is a widely sup- Native Americans. been exploited, the paradigm shift that ported goal. Senator DORGAN’s heart is In designing health care reforms, has to happen in Native American care in the right place on this issue. He markets work when they are allowed to where we go to prevention instead of knows the problems we have, and he to. They lower the price of all goods treatment of disease. It is not in here. spent countless hours trying to get to and services, and they attract much We are not doing it. this point with this bill. I do not want needed outside investment. Many Last year, we spent $3.18 billion to be seen—I have told him, and I com- tribes in Oklahoma are at the forefront doing this. If we just funded it at the mitted to him my goal is not to block of new and innovative health care de- level we fund per capita veterans care, his progress on this bill. livery systems. They are poised to be- we should be funding $6.5 billion in Na- However, I believe this legislation as come a model for delivery throughout tive American health care. That is just drafted does not fix the underlying the system. on a per capita basis, let alone any problems. He and I have had several Congress must ensure, however, that structural changes on how we might conversations about that. It does not their efforts are not discouraged or make preventative care, quality care, fix rationing that is going on today. It stopped altogether by the current sys- timely care, and compassionate care a does not fix waiting lines that are tem. Furthermore, there is no good part of Native American care. But we going on today. It does not fix the infe- reason that forward-thinking tribal are not doing that. Indians in compari- rior quality that is being applied to a governments should not be prevented son with the general population are 6.5 lot of Native Americans and Alaskans from developing market-driven health times more likely to die from alco- in this country. It does not fix any of care centers of excellence that will at- holism. That is a disease we need to be those problems. In fact, it authorizes tract researchers, physicians, and pa- preventing. That is a health care prob- more services without making sure the tients for cutting edge lifesaving treat- lem. They are six times more likely to money is there to follow it. The aver- ments. We do not do that in this bill. die from tuberculosis, a preventable age Native American in this country Furthermore, this legislation fails to disease; three times more likely to die has $2,100 per year spent on them. focus on empowering individual tribal from diabetes, a controllable and now Now, let’s put that in perspective. members. Individual patients tend to preventable disease, it is a preventable The average veteran we take care of receive better care and more effective disease; 2.5 times more likely to die has $4,300. The average individual per care when they are empowered to make from an accident. person, per capita, expenditure in our their own health care decisions. Con- Now, how can we look those statis- country is $7,000. Yet we are going to gress should explore ways to accom- tics in the face and say we have met pass a bill that does not fix anything. plish this objective and give tribal citi- our treaty obligations? We have failed. It does not fix the real problems about zens a reason to invest in their own We have absolutely failed. Only 71 per- addressing the No. 1 problem which is, health. Long lines, bureaucratic head- cent of Native Americans receive pre- we are not sending enough dollars to aches, and rationed substandard care natal care. That means one out of four meet the treaty obligations that we completely disallow this sort of invest- Native American moms who get preg- have with Native Americans. So really ment. That is what we have. nant do not have any prenatal care. We what this bill is, it is called the Indian Our Chairman has been on the Senate ought to be ashamed. We have failed. We have failed. Health Care Improvement Act, but it floor multiple times showing how we Eighteen percent of Native Ameri- improves our position with tribes be- are rationing care, how we have lines, cans who are pregnant smoke. That is how we do not give quality care, how cause we have done something, but it twice the rate of others. Where is our we take contract health care—it runs does not improve health care. It is not prevention? Where is our education? out in 4 or 5 months. And so what hap- going to improve health care. It is Where is the priority on what we can pens? People who need care do not get going to increase the availability of do something about? services without the money, without it, and we have not fixed that in this American Indians suffer from a great the control, without the quality, with- bill. Yet we are calling this health care death rate from chronic liver disease out eliminating the waiting lines. improvement. and cirrhosis. It is 22.7 per 100,000. That As a matter of fact, it is going to add The health care status of tribal mem- is twice what it is for Whites and three to the waiting lines as I read this bill, bers ranks below the general popu- times what it is for African Americans as somebody who is somewhat experi- lation. The Federal Government has in this country. We know what causes enced in medicine. Those who say a been providing health care to tribal it. We do not put the dollars there. We failure to reauthorize the Indian members for 175 years. The first time have not put in a streamlined preven- Health Care Improvement Act is a vio- was to give them a smallpox vaccine in tion program. lation of our trust obligations are cor- 1807. That is when we started Indian My words are harsh. They are not in- rect. However, I believe simply reau- health care. And what we are doing tended for either the chairman or the thorizing this system with minor modi- today in comparison to what our trea- ranking member. I passionately care fications is an even greater violation of ty obligations are—in comparison, it is that we meet our commitments, and so that commitment. It is a greater viola- the same thing we are doing to the vet- I do not want you to take the words I tion. Dozens of tribal leaders are not erans when we tell the veterans: We are say as directed toward you because I expressing enthusiasm for the current going to give you health care and do know you care as well. structure. not give it. It is the same thing we tell Where we have a difference is in the Chuck Grim, an Oklahoman, head of schools: We are going to have an IDEA ‘‘now.’’ What do we do now rather than this service, knows what is broken. I program and then not fund it. It is what do we do later? I think we should have had lots of conversations with morally bankrupt legislation that does be doing it all now. I think we should him. We know what is broken, we know not meet the commitments that we say radically change how we approach our how to fix it, but we have to be bold in we have. obligations in Native American health how we go about fixing it. We are not The Snyder Act of 1921 provided a care in this country. bold in this. We are not changing it. We broad and permanent authorization for Rationing plagues Indian Health are not doing the structural changes Federal Indian programs, including— Services. It is rationed care. That is

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00007 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1000 CONGRESSIONAL RECORD — SENATE February 14, 2008 why it is not good care. That is why it cess because there is a distance to trav- stetrics and Gynecology is 14. We aver- is not consistent care. That is why it is el, we are going to see the same prob- age six with Native Americans. You not preventative care, because we don’t lem. Nobody is going to go until they can’t call that care. have the resources. We haven’t applied absolutely have to. So we lose the ben- Under an overburdened system such the resources to the need. Senator DOR- efit of prevention. as this, drastically expanded services GAN has had numerous hearings. He has Most of the facilities in this GAO re- to four broad new areas—and this is the spoken on the floor about this ration- port did not have the staff or equip- problem I have with this bill—will only ing crisis. But if we don’t radically ment to offer services onsite so they drain the resources available to the change the system, if we don’t change resorted to contract care. The contract basic core medical services. We are incentives in the system, improving care budget, of course, is small. So going to expand where we can offer new the old will just bring more failure. what happens? We ration contract care services. Many of these people are al- The job vacancy rate for dentists is at 12 of the 13 facilities. This idea of ra- ready eligible under Medicaid or Med- 32 percent. They don’t have 80 percent tioning isn’t a political statement; it is icaid anyway, but we are going to ex- of the nurses they need. They don’t a reality. We are not doing what we are pand it. What is going to happen is, the have 85 percent of the optometrists, committed by treaty to do. Now we are tribal government is going to offer the and they only have 86 percent of the going to bring a bill to the floor that service, and they are going to take the doctors, based on the present system. I doesn’t meet that commitment. We are money off the top. They are going to am proposing a better system with bet- still not going to meet the commit- put that into the rest of the tribal ter care based on prevention, a para- ment. We will improve it, but we need funds. So we are actually going to take digm that says it is a whole lot cheaper to overhaul it. We need a top-down, money out of dollars for health care for to prevent your illness than it is to complete change in how we approach tribal members by expanding care and treat it once you get it. It is common our commitment to Native Americans not making sure there are adequate to hear in Indian Country—and I have as far as health care. If we did that, we funds. heard the chairman say it—‘‘don’t get could offer a whole lot more care for a Making new promises, when we don’t sick after June. Contract money is whole lot less money. keep current ones, doesn’t help the Na- gone. If you get sick after June, noth- We have a bureaucracy that is stum- tive American population. Let’s keep ing will happen. You will not get the bling all over itself. We are spending the promises we have already made be- referral to the center to take care of money. I will get to the point on the fore we expand services and not throw you because we don’t have the money. number of bureaucratic positions in money at it. It sounds good. The tribes A quote from Dr. Charles Grim, who IHS that don’t deliver any care. Gaps like to hear what we are going to do. has been a stellar leader for the IHS: in services result in diagnoses and We are going to add these four services, We’re only able to provide a certain level treatment delays which, of course, but we are not funding the services we of dental services in certain populations. make the health of the patient worse are supplying now. Why would we add We’re only able to refer a certain level or and raise the cost. IHS reports that services knowing that? If we do it, we number or types of referrals with our con- their facilities are required to pay for are going to do it on the cheap. But it tract health service budget into the private all priority one services but admit that feels good because they think we are sector. . . . But I guess one generalized many of their facilities’ available funds doing something, when, in fact, we are statement would be that we have a defined are expended before the end of the fis- not fixing the problems. It is kind of population and a defined budget. . . . But it cal year and the payment isn’t made. like taking a loan out on a brandnew has led to rationing in some parts of our I experienced that in my own home- health care system. car when you can’t buy food. It is the town. People come to Hastings Hos- same thing. That is what we are doing Here is the former head of IHS admit- pital to deliver a baby. Our hospital ting we are rationing the care. When with these additional services. hasn’t been paid on contract care for The majority of the bill is more of we ration care, we don’t match up need years. So those in the rest of the com- the same. I have expressed to the chair- with resources. We say: Here are all the munity are going to pay for it. The man that I think we need to radically resources there are regardless of what problem is, there is no continuity in overhaul the care of Native Americans. the need is. We don’t get on the leading care. Prenatal care was provided. Now I will have a lot more to say. I do have edge on prevention. We don’t get on the all of a sudden you don’t have a record some complications with other com- leading edge on treatment because we and you have somebody you have to mitments in terms of markup. My staff are scrambling to keep the doors open. take care of, let alone that the private e-mailed me a moment ago that you How can we have a coherent, fair hospital that is there isn’t going to get have made some substantive changes in health care system when we are ration- paid for the service. Somebody is going the managers’ amendment on some of ing because the demand is so far great- to pay for the service, but contract the Medicaid and the tribal issues re- er than we are willing to supply the re- health care isn’t. So the fact is, one in lated to urban Indians. I will get with sources? four Native Americans in Alaska aren’t you and try to discuss that because it According to a GAO report in 2005, getting prenatal care. And we know the may affect some of my amendments. I health care services are not always risk. The average cost for a premature wasn’t aware of that until this morn- available to Native Americans. There baby is $250,000, let alone the con- ing. are wait times and insufficient care. sequence of the problems those kids I will have an amendment I will talk GAO visited 13 IHS-funded facilities in have. Why in the world would we ever about now. I don’t know that I will 2005 and found waiting times at four allow that to happen? It is akin to when I actually bring it back up. One range from 3 to 6 months to get in to pouring money down the drain because way to meet our commitment to Na- see anybody. Six months? That is we have not addressed prenatal needs tive Americans is to give them options. worse than England. What happens of Native Americans. According to CBO, the amendment I when you can’t get in? The disease gets Twenty-one percent of those who do will be offering costs no money. It is a worse. The complications are worse. get care have less than three prenatal zero cost. But what it allows Native The quality of the your health gets visits on average. That is one in four Americans is an insurance policy that worse. Also, the cost to meet the need has less than three prenatal visits. says you can apply this and go to any explodes. So what we have done is That is like not having prenatal care. Indian Health Service you want to or raised the cost of care. But more im- Yet we count that as if they had pre- anywhere else in the country you want portantly, we have failed on our com- natal care. What do we think the con- to, but you get to choose. The same mitment to provide health to Native sequences will be? The antenatal, post- dollars get spent, but the services will Americans. natal, and perinatal consequences to be far superior. Three IHS facilities had 90-mile one- the Native American population are There are two results. One, when we way visits to get into a clinic, many higher. The birth complications are do that, it makes the Indian Health without transportation available to higher because we are not doing the Service have to get more competitive. them. Three of these, the average was prenatal care. No. 2, and most profoundly, when we do 90 miles to get to a clinic. Even if they The average recommended prenatal that, we finally live up to our commit- have the resources and there is no ac- visits by the American College of Ob- ment that is embodied in every treaty

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00008 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1001 we have with Native Americans. Here for deserve better than is in this bill. hypertension have not been managed, is the real care. It is not rationed. It is Actually, I believe Chairman DORGAN thinks we can wait. not limited to contract funds. You believes that too. He believes this is a The body will probably think we can don’t have to get in line to wait in line. stepped process. They deserve a choice. wait. But I think we have a moral obli- You don’t have to get an appointment They deserve the security to know gation to meet our commitments, and to get an appointment. You don’t have they can get health care when they that means radical change. When you to travel 90 miles, if you don’t want to. need it. They deserve quality. They de- have a cancer, you do not treat it You don’t have to have your care ra- serve the health care outcomes the rest lightly. You go in, you cut it out, you tioned. And at no cost increase to the of this country enjoys that they pres- treat it, you follow it, and you aggres- Indian Health Service, we can give Na- ently do not have. sively change things so you make an tive Americans their own health insur- Throughout this debate on this bill, impact in the quality of that person’s ance policy which gives them freedom, you will hear the same statistics on ra- life. dignity, and choice. tioning, wait lines from both the I think we have to do better. I appre- I know that will be controversial. It Democrats and Republicans. We see it. ciate the efforts of the chairman and is not controversial with any Indian I We know it is there. Some will argue it ranking member. My hope is we will have talked to. It is controversial with is a solution that just involves passing live up to our obligations. tribal leaders because it takes the this bill that has new programs. Every With that, I yield back the floor. dominance of tribal leaders away and time we pass an Indian Health Care Im- The ACTING PRESIDENT pro tem- gives freedom to members of the tribes provement Act bill, we cite the same pore. The Senator from North Dakota. to whom we have made a commitment terrible statistics. We pass the bill be- Mr. DORGAN. Mr. President, the for health care. cause we need to do something. But Senator from Oklahoma cannot pos- So as we offer that amendment and each time we pass the Indian Health sibly win a debate we are not having. I look at it, I know there will be objec- Care Improvement Act, Indian health have given his speech 17 times on the tions, but it does—most importantly, care does not improve. floor of the Senate. There is no dis- with the same dollars—allow us to ful- What does that mean? We pass an In- agreement between us. I am going to fill a commitment we are not fulfilling dian Health Care Improvement Act, give him a chance to be bold, however, today. It allows a pregnant Native but Indian health care does not im- as we go down the road on appropria- American to have 14 visits, allows her prove. Indian health care never im- tions because that is what he started to have the same care anybody else proves because we never fix the ineffi- talking about: the need for the re- would have. It allows us to get better ciency that plagues the IHS. We just sources, the need for the money. We outcomes. It allows us to get a patient reauthorize and add new regulations, have to reform this system. I agree into an endocrinologist, where they new obligations to the same dinosaur. with that. Then we have to fund it. The will manage their diabetes so they will Now, the statistics I was referring to fact is, we are going to have amend- not have complications. Kidney failure earlier: The Indian Health Service has ments that add sufficient money. You is twice as high in this population as 14,392 employees, including 2,192 com- talk about the fact that we are spend- anybody else. Why? Because diabetes is missioned officers; the latter COs in- ing twice as much per person on Fed- not managed. How many of you have clude 8 Assistant Attorneys General, eral prisoners for health care as we are gone into a dialysis center and watched 439 director grade individuals, 601 sen- to meet our responsibility for Amer- people sit there for 8 hours a day, ior grade individuals. The salaries for ican Indians—twice as much for those chained to a machine to keep them the COs total $135 million. The salaries we have incarcerated because we have alive, because we didn’t keep our com- for all other IHS employees is esti- a responsibility for their health care. mitment by having the dollars there to mated at $655 million. The IHS spent Now, we need additional money in prevent the complications of diabetes? $33.7 million on travel last year. On this system, and we need an overhaul This gives an equal ranking to a Na- travel? Think about what $33 million of the system itself. The Senator will tive American as a Member of Con- could do in terms of prevention for the find no controversy with me with re- gress. You can have preventative care complications of diabetes for American spect to giving American Indians a for your diabetes so you don’t end up Indians and Native Alaskans. card to show up at a health facility and on dialysis or with an amputation or The other significant thing is, IHS get the health care they need. He losing your vision. It offers them hope. carried, in 2005—I do not have the num- knows, and I know, there are many It offers honor and integrity because ber for 2006 or 2007 yet—their obligated American Indians who live far out on a we finally keep our commitments. balance at the end of the year was $162 reservation, 90 miles away from the I wanted to talk about a couple other million. Just efficiency in how we nearest hospital, and they do not have things and then I will close and come spend the money could improve health competition in the health delivery sys- back. I appreciate the chairman giving care in Indian Country. tem. They have one place to go when me this time. As Congress discusses In- I say to the Senator, Mr. Chairman, I they are sick that morning or their dian health care over the next several appreciate your efforts. I know you are child is sick that afternoon. days, America as a country should take truly committed to trying to make a So we are going to have a chance to note of what a single-payer system difference. I believe we need to be bold. be bold. This is an authorization bill, means in terms of the quality of care I believe we have an obligation to do not an appropriations bill. When appro- we can expect. America should not go better. I believe this is short of the priations come up, we will have a the route of a single-payer system. mark. So I am going to be voting chance to be bold. I hope the Senator That is what we are seeing. That is against this bill. I am going to be offer- will join me on that. what we have in IHS. It is a single- ing amendments to try to make it bet- Let me make a couple comments payer system. The promise sounds al- ter. I say to the Senator, I know in the about this issue. luring, but the reality is inevitably long run you and I have a lot of com- Mr. COBURN. Mr. President, will the negative. It is negative in terms of pre- monality in how we go about trying to chairman yield for a couple moments? vention. It is negative in terms of care. solve this problem. Mr. DORGAN. I am happy to. It is negative in terms of complica- I do not think Indian Country can Mr. COBURN. Mr. President, I wish tions. It is negative in terms of innova- wait for us to come back. I do not to make a couple comments, and then tion. It is negative in terms of the par- think the lady who gets on a dialysis I have to go to a markup. adigm of prevention. machine today for the first time thinks You will find me an ally on appro- Second, fixing the system for our Na- we can wait. I do not think the lady priations if we have the courage to tive Americans demands more than who pops into the delivery room who make priority choices on where we adding more new programs and serv- has not had any prenatal care thinks fund money. You know that. That has ices. We need a fundamental overhaul we can wait. I do not think the person been my history. But we do not have of the system. The Members of feder- who ends up with coronary artery dis- extra money, so that means we have to ally recognized tribes whom we have a ease at 40 years of age, because their take it from something else. My goal trust obligation to provide health care diabetes and their cholesterol and their will be that we take from the waste we

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00009 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1002 CONGRESSIONAL RECORD — SENATE February 14, 2008 all know is there and we put it to the Ta’shon Rain Littlelight got sick, ice, and the Indian Health Service doc- commitments. and they took her to the health clinic. tor says: ‘‘Wrap it in cabbage leaves for So I look forward to that debate. I They treated her for depression. Again 4 days.’’ That is Indian health care. think you are right. I think we need to and again, they treated her for depres- That is unbelievable, just unbelievable up the ante, and we need to add the sion. Even her grandparents said: Well, to me. money. But there is plenty of money the way her fingers look, with the My colleague from Oklahoma says, for us to go get, and I hope the chair- swelling of the fingertips, and so on, well, he does not support this bill be- man will help me go get it so we can there must be something else wrong. cause it is not bold. I have been on the put it there. Well, one day, of course, they had to floor of the Senate. I have offered Thank you. fly her to Billings, MT, and then imme- amendments to add $1 billion to Indian Mr. DORGAN. Mr. President, I cer- diately fly her to Denver, CO, where health care, and it gets defeated. I have tainly will do that. they discovered she had terminal can- seen the budget that came last week It is interesting, we are spending $16 cer and about 3 months to live. from this administration that says billion a month, $4 billion a week to re- She asked if she could go see Cin- they want less money for Indian health plenish the accounts for the war in Iraq derella’s Castle, so Make-A-Wish gave care. and Afghanistan and other issues. her the opportunity, with her mother, Let me put up something Chief Jo- There are plenty of places for us to de- to go to Orlando, FL, to see Cin- seph said years and years ago. We took cide it is time to fix things here at derella’s Castle. This little girl with all this Indian land, took all those mil- home. terminal cancer, the night before she lions and millions of acres—hundreds But I wish to talk about a couple of was to see Cinderella’s Castle, in the of millions of acres—from the Indians, issues. First of all, there are waiting motel room in Orlando, FL, told her but we said to them: Trust us. We will lines. There is rationing. The Senator mother, ‘‘I am so sorry. I am going to make you a promise. We will sign trea- from Oklahoma is absolutely correct. try to be better, Mommy. I won’t be ties. We will tell you that we will pro- vide for your health care. We believe Dr. Grim, by the way, came to the sick anymore.’’ And she died in her we have a trust responsibility. You can Committee in support always of the mother’s arms that night. This little 5- President’s request, saying that was trust us. year-old died because the system did Well, regrettably, that responsibility enough because he had a responsibility not work. has not been met. Those promises have and a requirement to support the I have shown a picture of Avis not been kept. Here is Chief Joseph. He President’s budget. But get him off the Littlewind. She was 14 years of age, said: dais at the hearing and ask him the lying in a fetal position in a bed for 90 Good words don’t last long unless they question, and he would admit there is days and then finally took her own life amount to something. Words don’t pay for rationing. About 40 percent of the because there was no mental health my dead people. . . .Good words cannot give health care that is needed by American treatment available on that reserva- me back my children. Good words will not Indians is not available. That is health tion—no mental health treatment give my people good health and stop them care rationing. That would be scan- available to try to help that little girl from dying. dalous if it were happening in other who felt hopeless and helpless. I care a lot about this issue. In my parts of the country. It ought to be This is a photograph, by the way, of State, we have four Indian reserva- front page headlines, but you will not Avis Littlewind on the Spirit Lake Na- tions. I have spent a lot of time with hear and you will not read many sto- tion Reservation. Avis was 14, and she them. The fact is, we have people living ries about it, regrettably. took her life. Her sister took her life. in the shadows. We have people living But the fact is, we have a cir- Avis took her life. in abject, desperate poverty. cumstance that brings tears to my This is a photograph of Ardel Hale I sat with a young girl once at a eyes. I disagree with the Senator from Baker. Ardel Hale Baker was having a table with her grandfather. This was a Oklahoma that this is not a worthy heart attack, diagnosed as having a young girl who was put in a foster bill. This is a step forward in the right heart attack on an Indian reservation. home at age 3. The woman who put her direction. It is not the reform we need, They wanted to send her to a hospital in a foster home was working 150 but this is a two-step process. If you an hour and a half away. She did not cases—150 cases. She did not have time cannot get this kind of thing done for want to go in the ambulance because to go check out the home, so she put a 10 years, how on Earth are you going to she knew if it did not get paid some- 3-year-old girl in a foster home. And on decide to do something much bolder? how, she would have to pay it, and she a Saturday night, in a drunken party Now, we just faced a budget that did not have any money. They put her brawl, a young 3-year-old girl got her came up last week that says not only in an ambulance anyway and took her arm broken, her nose broken, and her hair pulled out by the roots. That do we not have enough money for In- to the hospital. As Ardel Hale Baker young girl will live forever with those dian health care, let’s cut it. The Presi- was being taken off the gurney in the emergency room in the hospital, to be scars. dent says, let’s cut what we do have, at One hundred and fifty cases a social put on a hospital gurney, here is what a time when we have 40 percent ration- worker is dealing with? There is such was taped to her thigh—a piece of ing. So we are fighting a battle just to unbelievable difficulty because the re- keep the money we have. We need paper taped to the thigh of this Indian sources do not exist. We have people much more if we are going to do what woman; and it was to the hospital from living in Third World conditions. we promised we were going to do. the Department of Health and Human We had a tribal leader, a chairman of But let me show the Senator a photo- Services—it was saying, by the way, a tribe, say: ‘‘My two daughters live in graph, if I might. Let me show him a ‘‘If you admit this woman, understand used trailer houses that we moved from photograph of Ta’shon Rain Littlelight there is no money in contract health Michigan to the reservation in South because he says the system does not care to pay for her,’’ warning the hos- Dakota. They don’t have indoor plumb- work. I showed the photograph before pital: ‘‘Admit this woman and it is ing. They have an outdoor rest room, because her family has given me per- very likely you will not be paid.’’ This outdoor toilet. One of them has a wood mission. This beautiful young 5-year- woman is having a heart attack, and stove in the living room of the trailer old girl is dead. She is dead, in my shows up with a piece of paper taped to house vented out through the window.’’ judgment, because of a system that her leg, saying: ‘‘There is no money for I have seen all of these things. I have does not work. you to be paid, if you admit this experienced all of this. My colleague They took her again and again and woman to your hospital,’’ or the has seen the same in Alaska. We have again and again to the clinic. It was on woman who goes to the Indian Health people living in Third World conditions the Crow Reservation in Montana, Service with a knee that is so painful in this country. There is a full-scale, where I held a hearing and her grand- she cannot walk. It is bone on bone; an bona fide crisis in health care, housing, mother stood up with this photograph. unbelievable problem with her knee and education. This bill deals with the She told about little Ta’shon Rain that you or I or our family would get question of health care. We have a spe- Littlelight. You can see she loved to fixed by having a new knee joint put cial responsibility, unlike other re- dance. in. She goes to the Indian Health Serv- sponsibilities, because this country has

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00010 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1003 promised. We have signed treaties. The no contract health care. It has com- tentious issues that have bedeviled Supreme Court says we have a trust re- pletely ruined her credit rating because people on both sides of the aisle for sponsibility. We have not kept our she doesn’t have anything to pay for it, quite a long time. In the best spirit of promise, and we have not met our re- and the Indian Health Service did not working to get legislation accom- sponsibility. I am just flat tired of it. serve her needs. She was also treated plished in a bipartisan way, staffs from My colleague says: Let’s be bold. No- for depression. She had a heart valve the committee itself and the two Sen- body wants to be bolder than I want to problem that needed surgery, and she ators I mentioned and my staff and be, but we haven’t been able to get a was treated for depression. When she fi- others rolled up their sleeves, sat bill through here in 10 years, for God’s nally found a way to get the surgery, it down, and have worked out very satis- sake. If you can’t pass a bill in a dec- could not be paid for by Indian con- factory resolutions to three big prob- ade, how on Earth are you going to be tract health because they were out of lems that previously existed. As far as bold? Let’s at least take a step in the funds. ‘‘Don’t get sick after June.’’ We I know now, those issues are totally re- right direction. I am going to follow had one reservation tell us, don’t get solved, language is ready to be sub- that with step 2 on the Indian Affairs sick after January, because they didn’t stituted into the bill, and it represents Committee, and that is bold, dramatic have the money. This poor woman sat a real achievement to try to move this reform, because this system is not there in the chair sobbing as her sister bill forward. I appreciate their coopera- nearly as good as it can be. recounted the details of her desperate tion, and I commend the others who He talks about: Why would you add attempt to deal with a health care have worked on it as well. new services? Well, services dealing problem that was very acute. I must say also that I am looking for- with diabetes, with cancer screening, So, yes, I am a little bit emotional ward to working with the Senator from with mental health—let’s add those about these issues. When we have peo- North Dakota when he comes to the services because they are needed, and ple say, well, let’s do much more, I say: State of Arizona to address another then let’s decide, when the appropria- Absolutely. Let’s do much more than issue dealing with Indian Country; that tions bill comes around, to add the we are now doing. Let’s do that in ap- is, the deplorable state of law enforce- funding. My colleague knows this is an propriations. That is an awfully good ment, of facilities to deal with people authorization bill, not a funding bill. start. who are apprehended on Indian reserva- We will have a chance to be bold. Let’s This is an authorization bill which tions, and the staff to deal with those. see who is going to be bold. Let’s add does a lot more than the current Indian Crime is a huge problem, as is health the funding to keep our promises, for a Health Care Improvement Act. It does care, on our Indian reservations change. a lot more in areas we know are in ur- throughout the country. It is ne- My colleague talked a lot about Dr. gent need. glected. It needs more attention. I ap- Grim. I like Dr. Grim. He retired—re- We have teen suicide clusters on In- plaud the Senator from Alaska and the signed, I should say—from the Indian dian reservations. In the northern Senator from North Dakota for their Health Service. Dr. Grim came every Great Plains, there is a 10 times great- attention to this as well, and I look year, supporting the President’s budg- er rate of suicide among teenagers—not forward to working with them. et. He knew it was not adequate. We double, triple, or quadruple, but 10 Finally, I would note just on a per- know we are rationing health care. The times the rate of suicide. I went and sonal basis that a very good thing hap- fact is, we all know it. We need to stop sat and talked with kids on that res- pened to me because of the Indian it. Are we rationing health care with ervation, the one where we had a clus- Health Service, even though there are incarcerated prisoners in Federal pris- ter recently. It was just me with some a lot of improvements which need to be ons? No, we are not, because we have a high school kids, talking about what is made in that. Were it not for the In- responsibility for them. We arrest going on, what is their life like. It is dian Health Service, I probably them, we convict them, we send them unbelievable. wouldn’t be married to my wife right to prison, and then it is our responsi- We need to address these things. now. One might say: How on Earth did bility to provide for their health care That is what we try to do in this Indian that happen? But it happened because in Federal prisons, and we do it. We Health Care Improvement Act. It is not her father was a pharmacist with the spend twice as much per person for perfect, but it is certainly a step in the Indian Health Service, and I had the them as we do for American Indians. right direction. good fortune of being assigned to Tuc- Yet we have the same responsibility for I have other things to say, and my son, AZ, to work on what was then American Indians because we made the colleague may wish to weigh in, as called the Papago Indian Reservation, promise, signed the treaties, and told well. My hope will be at the end of the now the Tohono O’odham. As a result, them we would provide for these needs. day today that we will be able to get his daughter—now my wife—attended What gives us the right to continue to the amendments up and get them voted the University of Arizona, where we break our promises? We have done it on. Some of the amendments my col- met, and the rest is history, as they for decades and decades over almost 200 league described, I likely will support, say. So I have had some knowledge and years. What gives us the right to con- because I think we can improve this information about this for a long time. tinue to do that in the face of little piece of legislation. I think at the end I wish to make the point that there children who are dying and in the face of the day, all of us will hope we will are—and I know the Senator from of elders who can’t get health care? have done something we are proud of, North Dakota and the Senator from What gives us that right? to say to those who don’t now have Alaska agree with this—thousands of I say to my colleague, if you want to adequate health care or whom we dedicated personnel who are serving be bold, we are going to have a chance promised health care that we have our Indian community throughout all to be bold together, because this coun- made a step forward in trying to meet of our States under great difficulty. try ought to stare truth in the face and those needs. The working conditions are not good, look at what is happening on Indian Mr. President, I yield the floor. but the professionals are very profes- reservations. The ACTING PRESIDENT pro tem- sional. They are very good. They are The other night, I was on an Indian pore. The Senator from Arizona is rec- dedicated and really work hard on be- reservation, having a listening session ognized. half of our Native American citizens. It with Indians. There were two sisters Mr. KYL. Mr. President, let me make is as much to give them the resources sitting in the front row. One sister just a few comments in response to the they need as well as to help those stood up to speak, and the other sister Senator from North Dakota. whom they serve to get this legislation sobbed uncontrollably—cried and First of all, I commend him for his adopted and move the process forward. sobbed. It was an unbelievable story work on this bill, as well as the Sen- So I compliment those who have been about the sister who desperately need- ator from Alaska, who has worked very working on this important legislation ed health care and couldn’t get it and hard to get this bill in a position where and hope that in the remainder of this couldn’t find it. She finally had her it could be brought to the floor and day—and I will make this point to my heart surgery, and of course it was considered by this body—in particular, colleagues—that if you have amend- charged back to her, because there was in helping to work out some very con- ments you think would improve this

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00011 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1004 CONGRESSIONAL RECORD — SENATE February 14, 2008 legislation, please bring them to the Senator BARRASSO yesterday brought It has been mentioned we have not floor so that we can complete work on forward an amendment that asks for a reauthorized the Indian Health Care this legislation, so that we can take GAO study to look to the efficiency. Improvement Act in some 10 years. the amendments up and we can dispose There are some other amendments that Think about what has happened in this of them. Based upon the work we have have been introduced that also task us country in terms of health care and done in the past, I think it is quite pos- with evaluating to make sure we are how we provide health care, how we sible that a lot of good suggestions can doing right by the programs that are focus on prevention in the last 10 be considered by staff and eventually put in place, how the funding is di- years, the technologies that are made Members and perhaps adopted without rected to them, and are we doing what available to us, and also the areas of the need to take up the full Senate’s we need to be doing. I think it is fair to focus. Behavioral health is something time. But, in any event, bring your say that we recognize it is not suffi- about which in my State of Alaska we amendments down here so we can move cient, it is not enough. We do need to have been forced to be innovative. We this legislation forward as soon as pos- be doing more, and certainly, as the do not have the psychologists and the sible to do so. chairman of the Indian Affairs Com- psychiatrists who are available in all of The ACTING PRESIDENT pro tem- mittee has mentioned, we have to put our little communities. We have been pore. The Senator from North Dakota our money where our mouth is. We forced to utilize a telehealth system, is recognized. have to put our money toward those and we are absolutely making some re- Mr. DORGAN. Mr. President, let me programs. We have to make sure we markable progress. But through this thank the Senator from Arizona. He put the resources there to make the Indian Health Care Improvement Act has been working very hard with us to difference. and what we are allowing for, we can try to move this bill along. I would say The Senator from Oklahoma spoke allow for expanded opportunities to to my colleagues on this side of the about the rationed care. It is not ra- help, such as in the area of behavioral aisle as well: If you have amendments, tioned care because we just don’t want health. I have a whole list of other programs please bring them. The majority leader to give it; it is rationed care because of that are also included—programs to has indicated we are going to finish the lack of resources, and that is very control blood pressure, immunizations, this bill this week, and that will be a real and something that must be dealt youth suicide prevention, injury pre- significant step forward. I thank the with, and it must be dealt with in a Senator from Alaska and the Senator vention, sudden infant death syndrome very strong way. training, tobacco cessation programs. from Arizona for their work to help us The Senator from Oklahoma really These are all programs that go right to move this bill. He is correct that we spoke as well to the issue of preven- the heart of prevention. These are ini- had four or five very controversial tion, and it was his opinion in his com- issues that provoked some opposition. tiatives that will help us reduce our ments that this Indian Health Care Im- costs, that will help us keep people We worked through those, negotiated, provement Act doesn’t go far enough, and I think all of them are now re- from becoming ill in the first place, that we need to be doing more in the keep people from losing a limb due to solved. area of prevention. He speaks to a part I think when the Senator from Alas- diabetes, keep young people from hav- of me that I feel very strongly about. ka has completed any statement she is ing to live a life afflicted with FAS or When we talk about health care in this going to make, we do have the man- FASD. country, whether it is in Indian Coun- agers’ amendment that amends the There are initiatives contained with- try or in the United States as a whole, substitute we had offered, and that has in this legislation that need to be au- it has been referred to as not a system been negotiated and agreed to on both thorized, need to be updated and in- of health care, it is a system of sick sides. So when Senator MURKOWSKI has cluded to allow American Indians and completed her statement, we will ask care. We take care of you after you are Alaska Natives the same opportunity that it be completed as well. sick. It is no different within the In- for preventive care that we find wher- The ACTING PRESIDENT pro tem- dian health system. That does have to ever we go in the country in a commu- pore. The Senator from Alaska is rec- change. We must focus on the preven- nity hospital or in the clinic down the ognized. tion. We know this. We are seeing this. street. We have to make sure these pro- Ms. MURKOWSKI. Mr. President, I We are working here in the Congress to grams are included. understand that the Senator from Or- change those policies to help put great- Mr. President, I see Senator SMITH egon, Mr. SMITH, is on his way to the er focus on prevention because we has arrived. In recognition of his time floor, so when he arrives, I will yield know for a fact that we can reduce limitations today, I yield to him so he such time to him as he needs. I know costs if we focus on prevention. can speak to an amendment he is pro- he wants to speak to an amendment. Now, the Senator from Oklahoma has posing. I wish to take just a couple of min- indicated that there isn’t enough here The PRESIDING OFFICER (Mr. utes this morning to respond to some in the Indian Health Care Improvement KOHL). The Chair recognizes Senator of the comments made by the Senator Act in the area of prevention. I want to SMITH. from Oklahoma. Clearly, he is very mention some of the initiatives that AMENDMENT NO. 3897 TO AMENDMENT NO. 3899 passionate about Indian health care are included in the legislation that will Mr. SMITH. Mr. President, I ask and making sure that we do right by make a difference, that will reduce unanimous consent to call up for con- our treaty obligations and that we do health care costs, and that will provide sideration amendment No. 3897. right by all American Indians and for greater access. It is in the area of The PRESIDING OFFICER. Without Alaska Natives when it comes to their prevention. objection, it is so ordered. health care needs. He cited some of the Diabetes—we have all listened to the The clerk will report. The assistant legislative clerk read obvious. Unfortunately, the statistics stats. They are absolutely unaccept- as follows: are real. In fact, the statistics may be able. We have to be doing more when it even more devastating than he has in- comes to diabetes prevention. We must The Senator from Oregon [Mr. SMITH], for be doing more to keep the elderly himself, Ms. CANTWELL, Mr. WYDEN, Mr. dicated because we know that a lot of CRAPO, and Mrs. MURRAY, proposes an times our statistics aren’t as reliable woman whom he was discussing off of amendment numbered 3897 to amendment as we may want, and, in fact, they are the dialysis machine. We have to have No. 3899. worse than what we have seen. the focus there. So included within the Mr. SMITH. Mr. President, I ask When he spoke to prenatal care, legislation is a focus on diabetes pre- unanimous consent that the reading of when he spoke to the incidence of dia- vention. the amendment be dispensed with. betes and substance abuse and suicides, We also look to the issue of domestic The PRESIDING OFFICER. Without we know they are horrific statistics. violence and sexual assault. Again, in objection, it is so ordered. We recognize we must do more. I, too, these areas, our statistics with our The amendment is as follows: applaud him for bold action, for reform American Indians and our Alaska Na- (Purpose: To modify a provision relating to in a system that has been unwieldy and tives are absolutely unacceptable. Are development of innovative approaches) bureaucratic and stovepiped in so we doing enough in the area? No, we Strike subsection (f) of section 301 of the many areas. need to do more. Indian Health Care Improvement Act (as

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00012 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1005 amended by section 101) and insert the fol- amendment is just that: a good-faith tionately affect Native Americans—di- lowing: compromise that will provide equity to abetes, alcoholism, suicides that result ‘‘(f) DEVELOPMENT OF INNOVATIVE AP- the health facility system. It does so from mental disorders, and so many PROACHES.—The Secretary shall consult and others. The purpose and the mission of cooperate with Indian Tribes and Tribal Or- by providing the Indian Health Service ganizations, and confer with Urban Indian the authority to use an area distribu- this bill is to connect those cures with Organizations, in developing innovative ap- tion fund which would allocate a por- those who need it most, those who have proaches to address all or part of the total tion of health facility construction sought it longest, and through the dis- unmet need for construction of health facili- funds to all 12 Indian Health Service mal chapters of our Nation’s history ties, that may include— areas to improve, expand, or replace have a unique claim to those cures and ‘‘(1) the establishment of an area distribu- existing health care facilities. treatments. tion fund in which a portion of health facil- This area distribution fund is not the I urge the adoption of this amend- ity construction funding could be devoted to idea of a single Senator or a single re- ment. all Service Areas; gion of the country. It is the product of I yield the floor. Mr. President, I sug- ‘‘(2) approaches provided for in other provi- gest the absence of a quorum. sions of this title; and years of work and compromise by the Indian Health Service and tribes and The PRESIDING OFFICER. The ‘‘(3) other approaches, as the Secretary de- clerk will call the roll. termines to be appropriate.’’. after Congress recognized the need to create a more equitable facilities con- The legislative clerk proceeded to Mr. SMITH. Mr. President, I rise call the roll. today to speak in favor of reauthor- struction system. The current system has been locked Mr. COLEMAN. Mr. President, I ask izing the Indian Health Care Improve- unanimous consent that the order for ment Act. I begin by thanking Chair- into place since 1991, and it will be over 20 or 30 years before funding will go to the quorum call be rescinded. man DORGAN and Ranking Member The PRESIDING OFFICER. Without new projects. I do not see how that is MURKOWSKI for their leadership and for objection, it is so ordered. fair and equitable if we have an obliga- building on the momentum from the Mr. COLEMAN. Mr. President, I rise tion to all. in support of the Mikulski-Coleman- last Congress to reauthorize this very Sadly, this has resulted in wide dis- Klobuchar amendment to place a mora- important and overdue reauthorization parities in the level of health services torium on CMS’s December 4 rule on of this act. provided to tribal communities across Like most of my colleagues, I feel Medicaid case management services. the country. I believe this amendment that passing this legislation is critical Last night, Senator MIKULSKI—and I represents a rational middle ground on and it is about time. Since passage of joined with her—and Senator KLO- this issue. BUCHAR offered this case management the act in 1976, this legislation has pro- I also want to highlight that this legislation as an amendment to the In- vided the framework for carrying out compromise language is supported by dian health bill being debated on the responsibility to provide Native Ameri- regions of the country with nearly 400 floor. cans with adequate health care. As we of the 561 federally recognized tribes know, the act has not been updated in I begin by saying I fully understand that reside in 23 States. Those folks are the fiscal challenges our entitlement 16 years despite the growing needs out if this does not pass. among Native Americans. We cannot programs face, and I look forward to I also want to add that it is not my the day when we can put politics aside allow the health of this population to intention to rob one IHS area to pay remain in jeopardy any longer. and have an honest and productive dis- another. I believe that an area dis- cussion about how to preserve these Today, funding levels meet only 60 tribution fund works best when and if percent of the demand for services each programs for future generations. I funding for IHS is expanded. We simply think we can all agree that the goal of year which requires the Indian Health have to enlarge this pie so we are not Services tribal health facilities and that conversation is to find a delicate disadvantaging any tribes in the balance between fiscal responsibility urban Indian health care providers to Southwest of our country, but we must ration care, resulting in tragic denials and making sure our Nation’s most not abandon, as we have been, the vulnerable populations still have ac- of needed services. tribes all over the rest of the country. Speaking of the urban Indian health cess to the health care services they so That is why I asked my colleagues to desperately need. Unfortunately, when programs, reauthorization of the act join me in sending a letter to the ad- will facilitate the modernization of the it comes to the case management rule, ministration seeking a 15 percent in- while I support CMS’s intent to cut out systems, such as prevention and behav- crease in IHS funding for fiscal year wasteful spending, it is clear to me ioral health programs, for approxi- 2009. I hope we are successful in this ef- that it fails to achieve this delicate mately 1.8 million Native Americans. I fort. But regardless, we must take balance. sincerely hope we can pass this legisla- steps through this bill to establish a I cannot think of a better way to de- tion and send it to the President for his fairer system—just a fairer system—to scribe case management than to say it signature. distribute Federal funding. is the glue that holds together our Na- Although this bill makes vast and If we are sincere about the title of tion’s Medicaid system. In my home necessary improvements upon existing the legislation at hand—of better meet- State of Minnesota, I have consistently law, it is not perfect. Currently, the ing our statutory, our treaty, and our heard from social workers, county su- vast majority of Federal funding for moral obligations to improve the pervisors, health care providers, and construction and modernization of health care of all Native Americans— others about how devastating this new tribal health care facilities goes to then my amendment should be adopt- regulation will be for at-risk individ- tribes in less than 10 States. Unfortu- ed. uals and families. nately, this bill maintains that in- I ask my colleagues to support this Suffice it to say, when I travel equity among tribes by favoring con- amendment to ensure that all Native throughout Minnesota and I meet with struction in those few States. American Indians receive the health county commissioners, one of the first I offered today an amendment with care they need, they deserve, and what things they say to me is targeted case Senator CANTWELL that will correct we have promised. management and they raise the deep this problem and instill equity among I close with a quote from Morning concern that the proposed CMS rules all of the Native American tribes. Dove, the literary name of Christine will have on their ability to service This concern is particularly relevant Quintasket, a Sa-lish tribal woman needy individuals in my State. I sus- in my home State of Oregon which is 1 from the Pacific Northwest, now recog- pect if my colleagues across the coun- of over 40 States that have never—I re- nized as the first Native American try talk with a county commissioner, peat, never—received funding to build woman to publish a novel. She wrote: this is what they are going to hear. an Indian Health Service hospital. Everything on the earth has a purpose, I hear that without comprehensive Since the beginning of last year, I every disease an herb to cure it, and every case management services, millions of have worked with my colleagues to person a mission . . . this is the Indian the- Americans with mental illness will not find a compromise to resolve this issue ory of existence. be able to access the treatment medi- in a way that is not detrimental to any There are, indeed, cures and treat- cations they need to survive; that peo- region of the country. I believe my ment for the maladies that dispropor- ple living with disabilities will find

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00013 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1006 CONGRESSIONAL RECORD — SENATE February 14, 2008 themselves forced to remain in institu- sponsibility, but I cannot support re- The PRESIDING OFFICER. The Sen- tions instead of enjoying the dignity of forms that will have such a destructive ator from South Carolina is recognized. independent community-based living; impact on America’s foster care sys- Mr. DEMINT. Mr. President, I filed a that our most vulnerable children, tem. These children already have number of technical improvements to those in foster care, will be left alone enough obstacles to face. Let’s not this bill, which I wish to work on with to navigate a complex and often over- make their lives more challenging by the chairman to see if we can resolve whelming Medicaid system. taking away these critical case man- these without a vote. These are very That is why I introduced the legisla- agement services. small wording amendments, in some tion this amendment is based on, and I should note that this amendment is cases, that I would like the chairman that is why this legislation is not only fully paid for. Actually, the ‘‘paid for’’ and his staff to look at before I call cosponsored by 19 of our Senate col- is a key step forward in preserving our them up, because I think it is very un- leagues but also has the support of sev- entitlement programs. My investiga- likely we will need votes on these par- eral advocacy groups throughout the tion, as ranking member of the Perma- ticular amendments. country, including the Child Welfare nent Subcommittee on Investigations, AMENDMENT NO. 4067 TO AMENDMENT NO. 3894 League, Muscular Sclerosis Society, revealed that thousands of Medicare Mr. DEMINT. Mr. President, I call for National Alliance on Mental Illness, providers who are supposed to be serv- the regular order with respect to the National Council for Community Be- ing our Nation’s elderly and disabled Bingaman amendment No. 3894 and I havioral Health, and many others. are, instead, cheating American tax- send a second-degree amendment to the All these groups recognize the dev- payers in order to line their own pock- desk. astating effect this regulation will ets. As a solution, a provision in this The PRESIDING OFFICER. The have on those most in need of impor- amendment will save American tax- amendment is pending. tant case management services. payers close to $160 million over the The clerk will report the second-de- Let me take a moment to highlight next 5 years by ensuring that CMS par- gree amendment. some of the fundamental problems with ticipates in the Federal Payment Levy The legislative clerk read as follows: this rule. This new regulation requires Program so that Medicare payments to The Senator from South Carolina [Mr. that case management services must these tax cheats can be levied. The ad- DEMINT] proposes an amendment numbered be delivered by a single case manager, ministration supports this proposal, 4067 to amendment No. 3894. which sounds reasonable enough. How- going so far as to include it in the 2009 Mr. DEMINT. Mr. President, I ask ever, we are talking about populations budget. unanimous consent that reading of the that can have up to four or five or six This amendment is simple. We recog- amendment be dispensed with. chronic conditions. If this rule is final- nize that we need to provide more di- The PRESIDING OFFICER. Without ized, it would require that a single case rection in case management services, objection, it is so ordered. manager provide quality case manage- but all we are asking CMS to do is take The amendment is as follows: ment services to a person who may be another year and work with Congress suffering with HIV, mental illness, and (Purpose: To rescind funds appropriated by and the relevant stakeholders to de- the Consolidated Appropriations Act, 2008, diabetes all at the same time. Should velop a reasonable rule that clarifies for the City of Berkeley, California, and we not have a health system that al- the scope of the case management pro- any entities located in such city, and to lows a team of specialized case man- gram but still provides the critical provide that such funds shall be trans- agers to work together to address each services our most vulnerable popu- ferred to the Operation and Maintenance, of these complex issues? lations rely on. Marine Corps account of the Department of Isn’t the kind of care, integrated care My father was a carpenter by trade. Defense for the purposes of recruiting) a key element of making sure our He told me always that we should At the appropriate place, add the fol- health care system is keeping people measure twice and cut once. In this lowing: healthy, not just treating them when case management program, what we SEC. ll. RECISSION AND TRANSFER OF FUNDS. they get sick? have is individuals working as a sys- (a) RECISSION OF CERTAIN EARMARKS.—All Another concern I have consistently tem to deliver, in the most effective of the amounts appropriated by the Consoli- heard is the new limitations on moving way possible, services to the neediest. dated Appropriations Act, 2008 (Public Law people from an institutional setting to 110–161) and the accompanying report for It makes sense. I understand their con- congressional directed spending items for a less restrictive community-based set- cerns. CMS in my State—and I suspect the City of Berkeley, California, or entities ting. Let me remind you that moving in Wisconsin, the State of the Pre- located in such city are hereby rescinded. people to community-based settings siding Officer—our folks do this well. (b) TRANSFER OF FUNDS TO OPERATION AND was a key recommendation of the CMS found out that, in fact, we are MAINTENANCE, MARINE CORPS.—The amounts President’s own New Freedom Commis- doing it well. We are doing what the rescinded under subsection (a) shall be trans- sion on Mental Health. Yet under this program is supposed to do, with very ferred to the ‘‘OPERATION AND MAINTENANCE, MARINE CORPS’’ account of the Department new rule, case managers would have little waste. If there is waste in other significantly less time to prepare peo- of Defense for fiscal year 2008 to be used for areas of the country, let us have a con- recruiting purposes. ple to move from an institution to a versation about it but don’t hurt the (c) CONGRESSIONAL DIRECTED SPENDING community. Let me also point out that neediest and penalize the States that ITEM DEFINED.—In this section, the term the administration has made ‘‘home are doing a good job in providing co- ‘‘congressional directed spending item’’ has and community-based waivers’’ a key ordinated services to those at risk and the meaning given such term in paragraph element of its Medicaid reform efforts. those in need. 5(a) of rule XLIV of the Standing Rules of I could not be more supportive of this As I said before, this is an issue that the Senate. initiative. We should, whenever pos- each and every time I travel and visit Mr. DEMINT. Mr. President, I ask for sible, make every effort to allow people with my county commissioners, those the yeas and nays on my amendment to live with dignity and independence involved in the unheralded work of and the Bingaman amendment. in the setting of their choice. Unfortu- simply dealing with those in need— The PRESIDING OFFICER. Is there nately, this new rule will stand in the they don’t get a lot of credit being objection to obtaining the yeas and way of these efforts and force many county commissioners, but they are all nays on both amendments in one re- people to remain institutionalized. worried and concerned. They tell me: quest? Finally, this new rule eviscerates Senator, we are doing it right and we Mr. DORGAN. Mr. President, I ob- case management for some of our Na- are about to be penalized. ject. I have not had a chance to visit tion’s most vulnerable children, those We should be better than that. Let’s with my colleague. I wish to do so first. living in the foster care system. By not step back and take a breath and put a The PRESIDING OFFICER. Objec- allowing child welfare workers to pro- hold on the implementation of this tion is heard. vide case management services, many rule, and let’s figure out a way to do it Mr. DEMINT. Mr. President, we will children will be left to fend for them- right. Let’s measure twice and only cut talk about it and get the vote later on. selves when seeking medical services. once. I want to say a few words about this As I said before, I am all for fiscal re- I yield the floor. amendment.

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00014 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1007 My amendment is identical to the American policy, while defending dic- million for a school that is already sit- Semper Fi Act, which I introduced tator Hugo Chavez. The group is so dis- ting on a $3.5 billion endowment? along with Senators ALLARD, BOND, respectful that they have no problems Let me be clear, my amendment does BURR, CHAMBLISS, COBURN, CORNYN, demonstrating in front of wounded sol- not cut off all Federal funds to the city INHOFE, MARTINEZ, MCCONNELL, VIT- diers at Walter Reed Medical Center of Berkeley, though I am sure most TER, and probably a number of other with signs reading ‘‘Maimed for a lie.’’ Americans would feel that is justified. Members. Since the bill that is pending The council’s resolution sparked an It merely rescinds wasteful earmarks. now will probably be the last vote be- escalation of anti-Marine protests. Berkeley is free to compete with other fore the recess, I think it is important Code Pink organizer Zanne Joy points towns and cities across America for that we vote on this Semper Fi amend- to the city council as justification for merit-based Federal grants. ment. Last week, when I introduced the escalation. She said that ‘‘anything Actions have consequences. When the the bill, the majority leader did not re- legal is justified if it succeeds in per- Berkeley City Council decided to insult cess so that we could not get this on suading the Marine Corps to move its the Marines in a time of war, it was a the calendar. This is an important bill, recruiting station out of Berkeley.’’ $2 million decision. Especially in a which I will explain in a minute. We According to the San Francisco Chron- time of war, we cannot just allow cities also tried to move it by unanimous icle, Code Pink protesters have been to play insulting games at our troops’ consent through the hotline process, heard shouting at young men who are expense while continuing to shower and all of the Republicans approved the trying to enter the recruiting station, them with congressional favors. bill, but apparently someone on the ‘‘You guys are just cannon fodder!’’ and On Tuesday, the city council met to majority side is holding it. That is why ‘‘They want to train you to kill ba- revisit its ridiculous actions. Hundreds it is important that this amendment be bies!’’ of military supporters and antiwar pro- part of the bill we are considering It is sad to see a city like Berkeley testers gathered at Berkeley City Hall. today. moving so far left. The city in which Berkeley police reported four arrests The Semper Fi Act would rescind all the legendary World War II Pacific before the meeting began, all mis- earmarks, or specially designated Theater Commander, Fleet Admiral demeanors. Police said there were spending projects, contained in the fis- Chester W. Nimitz, established the minor scuffles between the antiwar and cal year 2008 Consolidated Omnibus Ap- Naval ROTC in the fall of 1926 is now promilitary camps. An American flag propriations Act for the city of Berke- sadly a shell of its former self, thanks was set aflame outside the city council ley and entities located therein, and re- to its elected leadership. chambers, damaging a pair of bicycles. directs those funds to the U.S. Marine This is disappointing, but in a repub- When the council meeting finally Corps. lican form of government, it must be started, more than 100 speakers took For those who have not been paying up to local voters to change their lead- turns at the podium. attention, the Berkeley City Council ership. In a sense, what happened in Berke- recently voted to ask the U.S. Marine However, this particular case became ley was a quintessential American ex- Corps to vacate their recruiting office the business of all Americans when perience, a spirited exchange and pro- in town, and that if they chose to stay they insulted our troops and their con- test followed by debate and democratic they did so as ‘‘uninvited and unwel- stitutional mission to defend our coun- action. And while I find some of the come intruders.’’ try; while coming to the Federal Gov- views and behavior of many of the During debate of the resolution, one protestors repugnant, the exchange council member called the Marines ernment asking for special taxpayer- itself is a solemn reminder of those ‘‘the President’s own gangsters’’ and funded handouts. Over $2 million was who have sacrificed so much to pre- ‘‘trained killers.’’ Another said the Ma- secretly tucked away for Berkeley ear- serve our freedom, especially our free- rines had given the country ‘‘horrible marks in the 2008 Omnibus appropria- tions bill, projects that were never dom of speech. karma’’ and said they had a history of Let me be clear. I do not question the ‘‘death and destruction.’’ In a docu- voted on or debated. sincerity of anyone on either side of ment drafted to support the resolution I do not believe a city that has the issue. I think there is genuine con- against the Marines, the council stat- turned its back on our country’s finest cern among many in this country ed: ‘‘Military recruiters are sales peo- deserves $2 million worth of pork bar- about the war. But while we can re- ple known to lie to and seduce minors rel projects. So my amendment re- spect the legitimate worries about the and young adults into contracting vokes these earmarks. war and can respect the sincerity of themselves into military service with Included in the $2 million worth of even the most radical protestors, we false promises regarding jobs, job pork are some particularly wasteful must recognize that words have mean- training, education and other bene- projects. ing and actions have consequences. fits.’’ One earmark provides gourmet or- After voting to insult the men and ganic lunches to schools in the Berke- Some of the hateful words that have women who fight and bleed for their ley School District. While our Marines come out of Berkeley, CA, have had freedom, the city council cast another are making due with MREs of Sloppy real consequences on our troops, their ridiculous vote in favor of giving the Joe and chili with beans, Berkeley stu- families, and our recruiting. radical protest group Code Pink a dents will get Federal tax dollars to de- One of those who spoke at the city parking space directly in front of the sign meals that promote ‘‘environ- council meeting was Debbie Lee of Ari- Marine Corps recruiting station. They mental harmony.’’ Chez Panisse’s zona, whose son Marc was the first also voted to give Code Pink a sound menu features ‘‘Comte´ cheese souffle´ Navy SEAL to die in the Iraq war. She permit for protests in front of the Ma- with maˆ che salad’’, ‘‘Meyer lemon demanded an apology from the council, rine Corps building. The city council e´clairs with huckleberry coulis’’; and and she said: My son gave up his life stated in the resolution that they ‘‘en- ‘‘Chicory salad with creamy anchovy for you. Lee told the council, as she courage all people to avoid cooperation vinaigrette and olive toast’’. That is clutched his framed picture, ‘‘I’m ap- with the Marine Corps recruiting sta- unacceptable. palled at what you did,’’ referring to tion’’ and to ‘‘applaud’’ Code Pink for Are we to understand that the city the council’s vote on Marine recruiters. working to ‘‘impede, passively or ac- that has been home to many of the Debbie Parrish, another military tively’’ the work of the Marines Corps country’s most rich and famous cannot mom whose son Victor is currently in Berkeley. afford to pay for its own designer serving in Iraq, said to the Berkeley Frankly, I just returned from a visit school lunches? City Council: to Iraq, saw our marines on the ground Another $975,000 earmark is for the It is despicable what you said about our and what they were doing. It is incon- Matsui Center for Politics and Public military. It is very, very sad. Shame on you. ceivable to me that any governing body Service at U.C. Berkeley, which may After all the testimony from the in this country would say such things include cataloging the papers of the military supporters and families, the to our marines. late Congressman Robert Matsui. Is it Berkeley City Council could only mus- Code Pink is a fringe organization really necessary to tax the paychecks ter the votes to not send a letter in- that distinguishes itself by attacking of Marines so we can earmark nearly $1 sulting the U.S. Marines by calling

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00015 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1008 CONGRESSIONAL RECORD — SENATE February 14, 2008 them ‘‘uninvited and unwelcomed in- geant Strowe is currently fighting to the Senators from Minnesota and my- truders.’’ Let’s be clear. They did not protect our freedom in Kuwait. Ser- self and 17 others and would simply do apologize for the letter. They just geant Strowe understands what the this: It would stop the CMS from im- didn’t mail it. Of course, the sending of Marine recruiters in Berkeley are plementing the new rule by delaying a letter at this point is inconsequential going through quite well because he its implementation until April 2009, given that the text of the letter has served as a recruiter himself for 7 when we have a new President and a been running on national television for years. And he just told me his folks new attitude. a week. The city council also modified serving with him wanted to thank Now, let me give the background. In one of its past resolutions to ‘‘recog- those of us who were standing up for December, CMS proposed this rule that nize the recruiters’ right to locate in them while they were fighting for our would cut Medicaid funding to some- our city and the right of others to pro- country. thing called ‘‘targeted case manage- test or support their presence.’’ After talking with the sergeant, I de- ment’’ services. The rule will go into But the resolution also stated that cided it would be a good idea to call the effect March 3. That is why we are of- the city council opposes ‘‘the recruit- marines at the Berkeley recruiting sta- fering it on this very important bill of ment of our young people into this tion to ask how they were holding up Indian health, and we thank the man- war.’’ amidst all the controversy. I talked to agers of the bill for their courtesy. The resolution proposing a formal GSgt Rick O’Frente, who seemed to be We hear all these government words, apology to the Marines failed. The city taking the events in stride. He even but I am going to talk today not only council also voted to let four addi- said a number of citizens from Berke- as the Senator from Maryland standing tional items passed at last week’s ley had come into the recruitment of- up for my constituents, but also as a meeting stand. One resolution encour- fice, brought them food, and some had professionally trained social worker. aged all people to avoid cooperation apologized for the actions of the coun- What is this? Well, a Medicaid case with the Marine Corps recruiting sta- cil. manager is either a social worker or a tion. A second one requested that the I guess I have said enough about all nurse who helps adults and children city attorney investigate if the Ma- of what we are hearing. I have pages with very complicated problems. Chil- rines are in violation of Berkeley’s pol- and pages of comments from people dren in foster care and children with icy against discrimination based on who are asking us to stand up for our disabilities get the medical and social sexual orientation. marines while they are fighting for us, services they need to be able to have a In addition, two resolutions giving and we will be asking again for votes as quality of life to be independent. But the radical antiwar group Code Pink a part of the deliberations on this pack- what does that mean in real terms? weekly parking space and a weekly age. Well, let me give you an example. sound permit to protest the Marine re- Mr. President, now that I think the I have a constituent in Baltimore, a cruiting station were upheld by the chairman has had a chance to under- 2-year-old, who was diagnosed with a council’s decision. stand in more detail what this bill is genetic disorder that leads to signifi- It was my hope that the city would about, I will once again ask for the cant feeding problems. This disease apologize and revoke its previous reso- yeas and nays on my amendment and causes very severe problems and with- lutions and move on. The council chose the Bingaman amendment. out help in early life. So what does the not to do that. We have no choice but The PRESIDING OFFICER. Is there case manager do? If the case is a very to acknowledge the reality of what objection to obtaining the yeas and complicated medical situation, often they have done and to defend our mili- nays on both amendments at the same the case manager is a nurse. If it re- tary recruiters who are doing the job time? quires lots of complicated social inter- we asked them to do. If we don’t take Mr. DORGAN. I object. I have not vention, it will be a social worker. action, we will be sending a message to had a chance to visit with the Senator, First of all, the case manager gets in other towns or cities that they can use and I will be glad to do so at some there and does a family assessment and their power to try to influence U.S. for- point. works with the doctors, such as Johns eign policy, thwarting our recruitment The PRESIDING OFFICER. Objec- Hopkins or the University of Maryland, efforts. tion is heard. so we know what medical plan is in This issue is not about free speech. It Mr. DEMINT. Mr. President, I yield order for this little child to have the is about a city that has shown total the floor. ability to thrive. Then the case man- disdain for our Armed Forces and used The PRESIDING OFFICER. The Sen- ager works with the family, who is in its official government powers to har- ator from Maryland is recognized. acute distress, to make sure they know ass our military as they try to keep AMENDMENT NO. 4023 someone is on their side and helps our country safe. And this amendment Ms. MIKULSKI. Mr. President, I wish them comply with the treatment plan. is not about forcing the city to change to speak on amendment No. 4023, a Now, what might that be? Well, in its mind. It is about whether we are very important amendment that af- the genetic disorder case, it will be going to shower the city with favors, fects over 200,000 people in my State. I very specialized nutrition services. with special goodies that do not meet am not calling up the amendment right That is a lot of coordination to get the national needs. I think the American this moment, pending some other par- right people there to help that family. people have spoken loudly and clearly liamentary action, but I do wish to It will be also speech and language and that they do not believe that should be speak on the amendment. occupational therapy, so a lot of com- the case. This is a bipartisan amendment spon- pliance to make sure that child will be There is a video with clips of the city sored by Senator KLOBUCHAR, who has able to get what they need. Then, very council meeting on YouTube. It has taken a very impressive lead, as well as important, psychosocial help because been viewed by over 200,000 people. It is Senator COLEMAN. This bipartisan when a child has this type of disorder, the 70th most viewed video this week amendment is to stand up for constitu- there are other very severe psycho- and the 11th most viewed video in news ents all over the United States of social problems that emerge. Then the and politics, with 767 people posting America who are severely disabled and case manager is working with the fam- comments overwhelmingly in support who are about to lose their case man- ily to get the child in the appropriate of the legislation. People are paying agers. very specialized daycare. You can attention. Thousands and thousands and thou- imagine the kind of supervision this is. I am amazed at the response received sands of people—severely handicapped This is tough, hands-on, gritty work. regarding my public outrage over the or disabled, both children and adults— Let’s also take a look at when there city of Berkeley’s behavior. My office are about to lose either their social is a child born with cerebral palsy. has received thousands of calls and let- workers or their nurses because of a Again, you have a biomedical plan and ters from military supporters all over new, harsh, punitive rule put out by the need to get the right education for the country. On Wednesday afternoon, the Centers for Medicaid and Medicare. the child and also assistance for the I received a call from Sgt James The amendment does the same thing as family on how to do it, then a lot of Strowe of the U.S. Marine Corps. Ser- Senate Bill 2578 that is sponsored by nitty-gritty work. In this case, the

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00016 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1009 child would be evaluated, say, at the I yield the floor. in 2005. If this rule is put into effect, fantastic Kennedy-Krieger Institute, The PRESIDING OFFICER. The Sen- that funding will be slashed in 2008. where some of the best neurosurgeons ator from Minnesota. I want to use one example; it is from and neuroscientists will be working Ms. KLOBUCHAR. Mr. President, I a county in my State, Dakota County. with them. But the case manager helps rise to speak in strong support of Now, this is not exactly a sort of wild- get the family a wheelchair, a ramp for amendment No. 4023. This is the eyed county; it tends to be a more con- the home, special education services, amendment my friend, Senator MIKUL- servative county in our State. But, like and counseling for the parents because SKI, just spoke about. It is a bipartisan any other county in our State, they this is going to be a significant respon- amendment. Cosponsors are myself, have needs for case management serv- sibility for a long time. Senator MIKULSKI, Senator COLEMAN, ices for people who are mentally ill, Without case management, the whole and many other Senators from across seniors, young kids who need help. This thing falls apart. If you don’t get the this country. county has made a practice of devel- right services for the family in the This amendment would stop the ad- oping a cost-effective, community- home and the educational programs, ministration from making drastic based system of services that relies you will not have the follow through changes to its targeted case manage- heavily on case management. Why did on the biomedical plan that helps them ment system that would hurt those in they do it? Well, they did it to save remain independent or able to grow up. our country who are most in need of money. Now, CMS says they do not want to assistance. Medicaid funding has been key to de- pay for that. They say they have the Targeted case management benefits veloping service alternatives in homes authority from the Deficit Reduction children in foster care, kids and adults and in less expensive settings than in Act and they can just slash these serv- battling mental illness, and seniors and institutional settings. This is the kind ices from Medicaid funding. Well, in disabled people receiving institutional of innovative, cost-effective approach my State, this affects 200,000 people. It care. It exists to help those individuals we want to encourage from Govern- means that over 1,400 social workers to navigate the complicated web of ment. Instead, with this sudden rule and nurses who have devoted their life available services, to help these men, change, they are being punished. Even to helping these families will be im- women, and children overcome bureau- worse, the vulnerable individuals they pacted, and it means a Governor will cratic barriers in order to achieve inde- serve are being punished. have to pick up the bill. In my State, pendence. These services include trans- I always believed this was a country these services cost $150 million, with 50 porting people with disabilities to and where we wrapped our arms around the percent paid by the feds and the other from doctor’s appointments as well as people who need the help. That is what 50 percent paid by the State. managing pharmacy services for indi- America is about. That is what patriot- CMS wants to eliminate the 50 per- viduals with severe mental illness. ism is about. But with this rule slash- cent, which means Maryland will lose These essential services are now and-burn of all these services, they are $75 million. I know Senator KLOBUCHAR threatened by a proposed rule change not wrapping their arms around these will tell us equally horrific stories. from the Centers for Medicare and people, they are rejecting them for Da- Senator COLEMAN has spoken about Medicaid Services. kota County, this suburban county in this. We object to CMS. We object to For 8 years, I served as the chief Minnesota. this rule. We want to delay the rule prosecutor and top lawyer for Min- For States such as California, Colo- until sensible heads prevail. nesota’s largest county, serving Min- rado, Maryland, New Jersey, New We have 20 Senators who have co- neapolis and 45 suburban communities, York, and North Dakota, pulling the sponsored the bill that is the same as with a population of over 1 million peo- plug on targeted case management will this Amendment. They have names ple. In that role, I worked closely with disrupt the lives of those served by such as CARDIN, CORKER, DOMENICI, our county child protection and adult these cost-effective efforts. Further- BINGAMAN, ALEXANDER, VOINOVICH, protection agencies, with our hospital, more, in the end, it will just increase BROWN, SNOWE, WYDEN, SANDERS, KEN- which was the biggest emergency hos- the total costs borne by State, local NEDY—the list goes on. Thirty States pital in the State of Minnesota. So I and Federal governments, which means would be so affected they have taken it saw firsthand what would happen if we all of us as taxpayers also pay more. It upon themselves to write directly to did not prevent people from getting in simply defies common sense. CSM. trouble, what would happen when they Our amendment will postpone the I must say to the distinguished chair- would end up at the emergency room or Center for Medicaid and Medicare Serv- man of the Indian Affairs Committee, when they would end up in the jail be- ices’ rulemaking by 1 year. We need a this also affects his State of North Da- cause they were not getting the nec- year to examine exactly how badly this kota. It affects severely handicapped essary mental health care they needed. will hurt our States and local govern- Native American children. I know firsthand the vulnerability of ments, especially the children, the dis- This is not about who is your favorite these individuals, young and old, and abled, and the seniors who need these bean counter at OMB or how can we the responsibility of Government to services most. control runaway Medicaid costs; it is help them achieve as much independ- I occupy the Senate seat once held by how do we in this country make sure ence, well-being, and dignity as pos- Hubert Humphrey. Some of my col- our constituents and our people get the sible. leagues had the great privilege of serv- services they need to be able to have an When Congress passed the Deficit Re- ing in the Senate with him. Hubert independent life. I believe we can give duction Act in 2005, it clarified exactly Humphrey was someone who, of course, help to those who are practicing self- what services are eligible for payment was never at a loss for words. Many of help. For those families who are out under the Targeted Case Management those words were memorable. there struggling to make sure a loved Program. Senator MIKULSKI went There is one statement in particular one with a handicap, a child, or an through those important services. that I believe is very appropriate for adult is able to remain independent, Unfortunately, the Centers for Medi- this topic. Senator Humphrey once said they need a government on their side. care and Medicaid Services has since this: So my amendment will delay the im- come up with a rule that goes miles The moral test of Government is how that plementation. It is not my amendment, and miles beyond what Congress in- Government treats those who are in the it is our amendment. It is a bipartisan tended. That rule is scheduled to be im- dawn of life, the children; those who are in amendment. I say to my colleagues plemented next month. This impending the twilight of life, the elderly; and those from the other side of the aisle, let’s be rule will have a devastating fiscal im- who are in the shadow of life, the needy, the those compassionate conservatives pact on States and local communities. sick, and the disabled. whom you once talked about. Join with It will endanger the well-being of vul- I submit that this hasty, ill-consid- us. Let’s do this. nerable people who benefit the most ered action to cut essential services for At the appropriate time, I will call from these crucial services. the most vulnerable people fails that up this amendment officially, and I Our States received over $2 billion in moral test of government. I believe we will ask for a vote on it. funding for targeted case management can and we must do better. That is why

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00017 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1010 CONGRESSIONAL RECORD — SENATE February 14, 2008 I strongly support our bipartisan tion taken by the Secretary of Health and For reasons I do not comprehend, we amendment, an amendment focused on Human Services during the period that be- are not able to legislate on this most saving money in the long term by gins on December 4, 2007, and ends on March vital piece of legislation to an keeping people in settings that actu- 31, 2009, that is based in whole or in part on underclass in America that we cre- the interim final rule described in subsection ally save taxpayers money, by not (a) is null and void. ated—Native Americans. slashing funds to the most vulnerable (b) INCLUSION OF MEDICARE PROVIDERS AND There is—I knew it—a stall going on in our society. That is why we support SUPPLIERS IN FEDERAL PAYMENT LEVY AND in regard to this legislation. I under- this amendment, and we ask our col- ADMINISTRATIVE OFFSET PROGRAM.— stood the direction of the minority on leagues to vote with us. (1) IN GENERAL.—Section 1874 of the Social FISA legislation. They wanted to stall I yield the floor. Security Act (42 U.S.C. 1395kk) is amended it at the last minute so that the House The PRESIDING OFFICER. The Sen- by adding at the end the following new sub- would have no time to work on it. They ator from New Mexico. section: ‘‘(d) INCLUSION OF MEDICARE PROVIDER AND accomplished that. But why on this? Mr. BINGAMAN. Mr. President, what SUPPLIER PAYMENTS IN FEDERAL PAYMENT Why now, when we can legislate to try is the pending amendment? LEVY PROGRAM.— to help a group of people who badly The PRESIDING OFFICER. The sec- ‘‘(1) IN GENERAL.—The Centers for Medicare need help? And the place they need ond-degree DeMint amendment to the & Medicaid Services shall take all necessary help more than any other place is their Senator’s amendment. steps to participate in the Federal Payment ability to be taken care of when they Levy Program under section 6331(h) of the AMENDMENT NO. 3894 WITHDRAWN are sick and injured. Internal Revenue Code of 1986 as soon as pos- Look what has happened in the State Mr. BINGAMAN. Mr. President, if it sible and shall ensure that— is in order, I will withdraw my under- ‘‘(A) at least 50 percent of all payments of Nevada. We used to have hospitals lying amendment. under parts A and B are processed through for Native Americans in Nevada. They The PRESIDING OFFICER. It is in such program beginning within 1 year after are gone. They have been taken away order. The amendment is withdrawn. the date of the enactment of this section; over the years. The health care for Na- The Senator from Maryland. ‘‘(B) at least 75 percent of all payments tive Americans in Nevada is extremely Ms. MIKULSKI. Mr. President, I ask under parts A and B are processed through limited. They are not served well. unanimous consent that the pending such program beginning within 2 years after We have an obligation—an obligation amendment be set aside. such date; and as a country—to help these people. ‘‘(C) all payments under parts A and B are The PRESIDING OFFICER. Without processed through such program beginning This is our opportunity, after years, to objection, it is so ordered. not later than September 30, 2011. legislate in that regard, and we are not Ms. MIKULSKI. I now call up amend- ‘‘(2) ASSISTANCE.—The Financial Manage- going to do it. I am saddened to hear ment 4023. ment Service and the Internal Revenue Serv- about this. I am saddened that the Re- The PRESIDING OFFICER. The ice shall provide assistance to the Centers publican minority is even filibustering clerk will report. for Medicare & Medicaid Services to ensure Indians. What is this place coming to? The legislative clerk read as follows: that all payments described in paragraph (1) Why are they doing this? There is no are included in the Federal Payment Levy The Senator from Maryland [Ms. MIKUL- reason we cannot legislate here, offer Program by the deadlines specified in that SKI] for herself, Mr. COLEMAN, and Ms. KLO- subsection.’’. amendments dealing with Native BUCHAR, proposes an amendment numbered Americans. But that is where we are. I 4023 to amendment No. 3899. (2) APPLICATION OF ADMINISTRATIVE OFFSET PROVISIONS TO MEDICARE PROVIDER OR SUP- am very disappointed. Ms. MIKULSKI. I ask unanimous PLIER PAYMENTS.—Section 3716 of title 31, I suggest the absence of a quorum. consent that the reading of the amend- United States Code, is amended— The PRESIDING OFFICER. The ment be dispensed with. (A) by inserting ‘‘the Department of clerk will call the roll. The PRESIDING OFFICER. Without Health and Human Services,’’ after ‘‘United The legislative clerk proceeded to objection, it is so ordered. States Postal Service,’’ in subsection call the roll. The amendment is as follows: (c)(1)(A); and Mr. SANDERS. Mr. President, I ask (B) by adding at the end of subsection (c)(3) (Purpose: To temporarily delay application unanimous consent that the order for the following new subparagraph: of proposed changes to Medicaid payment ‘‘(D) This section shall apply to payments the quorum call be rescinded. rules for case management and targeted made after the date which is 90 days after Mr. DORGAN. I object. case management services) the enactment of this subparagraph (or such The PRESIDING OFFICER. Objec- On page 397, after line 2, add the following: earlier date as designated by the Secretary tion is heard. SEC. 213. MORATORIUM ON IMPLEMENTATION OF of Health and Human Services) with respect The clerk will continue the call of CHANGES TO CASE MANAGEMENT to claims or debts, and to amounts payable, the roll. AND TARGETED CASE MANAGEMENT under title XVIII of the Social Security PAYMENT REQUIREMENTS UNDER The legislative clerk continued with Act.’’. MEDICAID. the call of the roll. (3) EFFECTIVE DATE.—The amendments (a) MORATORIUM.— Mr. SANDERS. I ask unanimous con- made by this subsection shall take effect on (1) DELAYED IMPLEMENTATION OF DECEMBER the date of the enactment of this Act. sent that the order for the quorum call 4, 2007, INTERIM FINAL RULE.—The interim be rescinded. Ms. MIKULSKI. Mr. President, I ask final rule published on December 4, 2007, at The PRESIDING OFFICER (Mrs. pages 68,077 through 68,093 of volume 72 of for the yeas and nays. MCCASKILL). Without objection, it is so the Federal Register (relating to parts 431, The PRESIDING OFFICER. Is there a 440, and 441 of title 42 of the Code of Federal sufficient second? ordered. Regulations) shall not take effect before Ms. MIKULSKI. I ask for a vote at an Mr. SANDERS. Madam President, I April 1, 2009. appropriate time. rise in strong support of the Indian (2) CONTINUATION OF 2007 PAYMENT POLICIES Mr. DORGAN. Mr. President, I sug- health care package being put together AND PRACTICES.—Notwithstanding any other gest the absence of a quorum. by Senator DORGAN. As Senator REID provision of law, the Secretary of Health and indicated, these are a group of people Human Services shall not, prior to April 1, The PRESIDING OFFICER. The clerk will call the roll. who have been the most neglected in 2009, take any action (through promulgation our country, and it is imperative we of regulation, issuance of regulatory guid- The legislative clerk proceeded to ance, use of Federal payment audit proce- call the roll. move rapidly to address longstanding dures, or other administrative action, policy Mr. REID. Mr. President, I ask unan- concerns. or practice, including a Medical Assistance imous consent that the order for the I have an amendment pending to pro- Manual transmittal or issuance of a letter to quorum be rescinded. vide $800 million in emergency funding State Medicaid directors) to restrict cov- The PRESIDING OFFICER. Without for the LIHEAP program. The reason I erage or payment under title XIX of the So- objection, it is so ordered. am offering this amendment is simple cial Security Act for case management and Mr. REID. Mr. President, if there and obvious. At a time when home targeted case management services if such were ever a time and a piece of legisla- heating fuel is skyrocketing, millions action is more restrictive than the adminis- trative action, policy, or practice that ap- tion where we should try to help the of senior citizens on fixed incomes, plies to coverage of, or payment for, such people whom this legislation is di- millions of low-income families with services under title XIX of the Social Secu- rected to help, it is this—Native Amer- kids, and persons with disabilities are rity Act on December 3, 2007. Any such ac- icans Indians. But that is not the case. desperately trying to keep their homes

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00018 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1011 warm this winter. Without this addi- the needs of a program or agency, is ir- month on the war in Iraq, with most of tional source of immediate funding, responsible. that sum being budgeted as emergency there is a major risk that old people Secondly, Senator GREGG excludes spending. It is not an emergency. We and lower income people all over Amer- from his cuts the department that re- know what is going on. Yet we are not ica will go cold. In the richest country ceives over half the discretionary fund- prepared to pay for the war. We are on the face of the Earth, we have a ing, and that is the Department of De- leaving that cost to our kids and moral responsibility not to allow that. fense. If Senator GREGG thinks all of grandchildren. That is emergency Over the past week, as everybody the $500 billion-plus that goes to the spending. We can pass that $12 billion a knows, in many parts of America, tem- Department of Defense is well spent month. Yet there are those who balk at peratures have been going well below and well accounted for, he is mistaken. spending $800 million on a real emer- zero. In my State of Vermont, in Lin- You cannot exclude the largest recipi- gency, and that is keeping senior citi- coln, VT, was 21 below zero. In Nome, ent of discretionary funding from ex- zens and families all over America AK, the high temperature was 15 below; amination. warm this winter. Grand Forks, ND, 12 below zero; Eure- In the real world, what would be the Providing a mere $800 million for ka, SD, 3 below zero. On and on all impact of the Gregg amendment if it LIHEAP would primarily benefit senior across the country, temperatures are were to pass? I know that .2 of 1 per- citizens, families with children, and getting cold. The cost of home heating cent may not seem like a lot of money people with disabilities earning be- oil is outrageously high. LIHEAP fund- at first blush, but let’s take a look at tween $10 and $15,000 a year. At a time ing is being depleted. People are unable what this cut would mean. It would when gasoline and home heating oil to afford to keep their homes warm. mean a $54 million cut for veterans prices in the State of Vermont and That, in a nutshell, is what we are dis- medical care, and overall veterans throughout the country are well above cussing. funding would be reduced by $86 mil- $3 a gallon, we should not be forcing The amendment I am offering has lion. I don’t think any Member of the seniors and others to make a choice been endorsed by many organizations Senate supports that. While we are try- about whether they are going to buy and many Members of the Senate. ing to fight and come up with an un- the medicine or food they need—hunger Some of the endorsees include the Na- derstanding of various cancers, Alz- is increasing—or keep warm this win- tional Governors Association, the heimer’s disease, Parkinson’s disease, ter. AARP, the National Conference of the National Institutes of Health would There is no great secret that the State Legislatures, many others. Let be cut by over $58 million by the Gregg American people are increasingly dis- me briefly excerpt from a letter I re- amendment. The Gregg amendment enchanted with what is going on in ceived from the National Governors As- would cut special education by $22 mil- Washington, whether in the White sociation in support of the amendment: lion. People are paying higher and House or in Congress. They wonder Additional funding distributed equitably higher property taxes because this Con- what planet we are living on. They are under this amendment will support critically gress, for many years, has not kept the struggling, millions, every single day needed heating and cooling assistance to promise it made by adequately funding to keep their heads above water to pay millions of our most vulnerable, including special education. The Gregg amend- for the food they need, to fill up their the elderly, disabled, and families that often ment would cut funding for special ed gas tanks in order to go to work, to have to choose between paying their heating by some $22 million. Head Start would keep warm in the winter. They wonder or cooling bills and food, medicine and other be cut by $14 million. We are grossly why we are not responding to their essential needs. underfunding Head Start right now. We needs. We have people here talking That is from the National Governors have a major early education crisis about more tax breaks for billionaires, Association. The AARP also has come from one end of America to the other. when workers are losing their jobs. out in support of the amendment, indi- This would only make that problem Passing the Sanders amendment cer- cating that some of the most signifi- worse. The Gregg amendment would tainly is not going to solve all those cant victims of what happens when it cut community health centers by over problems. becomes cold are senior citizens who $4 million at a time when 47 million But maybe at a time when people are suffer from hypothermia. They are Americans have no health insurance, going cold and others know that people very much in support of this amend- creating a process by which even fewer are going cold, maybe—maybe—it will ment, and we thank them for their sup- Americans can access primary health make the American people understand port. care. Homeland security would receive some of us are aware of the reality of This bipartisan amendment is also a cut of $70 million. Education would American life as it exists in cities and cosponsored by many of my colleagues, be cut by over $100 million. towns all across this country, that including: Senators CLINTON, OBAMA, I certainly share Senator GREGG’s maybe we know what is going on, and SNOWE, COLLINS, LEAHY, SUNUNU, KEN- concerns about the national debt. I we are prepared to respond in a proper NEDY, GORDON SMITH, COLEMAN, KERRY, look forward to working with him and way. STABENOW, SCHUMER, LAUTENBERG, LIN- other members of the Budget Com- Madam President, having said that, I COLN, KLOBUCHAR, MURRAY, CANTWELL, mittee to discuss how we should reduce ask unanimous consent that the Sen- MENENDEZ, DURBIN, and WHITEHOUSE. I our $9.2 trillion national debt, which ate now resume the Gregg amendment thank them. increased by $3 trillion under President No. 4022 and that it be modified to be a Yesterday, Senator GREGG offered a Bush. It is a real issue, one we have to first-degree amendments and that the second-degree amendment to my get a handle on. But maybe we will dis- Senate then debate concurrently amendment. In my view, his amend- cuss in the Budget Committee the ab- amendments No. 3900 and No. 4022, as ment is a poison pill which, if passed, surdity of trying to eliminate the es- modified, with 40 minutes of debate would either kill or slow down all our tate tax which would add $1 trillion to prior to a vote in relation to each efforts to increase emergency funding our national debt over 20 years by giv- amendment, with the time equally di- for LIHEAP. The Gregg amendment ing tax breaks exclusively to the vided and controlled between Senator would pay for the $800 million increase wealthiest .3 of 1 percent. SANDERS and Senator GREGG or their in LIHEAP by cutting overall discre- We are debating whether we should designees; that each amendment be tionary nondefense spending by about help senior citizens who are going cold subject to a 60-affirmative vote thresh- .2 of 1 percent. I am opposed to the this winter. But there are many, in- old, and that if the amendment does Gregg amendment for a number of rea- cluding the President, who say: No not achieve that threshold, it be with- sons. First, it is an extremely irrespon- problem, a trillion dollars in tax relief drawn; that if either amendment sible way to do budgeting. There are for the wealthiest .3 of 1 percent. achieves 60 affirmative votes, then the some agencies that need to be cut a lot We should be discussing why we are amendment be agreed to and the mo- more than .2 of 1 percent. And there providing other tax breaks to some of tion to reconsider be laid upon the are, in fact, programs and agencies the wealthiest people in this country. table; that the vote in relation to the that need significantly more funding. Perhaps we can discuss the appro- Gregg amendment No. 4022, as modi- An across-the-board cut, regardless of priateness of spending $12 billion a fied, occur first in the sequence and

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00019 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1012 CONGRESSIONAL RECORD — SENATE February 14, 2008 that there be 2 minutes of debate, of Berkeley has said the Marines there proach. Whether it is paid for or not equally divided, prior to each vote; pro- are unwelcome and has offered pro- paid for is another question. But the vided further that no intervening testers a free parking site in front of point is, that amendment is not ger- amendment be in order to either the Marine recruiting headquarters, mane to the Indian health bill, and if amendment; that upon the use or yield- with a megaphone to yell at the ma- there is a vote on the LIHEAP amend- ing back of time, the Senate proceed to rines—men and woman who have ment, the amendment of the Senator vote in relation to the Gregg amend- served us in war in Iraq—that proposal, from Vermont, there will be requests, I ment, to be followed by a vote in rela- which would have basically laid out the know, from this side of the aisle and tion to the Sanders amendment. objection of the Senate to that des- perhaps other requests to consider The PRESIDING OFFICER. Is there picable act by the city council in other nongermane amendments to the objection? Berkeley relative to the treatment of bill. Ms. MURKOWSKI. Madam President, our marines, is also not going to prob- I think what the majority leader was reserving the right to object—and I ably be offered because there is an at- saying is something that I subscribe to will object—I am certainly a supporter tempt to move this bill forward. on this side, which is that the Indian of LIHEAP, but I object at this time. I guess I appreciate the fact that the health bill is an important bill to get The PRESIDING OFFICER. Objec- Indian health bill is a good—I don’t done. If we begin consideration of a lot tion is heard. know if it is a good bill; I don’t know of extraneous or nongermane amend- The Senator from Vermont. enough about it, but it appears to be ments to the Indian health bill, it may Mr. SANDERS. Madam President, I supported by both sides here, and they well jeopardize our ability to conclude am kind of new to the Senate, but I want to move it forward. It is unfortu- work on the Indian health bill. That is would ask my friend from Alaska or nate the LIHEAP issue, which I think the only reason for the objection, and I my friend from New Hampshire: Why? should be addressed in the context I am hope the Senator can appreciate that. Why the objection? If we are sympa- proposing, which is that it be paid for, Mr. SANDERS. Reclaiming my time, thetic to LIHEAP—— will not be able to be addressed at this Madam President, I would ask my The PRESIDING OFFICER. To the time. But I understand the situation, friend from Arizona—and I understand Senator from Vermont, it is not in and I understand why it has happened. that. We want to move to the Indian order to propound questions to other But I do not think it can be laid at the health bill. There is a real solution to Senators who do not have the floor. feet of either party. that in the real world if we are serious; Mr. SANDERS. Madam President, I Mr. SANDERS. Madam President, re- that is, limiting the amount of time wonder why it would be that when we claiming my time, to the best of my and reaching a unanimous consent face a dire crisis all across this coun- knowledge, I heard the objection com- agreement about a few amendments try, we cannot move forward vigor- ing from the Republican side, not the that might be offered so we can vote on ously in providing relief to seniors and Democratic side. them and move on to Indian health. low-income people who need this help. Mr. GREGG. Madam President, if I Would the Senator from Arizona be I would love to have a response to that, may seek the floor, I think it is pretty prepared to do that? Madam President. obvious what is happening. I want the Mr. KYL. Madam President, I would Mr. GREGG. Madam President, is the RECORD to show that prior to the objec- be happy to respond to the Senator Senator yielding the floor? tion being made—it is not my fight— from Vermont but in this way: There Mr. SANDERS. Madam President, I but as a practical matter, the majority are people on my side of the aisle who yield to my friend from New Hamp- leader came to the floor and castigated have already attempted to propound shire. the fact that the bill was being slowed nongermane amendments that they The PRESIDING OFFICER. The Sen- down by amendments, one of which would like to have a time agreement ator from New Hampshire. would be the LIHEAP amendment. on as well. I suspect that before we Mr. GREGG. Madam President, obvi- Mr. SANDERS. Madam President, re- begin to get into that kind of a nego- ously, I have an amendment which is claiming my time, it is absolutely not tiation, the leaders will want to con- caught up in this effort. I would hope my intention, as I indicated to Senator sider what that is going to be doing to we could vote on it. I think it is the DORGAN, to slow this down. This is im- the time schedule for the bill, and the right approach that we fund LIHEAP portant legislation we want to pass. I managers of bill are going to want to but that we also pay for that funding would limit my time to 20 minutes, to do the same because we would like to so we do not pass the bill for LIHEAP 10 minutes. I think most people here try to conclude the bill as soon as we on to our children, so we do not put know what the issue is. I would like an can; and that will open up a process ourselves in a position where we are up-or-down vote, and let’s move on to that could delay matters. paying today’s energy bills with our Indian health. Mr. SANDERS. Reclaiming my time, children’s dollars 10 years from now, Mr. GREGG. Madam President, if the Madam President, I think, again, we plus interest. Senator is going to allow the bill to be want to move and pass, I hope, the In- But I understand, having heard the open to LIHEAP, then I presume it dian health bill. But I think if we are majority leader come to the floor ear- should be open to all extraneous honest—obviously, if people want to lier and say he did not want this bill amendments. I suspect the amendment bring up 30 amendments, that would filibustered or slowed down, that this of the Senator from South Carolina rel- kill the Indian health bill, but if that is is sort of part of an exercise by the ative to the city of Berkeley is an ex- not the desire, if there are very few leaders of this bill on this bill—because traneous amendment but one that is amendments and leadership can agree this is the Indian health bill—to try to, worth debating and should be dis- on a time limit on them, we can move I guess, clear the table so amendments cussed. forward on some serious amendments, which are not directly relevant to In- Mr. KYL. Madam President, will the have votes, and pass—at least vote on— dian health do not end up slowing down Senator from Vermont yield? the Indian health bill. this bill. Mr. SANDERS. Yes, I yield. Again, I ask my friend from Arizona I do not think this decision can be The PRESIDING OFFICER. The Sen- if that is something he would enter- laid at the feet of either party. It ap- ator from Vermont yields to the Sen- tain. It does mean that not everybody pears it is a joint decision by the lead- ator from Arizona. can offer every amendment they want. ership of the committee of jurisdiction Mr. KYL. I thank the Senator. There would have to be a limitation on Indian health. That is why this pro- Madam President, if I could further and a time limitation. posal, which Senator SANDERS has laid explain, first of all, I appreciate that Mr. KYL. Madam President, I will re- out, which I am perfectly amenable the Senator from Vermont has offered spond again to the Senator from to—and I would actually support the an amendment that is very important Vermont: There are nongermane unanimous consent request that he to his State. It is not germane to the amendments—at least one of which has propounded. It has been objected to. Indian health bill. I also understand already been brought up—that I doubt I understand an amendment from our how both Senators from New Hamp- the leaders and certainly the managers side dealing with the fact that the city shire are supportive of the LIHEAP ap- of the bill would like to see embroiled

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00020 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1013 into the Indian health care debate. All five times she got there, there were understand his passion about LIHEAP. Once the process begins, it is hard to 10 people ahead of her. Somebody from Vermont does not have control it. So it is not as simple as ask- Her medicine ran out on October 25, to tell somebody from North Dakota ing, would I be agreeable to a time 2007, her husband said. Five times for about cold weather. I know about cold agreement on perhaps the amendment the next month, she got up and drove weather and my constituents do. of the Senator from Vermont and the to that clinic. She could not stay LIHEAP is unbelievably important, amendment of the Senator from South there, because she was also a day care and we need to find a way to get the Carolina—because that would undoubt- provider for her grandchildren. So this money out for LIHEAP. I understand edly get brought into this. But there woman went, tried to sign up, but there that. I am very sorry he was unable to may be others as well. were 10 people ahead of her—that is all get the yeas and nays and so on. But he So it is not a question we can answer they would take—and she had to go also understands you have to try to when one cannot see where the end of home. offer amendments where you can to au- it might be. I think that is the concern Five times she did that in a month. A thorization bills. I understand that. He we have with beginning this kind of month later, she died. Her medicine is a supporter of this bill, the under- process. But I suggest that the Senator ran out October 25. She died November lying Indian health care bill we need to from Vermont continue to consult with 25. She had called her sister about 3 get done. It is also the case, I am sure, his leader, with the managers of the weeks before, and she said: ‘‘What do I that the Senator from Alaska knows a bill, and see if we can move the process have to do here to get the medicine I little about cold weather. I have been forward. need? Die?’’ Well, she did die because to Alaska. So my hope is that working The PRESIDING OFFICER. The Sen- she could not get service in this Indian together in this Chamber we will fund ator from Vermont. health system. the LIHEAP program, because it is Mr. SANDERS. I yield the floor. The fact is, people are dying. All we very important. That also can be life or The PRESIDING OFFICER. The Sen- are asking is that we maybe have death for people, so my hope is we can ator from North Dakota. somebody come over and offer an get that done. Mr. DORGAN. Madam President, it is amendment on Indian health care and But having said all of that, again let more than a little frustrating. We have start a debate on these amendments. If me say we have a managers’ package been here for 3 hours this morning. We we have people who have these amend- that perfects—after having negotiated have amendments on this bill dealing ments, come over and offer them. We now for several weeks on about five or with Indian health care. We have non- have some that are filed. Let’s have six very controversial issues, we have germane amendments that have been some votes and try to get through this negotiated in a way that we have offered: Medicare, LIHEAP, earmarks piece of legislation. reached a compromise on all of them, for Berkeley, abortion. This is the third day we are on the satisfactory to all of the parties. We This is a very serious issue. We have floor of the Senate with this bill. I said now have that in a managers’ package people dying in this country with re- earlier, it has taken 10 years to get which we intend to offer next. It has spect to this health care question here. Every single year we have worked not yet cleared. It has been a couple of about American Indians. I spoke ear- on this. Senator MCCAIN, who was hours since we have been able to clear lier this morning that the U.S. Govern- chairman of the Indian Affairs Com- that. My hope is that in the next 30 ment has a responsibility for health mittee, worked on it with me—Senator minutes or so we can clear that so at care for Indians. If you ask the ques- MURKOWSKI. We work on it and never least we can get the managers’ package tion: Why? Because we signed up for it. get it to the floor. We finally get it to done. We signed the treaties. We said: We the floor of the Senate, and this is like promise, and we have a trust responsi- a root canal, except a root canal hurts I believe Senator COBURN will be bility for it. less, because at least you are accom- here. He has some amendments filed. I So we spend twice as much money to plishing something. hope he will be here to call up amend- provide health care to Federal pris- Here we come to the floor of the Sen- ments which I believe he will do rea- oners as we do for American Indians. ate, and we cannot get amendments up. sonably soon, and I think Senator We are not meeting the needs. We have We cannot get amendments voted on. TESTER wishes to speak on the bill gen- people dying. So it takes 10 years to So my hope would be we can find a way erally. get a bill to the floor of the Senate—10 to move through this legislation. I yield the floor. years to get a bill to the floor—to try Mr. SANDERS. Madam President, The PRESIDING OFFICER. The Sen- to improve health care for Indians, and will the Senator yield? ator from Alaska is recognized. we get here, and we have unending ap- Mr. DORGAN. Madam President, I petites for amendments that have am happy to yield for a question. AMENDMENT NO. 3906 TO AMENDMENT NO. 3899 nothing to do with Indian health. Mr. SANDERS. Madam President, I Ms. MURKOWSKI. Madam President, Look, I support low-income energy thank my friend from North Dakota. I ask unanimous consent to set aside assistance. I support that. I support a AMENDMENT NO. 3900 WITHDRAWN the pending amendment and call up lot of these issues. Many of them have Madam President, I ask for the reg- amendment No. 3906. This is the nothing to do with Indian health. We ular order with respect to the Sanders amendment of Senator MARTINEZ of are just trying to get a bill passed here. amendment No. 3900. Florida. I ask that it be made the pend- Let me describe something I heard The PRESIDING OFFICER. Does the ing amendment. about a month ago to describe the ur- Senator from North Dakota yield for The PRESIDING OFFICER. Is there gency. I was at the Standing Rock In- that purpose? objection? dian Reservation in North Dakota. It Mr. DORGAN. Madam President, I Without objection, it is so ordered. straddles the North Dakota-South Da- yield for that purpose. I believe I un- kota border. The husband of Harriet derstand what the Senator from The clerk will report. Archambault came to a meeting I Vermont is doing. The assistant legislative clerk read had—a listening session on Indian The PRESIDING OFFICER. The as follows: health care—and he described his wife amendment is now pending. The Senator from Alaska [Ms. MUR- Harriet and her battle to try to deal Mr. SANDERS. Madam President, KOWSKI], for Mr. MARTINEZ, proposes an with this health care dilemma. They given the objection, I withdraw my amendment numbered 3906. lived nearly 20 miles from a clinic in amendment. Ms. MURKOWSKI. Madam President, South Dakota. It was an Indian health The PRESIDING OFFICER. The I ask unanimous consent that the read- care clinic. She would get up in the amendment is withdrawn. morning and drive 18 miles to the clin- Mr. DORGAN. Madam President, let ing of the amendment be dispensed ic because that clinic can take only 10 me say to the Senator from Vermont, I with. people in the morning and 10 people in understand his passion. He knows I The PRESIDING OFFICER. Without the afternoon. So five times, she got up have a lot of passion about this bill, objection, it is so ordered. in the morning to drive to that clinic. and I have expressed it this morning. I The amendment is as follows:

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00021 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1014 CONGRESSIONAL RECORD — SENATE February 14, 2008 (Purpose: To amend titles XI and XVIII of 7b(d)) is amended, in the second flush matter meet medical priority criteria for con- the Social Security Act to provide in- following subparagraph (B), by striking ‘‘not tract Indian Health Services, which is creased civil and criminal penalties for more than 5 years’’ and inserting ‘‘not more life or limb. Her family was left with acts involving fraud and abuse under the than 10 years’’. two options: She goes without the new Medicare program and to increase the (e) EFFECTIVE DATE.—The amendments amount of the surety bond required for made by this section shall apply to criminal prosthesis, leading to permanent dis- suppliers of durable medical equipment) penalties imposed for actions taken on or figurement or raise $3,000, which is not At the end of title II, add the following: after the date of enactment of this Act. an easy task for a struggling family on SEC. lll. INCREASED SURETY BOND REQUIRE- Montana’s economically depressed res- SEC. lll. INCREASED CIVIL MONEY PENALTIES MENT FOR SUPPLIERS OF DME. AND CRIMINAL FINES FOR MEDI- ervations. CARE FRAUD AND ABUSE. (a) IN GENERAL.—Section 1834(a)(16)(B) of Here is another example of the crit- the Social Security Act (42 U.S.C. (a) INCREASED CIVIL MONEY PENALTIES.— ical needs of the Indian health care Section 1128A of the Social Security Act (42 1395m(a)(16)(B)) is amended by striking ‘‘$50,000’’ and inserting ‘‘$500,000’’. system. A 35-year-old Montana woman U.S.C. 1320a–7a) is amended— was diagnosed with a heart condition (1) in subsection (a), in the flush matter (b) EFFECTIVE DATE.—The amendment following paragraph (7)— made by this section shall apply to the that led to dramatic heart failure. Her (A) by striking ‘‘$10,000’’ each place it ap- issuance (or renewal) of a provider number heart lost its ability to pump blood pears and inserting ‘‘$20,000’’; for a supplier of durable medical equipment adequately and she could hardly move (B) by striking ‘‘$15,000’’ and inserting on or after the date of enactment of this Act. without becoming short of breath. She ‘‘$30,000’’; and Ms. MURKOWSKI. Madam President, needed a new heart. She was referred to (C) by striking ‘‘$50,000’’ and inserting we understand that Senator MARTINEZ the Mayo Clinic where she received ‘‘$100,000’’; and will come to the floor to speak to this special cardiology care and was put on (2) in subsection (b)— amendment that relates to civil and a list for a heart transplant. Thanks to (A) in paragraph (1), in the flush matter criminal penalties for Medicare fraud, following subparagraph (B), by striking close monitoring and the use of many ‘‘$2,000’’ and inserting ‘‘$4,000’’; but I did want to get that rolling. medications and a permanent pace- (B) in paragraph (2), by striking ‘‘$2,000’’ I understand Senator TESTER has maker, her condition stabilized and her and inserting ‘‘$4,000’’; and some comments he wishes to make at ability to function improved a bit. (C) in paragraph (3)(A)(i), by striking this time regarding the Indian Health However, due to lack of funding in the ‘‘$5,000’’ and inserting ‘‘$10,000’’. Care Improvement Act. Indian Health Service, her ongoing vis- (b) INCREASED CRIMINAL FINES.—Section I yield the floor. its with the cardiologist, not to men- 1128B of the Social Security Act (42 U.S.C. The PRESIDING OFFICER. The Sen- tion the heart transplant, were no 1320a–7b) is amended— ator from Montana is recognized. (1) in subsection (a), in the flush matter longer covered. Without this followup, Mr. TESTER. Madam President, I her prospects for survival are grim. following paragraph (6)— thank the ranking member of the com- (A) by striking ‘‘$25,000’’ and inserting I could go on and on. There are thou- ‘‘$100,000’’; and mittee. sands of examples of how the Indian Today I rise in strong support of the (B) by striking ‘‘$10,000’’ and inserting health care system has failed. Indian health care program. The reason ‘‘$20,000’’; After I asked tribal folks about their (2) in subsection (b)— this bill is on the floor right now is due priorities, I asked what we can do in (A) in paragraph (1), in the flush matter to the hard work of our chairman and the Senate to improve Indian health following subparagraph (B), by striking ranking member which has been exhib- care. The response is unanimous and ‘‘$25,000’’ and inserting ‘‘$100,000’’; and ited here in the last few minutes. They overwhelming. They tell me to start (B) in paragraph (2), in the flush matter know how important this bill is. I ex- following subparagraph (B), by striking with the reauthorization of the Indian press my appreciation to Senator DOR- ‘‘$25,000’’ and inserting ‘‘$100,000’’; Health Care Improvement Act, and do GAN and Senator MURKOWSKI for all of (3) in subsection (c), by striking ‘‘$25,000’’ it now. and inserting ‘‘$100,000’’; their hard work. (4) in subsection (d), in the second flush Since arriving in Washington a little This reauthorization is long overdue. matter following subparagraph (B), by strik- more than a year ago, I have been The last comprehensive authorization ing ‘‘$25,000’’ and inserting ‘‘$100,000’’; and meeting with leaders throughout In- of the Indian Health Care Improvement (5) in subsection (e), by striking ‘‘$2,000’’ dian country, and one aspect is clear: Act was 16 years ago, in 1992. The dis- and inserting ‘‘$4,000’’. The challenges that face Indian coun- parity in the quality of health care (c) EFFECTIVE DATE.—The amendments try are large. I tell tribal leaders that provided to Native Americans is real, made by this section shall apply to civil despite all of the good intentions, there and it is disturbing. The Indian Health money penalties and fines imposed for ac- Service, or IHS, reports that members tions taken on or after the date of enact- is no way Congress can solve all of ment of this Act. their problems this year. of the 560 federally recognized Amer- ican Indian and Alaska Native tribes SEC. llll. INCREASED SENTENCES FOR FELO- As I began my tenure on the Indian NIES INVOLVING MEDICARE FRAUD Affairs Committee, I asked my friends and their descendants are eligible for AND ABUSE. in Indian country to share with me IHS services. This agency, within the (a) FALSE STATEMENTS AND REPRESENTA- their top priorities. I have met with Department of Health and Human TIONS.—Section 1128B(a) of the Social Secu- representatives and leaders from each Services, is supposed to provide com- rity Act (42 U.S.C. 1320a–7b(a)) is amended, in of the seven reservations in Montana prehensive health care for approxi- clause (i) of the flush matter following para- mately 1.8 million of the Nation’s esti- graph (6), by striking ‘‘not more than 5 multiple times, and every time they years’’ and inserting ‘‘not more than 10 point out to me that the most impor- mated 3.3 million American Indians years’’. tant issue is health care or the lack of and Alaska Natives. Its annual appro- (b) ANTI-KICKBACK.—Section 1128B(b) of the it. priation is $3 billion—$3 billion. Keep Social Security Act (42 U.S.C. 1320a–7b(b)) is Why is it such a priority? Let’s con- that number in mind as we consider amended— sider a few examples. the facts: (1) in paragraph (1), in the flush matter fol- Now 5 years old, a small girl from the Approximately 55 percent of Amer- lowing subparagraph (B), by striking ‘‘not Crow tribe was diagnosed with a rare ican Indians and Alaska Natives living more than 5 years’’ and inserting ‘‘not more in the United States rely on IHS to than 10 years’’; and form of cancer in her eye. The condi- (2) in paragraph (2), in the flush matter fol- tion required that her right eye be sur- provide access to health services in 49 lowing subparagraph (B), by striking ‘‘not gically removed. When doctors origi- hospitals and nearly 600 other facili- more than 5 years’’ and inserting ‘‘not more nally removed it in October of 2001, ties. American Indians and Alaska Na- than 10 years’’. they fitted her with a prosthetic eye tives die at higher rates from a myriad (c) FALSE STATEMENT OR REPRESENTATION with the understanding that every few of things more than regular Americans WITH RESPECT TO CONDITIONS OR OPERATIONS years, she would need a new prosthesis do: tuberculosis, 600 percent higher; di- OF FACILITIES.—Section 1128B(c) of the Social as she grew. Because doctors had al- abetes, nearly 200 percent higher; and Security Act (42 U.S.C. 1320a–7b(c)) is amend- the list goes on and on and on. ed by striking ‘‘not more than 5 years’’ and ready taken her eye, and because the inserting ‘‘not more than 10 years’’. wrong size prosthetic eye wouldn’t im- American Indians and Alaska Natives (d) EXCESS CHARGES.—Section 1128B(d) of mediately threaten her life when she born today have a life expectancy that the Social Security Act (42 U.S.C. 1320a– needed a new eye, her case failed to is lower than all other races in the

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00022 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1015 United States. This lower life expect- I yield the floor. graph (6), by striking ‘‘not more than 5 ancy is due, in part, to the dispropor- Mr. DORGAN. Madam President, I years’’ and inserting ‘‘not more than 10 tionate disease burden that exists in make a point of order that a quorum is years’’. (b) ANTI-KICKBACK.—Section 1128B(b) of the Indian country. not present. Social Security Act (42 U.S.C. 1320a–7b(b)) is It is suggested that the IHS-appro- The PRESIDING OFFICER. The amended— priated funding provides 55 percent of clerk will call the roll. (1) in paragraph (1), in the flush matter fol- the necessary Federal funding to as- The assistant legislative clerk pro- lowing subparagraph (B), by striking ‘‘not sure mainstream personal health care ceeded to call the roll. more than 5 years’’ and inserting ‘‘not more services to American Indians and Alas- Ms. MURKOWSKI. Madam President, than 10 years’’; and ka Natives. Let me repeat that: IHS I ask unanimous consent that the order (2) in paragraph (2), in the flush matter fol- provides only 55 percent of the funding for the quorum call be rescinded. lowing subparagraph (B), by striking ‘‘not The PRESIDING OFFICER. Without more than 5 years’’ and inserting ‘‘not more necessary to meet the health care than 10 years’’. needs of American Indians and Alaska objection, it is so ordered. (c) FALSE STATEMENT OR REPRESENTATION Natives in that IHS system. So now AMENDMENT NO. 3906, AS MODIFIED WITH RESPECT TO CONDITIONS OR OPERATIONS you can see why passing this bill is so Ms. MURKOWSKI. Madam President, OF FACILITIES.—Section 1128B(c) of the Social critically important to improving I ask unanimous consent to send to the Security Act (42 U.S.C. 1320a–7b(c)) is amend- health care in Indian country. desk a modification to Martinez ed by striking ‘‘not more than 5 years’’ and This legislation will help the Indian inserting ‘‘not more than 10 years’’. amendment No. 3906. With this modi- (d) EXCESS CHARGES.—Section 1128B(d) of Health Service facilities become up to fication, the surety bond amount is re- the Social Security Act (42 U.S.C. 1320a– date. It will create programs to address duced to better effectuate the intent of 7b(d)) is amended, in the second flush matter behavioral and mental health issues the act. following subparagraph (B), by striking ‘‘not that have been severely neglected. It The PRESIDING OFFICER. Without more than 5 years’’ and inserting ‘‘not more will begin to address the disturbing dis- objection, it is so ordered. than 10 years’’. parities between the health status of The amendment is so modified. (e) EFFECTIVE DATE.—The amendments made by this section shall apply to criminal American Indians and the general U.S. The amendment, as modified, is as penalties imposed for actions taken on or population. This legislation authorizes follows: after the date of enactment of this Act. appropriations necessary to increase At the end of title II, add the following: Ms. MURKOWSKI. Madam President, the availability of health care, develop SEC. ll. INCREASED CIVIL MONEY PENALTIES I suggest the absence of a quorum. new approaches to health care delivery, AND CRIMINAL FINES FOR MEDI- The PRESIDING OFFICER. The CARE FRAUD AND ABUSE. improve the flexibility of the Indian clerk will call the roll. health care service, and promote the (a) INCREASED CIVIL MONEY PENALTIES.— Section 1128A of the Social Security Act (42 The assistant legislative clerk pro- sovereignty of American Indian tribes. ceeded to call the roll. Now we must start funding Indian U.S.C. 1320a–7a) is amended— (1) in subsection (a), in the flush matter Mr. CORNYN. Madam President, I health care at levels authorized in this following paragraph (7)— ask unanimous consent that the order bill. Don’t think that failing to ade- (A) by striking ‘‘$10,000’’ each place it ap- for the quorum call be rescinded. quately fund Indian health care is a pears and inserting ‘‘$20,000’’; The PRESIDING OFFICER. Without budget savings. Without proper funding (B) by striking ‘‘$15,000’’ and inserting objection, it is so ordered. of this program, the cost will shift to ‘‘$30,000’’; and Mr. CORNYN. Madam President, I our emergency rooms and our already (C) by striking ‘‘$50,000’’ and inserting ask unanimous consent to speak as in overburdened hospitals. Make no mis- ‘‘$100,000’’; and morning business for up to 10 minutes. take about it, we will all pay for the (2) in subsection (b)— The PRESIDING OFFICER. Without (A) in paragraph (1), in the flush matter objection, it is so ordered. health care of our citizens, but we will following subparagraph (B), by striking pay a premium if we choose not to do ‘‘$2,000’’ and inserting ‘‘$4,000’’; FOREIGN INTELLIGENCE SURVEILLANCE ACT the right thing today and fully fund (B) in paragraph (2), by striking ‘‘$2,000’’ Mr. CORNYN. Madam President, I this program. and inserting ‘‘$4,000’’; and come to the floor to express grave con- There is another reason why we need (C) in paragraph (3)(A)(i), by striking cern at reports that I hear out of the to pass this bill. The Federal Govern- ‘‘$5,000’’ and inserting ‘‘$10,000’’. House of Representatives that they in- ment has a trust responsibility to Na- (b) INCREASED CRIMINAL FINES.—Section tend to adjourn and basically go on va- tive American Indians, a legally bind- 1128B of the Social Security Act (42 U.S.C. cation for the next week or so without 1320a–7b) is amended— taking action on the Foreign Intel- ing trust responsibility. As many in (1) in subsection (a), in the flush matter this body know, this bill has made it to following paragraph (6)— ligence Surveillance Act reauthoriza- the Senate floor in previous years and (A) by striking ‘‘$25,000’’ and inserting tion. That, of course, is the legislation failed. The managers of this bill this ‘‘$100,000’’; and we passed out of the Senate that pro- year have addressed a few remaining (B) by striking ‘‘$10,000’’ and inserting vides the eyes and the ears for the in- concerns and we have another chance ‘‘$20,000’’; telligence community in the United to pass it today. The bill before us is (2) in subsection (b)— States to detect and to deter future not perfect, but it represents a good (A) in paragraph (1), in the flush matter terrorist attacks against the United following subparagraph (B), by striking States. compromise bill. At the end of the day, ‘‘$25,000’’ and inserting ‘‘$100,000’’; and this legislation represents an historic (B) in paragraph (2), in the flush matter To me, it is unthinkable that the opportunity to make an incredible dif- following subparagraph (B), by striking House of Representatives would ad- ference in the lives of Americans who ‘‘$25,000’’ and inserting ‘‘$100,000’’; journ and be so irresponsible as to need it most. (3) in subsection (c), by striking ‘‘$25,000’’ leave this unfinished business undone This problem will not go away with- and inserting ‘‘$100,000’’; and to leave America unprotected out our action. The longer we wait, the (4) in subsection (d), in the second flush against future terrorist attacks. I worse the problem becomes. The longer matter following subparagraph (B), by strik- know there is an argument that exist- we wait, the more expensive the prob- ing ‘‘$25,000’’ and inserting ‘‘$100,000’’; and ing surveillance could be continued for (5) in subsection (e), by striking ‘‘$2,000’’ lem becomes. By passing this impor- and inserting ‘‘$4,000’’. up to a year. But what we are talking tant bill, we take a critical step toward (c) EFFECTIVE DATE.—The amendments about is new contacts, new information improving Indian health care and thus made by this section shall apply to civil that the intelligence community gets fulfilling our trust responsibility to money penalties and fines imposed for ac- that would be impeded, impaired, and American Indians. tions taken on or after the date of enact- blocked by the failure of the House of I hope this bill passes and passes ment of this Act. Representatives to act on this critical quickly today. I hope it doesn’t get SEC. ll. INCREASED SENTENCES FOR FELONIES piece of legislation that will expire on bogged down in amendments that are INVOLVING MEDICARE FRAUD AND February 15 unless they act today or ABUSE. important but have no connection to (a) FALSE STATEMENTS AND REPRESENTA- tomorrow. So it is the height of irre- Indian health care. I ask my comrades TIONS.—Section 1128B(a) of the Social Secu- sponsibility. I find myself questioning here in the Senate to vote yes for this rity Act (42 U.S.C. 1320a–7b(a)) is amended, in whether it could possibly be true that critical legislation. clause (i) of the flush matter following para- would happen.

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00023 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1016 CONGRESSIONAL RECORD — SENATE February 14, 2008 Also, one important part of the Sen- erybody is happy with the outcome—to gotiated over the last month or so, in ate legislation was to provide protec- address this issue, if the House of Rep- which we successfully negotiated on tion for the telecommunications car- resentatives leaves town and leaves about five or six very controversial riers that may have cooperated with this matter undone, the security of the issues—we negotiated an agreement be- the U.S. Government shortly after Sep- American people is in peril, and it tween the sides, and even being able to tember 11, 2001, in providing the means would be a tragedy indeed if something offer that at this point is denied be- to listen in to al-Qaida and other for- were to happen as a result of our intel- cause someone who is not even on the eign terrorists who were plotting and ligence community being blind or deaf Hill told their staff to tell others that planning attacks against the United to the dangers that do work both with- the leadership cannot allow this. It is States and its citizens. in our shores and beyond. unbelievable to me. I think it is a terrible message from I yield the floor. One might expect, perhaps, that the House of Representatives, if they The PRESIDING OFFICER. The Sen- today we can make progress on this are not going to act in a way that pro- ator from North Dakota is recognized. legislation. Everybody puts on a blue vides protection for those citizens, Mr. DORGAN. Madam President, let suit and shined shoes and comes to whether they be individual citizens or me say, I don’t think anybody in the work, and one might expect we can get corporate citizens, who are asked by Congress, the Senate, or the House something done for a change. We will their country to come to the aid of the wishes our intelligence community to have additional morning business, and American people and provide the be blind or deaf. Obviously, we have a we will see if those who have left the means to protect them from terrorist process in this country with the FISA Hill and want the entire world to stop attacks. What kind of message does Court that allows emergency actions. and wait for their whims will show up that send, that we are going to basi- The opportunity to be able to engage in at some point and maybe we can con- cally leave them out twisting slowly in surveillance and the appropriate sur- sider some amendments. I hope that the wind and being left to the litiga- veillance to make sure we are listening will be the case. tion—some 40 different lawsuits that to terrorists and all of those things are I yield the floor. have been filed against the tele- available. The PRESIDING OFFICER. The Sen- communications industry that may There is a debate about how wide ator from Ohio is recognized. have cooperated with the Federal Gov- should the drift net be, that the admin- Mr. BROWN. Madam President, I ask ernment in protecting the American istration might want to gather almost unanimous consent to address the Sen- people. This is on a request at the high- every communication everywhere in ate up to 10 minutes in morning busi- est levels, from the Commander in the world and data mine to find out ness. Chief, and upon a certification by the who is saying what. That is an impor- The PRESIDING OFFICER. Without chief law enforcement officer of the tant conversation because it deals with objection, it is so ordered. United States, the Attorney General. the basic rights in our Constitution. I RURAL REPORT CARD What they were being asked to do think there is no one in this Chamber Mr. BROWN. This past week, Presi- was entirely appropriate and within or in the other who believes we want dent Bush submitted to Congress his the bounds of the law. But then, when our intelligence community to be blind last budget for the Federal Govern- the litigation ensues, to basically leave or deaf and to not have the opportunity ment. It is a revealing document that them hanging out to dry would be to do the kind of surveillance nec- pretty clearly demonstrates the prior- wrong. The Senate wisely addressed essary to protect our country. That is ities of this administration. It used to that issue. But if the House adjourns very important to state. be that budgets were designed to rein without passing the Senate version of Madam President, we are not in in the Federal deficit. Under this ad- the reauthorization of the Foreign In- morning business, although we are ministration, budget after budget has telligence Surveillance Act, which in- doing some morning business. We are been submitted that would, if enacted, cludes protection for the telecommuni- on the piece of legislation that we re- widen the deficit. cations industry that may have par- ported out of the Indian Affairs Com- We know 7 years ago, when President ticipated in this lawful exercise of our mittee, dealing with Indian health care Bush took the oath of office in January powers to protect our country, it would improvement. I have always been enor- 2001, we had a huge Federal surplus. again be the height of irresponsibility mously proud to serve in this body. I Today, we have a huge Federal deficit and send the message that next time a am privileged and proud to serve. I that will be a burden on the backs of citizen, whether it is a corporate or in- have occasionally told friends that the our children and grandchildren. dividual citizen, is asked to come to Senate is 100 bad habits—that includes While funding for programs to help the aid of their country, you better myself, of course. We are not doing middle-class families hard hit by stag- think twice and consult your lawyers anything at the moment, I understand, nant wages would be slashed by the because you are going to get sued and because one Senator is downtown President’s budget, he gives enormous the Congress is not going to take ap- someplace, giving speeches, and the in- tax cuts to people who don’t need propriate measures to make sure those struction is that nothing is to be done them—and generally didn’t ask for who helped protect the safety and secu- while that Senator is gone. Good for them—the wealthiest 1 percent of the rity of the American public are pro- that Senator, but I don’t think this population. They simply don’t need a tected. place ought to come to a stop because tax cut. Finally, I don’t have the information somebody decides they are going to be In 2009, the President will give tax in front of me right now, but there are gone for 2 or 3 hours, so they want oth- cuts of $51 billion to those people mak- substantial news reports that indicate ers to object to everything on their be- ing over $1 million a year—again, that that a group of trial lawyers who stand half. That is, in my judgment, discour- is $51 billion for those making over $1 to make considerable amounts of teous, and my hope is that the Senate million a year. Yet he is cutting $15 money in terms of legal fees off this could do a little business today on billion from many of the programs that litigation are substantial contributors something that is urgent. That is not I am going to mention. to Members of Congress. I hope the evi- too much to ask for the Senate to per- Perhaps most disconcerting are the dence does not develop that there are haps consider legislation that is before President’s cuts in Federal programs decisions being made in the House of it. We are now on the third day of the that serve rural America. The Presi- Representatives on the basis of the in- Indian Health Care Improvement Act, a dent has failing grades on his budget terests of special interest groups such very urgent and serious matter. This is and what it does. He gets an F in as trial lawyers who stand to gain fi- the third day. We have been here for health care, an F in education, an F in nancially from continuing this litiga- over 3 hours today, and we have had law enforcement, and an F in economic tion that should be brought to an end amendments on all kinds of issues, ex- development. With faltering infrastruc- here and now. cept issues that deal with this legisla- ture, such as roads and bridges, dis- I am here primarily to voice my tion. appearing jobs, underfunded schools, grave concern that while the Senate Even just attempting to offer the and spotty access to health care, rural has acted responsibly—I know not ev- managers’ package, which has been ne- areas in Ohio, southeast Ohio—and

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00024 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1017 northwest Ohio especially—and across The EPA comes in and says to these people making over $1 million a year our Nation, these areas are fighting an communities: You need major renova- and then earn an F on health care, F on uphill battle without anywhere near tion—major replacement in some education, F on law enforcement, and the Federal support they used to get or cases—of a lot of these water and sewer F on economic development for these that they need now. systems, and then they simply do not struggling communities, the same kind More than one-half of Ohio’s counties help them do that. It means higher of rural areas in the Preside Officer’s are rural as defined by the U.S. Depart- sewer and water rates for unemployed State of Missouri, rural areas where I ment of Agriculture. Of the top 10 people and higher sewer and water know she has spent a lot of time, rural counties in Ohio—and there are 88 rates for people struggling, middle- areas where I have spent a lot of time, counties—with the highest unemploy- class families who are proud and strug- where people are struggling, trying to ment, every 1 of them is rural. Of the gling to stay above water. stay in the middle class, trying to sup- top 10 counties in Ohio with the high- In places such as Vinton County in port their kids, and trying to just get est proportion below the poverty line, 9 southeast Ohio, a third of the people along. out of 10 are rural. Of the top 10 coun- are on Medicaid. Medicaid is not a lux- The President’s proposal short- ties in Ohio with the highest percent- ury; it is a crucial support system for changes overall education funding by age of residents eligible for Medicaid, 9 children, the disabled, and the elderly $826 million. This budget would cut or are rural. living in poverty. Medicaid covers eliminate programs to support edu- Seven rural Ohio counties make all about one in every three nursing home cational opportunities for rural Ohio three of these lists: Vinton Pike, residents. What is to be become of sen- families, particularly programs such as Scioto, Adams, Meigs, Jackson, and iors under the President’s Medicaid career and technical education, for ele- cuts? Medicaid cuts: F in health care. Morgan—all counties in southeast mentary school counseling, for Safe What is to become of the seniors with- Ohio. Citizens of this counties need our and Drug-Free Schools—the kinds of out this successful insurance program? help, and they need it today. jobs many of these people, young peo- Yesterday, I spoke with about two The President’s budget cuts $18.2 bil- ple in southeast Ohio, want to get—ca- dozen officials and activists in those lion from Medicaid over 5 years. These reer education, tech education, elemen- counties in southern Ohio—people from cuts touted by the administration as tary school education. They want to the chamber of commerce, the county ‘‘savings’’ will be primarily achieved teach, they want to be nurses, they commissioners, the mayors, health de- by shifting costs to States, regardless want to be occupational therapists, partment directors, community devel- of whether States can actually shoul- they want to be physical therapists. opment people—and the stories they der these costs. Again, these $18 billion told about the President’s failure on cuts to Medicaid are to pay for a tax They want to work in their commu- health care, education, law enforce- cut for people making over $1 million a nities. They don’t want to go off to big ment, and economic development will year. cities and leave home. They want to be devastating and are devastating for The Bush budget slashes other pro- raise their children where their parents southeast Ohio. grams designed to help rural commu- are so their parents can see their Despite the alarming statistics and nities address unique health care chal- grandchildren. And they need jobs in the crucial role rural America plays in lenges. People who have to go to the Chillicothe, in Zanesville, in Cam- our Nation’s self-sufficiency and in our emergency room have to drive 30 min- bridge, and all over southern Ohio. cohesiveness and culture, the President utes, 45 minutes. A lot of people go to Our Nation’s future depends on our chose to slash funding for rural eco- emergency rooms in southeast Ohio be- actions now. We can either address bar- nomic programs, slash funding in rural cause they cannot afford any other riers to our children’s success in edu- health care, in rural law enforcement, care, and they go in hoping to get char- cation, we can address the issues of law in rural education—all so that he could ity care. These are not people who are enforcement, we can address the needs give a tax cut of $51 billion in 2009 to lazy. These are not people without a of health care, or we can abdicate re- people making over $1 million a year decent work ethic. These are people sponsibility and watch our rural areas and look what happens to health care, who work hard, have jobs, are barely continue to decline. If our rural areas education, law enforcement, and eco- making it, they go to food banks, in decline—and we know the strength of nomics development. too many cases, they are on Medicaid, our rural areas in building our country While communities in rural Ohio and they have to rely on the Govern- in the last 200 years—if they decline in struggle to keep jobs, President Bush ment because they are struggling, Missouri, Ohio, and around this coun- proposes to wipe away established working hard, working a couple of jobs, try, it means our country declines, and rural development programs that these and simply cannot make it. we cannot stand for that. people with whom I talked yesterday— Rural Ohio is experiencing unprece- As my State’s first Senator to serve Republicans and Democrats alike, con- dented challenges in law enforcement on the Agriculture Committee in four servatives and liberals alike, public as meth labs multiply and threaten decades and a member of the HELP health people, chamber of commerce families and communities. Yet, since Committee, which has jurisdiction over people, mayors, commissioners, com- 2001, President Bush has cut funding health and education programs, I will munity development people—these pro- for State and local law enforcement continue to fight to ensure that our grams matter to their well-being, to programs by over 50 percent. Law en- Nation invests in rural America. It is the economic vitality of these rural forcement: The President gets an F in the smart thing to do for our future. It areas. These housing programs, for in- rural Ohio for his budget. This year’s is the right thing to do for our fami- stance, support the construction, pur- budget would slash funding 63 percent lies. chase, and rehabilitation of single-fam- for all State and local law enforcement I suggest the absence of a quorum. ily homes, giving struggling rural programs in the Department of Justice. The PRESIDING OFFICER. The Ohioans a chance to own their own That is $1.6 billion, again, so the Presi- clerk will call the roll. homes. With all the problems we have dent can give tax cuts to people mak- The bill clerk proceeded to call the with foreclosures, they are not just ing over $1 million a year. roll. urban problems, suburban problems, or The budget also eliminates funding Ms. KLOBUCHAR. Madam President, rural problems; they are every year. for the COPS Program. Talk to people I ask unanimous consent that the order But the President takes special atten- in Windham, Athens, Gallipolis, Chil- for the quorum call be rescinded. tion to wiping out rural programs that licothe or Blair, communities that The PRESIDING OFFICER. Without can make a big difference in people’s need the COPS Program to keep these objection, it is so ordered. lives. communities safe. It is a program that Ms. KLOBUCHAR. Madam President, These programs encourage rural busi- has worked for 10 years. So the Presi- I ask unanimous consent to speak as in ness expansion, job creation, and dent wants to eliminate it so he can morning business. grants to extend broadband access give tax breaks to people making over The PRESIDING OFFICER. Without across Ohio. $1 million. objection, it is so ordered. These are critical programs that pro- I sound like a broken record, but it is The Senator from Minnesota is rec- vide water and sewer infrastructure. morally outrageous to do tax cuts for ognized.

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00025 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1018 CONGRESSIONAL RECORD — SENATE February 14, 2008 Ms. KLOBUCHAR. I thank the Chair. I told my colleagues once previously for the regular order and discuss my (The remarks of Ms. KLOBUCHAR per- about a Sunday morning in Fargo, ND, amendment No. 4034, after which I will taining to the submission of S. 2642 are at the veterans health care facility, ask for a vote. Then if the leadership located in today’s RECORD under ‘‘Sub- veterans hospital, where a veteran wants to stack votes, I am fine with mission of Concurrent and Senate Res- named Edmond Young Eagle was dying that. olutions.’’) of lung cancer. I did not know it that This is a simple amendment. I know Mr. GRASSLEY. Madam President, I day, but he would die 7 days later of the chairman is critical of it because ask unanimous consent that the order lung cancer. he thinks it is false in terms of its in- for the quorum call be rescinded. He was a man who lived on an Indian tent. During our budget debate, I plan The PRESIDING OFFICER. Without reservation. When called by his coun- on adding $2 billion to Indian health objection, it is so ordered. try, he served in Africa during the Sec- care. I also plan on making us make Mr. GRASSLEY. I ask unanimous ond World War, at Normandy, through- the tough decisions on where we take consent to speak as in morning busi- out Europe, served with great distinc- it from. We don’t have extra money, so ness. tion. it is about priorities, about keeping The PRESIDING OFFICER. Without He came back. He never had very commitments. I will be offering that objection, it is so ordered. much, lived a tough life, didn’t have when we get to the budget to make (The remarks of Senator GRASSLEY many relatives. At the end of his life sure there is an extra $2 billion for Na- pertaining to the introduction of S. his sister asked if I could get his med- tive American care, and then we will 2641 are printed in today’s RECORD als he had earned but never received. I decide whether we think that is a pri- under ‘‘Statements on Introduced Bills did. I took them on a Sunday morning ority as we vote on the budget and on and Joint Resolutions.’’) to the veterans hospital in Fargo, to the appropriations bills. Mr. DORGAN. I suggest the absence this man who was in his mid- to late- This is a straightforward amend- of a quorum. seventies, a World War II veteran, had ment. This allows tribal members to The PRESIDING OFFICER. The get insurance. If they want to use the clerk will call the roll. a tough life, never had very much, was dying of lung cancer. We cranked up IHS service, great. But if they have to The legislative clerk proceeded to wait in line to wait in line to get care, call the roll. his hospital bed to a seated position. He was a very sick man but very well maybe they can go somewhere else. Mr. DORGAN. Mr. President, I ask Then we are keeping our commitment. unanimous consent that the order for aware of what was going on. I pinned a row of medals on his pajama top at the If they know that the care for a certain the quorum call be rescinded. type of disease is terrible at IHS, they The PRESIDING OFFICER. Without veterans hospital. The doctors and can go where it is better. We are going objection, it is so ordered. nurses from the hospital packed into to put the security of our promise in Mr. DORGAN. I know my colleague, his room. This proud man said to me, real terms, and we are going to put Senator COBURN, is here. He is going to as I pinned his medals on his pajama choice, the same thing every Member offer an amendment. I should tell you top: This is one of the proudest days of of this body has, and security in health how pleased I am. Senator COBURN indi- my life. care, into the hands of the Native cated he would be here around 2 This is a man who had a difficult Americans. That is what the amend- o’clock. He was good enough to come time in life. He never had very much ment does. The reason it doesn’t cost this morning at 9:30 and engage in dis- but served his country when asked in Africa, in Europe, fought for his coun- anything is because we are going to cussion on this bill. charge IHS for what it costs. We have But we have discussion about vir- try. Many years later, just prior to his designed the amendment. We are wait- tually everything about the bill on the death, he was recognized by his coun- ing to see what the budget chairman floor of the Senate, Indian health care. try, as I told him: A country that is does with the budget and where we are The fact is we have had all kinds of grateful for your service. There are so going to find this $2 billion. But I amendments that have nothing to do many who have provided so much serv- promise you, we are going to get a with the bill. I hope we can finally get ice from Indian reservations, from In- chance to vote on my amendment to dian nations. this moving. put in $2 billion. So it is not an empty I had spoken this morning of some We have made a solemn pledge to the promise. people whose experience with the In- Indians—we signed it into treaties; we One of the things we know that im- dian health care system and the lack of have it as a trust responsibility—we proves everything is competition. One health care for American Indians has will provide for your health care. of the ways to get rid of some of the been devastating. Some people died as As my colleague from Oklahoma said waste that is in IHS and to put a pri- a result of not having access to ade- this morning, take a look at Medicare, ority back in is to start competing. quate care that we would take for Federal prisons, Indian health, a whole Mr. DORGAN. Will the Senator yield granted in our country. range of things. Just to take Federal for a question? Let me mention my colleague from prisons as an example, we spend twice Mr. COBURN. I am happy to. Oklahoma is on the floor and is going as much per person providing health Mr. DORGAN. This is an authoriza- to discuss one of his amendments. You care for prisoners as we do meeting our tion bill. The Senator is amending it. know, we have a trust responsibility. responsibility to provide health care Does his amendment anticipate an in- We have a responsibility to keep a for American Indians. That is a dis- crease by $2 billion for the authorized promise we have made in treaty after grace. It has to change. level because we are authorizing ex- treaty for Indian health care. I do not I can’t tell you how pleased I am to penditures? The Senator will perhaps think there is a disagreement on the see my colleague from Oklahoma be- offer a $2 billion appropriations meas- floor of the Senate about that. cause we have had so many amend- ure. I will as well. I hope we will be There is no disagreement that we ments that have so little to do with the able to work together on that. But we have a responsibility, that responsi- underlying bill. I know my colleagues will also have to increase the author- bility is in writing in all kinds of trea- have offered a number of amendments ization. Does the amendment increase ties. So we have made the promise; we that deal directly with it. the authorization? have not kept the promise. I yield the floor. Mr. COBURN. It does not at this Let me make one final point. There The PRESIDING OFFICER (Mr. time. I will give a commitment to the is no group of Americans who have SALAZAR). The Senator from Okla- chairman. Under our rules, when I served this country in greater percent- homa. want to take money away from some- age of their population than American Mr. COBURN. Mr. President, every thing else, I have to deauthorize it. We Indians. You take a look at the per- amendment I have has something to do don’t have enough money in Indian centage of veterans who have served with this bill. They are all germane, health so we have to deauthorize some- this country in wars and during peace- not meant to delay. I am happy to vote thing else. If we get it under the budg- time, no population has had a greater for cloture right now to prove that I et, I have every intention of making us percentage of people who have gone to don’t want to delay this bill. What I make a choice. I will vote for an in- serve America than American Indians. am going to ask is unanimous consent creased authorization at this point in

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00026 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1019 time right now for $2 billion. But I will petition in an area where someone is I can get you to come around. Maybe I also come back and say we have to find desperately sick and needs to see a doc- would not get your vote. I know I will the money to pay for it. tor quickly. I happen to agree the un- get your commitment to work toward Mr. DORGAN. Mr. President, why derlying notion of this amendment of it in the future. But I think just adding don’t we do that, provide the author- providing a card to someone to say, more money to IHS doesn’t fix the ized room? The Senator this morning take this card to a health care facility problem. I described that earlier when indicated—and I agreed—that we are and get that need fixed, if you must— I talked about 30 or 45 minutes. What about $2 billion short of fully funding I happen to think that has merit. I will this does is, it treats Native Americans Indian health care. We have full-scale be working with the Senator on that like every other American. That is rationing going on. The amendment with respect to the bolder approaches what this amendment does. It gives has a restriction in it. He limits the to Indian health care. But on page 4, them choice. It gets them out of the amount of funding in his amendment line 4, is where you have budget neu- prison we have placed them in that to the amount of funding that cur- trality: In conducting the program says: You only have one place you can rently exists in Indian health. The under this section, the Secretary shall go. And, by the way, if we run out of President has just proposed a reduction ensure the aggregate payments made contract funds, even if you need to go in funding, even though we are only to carry out the program do not exceed somewhere else, you can’t go. meeting 60 percent of current need. My the amount of Federal expenditures Contract funds actually have run out question is, should we not then remove which have been made available. That on average in June. So for 5 months of that restriction and actually increase is saying that we want to do all of this, the year, when we need to send Native the authorization because he and I which would expand contract care and Americans somewhere else, we don’t have the same goal. Let’s get the so on but within the same amount of have the money to do it. So who suf- amount of money in the system that money that currently exists in Indian fers? provides health care for Indians that health care. It is kind of a chicken and Under this system, you would not run we have promised. egg. out of contract money because you Mr. COBURN. I will happily vote for Mr. COBURN. I would like to reclaim bought an insurance policy. You have that. But what we have to do is de- my time if I might. The fact is, we ap- given them the average cost of an indi- authorize something else. I know you propriate $280 billion a year in stuff vidual insurance cost with what we are disagree with my thoughts on in- that is not authorized right now. So we spending now on care. creased authorizations versus offsets. I will not have any problem appro- By the way, I have another amend- believe we have a commitment. I be- priating this money if we don’t author- ment where we describe what an Indian lieve we have a treaty obligation. I be- ize it. A quarter of the discretionary is because, in my State, we have people lieve we have a moral obligation. But I budget is not authorized right now. We who are 1⁄512th stepping in front of a also believe it has to be balanced with will not have any problem with that. full blood. And most people don’t think the obligation that Members of Con- My amendment says, on the areas the somebody that is 5⁄11th out of 5⁄12th gress refuse to do, which is to make Senator just described, to do it only if ought to be getting full pay for their judgments about priorities. An empty it is geographically feasible. I recog- health care. And in fact, there are .12 promise to authorize that is not offset- nize there are some places where we of 1 percent Native blood. We call that ting some authorization somewhere have isolated reservations and we have light blood in Oklahoma. We have else without coming around and doing IHS. I am willing to put the money be- whole blood, mixed blood, and light it; tons of bills go through this place hind it, but I also realize more of the blood in our State. It actually is very authorizing things so we can send a same doesn’t get it done. So if we dou- complicated because what is happening signal out there that we did something, ble Indian health care money, we are now, we have tribes that have knowing that we never intend to fund still going to have an inefficient sys- quantums and say: If you are not a it. tem that will deliver care at a lower quarter or an eighth, you are not eligi- Right now we have over $8 trillion a level than what you can get in the pri- ble. But under the IHS system, from year in authorizations. It can’t be hard vate sector. some of the other tribes who have to find $2 billion to deauthorize to in- What I am saying with my amend- members who are 1⁄512th, they come crease the authorization for Indian ment is, let’s have both. We ought to down to their area and they get into health. We have to have a vote, and we do both. I am making a statement on IHS. So here is somebody with 1⁄512th have to decide what that is. the Senate floor—and the Senator will taking Indian dollars away from some- I will commit to the chairman, I will recognize, I believe, that I usually keep body who is a quarter or somebody who vote for that, as long as we are decreas- my word about coming back and doing is a full blood. ing somewhere else. I am willing to go what I say I will do—I will work to get What we have said is: Tribes, you find where that is for the chairman. I the extra $2 billion, but an extra $2 bil- have to decide who is an Indian. We ac- will commit that I will offer an amend- lion in a broken system is not just tually have some people who are a ment to increase the spending for this money that is broken with IHS. I be- thousand and 24th that we are giving in our budget. I also will commit that lieve the chairman will agree. What I full blown care to in Oklahoma. They when the appropriations come through, wanted to do is fix the system and in- have access to care somewhere else, although I may not vote for the whole crease the money, increase the choice but they don’t want to pay the deduct- appropriations bill because it is not and security that Native Americans ible or the copay. So they step in line going to just be for Indian health care, are entitled to that all the rest of us in front of a full blood. We have to I will vote for amendments that will have. change that. We have to fix that. We increase the amount of money that The fact is, if the only place a Native have to fix that because our obligation goes to Indian health care as long as it American can get care is IHS, that is has to be to the person with the most is within the budget. That is why I said not freedom. That is not the promise and then come down. So if we really my goal is to do that within the budget kept in its fullest bloom. It is saying, have restricted dollars, what we have where we could have a debate about here is the only place you can get care. to say is, if you are below a certain priorities. If the care happens to be great, super. level, you have to contribute some- Mr. DORGAN. If the Senator will But if the care happens to be average thing. That is the other way that we yield further, one of the dilemmas in and they need better, they don’t have solve this problem. That doesn’t de- providing Indian health care, not so that opportunity. If the care happens mean the heritage of our Native Ameri- much in the State of Oklahoma but in to be—and sometimes we know it is, cans. other areas where there are reserva- like some of the cases the chairman What that says is, the reality is, in tions, is in many cases the only health has presented—when it is substandard 2016 in this country, we are going to be care that is available is the Indian and that is the only choice they have, cutting spending all over the place be- Health Service clinic, and you are 80 that is not acceptable. cause that is the year interest rises miles away from the nearest hospital. Let me finish my deal, and I will let through the roof. That is the year we In many cases there will never be com- you go and you can hammer me. I hope run out of Social Security with which

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00027 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1020 CONGRESSIONAL RECORD — SENATE February 14, 2008 to pay for Medicare. That is the year in Mr. COBURN. I inquire of the Chair, My colleague says: I will support— which for the projected spending, based earlier this morning I made all my quoting him—increased funding, in- on revenues, based on growth even at 4 amendments pending. creased authorization. But the amend- percent, we start running trillion-dol- Mr. President, I ask for the regular ment he authors actually restricts the lar deficits—trillion-dollar deficits. order on amendment No. 4034. amount of money available. In order to Have we ever asked ourselves why The PRESIDING OFFICER. The do something new, if you are going to gold is worth four times more against amendment is pending. restrict the amount of money available the American dollar than it was 10 Mr. COBURN. Mr. President, I ask to what is available now—if you are years ago? Do you think it has any- for the yeas and nays on the amend- going to do something new—it is going thing to do with people thinking we ment. to come from some place. I will tell cannot pay back our debt? The PRESIDING OFFICER. Is there a you where it is going to come from. It So this idea that we are going to sufficient second? is going to come from clinics out in have more money in the future to do There appears to be a sufficient sec- those reservations where there is no more things is not going to be there. ond. choice. We need to come to the reality of the The yeas and nays were ordered. There is only one opportunity for situation. We need to start making The PRESIDING OFFICER. The Sen- somebody who has broken an arm or some of the hard choices. To me, keep- ator from North Dakota. developed an illness or disease and Mr. DORGAN. Mr. President, I thank ing our commitment to Native Ameri- needs to go someplace quickly to find my colleague for coming and debating cans has to be set up now; otherwise, it health care. They are going to go to the amendment. I understand he has to is not going to happen, and the funding the local Indian health clinic. This leave. money is going to come out of their is not going to get increased between The Senator from Oklahoma cer- hide because this amendment offered now and 2016. Other than what we do tainly is right, it is not more money provides a restriction that no addi- this year, it is going to be hard. The necessarily that is only going to solve money is going to be hard to get, even tional resources can exist. the problem. But I guarantee you that I do not denigrate the idea offered by if we get out of Iraq. less money will not solve the problem. We are going to get notice today on the Senator from Oklahoma. But this If we are 40 percent short of money what I have been working on for 2 clearly is not something that would be needed now, I guarantee you that the years, talking to the Census Bureau helpful to a lot of American Indians. In same amount of money will not solve about that they are going to be out of fact, I believe it would be hurtful to a the problem. The amendment he has of- control and spend a whole lot more lot of American Indians who are the fered has a provision that says we are money. I am getting ready to get no- ones who have no choice—who have no going to do something different, we are tice by the Secretary of Commerce—I choice at all—but must try to get their going to do something that is unique, have a meeting with him this after- emergency care and must try to get and, by the way, you cannot spend any noon—that there is going to be a close their basic health care met at those more money than you are now spend- to $3 billion more pickup to do some- clinics. ing in a system that is already 40 per- thing we have to do because it has been I mentioned this morning a woman cent short of money. totally mismanaged—totally mis- named Harriet Archambault whose How can we have an amendment that health care was in McLaughlin, SD, in managed. We have been having hear- restricts the amount of funding? When ings for 21⁄2 years on it, where they a satellite clinic of the Indian health he says that—he started this morning care facility for the Standing Rock have been denying it, and now they are by saying we are $2 billion short. It is coming to say it has been mismanaged. Tribe in Fort Yates, ND. That was her interesting, I do not necessarily dis- health care: the McLaughlin, SD, sat- They are coming to agree. agree with the proposition of trying to It is why oversight matters. Had we ellite clinic. They can handle 10 people find choices, providing an insurance gotten some of the amendments in the morning and 10 people in the card, or some other mechanism by through this body that we offered on afternoon. That is it. If you are not on which we create some competition with the census, we would not be here. But, the list of 10, that is it, and you cannot the Indian Health Service. But this instead, we are going to spend $2 bil- make a reservation. You come and you may be much better for Oklahoma than lion to $3 billion more because we did sign in. it might be for other States. not pass the amendments offered based Well, she came five times, drove 18 If you have an Indian Health Service on oversight that we did in my com- miles one way each time. Five times area where you are in an Indian res- mittee. she came, and 5 times she was too late The whole goal—I am not perfect. I ervation 80 miles from the nearest hos- to be in the top 10. She could not stay am not right, necessarily, on how I pital, and the only health care capa- because she was taking care of her want to do that. I will admit that to bility you have is to go to the Indian grandchildren. She was the daycare the chairman and ranking member. Health Service, well, you know what, provider for her grandchildren. Her But I know more money does not solve we better have adequate funding for medicine had run out for hypertension the problem on this, and unless we cre- that, at least current funding for that. and high blood pressure in mid-Octo- ate real freedom, real choice, and real If you add another program on top of ber. Five times she got up early in the health care security for Native Ameri- this for other Indians who can go some- morning to drive nearly 20 miles, and cans, we will never have an efficient where else in a metropolitan area and she did not get there in time. There IHS system, and we will never meet the be able to present a card, because they were 10 people on the list ahead of her. commitments that we say we have. have now taken money out of the sys- One month later she died. She tried So I will ask for the yeas and nays on tem and purchased their own insur- five times and never got there, in a re- this amendment. I will listen to the ance—you allow that to happen, then mote satellite location. chairman. I do have a meeting at 2 the American Indian who is living on The fact is, people are dying. Chil- o’clock I have to be at. Whenever the the reservation with the current Indian dren are dying. Elders are dying. There chairman would like to stack the Health Service clinic there has less is not nearly enough money to keep votes, if we run others, I will be happy money. the promise this country made to to work with whatever is his pleasure. How does that work to help the folks American Indians. The amendment of- Mr. President, I ask for the yeas and who are stranded with no competition? fered today is one I am very interested nays. It seems to me the way this is written, in working with the Senator from The PRESIDING OFFICER. The with a restriction that says there can- Oklahoma on in a significant reform amendment is not currently pending. not be any additional resources beyond package in which we dramatically in- AMENDMENT NO. 4034 that which currently exist—and, by the crease the resources to keep our prom- Mr. COBURN. I ask that amendment way, the President wants to cut that. ise, and then try to provide some com- be brought up, No. 4034 be made pend- We have wide-scale health care ration- petition and some choice. I am inter- ing, and ask for the yeas and nays. ing going on in this country, with peo- esting in doing that, frankly. The PRESIDING OFFICER. Is there ple dying because of it, and the Presi- I am not interested in passing an objection? dent’s budget cuts it. amendment that says, let’s do this in a

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00028 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1021 way that restricts funding for others, Senate from any further consideration Mr. DORGAN. I would be happy to which is what this amendment does. of this bill until he decides to return? yield. There is a specific restriction on fund- Is that the situation? Mrs. BOXER. Thank you. In order to ing, and that means there is going to Mr. DORGAN. Mr. President, I am try to get my schedule and Senator be less funding for those clinics, in- told one of our colleagues, who is upset BYRD’s schedule—I know Senator BYRD cluding the satellite clinics. That is about something, has gone off to give a wishes to speak for about 20 minutes. I not something I am willing to enter- speech downtown at a meeting and will wish to ask unanimous consent if I tain. not return for a while. His staff indi- could follow him because there was an But, again, I appreciate finally get- cates we are not to move without his amendment that involved California. I ting an amendment offered. My col- consent, and he won’t provide consent was not able to be here, and I wish to league indicated he will be back. I indi- until he comes back, if then. answer that. If I could follow Senator cated earlier we are at parade rest be- Mr. DURBIN. So the Senate is at a BYRD. cause one of our colleagues apparently halt at this point until the Senator’s Mr. DORGAN. Mr. President, how has an objection, through his staff, personal schedule accommodates his much time is Senator BYRD requesting? through leadership, and he is off, ap- return? Mr. BYRD. Fifteen minutes. parently, at a meeting downtown, and Mr. DORGAN. Well, it sounds that Mr. DORGAN. Mr. President, Senator has a speech, and he will be back some- way. But we will see. Again, it is very MURKOWSKI may wish to add some com- time around 3:30 maybe. But in the frustrating. We have worked very hard ments, at which point I believe I will meantime, through his staff, we are to bring this legislation to the floor of send the managers’ package to the told we are not able to move on any- the Senate. I know a lot of people are desk and ask for its consideration. thing. counting on the Congress to do the Mrs. BOXER. Mr. President, can I I have a managers’ package that is right thing. My hope is we can move have an answer to my question? agreed to, I believe, and I want to send forward. I think we have about four Mr. DORGAN. I intend to answer the it to the desk in a moment. My under- amendments we have cleared. We have Senator. standing is, we cannot move to em- a managers’ package that is cleared. Mrs. BOXER. Thank you. brace it despite the fact it would be a We will get votes on the Coburn Mr. DORGAN. Following that, I will unanimous consent, because one of our amendment, which is germane, right be happy to yield the floor. As I under- colleagues is downtown and will not be on target, on the bill. So there is no stand it, the Senator from California back for an hour and a half. That will reason we cannot move forward and get wishes to follow the Senator from West make him gone for 3 hours. In the this piece of legislation done. Virginia. Mr. DURBIN. Mr. President, I would Mrs. BOXER. If I might, yes. meantime, we sit here with our hands like, through the Chair, to ask the Sen- Mr. DORGAN. The Senator from in our pockets trying to figure out how ator from North Dakota, why don’t we West Virginia wants 15 minutes. And on Earth we explain this is a body that go ahead and move the package then, the Senator from California wants how is supposed to get something done. and we can preserve the right of that much time? I said this morning I have often Senator to offer his amendment when Mrs. BOXER. I think if I have 15 min- called this place 100 bad habits, despite he returns. That is preserving his right utes that would be fine. the fact I feel enormously privileged to as a Senator if he wants to offer an Mr. DORGAN. Mr. President, let me be here. I love the Senate. But I am not amendment. But to stop the entire defer on the managers’ amendment for very happy about the way this place amendment process and all the other a moment, and let us begin with Sen- works today because we deal with an possibilities—I hope we do not let that ator BYRD’s request for 15 minutes, fol- important issue that is life or death to happen. lowed by Senator BOXER. Then my hope some people, and we are having a dif- Through the Chair, I ask the Senator would be that we can come back to this ficult time. from North Dakota, is that being con- bill. We have amendments pending and Senator MURKOWSKI has worked on sidered? it is very important that we finish the this bill with me for a long period of Mr. DORGAN. Yes. Let me do this. bill itself this afternoon. time. Before her, Senator MCCAIN Let me say the managers’ package is Does Senator MURKOWSKI wish to worked on this legislation. We are fi- something we have negotiated. I be- comment at this point before Senator nally on the floor of the Senate, and lieve it has been agreed to unani- BYRD takes the floor? because of things that have nothing at mously. I do not know of any objection Ms. MURKOWSKI. I will defer to all to do with this bill, we are standing to the package itself. I do know of Senator BYRD. here frozen because somebody is gone, some objections to the process because Mr. DORGAN. Mr. President, I yield apparently. one Senator who is not here has staff the floor. Mr. DURBIN. Mr. President, will the objecting. The PRESIDING OFFICER. The Sen- Senator yield? Let me suggest in about 5 minutes I ator from West Virginia is recognized. Mr. DORGAN. Mr. President, I am am going to send the managers’ pack- WAR FUNDS happy to. age to the desk and ask for its consid- Mr. BYRD. Mr. President, on Feb- Mr. DURBIN. Mr. President, I say to eration. If there is someone who feels a ruary 11, 2008, the Congressional Budg- the Senator from North Dakota, this is managers’ package that has been et Office responded to an inquiry from a critically important bill for a lot of unanimously agreed to and worked on Senator KENT CONRAD, the chairman of very vulnerable people, Native Ameri- very hard—by the way, let me say—and the Committee on the Budget, regard- cans, who have not been treated well my colleague Senator MURKOWSKI can ing the costs to date of U.S. operations throughout our history. I thank the add to it—we have about five or six and involvement in Iraq and Afghani- Senator from North Dakota for his areas in the managers’ package that stan. Allow me to quote in full the crit- leadership in trying to bring this bill are very controversial and had caused ical summary line of this letter: to the floor. But could I ask the Sen- us a lot of problems. We worked and If the administration’s request for 2008 is ator from North Dakota, how many worked and negotiated with all of funded in full, appropriations for military days have we been on the bill on the those for whom this controversy exists, operations and other war-related activities floor of the Senate? and we negotiated something that is in Iraq, Afghanistan, and elsewhere in the Mr. DORGAN. Mr. President, this is agreeable to everybody. It was a good war on terrorism will rise to $188 billion this this third day we have been on the thing to have done. Finally, this man- year and to a cumulative total of $752 billion floor of the Senate. Our hope was this agers’ package, I think, is now agree- since 2001. would be the day in which we complete able to everybody, and it is a good It can be difficult to truly grasp how action by late this afternoon. Obvi- piece of work. So in about 5 minutes I large a number is $752 billion. Let me ously, it does not appear that way. wish to send it to the desk and ask for offer some comparisons. According to Mr. DURBIN. Mr. President, is it my its consideration. Forbes Magazine, the world’s most ex- understanding that one Senator has Mrs. BOXER. Mr. President, will the pensive car, a 1930 Bugatti Type 41 announced he is off for lunch and some Senator yield, through the Chair, for a Royale, is worth an estimated $10 mil- meetings and would like to stop the question? lion. For $752 billion, one could own a

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00029 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1022 CONGRESSIONAL RECORD — SENATE February 14, 2008 fleet—a fleet—of 75,200 Bugatti Type 41 much, much remains undone that was quest, to be able to share with our col- Royales; that is, if more than 6 had supposed to be done long, long ago. As leagues, I may ask her to yield so I ever been made, or for $752 billion one long as in-country government officials might propound a unanimous consent could purchase 442 space shuttles at and all of the associated contractors request during her presentation. $1.7 billion each, according to NASA. continue to profit from corruption and The PRESIDING OFFICER. The Sen- Here is one final comparison: Accord- an unchecked ability to commit fraud, ator from California is recognized. ing to the Bureau of the Census, the waste, and abuse, there is little—little, AMENDMENT NO. 4067 average price of a home in the United I say—incentive for anyone to make Mrs. BOXER. Mr. President, I am States in 2007 was $311,600. Let me re- the progress that would assist the speaking to an amendment that was of- peat: According to the Bureau of the United States and the rest of the inter- fered by Senator DEMINT, which he Census, the average price of a home in national community in departing. said he wants to reoffer. I want to ad- the United States in 2007 was $311,600, American taxpayers and the Com- dress this amendment which unfairly assuming one could still get a mort- mittee on Appropriations have invested targets and penalizes taxpaying Ameri- gage in today’s real estate market. For $752 billion in Iraq and Afghanistan. We cans by denying them some very im- $752 billion, one could buy 2,413,000 expect to see that treasure treated portant appropriations that were ap- homes—enough homes to house every with the same respect that we give to proved by Congress in 2008. family in a city roughly the size of our troops. They too have worked hard. Senator DEMINT came to the floor to Jacksonville, FL or Indianapolis, IN. They too have sacrificed much to pro- describe actions that the city of Berke- That is $752 billion and counting, as vide the security for reconstruction ef- ley took last week in relation to the the President’s fiscal year 2009 budget forts to take place. None of that sac- U.S. Marine Corps recruiting office. request has come in, and Secretary rifice—none of that sacrifice—should Let me be completely clear about those Gates has suggested that after the be thrown away on cases of fraud, actions. Three of the members, in par- ‘‘surge’’ troops come home, troop levels waste, abuse, and through rampant ticular, wanted to send a letter ex- in Iraq will not—not—drop below corruption. I—the personal pronoun I— pressing their disapproval of the Ma- 130,000 for at least—at least—the re- intend to conduct a hearing on this rines having a recruiting center in mainder of this year. In Afghanistan, matter as a first step, as a first step in Berkeley. The language was offensive the 27,500 troops currently deployed what will be a long, long, hard look at to many. I did not agree with anything will be augmented by an additional just where—just where—the taxpayers’ they said. 3,200 marines this spring. So I do not hard-earned money has been going. Now, on Tuesday, they explicitly believe that this budgetary comet will I intend to invite Senator DORGAN, I stated that the ill-advised letter they do anything but continue its meteoric intend to invite Senator LEAHY, and I were planning to send to the Marines rise. intend to invite Representative WAX- would no longer be sent. Therefore, you We all might still count this $752 bil- MAN to testify on the findings of their would think Senator DEMINT would lion as well spent if we thought we earlier investigations. I will also invite then say, fine, I am glad they changed were getting good value for our money, other witnesses to offer their expertise their mind. In addition, the city said if both nations were being rebuilt and on issues concerning the abuse, misuse, this in writing. showing signs of stability and recov- and loss of U.S. funds to corrupt prac- I ask unanimous consent to have ery. However, there is evidence that tices. I appreciate the encouragement printed in the RECORD the statement the vast sums of money being thrown and support of our Democratic leader, they made about the Marines, if I at Iraq and Afghanistan are not all Senator REID, in tackling this issue. might. being well spent. Far too much money This is not a partisan issue. Good There being no objection, the mate- is being siphoned off to line the pock- governance and the wise use of tax- rial was ordered to be printed in the ets of greedy contractors while the payer dollars are always nonpartisan RECORD, as follows: work which they are being paid to do goals. It is the responsibility of all of CITY OF BERKELEY, goes undone or is poorly done. Alarm- us—and I mean all of us—to determine CITY CLERK DEPARTMENT, ingly, money, weapons, and oil profits the scope and the scale of the problems Berkeley, CA, February 13, 2008. have apparently been delivered directly and then to devise the best—nothing To: Senator Barbara Boxer, Jennifer Tang: to insurgents and militias that are not but the best, and only the best—and Per your request, below is an excerpt from under government control in Afghani- fastest solutions to fix them. the February 12, 2008 City Council meeting stan and Iraq. That must be stopped. I yield the floor. Annotated Agenda in reference to Item 25. In Afghanistan, one U.S. think tank The PRESIDING OFFICER (Mr. NEL- 25. Reiteration of Berkeley’s Opposition to recently estimated that only $1 of aid SON of Nebraska). The Senator from the Iraq War and Clarification of the City’s out of every $10 actually reaches an Af- North Dakota is recognized. Support for the Men and Women who Volun- tarily Serve this Country in the Military. ghan. In Iraq, a local Iraqi businessman Mr. DORGAN. Mr. President, the an- From: Councilmembers Olds and Capitelli. told a reporter that: nouncement by the Senator from West Recommendation: I’d say that about 10 percent of business Virginia, chairman of the Appropria- (1) That the City Council through adoption was corrupt under Saddam. Now, it’s about tions Committee is, I think, good news. of this item, publicly differentiate between 95 percent. We used to have one Saddam, now It is the case that the Appropriations the City’s documented opposition to the un- we have 25 of them. Committee appropriates a great deal of just and illegal war in Iraq and our respect Despite the growing reports of cor- money, and the question about over- and support for those serving in the armed forces. rupt practices and the rising number of sight is very important. The Senator (2) Rescind point 2 of Item 12, of the Janu- allegations of the fraud, waste, and from West Virginia talks about under- ary 29, 2008 Berkeley City Council Agenda, abuse of Government contracts, not standing and needing to know how the ‘‘Marine Recruiting Office in Berkeley,’’ re- enough is being done to apply diplo- money is spent, where the money is garding communications with the Marine matic pressure on the Governments in spent. Recruiting Station in Berkeley. Iraq and Afghanistan to clean up their With nearly three quarters of a tril- Financial Implications: None. acts, and not enough resources are lion dollars having been spent on the Contact: Betty Olds, Councilmember, Dis- trict 6, 981–7160. being applied to efforts to investigate wars in Afghanistan and Iraq and the Action: M/S/C (Mario/Moore) to— and prosecute contract fraud. Congress war on terror, there has been so much 1. Accept Councilmembers Olds and has been watching, holding hearings, waste, fraud, and abuse, and there has Capitelli’s recommendation to publicly dif- and complaining on behalf of the tax- been too little oversight. The Senator ferentiate between the City’s documented payers, but much more—much more— from West Virginia is showing great opposition to the unjust and illegal war in needs to be done. After 7 years, we can- foresight and courage in saying we are Iraq and our respect and support for those not continue to hide behind feeble ex- going to provide that oversight. I think serving in the armed forces, and the Senate and the American people 2. Accept the following statement sub- cuses. Too much money is being lost to mitted by Mayor Bates and Councilmembers continue to let the systemic abuses owe him a debt of gratitude for launch- Anderson, Maio and Moore: persist. ing this effort. I say thank you. Given the confusion about the Council’s After 7 long years, 7 long years of oc- I know the Senator from California is action on January 29, 2008, a strong state- cupation and reconstruction efforts, going to speak. When we finish the re- ment of the Berkeley City Council’s position

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00030 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1023 regarding the Marine Recruiting Station is to see what they might say, and then because they are attracted to high- needed. The City of Berkeley and the citizens say I am going to punish everybody be- sugar foods and sodas and all the are strongly opposed to the war in Iraq. The cause I don’t agree with that speech. things that are not good for them. Here war has resulted in over 4,000 soldiers killed, The other thing I found interesting is is a program that teaches them to love tens of thousands wounded in body and spir- that in a press release the Senator the whole notion of eating in a healthy it, hundreds of soldier suicides, and millions of Iraqi people killed, injured and displaced from South Carolina, Senator DEMINT, way. That is a program Senator from their homes. In addition, the hundreds challenged the process by which the DEMINT went after, along with his of billions of dollars spent on this deeply im- funding requests were granted by the friends who are cosponsors. I wish to moral war could have been spent to meet the Appropriations Committee. Today, he show you some other programs that needs of our people and to strengthen our called them ‘‘secret’’ earmarks. Yet are impacted. This is unbelievable. economy. We recognize the recruiter’s right every one of these projects was funded In this photo, we see a few of the to locate in our city and the right of others in the most open and transparent man- most seriously disabled people you can to protest or support their presence. We ner. find in America today. They want to deeply respect and support the men and I will show you what those earmarks live independently. Here is Ed Roberts, women in our armed forces. However, we who needs oxygen every second, with a strongly oppose the war and the continued are. As a matter of fact, this is an op- recruitment of our young people into this portunity for me to celebrate those tube in his mouth. We want these won- war. particular projects because they are so derful people—some of them who are With the issuance of this statement there important to the police, to the fire de- veterans—to be able to live independ- is no need to send the letter to the Marine partment, to the children, to the dis- ently. Here you see pictures of them Corps that the City Council approved on Jan- abled, to students, to the memory of a doing that, with paralyzed bodies— uary 29, 2008. wonderful Congressman Bob Matsui, children, moms. He wants to take away Noes: Olds, Wozniak. and also to the environment. You will the funding because he disagreed with Mrs. BOXER. Mr. President, they see what I mean. Every document per- what some people said at the Berkeley said they ‘‘deeply respect and support taining to those projects was made City Council, which they now have the men and women of our Armed available to the public. Every request taken back. Outrageous. Outrageous. Forces.’’ I think the council did the was approved in the openness of the Let’s show you the other earmarks right thing. They realized they should House and Senate Appropriations Com- they are going after. Here are students not mix up the Iraq war, which was mittees and the openness of the House at UC Berkeley. There is a program brought to us by this President, and and Senate Chambers. named after Bob Matsui, the beloved the warriors who fight it. There is a If the Senator from South Carolina, Congressman. They are going after difference. They recognized that. I am Senator DEMINT, was so concerned that program as well. very glad about that. You would think with these funding requests for our po- Here is a picture of congestion in the Senator DEMINT would be very glad lice, for our fire department, for our San Francisco Bay area, where you can see the Bay Bridge here; and you can about that. He is not. He is still angry children, the disabled community, for barely tell it from where you are sit- and he is still wanting to fight the bat- our environment, and for our college ting, Mr. President, but all these dots tle of a couple weeks ago and not rec- students, he had the opportunity to are cars. We have the most congested ognize the fact that this letter he was challenge the funding of those re- areas in the country. We want to get railing about, which offended him and quests. He had that opportunity when funding for a ferry boat to carry people many others, was never sent. the bill was on the Senate floor. He and get them out of their cars and use That aside, the DeMint amendment didn’t do that. Oh, no, he is going to the waterways. This was Congress- is an attack on the rights of citizens to challenge them because someone in the woman LEE’s earmark. He wants to cut participate in free speech. There are a city council—several members—said lot of things that go on in this country this because he didn’t agree with mem- something offensive that he didn’t like bers of the council who have now taken that I think are terrible; I think they and, therefore, as a result of that, in- are wrong, mean spirited, and hurtful. back what they said. stead of standing up and talking to Here are our heroes, the firefighters. I think a lot of things, because we all those people who made those offensive They are part of the recipients of an have our own opinions on what is said. comments and trying to change their award that we said they deserve so If every time I heard about some city mind, he tries to punish all the people there could be some communication in councilman in some city in another in the surrounding area. The reason, I our region between the fire and the po- State saying something I thought was would posit, that the Senator didn’t lice in the jurisdiction, so that when offensive, that hurt our military, our challenge these earmarks at the time we have a terror attack—and we hope seniors, disabled people, minorities or they were made is because they are ex- we never do—or when we have a fire— children, I came out here and said: Oh, cellent programs. and we often do—or an earthquake, my goodness, let’s withhold funds from Congressional and executive funding which we often do, they have commu- that city because of that city council- requests, whether they are earmarks nications equipment. This is what Sen- man, we would have quite a situation from the President or Congress, should ator DEMINT wants to take away from on our hands. be awarded based on merit, not based law-abiding firefighters because he State and local governments all on what someone in a community said. didn’t agree with something the city across this Nation pass resolutions and It is just beyond belief. They should be council said, which they took back. measures that many of us don’t agree able to stand on their own merits and Here is the real point I have to make with on a host of issues. Disagreements serve the people we represent. about all this. Senator CHAMBLISS is an are part of the political discourse. Why I am going to show you some photo- original cosponsor of the DeMint on Earth would we punish good, decent graphs that talk about some of these amendment challenging these ear- citizens because some members of their earmarks. The first is of these beau- marks. Let’s look at an earmark he got local government or the sewer district tiful children standing in this garden in his State. It was for the Daugherty or mosquito abatement district or that is run for the benefit of public County School System Healthy Life- water district or others say something schools in the Berkeley School Dis- style Program. Ours is the Berkeley that is offensive? Yes, we have a right trict. These students learn how to Unified School District School Lunch to come to the floor, as Senator plant and grow vegetables and harvest Initiative. I don’t see Senator CHAM- DEMINT did, and say it is terrible and the vegetables. They work the garden. BLISS trying to give up his program. I wrong and take it back. That is fine. I They learn about nutrition. They learn would never try to take that away welcome that. But I don’t sit around how to cook the food, serve the food, from him because of something some- waiting to hear what they are saying in and clean up. This is such a popular body said in his State that I didn’t South Carolina, Georgia, Texas, and program that it is being replicated in agree with. Oklahoma—those are the States of the places as far away as Louisiana. We all Here is Senator CORNYN, another Senators who want to take away these know we have serious problems with proud sponsor of the DeMint amend- funds from the good people of northern our kids with diabetes. We know our ment to slash these earmarks: Ed Rob- California. I don’t sit around waiting kids don’t eat the way we want them to erts Disability Services Campus in

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00031 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1024 CONGRESSIONAL RECORD — SENATE February 14, 2008 Berkeley. I showed the people coming Berkeley is a tremendous supporter of all the If he wants to continue with this back from the war, paralyzed veterans military programs on campus as well as all amendment, if he wants to offer it to in wheelchairs. Senator CORNYN wants the military personnel, their dependents and every bill we have, then I will be right veterans who attend this university. It to cut that earmark because the city would be a travesty of justice to . . . punish down here with these photographs and council said something offensive which UC Berkeley for the actions of the Berkeley others that I have. I will be right down they have now since taken back. I City Council. here with more testimony from the would never go after Senator CORNYN’s When this was written, I don’t know military who will testify to how in- paratransit vehicle replacement in Abi- whether Captain Laird knew that the credibly welcoming UC Berkeley is to lene, TX. Berkeley City Council did not send our men and women in uniform. Here we go: The Strom Thurmond that letter and instead finally realized There will be wars in the future—we Fitness and Wellness Center at the their mistake and said how much they all hope there will not be, but there University of South Carolina. We don’t support our men and women in uni- may be—with which we do not agree, know who got that earmark because it form. but we must never confuse our anger at was secret. It was secret. But I would The fact is, this kind of a punishment the people who would send our young never try to take away the Strom for a community such as this, a com- people to a war of choice or a wrong- Thurmond Fitness and Wellness Cen- munity of families who care about headed war and the young people who ter. Then let them leave alone the Bob their country, who are taxpaying citi- are sent there. We must come here Matsui Center for Public Service at UC zens, because of actions of a few, is an every day to support those young men Berkeley. outrage. It would be a terrible prece- and women. Let’s not use this as a way Senator INHOFE, my friend, is a proud dent if we now started punishing chil- to take cheap political shots because sponsor of this amendment, too. He has dren, policemen, firemen, disabled vet- they do not deserve it. the Oklahoma City River Ferry Boat erans, and students. If that is what we Mr. President, I yield the floor. Transportation Program. He was proud are going to become in this Senate, The PRESIDING OFFICER. The Sen- to get that earmark. I would never go then we do not deserve to be here. That ator from North Dakota. after that if someone in Oklahoma said is absolutely wrong. Mr. DORGAN. Mr. President, we have something that I did not like, a city The Marine Corps has given 232 years been patiently waiting for some hours councilman, a mayor. Maybe I of exemplary service to our Nation and, now. It is pretty unbelievable to watch wouldn’t like it and I might write them tragically, 974 of the marines who this process work. The old saying a letter and say what they said was served in Iraq paid the ultimate price. about watching sausages being made or wrong, unpatriotic, I don’t agree with More than 440 of those were based at laws being made, it is not a very at- it. But I would never go after an ear- Twenty-nine Palms and Camp Pen- tractive picture. That certainly is true mark that helps move people from dleton in my home State of California. today on the floor of the Senate. We have legislation we reported out place to place. So let him leave alone The Marines deserve our respect and from the Indian Affairs Committee the San Francisco water ferry. our gratitude and our support. dealing with an obligation that this Here is Senator VITTER, another Again, I am glad that the council re- country has to provide Indian health proud cosponsor of the DeMint amend- alized there is a difference between a care. It is an obligation we promised in ment. I cannot tell my colleagues how war and a warrior. treaties. It is a trust obligation re- many times I have helped Senator VIT- Again, Senator DEMINT seems to be affirmed by our courts, and it has been TER in my committee get help for the making political points on an issue nearly 10 long years getting to the people of Louisiana. Do I agree with that essentially was resolved. But if he floor to reauthorize the Indian Health what every city council member says wants to come here and debate with me Care Improvement Act. It is not as if in Louisiana? Probably not. And if I why it is right to take away money from students, if he wants to debate anybody is speeding around here. did disagree with them, if they said We finally get to the floor of the Sen- something I found unpatriotic or not with me why it is OK to take away money from disabled veterans, why it ate, we are on the third day, and we caring about our troops, I would send have all kinds of amendments that them a letter, but I wouldn’t go after is OK to take away money from fire- fighters, many of whom are veterans, have little to do with Indian health Senator VITTER’s earmark for the many of whom put their lives on the care. Baton Rouge Communication Tech- We have been standing at parade rest nology Pilot Program because I think line every day, if he wants to have that debate, I will be on my feet, and I will for 3 hours while one of our colleagues it is important that police, fire, and has been giving speeches downtown and emergency workers, who are our he- have that debate. I know Senator DORGAN wishes to their staff has indicated they must ob- roes, have the funding they need. have the floor. Mr. President, is Sen- ject to this request. I do not under- The final item I want to show my ator DORGAN ready to make his UC re- stand the 25 stages of approval required colleagues is this: This move by Sen- quest? in this Chamber to say hello or good- ator DEMINT to take away the funding Mr. DORGAN. Mr. President, has the bye. Perhaps we can find a way to was addressed by the chair of the Mili- Senator from California completed? move on the issue that confronts the tary Affairs Department, Commanding Mrs. BOXER. I will yield to Senator Senate at this moment, and that is In- Officer, ROTC, at the University of DORGAN or I can complete in 2 minutes. dian health care. Even as we talk, peo- California. I want to read what he said Mr. DORGAN. Mr. President, I ask ple die out there because there is full- about the University of California at the Senator from California to com- scale rationing of health care. Berkeley. I will just read certain state- plete her statement, after which I will One part of this legislation that we ments: be recognized. have worked on is called the managers’ Given the recent spate of controversy sur- Mrs. BOXER. The point I am making package. It is not a typical managers’ rounding the U.S. Marine recruiting office is, we all have our opinion on what package we see with other legislation . . . I feel it is my obligation to inform mem- constitutes free speech. I support Sen- where there are a lot of additions. This bers of Congress of the relationship we have ator DEMINT’s right to express his managers’ package is a requirement we with the university and the outstanding sup- had to try to negotiate about five very port it provides not just to the ROTC Pro- opinion about what he thought of the gram but to all military personnel, their de- proposed actions of the Berkeley City difficult and very controversial issues. pendents and veterans as well. Council. He has every right to do that. We had great objections to certain UC Berkeley has been and continues to be He has every right to offer his amend- areas of the bill, so Senator MURKOWSKI a very big supporter of all our ROTC pro- ment. But I have every right to come and I and our staffs worked over the grams here on campus. They should in no down here and say I think not only is last month to negotiate, and we way be associated with or linked to the ac- it mean-spirited, it is hurtful to the reached agreement on five or six areas. tions of the Berkeley City Council which has wrong people. And I have every right to That agreement was pretty difficult taken on a very outspoken stance against to reach, but we did it with a lot of the United States Marine Corps Recruiting come down here and say: Senator Station in the city. . . . DEMINT, they never sent that letter to people on both sides of the aisle. That I would like to ensure that those in favor the Marines, happily. They rethought is what is comprised of this managers’ of the Semper Fi Act understand that UC it. package.

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AMENDMENT NO. 4082 TO AMENDMENT NO. 3899 ‘‘(4) substantive knowledge of the project (as amended by section 101) is amended by Our managers’ package is at the or function to be contracted for; striking paragraph (27) and inserting the fol- desk. I ask unanimous consent that the ‘‘(5) adequately trained personnel; or lowing: pending amendment be set aside and ‘‘(6) other necessary components of con- ‘‘(27) The term ‘urban Indian’ means any tract performance. individual who resides in an urban center that the managers’ amendment, which ‘‘(b) PAY RATES.—For the purpose of imple- and who meets 1 or more of the 4 criteria in is at the desk, be considered. menting the provisions of this title, the Sec- subparagraphs (A) through (D) of paragraph The PRESIDING OFFICER. Without retary shall assure that the rates of pay for (12).’’. objection, it is so ordered. The clerk personnel engaged in the construction or Beginning on page 358, strike line 23 and will report. renovation of facilities constructed or ren- all that follows through page 360, line 11, and The assistant legislative clerk read ovated in whole or in part by funds made insert the following: (d) SATISFACTION OF MEDICAID DOCUMENTA- as follows: available pursuant to this title are not less than the prevailing local wage rates for simi- TION REQUIREMENTS.—Section 1903(x)(3)(B) of The Senator from North Dakota [Mr. DOR- lar work as determined in accordance with the Social Security Act (42 U.S.C. GAN], for himself and Ms. MURKOWSKI, pro- sections 3141 through 3144, 3146, and 3147 of 1396b(x)(3)(B)) is amended— poses an amendment numbered 4082 to title 40, United States Code. (1) by redesignating clause (v) as clause amendment No. 3899. On page 176, strike lines 12 through 15 and (vii); and Mr. DORGAN. Mr. President, I ask insert the following: (2) by inserting after clause (iv), the fol- unanimous consent that the reading of ‘‘(3) staff quarters; and lowing new clauses: the amendment be dispensed with. ‘‘(4) specialized care facilities, such as be- ‘‘(v) Except as provided in clause (vi), a havioral health and elder care facilities. document issued by a federally recognized The PRESIDING OFFICER. Without Indian tribe evidencing membership or en- objection, it is so ordered. On page 196, line 15, insert ‘‘, including pro- grams to provide outreach and enrollment rollment in, or affiliation with, such tribe The amendment is as follows: through video, electronic delivery methods, (such as a tribal enrollment card or certifi- On page 139, strike lines 5 through 9 and in- or telecommunication devices that allow cate of degree of Indian blood). sert the following: real-time or time-delayed communication ‘‘(vi)(I) With respect to those federally rec- ‘‘(III) may include such health care facili- between individual Indians and the benefit ognized Indian tribes located within States ties, and such renovation or expansion needs program,’’ after ‘‘trust lands’’. having an international border whose mem- of any health care facility, as the Service On page 269, strike line 18 and insert the bership includes individuals who are not citi- may identify; and following: zens of the United States documentation (in- On page 143, strike lines 15 through 17 and ‘‘(d) ALLOCATION OF CERTAIN FUNDS.— cluding tribal documentation, if appropriate) insert the following: Twenty per- that the Secretary determines to be satisfac- wellness centers, and staff quarters, and the On page 336, between lines 2 and 3, insert tory documentary evidence of United States renovation and expan- the following: citizenship or nationality under the regula- On page 145, line 13, insert ‘‘and’’ after the ‘‘SEC. 8ll. TRIBAL HEALTH PROGRAM OPTION tions adopted pursuant to subclause (II). semicolon. FOR COST SHARING. ‘‘(II) Not later than 90 days after the date On page 145, line 16, strike ‘‘; and’’ and in- ‘‘(a) IN GENERAL.—Nothing in this Act lim- of enactment of this subclause, the Sec- sert a period. its the ability of a Tribal Health Program retary, in consultation with the tribes re- On page 145, strike lines 17 and 18. operating any health program, service, func- ferred to in subclause (I), shall promulgate On page 146, line 9, strike ‘‘hostels and’’. tion, activity, or facility funded, in whole or interim final regulations specifying the On page 147, strike lines 15 through 21 and part, by the Service through, or provided for forms of documentation (including tribal insert the following: in, a compact with the Service pursuant to documentation, if appropriate) deemed to be ‘‘(e) FUNDING CONDITION.—All funds appro- title V of the Indian Self-Determination and satisfactory evidence of the United States priated under the Act of November 2, 1921 (25 Education Assistance Act (25 U.S.C. 458aaa citizenship or nationality of a member of U.S.C. 13) (commonly known as the ‘Snyder et seq.) to charge an Indian for services pro- any such Indian tribe for purposes of satis- Act’), for the planning, design, construction, vided by the Tribal Health Program. fying the requirements of this subsection. or renovation of health facilities for the ben- ‘‘(b) SERVICE.—Nothing in this Act author- ‘‘(III) During the period that begins on the efit of 1 or more Indian Tribes shall be sub- izes the Service— date of enactment of this clause and ends on ject to the provisions of section 102 of the In- ‘‘(1) to charge an Indian for services; or the effective date of the interim final regula- dian Self-Determination and Education As- ‘‘(2) to require any Tribal Health Program tions promulgated under subclause (II), a sistance Act (25 U.S.C. 450f) or sections 504 to charge an Indian for services. document issued by a federally recognized and 505 of that Act (25 U.S.C. 458aaa–3, On page 347, after line 24, add the fol- Indian tribe referred to in subclause (I) evi- 458aaa–4). lowing: dencing membership or enrollment in, or af- Beginning on page 159, strike line 12 and SEC. 104. MODIFICATION OF TERM. filiation with, such tribe (such as a tribal en- all that follows through page 161, line 16, and (a) IN GENERAL.—Except as provided in rollment card or certificate of degree of In- insert the following: subsection (b), the Indian Health Care Im- dian blood) accompanied by a signed attesta- ‘‘SEC. 303. PREFERENCE TO INDIANS AND INDIAN provement Act (as amended by section 101) tion that the individual is a citizen of the FIRMS. and each provision of the Social Security United States and a certification by the ap- ‘‘(a) DISCRETIONARY AUTHORITY; COVERED Act amended by title II are amended (as ap- propriate officer or agent of the Indian tribe ACTIVITIES.—The Secretary, acting through plicable)— that the membership or other records main- the Service, may utilize the negotiating au- (1) by striking ‘‘Urban Indian Organiza- tained by the Indian tribe indicate that the thority of section 23 of the Act of June 25, tions’’ each place it appears and inserting individual was born in the United States is 1910 (25 U.S.C. 47), to give preference to any ‘‘urban Indian organizations’’; deemed to be a document described in this Indian or any enterprise, partnership, cor- (2) by striking ‘‘Urban Indian Organiza- subparagraph for purposes of satisfying the poration, or other type of business organiza- tion’’ each place it appears and inserting requirements of this subsection.’’. tion owned and controlled by an Indian or ‘‘urban Indian organization’’; On page 360, strike lines 21 and 22. Indians including former or currently feder- (3) by striking ‘‘Urban Indians’’ each place Beginning on page 361, strike line 19 and ally recognized Indian Tribes in the State of it appears and inserting ‘‘urban Indians’’; all that follows through page 362, line 4, and New York (hereinafter referred to as an ‘In- (4) by striking ‘‘Urban Indian’’ each place insert the following: dian firm’) in the construction and renova- it appears and inserting ‘‘urban Indian’’; ‘‘(1) NO COST SHARING FOR INDIANS FUR- tion of Service facilities pursuant to section (5) by striking ‘‘Urban Centers’’ each place NISHED ITEMS OR SERVICES DIRECTLY BY OR 301 and in the construction of safe water and it appears and inserting ‘‘urban centers’’; THROUGH INDIAN HEALTH PROGRAMS.— sanitary waste disposal facilities pursuant to and ‘‘(A) NO ENROLLMENT FEES, PREMIUMS, OR section 302. Such preference may be accorded (6) by striking ‘‘Urban Center’’ each place COPAYMENTS.— by the Secretary unless the Secretary finds, it appears and inserting ‘‘urban center’’. ‘‘(i) IN GENERAL.—No enrollment fee, pre- pursuant to rules and regulations promul- (b) EXCEPTION.—The amendments made by mium, or similar charge, and no deduction, gated by the Secretary, that the project or subsection (a) shall not apply with respect copayment, cost sharing, or similar charge function to be contracted for will not be sat- to— shall be imposed against an Indian who is isfactory or that the project or function can- (1) the matter preceding paragraph (1) of furnished an item or service directly by the not be properly completed or maintained section 510 of the Indian Health Care Im- Indian Health Service, an Indian Tribe, a under the proposed contract. The Secretary, provement Act (as amended by section 101); Tribal Organization, or an urban Indian or- in arriving at such a finding, shall consider and ganization, or by a health care provider whether the Indian or Indian firm will be de- (2) ‘‘Urban Indian’’ the first place it ap- through referral under the contract health ficient with respect to— pears in section 513(a) of the Indian Health service for which payment may be made ‘‘(1) ownership and control by Indians; Care Improvement Act (as amended by sec- under this title. ‘‘(2) equipment; tion 101). ‘‘(ii) EXCEPTION.—Clause (i) shall not apply ‘‘(3) bookkeeping and accounting proce- (c) MODIFICATION OF DEFINITION.—Section 4 to an individual only eligible for the pro- dures; of the Indian Health Care Improvement Act grams or services under sections 102 and 103

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00033 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1026 CONGRESSIONAL RECORD — SENATE February 14, 2008 or title V of the Indian Health Care Improve- ernment is that their tax dollars are I thank the Chair. ment Act. too often misspent. Nowhere is this The PRESIDING OFFICER (Mrs. LIN- Mr. DORGAN. Mr. President, about 5 problem more prevalent than in the COLN). The Senator’s time has expired. hours ago, we were hoping to send that Medicare Program where fraud is con- The question is on agreeing to amendment to the desk and have it cerned. amendment No. 4082, the managers’ considered. We hoped to have a vote on Currently, Medicare fraud consumes amendment. it. What we are waiting for at the mo- an estimated $60 billion a year. That is Mr. DORGAN. I ask for the yeas and ment is the remainder of the unani- as much as 20 percent of the program nays. mous consent request. The remainder lost to criminals scamming the Federal The PRESIDING OFFICER. Is there a of the unanimous consent request I will Government. sufficient second? propound, when we determine who of- In South Florida, the region has only Mr. DORGAN. Have the yeas and fers levels of approval in the Chamber, 8 percent of the Nation’s AIDS pa- nays been ordered on the Coburn will be that we have a vote—the way it tients. Yet 73 percent of Federal AIDS amendment? is constructed is at 3 o’clock, but that medication payments are sent there. The PRESIDING OFFICER. There is was 25 minutes ago—that we have a That alone is an estimated $2 billion of a sufficient second, and the yeas and vote on two amendments. fraud. nays have been ordered on the Coburn One will be the managers’ amend- We have only recently begun to un- amendment as well. ment I sent to the desk on behalf of cover some of the cases of widespread The clerk will call the roll. myself and Senator MURKOWSKI, bipar- fraud and abuse. An 82-year-old con- The bill clerk proceeded to call the tisan, I believe, an amendment that stituent of mine kept getting $10,000 roll. does not have objections anywhere in Medicare payment statements. If you Mr. DURBIN. I announce that the the Chamber because we have resolved looked at the bills, it appeared this el- Senator from New York (Mrs. CLIN- those objections, but we will have a re- derly woman had artificial knees, an- TON), the Senator from Hawaii (Mr. corded vote on that, and then we will kles, one glass eye, was in a wheel- INOUYE), and the Senator from Illinois have a recorded vote on the amend- chair, and suffered from diabetes and (Mr. OBAMA) are necessarily absent. ment that has been offered by Senator AIDS. The truth is, she is completely Mr. KYL. The following Senators are healthy. She had not called on Medi- COBURN, amendment No. 4034. necessarily absent: the Senator from My hope is that we will be able to care, and someone else was using her South Carolina (Mr. GRAHAM) and the propound a unanimous consent request stolen Medicare number. Senator from Arizona (Mr. MCCAIN). Her case is typical of many in my that will be approved in a few minutes, The PRESIDING OFFICER. Are there State and far too many other States with a couple-minute debate prior to any other Senators in the Chamber de- where Medicare fraud abuse has been each vote, and then we will have two siring to vote? reported. votes. Our hope is to begin that at 3 The result was announced—yeas 95, Hard-working Americans are out- nays 0, as follows: o’clock. My hope remains that will be raged by seeing their tax dollars lost to [Rollcall Vote No. 24 Leg.] the case. I will not propound the unani- criminal fraud. My amendment to the mous consent request at the moment Indian health bill will double the jail YEAS—95 because I understand it has not yet time, double the penalties, and give Akaka Dole Menendez Alexander Domenici been cleared. judges greater discretion in sentencing Mikulski I understand it has now just been Allard Dorgan Murkowski those who are guilty of Medicare fraud. Barrasso Durbin cleared, which is great news. Murray The message needs to be stronger than Baucus Ensign Nelson (FL) I ask unanimous consent for the fol- Bayh a slap on the wrist. It has to be hard Enzi Nelson (NE) lowing: that the pending amendment, Bennett Feingold Pryor time. which is the managers’ amendment Biden Feinstein Reed But tougher penalties are only a first Bingaman Grassley that I just filed on behalf of myself and Reid step. There is a larger problem. We Bond Gregg Roberts Boxer Hagel Senator MURKOWSKI, be set aside and Rockefeller need better oversight, more account- Brown Harkin that at 3 p.m. today, the Senate pro- Salazar ability, and fewer dollars sent to orga- Brownback Hatch Sanders ceed to vote in relation to the amend- Bunning Hutchison nizations that can’t prove they are Schumer ment, the managers’ amendment; that Burr Inhofe anything more than a P.O. box. So I Sessions Byrd Isakson the amendment not be divisible; and call upon my colleagues to join with Shelby that upon disposition of that amend- Cantwell Johnson me in addressing this situation. Help Cardin Kennedy Smith ment, the Senate resume the Coburn put a stop to the billions and billions of Carper Kerry Snowe amendment No. 4034; that there be 2 Casey Klobuchar Specter taxpayer dollars padding the pockets of Stabenow minutes of debate prior to a vote in re- Chambliss Kohl criminals each and every year. We owe Coburn Kyl Stevens lationship to that amendment; and it to the American people to handle Cochran Landrieu Sununu that no amendments be in order to ei- their money with greater care, and I Coleman Lautenberg Tester ther amendment prior to the vote, with Collins Leahy Thune believe we can do this by just cutting Vitter the second vote in sequence 10 minutes Conrad Levin wasteful spending and stiffening the Corker Lieberman Voinovich in duration. penalties that already exist for fraud Cornyn Lincoln Warner The PRESIDING OFFICER. Without cases. Craig Lugar Webb objection, it is so ordered. There are a number of cases I can Crapo Martinez Whitehouse Mr. DORGAN. Mr. President, for the DeMint McCaskill Wicker point to in my State, and these are just Dodd McConnell Wyden information of Senators, the vote will cases that have come to the attention NOT VOTING—5 begin in about 3 minutes, and we will of my office. Maggie of Sunrise talks have two votes in sequence. about a doctor she had never seen bill- Clinton Inouye Obama Graham McCain The PRESIDING OFFICER. The Sen- ing Medicare for $2,590 worth of serv- ator from Florida. ices in July of 2006. Leslie of Punta The amendment (No. 4082) was agreed AMENDMENT NO. 3906 Gorda reported a fraudulent claim filed to. Mr. MARTINEZ. Mr. President, I using his deceased wife’s claim number Mr. LEVIN. Madam President, I wish to speak on amendment No. 3906, after her death. The claim was filed in move to reconsider the vote. which has been pending. I believe I can April of 2006, and his wife passed away Mrs. MURRAY. I move to lay that do that between now and the time of in March of 2005. motion on the table. the vote. I ask to be recognized for the There are many other examples like The motion to lay on the table was time remaining before the vote. these. For that reason, I urge passage agreed to. The PRESIDING OFFICER. Without of my amendment, and I know it may AMENDMENT NO. 4034 objection, it is so ordered. be part of the managers’ package, The PRESIDING OFFICER. There Mr. MARTINEZ. Mr. President, after which I think would be a great step for- will now be 2 minutes of debate evenly high tax rates, the thing that disturbs ward in stemming the waste, fraud, and divided on the Coburn amendment, No. Americans the most about their Gov- abuse in this program. 4034.

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00034 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1027 The Senator from Oklahoma is recog- Sessions Specter Vitter Mr. DORGAN. Let’s make it 4:30, nized. Shelby Sununu Warner Madam President. Mr. COBURN. Madam President, this NAYS—67 Mr. COBURN. I do not have any prob- is a pretty simple amendment. What it Akaka Durbin Nelson (FL) lem with that. says is we are going to give the Native Baucus Feingold Nelson (NE) The PRESIDING OFFICER. Without Bayh Feinstein Pryor objection, it is so ordered. Americans what we promised them in Bennett Hagel Reed our treaties. We are going to give it to Biden Harkin Reid Mr. COBURN. Madam President, them in the same way we deliver secu- Bingaman Hatch Roberts amendment No. 4036 is a real simple rity, choice, prosperity, and health Boxer Johnson Rockefeller amendment. What it says is we are Brown Kennedy Salazar care for Members of Congress. We are Byrd Kerry going to prioritize the funds that go Sanders Cantwell Klobuchar into the Indian Health Service. We going to give them an insurance policy. Schumer Cardin Kohl In basics, I think my chairman agrees Smith have had debate all day on whether we Carper Landrieu are improving Indian health care when with it; he does not agree with the way Casey Lautenberg Snowe we are doing it at this time. I under- Cochran Leahy Stabenow we add services but do not add money, stand that. What you all should know Coleman Levin Stevens and we have not done the structural re- Collins Lieberman Tester forms that need to happen in the In- is three-quarters of the Native Amer- Conrad Lincoln Thune ican population of this country lives in Craig Lugar Voinovich dian Health Service. urban areas; it does not live on the res- Crapo McCaskill Webb We know the Indian Health Service is ervation. That is three-quarters. Dodd Menendez Whitehouse plagued by rationing on a life-and-limb Dole Mikulski Wicker basis. As to the quality of care we are What this does is fulfill our commit- Domenici Murkowski Wyden ment through giving them access to Dorgan Murray offering in IHS, for some places it is great, but on average it is less than quality choice and care—not sub- NOT VOTING—5 what we offer other people. Instead of standard care, not rationed care, but Clinton Inouye Obama real care. Graham McCain fixing the problem with basic medical services, this bill includes new serv- The PRESIDING OFFICER. The Sen- The amendmemt (No. 4034) was re- ator from North Dakota. ices. We are not funding the services jected. we do now, and the services we are Mr. DORGAN. Madam President, I Mr. DURBIN. I move to reconsider funding are not at the level they need oppose the amendment, as does my col- the vote and to lay that motion on the to be in terms of their quality. league Senator MURKOWSKI. table. This bill expands the burden of IHS Senator COBURN offers some inter- The motion to lay on the table was to fund things that in terms of priority esting ideas here, but he offers them in agreed to. are not as important, No. 1, but, more the context of saying: We will do some Mr. NELSON of Florida. Madam importantly, most have an eligibility different and additional things with In- President, I suggest the absence of a avenue with which to get these services dian health care, but we will explicitly quorum. through some other Government pro- restrict any additional money that is The PRESIDING OFFICER. The gram. So by supporting this amend- in the bill itself. That means if you clerk will call the roll. ment, you are not denying the four new have Indian reservations out in the The legislative clerk proceeded to services because they are already country someplace, there is an Indian call the roll. available, just not through the IHS. health clinic, and that is the only Mr. COBURN. Madam President, I This amendment would require fund- health care available, I guarantee you ask unanimous consent that the order ing go to what has already been prom- they will end up with less money to for the quorum call be rescinded. ised to tribal members before we ex- provide health care to those Indians on The PRESIDING OFFICER. Without pand to new promises. In other words, those reservations given that restric- objection, it is so ordered. before we add new services, let’s make tion in the bill. AMENDMENT NO. 4036 Mr. COBURN. Madam President, I sure we are funding the services we are For that reason I do not support it, offering now and that we are funding but I look forward to working with my now ask unanimous consent that we have the regular order on Coburn them at a level of quality that is ac- colleague from Oklahoma on ideas of ceptable. this type. amendment No. 4036. The PRESIDING OFFICER. Without So this would say IHS would have to The PRESIDING OFFICER. The prioritize basic medical services before question is on agreeing to the amend- objection, the amendment is pending. The Senator from North Dakota. paying for new programs. We have ment. Mr. DORGAN. Madam President, if I talked a lot about the history on this. The yeas and nays have been ordered. might, the Senator from Oklahoma is We know where our problems are. The The clerk will call the roll. intending to debate and discuss amend- chairman is trying to move in a direc- The legislative clerk called the roll. ment Nos. 4032 and 4036, and requests tion to help solve some of the prob- Mr. DURBIN. I announce that the recorded votes on both. First of all, I lems. Senator from New York (Mrs. CLIN- appreciate his cooperation. I under- I disagree that we are making the TON), the Senator from Hawaii (Mr. stand he is prepared to initiate that de- major steps. I think we have to totally INOUYE), and the Senator from Illinois bate. What I would like to suggest is reform IHS. I have said that to the (Mr. OBAMA) are necessarily absent. whatever time he needs for that de- chairman. He knows the structural Mr. KYL. The following Senators are bate, we could probably, by consent, problems that are there. I think when necessarily absent: the Senator from with the consent of Senator MUR- we promise health care, we ought to South Carolina (Mr. GRAHAM) and the KOWSKI, agree to a time for both those give it. Senator from Arizona (Mr. MCCAIN). votes. We talked earlier today that one in The PRESIDING OFFICER. Are there I might ask the Senator, how long every four Native American women any other Senators in the Chamber de- would he like to debate both amend- have a baby without any prenatal care. siring to vote? ments? The average number of visits for those The result was announced—yeas 28, Mr. COBURN. Probably, Madam who have prenatal care is half what the nays 67, as follows: President, I will not use more than 30 national average is. So just in prenatal [Rollcall Vote No. 25 Leg.] minutes and probably less. care, in pediatrics, and diabetes we YEAS—28 Mr. DORGAN. Madam President, know we are behind the curve. Yet we would it be satisfactory to the Senator are going to add new services in the Alexander Coburn Hutchison Allard Corker Inhofe from Oklahoma and Senator MUR- bill that are already available in other Barrasso Cornyn Isakson KOWSKI if we set the two votes on ways. Bond DeMint Kyl amendment No. 4032 and amendment We also know, as the chairman has Brownback Ensign Martinez No. 4036 no later than 4:20? said, that we spend half per capita on Bunning Enzi McConnell Burr Grassley Mr. COBURN. That is 30 minutes for Native Americans than we do on pris- Chambliss Gregg me and none for you. oners. We spend less than half than we

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00035 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1028 CONGRESSIONAL RECORD — SENATE February 14, 2008 do on veterans. We spend a third based So the flexibility is completely up to against the amendment. He is talking on what we spend on Medicare. So we the IHS. Nothing limits it other than about using the funds for essential are obviously not there, and a lot of it you have to meet the core basic med- medical services. Yes, I am all in favor is money. There is no question about ical needs first before you go into other of that. But let me also say that the it. But it is not all money. It is struc- areas. issue of hospice care and some long- tural. With that, I yield the floor and await term care issues we have added to this Obviously, that is the reason for my the response from my chairman. Then I bill—if you visited a hospice care set- opposition to this bill because I think will talk about the other amendment ting, it is pretty hard to take a look at we have an opportunity to go much in a moment. what hospice care is offering dying pa- further to totally change the structure The PRESIDING OFFICER. The Sen- tients and suggest that is not essential and quality and delivery and to get a ator from North Dakota. as well. lot of the bureaucracy out. I think we Mr. DORGAN. Madam President, That is a wonderful health care op- also need to add money. We need to do with the permission of the Senator tion that is available to many in this all three. from Oklahoma, let me ask if he might country. What we have tried to do in This amendment is designed to make also discuss his second amendment. the Indian Health Care Improvement IHS prioritize the money. So even Mr. COBURN. Madam President, I Act is to expand some services. That is though we authorize these programs— will be happy to. correct. The Senator and I talked a lit- this does not eliminate the authoriza- Mr. DORGAN. Thank you very much. tle bit about that this morning. But tion—it just says you cannot effec- The PRESIDING OFFICER. The Sen- they are in most cases services that tively do it until you have funded ade- ator from Oklahoma. many other Americans have available quately what you are already prom- AMENDMENT NO. 4032 to them that we would hope and expect ising Native Americans. Mr. COBURN. Madam President, would be made available to American What this bill will do, in my esti- amendment No. 4032, which the chair- Indians as well. My colleague and I mation, is drain resources available to man has graciously allowed me to dis- both described this morning our inter- basic core medical services. It is also cuss at this time, which I also would est in adequately funding Indian health going to do something else. Our tribes like to call up and have as the pending care. He said—and I agree, and I said are getting to be pretty good business- order of business under the regular earlier—that about 60 percent of Indian men. What it is going to do is, it is order, is real simple. We do this in a lot health care is delivered to American going to put into individual tribes busi- of other places, but we do not do it in Indians, and 40 percent is withheld. nesses for these services. IHS. That means you have full-scale health So what is going to happen is, these I ask unanimous consent for that. care rationing going on. It should be services are going to be part of the The PRESIDING OFFICER. The front-page, scandalous headlines in this tribal organization business complex unanimous consent has been granted. country. It ought to be trumpeting the but not part of the service, and so we Mr. COBURN. I thank the Chair. news in this country. But it is not. are going to transfer funds outside IHS, This is a real straightforward amend- There is a giant sleep going on about transfer IHS moneys into tribal organi- ment. It says if you are a tribal mem- what is happening to people out there zations with no guarantees that the ber and you have been the victim of who are living in the shadows, des- money that was spent is going to come rape or sexual assault, the right to perately poor, in many cases an hour, back into health care. So if we were to have your assailant tested for HIV and an hour and a half, 2 hours away from do this, what I would rather is these be AIDS and other sexually transmitted the nearest large-scale health care IHS services only, rather than out for diseases cannot be denied you. We have clinic, so their opportunity to get bid to be utilized that may be not at a done this a lot of times. Most of us health care is through the Indian competitive bid price so we enhance agree with that. We think it is the Health Service, and we are trying very private profitability rather than tribal right thing to do when somebody is an hard to improve that. health care. So there is that other lit- assailant and we have people at risk, But I understand the purpose of the tle problem. Again, if we make new and not putting those Native Ameri- amendment offered by the Senator. I promises, at a time when we are not cans into a period of a year waiting or would hope, however, when we finish funding the promises we have, we are taking medicines they should not have doing what he said he is going to do, not helping the Native American popu- to take because they do not know the and what I said I am going to do, and lation. status of the person who committed an when we talk about what we are really This amendment is about priorities. assault on them. going to fund this year, that we will It is not saying IHS cannot fund these So it is very straightforward. I will have sufficient funds; A, that we will new programs. It is just saying we need not spend a lot of time on it. I am not have a system we are proud of, that de- to focus on basic medical services first, trying to inflame the issue. I think it livers health care to people who are such as prenatal care. When one in four is something Native Americans ought sick and who were promised health Native Americans do not have prenatal to have that every other American care; and B, to fully fund the services care, and we are going to add long-term today has. that most people expect would be home health care, hospice, DME, and I yield back and intend to ask for the available to them and their loved ones, some of these other areas, when we are yeas and nays at the appropriate time. and that would include hospice care. not taking care of the women who walk The PRESIDING OFFICER. Who in and deliver without prenatal care, it yields time? Mr. COBURN. Madam President, will does not make sense. The Senator from North Dakota. the Senator from North Dakota yield? So I will put this amendment up. I Mr. DORGAN. Madam President, let Mr. DORGAN. I am happy to yield. am going to ask for the yeas and nays me talk for a moment about amend- Mr. COBURN. Madam President, on amendment 4036. I appreciate the ment No. 4032, the HIV mandatory test- through the Chair, would the chairman consideration of the chairman and his ing issue. I support that, I think, at the agree a large portion of people who are heart toward Native Americans. But a request of the victim. I think that is a eligible for Indian health care service half promise fulfilled is a promise not thoughtful amendment and would have today already have these services kept, and that is where we are on accepted it. I understand the Senator available to them through another health care. Making us prioritize—in wishes a recorded vote. I understand Federal Government program? some places we will be able to do this; why that is the case. But I do think it Mr. DORGAN. A large portion? I where we have effective, efficient care, is an amendment that has a lot of don’t know that I would agree with they will have the money to offer these merit. that. I don’t believe I would at all. services. In areas where we are not AMENDMENT NO. 4036 Mr. COBURN. A large portion of doing well, they should not be expand- With respect to the other amend- them are Medicaid eligible. As a mat- ing into new services when they are ment, No. 4036, I understand what the ter of fact, 27 percent of the funds that not taking care of the services we have Senator is trying to do. I am going to go into IHS are people from Medicaid. today. oppose the amendment and vote If they are Medicaid eligible, then they

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00036 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1029 are eligible for every one of these pro- The point I have been trying to make and both in a constructive way to help grams. A large portion are Medicare el- most of today is when you have 40 per- American Indians. igible. A large portion of money that cent of the health care needs unmet, The PRESIDING OFFICER. The Sen- comes into IHS comes from Medicare, we are in a desperate situation. We ator from Oklahoma is recognized. and they are also eligible under that. need to fix that. Mr. COBURN. Madam President, I So the majority of our Native Amer- The Senator from Oklahoma has just want a few more minutes and then ican population already have these talked a lot about reform, and I am I am through. services available to them under two very anxious, when we get this bill The Senator from North Dakota other programs. done—we will get it out of the Senate, makes a great point: that there are The other question I would ask we will get it to conference, and hope- people who are using reservation-based through the Chair of the chairman is— fully get it signed into law by the IHS facilities who are essentially there are other clinics and IHS facili- President. We will, for the first time in trapped. They are trapped. They don’t ties, I believe, and please correct me, nearly a decade, have advanced an im- get the option to go somewhere else. that are being run well and that will be provement in Indian health care. I am What this bill does—and in many of able to utilize these services for that very anxious to turn immediately—and those instances, the core medical needs smaller portion of Native Americans the Senator serves on our committee— are not being met. What this bill does because they will have the funds be- to work with him and Senator MUR- is makes sure the core medical needs cause they are meeting basic core med- KOWSKI from Alaska to say: All right, are going to be met because we are ical needs now. My amendment doesn’t now, let’s put this on a different course going to add four new services for those take that away. It just says if you are with a much bolder, a much bigger people. So now they are trapped in a in an IHS clinic and over half of them bite, to try to figure out how we dra- system that doesn’t deliver the qual- already have these services available matically improve health care. That ity, doesn’t deliver the service, and through another government program, would not be done unless we have sub- doesn’t deliver the prevention, we are why would we add that when we are stantial additional income as well. But going to make it worse. We are going not taking care of the diabetes, the di- income is not going to solve the prob- to make it worse because we are going alysis, and every other thing we have? lem by itself. You need reform. to add services that are available to My question to the chairman is—I It is interesting. When the Senator half of the Native American population would love for him to consider that talked earlier today about giving right now through another Government this is a better way to go rather than American Indians the opportunity to program, and we are going to dilute the blanketly treating everybody the same go someplace with a card and say: Here resources for the very people who are and that we have to prioritize, and that is my health care coverage—I am in trapped on reservations. by having IHS Directors make that pri- favor of that. But that card would not But the very point is, three-quarters ority—in different areas, that is true— do much good for somebody who is sick of Native Americans are in an urban in terms of what goes through the trib- and is living, for example, in Fort area. They are not limited to that. al government, what we will get is bet- Yates, ND, because the only option They are not limited at all. They ter care. they have is to go to that Indian should have had the choice to be able Mr. DORGAN. Madam President, we Health Service or they can get in the to go wherever they wanted to go look at this and, in many ways, see the car and drive a fairly long way to find today. We turned that down. We had 29 same side. I think the Senator from a hospital someplace. So we need to ad- people vote for that—or 28 people vote Oklahoma and I see a situation in dress these issues. for that. which gripping poverty exists in many I want the Indian Health Service to I know the chairman is going to work areas, joblessness, inadequate health be better, to be more effective, to pro- with me to try to get there someday. care. The Senator from Oklahoma is vide better health care for American But that is when you give Native correct there are circumstances—I Indians, and I want to reform the en- Americans their due and meet our com- have been there, I have seen them— tire system to see if we can establish mitments. When they have the same where the health care is wonderful. I competition where competition will choice, the same security, the same toured a clinic recently and the doc- work. I know Senator COBURN will health care that you and I have, then tor—a wonderful doctor at that clinic readily agree there are places in the we will have met our commitment working for the Indian Health Service, country where you can’t even talk under our treaties, and not until then who is very dedicated and by all ac- about real competition because you are would we have met it. counts a terrific doctor—said to me: living way out, way away from any Mr. DORGAN. Madam President, if You know, we are waiting for this new other facilities, and all that exists is the Senator would yield on that point x-ray equipment that is supposed to the Indian health care facility. just briefly. come. The waiting room is full, by the If I might make one additional point Mr. COBURN. I will yield. way. The building is in disrepair, it is I understand why—I quoted Chief Jo- Mr. DORGAN. Do you know why in an old building, but the doctor is giv- seph this morning. I understand why many cases the urban Indians are a ing me a tour, and he says: We are American Indians are a little skeptical. population that is exclusive? Because waiting for this x-ray machine which is They have been lied to, cheated. They we went through a period of time when really going to help us out. we did these zigzags. At one point in I said: How long have you been wait- have had their agreements in writing, this country we said to the Indian com- ing? and they haven’t been worth the paper He said: Two years. on which they are written. It is pretty munity: You know what. Yes, you are I said: What is the trouble? unbelievable when you think about it. on a reservation. Here is a one-way bus He said: Well, I wish I knew. It is pa- We have all seen this, the promises ticket. We want you to leave. So we perwork. Can’t get it through the re- that were made but never, ever kept. sent them to the cities. Now we prom- gional office. The money is there. The The purpose of today and the purpose ised them health care back on the res- money is there for it, but we can’t get of our work is to say: You know what. ervation. Now we say: You have a bus the regional office to get the paper- These were the first Americans and we ticket one way. Go to the city. In fact, work done to get the x-ray machine. have certain obligations to them and the budget request this year once again So the Senator from Oklahoma and I we must do a better job of meeting says: By the way, we don’t intend to both know there are circumstances those obligations. fund any—we don’t intend to fund any where there is unbelievable bureauc- So I don’t know that I was particu- health care for urban Indians. Well, we racy that is almost shameful, and larly responsive to the Senator from should, and I think we will say to the nothing gets done. There are other Oklahoma, but both of us want the President that we don’t agree with that areas where there is sterling medical same thing, we end up wanting exactly recommendation. But we have done a care by men and women who, in that the same goals out of this debate. And lot of egregious things in this country, service, get up every morning and say: my hope is, working together during even with respect to preventing Indians I want to make a difference in the lives the next couple of years we will take the right to vote for the majority of of people. So all of that exists. two steps, both in the right direction the history of this country. They didn’t

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00037 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1030 CONGRESSIONAL RECORD — SENATE February 14, 2008 get the right to vote until about 90 hooked up to a machine for 8 hours a carrying out any class III gaming activity years ago or so. day because we are—but we are going (as defined in section 4 of the Indian Gaming Mr. COBURN. Madam President, I to feel good about ourselves saying we Regulatory Act (25 U.S.C. 2703)). would like to reclaim my time, if I now have hospice and long-term care, AMENDMENT NO. 4066 might. and all of these other things. On page 207, strike lines 4 and 5 and insert Mr. DORGAN. Yes, of course. I think it is a mistake the way we the following: Mr. COBURN. Madam President, I have done that. It is my main opposi- care organization; want to make a couple of points be- tion to the bill. I think we have an op- ‘‘(4) a self-insured plan; or cause what we have heard is a lot of ‘‘(5) a high deductible or health savings ac- portunity to rigorously and tremen- count plan. negative today. I want to say how dously change the structure, the deliv- AMENDMENT NO. 4038 proud I am of the Cherokees, the ery of care. We have an opportunity to Chickasaw, the Choctaw, and the Creek On page 294, strike lines 11 through 15 and change the paradigm under which we insert the following: in Oklahoma. I totally disagree with treat Native Americans, to prevention. grams involving treatment for victims of gaming. I think it undermines virtue. I We have talked about suicide on all of sexual abuse who are Indian children or chil- think it is destroying a lot of society. the reservations. The chairman and dren in an Indian household. But several of the tribes in my State many have been concerned about pre- AMENDMENT NO. 4015 have invested their dollars—not IHS vention of that. But we ought to be (Purpose: To authorize the Secretary of dollars, their dollars—in health care, just as concerned about prevention of Health and Human Services to establish an and they need to be recognized. Their all of the other diseases and change the Indian health savings account demonstra- facilities, most oftentimes, are fan- paradigm under which IHS works in- tion project) tastic, and their care is fantastic. So I stead of more of the same. On page ll, between lines ll and ll, don’t want us to leave the debate with- So with that, I ask for the yeas and insert the following (at the end of title VIII out recognizing some of the vast im- of the Indian Health Care Improvement Act, nays. as amended by section 101(a) add the fol- provements that where we have failed, I yield the floor. lowing): LO the tribes have actually picked it up The PRESIDING OFFICER (Ms. K - ‘‘SEC. 818. INDIAN HEALTH SAVINGS ACCOUNT and supplied it, and that means shame BUCHAR). Without objection, the Sen- DEMONSTRATION PROJECT. on us because maybe there wouldn’t be ator may seek the yeas and nays on ‘‘(a) IN GENERAL.—The Secretary shall es- as much gaming if we were fulfilling both amendments with one show of tablish a demonstration project under which the needs. Gaming is not without its hands. eligible participants shall be provided with a societal consequences, regardless of Is there a sufficient second? There subsidy for the purchase of a high deductible appears to be a sufficient second. There health plan (as defined under section 223(c)(2) how much we benefit in terms of dol- of the Internal Revenue Code of 1986) and a lars that come into the Treasury. is a sufficient second. contribution to a health savings account (as So I didn’t want us to leave this Mr. DORGAN. Madam President, I defined in section 223(d) of such Code) in without recognizing that we have lots ask unanimous consent that when we order to— of great performance in lots of great do vote at 4:30, we vote on amendment ‘‘(1) improve Indian access to high quality areas. We also have lots of great pro- No. 4036 first and amendment No. 4032 health care services; viders and doctors and workers in IHS, second, and that there be 2 minutes be- ‘‘(2) provide incentives to Indian patients tween the votes, a minute on each side, to seek preventive medical care services; but we have some who aren’t. We also ‘‘(3) create Indian patient awareness re- have some who couldn’t get a job any- and that there be no intervening sec- garding the high cost of medical care; and where else, some whom nobody else ond-degree amendments. ‘‘(4) encourage appropriate use of health would hire. Yet we will hire them be- The PRESIDING OFFICER. Without care services by Indians. cause we are so short, both on funds objection, it is so ordered. ‘‘(b) ELIGIBLE PARTICIPANT.— and needs. That ought not to be there AMENDMENTS NOS. 4070, 4073, 4066, AND 4038 TO ‘‘(1) VOLUNTARY ENROLLMENT FOR 12-MONTH either. If somebody is not competent to AMENDMENT NO. 3899, AND AMENDMENT NO. 4015 PERIODS.— ‘‘(A) IN GENERAL.—In this section, the term practice with the public, they Ms. MURKOWSKI. Madam President, I ask unanimous consent that the ‘eligible participant’ means an Indian who— shouldn’t be competent to practice at ‘‘(i) is an eligible individual (as defined in IHS and the same at the VA and the pending amendments be set aside, and I section 223(c)(1) of the Internal Revenue Code same in our prisons and the same in call up these four amendments on be- of 1986); and other areas. half of Senator DEMINT: Nos. 4070, 4073, ‘‘(ii) voluntarily agrees to enroll in the So it is my hope we will look straight 4015, and 4066; and I call up amendment project conducted under this section (or in forward. It is hard to run against your No. 4038 on behalf of Mr. VITTER. the case of a minor, is voluntarily enrolled own chairman on amendments on a The PRESIDING OFFICER. Without on their behalf by a parent or caretaker) for a period of not less than 12 months in lieu of bill, and we intentionally did not put objection, it is so ordered. The clerk will report the amend- obtaining items or services through any In- up these amendments at the request of dian Health Program or any other federally- the chairman when we were doing the ments, en bloc. The legislative clerk read as follows: funded program during any period in which markup on the Indian health care bill. the Indian is enrolled in the project. The Senator from Alaska [Ms. MUR- Again, I will state in finality, and ‘‘(B) VOLUNTARY EXTENSIONS OF ENROLL- KOWSKI], for Mr. DEMINT, proposes amend- then sit down, these ‘‘improvements’’ MENT.—An eligible participant may volun- ments Nos. 4070, 4073, 4015, and 4066, en bloc. tarily extend the participant’s enrollment in in many areas will offer some improve- The Senator from Alaska [Ms. MURKOWSKI, the project for additional 12-month periods. ment but in many more areas will take for Mr. VITTER, proposes an amendment ‘‘(2) HARDSHIP EXCEPTION.—The Secretary away from core medical care that is of- numbered 4038. shall specify criteria for permitting an eligi- fered to the very people who aren’t get- The amendments are as follows: ble participant to disenroll from the project ting adequate care today. So it ought AMENDMENT NO. 4070 before the end of any 12-month period of en- to be flexible. It ought to be where the On page 309, between lines 19 and 20, insert rollment to prevent undue hardship. core medical needs are met, we are of- the following: ‘‘(c) SUBSIDY AMOUNT.—The amount of a fering these, and whether or not we ‘‘(c) FIREARM PROGRAMS.—None of the subsidy provided to an eligible participant shouldn’t be offering them because funds made available to carry out this Act for a 12-month period shall not exceed the may be used to carry out any antifirearm amount equal to the average per capita ex- what we are doing is, we are taking penditure for an Indian obtaining items or that lady who is going to be on dialy- program, gun buy-back program, or program to discourage or stigmatize the private own- services from any Indian Health Program for sis, and we could have prevented it be- ership of firearms for collecting, hunting, or the most recent fiscal year for which data is cause we are not doing the core med- self-defense purposes. available with respect to the same popu- lation category as the eligible participant. ical things and we are looking at the AMENDMENT NO. 4073 ‘‘(d) SPECIAL RULES.— wrong thing. We are taking a gal who At the end, add the following: has early diabetic neuropathy and we ‘‘(1) NO DEDUCTION ALLOWED FOR SUBSIDY.— TITLE III—APPLICABILITY For purposes of determining the amount al- are going to condemn her to a life on SEC. 3ll. INDIAN TRIBES OPERATING CLASS III lowable as a deduction with respect to dialysis or a kidney transplant, and GAMING ACTIVITIES. amounts contributed to a health savings ac- most of them would not get kidney This Act and the amendments made by count by an eligible participant under sec- transplants. They are going to get this Act shall not apply to any Indian tribe tion 223 of the Internal Revenue Code of 1986,

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00038 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1031 the limitation which would (but for this lation, our elderly—the elders in the Hart 216 right now. I thought it was paragraph) apply under section 223(b) of such village who have lived through some important to clarify some points that Code to such participant for any taxable pretty incredible times. At the end of he made in response to some very im- year shall be reduced (but not below zero) by their lives, they are certainly seeking portant questions raised by Chairman the amount of any subsidy provided to the participant under this section for such tax- basic medical services. Yet we recog- ROCKEFELLER. able year. nize that with the facilities we have Chairman ROCKEFELLER asked what ‘‘(2) TREATMENT.—The amount of a subsidy available to them, the services we have would happen if FISA expires—as it provided to an eligible participant in the available to them, the medical profes- does on February 15—without being re- project shall not be counted as income or as- sionals we have available to them, it is newed. He asked, could these collec- sets for purposes of determining eligibility very difficult to meet all of those tions not continue? There is a very im- for benefits under any Federal public assist- needs. So for them, the opportunity for portant ‘‘yes, but’’—for acquisitions ance program. hospice care, assisted living service, that have been ordered by the FISA ‘‘(3) BUDGET NEUTRALITY.—In conducting long-term care service, or the home or Court which have years in length; it is the demonstration project under this sec- tion, the Secretary shall ensure that the ag- community-based service—that is sin- possible that those could continue. But gregate payments made to carry out the gled out in the amendment. They are the major problem the Director sees project do not exceed the amount of Federal looking at this not as a luxury, or an and the attorneys with him see is that expenditures which would have been made add-on, certainly, but something that if they needed to change targets, if for the provision of health care items and is basic, something that would be fun- they needed to change methods, if they services to eligible participants if the project damental to a quality of life in their needed to change means by which they had not been implemented. final years. gathered the information, they would ‘‘(e) DEMONSTRATION PERIOD; REPORTS TO This is a matter for many seniors, not be able to do so. CONGRESS; GAO EVALUATION AND REPORT.— Furthermore, he highlighted a very ‘‘(1) DEMONSTRATION PERIOD.— not just in the State of Alaska, and for ‘‘(A) INITIAL PERIOD.—The demonstration many who are looking to, again, pro- real problem having to do with the pri- project established under this section shall vide for those services at a level and in vate sector. As we have said on the begin on January 1, 2007, and shall be con- a manner that is culturally relevant floor before, the private sector carriers ducted for a period of 5 years. and appropriate—the community-based are absolutely essential to the oper- ‘‘(B) EXTENSIONS.—The Secretary may ex- services, home-based services. I think ation, not only of FISA, foreign intel- tend the project for such additional periods it is important that we recognize we ligence surveillance, but for work with as the Secretary determines appropriate, un- are not without limitation when we are the FBI and others on criminal mat- less the Secretary determines that the project is unsuccessful in achieving the pur- talking about the services that are pro- ters. The fact that we have left the poses described in subsection (a), taking into vided to American Indians and Alaska telecom carriers, that are alleged to account cost-effectiveness, quality of care, Natives. You have heard time and time have participated in the President’s and such other criteria as the Secretary may again on the Senate floor that we are lawful terror surveillance program specify. not meeting their needs; that we are without liability protection, they are ‘‘(2) PERIODIC REPORTS TO CONGRESS.—Dur- funding at 60 percent; that there is a being advised by their general counsel ing the 5-year period described in paragraph curtailment or a shortage in services of their responsibility under Sarbanes- (1), the Secretary shall periodically submit based on the resources. So when we are Oxley, and others, that they could only reports to Congress regarding the success of demonstration project conducted under this able to enhance the quality of life, cooperate with a fresh court order. section. Each report shall include informa- whether it is through assistance, such Since there is no authority for addi- tion concerning the populations partici- as long-term care services or assisted tional court orders, they have a grave pating in the project and the impact of the living or the community-based serv- question as to whether they are risking project on access to, and the availability of, ices, or whether it is enhancing the not only their firm’s reputation but high quality health care services for Indians. end-of-life care, as we do throughout under Sarbanes-Oxley certain duties to ‘‘(3) GAO EVALUATION AND REPORT.— this Indian Health Care Improvement shareholders. That is why he felt it was ‘‘(A) EVALUATION.—The Comptroller Gen- Act, these are the things we ought to necessary to get this measure that has eral of the United States shall enter into a contract with an organization with expertise be encouraging, that we ought to be passed the Senate implemented by the in health economics, health insurance mar- moving forward with in a positive man- House. kets, and actuarial science for the purpose of ner. I also noted in my comments that conducting a comprehensive study regarding So I stand in opposition to the the House passed its bill almost as long the effects of high deductible health plans amendment of the Senator from Okla- ago as the Senate passed its bill. At and health savings accounts in the Indian homa which says we cannot attend to that time, the intelligence community community. The evaluation shall include an any of these quality-of-life issues—if it said it was not workable, that the analysis of the following issues: is in your final days—unless and until Rockefeller-Bond proposal that passed ‘‘(i) Selection of, access to, and avail- the Secretary has given priority to the overwhelmingly 2 days ago was the ability of, high quality health care services. ‘‘(ii) The use of preventive health services. provision of these basic medical serv- only thing that was workable; and the ‘‘(iii) Consumer choice. ices to all Indians. fact that the House says they don’t ‘‘(iv) The scope of coverage provided by It is, again, a situation where we have time to work on it ignores the high deductible health plans purchased in want to attempt to do as much as we fact that they have known for a couple conjunction with health savings accounts possibly can. But I think if you were to of months that they were going to have under the project. tell the elder in the community of to make significant revisions in their ‘‘(v) Such other issues as the Comptroller Buckland that somehow or other serv- measure if they wanted it to be passed General determines appropriate. ices to help her in her final years, to and signed into law. So my sympathies ‘‘(B) REPORT.—Not later than January 1, 2013, the Comptroller General shall submit a die gracefully and with dignity in her for the House. I understand they are report to Congress on the evaluation of dem- home, is something she doesn’t qualify pressed for time, but they knew this onstration project conducted under this sec- for, is not eligible for, I think we would was coming. They have a measure be- tion.’’. all find that cuts to the quick. fore them that could be passed, which I Ms. MURKOWSKI. Madam President, Madam President, I understand that hope they will pass. if I may take a few moments to speak there are several Members who are One other thing. I asked the Director to some of the issues the Senator from here and wish to speak briefly on FISA about some of the very misdirected, Oklahoma has raised about the for a few minutes before we move to improper, wrong and, in some in- prioritization, giving priority to the our vote. I am prepared to yield to the stances, irresponsible suggestions made provision of those basic medical serv- Senator from Missouri. on the floor about the tactics that the ices, medical needs. FISA CIA may use in questioning high-value I think we all agree that is the first Mr. BOND. Madam President, I will detainees. The DNI made it clear, as I requirement, to make sure those serv- take a minute to update my colleagues attempted to make clear yesterday, all ices are provided for. In the State of on some information we received from of the things banned by the Army Field Alaska, we hear from those most vul- the Director of National Intelligence in Manual, such as burning, electro- nerable in our Alaska Native popu- an open hearing that is going on in cuting, beating, sexual harassment—all

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00039 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1032 CONGRESSIONAL RECORD — SENATE February 14, 2008 those things are not only repugnant There are those who believe in a rad- Bond Harkin Nelson (NE) but they are not permitted to be used ical ideology that celebrates the mur- Brown Hatch Pryor Bunning Hutchison Reed by any of our intelligence agencies. He der of innocent men, women, and chil- Byrd Johnson Reid reiterated that waterboarding is not dren, and who are willing to use instru- Cantwell Kennedy Roberts permitted under the political guide- ments of destruction, whether they be Cardin Kerry Rockefeller Carper Klobuchar lines that include legislation and that primitive tools such as flying an air- Salazar Casey Kohl Sanders we have passed here in direct orders. Cochran Kyl plane into a building, or chemical, bio- Schumer So what was done yesterday does not Coleman Landrieu logical, or nuclear weapons—whatever Smith prevent torture. That is prevented al- Collins Lautenberg they can get—to kill innocent civil- Conrad Leahy Snowe ready. It doesn’t prevent cruel, degrad- ians. We have to do everything in our Corker Levin Specter ing, and inhumane interrogation tech- power to protect ourselves. Thank Craig Lieberman Stabenow Stevens niques. It does not prevent other cruel, goodness, due to the noble work of our Crapo Lincoln degrading, or inhumane acts by the in- Dodd Lugar Tester men and women in uniform who are Dole Martinez Thune telligence agencies. Those are already fighting in places such as Afghanistan, Domenici McCaskill Voinovich prohibited. Iraq, and elsewhere around the world, Dorgan Menendez Webb What the measure that was passed we are keeping the enemies of the Durbin Mikulski Whitehouse yesterday does—were it to be signed Feingold Murkowski Wicker United States on the run. Feinstein Murray Wyden into law, and I certainly hope it will The best way we can deter these ter- Hagel Nelson (FL) not be—would be to deny the intel- rorist attacks is to listen in on con- NOT VOTING—6 ligence community the ability to use versations and communications. That techniques that are similar to but dif- Boxer Graham McCain is the only way we are going to be able Clinton Inouye Obama ferent from the techniques authorized to continue to do it. For the House of in the Army Field Manual. These en- The amendment (No. 4036) was re- Representatives to know that they are hanced techniques have been used only jected. causing our intelligence community to on roughly a couple of dozen detainees AMENDMENT NO. 4032 go deaf to the communications of ter- in the custody of the CIA. They are rorists who are plotting attacks The PRESIDING OFFICER. There is lawful, and they have produced some of against the United States is the height now 2 minutes of debate equally di- the most important intelligence that of irresponsibility. I hope it is not true vided on Coburn amendment No. 4032. the intelligence community has gath- and that they reconsider. The Senator from Oklahoma is recog- ered to identify high-level members of My hope is they will come back and nized. al-Qaida and other terrorist organiza- Mr. COBURN. Madam President, this tions, and to interfere, impede, and they will pass this important legisla- tion that will encourage our tele- is a straightforward amendment that stop terror attacks directed not only at says when somebody has been abused our troops abroad, our allies, but the communications industry to cooperate with the lawful requests of the Com- or sexually assaulted, they have the United States. right, postindictment, to have the per- Unfortunately, some people were mander in Chief as certified by the chief law enforcement officer of the son who assaulted them tested for HIV misled by comments that were bor- and sexually transmitted diseases. It is dering on irresponsible on the floor United States, and that is the Attorney General, so we can continue to listen current law in many other areas, and I yesterday, to say that we banned tor- would appreciate your support. ture, cruel, inhumane, and degrading to these communications in a lawful and legal way and protect the Amer- The PRESIDING OFFICER. The Sen- conduct. That is not what happened. ator from North Dakota. We tied the hands of the CIA with the ican people. For the House of Rep- resentatives to refuse to take up this Mr. DORGAN. Madam President, I purported provision that would se- support the amendment. verely limit their ability to gain infor- matter and to vote on it is, again, I say, the height of irresponsibility, and The PRESIDING OFFICER. The yeas mation using totally lawful techniques and nays have been ordered on amend- in questioning high-value detainees. it endangers American lives. I yield the floor. ment No. 4032. The clerk will call the Rather than being a blow for freedom, roll. reaffirming our values, it merely pro- AMENDMENT NO. 4036 The legislative clerk called the roll. posed to cripple our intelligence collec- The PRESIDING OFFICER. The Mr. DURBIN. I announce that the tion. question is on agreeing to amendment Senator from California (Mrs. BOXER), I thank the Chair and yield the floor. No. 4036. the Senator from New York (Mrs. CLIN- The PRESIDING OFFICER. The Sen- The yeas and nays have been ordered. ator from Texas is recognized. TON), the Senator from Hawaii (Mr. The clerk will call the roll. INOUYE), and the Senator from Illinois Mr. CORNYN. Madam President, I The assistant legislative clerk called commend the ranking member and (Mr. OBAMA) are necessarily absent. the roll. Mr. KYL. The following Senators are chairman of the Select Committee on Mr. DURBIN. I announce that the Intelligence for the outstanding work necessarily absent: the Senator from Senator from California (Mrs. BOXER), they have done on this critical piece of South Carolina (Mr. GRAHAM) and the the Senator from New York (Mrs. CLIN- legislation, passing it in the Intel- Senator from Arizona (Mr. MCCAIN). TON), the Senator from Hawaii (Mr. ligence Committee by a vote of 13 to 2, The PRESIDING OFFICER (Mr. INOUYE), and the Senator from Illinois which was no easy feat. This passed in WEBB). Are there any other Senators in (Mr. OBAMA) are necessarily absent. the Senate by a strong bipartisan vote the Chamber desiring to vote? Mr. KYL. The following Senators are of 68 to 29, I believe. It is about as The result was announced—yeas 94, necessarily absent: the Senator from strong a bipartisan vote as you can nays 0, as follows: South Carolina (Mr. GRAHAM) and the possibly get. This is a well-thought-out [Rollcall Vote No. 27 Leg.] Senator from Arizona (Mr. MCCAIN). piece of legislation that, once sent over YEAS—94 to the House of Representatives, we The result was announced—yeas 21, nays 73, as follows: Akaka Cantwell Dodd were told the House of Representatives, Alexander Cardin Dole rather than to deal with this legisla- [Rollcall Vote No. 26 Leg.] Allard Carper Domenici tion, would simply decide to fold their YEAS—21 Barrasso Casey Dorgan Baucus Chambliss Durbin tent and go home. That is the height of Alexander Cornyn Isakson Bayh Coburn Ensign irresponsibility. Allard DeMint McConnell Bennett Cochran Enzi The Senator from Missouri described Barrasso Ensign Sessions Biden Coleman Feingold Brownback Enzi Shelby why it is so important for us to be able Bingaman Collins Feinstein Burr Grassley Sununu Bond Conrad Grassley to listen to our enemies: because, sim- Chambliss Gregg Vitter Brown Corker Gregg ply, it saves American lives. We Coburn Inhofe Warner Brownback Cornyn Hagel learned a harsh lesson on September 11, NAYS—73 Bunning Craig Harkin Burr Crapo Hatch 2001, which is that we are not safe even Akaka Bayh Biden Byrd DeMint Hutchison within our own shores. Baucus Bennett Bingaman

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00040 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1033 Inhofe McConnell Smith the future to surveil new terrorist tar- all the assets of their companies and, Isakson Menendez Snowe gets overseas. So the notion that some- thereby, generating a lot of share- Johnson Mikulski Specter Kennedy Murkowski Stabenow how no harm is done by allowing the holder lawsuits against the directors Kerry Murray Stevens law to expire is simply incorrect. In for violating their fiduciary responsi- Klobuchar Nelson (FL) Sununu fact, it borders on outrageous. bility. It is a terrible position to be put Kohl Nelson (NE) Tester This was going to be another example in. They are entitled to be able to co- Kyl Pryor Thune Landrieu Reed of bipartisan cooperation on behalf of operate with the request of our Govern- Vitter Lautenberg Reid Voinovich the American people. We saw it at the ment and not squander all the assets of Leahy Roberts Warner end of the year last year when we Levin Rockefeller their companies. Lieberman Salazar Webb passed a bipartisan AMT fix without Mr. LEAHY. Will the Senator yield Lincoln Sanders Whitehouse raising taxes on anybody else. We for a question? Lugar Schumer Wicker passed an energy bill without a tax in- Mr. CORNYN. Will the Senator yield Martinez Sessions Wyden for another question? McCaskill Shelby crease and without a rate increase. We met the President’s top line on the ap- Mr. MCCONNELL. I yield to my NOT VOTING—6 propriations bills. And, yes, we appro- friend from Texas. Boxer Graham McCain priated $70 billion for Iraq and Afghani- Mr. CORNYN. Mr. President, I would Clinton Inouye Obama stan without any kind of micro- like to ask the distinguished Repub- The amendment (No. 4032) was agreed management. At the beginning of this lican leader if, in fact, because of the to. year, we came together. It was a bit burden of these lawsuits, some 40 dif- The PRESIDING OFFICER. The Re- challenging in the Senate, but we came ferent lawsuits against any tele- publican leader. together and passed a bipartisan stim- communications companies that may FISA ulus bill to try to deal with our slowing have participated, if, in fact, they Mr. MCCONNELL. Mr. President, we economy. We did it in record time. In chose not to participate in this pro- have a serious crisis confronting our fact, the President had a signing cere- gram, is there any other option avail- country as a result of the House of mony 2 days ago. able to the intelligence authorities to Representatives’ refusal to take up the I am wondering why this new bipar- listen in on communications between Senate-passed Foreign Intelligence tisan spirit we experienced in Decem- terrorists who are bent on wreaking Surveillance Act. We know for a fact ber and again in January is breaking havoc, death, and destruction on the the following: We know that the Sen- down on a matter that is extraor- American people? Is there anywhere ate approved yesterday, with 69 votes, dinarily important to protecting the else to go? a Foreign Intelligence Surveillance Act American people. It is absolutely irre- Mr. MCCONNELL. I don’t think so, crafted by Senator ROCKEFELLER and sponsible for the House of Representa- Mr. President. This is the only solution Senator BOND that came out of the In- tives to simply throw up its hands and to the problem. What is tragic, we telligence Committee 13 to 2. This is leave, particularly when the only know as a result of a letter from the about as bipartisan as it ever gets measure that enjoys a bipartisan ma- so-called blue dog Democrats, the more around here. We know in addition this jority in the House is exactly what en- conservative Democrats in the House, bill is the only bill that can pass the joyed a bipartisan majority in the Sen- to Speaker PELOSI for sure that there House of Representatives. They took ate. It is the only measure that can is a bipartisan majority in the House up yesterday a 21-day extension of ex- pass the House. So the refusal of the for passing the bill the Senate passed. isting law, and it was defeated. It was House leadership to take up and pass This is what the blue dog Democrats defeated because there were 20 to 25 the only bill that could possibly pass is had to say to the Speaker. House Democrats who didn’t want the an act of extraordinary irrespon- Following the Senate’s passage of a FISA bill at all, want it to die, want to walk sibility. Nothing else would pass over bill, it will be necessary for the House to away from it and leave the American quickly consider FISA legislation to get a there. bill to the President before the Protect people unprotected. I don’t know why the House is even America Act expires. In fact, there is a bipartisan majority thinking about leaving town. They That, of course, will be Saturday. for the Senate-passed bill in the House, have an important responsibility to We— and that is the only bill for which help protect the American people. The there is a bipartisan majority in the opportunity is right before them, and Referring to the blue dog Demo- House. Now we have all learned that they will not take it. crats—— the House of Representatives is going Mr. CORNYN. Will the Senator yield fully support the Rockefeller-Bond FISA leg- to close up shop and simply leave town, for a question? islation, should it reach the House floor without substantial change. We believe these arguing that somehow allowing this Mr. MCCONNELL. I am happy to components will ensure a strong national se- law to expire will not harm America. yield the Senator from Texas for a curity apparatus that can thwart terrorism We know that at the heart of this question. across the globe and save American lives in struggle is retroactive liability for Mr. CORNYN. I ask the distinguished our country. communications companies that Republican leader whether the vol- The blue dog Democrats, coupled stepped up, in the wake of the 9/11 dis- untary cooperation of the tele- with House Republicans, make it abso- aster, at the request of the Govern- communications companies that have lutely certain there is a bipartisan ma- ment, to help protect us from ter- cooperated at the request of the Gov- jority for our bill in the House. rorism. As a result, there are numerous ernment and upon certification by the Further, the consequences of not passing lawsuits pending against these compa- chief law enforcement agent of the such a measure could place our national se- nies, I assume largely by the American country, the Attorney General, is in curity at undue risk. Civil Liberties Union. The CEOs and jeopardy, if we merely continue the This is 21 blue dog Democrats in the the boards of directors of these compa- current law as opposed to passing the House requesting the Speaker to take nies have a fiduciary responsibility to bipartisan Senate bill? And if that is up the bill that passed the Senate with their shareholders. These lawsuits have the case, doesn’t that just as effec- 69 votes, obviously an overwhelmingly the potential to put them out of busi- tively deny us access to terrorist com- bipartisan vote, pass it and send it to ness. As a result of doing their duty munications as if we did not pass the the President for signature. This re- and responding to the request of the law itself? fusal to act is stunning, almost incom- President of the United States to help Mr. MCCONNELL. My understanding prehensible. protect America, they run the risk of is the question suggests the answer. Mr. CORNYN. Will the Senator yield being put out of business. That is what The leadership of these companies has for one final question? is before us. This retroactive liability indeed a Hobson’s choice, two bad al- Mr. MCCONNELL. I will. problem continues. It is not solved by ternatives. They either continue to re- Mr. CORNYN. The Republican leader continuation of existing law. spond to the request of the American is aware that the House of Representa- In addition, with the law expiring, it Government to protect the homeland tives only recently had widely pub- hampers opportunities prospectively in and then run the risk of squandering licized hearings into the use of steroids

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00041 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1034 CONGRESSIONAL RECORD — SENATE February 14, 2008 and human growth hormone by base- Mr. KYL. If the Senator will con- talking about might be mandating our ball players. There has also been an ac- tinue to yield, my recollection of the own Government to pay the bills for tion taken recently to hold a former words of Admiral McConnell, Director the wiretaps. White House counsel and the Chief of of National Intelligence, is that—and I I ask that only because it seems this Staff of the President in contempt. Yet ask the leader to verify if I recall this public spiritedness goes one way if they there appears to be no time available correctly; I think I am recalling it cor- want to be immunized or the adminis- on the House calendar to do things that rectly—it doesn’t matter whether the tration wants to be immunized from actually would protect the lives of the Protect America Act expires or does anybody asking them questions, but it American people. Perhaps it is an obvi- not expire or is simply reauthorized in goes a different way if it comes down ous answer, but it would seem to me to its exiting form; the reality is, unless a to the question of getting paid. be clear that this ought to be a high new law is passed that contains the Mr. REID. My understanding is, there priority. Before we get to these kinds retroactive liability protection feature, are millions of dollars owed to the tele- of political machinations or perhaps it will become or is becoming increas- phone companies, Mr. President. publicity stunts, we ought to first pro- ingly difficult for the telecommuni- Mr. LEAHY. Thank you, Mr. Presi- tect the security of the American peo- cations companies to provide the serv- dent. ple by passing this bipartisan legisla- ice the U.S. Government needs them to Mr. REID. Mr. President, my friend tion. provide to acquire this intelligence. from Texas talked about a publicity Mr. MCCONNELL. Mr. President, it is I wish to make sure I am not mis- stunt. That is what we have, but it is my understanding that the House was stating this, that it is increasingly dif- inverse. The publicity stunt is all from dealing with steroid use in baseball and ficult for these telecommunications the White House, supported by the peo- trying to punish some White House of- companies to provide the service our ple in the Senate, the Republicans, who ficial over some internal dispute. It Government needs to collect this intel- always walk lockstep with whatever does strike me that is a strange use of ligence. President Bush wants. time, when we are 2 days from the expi- Mr. MCCONNELL. My understanding First of all, Mr. President, legal ration of arguably the most important is, the Senator from Arizona is correct. scholars are almost uniform in saying piece of legislation we have passed It is not exactly that these public, spir- that existing orders are broad enough since 9/11 to protect us here at home. It ited corporate leaders do not want to and they would be broad enough for the is no accident that we haven’t been at- help prevent terrorist attacks. It is next year. Whatever is happening now tacked again since 9/11. There are two that the exposure to their companies is good for next year. In fact, if some- reasons for it. One is, we went on the as a result of these lawsuits runs the one disagrees with that, you have ex- offense and have had great success in risk of destroying the company and isting FISA law that allows application Afghanistan and Iraq, killing a lot of then opening them up to shareholders’ for an emergency. terrorists, many of them at Guanta- suits for irresponsible actions or viola- Mr. President, let me say this: I sent namo, which I happen to think is a tions of their fiduciary responsibilities to the President of the United States good place for them. A lot of the rest of to their shareholders. today a letter. Let me read this: them are on the run. I am often asked: They are in an impossible position. Dear Mr. President: We don’t have Osama bin Laden. I say: We have, in effect, put them in an im- I regret your reckless attempt to manufac- Well, we wish we did. But I can assure possible position by failing to provide ture a crisis over the reauthorization of for- you, he is not staying at the Four Sea- for them the retroactive immunity eign surveillance laws. Instead of needlessly sons in Islamabad. He is in some cold from liability they clearly deserve. frightening the country, you should work with Congress in a calm, constructive way to cave somewhere looking over his shoul- These were public, spirited Americans provide our intelligence professionals with der, wondering when the final shoe is responding to a request from the Gov- all needed tools while respecting the privacy going to drop. So going on offense was ernment to help protect us at home. of law-abiding Americans. an important part of protecting Amer- What they got for it was a couple of Both the House and the Senate have passed ica and also this extraordinarily sig- scores of lawsuits. bills to reauthorize and improve the Protect nificant legislation about which we Mr. KYL. I thank the leader. America Act. Democrats stand ready to ne- have had testimony from the highest Mr. REID addressed the Chair. gotiate with Republicans to resolve the dif- ferences between the House and Senate bills. Mr. MCCONNELL. Mr. President, I officials that it has actually helped us That is how the legislative process works. thwart attacks against our homeland. still have the floor. Your unrealistic demand that the House sim- There isn’t anything we are doing that Mr. REID. I am sorry about that. ply acquiesce in the Senate version is pre- is more important than this, certainly Mr. MCCONNELL. But I will be venting that negotiation from moving for- not looking at steroid use in baseball. happy to yield. ward. As important as that may be, it cer- Mr. REID. I did not want to interrupt Our bicameral system of government was tainly does not rise to this level, or the distinguished Republican leader. designed to ensure broad bipartisan con- censoring White House officials. Have you finished? sensus for important laws. A FISA bill nego- Mr. LEAHY. Will the Senator yield Mr. MCCONNELL. I will be happy to tiated between the House and the Senate would have firmer support in Congress and for a question? yield the floor. The PRESIDING OFFICER (Mr. among the American people, which would Mr. MCCONNELL. I yield to my serve the intelligence community’s interest friend from Arizona for a question. WHITEHOUSE). The majority leader is in creating stronger legal certainty for sur- Mr. KYL. Mr. President, the first recognized. veillance activities. question I have is: Could the intel- Mr. LEAHY. Mr. President, will the That negotiation should take place imme- ligence community acquire new tar- distinguished majority leader yield for diately. In the meantime, we should extend gets, if the Protect America Act ex- a question from me? the current Protect America Act. Earlier pires, without going to the FISA Court Mr. REID. Sure. this week you threatened to veto an exten- for some kind of an additional war- Mr. LEAHY. Mr. President, I tried to sion, and at your behest Senate Republicans get the distinguished Republican leader have blocked such a bill. Yesterday every rant? House Republican voted against an exten- Mr. MCCONNELL. Mr. President, it is to yield, but he was unwilling. sion. my understanding they will not be able Let me ask the distinguished major- to do that. So in addition to the retro- ity leader, is it not a fact that these So it is obvious the marching orders active liability issue, which clearly is public, spirited telephone company have come from the White House. That not solved by failing to act, we have owners are threatening to turn off was a paraphrase from me. That was this problem that the Senator from Ar- wiretaps, according to the press ac- not in the letter. I continue the letter: izona has raised with regard to new counts, that have been legally ordered Your opposition to an extension is inex- targets. We are clearly more vulner- through search warrants because the plicable. Just last week, Director of National Intelligence McConnell and Attorney Gen- able as a result of allowing this legisla- U.S. Government has failed to pay eral Mukasey wrote to Congress that ‘‘it is tion to expire, which will happen Sat- them millions of dollars, and does not critical that the authorities contained in the urday if the House of Representatives pay them the millions of dollars? I just Protect America Act not be allowed to ex- does not act. wonder if any of the legislation we are pire.’’

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00042 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1035 In commentary, Mr. President, I say a bipartisan basis, thinks that law are just, unfortunately, a few lives this is from the head of the National ought to be taken up and passed. That away from losing 4,000 soldiers in this Intelligence Agency, Director McCon- is what we ought to be doing. war in Iraq. They want to manufacture nell, and General Mukasey, our Attor- I am sure the Democrats in the a security crisis. ney General. They said: House are grateful to their good friend, The Senator from Kentucky should [I]t is critical that the authorities con- the majority leader, for trying to pro- know—and I am sure he has able staff tained in the Protect America Act not be al- tect them from their actions. But the to alert him—the law, as it currently lowed to expire. fact is, there is only one reason we exists, the FISA law—even if we do not Similarly, House Minority Leader Boehner have a crisis. It is because the House change it—gives ample authority to has said ‘‘allowing the Protect America Act Democratic leadership refuses to act on this President to continue to monitor to expire would undermine our national se- a bill that enjoys bipartisan majority the conversations of those who endan- curity and endanger American lives, and that is unacceptable.’’ And you yourself said support in the House of Representa- ger the United States. at the White House today— tives that we have already passed over- But, instead, as Senator Harry Reid has said repeatedly, this President is That is today, Thursday— whelmingly. Therefore, I object. The PRESIDING OFFICER. Objec- trying to make America afraid—make ‘‘There is really no excuse for letting this tion is heard. America afraid. I thought there was a critical legislation expire.’’ I agree. UNANIMOUS CONSENT REQUEST—H.R. 3773 great leader who said once: The only I agree, Mr. President. Mr. REID. Mr. President, I ask unan- thing we have to fear is fear itself. It Nonetheless, you have chosen to let the imous consent that the Senate request turns out that it is fear itself that is Protect America Act expire. You bear re- the House to return the papers of H.R. motivating this Republican leadership. sponsibility for any intelligence collection If they would have provided 30 votes gap that may result. 3773, FISA legislation; and that if the Fortunately, your decision to allow the House agrees to the request, the Senate yesterday in the House of Representa- Protect America Act to expire does not, in insist on its amendment, request a con- tives, this law would have been ex- reality, threaten the safety of Americans. As ference with the House on the dis- tended. But they had their marching you are well aware, existing surveillance or- agreeing votes of the two Houses, and orders from the White House to vote ders under the law remain in effect for an ad- the Chair be authorized to appoint con- no, and they did. So the attempt to ex- ditional year, and the 1978 FISA law itself re- ferees on the part of the Senate, with tend it failed. If only 30 Members on mains available for new surveillance orders. no intervening action or debate. the Republican side in the House had Your suggestion that the law’s expiration stood up and voted to extend the law, would prevent intelligence agents from lis- Is it my understanding the first re- tening to the conversations of terrorists is quest was objected to. Is that right? it would have happened. utterly false. The PRESIDING OFFICER. There If the Republican minority leader, In sum, there is no crisis that should lead was objection. Objection was heard. Senator MCCONNELL, had not objected you to cancel your trip to Africa. But wheth- Is there objection? just moments ago to the unanimous er or not you cancel your trip, Democrats Mr. MCCONNELL. Mr. President, re- consent request of Senator REID, the stand ready to negotiate a final bill, and we serving the right to object, there is no Democratic leader, this law would have remain willing to extend existing law for as need for a conference when you have an been extended. short a time or as long a time as is needed overwhelming bipartisan majority of It is obvious to those following the to complete work on such a bill. the Senate in favor of the bill and a bi- debate, the crisis is in the logic on the I signed that ‘‘Harry Reid.’’ partisan majority of the House in favor Republican side. You cannot have it Mr. President, the President has cre- of the same bill that the Senate has al- both ways. You cannot complain that ated a crisis. As I have said on the Sen- ready passed. There is no need to go to the law is going to expire, and then ob- ate floor, during the past 7 years he has conference because we know where the ject to an extension. It does not work become increasingly proficient at scar- majority of the Senate is and we know that way. Even at the University of ing the American people. That is what where the majority of the House is. Louisville, it does not work that way. he is trying to do again today. Cancel Why would we want to have a con- Their philosophy department would his trip to Africa for this? But we, Mr. ference when the work the Senate has tell you that does not track, it does President, are willing to work with done, the Rockefeller-Bond bill, is sup- not follow. him. The expiration of the law stands ported by a bipartisan majority in the So I would urge the Senator from on the shoulders of one person: George House? Therefore, I object. Kentucky, if you really are concerned Bush. I am sure his ear has been whis- The PRESIDING OFFICER. Objec- about whether this law is extended, pered in several times in the last week tion is heard. please reconsider your objection to ex- or so by the Vice President. But the The majority whip. tending this law, as Senator REID has President is the one responsible ulti- Mr. DURBIN. Mr. President, what we asked repeatedly. I think the American mately. He has instructed Republicans are witnessing is not a crisis in secu- people know what is going on here. in the House not to agree to any exten- rity. It is a crisis in logic. How can the This is not about security. This is sion, and obviously the Senate Repub- Republican leader stand here and argue about political cover. This is about licans also. how endangered America would be if manufacturing a political argument UNANIMOUS CONSENT REQUEST—S. 2615 we allowed this law to expire and then and manufacturing a crisis—a crisis of So, Mr. President, I ask unanimous object to extending the law? How can the White House’s own creation. The consent that the Senate proceed to the the minority leader, Senator MCCON- President and his party bear full re- consideration of Calendar No. 571, S. NELL, stand here and argue that we sponsibility if any intelligence gaps re- 2615; the bill be read a third time and should pass this legislation and then sult. passed, and the motion to reconsider be object when the majority leader asks The PRESIDING OFFICER. The Re- laid upon the table, with no inter- for a conference committee? publican leader. vening action or debate. This is not a crisis in security. It is Mr. MCCONNELL. Now, Mr. Presi- The PRESIDING OFFICER. Is there a crisis in logic. This is a manufactured dent, facts are a stubborn thing—a objection? political crisis by the White House and very stubborn thing—and I am sure the Mr. MCCONNELL. Mr. President, re- the Republican leaders. If the Repub- Democrat leadership over in the House serving the right to object. lican leader was so focused on giving appreciates the efforts being made by Mr. REID. This is a 15-day extension. this power to the President, he could the majority leader and the majority Mr. MCCONNELL. Yes. Reserving the have said, ‘‘I do not object,’’ when the whip to protect them from the obvious. right to object, there is no need for an majority leader asked for a 15-day ex- The obvious is—and they know this extension. This current law expires tension. even at the University of Illinois—that Saturday. We know 68 Members of the But, no, they want a press release. the majority of the Senate has spoken, Senate have already voted for a Pro- They want something to put in front of an overwhelming majority of the Sen- tect America Act that would extend the American people to take their ate, not just on final passage which the law for 6 years. We know a major- minds off the state of our economy, to was 68 to 29, and cloture, which was 69 ity of the House of Representatives, on take their minds off the fact that we to 29, but also the Feingold amendment

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00043 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1036 CONGRESSIONAL RECORD — SENATE February 14, 2008 was defeated 63 to 35, the Dodd amend- the Senator from Texas indicates, is jority what they thought should hap- ment 67 to 31, the Feingold amendment not acceptable. Not only that, but we pen in the way of extending this. We, a 60 to 37, the Specter-Whitehouse know for a fact that the continuation few days ago, decided what we thought amendment 68 to 30. This is not close. of the status quo hampers the ability we should do. It is elementary that This bill went out of the Senate with a to go up on new targets prospectively, after that happens, there must be a riproaring, bipartisan majority. And so we not only have a deteriorating sit- conference. They won’t let us go to we know for a fact—and facts are a uation in terms of continued coopera- conference—‘‘they’’ meaning the Re- stubborn thing, I say to my good friend tion from the communications compa- publicans. So a majority of the House from Illinois—we know for a fact that nies—not because they are not public- voted in November for a different bill. the Rockefeller-Bond bill is supported spirited citizens, not because they That is why we need a negotiation. by a bipartisan majority in the House don’t want to help America, but be- That is why we need a conference. That of Representatives. We know that. It is cause they run the risk of squandering is how a bill becomes law. That is the a matter of simple addition. So why all the assets of their companies and way it is. That is the law. We have al- would we want to have a short-term ex- enhanced exposure to new actions that ready decided that facts are stubborn. tension to provide an opportunity to might occur by terrorists. Clearly, if we were arguing this case to resolve a dispute that doesn’t exist? So the status quo is clearly not ac- a jury—and I think probably as well The majority has spoken in the Sen- ceptable, I say to my friend from the American people—they probably ate. The majority will speak in the Texas. I think his question suggests know that this is an effort by the House if given the opportunity to the answer. President to scare us and in exchange speak. They are being denied the op- This is a very serious matter and I for that, he wants to try to take care of portunity to speak because the House regret that we are where we are. We the phone companies, not the Amer- runs in a different way from the Sen- had gotten off, I thought, to a pretty ican people. ate, and the House leadership can sim- good bipartisan start this year. I had The PRESIDING OFFICER. The Sen- ply refuse to take up a matter that is hoped—and frankly expected—that we ator from West Virginia is recognized. supported by a bipartisan majority in would be having another signing cere- Mr. ROCKEFELLER. Mr. President, the House. In this particular instance— mony down at the White House on the my name has been invoked frequently talk about a publicity stunt or cre- Rockefeller-Bond bill in the next few here over the last several weeks as ating a crisis—what created the crisis days and we could breathe easy that we passing a bill which was not favored by was the refusal of the House of Rep- had done our job and had protected the the majority of the people of my aisle, resentatives to act. Now, the notion American people to the maximum ex- and the phrase actually was used by that somehow they didn’t have time— tent possible for the foreseeable future. the majority leader, who is never we have been dealing with this issue I yield the floor. wrong, that we did what the President since last August—since last August. The PRESIDING OFFICER. The ma- wanted. The House had previously sent a bill jority leader is recognized. I didn’t do what the President want- over here that was unacceptable. We Mr. REID. Mr. President, facts are ed. I did what I thought was the right are all familiar with the subject mat- stubborn. The facts are that within the thing to do. I was joined by a variety of ter. last few days, we received a commu- my colleagues, including the Presiding It is time to let a majority of the nication from the Attorney General of Officer, who reserved the right to have House of Representatives speak—legis- the United States and the man who is other views on the floor, which he did, late. They are waiting there to be the Director of National Intelligence but ended up voting for the bill. given permission to ratify the fine saying: ‘‘It is critical the authorities What absolutely baffles me is that we work led by Senator ROCKEFELLER and contained in the Protect America Act are literally—we can do this FISA bill. Senator BOND here in the Senate and not be allowed to expire.’’ That is a I am meeting tomorrow morning with ratified by a total of 68 out of 100. fact. That was followed up with a the chairman of the House Intelligence So we have a crisis, but the crisis is statement by the House minority lead- Committee, who may be the only created by the majority in the House er who said: ‘‘Allowing the Protect House member in town—I have no idea, and its refusal to accept the obvious, America Act to expire would under- but I don’t care because he is the chair- which is that a majority of the Con- mine our national security and endan- man—on what we can do to save this. I gress wishes to pass the legislation in ger American lives, and that is unac- am absolutely convinced that we can the form that will achieve a Presi- ceptable.’’ And today, the President of have—in the hearing this afternoon, dential signature. the United States said: ‘‘There is really the Presiding Officer heard me put this Mr. President, I yield to the Senator no excuse for letting this critical legis- to the Director of National Intel- from Texas for a question. lation expire.’’ ligence, who couldn’t answer it because Mr. CORNYN. Mr. President, I ask Those are the facts. So when we ask it was not a policy question, but more the distinguished Republican leader— to accomplish what they want, there is of a political question. I said: You are the majority whip has said there is an objection. going to get the majority of your infor- some sort of crisis in logic, but I ask It is very clear, this is not an effort mation all the way through August. the minority leader to respond. Isn’t by the White House to protect the The President praised our bill and then the crisis in logic that the tele- American people, it is an effort to pro- came out the next day and said: Of communications carriers, whose co- tect the phone companies. It is not the course, if the House doesn’t pass it, we operation is absolutely essential to the American people. are going to lose our intelligence and continuation of our ability to listen in We heard from the Attorney General, we will be vulnerable to the terrorists. on communications between terrorists, we heard from the Director of National That was a misstatement, I think an isn’t that what is at risk here, by mere- Intelligence, the minority leader of the annoying misstatement. ly extending the current law and fi- House, and the President of the United I don’t understand. I simply don’t un- nally to come to grips with the bipar- States. We agreed to do what they derstand, if something is good and if tisan legislation that passed the Sen- want to do to try to extend. The Re- the President is willing to sign a bill ate and is supported by a bipartisan publicans were given the orders not to which this Senator in his conscience majority in the House? do what they wanted. Those are the feels is right, and it takes 15 days to do Mr. MCCONNELL. Mr. President, I facts. it, what the minority leader needs to say to my friend from Texas, he is en- Now another issue that is very im- understand—and he served in the tirely correct. There are multiple law- portant: The majority in the House of House. I am sure he understands that suits pending against the companies. Representatives and the majority in they have now been jammed twice. They are surely being pressured by the Senate have both spoken. A basic They have been jammed. There is their shareholders and their boards of elementary rule of this Government is something called human nature, and it directors on the issue of whether con- that we have a bicameral legislature. is not illegal to talk about human na- tinued cooperation means the demise We have the House and the Senate. In ture on the floor of the Senate. They of the companies. The status quo, as November, the House passed by a ma- have been jammed. They have been

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00044 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1037 pushed down to a 2-day period or a 3- (Purpose: To rescind funds appropriated by (6) the foundational English settlements in day period when they had to make a the Consolidated Appropriations Act, 2008, Jamestown, Virginia, and Plymouth, Massa- decision. They resent that. But if they for the City of Berkeley, California, and chusetts, owed their survival in large meas- were given a period of time, they would any entities located in such city, and to ure to the compassion and aid of Native Peo- provide that such funds shall be trans- ples in the vicinities of the settlements; come, in my judgment, to where we ferred to the Operation and Maintenance, (7) in the infancy of the United States, the are, and the bill would go to the Presi- Marine Corps account of the Department of founders of the Republic expressed their de- dent and he would sign it. Defense for the purposes of recruiting) sire for a just relationship with the Indian Now, let me say something more. At the appropriate place, add the fol- tribes, as evidenced by the Northwest Ordi- What people have to understand around lowing: nance enacted by Congress in 1787, which be- here is that the quality of the intel- SEC. ll. RECISSION AND TRANSFER OF FUNDS. gins with the phrase, ‘‘The utmost good faith ligence we are going to be receiving is (a) RECISSION OF CERTAIN EARMARKS.—All shall always be observed toward the Indi- going to be degraded. It is going to be of the amounts appropriated by the Consoli- ans’’; dated Appropriations Act, 2008 (Public Law (8) Indian tribes provided great assistance degraded. It is already going to be de- to the fledgling Republic as it strengthened graded as telecommunications compa- 110–161) and the accompanying report for congressional directed spending items for and grew, including invaluable help to nies lose interest. Everybody tosses the City of Berkeley, California, or entities Meriwether Lewis and William Clark on that around and says: Well, what do located in such city are hereby rescinded. their epic journey from St. Louis, Missouri, you mean? I say: Well, what are they (b) TRANSFER OF FUNDS TO OPERATION AND to the Pacific Coast; making out of this? What is the big MAINTENANCE, MARINE CORPS.—The amounts (9) Native Peoples and non-Native settlers payoff for the telephone companies? rescinded under subsection (a) shall be trans- engaged in numerous armed conflicts in They get paid a lot of money? No. They ferred to the ‘‘OPERATION AND MAINTENANCE, which unfortunately, both took innocent get paid nothing. What do they get for MARINE CORPS’’ account of the Department lives, including those of women and children; (10) the Federal Government violated many this? They get $40 billion worth of of Defense for fiscal year 2008 to be used for recruiting purposes. of the treaties ratified by Congress and other suits, grief, trashing, but they do it. (c) CONGRESSIONAL DIRECTED SPENDING diplomatic agreements with Indian tribes; But they don’t have to do it, because ITEM DEFINED.—In this section, the term (12) the United States forced Indian tribes they do have shareholders to respond ‘‘congressional directed spending item’’ has and their citizens to move away from their to, to answer to. There is going to be a the meaning given such term in paragraph traditional homelands and onto federally es- degrading of the nature of our intel- 5(a) of rule XLIV of the Standing Rules of tablished and controlled reservations, in ac- ligence in some very crucial areas if we the Senate. cordance with such Acts as the Act of May 28, 1830 (4 Stat. 411, chapter 148) (commonly follow the path that the minority lead- Mr. DEMINT. Mr. President, I yield the floor. known as the ‘‘Indian Removal Act’’); er is suggesting, because we will go (13) many Native Peoples suffered and per- right back to where we were last Au- Mr. DORGAN. Mr. President, I make ished— gust, and that will be a further jolt to a point of order that a quorum is not (A) during the execution of the official the telecommunications companies, be- present. Federal Government policy of forced re- cause they will understand that you The PRESIDING OFFICER. The moval, including the infamous Trail of Tears cannot count on the Congress, you can- clerk will call the roll. and Long Walk; not count on us to make policy which The legislative clerk proceeded to (B) during bloody armed confrontations will give stability to their—not govern- call the roll. and massacres, such as the Sand Creek Mas- sacre in 1864 and the Wounded Knee Massacre ment agencies but to their corpora- Mr. BROWNBACK. Mr. President, I ask unanimous consent that the order in 1890; and tions. (C) on numerous Indian reservations; Fifteen days. We are off for a week, for the quorum call be rescinded. (14) the Federal Government condemned so maybe it has to be 25 days. I don’t The PRESIDING OFFICER (Mr. NEL- the traditions, beliefs, and customs of Native know. I don’t care about that. We could SON of Florida). Without objection, it is Peoples and endeavored to assimilate them have the same bill on this floor from so ordered. by such policies as the redistribution of land the House. I am convinced of it. It is AMENDMENT NO. 3893, AS MODIFIED under the Act of February 8, 1887 (25 U.S.C. Mr. BROWNBACK. Mr. President, I 331; 24 Stat. 388, chapter 119) (commonly human nature. Give them a chance to known as the ‘‘General Allotment Act’’), and have a grudge. I am going to meet with ask for the regular order and call up the forcible removal of Native children from the chairman tomorrow. Let him rip my amendment No. 3893. I send a modi- their families to faraway boarding schools into me for not giving the House an fication to the desk. where their Native practices and languages adequate chance for the second time to The PRESIDING OFFICER. The were degraded and forbidden; discuss this matter. But I am abso- amendment is pending. (15) officials of the Federal Government lutely convinced that we could have The amendment is so modified. and private United States citizens harmed that bill on the floor in this body and The amendment, as modified, is as Native Peoples by the unlawful acquisition follows: of recognized tribal land and the theft of pass it and send it to the President. tribal resources and assets from recognized Why they don’t want to do that, I do At the end, add the following: tribal land; not know. TITLE III—MISCELLANEOUS (16) the policies of the Federal Government I yield the floor. SEC. 301. RESOLUTION OF APOLOGY TO NATIVE toward Indian tribes and the breaking of cov- The PRESIDING OFFICER. The Sen- PEOPLES OF UNITED STATES. enants with Indian tribes have contributed ator from South Carolina. (a) FINDINGS.—Congress finds that— to the severe social ills and economic trou- (1) the ancestors of today’s Native Peoples bles in many Native communities today; AMENDMENT NO. 4080 TO AMENDMENT NO. 4070 inhabited the land of the present-day United (17) despite the wrongs committed against Mr. DEMINT. Mr. President, I call for States since time immemorial and for thou- Native Peoples by the United States, Native the regular order with respect to sands of years before the arrival of people of Peoples have remained committed to the amendment No. 4070, and I call up European descent; protection of this great land, as evidenced by (2) for millennia, Native Peoples have hon- the fact that, on a per capita basis, more Na- amendment No. 4080 as a second-degree ored, protected, and stewarded this land we tive Peoples have served in the United States amendment. cherish; Armed Forces and placed themselves in The PRESIDING OFFICER. The (3) Native Peoples are spiritual people with harm’s way in defense of the United States clerk will report the amendment. a deep and abiding belief in the Creator, and in every major military conflict than any The legislative clerk read as follows: for millennia Native Peoples have main- other ethnic group; tained a powerful spiritual connection to (18) Indian tribes have actively influenced The Senator from South Carolina [Mr. this land, as evidenced by their customs and the public life of the United States by con- DEMINT] proposes an amendment numbered legends; tinued cooperation with Congress and the 4080 to amendment No. 4070. (4) the arrival of Europeans in North Amer- Department of the Interior, through the in- Mr. DEMINT. Mr. President, I ask ica opened a new chapter in the history of volvement of Native individuals in official unanimous consent that the reading of Native Peoples; Federal Government positions, and by lead- the amendment be dispensed with. (5) while establishment of permanent Euro- ership of their own sovereign Indian tribes; pean settlements in North America did stir (19) Indian tribes are resilient and deter- The PRESIDING OFFICER. Without conflict with nearby Indian tribes, peaceful mined to preserve, develop, and transmit to objection, it is so ordered. and mutually beneficial interactions also future generations their unique cultural The amendment is as follows: took place; identities;

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I ask head of the Office of Veterans’ Affairs of happiness. for a favorable consideration of the two for the Embassy of the Philippines, be (b) ACKNOWLEDGMENT AND APOLOGY.—The amendments. printed in the RECORD. This letter pre- United States, acting through Congress— The PRESIDING OFFICER. The sents a historical overview of Filipino (1) recognizes the special legal and polit- question is on agreeing to the Brown- involvement during World War II and ical relationship Indian tribes have with the back amendment No. 3893, as modified, what has ensued since that time. United States and the solemn covenant with General Lorenzana notes that these the land we share; and the Mikulski amendment No. 4023, (2) commends and honors Native Peoples en bloc. veterans fought in a war between the for the thousands of years that they have The amendments (Nos. 3893, as modi- United States and Japan, under the stewarded and protected this land; fied, and 4023) were agreed to en bloc. U.S. flag as part of the U.S. Army (3) recognizes that there have been years of Mr. BROWNBACK. Mr. President, I Forces in the Far East. He notes that official depredations, ill-conceived policies, move to reconsider the vote. out of the nearly half-a-million Fili- and the breaking of covenants by the Federal Ms. MIKULSKI. I move to lay that pino veterans who served, only 18,000 Government regarding Indian tribes; survive today. In another decade, only (4) apologizes on behalf of the people of the motion on the table. United States to all Native Peoples for the The motion to lay on the table was a few of them will remain. many instances of violence, maltreatment, agreed to. I am happy to note that many Fili- and neglect inflicted on Native Peoples by Mr. DORGAN. Mr. President, I sug- pino veterans enjoy eligibility for ben- citizens of the United States; gest the absence of a quorum. efits and health care services on the (5) expresses its regret for the ramifica- The PRESIDING OFFICER. The same basis as other U.S. veterans. tions of former wrongs and its commitment clerk will call the roll. However, there is still work to be done to build on the positive relationships of the in order to extend these eligibilities to past and present to move toward a brighter The legislative clerk proceeded to all of those who served with the United future where all the people of this land live call the roll. reconciled as brothers and sisters, and har- Mr. DORGAN. Mr. President, I ask States military during World War II. moniously steward and protect this land to- unanimous consent that the order for Last June the committee held a gether; the quorum call be rescinded. markup where the then ranking mem- (6) urges the President to acknowledge the The PRESIDING OFFICER. Without ber, Senator CRAIG, offered an amend- wrongs of the United States against Indian objection, it is so ordered. ment to reduce the amount of pension tribes in the history of the United States in that Filipino veterans residing in the Mr. DORGAN. Mr. President, I ask order to bring healing to this land; and Philippines would receive under S. 1315. (7) commends the State governments that unanimous consent that the Senator I stress that the amendment was not to have begun reconciliation efforts with recog- from Hawaii, Mr. AKAKA, be recognized strip pension benefits from the bill en- nized Indian tribes located in their bound- for 7 minutes as in morning business. tirely—merely to reduce the benefit in aries and encourages all State governments The PRESIDING OFFICER. Without similarly to work toward reconciling rela- line with what Senator CRAIG viewed as objection, it is so ordered. tionships with Indian tribes within their appropriate. I disagreed with Senator The Senator from Hawaii is recog- boundaries. CRAIG’s assessment and his amendment nized. (c) DISCLAIMER.—Nothing in this section— was not adopted. (1) authorizes or supports any claim VETERANS BENEFITS ENHANCEMENT ACT In the months that followed markup, against the United States; or Mr. AKAKA. Mr. President, I come to (2) serves as a settlement of any claim consideration of S. 1315 was put off against the United States. the floor today to speak—again—about while Republican leadership on the S. 1315, the Veterans Benefits Enhance- committee suddenly changed hands. Mr. BROWNBACK. Mr. President, ment Act of 2007. This critical legisla- In late fall, my efforts to seek a mid- this is an amendment brought up at tion would affect real change in the dle ground between the level of pension the very outset of this debate. I under- treatment of our Nation’s veterans. benefits in the bill as reported, and the stand there has been an agreement Provisions in S. 1315 would improve level former Ranking Member CRAIG that we can move forward with this life insurance programs for disabled sought during markup, were rejected. amendment. So I have worked with the veterans, expand the traumatic injury When a counteroffer was finally made chairman of the committee and the protection program for active duty by the committee’s new ranking mem- ranking member, and the modifica- servicemembers, and provide individ- ber, Senator BURR, supported by Sen- tions have been made. uals with severe burns specially adapt- ator CRAIG, it proposed to entirely I ask for the yeas and nays on this ed housing benefits. These provisions strip pension benefits from Filipino amendment. are vital to improve benefits and serv- veterans residing in the Philippines Mr. DORGAN. Mr. President, my un- ices for our veterans. from the bill. This is not acceptable to derstanding is that we were going to However, for many months now, S. me. It is possible, however, that it voice vote this amendment. Senator 1315 has been blocked from debate by might be acceptable to some in the MIKULSKI is in the room, and she will Republican Members opposed to a pro- Senate. That is why I continue to ask want to call up her amendment No. vision in the bill that would extend that we move forward with delibera- 4023. My hope is that we could agree to certain VA benefits to Filipino vet- tion of this measure. Let us have a real these two amendments en bloc by voice erans, residing in the Philippines, who debate on this bill, and then have an vote. fought alongside U.S. troops during up-or-down vote. Mr. BROWNBACK. We do not need a World War II. These veterans have been I again ask that the Senate be al- recorded vote. I will agree to a voice denied these benefits for over 50 years. lowed to debate this important meas- vote. I believe it is time to give these elderly ure. Our committee must be permitted First, I ask unanimous consent to veterans the benefits that they earned to finish our work. America’s veterans add Senator COBURN as a cosponsor of and so richly deserve. deserve no less. my amendment. In the 62 years since the end of the Mr. President, I ask unanimous con- The PRESIDING OFFICER. Without Second World War, Filipino veterans sent that the letter from General objection, it is so ordered. have worked tirelessly to secure the Lorenzana, which I mentioned earlier, AMENDMENT NO. 4023 veterans status they were promised be printed in the RECORD. Ms. MIKULSKI. Mr. President, I ask when they agreed to fight under U.S. There being no objection, the mate- unanimous consent that my amend- command during World War II. They rial was ordered to be printed in the ment No. 4023 be considered en bloc were considered U.S. veterans until RECORD, as follows:

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EMBASSY OF THE PHILIPPINES, of veterans). What is the price of the services rightful benefits under U.S. laws by an act of Washington, DC, February 6, 2008. and sacrifices so generously given to Amer- Congress. During the deliberation of the Re- Hon. LARRY E. CRAIG, ica by these veterans and the entire Filipino scission Act of 1946, the Head of the Veterans Member, Senate Veterans’ Affairs Committee, nation during that Great War, Senator Administration testified that the Filipino Hart Senate Office Building, U.S. Senate, Craig? They were prepared to offer the ulti- soldiers who served under the U.S. Army Washington, DC. mate sacrifice for America. Their homeland during World War II pursuant to the military DEAR SENATOR CRAIG: In November and De- was made a battlefield in a war between order’ of President Franklin Roosevelt sat- cember last year, S1315, the Veterans Bene- Japan and the United States. An estimated isfy the statutory definition of a U.S. vet- fits Enhancement Act (which includes bene- one million Filipinos, combatants and non- eran and that it would cost the U.S. $3.2B to fits for surviving Filipino World War II vet- combatants, died in that war. If at all, for so pay them on equal terms as their U.S. coun- erans) was brought to the Senate Floor for many of these veterans, these benefits may terpart. Subsequently, the Rider to P.L. 79– unanimous consent. On both occasions, you be too little, too late. 301 was inserted to become Sec. 107, Title 38 strongly objected to the passage of the Bill, And yet after the war, these veterans were of the U.S. Code which S1315 aims to amend. specifically Title IV, the portion on Filipino denied their benefits under U.S. laws by an How much is $3.2B in today’s dollars, Sen- WWII veterans, citing reasons such as: the Act of Congress (PL 79–301). It was a dis- ator Craig? Furthermore, the Rider to P.L. Filipino veterans are not U.S. citizens; the criminatory, unfair and unjust law because 79–301 provided an appropriation of $200M to proposed benefits are too generous; they while it barred these veterans from getting the Philippine Army to compensate Filipino would have undue advantage over U.S. vet- benefits it also provided for widows and or- veterans. Immediately upon enactment of erans residing in the U.S.; we have treated phans of those who died in line of duty and P.L. 79–301, the Philippine Resident Commis- them fairly by providing $620M in recon- to those who had service-connected disabil- sioner to the U.S., the Honorable Carlos P. struction after the war ($6.7B in today’s dol- ities even if only at 50 cents to the dollar. Romulo, protested the Rider and rejected the lars); we have a hospital in the Philippines; But were the services of the survivors less $200M appropriation to the Philippine Army. we are taking away money from our veterans important than those who were killed at the Our research yields no record of the amount to give to a foreign veteran—a Filipino (the onset of the war and later or those who were going into the Philippine Army budget in the Robin Hood in reverse effect). imprisoned, wounded and incapacitated? years 1946–48. Again, how much is this in to- It would be reasonable for such arguments In reality, they were an indispensable part day’s dollars? By all accounts, this measure to appeal to the American public, especially of the underground Army that tied up large has saved the U.S. billions of dollars at the those who are uninformed of the complete number of Japanese forces otherwise de- expense of the Filipino veterans. facts of the issue. But in the interest of fair- ployed elsewhere. They aided and protected Mr. Senator, these Filipino WWII veterans ness, it is necessary to see the entire picture. American officers and soldiers who escaped were no different from the more than 15 mil- First of all, Filipinos who served under the capture. They served in the underground lion American men and women who were dis- U.S. Army pursuant to a military order by units led by USAFFE officers. They provided charged from the military service at the end President Franklin D. Roosevelt on July 26, vital intelligence and forces-in-place that fa- of WWII. They came from all walks of life 1941 were in fact U.S. veterans by U.S. defini- cilitated the counter-invasion of the allied and cross-section of the country the same as tion and the Rider to the Rescission Act of forces that minimized allied casualties. They their U.S. counterparts: from cities, small 1946 (PL 79–301) was, therefore, grossly dis- provided invaluable intelligence and combat towns, farms and villages. But the similarity criminatory, unfair and unjust. support in the rescue of 513 American POWs ends there. After the war the U.S. veterans The Filipino WWII Veterans claim is based in Cabanatuan in Central Luzon on January could go to school under the GI Bill of on the Philippines’ status as a U.S. colony 28, 1945—considered as the most successful Rights. They were eligible to generous hous- and a U.S. law, the Tydings-McDuffie Act of rescue in the annals of the U.S. Army. This ing loans, medical and other benefits. Edu- 1934, also known as the Philippine Independ- rescue operation was later made into the ac- cated and trained, they became a vital cog of ence Act. This law was passed by the U.S. claimed book ‘‘The Ghost Soldiers’’ and postwar America that propelled this great Congress on March 24, 1934 to provide self- eventually into a movie ‘‘The Great Raid’’. nation to its preeminent place in the world government to the Philippines leading to its U.S. role in the Philippine postwar recon- today. Two of your esteemed Senate col- eventual independence from America after a struction and rehabilitation was to be ex- leagues, Senators John Warner and Frank transition period of 10 years. This law man- pected. The war, after all, was on account of Lautenberg, both WWII veterans, dates that all citizens of the Philippines the United States. But these postwar recon- jumpstarted their careers through the GI shall owe allegiance to the United States. struction and aid came at a great cost to the Bill. No such luck came for the Filipino vet- Under this law, the United States of America fledgling Philippine Republic as this excerpt erans. retains control and supervision of national from a history book states: ‘‘The Philippines Senator Craig, the 110th Congress is in a defense and foreign affairs. The President of had gained independence in the ‘ashes of vic- position to redress a 62-year old injustice the United States of America was likewise tory’. Intense fighting, especially around done to Filipino veterans by the same insti- granted power to call into service all mili- Manila in the last days of the Japanese re- tution that you now serve, by passing S1315. tary forces located within the Philippine treat (February–March 1945), had nearly de- Out of the original 470,000 listed after the Commonwealth Government. This power was stroyed the capital. The economy generally war which the U.S. Army trimmed down to invoked and exercised by President Franklin was in disarray. Rehabilitation aid was obvi- 260,143 in 1948, barely 18,000 survive today. D. Roosevelt on July 26, 1941 when war with ously needed, and President Roxas was will- They are in their mid-80s and in about a dec- Japan became imminent. ing to accept some onerous conditions placed ade only a few of them would be left. They Some have argued that the responsibility implicitly and explicitly by the U.S. Con- are not seeking equal benefits as their Amer- for taking care of Filipino veterans rests gress. The Bell Act in the United States ex- ican counterparts. The Veterans Federation upon the Philippine Government because tended free trade with the Philippines for 8 of the Philippines welcomes and fully sup- they fought for their country. Our Govern- years, to be followed by 20 years of gradually ports the Senate Veterans Affairs’ Com- ment has been doing this within its re- increasing tariffs. The United States de- mittee markup. Your statement that it sources for more than 60 years. In fact the manded and received a 99-year lease on a would give them undue advantage over U.S. Philippine Congress is passing a law that number of Philippine military and naval veterans residing in the U.S. vis-a` -vis the would allow these veterans to continue re- bases in which U.S. authorities had virtual difference in the cost of living in both coun- ceiving their old-age pensions even after the territorial rights. And finally, as a specific tries is not the case on closer scrutiny. U.S. has passed a law that would give them requirement for release of U.S. war-damage Whilst the U.S. veterans have access to VA veterans benefits. payments, the Philippines had to amend its medical facilities & medicines, loan guaran- That they fought for their country’s lib- constitution to give U.S. citizens equal tees, low insurance premiums and food eration cannot be denied. But primarily, rights with Filipinos in the exploitation of stamps the Filipino veterans do not. Only these veterans fought in a war between U.S. its natural resources—the so-called Parity those in Luzon have easy access to the Vet- and Japan, under the U.S. flag as part of the Amendment.’’ The aggressor nations were erans Memorial Medical Center in Manila (a United States Army Forces in the Far East actually treated better. hospital built by the U.S. in 1950 and con- (USAFFE). Japan invaded the Philippines to Your statement that granting these bene- veyed to the Philippine Government in 1953) defeat the American forces stationed thereat fits to the Filipino veterans is stealing but they usually pay for their own medi- which it considered an obstacle in its drive money from U.S. veterans and giving it to a cines. Whatever meager income they have is to the resource-rich Dutch East Indies. Some foreign veteran—a Filipino (the Reverse augmented by a 5,000 pesos old-age pension historians have argued that if the Phil- Robin Hood effect), is most unfair to all from the Philippine Government. Further- ippines then had not been a colony of the these veterans, Filipinos and Americans. more, the appreciation of the Peso against U.S., it could have been easily bypassed by They served the United States faithfully and the Dollar which was 55:1 a year ago is now Japan in its southward drive. Because of the selflessly and it is uncharacteristic that they 40: 1, thus greatly diminishing the real value vagaries of history we will never know this should be pitted against each other over ben- of the proposed pension benefits. for sure, but the fact is, Thailand, a country efits. These Filipinos are U.S. veterans at We hope that the debate on the Filipino not under a colonial rule, was not invaded. the end of WWII as pointed out earlier. Our WWII veterans issue would focus more on the You claimed that the pension benefit is too research into U.S. Congressional records of merits of their claims and not their being generous ($375 for veterans with dependents, early 1946 indicates that, in fact, it was the non-U.S. citizens. After all, this was not an $300 for single veterans, and $200 for widows Filipino veterans who were stripped of their issue in 1941 when the U.S. President ordered

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them into the service of the U.S. Army to the results of, a study to determine possible AMENDMENT NOS. 4024, 4025, 4026, 4027, 4028, 4030, fight under the U.S. flag. They were U.S. vet- causes for the high prevalence of tobacco use 4031, 4033, 4035, AND 4037 WITHDRAWN erans under U.S. law after the war and enti- among Indians. Mr. DORGAN. Mr. President, Senator tled to VA benefits until PL 79–301 was AMENDMENT NO. 4083 COBURN has indicated to me that the passed. (Purpose: To require the Comptroller Gen- pending Coburn amendments will not As we commemorate the Anniversary of eral of the United States to conduct a the Rescission Act of 1946 on February 18, we be dealt with further. Therefore, on his study on payments for contract health behalf, I ask that the Coburn amend- pray that this 62-year old claim for recogni- services) tion and benefits of these remaining gallant ments be withdrawn. I believe Senator At the end of title I, add the following: men and women who served America with MURKOWSKI is with the same under- lll utmost loyalty and devotion during WWII be SEC. . GAO STUDY AND REPORT ON PAY- MENTS FOR CONTRACT HEALTH standing. He came to both of us. He of- finally granted. SERVICES. fered some of his amendments. He got Lastly, the Philippines is one of the lead- (a) STUDY.— us to accept other amendments with- ing allies of the U.S. in today’s war against (1) IN GENERAL.—The Comptroller General out a vote. We appreciate very much terror. In the same way that the Filipino sol- of the United States (in this section referred diers in WWII shed their blood with U.S. sol- his cooperation. But the other pending to as the ‘‘Comptroller General’’) shall con- amendments that were accepted origi- diers in defense of freedom and democracy, duct a study on the utilization of health care today’s Filipino soldiers help make the world furnished by health care providers under the nally to be en bloc, we ask they be a safer and more secure place to live. Would contract health services program funded by withdrawn. it be too much to ask, therefore, that if only the Indian Health Service and operated by Ms. MURKOWSKI. Mr. President, we in tribute to their long lasting partnership, the Indian Health Service, an Indian Tribe, have no objection on this side to with- that a great injustice be formally corrected or a Tribal Organization (as those terms are drawing the pending Coburn amend- and our WWII veterans given the recognition defined in section 4 of the Indian Health Care ments. and benefits they so richly deserve. That’s Improvement Act). The PRESIDING OFFICER. Without all that we ask. (2) ANALYSIS.—The study conducted under With my best wishes for your continued objection, it is so ordered. The amend- paragraph (1) shall include an analysis of— ments are withdrawn. success, I remain (A) the amounts reimbursed under the con- Sincerely yours, tract health services program described in The Senator from North Carolina. DELFIN N. LORENZANA, paragraph (1) for health care furnished by en- Mr. BURR. Mr. President, I ask unan- Special Presidential Representative/ tities, individual providers, and suppliers, in- imous consent to address the Senate Head, Office of Veterans’ Affairs. cluding a comparison of reimbursement for for 10 minutes as in morning business. Mr. AKAKA. I yield the floor and such health care through other public pro- The PRESIDING OFFICER. Without suggest the absence of a quorum. grams and in the private sector; objection, it is so ordered. The PRESIDING OFFICER. The (B) barriers to accessing care under such SECTION 303 clerk will call the roll. contract health services program, including, Mr. KENNEDY. Mr. President, I The legislative clerk proceeded to but not limited to, barriers relating to travel distances, cultural differences, and public would like to thank the senior Senator call the roll. and private sector reluctance to furnish care from North Dakota for his leadership Mr. DORGAN. Mr. President, I ask to patients under such program; on the issue of Indian health care. As unanimous consent that the order for (C) the adequacy of existing Federal fund- he and the Senator from Alaska have the quorum call be rescinded. ing for health care under such contract emphasized during the debate in recent The PRESIDING OFFICER. Without health services program; and days, our Government must ensure objection, it is so ordered. (D) any other items determined appro- that Native Americans have access to priate by the Comptroller General. AMENDMENTS NOS. 4078, AS MODIFIED; TO quality health care throughout our (b) REPORT.—Not later than 18 months AMENDMENT NO. 3899, AND 4083 after the date of enactment of this Act, the country. Mr. DORGAN. Mr. President, I have a Comptroller General shall submit to Con- Mr. DORGAN. I thank the Senator unanimous consent request that has gress a report on the study conducted under from Massachusetts for his support. been cleared on both sides, to clear subsection (a), together with recommenda- Mr. KENNEDY. I understand that in some amendments that are agreed to. tions regarding— the managers’ amendment, section I ask unanimous consent that the (1) the appropriate level of Federal funding 303(b) of the bill has been modified so pending amendment be set aside so that should be established for health care that the language is now identical to under the contract health services program that I may call up the following current law; is that correct? amendments en bloc: Coburn, No. 4078, described in subsection (a)(1); and (2) how to most efficiently utilize such Mr. DORGAN. Yes. The intent of the as modified; Vitter, No. 4038; Binga- funding. provision in the managers’ amendment man, No. 4083. (c) CONSULTATION.—In conducting the to the bill is to maintain current law. The PRESIDING OFFICER. Without study under subsection (a) and preparing the Generally, when Indian health facili- objection, it is so ordered. report under subsection (b), the Comptroller ties are constructed or renovated, The clerk will report the amend- General shall consult with the Indian Health Davis-Bacon prevailing wage rates ments. Service, Indian Tribes, and Tribal Organiza- apply. However, pursuant to current tions. The legislative clerk read as follows: Federal law and longstanding policy of Mr. DORGAN. Mr. President, I ask The Senator from North Dakota [Mr. DOR- the Department of Labor, Indian unanimous consent that the following GAN], for Mr. COBURN and Mr. BINGAMAN, pro- Health Service, and Bureau of Indian amendments be agreed to en bloc: Mar- poses amendments numbered 4078, as modi- Affairs, when Indian tribes and tribal tinez, No. 3906, as modified; Bingaman, fied, and 4083, en bloc. organizations construct or renovate No. 4083; Barrasso, No. 3898; Coburn, The amendments are as follows: federally funded Indian health facili- No. 4078, as modified; Coburn, No. 4029; AMENDMENT NO. 4078, AS MODIFIED ties using their own employees, Davis- and Vitter, No. 4038. At the appropriate place in title VIII of the Bacon prevailing wage rates do not The PRESIDING OFFICER. Without Indian Health Care Improvement Act (as apply. Our intention in the managers’ objection, it is so ordered. amended by section 101), insert the fol- amendment is to maintain the status lowing: The amendments (Nos. 3906, as modi- fied; 4083; 3898; 4078, as modified; 4029; quo of current law and policy in these ‘‘SEC. 8ll. STUDY ON TOBACCO-RELATED DIS- regards. EASE AND DISPROPORTIONATE and 4038) were agreed to en bloc. HEALTH EFFECTS ON TRIBAL POPU- Mr. DORGAN. Mr. President, I sug- Mr. KENNEDY. So this language LATIONS. gest the absence of a quorum. does not change the construction or ap- ‘‘Not later than 180 days after the date of The PRESIDING OFFICER. The plication of existing statutes? enactment of the Indian Health Care Im- clerk will call the roll. Mr. DORGAN. Correct, it does not provement Act Amendments of 2008, the Sec- The legislative clerk proceeded to change current law. It is our intent retary, in consultation with appropriate Fed- call the roll. that the prevailing wage provisions in eral departments and agencies and acting both the Indian Health Care Improve- through the epidemiology centers estab- Mr. DORGAN. Mr. President, I ask lished under section 209, shall solicit from unanimous consent that the order for ment Act and the Indian Self-Deter- independent organizations bids to conduct, the quorum call be rescinded. mination and Education Assistance and shall submit to Congress, no later than The PRESIDING OFFICER. Without Act will continue to apply when Fed- 5 years after enactment, a report describing objection, it is so ordered. eral funds are used for the construction

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Nothing could be further from care facilities. It expands behavioral section 303 in current law untouched, is the truth. health services to address disorders be- a purely technical matter arising from At a time when our health care sys- yond the traditional focus on alcohol the difficulty, or awkwardness, of leav- tem is overburdened and our economy and substance abuse. And it requires ing only one provision of the Indian is in a slump, why would we introduce that individuals in need of mental help Health Care Improvement Act in place chaos into cost-effective, coordinated get access to a continuum of care such while restating or amending the rest of care? as hospitalization and detoxification that act. If the administration hamstrings ef- services. Mr. DORGAN. That is correct, that is fective case management, Medicaid Importantly, this bill includes long- why the managers’ amendment re- costs will not drop, they will likely term reauthorization of health services states current section 303 verbatim. balloon. Without solid case manage- for urban Indians. As my colleagues Ms. MURKOWSKI. More specifically, ment grounded in seamless administra- know, urban Indians account for a vast it is my understanding that by simply tion and service delivery, state Med- majority of the American Indian popu- restating section 303 verbatim in this icaid Programs will lose ground. lation, with nearly 7 out of 10 Amer- They will forsake precious progress bill, Congress is not superseding or al- ican Indians and Alaskan Natives liv- they have made toward eliminating du- tering the effect of the prevailing wage ing in or near an urban area. plicative or unnecessary care, reducing provisions of the Indian Self-Deter- Such a large population cannot be hospitalizations, and improving out- mination and Education Assistance left behind in this reauthorization. comes. Urban Indians face similar health dis- Act—including the exception referred This rule is bad for Ohio and bad for parities as their counterparts who live to by the Senator from North Dakota the nation. applicable when construction or ren- It is misguided, and frankly, it is on reservations, and they are not re- ovation work is carried out by employ- cruel. moved from our Nation’s trust obliga- ees of an Indian tribe or tribal organi- Whether your vote arises from com- tion because of where they live. zation—the regulations promulgated passion or common sense, I urge every Washington State is grateful for the under that act. Member to support this amendment. efforts of two urban Indian organiza- Mr. KENNEDY. That is correct. Ms. CANTWELL. Mr. President, I tions working to provide critically Mr. DORGAN. Yes, that is correct. rise in strong support of the Indian needed health care to this underserved Mr. BROWN. Mr. President, I rise Health Care Improvement Act and the population. The Seattle Indian Health today in support of amendment No. reauthorization we are considering Board and the N.A.T.I.V.E. Project of 4023, which would halt draconian new today. Spokane have remained strong compo- rules that would hamstring cost-effec- Passage of this bill in the Senate is nents of our State’s health and social tive case management services under long overdue. We haven’t passed an up- safety net, providing over 15,000 unique the Medicaid Program. date to the Indian Health Care Im- patients with comprehensive primary In March of this year, the Centers for provement Act since 1992, and the law care, mental health, and social serv- Medicare and Medicaid Services plans has now been expired for 8 years. ices. to implement a regulation designed to Since this time, we have seen the The Seattle Indian Health Board also limit case management services: For continuation of unacceptable trends in serves as a vital health research and children in foster care; for the elderly, the health of American Indians and surveillance center for the country who, if not for case management, Alaskan Natives. American Indians and under its Urban Indian Health Insti- would be in nursing homes; for Ameri- Alaskan Natives across the country are tute program. There is much to be cans with disabilities; and or individ- 400 percent more likely to die from tu- learned about the issues and barriers uals with severe mental illness. berculosis, 291 percent more likely to facing urban Indians, making the com- These are Americans who not only die from diabetes complications, and 67 prehensive collection and analysis of live with severe health or mental dis- percent more likely to die from influ- information from this program abilities, they live in poverty. enza and pneumonia than other groups. indispensible to our work to improve This administration is nothing if not In my State of Washington, the aver- the health of our communities. consistent. age life expectancy of an American In- Continuing Federal support for these This administration consistently dian is estimated to be 4 years below and the other 32 entities currently re- woos those with wealth and neglects that of the general population, as re- ceiving Federal resources for urban In- those in need. ported by the Indian Health Service for dian health care must remain a top pri- Ohio has worked over the past 24 the years 2000 through 2002. This is a ority under this Government’s strategy years to develop and fine tune an effec- troubling increase from the gap of 2.8 to address the disparities facing all tive system for providing case manage- years reported by the Indian Health American Indians. ment to Medicaid beneficiaries who Service for 1994. I am excited that we have come so meet a nursing home level of care but These disparities must not continue. close to passing this reauthorization. I want to remain in their homes. We owe it to Indian Country to make hope to work with Chairman DORGAN, Enabling these Ohioans, most of good on our promise—a promise embed- Vice Chairman MURKOWSKI, and my whom are elderly, to live independ- ded in long-standing trust agree- colleagues on the Indian Affairs and Fi- ently is not only right, it is smart. ments—to ensure that the health needs nance Committees to seeing this Per capita nursing home care is more of American Indians and Alaskan Na- through and getting a bill signed into expensive than per capita home health tives are taken care of. law. care. Enactment of this bill, of which I am However, I want to also urge my col- And home and community-based care a proud cosponsor, is a necessary step leagues to remember that our trust re- fosters independence, self-determina- that will help us fully realize our obli- sponsibility does not end with reau- tion, and rehabilitation. gations. The Indian Health Care Im- thorization of the Indian Health Care Case managers are the foundation of provement Act must be reauthorized, Improvement Act. It continues as we this system of care. It cannot work and most importantly, modernized to craft a budget for the coming fiscal without them. ensure that the services delivered year and make the appropriations for But case managers cannot do their under the Indian Health Service reflect the Indian Health Service. The pro- jobs if they are hung up by rules that the advances made in health care deliv- grams we are about to reauthorize are just do not make sense. ery. useless if we don’t make gains in the

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00049 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1042 CONGRESSIONAL RECORD — SENATE February 14, 2008 paltry amount of funds for health serv- In addition, in the Indian Health gram for Indians, diabetes patients are ices, urban Indian health, and facilities Amendments of 1992, Congress specifi- losing weight and improving their life- construction. As my colleagues know, cally pledged to ‘‘assure the highest style. I am also pleased to note that the Indian Health Service is only fund- possible health status for Indians and the One Sky Center, a National Native ed at 60 percent of estimated need. urban Indians and to provide all re- Resource Center for Substance Abuse Today’s actions should be the begin- sources necessary to effect that pol- and Mental Health Services located at ning of a renewed commitment to our icy.’’ These combined commitments Oregon Health and Science University first Americans. I look forward to are absolutely essential to help the in Portland, is the only National Re- starting a new chapter in our relation- Federal Government meet its legal and source Center of its kind in Indian ship with Indian Country. moral responsibilities to Native Ameri- Country. Indian Country is in a crisis Mr. WYDEN. Mr. President, today cans. in combating alcohol, substance abuse, the Senate is considering the Indian Sadly, we haven’t even come close to and methamphetamine. There is a real Health Care Improvement Act Amend- honoring these commitments. Suffi- need for such a center for not only trib- ments. American Indians and Alaska cient funding has not been provided. al people, but also for those who work Natives—along with all other Ameri- IHS is so underfunded and understaffed and interface with Indian Country to cans—should receive modern, efficient, that patients routinely are being de- try to find solutions, leverage pro- and quality health care. Unfortunately, nied care that most of us would take grams, and build partnerships to ad- too many of those in the Indian health for granted and, in many cases, would dress these key health issues. system do not receive that care today. consider essential. The resulting ra- In addition, on the national level, the This important legislation will change tioning of care means that all too often recently reauthorized Special Diabetes that. Indians are forced to wait until their Program for Indians, SDPI, has had Reforming our Nation’s broken medical conditions become more seri- significant success and is viewed as a health care system is one of my high- ous—and more difficult to treat—be- model for improving preventive care est priorities and I strongly support ef- fore they can even access necessary and disease management for this sig- forts to shore up Indian health care health care. The chronic underfunding nificant chronic illness. Tragically, Na- services, such as those proposed in this has only grown worse in recent years, tive Americans are 2.6 times more like- important legislation. Like all Ameri- as Federal appropriations failed to ly to be diagnosed with diabetes than cans, American Indians and Alaska Na- keep up with the steep rise in public the general U.S. population and diabe- tives cannot prosper without access to and private health care costs and ex- tes mortality is believed to be 4.3 times modern, efficient, and quality health penditures. higher in the Native American popu- care. The results are startling and dis- lation than in the general U.S. popu- The most recent census information turbing. While per capita health care lation. The combination of this special available indicates there are 2.3 million spending for the general U.S. popu- program and the legislation before us American Indian and Alaska Native lation is about $7,000, the Indian Health today could help make significant people in the United States. In my Service spends only about $2,100 per strides against this ongoing public State of Oregon alone there are nine person on individual health care serv- health threat that disproportionately federally recognized tribes, and a large ices. The Government also spends con- hits Native Americans. Importantly, urban Indian population. Less than 40 siderably less on health care for Indi- the SDPI has given Indian health pro- percent of their people reside on res- ans than it spends for Medicare bene- grams and tribal communities invalu- ervations. It is a continuing failure of ficiaries, Medicaid recipients, and vet- able resources and tools to help pre- this Nation that American Indian and erans. vent and treat diabetes. And it has had Alaska Native people rank at or near It is appalling that we can live in one real medically measurable results. In the bottom of so many social and eco- of the most prosperous nations on just 10 years, the mean blood sugar nomic indicators. Earth, where most—but by far not all— level has decreased by 13 percent. Sci- Most striking of these indicators are Americans have access to health care entific research demonstrates that the health statistics involving Amer- services, yet we provide woefully inad- such a decrease results in a 40-percent ican Indian and Alaska Natives. Diabe- equate health care for our Native decrease in diabetes-related complica- tes, tuberculosis, alcoholism, fetal al- American population. tions, such as blindness and amputa- cohol syndrome, and increasingly, These resource shortcomings under- tions. Furthermore, on the prevention AIDS, plague America’s Native com- score the need to make the Indian front, it has also increased school- munities at rates far and above those Health Service a priority in the Fed- based prevention programs for chil- of other Americans. As of 2007, there is eral budget. It is also why I am sup- dren, such as increased physical activ- a $1 billion backlog in unmet needs for porting an amendment offered by my ity programs, better school lunches, health facilities, contributing to the colleague from the State of Oregon, and removal of junk food-filled vending degenerating health of Native commu- Senator GORDON SMITH, along with my machines, and diabetes awareness edu- nities. colleague from Washington State, Sen- cation. There are also more commu- The plight of Native American health ator MARIA CANTWELL. It would provide nity-based wellness centers offering ex- care in this country is the result of one for innovative approaches in funding ercise and nutrition programs for indi- simple and tragic fact: The Federal health care facilities by providing a viduals at risk for diabetes. Government has failed to meet its way to distribute funds more equally promise to Native Americans. with the establishment of an area dis- Yet, this program has been funded Through treaties and statutes, the tribution fund. apart from the traditional sources of Federal Government has promised to Each year, I travel to every county funding for Indian health care, the IHS. provide health care to American Indi- in Oregon to learn firsthand the chal- It is imperative that Congress pass the ans and Alaska Natives. A critical as- lenges confronting my constituents. I Indian Healthcare Improvement Act pect of this promise is sufficient fund- often find that my most enlightening Amendments so that our country can ing for the Indian Health Service, IHS, visits occur when I travel to Indian begin to fill the many gaps in Indian part of the Department of Health and Country, especially when I hear or read health care and have more success sto- Human Services. IHS arranges health compelling stories about Indian health ries like the ones I just described. care services for Native Americans and care afforded to my tribal constituents. I want to just take a few moments to provides some services through direct But I am also pleased that the north- reiterate how important it is for all care at hospitals, health centers, and west region has its share of success sto- Americans that the Federal Govern- health stations, which may be federally ries and examples of medical care for ment move to reform our nation’s or tribally operated. When services are Native Americans that have worked. health care system. It is very clear, in not offered or accessible onsite, IHS of- With the support of the Native Amer- my view, that our Nation faces a fers them, as funds permit, through ican Rehabilitation Association’s Dia- health care crisis. In fact, I think when contract care furnished by outside pro- betes Prevention Program, made pos- we get on the floor debating any health viders. sible by the IHS Special Diabetes Pro- program, the Senate will see and the

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00050 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1043 country will see that this debate illus- My fellow Senators, it is my hope abled veterans who sustained severe in- trates how broken our health care sys- that we pass the Indian Healthcare Im- juries since the war on terror began. tem is. provement Act Amendments as soon as Currently, severely injured veterans Native Americans are not the only possible and live up to our legal and can only receive this retroactive pay- Americans who believed they would moral obligations to provide health ment if they sustained their injuries in have health care when they would need care services to our Native American Iraq or Afghanistan. But if they were it, only to find that faced with a seri- population. I have been proud to join injured on the way to or returning ous or life-threatening illness the care efforts to increase funding for the In- from a combat zone, they are not eligi- or coverage available doesn’t match dian Health Service, and I will con- ble. This provision would correct that their need. Despite paying more per tinue to fight for more IHS funding be- mistake. person for health care services than cause it benefits all people, Native and It also increases the amount of insur- any nation on Earth, so many go with- non-Native people, in tribal and sur- ance coverage available to severely dis- out care or coverage. For some Ameri- rounding communities. I am pleased to abled veterans under the Veterans’ cans, this happens when they have lost support these needed improvements Mortgage Life Insurance Program. a job, and hence the coverage that and funding, which will move forward Additionally, it provides adapted went with it, or they had minimal in- the cause of improved Indian health housing and auto grants to veterans surance that doesn’t come close to pro- care. with severe burn injuries who require viding them the financial security modifications to their homes or their LIFE INSURANCE BENEFITS FOR DISABLED needed to cover the costs of the health VETERANS vehicles. And it provides severely in- care services they need. For 47 million Mr. BURR. Mr. President, a few min- jured service men and women with Americans, often through no fault of utes ago the chairman of the Veterans’ housing grant assistance who tempo- their own and despite having tried to Affairs Committee came to the floor rarily live with family members while be able to afford or purchase health and talked about the history of a bill, still on Active Duty. My bill would coverage, they find themselves with no S. 1315, the spirited debate we had in keep these provisions and other good health coverage at all. These fellow committee and the continued negotia- provisions from S. 1315. citizens are at the mercy of hospital So what would my bill do that differs tions that have gone on since that emergency rooms should health care from S. 1315? tragedy strike them or their families. markup. I am here to announce that First, it would eliminate the provi- Plus, in an unconscionably large num- today I introduced an alternative bill sion that creates a special pension for ber of cases, they are unable to pay for to S. 1315. I know I am joined by mil- non-U.S. citizens, Filipino veterans needed care without risking personal lions in America who also salute our who live in the Philippines and do not bankruptcy, if at all. Nation’s veterans. These brave men have wartime injuries. This would free Many people agree with the need for and women and their families have sac- up over $220 million to spend on bene- change, but have a healthy skepticism rificed so much to defend our country fits for veterans of Operation Enduring about whether real, meaningful struc- and to protect our freedoms. Freedom and Operation Iraqi Freedom. tural reform is possible in our life- As the ranking Member of the Senate It is important to note it would still times. I understand these doubts, and I Committee on Veterans’ Affairs, I take provide over $100 million to grant full do not underestimate the challenge. very seriously my responsibilities to equity to Filipino veterans living in Yet, I do believe we have the possi- ensure that our veterans are getting the United States and full disability bility of a real ideological truce now in the respect and benefits they deserve. compensation for those living abroad health care. More and more Senators of This appreciation is the very reason who have service-related injuries. both political parties have come to un- why I wish to talk about the substitute Also, my bill would create savings by derstand that to fix health care we to S. 1315. My bill is a commonsense al- changing how S. 1315 would fund State must cover everybody. If we don’t ternative to an omnibus veterans bill approving agencies, the entities that cover everybody, people who are unin- that was reported out of the Senate accredit schools and training programs sured shift their bills to those who Committee on Veterans’ Affairs last for VA education benefits. My bill have insurance. So colleagues on my June contained over 35 provisions com- would begin to transition these entities side of the aisle who made the point piled from other bills. from entitlement funding to discre- about getting everybody coverage, in Unlike in past Congresses, S. 1315 tionary appropriations. Subjecting my view, have been correct, and clearly does not enjoy the kind of customary these agencies to the annual appropria- the country and citizens of all political bipartisan support that such omnibus tions process would help make sure persuasions have come around to that bills have received in the past. Why is veterans are being well served by any point of view. this? In addition to all the good things funds spent on this bureaucratic func- There is also strong support for it would do for the veterans, this bill tion. something the Republicans feel strong- also is a vehicle for a provision that My bill then takes these savings, the ly about, and that is not having the would take money away from helping savings we have gained from elimi- government run everything in health veterans of the war on terror and in- nating this pension fund for non-U.S. care. There can be a role for a healthy stead send the money overseas. I am citizens and Filipinos not injured in private sector in universal health care, talking about a provision that would the conflict and it would provide fund- one where there is a fairer and more ef- establish a flat rate special pension for ing to increase the specially adapted ficient market. And there ought to be World War II Filipino veterans who did housing grants for severely disabled more choices; in fact, there can be an not suffer any wartime injuries, gen- veterans from $50,000 to $55,000 and for abundance of choices in a system like erally are not U.S. citizens, and who do less severely disabled veterans from Members of Congress enjoy today. not even live in the United States. In a $10,000 to $11,000. It would then annu- I am very pleased that I could join few minutes, I will talk more about the ally adjust the amount of these grants with Senator BENNETT of Utah, a mem- Filipino provision benefits and why it for inflation. ber of the Republican leadership, in of- is wrong and the wrong priority at the My bill would also increase the auto fering a bill based on just those prin- wrong time. grant assistance for traumatically in- ciples. It is S. 334, the Healthy Ameri- First, I wish to share some good pro- jured veterans from $11,000 to $16,000, cans Act, and it is the first bipartisan visions of S. 1315 which I have included and then also index that grant for in- universal coverage bill in more than 13 in the alternative omnibus bill I have flation. years. The last bipartisan, universal introduced today. This benefit provides mobility and coverage health bill was offered by the S. 1315 has some very important pro- freedom to people such as SGT Eric late Senator Chafee more than 13 years visions to help our men and women Edmundson—whom my colleague from ago. Now we do have the opportunity who have fought in the war on terror North Carolina talks about fre- for the Senate to come together on a and should be passed as soon as pos- quently—a young veteran from my bipartisan basis and deal with the pre- sible by this body. State of North Carolina who lost the mier challenge at home, and that is fix- It provides retroactive payments—be- use of his legs after being injured dur- ing American health care. tween $25,000 and $100,000—to all dis- ing combat. As a result, Eric now uses

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00051 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1044 CONGRESSIONAL RECORD — SENATE February 14, 2008 a motorized wheelchair. The expense to ping of a hospital in the Philippines for The PRESIDING OFFICER. Without get a van that is wheelchair accessible the care of Filipino veterans and later objection, it is so ordered. is enormous. This provision makes it donated that hospital to the Philippine HONORING OUR ARMED FORCES financially possible for others, such as Government. On top of that, the United SERGEANT EDWARD O. PHILPOT Eric, to afford what most of us take for States continues to provide annual Mr. MCCONNELL. Mr. President, I granted: mobility. grants to support the operation of that rise to speak on behalf of a fallen sol- My bill would also provide annual in- hospital in the Philippines. dier. On October 23, 2007, SGT Edward creases in the funeral assistance and For those Filipinos legally residing O. Philpot of Manchester, KY, was on plot assistance benefits to families of in the United States, the benefits are patrol with U.S. soldiers and members deceased veterans to keep up with in- even more robust. They are eligible for of the Afghan National Army in flation. full-dollar disability compensation, for Kandahar, Afghanistan, conducting It would increase ‘‘kickers’’ for mem- cash burial benefits, access to our VA tactical convoy operations in hostile bers of the Guard and Reserve from health delivery clinics and medical territory. Sergeant Philpot was killed $350 to $425 per month, providing extra centers, and burial in our national in a tragic humvee rollover accident. monthly education benefits that may cemeteries. He was 38 years old. be paid to members with certain crit- With these initiatives and others, our Sergeant Philpot handled a number ical skills. Government has taken a significant of jobs in his unit, from gunner to driv- It also allows Guard and Reserve per- step to recognize the service of Filipino er to humvee commander. He was sonnel activated for a cumulative 2 veterans. More importantly, the money proud to wear the uniform and proud to years after the war on terror began to that S. 1315 would send overseas to cre- serve his country. receive maximum education benefits. ate a new special pension for Filipinos ‘‘Ed had found his calling with the The current requirement is either 3 cu- is money that is needed in the United military,’’ says Renee Crockett, his sis- mulative years or 2 continuous years of States to support our men and women ter. ‘‘He loved being a soldier and felt service. This change will make it easi- who have served our country, espe- he was finally doing exactly what he er for our men and women who have cially in Iraq and Afghanistan. Simply was supposed to do.’’ gone on multiple deployments, includ- put, with our Nation now at war, this For his bravery in uniform, Sergeant ing many of the Guard and Reserve Filipino pension provision is the wrong Philpot received numerous medals and from my home State of North Carolina, priority at the wrong time. awards, including the Bronze Star to earn the highest level of education Since the committee’s markup, we Medal. benefits. have tried to refocus this bill and the Military service ran in Ed’s family, With these changes to S. 1315, we priorities that so many of our col- as his Uncle Willard Philpot of Man- have a well-balanced package of benefit leagues share, such as enhancing bene- chester served in Vietnam and, sadly, enhancements for our Nation’s vet- fits for men and women fighting in the perished in Thailand. Family members erans which could garner the support war on terror. Because those efforts saw a lot of similarities between Ed of the entire Senate. have not worked, I introduced today an and his uncle, who died before Ed was Unfortunately, the same cannot be alternative omnibus bill to 1315. I kept born. ‘‘Both were quiet, warm, and car- said about S. 1315 in its current form. most of the provisions found in 1315 be- ing individuals, and both gave the ulti- The problem with S. 1315 is the provi- cause it is generally a good bill. It mate sacrifice while serving their sion that creates a special pension for would provide enhancements to a wide country,’’ says Renee. Raised by his parents, Ottas and World War II Filipino veterans. This is range of benefits for our Nation’s vet- Willa Philpot, Ed grew up a student of both wrong and it is costly. It is wrong erans. In short, my bill serves as a fair and history. He soon amassed a personal li- because it takes money from American just compromise. It improves benefits brary of books on many historical fig- veterans and sends it to the Philippines for Filipinos, but it also places the ap- ures. He was also a fan of mystery to create a special pension for noncit- propriate priority on our returning OIF books, and enjoyed a sharp political de- izen, nonresident Filipino veterans and OEF veterans. I believe it is a rea- bate. with no service-connected disabilities. sonable alternative to S. 1315, and I be- Ed was born in Farmington, MI, and Allow me to explain this provision in lieve it is one we can all embrace and grew up in that State. As a child, he S. 1315 and what it would actually do. pass quickly. I ask my colleagues for spent all his holidays and most of his It proposes to send $328 million over their support. summers in Kentucky, in Manchester, 10 years in benefits for Filipino vet- I am ready to debate the contents of with his paternal grandparents Walter erans. Although I am supportive of the this bill against S. 1315. I am sure, if and Lillie Philpot, and would travel increased benefits for Filipino veterans the leadership sees fit, they will set the back and forth often between Kentucky residing in the United States and even structure up to do that. But it is im- and Michigan. increasing benefits for Filipinos with portant that every Member of the Sen- When Ed was only 8 or 9 years old, he service-connected injuries residing ate and every American understand we began to learn how to play the saxo- elsewhere, I cannot support sending have done a tremendous job of sup- phone. One day he took out his horn to $221 million to the Philippines to cre- porting people who have fought with us practice and found a perfect audience ate a special pension for noninjured in battle, and the Filipinos are no dif- in Sandy, the family dog, sitting on the Filipino veterans. ferent. The reality is, at this time, we patio. Young Ed began playing with all To some, this may sound like a nice should focus on the needs of those who the charisma and passion he could thing to do, and I fully respect their are U.S. citizens, the needs of those muster, but it wasn’t good enough for desire to recognize the valued service who were injured in battle, but not to Sandy, who ran all the way to the made by Filipino veterans in defense of create a special pension fund for indi- backyard and buried her head beneath the Philippine islands. But I point out viduals who had an affiliation, and I her paws. Thus ended Ed’s musical ca- that our Government has already done might say that exceeds the annual in- reer. a great deal to provide for Filipinos come of most Filipino residents. Ed graduated from Garden City High who fought in World War II. I urge my colleagues to learn about School in Garden City, MI, in 1987 and For instance, after the war, the this issue and to get ready to engage in Coastal Carolina University in Conway, United States gave $620 million to the debate. SC, in 1992. After college, Ed returned Philippines for repair of public prop- I yield the floor, Mr. President, and I to Manchester, where he spent some of erty and war damage claims; provided suggest the absence of a quorum. the happiest times of his youth. partial-dollar VA disability compensa- The PRESIDING OFFICER. The Ed went into law enforcement, be- tion to Filipinos with service-related clerk will call the roll. coming the director of a home incar- disabilities, and provided benefits to The legislative clerk proceeded to ceration program. In 1995, he married the survivors of Filipinos injured in the call the roll. Stephanie, and they raised three beau- war. Mr. MCCONNELL. Mr. President, I tiful daughters, Hollen, Lily, and Ella The United States also provided $22.5 ask unanimous consent that the order Grace. Eventually, Ed and his family million for the construction and equip- for the quorum call be rescinded. settled in South Carolina.

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00052 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY February 14, 2008 CONGRESSIONAL RECORD — SENATE S1045 Ed’s family was the most important killed in Damascus. With his death, someone is dead, but I say, through the thing to him. ‘‘He would take his long-delayed justice has finally been Chair to my friend, the distinguished daughters out to the coffee shop for served. Republican leader, I join in his re- cookies on Saturday mornings,’’ his News reports are still coming in, and marks. This was a vicious man. sister Renee said. Ed loved to take so far no one has claimed responsibility There is nothing we can do to restore walks with them and ride them on his for his death. But we know one thing the lives of those he is responsible for shoulders. He would also take them for for certain: As Sean McCormack, a killing, the number of which we don’t daddy-daughter dates to celebrate their spokesman for the State Department know. accomplishments. put it, ‘‘The world is a better place But what happened yesterday will Sergeant Philpot’s family ‘‘was clear- without this man in it.’’ cause this man not to be involved in ly his life and his motivation,’’ says Let me describe for my colleagues killing other innocent people. So as MAJ Bill Connor, who served with him just a few of this murderer’s many hei- difficult as it is to recognize that some- in Afghanistan. ‘‘He spent his little bit nous crimes. American officials accuse one’s life has been snuffed out, it goes of off-duty time going to the nearest him of plotting the 1983 bombing of a without saying that for mankind this bazaar to buy trinkets for his daugh- U.S. Marine compound in Beirut, kill- was the right thing to do. However it ters and his family.’’ ing 241 troops. happened, it was the right thing to do. Ed enlisted in 2001 and served with He is accused of masterminding a car This was a person who was waiting for the South Carolina Army National bomb which exploded at an American the next opportunity to see what he Guard’s 1st Battalion, 263rd Armor embassy in Beirut, also in 1983, killing could do to act out his devilish ways. Regiment in Afghanistan, where he was 63 people. CLOTURE MOTION promoted to sergeant. He enjoyed the American prosecutors charged him in simple pleasure of giving candy to Af- the hijacking of a TWA jetliner in 1985. Mr. REID. Mr. President, I send a ghan children. He is also accused of shipping arms to cloture motion to the desk on the sub- ‘‘He was one of the most dedicated violent, radical terrorist groups. stitute amendment. men you would ever see,’’ said SGT And then there is one brutal act that The PRESIDING OFFICER. The clo- Kenneth Page, who served alongside struck deep in the heart of my home- ture motion having been presented Sergeant Philpot. ‘‘He always liked to town of Louisville, KY. Imad Mugniyah under rule XXII, the clerk will report hang around at the armory, even when was behind the brutal kidnapping, tor- the motion. it wasn’t drill weekend. He just liked ture and murder of U.S. Marine COL The assistant legislative clerk read to be there.’’ William Richard Higgins. as follows: The Philpot family is in my prayers Colonel Higgins was a Kentuckian, CLOTURE MOTION today as I recount Ed’s story. We are born in Danville. He graduated from We, the undersigned Senators, in accord- thinking of his wife Stephanie; his Southern High School in Louisville, ance with the provisions of rule XXII of the daughters Hollen, Lily, and Ella Grace; participated in ROTC at Miami Univer- Standing Rules of the Senate, hereby move his father Ottas; his mother Willa; his sity in Ohio, and served multiple tours to bring to a close debate on the Dorgan sub- sister Renee Crockett; his nephew in Vietnam. stitute amendment No. 3899 to S. 1200, the In- Trevor Crockett; his niece Taylor Over a 20-year military career, he re- dian Health Care Improvement Act Amend- Crockett; and many other beloved fam- ceived numerous medals and awards, ments. ily members and friends. including the Defense Distinguished Harry Reid, Russell D. Feingold, Kent Ed was predeceased by his grand- Conrad, Richard Durbin, Amy Klo- Service Medal, the Defense Superior buchar, Patty Murray, Maria Cantwell, parents Walter and Lillie Philpot and Service Medal, the Legion of Merit, the Jon Tester, Jeff Bingaman, Carl Levin, Tom and Viola Hollen, all of Man- Bronze Star with combat ‘‘V’’ and the Max Baucus, Byron L. Dorgan, Barbara chester. Purple Heart. Boxer, Dianne Feinstein, Debbie Stabe- His funeral service was held October On February 17, 1988, Colonel Higgins now, Ken Salazar, Daniel K. Akaka. 30 last year in Manchester at the Horse was captured by armed terrorists in CLOTURE MOTION Creek Baptist Church. After the serv- Lebanon while serving on a U.N. peace- Mr. REID. Mr. President, I send a ice, the funeral procession stopped for keeping mission. He was held, interro- second cloture motion to the desk on a moment of silence in front of Hacker gated and tortured. the bill. Elementary School, where the entire A year and a half after his capture, The PRESIDING OFFICER. The clo- student body and staff assembled out- terrorists released a grisly videotape of ture motion having been presented side. Ed’s parents had both attended Colonel Higgins’s lifeless body, hung by under rule XXII, the clerk will report Hacker Elementary as children. the neck, which played on television the motion. Thirty-eight young students each sets around the world. The assistant legislative clerk read held a red, white, or blue balloon, one In Louisville, we built a memorial to as follows: for each year of Ed’s life. At the same Colonel Higgins on the grounds of his moment, they released the balloons up alma mater, Southern High School. CLOTURE MOTION into the air. The rest of the students We were outraged then and we are We, the undersigned Senators, in accord- held up American flags, in honor of the still outraged now to see what hap- ance with the provisions of rule XXII of the soldier who had given his life for that pened to this good and brave man at Standing Rules of the Senate, hereby move same flag. the hands of thugs. to bring to a close debate on S. 1200, the In- dian Health Care Improvement Act Amend- ‘‘Ed was always quick with a smile Now, at long last, we know justice and a positive attitude that was re- ments. has been brought to his murderers. Harry Reid, Russell D. Feingold, Kent membered by all,’’ says his sister In an essay titled ‘‘My Credo,’’ Colo- Conrad, Richard Durbin, Amy Klo- Renee. ‘‘He is definitely a hero.’’ nel Higgins once wrote: ‘‘As an officer buchar, Patty Murray, Maria Cantwell, I want the Philpot family to know of Marines, I believe it is my charge to Jon Tester, Jeff Bingaman, Carl Levin, that this Senate agrees, and today we set the example.’’ Max Baucus, Byron L. Dorgan, Barbara honor SGT Edward O. Philpot’s life of Well, Colonel, the high-school stu- Boxer, Dianne Feinstein, Debbie Stabe- honor and of service. His immense sac- dents in Louisville who pass by your now, Ken Salazar, Daniel K. Akaka. rifice made on behalf of his Nation, memorial every day will always re- Mr. REID. Mr. President, I ask unan- State, and family allows us all to live member the example you set. You imous consent that the vote on the mo- in freedom. served your country with pride, and tion to invoke cloture on the sub- IMPORTANT MILE MARKER IN WAR ON TERROR now may rest in peace. stitute amendment occur at 5:30 p.m., Mr. President, an important mile Mr. President, I yield the floor. Monday, February 25; that if cloture is marker in the war on terror was passed The PRESIDING OFFICER. The ma- invoked on the substitute, all late Tuesday night. A terrorist by the jority leader. postcloture time be yielded back ex- name of Imad Mugniyah, one of the Mr. REID. Mr. President, it is dif- cept for the times specified in this world’s most wanted murderers and a ficult to speak publicly or privately ex- agreement, and that the managers each top commander of Hezbollah, was pressing your views that you are glad have 10 minutes of debate for their use;

VerDate Mar 15 2010 22:08 Mar 19, 2014 Jkt 081600 PO 00000 Frm 00053 Fmt 4624 Sfmt 0634 E:\2008SENATE\S14FE8.REC S14FE8 mmaher on DSKCGSP4G1 with SOCIALSECURITY S1046 CONGRESSIONAL RECORD — SENATE February 14, 2008 that all debate time be equally divided The assistant legislative clerk pro- up around the Nation. In 1865, both and controlled in the usual form; that ceeded to call the roll. Houses of Congress gathered for a me- Senator DEMINT be recognized for up to Mr. REID. Mr. President, I ask unan- morial address. President Lincoln’s 1 hour to speak with respect to any of imous consent that the order for the birthday became a legal holiday in sev- his pending germane amendments; that quorum call be rescinded. eral States, although it did not become with respect to the Vitter amendment The PRESIDING OFFICER. Without a Federal holiday like President Wash- No. 3896 and a first-degree germane objection, it is so ordered. ington’s. However, in 1968, legislation amendment from the majority on the f was enacted to simplify the Federal subject matter of Vitter, that debate holiday schedule. As a result, Washing- MORNING BUSINESS time on these two amendments be lim- ton’s birthday observance was moved ited to 60 minutes each; that the Smith Mr. REID. Mr. President, I now ask to the third Monday in February, re- amendment No. 3897 be limited to 20 unanimous consent the Senate proceed gardless of whether or not that day was minutes of debate; that no further to a period of morning business with February 22. Officially, this holiday is amendments be in order, and that upon Senators allowed to speak therein for still known as Washington’s Birthday, the use of time with respect to the up to 10 minutes each. but it has become popularly known as DeMint amendments, the Senate then The PRESIDING OFFICER. Without President’s Day to honor both Wash- proceed to vote in relation to the objection, it is so ordered. ington and Lincoln, as well as all who amendments; that the vote sequence The Senator from West Virginia is have served as President. Why were President Washington and occur in the order in which the amend- recognized. President Lincoln so widely and spon- ments are listed in this agreement ex- f taneously revered by the public, even cept the majority amendment with re- CELEBRATING PRESIDENT’S DAY in the immediate aftermath of their spect to the Vitter amendment would deaths, before time had a chance to occur first; that there be 2 minutes of Mr. BYRD. Mr. President, on Mon- day, February 18, the United States burnish their memories and fade their debate prior to each vote; further, that less enobling characteristics? Cer- upon the disposition of all pending will celebrate President’s Day. Presi- dent’s Day takes on a particular sig- tainly, the great events that were amendments, the substitute, as amend- shaped for the better by their decisions ed be agreed to, and the bill be read a nificance this year, as the Nation is ac- tively involved in the selection process were a major factor. Both George third time, and the Senate then pro- Washington and Abraham Lincoln ceed to vote on the motion to invoke for a new President. It is heartening to see the level of interest and participa- made a name for themselves as inspir- cloture on the bill; that if cloture is in- ing leaders of men and the Nation dur- voked, all postcloture time be yielded tion in all of the Presidential campaign events and in the primaries and cau- ing pivotal wars in our Nation’s his- back, and without further intervening tory. Both demonstrated true patriot- action or debate, the Indian Affairs cuses. It is a sign that Americans’ faith in the basic processes of their Govern- ism, a deep love of the Nation that was Committee be discharged from further the prism through which they viewed consideration of H.R. 1328, the House ment is still strong, even as a recent poll indicates that the public holds a all problems and made all decisions. companion, and the Senate then pro- Both men selflessly sacrificed their very low opinion of the current Presi- ceed to its consideration; that all after own personal lives to serve the Nation dent and of Congress. In a 1789 letter to the enacting clause be stricken, and throughout their lives. the text of S. 1200, as amended, be in- Richard Price, Thomas Jefferson wrote In honor of President’s Day, I urge serted in lieu thereof; that the bill be that, ‘‘Whenever the people are well-in- everyone to listen to or read Washing- advanced to third reading, passed, and formed, they can be trusted with their ton’s Farewell Address and apply its the motion to reconsider be laid upon own Government. Whenever things get wisdom to the Nation’s current situa- the table; that upon passage of H.R. so far wrong as to attract their notice, tion and to the decision each of us will 1328, S. 1200 be returned to the cal- they may be relied upon to set them to make in November. A collaborative ef- endar; further, that the mandatory rights.’’ I believe we are witnessing the fort between George Washington and quorum be waived; provided further truth of Thomas Jefferson’s observa- the authors of The Federalist Papers, that if cloture is not invoked, this tion. James Madison, Alexander Hamilton, agreement is null and void. As early as 1796, Americans were ob- and John Jay, Henry Cabot Lodge I would further inform all Members serving the birthday of our first, and wrote of the Farewell Address that that debate time utilized will be uti- still one of our greatest, Presidents, ‘‘. . . no man ever left a nobler polit- lized on Monday. We will have three George Washington. According to var- ical testament.’’ In it, Washington sup- votes on Monday beginning at 5:30, and ious old style calendars, George Wash- ported the Federal Government as ‘‘a we will have the other two votes Tues- ington was born on either February 11 main pillar in the edifice of your real day morning. Senator KYL asked for or February 22, 1732. On whichever date independence . . .’’ warned against a this. I think it is reasonable. people preferred, President Washing- party system that ‘‘. . . serves to . . . The PRESIDING OFFICER. Without ton’s birthday was feted with agitate the Community with ill-found- objection, it is so ordered. ‘‘Birthnight Balls,’’ speeches, and re- ed jealousies and false alarms . . .’’ and Mr. REID. Mr. President, let me say ceptions. Here in the Senate, one of our ‘‘. . . kindles the animosity of one . . . that I send my appreciation to Chair- most enduring traditions is the annual against another.’’ He stressed the im- man DORGAN and Ranking Member reading of Washington’s 1796 Farewell portance of religion and morality, fa- MURKOWSKI. They worked very hard. Of Address by a current Member of the mously warned against the entangle- course, I want to express my apprecia- Senate. This practice began in 1862, and ments of permanent foreign alliances, tion to Senator KYL who has been in- became an annual event in 1893. Begin- cautioned against an over-powerful volved in our getting to this point. He ning in 1900, the Senator who read the military establishment as ‘‘ . . . inaus- has been a big help to our getting here. address then signed his or her name picious to liberty . . .’’ and urged the It has been a difficult road. and perhaps wrote a brief remark in a Nation to ‘‘. . . cherish public credit It is a bill that is long overdue but book maintained by the Secretary of . . .’’ by using it as little as possible. certainly is necessary to do. I appre- the Senate. For the historically curi- Only then could the Nation avoid the ciate everyone’s cooperation. I am ous, both Washington’s Farewell Ad- accumulation of debt, because ‘‘. . . to- going to confer briefly, in a matter of dress and a selection of the remarks wards the payments of debts there minutes, with the distinguished Repub- from the book can be found on the Sen- must be Revenue, that to have Revenue lican leader to determine if there is ate’s Web site (www.senate.gov/ there must be taxes; that no taxes can any reason for us to be in session to- artandhistory/history/common/generic/ be devised, which are not . . . incon- morrow. That announcement will be FarewellAddressBook.htm). venient and unpleasant.’’ We cannot made very quickly. After the 1865 assassination of Presi- have our cake and eat it, too—tax cuts I suggest the absence of a quorum. dent Lincoln, another revered Presi- and deficit spending cannot occur si- The PRESIDING OFFICER. The dent who was also born in February, multaneously if the economy is to re- clerk will call the roll. similar memorial observations sprang main sound over the long run.

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