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Made the case, the leadership case for more defense spending in reaction to, i think, a world of rising threats. The pentagons making the case that they need to tread water. Theyre not increasing. Is there anything we can do, the members of the electorate, people in different districts congressional districts, senatorial districts . Can we make any difference or are we just having the conversation so we can educate people for the next administration in is there something we can do right now . I think thats the question every panelist would love to hear, i mean, it really, truly is the right question. Im going the let you guys take the first stab at that. Well, i was going to say that, i mean a little bit of Political Party analysis whats blocking greater defense spending . Obviously, now we have the democrats control the white house, republicans have majority but not a vetoproof, certainly not a vetoproof or a filibusterproof in the senate. And i think if you listen to a lot of Armed Services Committee Hearings in either the house or the senate, you hear people from both parties denounce sequestration and its limits again and again. And if the Armed Services committee were the entire house is and senate, they would want to do anything about it, they would be absolutely fired up to do something about it, but they would still hit a roadblock because when democratic members of those committees speak, what they cant sort of say explicitly is they need to have that one for one. For every additional dollar of defense spending to bring the whole Party Onboard you need another dollar of nondefense spending. And when you look at how republicans react to that, you know those on the Armed Services committee could probably tolerate some degree of tradeoff, that the Security Threat is so acute that nondefense spending, they will have it. But yet the party as a whole isnt necessarily in a place to be comfortable with that tradeoff. Sequestration, with all its problems, a fair number of people on the republican side say this is the exceptionally rare case where we actually controlled, brought down federal spending by about 100 billion a year. We dont want to give it up. And, first of all, even if we do come to a deal its inefficient. What if the democrat set as their price one for one . So even if theres sort of a willing block on either side for more defense spending, the relates conditions about needing even more spending or demanding even less spending dont want to go along with it. So you can imagine a major tilt in either election if the democrats came out of the next election with both houses of congress including 60 in the senate and the white house, they could pursue the plusup strategy of lift sequestration and have another 100 billion for defense and 100 billion for nondefense discretioning their. If republicans had all the cards, they controlled the house, they could pursue more defense at the expense of other accounts, or they could push through entitlement reforms unacceptable to the democrats in order to generate money for oh concerns other concerns. But the conditions each side imposes on more defense spending prevent them from doing that much even though they all say this is a terrible situation. Thank you. Im a little more optimistic than these two. I really am. Youre getting Social Security. [laughter] thats true. Im getting 75 cents on the dollar. Post2016 theres the chance to really fundamentally make some changes. Thats not going to happen until then. But in terms of incremental funding of the Defense Department, you know i think there is more will than these folks believe because the president came p in above the caps right . So hes laid down a marker and yes, therell be a price which is the nondefense discretionary spending. Absolutely. Yes, therell be people who hate that but thats the nature of deals. Deals are not clean victories, they are coalitions of the disgruntled getting half of what they want. And, you know i think again, the key is going to be what are the offsets . Its going to have the offset, it should be offset and the president has to give republicans air cover on the offsets. If he hangs them out to dry prior to the 16 election, then this is all right, nothing gets dope. But if the president does what the president should do to get the right policy, then theres a chance to get a little keel in 16 deal like 16 thatll look like ryanmurray. Therell be some gimmicks involved here as well. Youll do it again for the fy17 budget. It will be tiny amounts of money, enormous amounts of political pain and theyll decide the year after that to stop this nonsense and do something bigger. I think theres a chance for that dynamic to prevail. Let me just quickly round that out. Its all incredibly true. And i believe thats where you dont have to say incredibly true. [laughter] just absolutely characterizing the process. So much pain and fake money anyway, and its not even that much, but that is how it will, ultimately happen. I never discount the sort of good oldfashioned shoe leather politics here. My colleague, former senator from missouri, jim talent he says when a politician says three times publicly, mackenzie they own it. They want to make it an issue. If theyre not hearing that this is a priority congress is always, theyre just human beings right . Theyre going to deal with whatever is the next crisis at the front door. Theyre not, theyre not going to fix the leaking roof if the car has a flat tire right . Were talking about the leaking roof, the longterm sort of systemic problems. And its the squeaky wheel met a for metaphor right . And thats going to get the grease. And if they dont think this is a priority those who spend time with elected officials in both branches or appointed in some cases, then it really wont get the attention that it deserves or at least longterm attention. I keep reading the headlines that and shock and a little bit of awe i i guess that Speaker Boehner and nancy employees pelosi are working together to come up with a permanent fix to the permanent doc fix repealing. They made this decision in a previous budget deal, and it was kind of a gimmick, and every time that bill comes due for this medicare something or other, he could probably speak to what it is i live in the defense world, they continue to pass ways to pay for it so that this cut to. Doctors payments on your medicare never actually becomes a reality. Its over 200 billion. We could only dream of a permanent fix for defense of that amount right now. But there seems to be a will and a way shockingly, when it comes to the a big three Entitlement Program that needs some permanent fixing. So theyve shown they can do stuff. Theyve shown they can be bipartisan. Theyve shown theyll find the money. So if they dont know its a priority, then it wont be a priority. I want to point out they had to go through the doc fix pain 17 times in ten years before they decided to fix that, so theres a slow learning curve. [laughter] yes sir. Jeff steele with the american legion. House Armed Services chairman thornberry spoke this morning at csis on acquisition reform, the post had an article quoting gordon adams, a little bit of skepticism. Curious what you think about thornberrys reforms and their possibilities. I was so busy preparing for this panel, i didnt read the article. Chairman thornberry gave his maiden speech at aei recently. He previewed what he was going to do on acquisition. Talked about the fact that itll be bitesized look, it will not be a sweeping levinmccain type of bill like we saw two congresses ago which i think is finally a good thing. Usually when you just administer people bodies, regulation and dollars, it must be for more acquisition reform problems in the future. I dont know the specifics of the proposal but i think his fresh approach and in some cases up winding im really more interested in not what youre going to add to this defense acquisition system but what youre going to take away. So im going to give him a report card of his ratio of adding to the taking away, and if its more taking away then he gets an a from me. Also not in a position to comment on the specifics of what chairman thorn brlys offering, but id like to put the issue in a bit of a larger context for the audience. At one point another thing you often hear from both sides whenever you talk about the need for more defense is how can you ask for a single more dollar when so much is being wasted, you know, the unholy trinity of waste, fraud and abuse. Until you exterminate those how can you ask for more . There have been occasional scandals at the pentagon but i think waste is far and away the biggest problem that people are targeting, and i think the message thats important is we cant reform our way out of this budget crisis because the impulse would be well, if there is this waste to get rid of and its especially the acquisition of procurement that has the greatest trouble probably of any of the major areas lets deal with it that way. So, obviously, in some ways the jury is still out. We saw the mccainlevin reform. They tend not to generate big ticket savings in the near term, so even if you had effective savings, it might take quite a long time before you even knew you had an effective means to achieve those kinds of savings. Acquisition reform in general in the Defense Community is an area where so much individual effort has been invested over decades, and people dont seem to have engineered the problem correctly. Perhaps its a culture problem its about individual leaders who can force someone to be accountable. You may be familiar that senator mccain, one of his standard questions he always throws at witnesses especially from the navy is how much was the ford class carrier over budget, and the answer is two billion generally. And hell say how many people lost their jobs because of that, and the answer is none because its hard to find a single point of authority or responsibility is the point hes trying to make. And you really couldnt necessarily say there was a Single Person who should lose their job even when an entire carrier is two billion or 20 over budget. So the general issue is, first even if we did as well as we could all of these reforms we wouldnt generate near what is necessary to make up the difference between sequestration level budgets and National Defense panel budgets or even what might be necessary if threats continue to grow as they have in the past year. Ill just say i never wanted to learn about acquisition reform, so i hired rachel to learn it. [laughter] its her problem. The thing i would stress is the pentagon budget has the same problem the u. S. Budget has on a smaller scale. Its got a retirement problem a health care problem, and there isnt enough acquisition reform to compensate for those things crowding out sort of what we think of as real military capability. And so there has recently been a panel to propose compensation reforms, and thats important and thats the reform i think weve got to see move forward if you want to clear out some room in the pentagon budget. Apologies for double dipping, but i agree with that. Those areas, theyre not often thought of as washington because when we think about money going to troops, there really is no way you can compensate them for the restrictions in their lives or the risks they take on the battlefield. So theres never a right answer, and yet we need some way to cocontrol this cost growth because ultimately and mackenzie said it quite well in a number of other pieces you know, we have these two binding obligations to the troops, both to compensate them appropriately because theyve given up careers in other fields, and to make sure when they go out there they have the best equipment. We want to satisfy both all the time, but were increasingly at the point where proper compensation is muscling out those other parts of the budget. Michelle flournoy, undersecretary of defense for president obama, she talks about it as her own personal experience as a navy wife. The benefits are important in terms of pension, health and other things, but shes also potentially a navy mom with a son going in, i believe to annapolis, and she said that concerns me far more. Im much more worried about my son and his units having all the right units and equipment they need to accomplish the mission and survive than i am about a marginal decrease in the benefits. But its politically difficult. Thats not often what a congressman is going to hear because theres a huge amount of pressure from tens of thousands or hundreds of thousands of people who dont want to have their been fits cut. And the line you hear one can have reasonable sympathy, why are e going to balance the budget on the backs of veterans before we take on entitlements for people who havent served their country . Well leave it on that provocative note. Thank you to the panel for a wonderful discussion, to senator cotton for getting our conversation started today, my colleagues and to all of you for joining us. [applause] [inaudible conversations] monday marked the fifth anniversary of the passing of the health care law. Senator Bernie Sanders of vermont spoke on the senate floor in defense of the law. This is 15 minutes. During all of my time in the house and senate, this country faced and still passes a major faces a Major Health Care crisis. As you know, the United States is the only major country on earth that does not guarantee health care to all of our people, and today despite the modest gains of the Affordable Care act which i will discuss in a moment we still have about 40 million americans without any Health Insurance. And by the way despite so many uninsured and so many underinsured, we end up paying by far per capita the highest costs of any other country. How does it happen . Millions of people uninsured, millions more underinsured and we end up paying per capita almost double what any other nation faces. Now, i was in the congress during the years of the bush administration, and i waited eagerly to hear what my republican colleagues had to say about tens of millions of people without any Health Insurance and about the cost of health care being so expensive. And i waited, and i waited and my republican colleagues had nothing to say. Apparently, the private Insurance Companies were doing just great under that system, Drug Companies were charging our people the highest prices in the world under that system. Whats to complain about . Whats to worry about . So 50 Million People have no Health Insurance, people cant afford health care, not a problem to my republican colleagues. Five years ago the congress with no republican support passed the Affordable Care act. And let me be very clear i voted for the Affordable Care act. I will be the first to say that the Affordable Care act has many problems and, in fact, in many ways did not go anywhere near as far as it should have gone. By far not a Perfect Piece of legislation. But yet i still wait to hear what my republican colleagues have to say about how we address Health Care Crisis other than doing what they are doing in this budget which is to repeal the Affordable Care act completely. So lets take a look at what the Affordable Care act obamacare has accomplished and what they want to end completely. Mr. President , after five years of the Affordable Care act, more than 16 million americans have gained health coverage. Many of those people never had Health Insurance in their entire lives. Some of those people were getting their health care through the emergency room at outrageously high costs. Since 2013 we have seen the largest decline in the uninsured rate in decades and the nations uninsured rate is now at the lowest level ever recorded. Just since october 2013 the uninsured rate for nonelderly adults has fallen by 35 . 16 million more americans have Health Insurance. Republican response, get rid of the aca, throw 16 million americans off of Health Insurance. Since the affordable cower act was enacted care act was enacted, Health Care Prices have risen at the slowest rate in nearly 50 years. All of us can will be seven eight, ten Years Ago Health Care Insurance rates 20, 30 increase. Since the Affordable Care act was enacted, Health Care Prices have risen at the slowest rate in nearly 50 years. Are they going up . Yes, they are. But at the slowest rate in nearly 50 years. Thanks to exceptionally slow growth in perperson costs throughout our health care system, National Health expenditures grew at the slowest rate on record on record from 2010 through 2013. Are we making progress in controlling the growth in Health Care Costs . Yes, were. Republican response, throw it out. Mr. President ten million low income americans are now able to get Health Insurance through medicaid, and if you are a low income american struggling to make ends meet and not able to afford health care in many instances this is Health Insurance that saves your life. It saves your life because you know have the opportunity. Maybe for the first time in years to be able to go boo a Doctors Office to go into a Doctors Office because you have medicaid. Republican response, throw it out. Ten million low income americans no longer have Health Insurance. Mr. President all of us remember not so many years ago before the aca you have a kid, and at the age of you have Health Insurance for your family, and when your child reaches the age of 21, that child is now off of your Health Insurance plan. Huge uninsured numbers for young people in this country who were no longer able to be on their parents Health Insurance plan. Well, you should the Affordable Care act some 5. 7 million young adults have been able to stay on their parents policies. The uninsured rate for young adults has dropped by 40 . Well, id like to see it drop even more than that but 40 is nothing to sneeze at. The republican response, hey, lets make sure that all of these young people from 21 to 26 rejoin the ranks of the uninsured. Mr. President , one of the great scandals that existed in this country before we had the Affordable Care act and we think back on it, people find it hard to believe, but if somebody was diagnosed with diabetes, with cancer with Heart Disease with aids whatever it may be and that potential walked into an that person walked into an Insurance Company and said, you know, i need some insurance, and you fill out forms and the Insurance Company says oh you had Breast Cancer three years ago, were not going to insure you. You had diabetes, youre not going to get insurance. So the people who need insurance, needed insurance the most were the people least likely to be able to get insurance. Can you imagine that . That people who had a history of Heart Disease, history of cancer scared to death that it may reoccur, in absolute need of insurance, Insurance Companies said no, we can discriminate against you. You are sick, you may get sick again. We dont want your business. Well the aca did something that should have never been allowed to happen in the first place, it provided protections for people with preexisting condition. Republicans want toened the aca to end the aca. That is in this budget. They want to get rid of it. So for those of you who have serious illnesses understand that if the republicans succeed you may not be able to get Health Insurance because well go back to a time when companies could discriminate against people with serious illnesses. Before the aca many individuals couldnt gain access to Health Insurance for a variety of illnesses, quoteunquote, including pregnancy. I guess pregnancy is an illness that you dont deserve insurance for. Doesnt make a lot of sense to most american, but that is what will reoccur if the republicans are successful. Millions of seniors in this country are struggling in terms of how to pay for their medicines. Cost of medicine in america is very, very high, highest of any country on earth. And what the Affordable Care act is it moves to close the doughnut hole which means money that has to come out of seniors own pockets. Republican budget gets passed that gets implemented into law seniors will now be paying significantly more for their prescription drugs. The Affordable Care act includes important help to seniors including 45 discounts on the cost of their drugs but housing the full price of the drug to be counted to the amount they need to pend to get out of the hole to spend to get out of the hole. The Affordable Care act gives people access to free Preventive Care that keeps them healthy and out of the hospital. The Affordable Care act ends discrimination against women by Health Insurance companies so that they dont have to to pay more for Health Insurance simply because they are a woman. Are we going to go back to the days that because a patient was a woman she has to pay more for Health Insurance than a man in i certainly hope not but that is what happens if you end the Affordable Care act. If affordable the affordable cower act protects against a practice by Insurance Companies of including lifetime limits in their policies. Prior to aca many insurance plans included lifetime limits, a limit on the amount of coverage that plan would provide an individual or family in their lifetime. In other words if somebody was racking up large claims because they were seriously ill, the Insurance Company say sorry thats it. You cant were not going to pay any more. Those are the days that we want to go back to. So i think, mr. President that we could all agree that the Affordable Care act is far from perfect. In my own view, we should provide health care to every person in this country as a right, and i would do it through a medicare for all program. Other people have different ideas. But it is hard for me to imagine anyone thinking that the solution to Americas Health care problems today is simply eliminate the Affordable Care act. Let me change topics, mr. President , and take a broader look at the republican budget going beyond the Affordable Care act which they want to abolish. Mr. President the question that we have got to ask ourselves is whether or not we are such a poor country that we should move toward a republican budget which enables, forces more and more people to have no Health Insurance, which makes it harder for working families to send their kids to college which makes it harder for low income families to send their kids to head start, which cuts back on nutrition programs whether its the food stamp program, the meals on Wheels Program the wic program, which helps people who are struggling literally with trying to come up with the income to adequately feed themselves. We have many people in this country who are actually hungry and the republican budget cuts those programs. Are we such a poor country that those are the choices that stand before us . I think not. I think the facts are quite the opposite. I think the facts tell us that the United States of america is in fact, the wealthiest country on this planet and, in fact, we have never been a more wealthy country. Were not a poor country, were an extremely wealthy country. The problem that we face is that we have a grotesque level of income and wealth inequality such that tens of millions of families are struggling economically. Many are hungry while at the other side people on top are doing phenomenally well. But when you add it all together, it turns out that we are a very, very wealthy country. And the idea that people would come forward and say we are going to make it harder for low income families to feed their kids were going make it harder for working class families to send their kids to college were going to make it harder for working families to get their kids into childcare is a totally absurd argument. The u. S. Senate is about to gavel in on this tuesday morning. Debate until noon eastern on the 2016 budge plan and then a vote on an amendment by the Ranking Member Bernie Sanders that would provide nearly 480 million for the nations infrastructure by closing offshore tax loopholes. The senate will recess for party lunches between 12 30 and 2 15. The house comes in at moon for work on its at noon for work on its version of the budget. And now live to the senate floor. The president pro tempore the senate will come to order. The chaplain, dr. Barry black, will lead the senate in prayer. The chaplain let us pray. Holy god, superintendent of the universe, thank you that you give us the gift of forgiveness. In spite of our shortcomings you continue to bury our mistakes in the sea of forgetfulness. Help us to respond with loving gratitude for your generous mercies. Today, use our lawmakers to advance your kingdom. Lord enable them to contribute to the well being of our nation and world. Help them to remember as they labor they are either making a deposit or a withdrawal. May all the deliberations on this high hill of our nations life begin continue and end with you. We pray in your great name. Amen. The president pro tempore please join me in reciting the pledge of allegiance to the flag. I pledge allegiance to the flag of the United States of america and to the republic for which it stands, one nation under god indivisible, with liberty and justice for all. Mr. Mcconnell mr. President . The presiding officer the majority leader. Mr. Mcconnell throughout the obama era families across the country have had to make a lot of tough decisions. Lost jobs or lower wages meant doing more with less and refocusing on what truly mattered. It wasnt easy, but families made the best of difficult situations in order to position themselves for greater success in the better days to come. Meanwhile in washington, you saw record levels of overspending, trilliondollar deficits, historic levels of debt, hardworking families made tough choices while the Obama Administration and its allies aimed to keep right on overspending. It was more than just wrong. Many would say it was unfair. But today democrats can join together with republicans to help rectify the inequity. Instead of having Washington Play by one set of rules and the middle class by another, we can force washington to start confronting really big challenges just like everyone else has to. We can force washington to focus on serving the middle class again instead of the other way around. And we can begin by passing the balanced budget before the senate today. This balanced budget, mr. President , pivots on an essential truth that washington has a spending problem not a revenue problem and strives to make government more accountable, more efficient and more accessible. It represents a significant step forward when it comes to solving our countrys many fiscal challenges. But thats just one reason this balanced budget is so important. Heres another. It will help promote Economic Growth right now and promote sustained opportunity well into the future. It aims to do so in a variety of ways. One is promoting Energy Advancement as an engine for growth. The Energy Revolution is truly historic. Its creating thousands of jobs, lowering costs for the middle class and helping lift many into that middle class. This budget embraces that progress. It aims to remove needless barriers to environmentally responsible Energy Development and i expect other members to come to the floor to discuss the Energy Component in greater detail today. I also expect members will come to discuss funding Americas National security needs. As we know, there are numerous threats facing our country terrorism practiced by groups like isil, al qaeda and its associates iranian efforts to advance its Ballistic Missile program, pursue a Nuclear Weapon and sponsor terror and russian and chinese attempts to expand their sphere of influence which will require us to modernize our force. We must eventually give the Defense Department the certainty it needs to modernize the force. Members continue to work towards solutions for funding defense in the most robust and predictable way possible. But i commend chairman enzi and senator Lindsey Graham for providing us with a path forward in the interim. Their proposal represents a goodfaith compromise to begin the legislative process for the Defense Authorization bill well continue later this year. When the additional overseas contingency Unfunded Mandates can be prudently reallocated against the actual procurement and modernization needs of our military if only for the coming fiscal year. Short of revising the b. C. A. , this is the best strategy to keep l faith with our armed sofses and this is services and this is the best option we have for leaving president obamas successor in the position to face so many global challenges. Every budget obviously is a compromise. This one is surely that, but its a good compromise. It embraces growth. It reaches for a more Prosperous Energy future. It positions our nation for a better outcome than wed see otherwise on defense. Its bold yet balanced and it aims to change washingtons focus away from the needs of big spending politicians and toward the aspirations of hardworking americans who are very right to demand a government thats efficient, accountable and focused on growth. This budget is all those things, and i urge our colleagues to support it. Mr. Reid mr. President . The presiding officer the democratic leader. Mr. Reid these budgets we deal with are more than just a piece of paper. Its a lot of numbers. Each budget that we put forward and republicans put forward are statements of our values, and it tells americans basically whose side were on. I think if you look at these budgets, youll find that the budget that we propounded and you will see when the votes take place this week are those that put the middle class first s. A budget that supports hardworking families, creates jobs invests in our future. The republican budget, by contrast, theyve developed a budget that attacks the middle class, preserves the interest of special interests and the super wealthy. How can i say that . I say that because its the truth. For example heres some of the things that the republicans are proposing in their budget. They want to take away health care from 16. 4 million americans now insured through obamacare. Senate republicans budget wreaks havoc on medicare at the is expense of americas seniors. The Senate Republican budget makes drastic cuts to medicaid and cuts millions of families that rely on it to pay for Nursing Homes and other care. A lot of that care that we have in Nursing Homes is not for people who are indigent. Its people who have had to go to medicaid because everything theyve worked for their whole life is gone. The budget the republicans are pushing cuts nutrition assistance for those in need. It slices job training and sources for millions of American Workers and it cuts millions of Financial Aid for college students. And thats the truth. These are all attacking middleclass priorities. Republicans as usual have gone the extra mile to protect special interests and the super rich. Incredibly even as they take money away from hardworking families seniors and students, republicans wont close a single tax loophole to reduce the deficit. Not one. But they pay those indirectly, those super rich more money . Of course they do. Mr. President , Forbes Magazine had an article between 2011 and 2013 top 14 richest people in america gained during that period of time almost 200 billion. Hard to comprehend but its true. 14 people, about 200 billion. With the budget that has been put forward by the republicans in tax breaks for companies who ship jobs overseas . No. Would they close loopholes for wealthy Hedge Fund Managers . No. Would they take away wasteful and unneeded break for these huge oil and Gas Companies . No not a single one. Would they ask millions, even billionaires pay a penny more . No not one. Mr. President , attacking the middle class while protecting the super wealthy isnt just irresponsible. Some would say its immoral. And theres more. The budget is dishonest. It claims to balance but it doesnt. Talk about a balanced budget over ten years is so foolish so untrue. S usa today, the newspaper said quote the republican budget rely im quoting. Relying on huge spending cuts and bewildering gimmicks that dont begin to add up. The New York Times in one of its opeds said the budget is a trilliondollar con job. Close quote. Im not saying this, mr. President. We have usa today, the New York Times. But whos being fooled here . The fact is one area with so far many people have been fooled and they have been fooled a lot. During the markup of the budget resolution Senate Republicans claimed to increase defense spending by adding an extra 38 billion in war funding known as overseas Contingency Operations or o. C. O. The republican leader talked about that a few minutes but that money isnt close to being real because of what seems to be a drafting error not one extra dollar can be spent on defense of sequestration caps. The resolution on the floor puts a strict cap on o. C. O. Funding. For whatever reason republicans neglected to allow the cap to allow an additional 38 billion for defense. In other words the republicans extra defense money is a fraud a hoax, certainly a political gimmick. We want to provide real sequestration im sorry. We want to provide real relief to sequestration which is so bewildering the country in so many different ways. Not only defense in virtually every program in america. And were going to propose just that as the big move. Get rid of sequestration. We look forward to this side of the debate. When its over americans will have no doubt which party stands with the middle class and which party stands with special interests, millionaires and billionaires. The presiding officer under the previous order the leadership time is reserved. Under the previous order the senate will resume consideration of s. Con. Res. 11 which the clerk will report. The clerk calendar number 31, s. Con res. 11, setting forth the congressional budget for the United States government for fiscal year 2016, and so forth and for other purposes. Mr. Enzi mr. President . The presiding officer the senator from wyoming. Mr. Enzi colleagues, good morning. Working with senator sanders yesterday, we made Good Progress on opening day for the budget resolution. It might not have been as fun as being at opening day for baseball but getting underway on the first balanced budget resolution that this senate has seen in nearly 20 years was pretty exciting for me, and i appreciate the good work and the full debate we had. Today im looking forward to more work on a variety of amendment ideas for the resolution. Some senators want to debate amendment ideas that have to do with the budget, and some senators want to debate amendment ideas that have nothing to do with the budget. So well hear from some senators today on issues such as our spending caps, the sequester how best to preserve and protect Social Security and whats the best way to ensure women are treated fairly in the workforce. Other senators may want to discuss items such as how to treat the waterways of the United States, free from overreach of the e. P. A. , or how our communities and localities are under siege from washington when it comes to ideas about taxing carbon or coal. And senators may wish to discuss how our National Security is best served by the spending levels contemplated in the budget. But well also hear about something that really interests me as it marries the numbers of our budget resolution carries with the work our committees in congress can do once the budget is passed. I think one of the frustrations on the other side is this is a fairly general budget just it just sets the spending limits for the committees and then builds in some reserve funds for some flexibility and it doesnt go into the specifics of exactly how the committees ought to operate, and the reason for that is the committees are the people that have at least an intense interest in that field or maybe even a lot of expertise and when we try to preclude what theyre doing by what we do in the budget, it wont work. So well also hear about something that marries the numbers our budget resolution carries with the work our committees in congress can do once the budget is passed. The statutory deadline for passing the budget is april 15. Were going to have a twoweek recess just prior to that, which really shortens the amount of time we have to work. Id remind everybody that the republicans have only been in charge for a few weeks and are going to pass the first budget that would be done in six years. But thats a pretty fast track to be done, but im believed with where we are at the moment. Later on this morning the senate willer consider an amendment to help improve care for children with medical complexity within medicaid. Children with medical complexity require intensive Health Care Services. These children often have two or more serious chronic conditions and often see six or more specialists and a dozen or more physicians and they also often require care that takes them across state lines. There are two million of these children on medicaid. Reflecting a bipartisan bill, senator rob portman intends to offer an amendment to create a reserve fund in anticipation of the Committee Action which recognizes the critical importance of medicaid to children with medical complexity and the need for greater coordination and integration of care for this population within medicaid. If congress can write a bill that fits this reserve fund, then we can benefit children with medical complexity and their families. I look forward to a good debate and several votes in the senate said and mr. President i yield the floor. Mr. Sanders mr. President. The presiding officer the senator from vermont. Mr. Sanders thank you mr. President. And i look forward to continuing to work with senator enzi in a thoughtful and important process, and i thank him for his civility and i think were going to have an interesting few days. Mr. President , to my mind, the basic issue surrounding this budget debate is whether we address the enormous needs facing a declineing declining middle class and whether we come forthwith ideas that create the jobs the millions of jobs that our people need whether we raise the wages that millions of workers desperately need who today are working for 7. 50 an hour, 8 an hour, whether we deal with the scandal of pay equity in this country where women are making 78 cents on the dollar compared to men whether we make sure that we do not cut Social Security at a time when there are so many vulnerable seniors out there whose entire income or almost their entire income is Social Security, and in my view, we cannot balance the budget on the most Vulnerable People in this country. We cant cut the meals on Wheels Program. We cant cut head start. Essentially, at a time when the middle class is shrinking we cannot balance the budget on the backs of the elderly the children, the sick and the poor. And on my side of the aisle, in the democratic caucus, what people are looking at is massive wealth and income inequality taking place in america. Senator reid a few minutes ago made the point that in the last two years alone the last two years alone the wealthiest 14 people in this country have seen their wealth increase by over 150 billion in two years. That is more wealth that they have increased in two years than the bottom 40 of the American People own. Thats pretty crazy stuff. The rich are becoming phenomenally richer, and we have tens of millions of americans struggling to keep their heads above water and my republican colleagues say well, we want to deal with the deficit by cutting programs for the working families the lower income people the people who are struggling, but were not going to ask the wealthy or largest corporations of this country who are doing phenomenally well, to pay an additional nickel in taxes. That does not make sense to me. I do not believe it makes sense to the American People. Having said that, mr. President what i would like to do now is get to an amendment that is currently at the desk, and i would ask that the pending amendment be modified with the changes that are at the desk. The presiding officer the amendment is so modified. Mr. Sanders thank you mr. President. What this amendment deals with is something that i think virtually every member of this body understands to be an enormously important issue and the American People understand it as well. And that is our crumbling infrastructure and the fact that we have got to begin the process to substantially invest in our roads, in our bridges in our Water Systems in our waste water plants, in our levees our dams and our airports. The needs out there are enormous. And when we do that, mr. President , we can create millions of jobs at a time when we need to create millions of jobs. Now, i know what my i heard senator enzi yesterday speaking on the issue and i think he reflects the views of many republicans. They recognize the problem. I dont think there is a great debate on whether or not our infrastructure is crumbling. I dont think theres a great debate, and i speak as a former mayor, that if you allow your infrastructure to continue to crumble, it only becomes more expensive to rebuild it. I dont think theres a debate on that. The debate, of course, comes down to how you pay for it. Well you know, that debate has been going on here for many, many years. If anyone had a magical solution id suspect it would have been brought forth already. But the proposal that we are bringing forth calls for a 478 billion investment over a sixyear period, and that will be paid for by eliminating some outrageous corporate loopholes today that, among other things, allow large profitable corporations to stash their profits in the Cayman Islands in bermuda and in other tax havens and not have to pay one nickel in taxes to the United States government. So our proposal is pretty simple. Lets eliminate some of those loopholes. Lets take that money. Lets invest in rebuilding our crumbling infrastructure. Lets make our country more efficient, more productive, safer. And let us create millions of jobs. Mr. President , the need starway building our the need for rebuilding our infrastructure should not be in doubt. Nearly one quarter of our bridges are functionally obsolete. Almost onethird of our roads are in poor or mediocre condition, and as anybody stuck in a traffic jam at this moment knows, more than 42 of urban highways are congested. Much of our rail network is obsolete. We are competing against countries which have highspeed rail which operate much more rapidly than our railroads do. Americas airports are bursting at the seams and still rely on antiquated 1960s radar technology. More than 4,000 of our nations dams are considered deficient and nearly 9 of all levees are likely to fail during a major flood, and thats a pretty scary proposition. Our Drinking Party systems are nearing the ends of their useful lives. All over this country virtually every day, there is another pipe which bursts, causing flooding in downtowns and wasting huge amounts of clean drinking water. Further, our waste water plants routinely fail during heavy rains, allowing all kinds of crap to go into our lakes and our rivers, which should not be the case. Our aging electrical grid has hundreds of avoidable power failures each year and is unacceptably vulnerable to cyber attacks. Mr. President , 478 billion may seem like a lot of money and it is a lot of money but the American Society of Civil Engineers tells us that we need to invest an additional 1. 6 trillion to get our infrastructure into a state of good repair by 2020. So to be honest with you while this amendment is a significant step forward it does not go anywhere near as far as it should go. So mr. President i would hope that on this amendment we would have strong bipartisan support. It is not good enough for people to continue to say what everybody acknowledges. Yes, we need to rebuild our crumbling infrastructure, but no we just dont know how were going to come up with the money to do it. Its too late to keep expressing that rhetoric. Weve heard it for too many years. And every day that we dont act it becomes more expensive for us to act. So i urge my colleagues on both sides of the aisle to today make an important statement that, a we cannot continue to delay rebuilding our crumbling infrastructure. That b when real unemployment in this country is not 5. 5 but 11 , when youth unemployment is 17 , when africanamerican youth unemployment is off the charts, we need a major jobs program to put our people back to work at decent wages and thats what work on infrastructure does. So the time for rhetoric is gone. The time for action is now. Lets rebuild our crumbling infrastructure. Lets put people to work. Lets end outrageous Corporate Tax loopholes. Lets make our country safer more efficient and more productive. And, mr. President i ask for support for that important amendment which comes up for a vote, i believe at around 12 00 or so. Mr. President , i would yield five minutes off the resolution to senator boxer. Mrs. Boxer thank you so much. The presiding officer the senator from california. Mrs. Boxer mr. Chairman, if no one arrives may i have ten minutes . Thank you so much. Mr. President , im so grateful to senator sanders because he explains things like no one else. He takes it down to the average working family in america and thats really who were here to protect. Not the super top rich people. Theyre doing fine. Senator sanders taught me something this morning. Im just going to make sure i remember it correctly. That the wealth of the top 14 richest people in america in the last couple of years went up over 100 billion. How much was it . Mr. Sanders 157 billion in a twoyear period. Mrs. Boxer in a twoyear period the wealthiest of the wealthiest 14 people that wealth rose 157 billion. And yet and still when you look at this republican budget, those people get every benefit you can imagine. They are not asked to do a thing, a thing. When people are struggling, sending their kids to college lord knows. When people are struggling trying to afford a new home. When people are struggling every day to make ends meet. Some even to put nutritious food on the table. This budget is a blueprint of unfairness. This budget, this republican budget is a blueprint for another recession. This is a terrible budget, and it makes believe it balances. It doesnt balance one bit and our Ranking Member will explain the smoke and mirrors that are being used in this budget. I used to serve on the Budget Committee. Let me be clear to anyone within the sound of my voice in recent times, the only time the budget was balanced was when president clinton was president and only democrats voted for his budget. We balanced the budget. And you know what . We created 23 million jobs, because we invested in people, in a education in our children. Not this budget. They cut deep cuts out of domestic spending. They take 236 billion over ten years from nondefense. That means theyre cutting education, scientific research, food safety, Law Enforcement every Single Program that the middle class depends on and working americans. And i want to thank the Ranking Member of the Budget Committee. Hes taking such leadership in his position here and on the environment and Public Works Committee by calling attention to our failing infrastructure. 63,000 bridges to be exact 63,500 bridges are structurally deficient in america and 50 of our roads are in less than good condition. And what does this republican budget do . And, by the way, this is a big problem for our businesses. They cut 17 to overall spending ignoring the fact that our roads are in disrepair ignoring the fact that we face the prospect of crumbling bridges. That is a blow to everyone who drives on our roads. And at a time when energy costs are weighing heavily on families and businesses, they cut 85 in Overall Energy spending, including weatherization funding. What are they thinking . When a middleclass family weatherizes their home, the energy bill goes down. Theyre putting a tax on every middleclass person who has to pay a heating bill. Energy efficiency grants, no. Cut. Research into clean energy, cut. A blow to our consumers and to our efforts to mitigate climate change. At a time when college is a necessity and a priority, they want to cut pell Grant Funding by 30 over ten years and to reduce overall spending on education and training by 15 . A blow to our students. Oh not the students whose parents are in that top echelon. No problem there. They can afford 40,000 a year college, 30,000 60,000. But to our middle class and those striving to be in the middle class, they are doomed with this budget. Now president obama has turned this Great Recession around, but our Ranking Member points out the problems that remain. But the solutions arent that hard to come by. You make investments not wasteful spending, investments in energy, investments in transportation investments in finding cures for diseases. And what do you do . You make this a greater country and you make lives better across the board. 45 Million People are still recovering from the recession including 16 million children who live in poverty. They the republicans, they leave the top echelon alone who are making billions of dollars and theyre cutting 660 billion from income security over ten years. That means theyre cutting supplemental nutrition assistance, school lunch Unemployment Insurance earnedincome tax credit. I dont know who they represent who they think they represent but ill tell you who they fight for. The wealthiest of the wealthiest few. Thats who they fight for. That old notion you give billionaires money and somehow it will trickle down to the rest of us, it doesnt work. It doesnt work to cut education funding. It doesnt work to cut transportation funding. It doesnt work to cut Energy Assistance programs. Ive got to say it is a shock to see this budget. And if thats why they think they got elected then the People Better pay attention. Listen to what they do with health care. They do away with the Affordable Care act. When 16 Million People now have insurance who didnt have it before. And guess what . Do they have a replacement . Theyre working on it. Oh good. Weve worked on it for 50 years. We finally got it done. Its not perfect but its working. In my state, it is magnificent to see people who now know they wont lose everything if they get sick. At a time when 70 million americans rely on medicaid and Childrens Health coverage, they want to block grant that program and cut it by more than 1. 2 trillion. What will it mean for Maternity Care when half of all births in the u. S. Are financed by medicare another blow to our families to our babies. They fight for your right to be born. How about after youre born . How about after youre born . At a time when more than 50 million seniors and disabled americans are in medicare and the baby boomers continue to age in, they want to cut medicare by 430 billion. Now look, theyre afraid to spell out how they want to cut it. They kind of hide it in the document but we know it happens. People will be suffering paying more getting less care, a blow to our seniors. They do not close one tax loophole for the wealthiest corporations some of who pay no income tax or these billionaires. Now i have nothing against being a billionaire at all but this congress ought to ask everyone to pay a fair share including billionaires. Not just the middle class. Now, their gimmicks are unbelievable. They hide defense spending in an offbudget account called o. C. O. Oh no, o. C. O. They hide it, but we got their number. As i think al sharpton says on his show, we gotcha. We know what youre doing. Wheres the Emergency Fund for children . Wheres the Emergency Fund for education . Wheres the Emergency Fund for transportation . No theres no o. C. O. For that. No. And then they claim they balance the budget. Thats the biggest fib ever. Look at their record. When george w. Bush got elected he had a surplus. It took him 15 minutes to blow it. Wars two wars on the credit card. Tax cuts to the rich on the credit card. This budget continues that legacy of shame. Shame, hurting our seniors hurting our children, hurting our middle class all at the expense of the wealthy few. We see that president obama has cut this deficit by more than half. Were on the right track. Lets not walk away from policies that work. And i want to say the Ranking Member, senator sanders i strongly am supporting your amendment on infrastructure because to be a great nation, we have to move people. We have to move goods. This is a global marketplace. The ships are coming in to california 40 of the imports. Then they go on, they are transferred to trucks. They go on roads that are full of potholes, that are a mess. They have rail crossings that are dangerous and so on. So ill conclude in 20 more seconds if i might. 20 seconds additional. Ill conclude. I want to thank our Ranking Member on the budget because he talks from the heart the soul and from facts. And if we followed his leadership rather than the leadership of those on the other side of the aisle who want to go back to the days of high deficits high unemployment and chaos and we were here. We know there was chaos then vote for this republican budget. I hope well vote no and i hope well support the amendments that come forward to put us on the right track again. Thank you very much. I yield the floor. The presiding officer if no one yields time, time will be charged equally to both sides. The senator from wyoming. Mr. Enzi i note the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call quorum call the presiding officer the senator from ohio. Mr. Portman mr. President i ask unanimous consent that the quorum call be dispensed with. The presiding officer without objection. Mr. Portman i ask unanimous consent to set aside the pending amendments and call up my amendment number 349. The presiding officer is there objection . Without objection. The clerk will report the amendment. The clerk the senator from ohio mr. Portman proposes an amendment numbered 349. At the appropriate place insert the following mr. Portman mr. President , i ask unanimous consent that the reading be dispensed with and that we the presiding officer without objection. Mr. Portman thank you mr. President. So were here talking about the budget and one of the issues in the budget is how we spend our money, including on health care and in this case some of our most vulnerable young people, our children, who have what are termed to be complex medical conditions. I appreciate the fact that senator bennet is cosponsoring this amendment with me. Its its based on some Bipartisan Legislation we have been working on over the years that helps to ensure that these children have the opportunity to get better care and also that we can save some funds in what is a very inefficient medicaid Delivery System now for these children. It would allow basically Health Care Providers to deliver Health Care Services to these medically complex kids through models that coordinate care, between providers, again helping to improve quality of care and much Better Outcomes in the cases where this has been tried but also at a lower cost for medicaid. There are roughly three Million People who fit in this category. Its about one in every 25 children. Of these children, by the way most of them rely on medicaid to access care. About two million out of the three million. Although children with complex conditions represent only about 6 of pediatric medicaid patients they comprise about 40 of the costs. So 6 of the kids, about 40 of the costs of all medicaid spending on children. Children with these medical complex situations, they tend to have multiple and high acuity and chronic conditions that often require the service of a lot of different specialists. These circumstances just call out for better coordination of care particularly because a lot of it goes across state lines so each Medicaid Program in each state has some different rules but specialized care often requires these children to go to specialized providers outside of their state. This amendment would correct that fragmented system those kids sometimes encounter now when they do seek that access across state lines. Not only would the amendment ensure medically complex children have access to necessary care, it again would also allow the medicaid system to realize savings through these increased efficiencies, including reducing hospitalizations and emergency room visits, while providing the array of outpatient and Community Services and support that are needed by these children. So its a more holistic approach to their care, avoiding, frankly, some of the costs associated with emergency room visits and other hospitalizations and other fragmented care. Its based on the experience in the real world so there are programs that are doing quite well at improving these outcomes and saving costs. Some of the great childrens hospitals have established a track record in developing these care coordination models for kids with medical complexity. Ive seen it in action in ohio where were blessed to have a number of great childrens hospitals. I have talked to medical professionals who are very pleased to have this better coordination of care. More importantly ive talked to the parents and talked to some of the children themselves who were ecstatic about it. Many of them receive their care through a different process previously that was not coordinated, and what they tell me is they are deeply grateful for the coordination, partly saves them a lot of time and effort, partly because theyre getting much better care, partly because they just feel like somebody cares and theyre getting the love and support and care that they need through the coordination. They are grateful for the difference. As the overall population of children with medical complexity continues to grow, thanks to some great advances in medical science and medical care, including care for premature babies were going to see more and more of this need for better coordination. So again i want to thank my colleague senator bennet and many others on both sides of the aisle who have been involved in this issue over the years. This is an important amendment for us to have in the Budget Committee because it shows where our heart is, as the senate, to be able to take better care of these kids and also have more efficient care in the medicaid system where again 6 of these children now comprise about 40 of the costs in medicaid for children. I encourage all my colleagues to support this commonsense approach to provide Better Health care outcomes for some of the most vulnerable of our nations children, and i yield back my time. Mr. Sanders madam president. The presiding officer the senator from vermont. Mr. Sanders i ask unanimous consent to set aside the pending amendment so that i may call up my amendment number 386. The presiding officer is there objection . Without objection. The clerk will report the amendment. The clerk the senator from vermont, mr. Sanders proposes an amendment numbered 386 at the mr. Sanders i ask unanimous consent that further reading of the amendment be dispensed with. The presiding officer without objection. Mr. Sanders madam president senator portmans amendment touches upon a serious issue that i hope and expect will have broad bipartisan support and that is the needs of children with serious chronic conditions in the United States over three million children have medically complex Health Conditions, and of those three million kids, two million rely on medicaid for their Health Insurance. That is two out of three kids, which should tell every member of the u. S. Senate how important medicaid is. So let me repeat two out of three children rely on medicaid who have medically complex issues the issues that senator portman is speaking about. Last congress, senator nelson offered a similar amendment during the budget process to address this important issue and i was pleased to support it. I also plan to support this amendment today and hope that we have widespread bipartisan support for it. But what i must say is that given the republican budget which eliminates the Affordable Care act which throws 15 million americans off of Health Insurance, many of whom have just for the first time in their lives received Health Insurance in a republican budget which cuts medicaid by some 400 billion over a tenyear period, the amendment that senator portman is offering deals with only one tiny and small part of what the republican budget is doing. What the republican budget is doing is decimating health care in the United States of america. And senator portman says, well, we have a situation with kids who have medically complex problems. Hes right. But we have many, many other issues out there that the republicans are decimating. Medicaid provides 6. 4 million elderly seniors who rely on medicaid many of whom are living in Nursing Homes. 6. 4 million elderly seniors some 80 or 90 years of age rely on medicaid for their nursing home care. In some cases these seniors have incomes of 8,000, 9,000 a year. The portman amendment does not address the devastating cuts that happen to elderly americans in Nursing Homes. Pregnant women who rely on medicaid for vital prenatal care that improves their health and wellbeing of mothers and babies those programs are going to be cut. Portman amendment does not protect them in any way. Nearly 33 million children in our country rely on medicaid for their Health Insurance. These are kids of lowincome, workingclass families who need important medical care while they are young like immunizations and wellchild visits. The portman amendment does not address the fact that many of those people will be thrown off of Health Insurance. Some ten million americans with disabilities rely on medicaid to treat serious sometimes lifethreatening disabilities. The portman amendment does not address what happens to people with disabilities who are on medicaid. So madam president while i support this amendment, i am also concerned about the devastating impact that the republican budget will have on many many millions of americans by ending the Affordable Care act, 16 million americans thrown off Health Insurance 400 billion cuts in medicaid, millions more. I believe we need a budget that strengthens health care in america, not decimates it. I believe that we need a budget that doesnt force us to choose between a serious seriously ill child and a pregnant woman with small children at home. These are false choices that a great nation like ours should not be forced to make, especially at a time, as senator boxer mentioned, we have the wealthiest 14 people in this country seeing their wealth increase in the last two years by 157 billion and our republican friends say no, these people should not be asked to pay more in taxes but we should balance the budget by taking millions and millions of people off of Health Insurance. I dont think anybody in america thinks that those priorities make any sense at all. So madam president i am offering a sidebyside. And in doing so, i urge my colleagues to vote for the portman amendment but also to vote for my amendment cosponsored by senator wyden which supports all medicaid beneficiaries by opposing cuts to the program. Lets not sit around and say well, were making some progress in one area but we dont care about the millions of other people who have been thrown off of medicaid. So i would urge support for the amendment that senator wyden and i are offering. A senator madam president . The presiding officer the senator from wyoming. Mr. Enzi i ask unanimous consent that the time until 12 00 noon today be equally divided between the managers or their designees and that at noon the senate vote in relation to the following amendments in the order listed with no seconddegree amendments in order prior to the votes sanders number 323 as modified. Sanders number 386. Portman number 349. With two minutes of debate equally divided before each vote and that following the votes the Senate Recess under the previous order. I further ask that the time from 2 15 to 3 00 p. M. Be under the control of the minority and the time from 3 00 to 3 45 under the control of the majority. The presiding officer is there objection . Without objection, so ordered. Mr. Enzi for the information of all senators, there will be three roll call votes at noon today, with an additional stack of votes expected at 4 30 today. I yield the floor. The presiding officer who yields time . A senator madam president . The presiding officer the senator from oklahoma. Mr. Inhofe madam president despite the repeated statements and warnings from our military and some of our congressional leaders, including myself, were again staring down the barrel of sequestration. This has been the great fear that weve had and i think weve come to a compromise here that might be livable. Not ideal not where we should be but where we are at this time. Each service chief and each secretary and ive never seen this before. Each one has testified that no service will be able to meet the wartime requirements under sequestration. That is in the event that we have to have sequestration of the military portion of this. Let me just mention this, that it was done wrong from the very beginning. When you talk about sequestration, it would seem to me that we would want to be sequestering or reducing in a relationship or proportion as to what that is of the budget. For example, we are our military is 16 of the budget and yet weve had to take 50 of the cuts. So sequestration has gotten us to this point. And this budget that well be voting on has got kind of a temporary solution or relief from sequestration. Secretary carter testified that and this is a quote the new secretary of defense. He said quote readiness remains at troubling levels across the force and even with the fiscal 2016 budget, the army navy and marine corps wont reach their readyness goals until 2020 and the air force until 2023. Madeleine albright this was interesting because we had a hearing where we had faces from the past. We had kissinger. We had george schultz. We had madeleine albright. So we had democrats and republicans, and they all agreed and she testified about her concern about the deep cuts to the Defense Department saying it jeopardizes americas military reach. Now this is a democrat talking. This is madeleine albright. Over the last six years significant cuts to the National Security spending have forced our men and women in uniform to endure a steep and damaging drop in capabilities and readiness. Readiness, all of them testified that our readiness is dropping down. When youre talking about readiness youre talking about risk. When you talk about risk youre talking about american lives. Our naval fleet is at an historic low level of ships. Air force is the smallest in its history. The army is shrinking to a force not seen since before world war ii. And at a time when our security is being increasingly threatened by terrorism, a rising china and isis and rogue nations like iran and north korea the men and women charged with protecting this nation are being undermined and forced to endure devastating cuts to the tools that they need to keep america straight. And what were talking about here is something that up to this point the sequestration not the potential sequestration which hopefully we can avoid and i think we will avoid but what has happened up to this point. The president believes the worlds getting safer. Hes negotiating a bad deal with iran. He thinks that Global Warming is a bigger threat to americans than terrorism. But top leaders i side and out of the top leaders inside and out of the administration disagree. Director of the National Intelligence James Clapper James Clapper has been in this kind of capacity for well over 40 years he said, and this is a quote, he said when the final accounting is done, 2014 will have been the most lethal year for global terrorism in the 45 years such data has been compiled. Roughly half of the worlds currently stable countries are at some risk of instability over the next two years. Director of defense intelligence, Lieutenant General Vincent Stewart he stated, and this was before our committee a couple of weeks ago. He said quote a confluence of Global Political military, social and Technological Developments taken in aggregate have created security challenges more diverse and complexion than those and complex than those we have experienced in our lifetime. That was general Vincent Stewart. Hes the d. I. A. Director. Over the last three decades we built the most powerful fighting force in the history and filled it with the most talented men and women ever to wear our uniform. We cant break our promise to them and our responsibility to protect the nation. I believe our military, our men and women in uniform would not accept failure and would do everything they can to succeed no matter how constrained they are by inadequate budgets. However, they come to a point when the training, equipment and force size, it will fail because it was not given the resources to succeed. We cant let our military get to this point and that is what were risking should we have another level of sequestration. Before sequestration even came into effect, the president had cut some 500 billion from our military. We stood on this floor and talked about it at that time, that how you cant continue to have the cuts just to the military. And thats whats happened before sequestration from this president. Now because of sequestration for the fiscal year of 2013, the army had to cancel seven combat Training Center rotations deferred maintenance on aircraft and vehicles and postponed reset of weapons and equipment. The air force stood down 17 combat battalions, cut 40,000 flying hours. This is a problem that we have there too because we have to consider the difference between retraining and retaining in the air force. The pilots to train a pilot to f22 standards is in excess of 9 million. While retentions are Something Like 200,000 over a nine or tenyear period. And since the just because of the sequestration in 2013, the navy and marines canceled deployments, deferred p maintenance on ships aircraft and reduced purchases of spare parts, reduced training activities. All the services had to cut or delay Weapons Systems and infrastructure modernization. Modernization is one of the first things they do when they cut. They really cant do the readiness. They cant cut the personnel thats out there the force strength but modernization is what suffers because its not something that is aware of today. Yet thats where the cuts were. Theyre still attempting to recover from all these cuts but recent budget turmoil forced our generals and admirals to worry about our militarys ability to fulfill its critical National Security role. And arguably, the most dangerous time in our nations history. The chairman of the joint chiefs of staff thats general dempsey warned that continued National Security cuts will quote severely limit our ability to implement our Defense Strategy. Thats the Defense Strategy to defend our country to save lives that are out there. It will put the nation at a greater risk of coercion, and it will break faith with men and women in uniform. Thats general dempsey the chairman of the joint chiefs of staff. Our nation relies on less than 1 who volunteer to risk their lives on its behalf. I was trying to get a comparable figure to kind of get that in perspective, but what were talking about here is 1 of our population is involved in protecting the other 99 . When these brave men and women are ordered into harms way they they will salute with courage and they will go and do their job and their mission and very effective. They dont have the right equipment to do it with. In return, they rightfully expect a supportive nation to provide them with the best Training Technology and equipment and to accomplish a mission, their mission and then come home safely. Tragically, were not doing that. Put simply, top military leaders are telling us that continued cuts to National Security spending are making this country less safe. These cuts are making it more likely that our military men and women will not return from the battlefield alive and this is immoral. We must increase our Defense Budget and i prefer to increase its base budget in fiscal year 2016 and over the next five years to give our military leadership the required and predictable funding that they need. Because of senate rules however, we arent able to do this without changing the law. Im committed to working to that point where we can replace sequestration with puts to mandatory spending, as was originally planned with the budget control act. We went through the budget control act assuming some of these things would happen. For the purpose of the Senate Budget resolution, however i am proud of the Budget Committee and the hard work that they have done for adopting an amendment during its markup to provide additional funding for the department of defense through overseas Contingency Operations. Thats o. C. O. This is far from ideal. O. C. O. Money is better than no money at all and until we provide the solution to sequestration that we need, this is the best that we can do. Our countrys at war and will be for the foreseeable future. Were going to have to do something to to keep america strong, and i do i dont like this alternative. We had nothing but a series of bad alternatives. This is the least bad alternative, and i salute senator enzi and others who are responsible for coming up with something that still is going to defend our nation and particularly as were faced with a potential another round of sequestration, and we cant let that happen to our men and women in uniform or to america. With that, i yield the floor. The presiding officer who yields time . Mr. Inhofe i note the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call mr. Enzi madam president. The presiding officer the senator from wyoming. Mr. Enzi id ask that the quorum call be dispensed with. The presiding officer without objection. Mr. Enzi id also ask that even though we have an agreement for time to be equally divided that yesterday we passed one that whenever were in a quorum call, it will be equally divided. I would hope that that would continue through all of these quorum calls that we have and would ask unanimous consent that that be the case. The presiding officer without objection. Mr. Enzi id note the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call the presiding officer the senator from oklahoma. Mr. Inhofe madam president i ask unanimous consent that the quorum call in progress be vitiated. The presiding officer without objection. Mr. Inhofe madam president first of all, i want to thank my good friend from vermont for drawing attention to the critical importance of passing a longterm transportation reauthorization bill. This is one that senator boxer and i have been working together on for a long period of time. Weve gone through these reauthorizations for many, many years, and we know that this is the way to do it. The reauthorization bill is far superior than just the shortterm efforts that for extensions. I think we all realize that extensions cost about 30 off the top. While i cant support the specific proposal of my good friend from vermont passing a bipartisan longterm fully funded bill is my top priority as chairman of the environment and Public Works Committee. As we all know, the current transportation reauthorization expires on may 31, and e. P. W. Will be prepared to move on a reauthorization bill before that deadline. Thats our goal. My staff has been working closely with the staff of my good friend and partner from california the Ranking Member, senator boxer and we are getting close to having our bill ready. I know that my colleagues on the finance, commerce and the banking committees are also committed to passing a longterm bill as soon as possible, because this does involve not just the environment and Public Works Committee but the other two committees also. Mrs. Boxer madam president i want to thank my friend from the presiding officer the senator from california. Mrs. Boxer i want to thank my colleague and my friend from oklahoma, and i also want to thank the Ranking Member of the finance committee for being here because hes so right. We have to Work Together. The e. P. W. Committee we know how critical this is. The finance committee knows how critical this is. They have to figure out the payfors. Thats, to be honest, the hardest part of all this. And the Commerce Committee also has to work, and im sure senator thune is very aware of that in his ranking as well. Our transportation bill is set to expire as the summer construction season is beginning. Several states, arkansas, georgia, wyoming and tennessee have already delayed or canceled Construction Projects due to the uncertainty in the federal transportation funding system. Other states are considering similar actions as the construction season fast approaches. I want to make this point. Were going to hear from all of our states. Im fortunate that i have such a large state. They can go a little longer with the uncertainty but even california that receives quite a bit from the Highway Trust Fund is going to start to hurt pretty soon. And im so proud that my my friend, my chairman is here because we have such a great history of working together on infrastructure projects, not so good on the environment. We go toe to toe and dont Work Together on that, but we Work Together on infrastructure. He talks about it as a proud conservative and i talk about it as a proud liberal and we see why its so critical for our nation. So we do have to work carefully to craft another bipartisan map 21. And i look forward to bringing that bill to the floor and i want to make sure that when we do bring that bill to the floor we have no controversial riders on it to bring it to a stop, a dead stop. Weve seen that on so many bills already. And im really looking forward to bringing such a bill that is a clean bill, that addresses our transportation funding to the floor with chairman inhofe, with the support of chairman hatch and Ranking Member wyden and others. Mr. Inhofe let me say i will agree and looking forward to that. Sometimes people forget some of the things were supposed to be doing around here. The constitution says roads and bridges, this is what were supposed to be doing. I will work very closely with my good friend from california to achieve this goal and make it a reality. Mrs. Boxer thank you senator inhofe. I yield the floor. Mr. Wyden madam president . The presiding officer the senator from connecticut. I ask unanimous consent oregon. Mr. President wyden the presiding officer my apologies. Mr. Wyden i ask unanimous consent the privileges of the floor be granted to rob jones vigilant ahan, Baxter Matthews jennifer phillips, jacob paul, Polly Webster and Austin Williams for the remainder of the 114th congress. The presiding officer without objection. Blipped madam president , the senate is going to spend much of this week debating the contours and the details of the federal budget. And our colleagues are going to offer a variety of amendments, and we will undoubtedly cast a lot of votes. Those watching are going to hear speeches that are peppered with numbers. Mr. Wyden and statistics. So id like to start the debate out by setting aside to the extent you can this flood of numbers and statistics and focus on what this really means to working families in my home state of oregon and across the country. My view is, the great economic challenge of our time is expanding opportunity for these families. Its about strengthening the middle class and adding sturdier rungs to americas economic ladder so that everybody has the chance to climb upward. Seven years after a crippling economic collapse, weve seen our Unemployment Rate go down. Home foreclosures have gone down. Gas prices have gone down. Were finally starting to see wages beginning to grow. And manufacturing is picking up steam. The American Economy is now performing better than at any recent time in memory. But the fact is, there are still millions of americans who feel stuck. They listened to all of the positive Economic News that ricochets across the news media and wonder when things are actually going to get better for them and their families. I hear it firsthand in every town hall meeting i hold in our state, including several this month. These are young parents who are overwhelmed by the cost of child care. There are students practically in shock over the Sticker Price of a college education. We have workers who are nearing retirement age concerned by the finance committee who have hardly been able to save at all. What the budget in the senate is all about is not just facts and figures, but about the hopes and aspirations of those people i have described who want things to change. In my view the budget the Congress Sets should take on those middleclass challenges directly. It ought to help workingclass families and give more americans a chance to get ahead in life. Now, this week our colleagues on the other side of the aisle are putting forward a different kind of budget, a budget that would poke some new holes in the safety net and in my view would worsen inequality. Youd see millions of americans face cuts in programs that are a life line for them. I have to ask how will cutting a pell grant and education tax credits help a disadvantaged student in legrand oregon, who wants to work hard, play by the rules and get ahead. How is cutting food stamps going to help a single mother in ashland who is walking on an economic tightrope every month how is it going to help her keep food on the table . And how will slashing medicaid help a struggling family in roseburg oregon stay healthy and out of the emergency room . And finally how would repealing the Affordable Care act help a cancer survivor in corvallis who madam speaker has finally been able to get Health Insurance for the first time in years. So my bottom line is pretty direct. Our middle class declines with every rung thats pulled from the ladder of opportunity. So what we all ought to say is the budget is about trying to help americans climb upward with a budget thats designed to give all americans all americans the opportunity to get ahead. To me, you start by investing in americas infrastructure. You simply cannot have bigleague Economic Growth with a littleleague infrastructure. The roads and highways in oregon and across our country are now pocked by ruts and potholes, making it harder to do business and harder to travel. Dozens of people have been killed or injured in bridge collapses. And without adequate roads bridges, and transit drivers spend far too much time sitting in traffic choking on exhaust. This also has taken a big toll, madam president , on americas ability to compete internationally. We have to have bigleague infrastructure to draw jobs and investment to our country and that depends on the quality of our roads and ports and airports and railways. And we know that investing in infrastructure creates thousands of jobs in america right away and supports millions more over the long term. In my view, effective targeted investments in infrastructure ought to be a nobrainer on both sides of the aisle. Second the congress ought to strengthen programs that assist Rural Communities and brighten their economic futures. For example homes in oregon and across the west are being threatened by fires that are growing bigger and hotter and more damaging each year. Chairman enzis budget took several steps in the right direction to improve the way that governments budget for fires. But with a growing threat, more resources are needed to fight and prevent fires. Madam president , having jussivessed me dumpford, oregon they told me it was going to be the dryest in 25 years. You take out a happen and california just looks dry dry, dry. Passing the Bipartisan Legislation that senator crapo and i have authored is urgent. And i also feel that funding for Agricultural Research is another vital tool for giving Rural Communities a chance to get ahead. Each dollar that goes into Agricultural Research will be far outstripped by the value created in crops and crop lands. I was told just recently, madam president , by wheat farmers in Eastern Oregon that investing in Agricultural Research is going to give them and people all through Eastern Oregon a better chance to get ahead and be more successful with their farms. Now i want to make mention of the important of lowincome and middleclass tax challenge. We ought to make the tax cuts for middleclass and lowincome americans permanent. There is a very big tax looming in 2018 unless the Congress Moves to prevent it. Millions of families in oregon and across the nation depend on the expansion of the earned income tax credit, the child tax credit, and the American Opportunity tax credit. These are all set to expire madam president. And the longer families sit in the dark wondering what their Tax Obligations will be, the harder it is for these families, already struggling to get ahead the harder it will be for them to predict how to budget. In my view, it would just be legislative malpractice to leave these lowincome and middleclass cuts teetering on a cliff while others are permanently enshrined into the law. Furthermore, taking that uncertainty off the table is going to make comprehensive tax reform easier to accomplish. My colleagues and i on the finance committee are working hard to bring our broken tax code into the 21st century. I have worked for more than a decade, madam president , first with our former colleague senator gregg most recently with our current colleague senator coats to produce the first bipartisan federal income tax reform plan in more than a quarter century. So i know that it is possible to make the tax code simpler and fairer it ought to give everybody the chance to climb the economic ladder, and making the critical lowincome and middleclass tax cuts permanent is a big step in that direction. Next i think the question of college fortunate and doing affordability and helping students get to Graduation Day ought to be a focus of this budget. The skyrocketing price of tuition keeps far too many young people from enrolling in college and it keeps too many others from completing it. In effect, the price of college can reinforce inequality. Millions of students are buried up to their eyeballs in debt before they ever put on that cap and gown. It is time to come at this challenge from every angle. For one its important to make student debt more manageable so graduates dont spend decades weighed down by loan payments. Its absolutely essential to help students take on less debt from the start. That will get more students in the door to challenge and free graduates from a lifetime of debt. Thats why in my view cutting the pell grant is the wrong way to go. And the byzantine web of tax incentives for Higher Education needs to be cleaned up as well. It should not take dozens of calculations and hours of time for students to navigate the byzantine tax rules. It should be simpler and easier so that more students see a more meaningful benefit. Some Student Loan Debt may be unavoidable, but leaving students with less debt is possible. My next concern with respect to the budget is making sure that needless needless cuts are made in essential health programs. The cuts to medicaid in my view that have been proposed by the other side are a guaranteed formula to make life harder for struggling families. Just contemplate madam president , having been to iowa i know of the many seniors in iowa. Seniors who rely on medicaid to cover the cost of nursing home care, that is to a great extent what the Medicaid Budget is all about. And medicaid for those frail seniors, whether its oregon or vermont or iowa, medicaid is what keeps a lot of those frail seniors from falling into absolute destitution. In another era impoverished seniors might have been thrown some into alms houses or poor farms. The Budget Proposal weve seen from the other side would inflict substantial cuts on medicaid endanger our future and i dont believe that that is the right course for frail seniors who rely on medicaid for nursing home care. And the last point i would make, madam president , i see the distinguished Ranking Member, is waiting to speak deals with the effects of repealing be the Affordable Care act. If you repeal the Affordable Care act make no mistake about it america goes back to the days when health care is for the healthy and the wealthy because no longer will you have protections for people with preexisting conditions. Now, its fine in youre healthy and fine if youre wealthy, but thats not most americans. So there are plenty of ways to improve the Affordable Care act in a bipartisan fashion. Thats not what the budget from the other side does. I hope we wont go back to today days in america when health care is for the healthy and wealthy which is the bottom line consequence of full repeal. With that, madam president , i yield the floor. Mr. Sanders madam president . The presiding officer the senator from vermont. Mr. Sanders first let me thank senator wyden for his remarks and i concur with what he said and i also want to thank him for cosponsoring the amendment on infrastructure that were going to be voting on in a few minutes. Senator wyden and i understand that you cannot be a great nation if your roads and your bridges and your Water Systems and your wastewater plants and your airports and your levees and your dams and your railroads Railroad System is crumbling. That is not what a great nation is about. Madam president , years ago the United States used to be the envy of the world in terms of infrastructure. Countries all over the world looked to the United States to say how do you do it . How do you provide clean water to your people . How do you have such an efficient Transportation System . How do you have such great roads . That is no longer the case. Today we are in 12th place and there is no denying i dont think any of my republican colleagues would deny it that in fact our infrastructure is crumbling. So we have got to address this issue. We cant kick the can down the road. We cant say well, lets wait a few years until we come up with some magical funding formula. Weve got to do it, and weve got to do it now. And the reason we have to do it now is that every year that we dlairks the problem only delay, the problem only becomes worse. We are spending billions of dollars just to maintain the status quo patching up a deteriorating system, whether it is transit system, roads bridges. We have to rebill our crumbling we have to rebuild our crumbling infrastructure. There is no disagreement on that, i believe in this senate on that. The second of all, i would hope that there is no disagreement that unemployment in this country is much too high. Real unemployment, 11 counting those who have given up looking for work and those who are working parttime. Youth unemployment, 17 . Africanamerican youth unemployment higher than that. We need a major jobs program to put millions of people back to work at decent wages and thats what rebuilding our infrastructure does. The economists tell us, you want to create jobs . The fastest way to create jobs in america is to rebuild our roads and bridges and rail system. Thats the fastest way to do it. And probably many of my republican colleagues understand that as well. Where we disagree is how you fund the project. And some on the republican side will say well, were looking at tax reform. Were looking at this, were looking at that. And maybe it will happen, but maybe it wont happen. Certainly weve not had a lot of luck on these issues in recent years. Our republican friends are not particularly interested in investments in america. Their idea of dealing with the deficit is to cut cut cut. So what we are proposing here is a 478 billion infrastructure package for six years and it is funded by something that i hope all of us can agree is unacceptable and that is at a time when corporate profits are at an alltime high, many corporations are stashing their profits in the Cayman Islands bermuda, luxembourg, tax havens around the world. And you know what theyre paying in American Income tax to the United States government . Zero. So we eliminate those loopholes. We raise substantial sums of money. We put that money into rebuilding our infrastructure, creating jobs, and making our country more efficient safer more productive. Thats what happens when you have a strong infrastructure. Madam president , i would ask americans to try to imagine what america will look like when we have some 9 million workers this proposal would create and maintain some 9 million jobs, goodpaying jobs, in all of our states people, wooing to people working to improve our roads and Water Systems try to begin competing with the rail systems of countries throughout the world. Think of what america will look like what were becoming and developing a firstrate infrastructure not a thirdrate infrastructure. I know people think this is a lot of money. It is a lot of money. But it is nowhere what the American Society of Civil Engineers are telling us that we need. So if you are interested in creating a 21st century infrastructure please vote for my amendment. If you are interested in creating and maintaining some 9 million jobs over a sixyear period please vote for my amendment. And if you are interested in ending an outrageous corporate loophole which enables in some cases, large profitable, multinational corporations to pay zero in federal income tax please vote for this amendment. It will send a powerful message that now is the time to rebuild our crumbling infrastructure and put our people to work and end absurd loopholes. And with that, madam president i would yield the floor. Mr. Wyden madam president . The presiding officer the senator from oregon. Mr. Wyden i will be very brief. I think my colleague has expressed this well, and the distinguished chairman of the committee there have been a number of discussions on infrastructure. I just come back to the fact that all americans have a stake in this amendment whether youre a commuter, whether youre an exporter, whether youre someone who lives in rural wyoming in rural oregon the presiding officer the times time has expired. The democrats time has expired. Mr. Sanders i ask unanimous consent for one more minute. The presiding officer without objection. Mr. Wyden madam president ill be very brief. I thank my colleagues for their courtesy. This amendment is about more than bumpy roads and broken axles. It is about jobs and Economic Growth in every nook and cranny. The key to that growth is infrastructure. Attracting investment depends on the condition of our infrastructure. And suffice it to say our competitors, in a tough global marketplace, are increasing their investments in infrastructure. Its time to pass this amendment and for us to do the same. I yield the floor. Mr. Enzi madam president . The presiding officer the senator from wyoming. Mr. Enzi i have to get a little upset when i hear one side say that the other side doesnt care about infrastructure. Thats not true. We even have had a colloquy just a little while ago where the two sides said we need infrastructure. I agree we need infrastructure. But im going to oppose this amendment because its telling the Tax Committee exactly what to do to provide infrastructure. So the one committee is getting into another committees jurisdiction to say exactly how to do it. Thats not right. Thats not the way we do legislation around here. Senator wyden is on the Tax Committee. He is the Ranking Member on that committee. Senator hatch is the chairman of that committee. Theyre both concerned about infrastructure. So theres already a provision in the bill that allows for this for the money to be put into place to be able to do it, but it does not tell the finance committee that they have to plug a certain tax loophole and put it into infrastructure. They can do that, and the president s budget one of the reason theres some excitement here is the president s budget on money thats held overseas by companies puts a 14 tax on that mandatory. And it expects it to be brought back right away to fund these things. Thats been a proposal thats been in the Tax Committee before not at 14 ; its been at a lower rate. Which 14 is higher than both the finance committee and the comiert acomiertcommittee youre talking about. We build in the flexibility so they can do their job and the chairman of the committee is convinced that we can do the job of fixing our infrastructure. Of course, well never fix the infrastructure as well as wed like to have it fixed. I think that the the Ranking Member on budget mentioned that we have four times as much as what his proposal is. He has a proposed for 468 billion. Theres a couple of trillion dollars worth of the need out there. Of course, we hope that we can get a lot of people involved in fixing these problems, that its not just a federal problem; it is a local and a state problem as well. And we hope everybody will participate, we can improve the infrastructure. It does work, just like keystone would put people to work. I would ask for you to vote against the bill because were telling one committee exactly where to get the money by another committee. I yield the floor and reserve the balance of our time. Dedisee madam president id yield the balance of our time to the senator from oklahoma. Mr. Inhofe madam president , . Just a few minutes well be voting. And i and while i sincerely appreciate the effort of my good friend senator sanders, i will be opposing this approach, mostly because i dont think we need to go through what i would consider to be a massive tax increase in order to do this. But let me just, for a moment, talk about the seriousness of the transportation reauthorization bill. I know this is has been talked about during the budget conversation and debate. But i think sometimes we ought to drag up that old document that hardly anyone pays any attention to anymore called the constitution. The constitution, it says specifically in article 1 section 8 that there are some things that we are supposed to be doing here, and the two major things that are mentioned in article 1 section 8 are number one defending america thats our military and the other is roads and bridges. And so i think that we are concentrating now working very hard and a minute ago i had a coquey with my friend from a colloquy with my friend from california senator boxer. Senator boxer observed that she is a proud liberal and recognized me as a proud conservative. And yet heres something we can agree on. Something we can do. Something that is very important that we take care of. Now, i wont say anything about the defense problem. We have a serious problem in our Defense System right now and thats but thats not the discussion for today. And i do believe that while we have an amendment that would address a highway reauthorization bill and how critical that is, we are working on that. The and i have to remind people that there is and i have to remind people that there is a reserve fund in chairman enzis budget that served as a place holder for chairman hatch to address a longterm highway bill later this year. If youll remember, madam president , the last bill that we had was one that was a 27month bill. Again, that was to set up this idea of having a longterm bill the last good bill we had was in 2005. And that was a fiveyear bill. And its one that was really produced very well. Problem with extensions and i think we all know that is that the extensions take about 30 off the top because shortterm extensions extensions are things that you cant do in the short term. You cant get the streamlining. I would say that we in our 27month bill, we got a lot of really good streamlineing provisions in there. You cant do that in shortterm extensions. So i look forward to having a very large bill, and we have a deadline at the end of may to make this a reality. And i think that were going to be able to do that. We are meeting on a regular basis, including meetings today with senator hatch in coming up with ways that we can pay for this. We again its our i can remember in the very beginning we used to have a problem in the Highway Trust Fund because we had too much surplus. Well its not that way anymore. We all know how we got in the mess that were in now. So were going to have to address that. The and i look forward to doing that and i look forward to doing that and providing some of the leadership right along with senator box he boxer and senator sanders in making this a reality. In knowing noon is here, i would yield the floor. I suggest the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call quorum call mr. Sanders mr. President . The presiding officer the senator from vermont. Explained i ask that the quorum call be vitiated. The presiding officer without objection. Mr. Sanders mr. President , i want to thank senator inhofe for his remarks on infrastructure and i do hope that we can all Work Together for what i would expect every member here sees as a serious problem. But this amendment says lets not kick the can down the road. Our infrastructure is crumbling. We used to be the envy of the world, today we are in 12th place. This impacts not just people who are driving cars, it impacts every business in america. We need now to start the process of rebuilding our roads and bridges and dams and levees and airports and when we do that, this amendment over a sixyear period can create and maintain nine million jobs. Nine million jobs at a time when we need decentpaying jobs. I understand the difference of opinion stemson how we get the funding for this. And hour approach is pretty simple. It eliminates an outrageous loophole that allows large profitable corporations to stash their money in tax havens around the world in some cases pay zero federal taxes. The presiding officer the senators time has expired. Mr. Sanders i ask support for this amendment. Mr. Inhofe mr. President . The presiding officer the senator from oklahoma. Mr. Inhofe ask to be recognized for one minute in opposition. The presiding officer without objection. Mr. Inhofe as i said a few minutes ago i agree with senator sanders the author of this amendment in terms of what is the problem that we have out there. We to have a defense a transportation reauthorization bill were going to have it. I know that senator sanders has characterized his bill as being paid for by closing tax loopholes, but i would still say in my opinion my analysis of this and this would equate to nearly a half trillion dollars half increase and this is not the way i want to have a defense a transportation reauthorization bill. Let me just remind you mr. President , there is a reserve fund in chairman enzis budget that serves as a placeholder for chairman hatch to address a longterm highway bill later this year. We have a deadline of may 31 and i think we can meet that deadline were working with senator hatch right now to come up with that funding. Soy i urge you to vote against the so i urge you to vote against the sanders amendment and pursue our bill. Mr. Enzi i have two unanimous consent requests. The presiding officer the senator from wyoming. Mr. Enzi i have 12 unanimous consent requests for committees to meet during todays session of the senate. They have the approval of the majority and minority leaders i ask unanimous consent these requests be agreed to and these requests be printed in the record. The presiding officer without objection. Mr. Enzi you i ask unanimous consent that the votes following the first vote in this series be ten minutes in helping. The presiding officer without objection. Under the previous order the question occurs on amendment number 323 as modified offered by the senator from vermont mr. Sanders. Mr. Sanders i ask for the yeas and nays. The presiding officer is there a sufficient second . There appears to be. The clerk will call the roll. Vote vote vote the presiding officer anyone wishing to vote or change their vote . If not the yeas are 45, the nays are 52. The amendment is not agreed to. Under the previous orders, there will be a there will be two minutes of debate equally divided prior to a vote in relation to amendment 386 offered by the senator from vermont, mr. Sanders. Mr. Sanders mr. President could we have order. The presiding officer the senate will be in order. The senator from vermont. The senate will be in order. A the senate will be in order. The senator from vermont. Mr. Sanders senator portmans amendment touches on a very serious issue that i believe has broad bipartisan support the need to deal with children who have serious chronic conditions and, in fact, over three million kids in this country have medically complex Health Conditions and senator portman appropriately is calling attention to that issue and i support him. But when you look at the overall republican budget, it throws 16 Million People off of Health Insurance by ending the Affordable Care act, and millions more through a 400 billion cut in medicaid. What happens to a pregnant woman on medicaid who needs prenatal care . No Health Insurance for her. What about a kid who is in an Automobile Accident whose family has no Health Insurance and thrown off of medicaid . No Health Insurance for that kid. What about an elderly person in a nursing home, we have millions of elderly people on medicaid in Nursing Homes. The presiding officer the senators time has fjord. Mr. Sanders please support this amendment. No cuts to medicaid for all our kids. The presiding officer the senator from wyoming. Mr. Enzi i appreciate the comments in support of the portman amendment and i want you to know im in support of the sanders amendment. Were not against pregnant women or kids that get hurt in Car Accidents or the other things. The presiding officer the senate will come to order. Mr. Enzi wed be happy to take this by voice vote. Mr. Sanders i think it would be better to do a roll call vote if thats okay. We appreciate your support mr. Chairman. Mr. Enzi i ask for the yeas and nays then. The presiding officer is there a sufficient second . There appears to be. The yeas and nays are ordered. Under the previous order the question occurs on the sanders amendment. The yeas and nays have been ordered. The clerk will call the roll. Vote vote vote the presiding officer are there any senators in the chamber wishing to vote or change their vote . If not the yeas are 94, the nays are 3. Amendment is agreed to. Under the previous order, there will be now two minutes of debate equally divided prior to a vote in relation to amendment 349, offered by the senator from ohio mr. Portman. The senator from ohio. The senate will come to order. The senate will come to order. Mr. Portman mr. President . This is a very simple amendment. Its a deficitneutral reserve fund to help the most vulnerable kids among us to have better coordinated care under medicaid. It allows Health Care Providers to deliver Health Care Services to medically complex kids through models that coordinate care between providers resulting in better care but also lower cost. Including helping with regard to a problem the presiding officer the senate will please come to order. Mr. Portman mr. President these children are complex medical conditions make up about 6 of the children who get health care under medicaid, but it is about 40 of the cost of pediatric care under medicaid. So this is an opportunity for us on a bipartisan basis i know to be able to help these kids to get the necessary care they need and actually allow the medicaid system to realize some savings through efficiencies like reduced emergency room stays hospitalization and other procedures. I urge all my colleagues to support this commonsense measure to help these vulnerable kids. Mr. Bennet mr. President . The presiding officer the senator colorado. Mr. Bennet thank you. I also rise to speak in favor of the portmanbennet amendment. This amendment is based on a bill i introduced earlier this year called the ace kids act that recognizes the critical importance of medicaid to children with severe medical conditions and highlights the need for greater coordination and integration of care across the country for 2 million children. Earlier this month i met with he everett ettinger, aen 8yearold boy who has spina bifida, a neurological disorder of the spine. It took his mom maureen two years to get him signed up under medicaid and to establish a system to coordinate all all his care. He let his mom explain to me her frustrating experience trying to coordinate the payments for her care. We need to focus on kids like everett all across this kufnlt i thank senator portman for his leadership in offering this amendment and urge my colleagues to vote yes. Thank you, mr. President. Mr. Portman mr. President , i ask for the yeas and nays. The presiding officer is there a sufficient second . There appears to be. The clerk will call the roll. Vote vote vote the presiding officer are there any senators in the chamber wishing to change their vote . If not the ayes are 96, the nays are zero the amendment is agreed to. Under the previous order the Senate Stands in recess until 2. A 15. Members finishing up the last of three votes on amendments to the 2016 republican budget resolution. They are now in recess until 2 15 eastern for their weekly party lunches. More debate and votes at 4 30 eastern here on cspan2. The house is also working on its version of the budget and a capitol Hill Reporter joins us to talk about the budget plans. John shaw joins us with market news international. Talk about the 2016 gop budget plans in the house and senate, taking them up this week. What are the main details of this plan john, and how do they differ from one another . Guest well, they are both tenyear plans that purport to balance the budget within a decade. Both plans by tom pryce in the house and mike enzi in the Senate Effective he get about 5. 5 trillion in tenyear budget savings. About half of that comes from a little less than half comes from repealing the Affordable Care act. Theres other large sums that come from unspecified savings in Entitlement Programs such as medicaid and medicare, and also theres going to be some discretionary savings. So its 5. 5 trillion over a decade. They reach balance, at least on paper. I think a lot of budget experts think there is perhaps some optimistic growth assumptions that probably will not pan out. Of course, the president will not allow his Affordable Care act to be repealed. So its a budget that republicans were determined to have a balanced budget plan and it seems driven very, very intently by reaching balance, actually a slight surplus near the end of the budget window. Budget experts, i think, are a little bit skeptical they would actually reach balance, but they do credit republicans for putting together a package that at least drives deficits down. Host and one of the main sticking points seems to be this extra funding for the department of defense and for current wars. How are they dealing with this issue in the house . Guest one of the big debates is whether they should adhere to the budget Enforcement Agreement and particularly the caps on discretionary spending, both defense and nondefense. And republicans have said they will adhere to the defense cap which is 523 billion, but theyre also using, actually House Minority whip steny hoyer called it a slush fund created to fund the wars in iraq and afghanistan. It has been used fairly ayes sir ily in the last couple of years as sort of a separate Defense Budget where they can tap into to pay for other Defense Operations outside the base budget. So the house and nat republicans use this overseas account, its called oco is the acronym. They use it pretty aggressively, about 94, 95 billion. So democrats argue this is, effectively, a second Defense Budget as it were and they say that republicans are using that while purporting to the adhere to defense caps. So they say its a hell game thats sort of its a shell game sort of disguises what theyre trying to do. Host and weve also heard the house is going to use a procedure called the queen of the hill on thursday. What is queen of the hill, and why do they need to use it . Guest well, what theyre looking to do is to have votes on six different alternatives, basically, three democratic plans, three republican plans. And theyre doing this process called queen of the hill which ive seen done a couple of times before in the early 90s i think the democrats did it a few times. It allows people to actually vote for multiple budgets, and its usually set up in such a way that the budget that the leadership wants to have pass is reserved for the end. And so what the House Republican leadership is doing is having the final vote on a budget that is very similar to the budget that was passed in the house Budget Committee last week by tom pryce, but it also will have two excuse me, 2 billion additional for defense programs. And this one is being set up for the House Republican leadership wants to have passed. The speaker has said its the version that he wants to see approved by the house. So i think the notion is it would allow people to vote on various alternatives, but structure the votes in such a way that the final vote is on the plan that the leadership wants to have prevail. Host and then in addition to the two republican plans, you mentioned some alternatives four alternatives including one from House Democrats. How does their plan differ from the gops . Guest quite substantially. The House Democrats dont even try to balance the budget. I think in the last year they still have a deficit of about 700 billion. They have some significant tax increases, they have lots of spending on investments, and they say that theyll focus their budget more to generate growth than it is to actually balance the federal budget. So this is a plan that is sort of the democratic agenda. Its, and its based on what they call the architecture of president obamas budget which was introduced in early february. Host well, john, were going to be keeping tabs on you, and if anyone wants to follow you on twitter, the hashtag is mminews and follow your reporting at mmi news market news. Com. Thank you very much for joining us. Guest thank you very much. And the house is debating the budget right now. You can watch the house on cspan. And the senate is currently in their party lunches, will return at 2 15 eastern for votes at 4 30. A portion now of todays washington journal with a republican member of the house discussing the medicare doc fix and the republican agenda. Host and we turn now to congressman and dr. Michael burgess joining us again at our table. Congressman, joining us during a week that congress is considering taking up a fix to the socalled annual medicare doc fix. First, explain the doc fix issue and the problem that youre trying to address here. Guest well john, first, thanks for having me on, and i really appreciate being able to come on and to talk to people about one of the things, its one of the biggest problems that youve never heard about which is the medicare payment formulas which turns out to be an access problem for americas seniors, patients. And, you know, i hear this all the time at my town halls. People raise their hand and say how come when you turn 65 youve got to change your doctor. Or someone moves to be closer to their grandkids after they retire and finds that theres no medical practice thats open and accepting new medicare patients and the reason that is is because since 1988 and then it got a little worse in 1997 there has been this annual episode that occurs where payments to physicians are ratcheted down. Its called the Sustainable Growth rate. Under its current envisage, one of the most important things of a bill that were going to vote on this week one of the most important things that it will do is repeal this formula once and for all and get us out from under it. The reason the formulas been so pernicious is part of the formula goes back every Year Congress comes in and says well, wait we didnt really mean that doc, were not going to cut your pay after all, were going to hold you level. But then the amount that should have been saved with that pay chut cut is actually added onto the tally at the end of the run whenever that occurs. So there is this large accumulated debt that is associated with a Sustainable Growth rate. And when people talk about weve got to pay for the doc fix thats what theyre talking about. Its not real must money its not like theres money sitting in the treasury thats earning interest and now suddenly siphoned off and added to the debt. Its actually a book keeping industry that needs to be paid. Weve already paid this money to the doctors. There is no actual money in the treasury. We need to do a bookkeeping acknowledgment that that money has, in fact, been spent. Host and this formula goes into effect at the end of this month, or april 1st i guess if congress doesnt do something. This is the last Week Congress is going to be in session before a two week recess. Your talking about this legislation, its h. R. 1470. Heres a headline about it from the wall street journal, baner in and pelosi reach across the aisle on doc fix legislation. Youre talking about repealing the Sustainable Growth rate formula. What do you replace it with . What would your legislation do . Guest well, theres actually a straightforward way to deal with this. You repeal the Sustainable Growth rate and pay people for their, for their work activities. There is a large school of thought currently i cant say that im a charter member of it, but ive warmed to the concept that, hey better than paying for volume we pay for value. So there are some changes that will occur in medicare that sort of move in that direction. But it was very important to me that in the formula or in whatever emerges in the followon from the Sustainable Growth rate is that there has to be a place for feeforservice medicine. You take a physician my age what id like to call a mature physician, and thats what they know. If you walk into a room full of 60yearold physicians, men and women who have practiced for a number of years who perhaps are at the peak of their performance and say were going to pay you by an entirely different way going forward, you will get some attenuation from the members in that room. Theyll say well, i dont want to do that. I dont want to change the way i practice. And they will leave the program which is really one of the things that has become injurious to medicare and one of the things that affects access for seniors, is you have doctors dropping out. I thought it was important to preserve a feeforservice option so that is preserved, but there are alternative Payment Methods that are now embraced in the formula. And heres the important thing you kind of allow the docs to participate in what type of practice do you have, what tube of practice do you want to continue . Type of practice do you want to continue . The other thing that happens, there are all these performance metrics that have been put in place by various congresses over the years. We actually consolidate that and theres still going to be reporting measures to be sure, and ill probably get some criticism about that this morning, but it is a consolidation of three prior reporting methods that are now consolidated into one. Host and in trying to move this legislation, theres been some efforts as we noted by democrats and Republican Leadership to move this legislation. And some other provisions included in h. R. 1470 not necessarily dealing with the Sustainable Growth rate. If you could talk through what those are to try to bring both sides onboard. Guest well, what has happened over time since the doc fix as its been come to be known, every time that comes up no one wants to vote against it because there is it makes people angry seniors and doctors. So you get the wrong kind of attention if you vote against the doc fix. Since it is a fastmoving train that comes through Congress Every year, there are things that have been attached to it. Those things are referred to by a colloquial expression the extenders. So theres a package that every year gets renewed in the postponing of the Sustainable Growth rate formula. As part of this legislation that will be on the floor of the house this week the extenders are extended for two years. So it gives them perhaps a reprieve. Congress needs to deal with those individually. That would be the correct approach, to have them every year hooked onto the doc fix has been disingenuous at best. So the extenders will be continued, but for two years time. Host and to know what some of folks those extenders are, the state childrens Health Insurance program, one of those that would be extended for guest schip is not included in the extenders, the state childrens Health Insurance program is in a different category. Obviously, that is something that was enacted in 1996. Speaker gingrich, that was one of the accomplishments of the congress that year. Schip was reauthorized, in fact, five years ago in the Affordable Care act funded until authorized until 2019, but only funded until the end of the fiscal year of 2015, so it expires at the end of this year, but not one of the extenders. As part of the arrangement for bringing the bill to the floor with bipartisan support, the extension of state childrens Health Insurance for an additional two years is included. Host were talking with congressman Michael Burgess about the doc fix. If you have questions about this effort whats happening on the floor this week, what could happen if this legislation doesnt pass this week and what happens april 1st if the sgr formula goes into effect, happy to talk through those with you. Its a complicated issue want to talk about it for the next 35 minutes. Democrats, 202748800. Republicans, 2027488001. Independents 2027488002. Before we turn to calls want to get your understanding of the numbers involved here. How much is it going to cost to implement h. R. 1470, this permanent fix to the medicare doc fix . Guest again, met me just stress the cost is let me just stress the cost is money thats already spent now being accounted for on the books. And that number had grown to an almost unbelievable number in 2012. It was up to over 380 billion. The Congressional Budget Office recalculated in early 2013, and the number came down substantially. Thats, if you will, what sort of gave new life to getting the Sustainable Growth rate repealed. Since that time it has crept back up again and now for just repealing the Sustainable Growth rate formula, that number is about 140 billion over a tenyear budget cycle. What is the cost of not doing it . The cost of not doing it is that every physicians practice starting on april 1st will have to absorb a 2123 reduction in pay in reimbursement from medicare. Now, due bear in mind that medicare is kind of a special system as far as payers in our health care system. Medicare sets their rates. They dont negotiate with doctors. They dont call a bunch of doctors into the room and

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