Service Members Home Ownership Tax Act Of 2009

Floor Speech

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Mr. DURBIN. Madam President, I thank the majority leader for designating that I should control half the time between now and 1:30.

I would like to, first, thank all the people who are here, the staff and the pages. This has been a tough session for many but tougher for many of them than some Members of the Senate because many times they have had to wait until the very last Senator of either political party has finished for the day before they go home. I was reflecting on that yesterday afternoon in the midst of one of the toughest, historic snowstorms in Washington, DC; that hundreds of staff people were waiting at their post, doing their jobs on a Saturday, in the middle of a snowstorm, when virtually every business around Washington was closing down. I wish to thank them and the pages on both sides of the aisle for their patience and commitment to this great country and this great institution.

Why are we here on Sunday? Why were we here on Saturday? Why are we going to take a vote at 1 in the morning on Monday? Good questions, and I am not sure there are satisfying answers. But there are answers. We are here because we are trying to finish health care reform. It has been a project that has been underway for almost a year now, since the President challenged us to do something, and a lot of effort has been expended on both sides of the aisle. But I will say I can speak for our side of the aisle.

Senator MAX BAUCUS came to me more than a year ago and sat down in my office to talk about health care reform. He was preparing for this battle as chairman of the Senate Finance Committee and knew he would play a central role, gathering the opinions of members of his committee and Members of the Senate.

Efforts were underway with Senator Kennedy from his remote location in Massachusetts, recuperating from surgery and from cancer therapy, trying to keep his committee on track toward health care reform. He turned over that mantle to Senator CHRISTOPHER DODD of Connecticut, who did an admirable job with the Senate Health, Education, Labor, and Pensions Committee.

They prepared for and had hearings. They entertained hundreds of amendments. In fact, I believe there were over 160 amendments that were proposed by the Republicans, and many of them were adopted in the HELP Committee.

Senator Coburn of Oklahoma filed 212 amendments during the HELP Committee markup. He offered 38 amendments to the bill. Nineteen of his amendments--half of them--were agreed to. Of those that were offered, 15 were not agreed to--all by rollcall vote. So 13 amendments offered by the Senator from Oklahoma were included in the bill that is before us today.

He has questioned whether the current procedure gives him an opportunity to offer amendments. The fact is, we are now on our 21st day of considering health care reform. Exactly 4 amendments have been offered by the Republican side of the aisle, 4 substantive amendments to change provisions in this bill of 2,000 pages--in 21 days, 4 amendments. They offered six motions to stop the debate, send the bill back to committee. They were generic motions. They did not ask for specific changes. They just take on an issue in the bill and say: Send it back to the committee and tell them to solve this problem and then bring it back to the floor at a later time. Well, that is kind of a procedural and, if I might say, political statement more than a substantive statement about a provision in the bill.

So exactly four amendments have been offered by the Republican side of the aisle that deal with substance. Some of their efforts have been in protection of the health insurance industry, particularly a program called Medicare Advantage, which was created by private health insurance companies to prove to government they could provide Medicare more cheaply.

Some did but most did not, and now we are paying up to $17 billion a year subsidizing private health insurance companies that told us at the start: We will save you money. It turns out they are costing us money--a lot of money--and many of us think it is wasteful. We would rather have that money spent on basic Medicare, making certain there is solvency in Medicare and a good, strong future.

So when you look at the state of the situation, we are now on a cloture motion to bring a close to the debate on health care reform, after almost 3
weeks and four Republican amendments--only four were offered. There never was a Republican substitute, no Republican proposal for health care reform. We have been told this might exist. We have never seen it. Of the four amendments they offered, not one was this substitute that was going to deal with the health care system. It is a promise that has not been kept. They kept saying: It is coming. Pretty soon we are just going to put this thing right in the Record. Well, it never happened. In 3 weeks, it never happened.

It is hard work to prepare a substitute. The reason this took so long and has dragged on for so long is we had to take every page of this and turn it over to the Congressional Budget Office. They sit there with their economists, pore over it and say: Well, is it going to add to the deficit or reduce the deficit? Is it going to reduce health care costs? What is the impact? It takes them some time to do that. The Republicans know if they are going to have a substitute, it will have to go through the same rigorous appraisal, and they have not done that, I think because it is hard. In fact, from their political point of view, it might be impossible to try to solve the problems facing health care in America without taking the path we have taken.

What does this bill do? The basics are obvious. First,--and this is all backed up by the Congressional Budget Office--it will reduce the cost of health care. It will make it more affordable. A health care policy for a family of four offered by an employer, on average, cost $6,000 10 years ago. Today, it costs $12,000 a year. It has doubled in 10 years, and in 8 years it will double again to $24,000. We have to slow this down or it will reach a point where more and more people will be uninsured, fewer businesses will offer health insurance, and more individuals will find themselves unable to afford the basic protections they need for themselves and their families.

So the Congressional Budget Office tells us we reduce the growth in the cost of health care, and that is a good thing. They came through with a dramatic revelation yesterday when they said this bill will reduce our deficit as well. If the cost of health care goes down, the cost of health care programs offered by government goes down. They tell us in 10 years we will save $130 billion from the deficit. That is a dramatic savings--the largest in history. But then the news got better. They said, in the second 10 years, instead of saving $650 billion from our debt and deficit, it could reach double that amount: $1.3 trillion in savings in the second 10 years.

I would say to those who give speeches day after day about our deficit, I invite you--in fact, I challenge you to come up with a bill that does this, that gives us actual savings of $130 billion in 10 years and $1.3 trillion in the next 10 years. It is hard to do. It may be impossible for some to come up with such a bill.

This bill also will extend the coverage of health insurance so 94 percent of Americans will have coverage. Madam President, 30 million Americans today who have no health insurance will have health insurance under this bill. Half of them are poor enough that they will receive Medicaid; the other half will qualify for the insurance exchanges and other tax credits to help them pay their premiums so they can have and afford health insurance.

Ninety-four percent of Americans--we have never, ever achieved a level of insured Americans that reached that number. Thirty million Americans will be receiving health insurance at the end of the day.

This bill will start giving consumers across America protections they need against abuses from health insurance companies. One of the things near and dear to my heart about this amendment, which has been criticized by some, is this amendment, which was offered yesterday, has been on the Internet, for those who are interested to read it, for 24 hours, and will continue to be available.

This amendment says that as soon as this is signed, health insurance companies across America cannot deny coverage to children, those under the age of 18, because of a preexisting condition. That means if your son or daughter is diagnosed with diabetes, juvenile diabetes, and you find it difficult to get health insurance today because of that preexisting condition, they will no longer be able to discriminate against your child and your family because of this bill. That is one thing. There are many others.

This whole notion of health insurance companies waiting until you get sick and cut you off when you need them the most, that comes to an end, under this amendment, in 6 months. So over and over again, we give consumers across America a chance to have the coverage they paid for when they need it the most. We used to call it the Patients' Bill of Rights, and it used to be bipartisan. It was Senator Kennedy and Senator McCain who brought it to us, and it failed because the health insurance companies were so politically powerful. But we have got them this time. If we can pass this bill, we finally have the protections the American people so desperately need.

There are other provisions in the bill. Right from the beginning, we provide more help to small businesses. These are businesses with 50, 25 employees and an average payroll of $50,000 an employee to $25,000 an employee or less. For each of those businesses, we say: We are going to help you buy health insurance for the owners of the business as well as for the employees. Those are the folks who are struggling and losing coverage, people such as the realtors in your hometown. Did you know one out of four realtors in America has no health insurance. I did not know it until they came to see me. Well, this gives them a hand. It gives them a tax break as a small business to provide health insurance for their people.

I am going to reserve the remainder of my time. I will tell you, we are here today. We are burning the hours off the clock to vote at 1 a.m. in the morning.

It would be more humane to the people who work here, to the Members of the Senate and their families, for us to reach a gentlemanly and gentlewomanly agreement that we will have this vote at a more reasonable time. If we have the 60 votes, which I think we have the commitments for, then we can decide how to move forward.

We have had a long, arduous, and sometimes taxing debate leading to this moment. I think it is time for a vote. The sooner we can reach that vote, the sooner the American people will know that we will either succeed or fail in bringing stability and security when it comes to their health insurance, making that health insurance more affordable, extending the reach and protection of health insurance to record levels of Americans, making sure we have health insurance reform as part of this, and at the same time, at the very same time reducing our deficit.

I reserve the remainder of our time.

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Mr. DURBIN. Mr. President, would the Senator yield for a question? I am going to be speaking at the end of this hour that has been allocated to our side, and I don't want to interrupt the Senator from Ohio but for one reason. I don't know if the Senator from Ohio heard or is aware of a statement made earlier today by our colleague from Oklahoma, Senator Coburn, who came to the floor and said:

What the American people ought to pray is that somebody can't make the vote tonight. That is what they ought to pray.

I have been trying to reach Senator Coburn because he is on a committee on which I serve and I work with him. This statement troubles me. I am trying to reach him to come back to the floor and explain exactly what he meant about a Senator not being able to make the vote tonight.

I don't know if the Senator from Ohio is familiar with this statement, but I am reaching out to Senator Coburn. I will be on the floor in the next 45 minutes, and I hope he will join me.

I thank the Senator from Ohio for yielding.

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Mr. DURBIN. Mr. President, I thank my colleague. I wish to renew my invitation to Senator Coburn to please come to the floor but do it soon before my time expires. I called his office to make sure he knew I was trying to reach him. I have spoken on the floor to alert the Republican side that I wished to ask him to explain a statement he made on the floor earlier today. The statement of Senator Coburn of Oklahoma said:

What the American people ought to pray is that somebody can't make the vote tonight. That's what they ought to pray.

I am troubled by this statement. I want to give the Senator from Oklahoma an opportunity to explain it because the simple reality is, I don't think we should be wishing misfortune on any of our Senate colleagues on either side of the aisle. I don't know if this was an innocent statement or something he now wants to clarify. But as stated, it troubles me.

It troubles me because I am afraid it reflects the situation we find ourselves in too often in the Senate, where people are literally invoking God's name in prayer for political purposes--in this case, to wish misfortune on one of our colleagues who would not be able to make our 1 a.m. scheduled rollcall. I do not wish misfortune on any of our colleagues.

Mr. BAUCUS. Will my colleague yield on that point?

Mr. DURBIN. I am happy to yield.

Mr. BAUCUS. I wish to ask my colleague, who knows the Senate procedures so very well, why are we having a 1 a.m. vote? Isn't it possible it could be a different time?

Mr. DURBIN. I thank the Senator because he is exactly right. Under the usual business of the Senate, we agree that we will do something more thoughtful and humane and a vote at an earlier time. Senator Reid has approached Senator McConnell and said we have one of our Senators, Senator Byrd of West Virginia, with significant health problems, who was been brought to the floor now early in the morning, late at night, and in a wheelchair. He looks better than ever, I might add. He is being asked to show up at 1 in the morning because we could not reach what is usual comity and gentlemanly accord on scheduling a vote.

It is unfortunate because now we face this 1 a.m. vote and with no cooperation on the other side to even change the vote for a very humane reason.

Mr. BAUCUS. The requests on this side for a vote at a reasonable hour--now it is 10 after 5 say maybe 5, 6, 7, 8 eight clock--a reasonable time, instead of 1 a.m., have been rejected by the other side?

Mr. DURBIN. Unfortunately, the Senator from Montana is correct. What the Senator from Oklahoma says is:

What the American people ought to pray is that somebody can't make the vote tonight. That's what they ought to pray.

I do not think it is appropriate to be invoking prayer to wish misfortune on a colleague. I want him to clarify that. I have invited him. I tried to reach out to him. He is my friend and I have worked with him. But this statement goes too far.

The simple reality is this. We are becoming more coarse and more divided. It is understandable we would disagree on political issues. That happens all the time. But, unfortunately, we have allowed that political disagreement to spill over into our personal relationships and friendships and that does hurt this institution.

We rely on one another on both sides of the aisle so much. I would say from the start that Senator Reid has offered the Republican side of the aisle accommodations and asked we try to do things that might help the families and individuals in the Senate, and we have not had any luck to date.

Hope springs eternal. I hope Senator Coburn can make it to the floor to explain his statement. Earlier this week, there was a prayercast involving several Senators--I did not hear it; I only heard references to it--where they were actually in a group praying for the defeat of this legislation on health care reform. It is their right to do that.

I can recall as a high school football player saying a prayer my team would win a football game. I don't know if God had any time to worry about my little football game. But when it reaches a point where we are praying, asking people to pray that Senators won't be able to answer a rollcall, I think it has crossed the line. I hope my friend and colleague from Oklahoma will come and explain exactly what he meant.

I wish the bill before us were different. I wish it had a strong public option. I wish it offered Medicare to people 55 years and older. I wish it eliminated the McCarran-Ferguson antitrust exemption for health insurance companies. Unfortunately, it does not do those things.

My disappointment over those elements should not lead me to conclude this bill is wanting or bad. The opposite is true. We have to look to the positive side of what this legislation will do.

This health care reform will extend the reach of health insurance coverage to 30 million more Americans. I see on the floor this evening my colleague from Arizona. He and I were on a television show early this morning. I am sure we got great ratings because the public can't wait to hear us, but during the course of that television show, the Senator from Arizona expressed concern that 20 million Americans would not be covered by our bill.

Interesting, isn't it? Today 50 million Americans are not insured; 50 million Americans are uninsured. This bill will provide insurance for 30 million more, meaning 94 percent of Americans will have coverage, the highest percentage in the history of our country. The Senator from Arizona says it does not go far enough to include more people.

We have waited patiently now for 21 days during the course of this debate on health care reform for the Republican plan for reforming health care. It has never been produced. Promised but never produced. I think the reason is obvious. It does not exist. Several times they have said on the floor: We have a plan, and they will wave a bill at us. When the Republicans had a chance over a 3-week period of time to offer their substitute, they never did. In fact, in over 20 days of active debate on the floor, there were exactly four Republican amendments on health care reform. Four in 20 days, 1 every 5 days. At that rate, how long would the Republicans have us stay on the floor waiting for the next amendment?

That is the reality. They offered six motions to stop the debate, remove the bill from the floor, and send it back to committee. Of course, when it came to actual substantive amendments changing sections of the bill, they would not do it. So the Republicans have come up empty. They are running on empty when it comes to health care reform which means this task of writing a bill is either beyond their pay grade or beyond their will and they like the system as it exists.

I do not. Fifty million uninsured Americans is unacceptable in this country. I think we have to reach a point where we move forward with 30 million now and then find ways to bring in the additional 20 million. Remember, when Social Security was enacted into law, with the resistance of the Republicans--they resisted it saying it is too much government--the safety net extended to widows. We extended in years that followed Social Security protection to dependents, survivors, and the disabled and we added a cost-of-living adjustment.

It was not the end of Social Security in the 1930s. In the years that followed, we built on the original bill and we will build on this original model of health care reform. The same thing is true under Medicare. Medicare as originally offered did not cover disabled people. It did not provide home health care, therapy, or prescription drugs. Over the years, we added those benefits.

I believe this is an important starting point. I also think it is important we provide insurance protection for Americans. When it comes right down to it, too many people are denied the therapies, the surgeries, the medications their doctors recommend because some clerk in an office at a health insurance company is instructed to just say no, and they say no repeatedly.

We also make sure that patients are first, even with our additional amendment guaranteeing the right of people to pick their doctor and keep their doctor. It is a patient-first approach that we are using on this bill.

We hold the health insurance companies accountable and say if they turn around and gouge the patients before they want to be part of the insurance exchange, they can be disqualified. We saw what happened with credit card reform. When the banks had their way after the passage of credit card reform and during the period before it went into law, they ran up the interest rates on credit cards. I got letters in the mail from American Express and others saying: Incidentally, because of the new Federal law, we are going to raise your interest rate on your credit card over 20 percent. We know some of these merchants, given enough time, will capitalize on that time and try to exploit that system. Our bill is going to go after them.

The medical loss ratio is an important part in the bill. I am sure the health insurance companies are not going to be happy with it. It says: Stop taking those premium dollars and turning them into administrative expenses, advertising, bonuses for CEOs' high-paid salaries. Take the money and pay for medical services for the people you insure. If you do not, if you take too much of this money for profiteering, you are going to have to rebate it to your customers. It is changing the balance, giving customers a chance when it comes to health insurance--something that is long overdue.

We extend the health care safety net in this bill. Mr. President, 1.8 million people in my home State of Illinois will have access to affordable health insurance. I have met them. They are hard-working people, small businesses, part-time employees, unemployed people--none of them has health insurance. Again, 1.8 million in my State of almost 13 million are going to have the chance to be covered.

We will have 10,000 more community health centers.

I cannot tell you what an exciting idea this is. If you visit a community health center in Arizona or Illinois, you know what I am talking about. This is a clinic in a neighborhood, usually, or small town where people can literally walk through the front door and get access to primary care physicians who will help them through their medical difficulties. They do not have to wait until they are so bad they end up in an emergency room where costs are dramatically higher. They have a doctor, a nurse, a medical professional, a dentist right there in their community. We estimate this bill will add 10,000 more community health clinics across the United States. That is going to be a dramatic change.

It also will create the opportunity for 20,000 more primary care physicians across America. If there is anything more we need, it is family care, internists who can deal with the medical needs of people before they are referred to a specialist or before their situation has deteriorated.

This bill is going to provide for all people under 133 percent of poverty--that is about $29,000 for a family of four--the security of knowing they are under Medicaid protection without health insurance costs, without health insurance premiums. We will say to those working poor people: You are going to have health insurance. We also believe that progress is going to take some time.

I recall that Senator Teddy Kennedy, who I wish were here for this great battle for which he prepared for four decades, said in his book ``True Compass'' toward the end that real reform is never over. It is not. This is a beginning. It is an important beginning. It establishes important principles.

I say to the critics, we don't expect every aspect of this bill to work perfectly. It is an imperfect product made by mere humans trying to do their best. But some of the things in this bill are going to dramatically change health care in America for the better. We are going to find ways to deliver quality care to people in a cost-effective way. We are going to change parts of our system today which, unfortunately, under this current system are out of control. The costs are out of control.

Moving coverage to an additional 30 million people, 94 percent of Americans under coverage, something no other bill from either side of the aisle has proposed, reducing our deficit--incidentally, we now have a CBO statement which makes it clear that the budget savings in the second 10 years--the first 10 years is $130 billion; the second 10 years is up to $1.3 trillion. They qualified it, but it still is the most dramatic deficit reduction bill in the history of the United States. There has never been a bill that has come before us that reduces our deficit so dramatically.

It reduces it because it works. It brings down the cost of health care. As far as Medicare is concerned, this bill will add at least 9 years of life to Medicare. Medicare, which is going to face serious financial problems in about 7 or 8 years, has a new lease on life with this bill of 9 or 10 years.

To say this saves Medicare and puts it on sound footing is a fact that has been confirmed by the Congressional Budget Office, all the speeches on the floor notwithstanding.

This bill is also going to move us forward in the whole area of looking at ways to deal with medical negligence and medical malpractice. We provide incentives and grants to States to find ways, without penalizing the true victims of medical malpractice, to reduce the incidence of lawsuits, to reduce defensive medicine. That is a conscientious and thoughtful way to approach this.

I would say, if I were to ask anyone to offer a prayer--and I don't do that very often--I would say a prayer for the 50 million uninsured Americans, folks who go to bed without peace of mind that they have health insurance for themselves and their families. I would say a prayer for those turned down by health insurance companies when their doctor says they need a certain therapy or a certain medication or a certain surgery. Those are the people I think of. I pray good fortune for them. I do not pray for misfortune for anyone in the Senate--not for any of my colleagues, not for any of my political opponents. I do not think that is appropriate use of prayer to do that.

I am sorry, as I bring this to an end, that the Senator from Oklahoma has not been able to come to the floor. I have tried now on several occasions through the cloakroom and other ways to invite him to come and explain his remarks. I am troubled when he says the American people ought to pray that somebody can't make the vote tonight. I pray for everybody. I don't pray for misfortune for anyone in the Senate. Let's have the vote. Let's have all 100 Senators here voting their conscience, voting their heart.

Mr. President, I yield the floor.

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Mr. DURBIN. Mr. President, let me first acknowledge the Senator from Connecticut, who played a critical role in not only the inspiration but the preparation of this important landmark legislation. Senator Dodd has been given some tough assignments in his career. He has been handed some of the toughest, and this was one. His Health, Education, Labor, and Pensions Committee met, I understand, 54 hours, if I am not mistaken. I think that is what he said earlier on the floor. It considered hundreds of amendments with the notion that we could create a better, more effective health care system in America. I have yet to hear anyone criticize his chairing that committee. He was evenhanded and fair. He entertained and accepted some 150 or 160 Republican amendments to this bill in an effort to try to build some bipartisan support for it. He went the extra mile with extra hearings. His committee was weary at the end, but he proved that his experience in the Senate had taught him valuable lessons about what it took to be respectful to the other side of an issue. He was not rewarded with a final vote in committee. Not a single Republican Senator would vote for the bill. It was not for any lack of effort on the part of Senator Dodd.

When this bill passes--and this bill will pass--he deserves special credit for it, and I am going to be one of the first to applaud him. He included a provision in this bill near and dear to me on congenital heart research that will save lives and will spare suffering to families across America. I will forever be indebted to him for it.

In just 4 hours, in the early morning hours of Monday, December 21, 2009, one of the most significant votes in the history of the Senate will take place. It is hard for us in the midst of this debate, after all that has come before us and all that is likely to follow, to properly put this in historical context. For those of us who were honored by the people of our State to be here at this moment in history, it is humbling to know we will be called on to cast a vote that can change a nation.

It has happened here before but only rarely. It happened 75 years ago when other Senators, in a much different era, battling through the worst depression in our Nation's modern history, were called on by a President in a wheelchair to rally and stand for the elderly of America. He asked to create Social Security, an insurance plan primarily for widows. President Franklin Roosevelt came to this Senate in this Chamber asking each and every one of the Senators to be mindful of the plight of our parents and grandparents in that time.

I can recall, in my family, it was not uncommon for grandparents to end up living in the same home as their children because after they reached the point where they could no longer work for a variety of reasons--physical, retirement, whatever it happened to be--their savings were meager and the chance of living independently was limited. So their children took them in in that spare bedroom, made them part of the family and welcomed, but understood that was the only way mom and dad were going to have the dignity they deserved in life.

Franklin Roosevelt had a different vision. He thought if workers throughout their worklife paid a little bit of money each week into a fund, they could be ensured there would be a check waiting for them at retirement that would allow them independence and dignity. He prevailed, and Senators stood up in that era of the 1930s and gave him the votes that were needed to change our Nation when it came to the way we treat the elderly.

Those on the other side of the aisle--Republicans--were skeptical. They were fearful of government; fearful of a new program. They argued we were headed down a path we would regret--echoes of many arguments we are hearing today in opposition to health care reform. When their time came later, even as recently as a few years ago, they tried to dramatically change and rewrite the Social Security Program. They called for privatizing it, saying we would be much better off if the Social Security trust fund were actually in the stock market. Thank goodness the wisdom of America rejected that idea. Within months of the suggestion, it was proven to be totally false, as life savings were lost with the recession that we now are enduring.

It is an indication of the bravery of a President, the courage of a Senate, and the fact that they rejected the pleas of those who would say: ``Do nothing. Don't touch it. Leave that problem alone.''

It was about 45 years ago when another great President had another great idea, and that idea was to create Medicare, and with the creation of Medicare to say to those same elderly: It isn't enough to give you a check to get by each month. We want to make sure you have access to doctors and hospitals when you need it. Lyndon Baines Johnson, the master of the Senate, then President, managed to engineer the passage of that legislation against critics who once again said: It is too much government. It is a program that will cost too much money. It is not needed. We shouldn't do it.

Their counsel was rejected. Medicare was created. It wasn't the Medicare we know today. It didn't reach the disabled. It didn't provide some of the basic services that many seniors now desperately need, and it didn't cover prescription drugs, but it was a start. It was a critical decision made to move forward. The same Republican Party that objected to the creation of Medicare has been critical of the program ever since. They have argued that it is wasteful, that it is doomed, that it should be allowed to wither on the vine. That was actually a quote from a leading Republican not that long ago.

They suggested there was a better way--let's privatize Medicare. They love the notion of privatizing. Get government out of the picture. They came up with this theory, with the health insurance industry, of something called Medicare Advantage. This was where those flinty-eyed entrepreneurs would teach government a lesson. They would offer the benefits of Medicare and show how to do it at a lower cost. Well, we accepted their challenge and gave them their opportunity, and what we found was: They failed. Oh, some succeeded, but by and large when the final count took place, those private insurance companies couldn't help but have the urge to maximize profits at the expense of Medicare. So now we spend about $17 billion a year out of Medicare subsidizing private health insurance under the so-called Medicare Advantage Program. The experiment has failed.

The basic idea of Medicare was proven right. It gave to our seniors something that we had promised and hoped we could deliver--longer healthier lives. It also triggered the creation of a medical health establishment across America--the building of hospitals and medical schools and more medical professionals than our Nation had ever seen--because of Medicare, because of a President, Lyndon Baines Johnson, and his courage, and because of a Senate that could rise to the challenge of passing it, despite the critics.

Well, in the early hours of Monday, December 21, 2009, our generation of the United States Senate will face our rendezvous with destiny, our opportunity to change this Nation, to make such a significant change in the way health care is delivered in America that we can say to future generations: We had our moment, and we seized it. To think that we will--with the passage of this bill in perhaps just a few days in the Senate, and a few weeks on Capitol Hill--enlarge the percentage of Americans with the security of health insurance from 83 percent to 94 percent--the highest percentage of Americans ever insured in the history of our Nation. Of 50 million uninsured Americans today, 30 million of those people will finally be able to rest at night knowing they are covered; that they have health insurance.

It will be Judy, a worker in Marion, IL, at a hotel, making $8 an hour, working 30 hours a week, $12,000 in annual wages. She is a diabetic. She has never had health insurance in her life. She goes to work every day. She is 60 years old. She will have health insurance because of this bill. She will be covered by Medicaid, and she won't have to pay for it because Judy's wages are at the low end of workers in America.

I said to her: If you had health insurance, Judy, what would you do?

She said: Senator, I have a few lumps I have been worried about a long time, and I can't afford to go to the doctor. I would go to the doctor.

Thank God she can. Thank God for a lot of others--those who have lost their jobs, who are unemployed, who have exhausted their savings, who stand to lose their homes--who will at least have the peace of mind they will have health insurance. That is going to come too.

If you have a child with a health problem, as many people do, something they call a preexisting condition, this bill will tell the health insurance companies immediately: You can no longer discriminate against that child. You can't turn down the family or that child for coverage. As someone who has been through that experience, I can't tell you what that means, to know that you have that kind of coverage; that your child, with that health care challenge, can go to the doctor they need to see and the hospital they need to be in.

When my wife and I were first married and had our first baby, I was in law school, and we had no health insurance. When our baby had a problem, I had to go to Children's Hospital here in Washington and sit in a room filled with people who had no health insurance. I took a number, and we waited for a doctor. Every time we went, it was a different one. I felt like I had let my family down. At a time when my family needed health insurance, I had not delivered. I know that feeling personally, and I know what it must mean to 50 million Americans who face it today. For 30 million of those Americans, this bill will give them the peace of mind that they have health insurance.

It also says to companies across America, we are going to change the terms of this relationship between health insurance companies and the people they insure. We are going to finally step in on the side of the consumers of America--the families of America, the ones that are so often turned down because of preexisting conditions, turned down because companies canceled their insurance when they started running into high medical bills. For the first time, these people will have legal rights created by this bill to stand up and be covered and to be confident at the end of the day that they will have the coverage they paid for their whole life.

It is an amazing thing we are considering. In the middle of it, with all these speeches and all the press releases and all the charts and all the time, it is sometimes difficult to focus on the historical impact of what we are about to do at 1 a.m. on December 21, 2009. But if we do this, and do it right; if 60 Senators step forward, as I think they will--commitments have been made--we will make history. It will be reported across America that for the first time in memory, the United States Senate has voted for comprehensive health care reform.

The critics will still be there, and they will say the same thing they did about Social Security and the same thing they did about Medicare: It is too much government. It is not going to work. We shouldn't do it.

Thank God, that counsel was rejected in the 1930s and the 1960s, and it should be rejected on December 21, 2009. We need to stand together for people who otherwise have no voice--the uninsured, many of whom have low-wage jobs, or maybe no jobs at all, and their children, who really can't afford the best lobbyist in Washington. It is time for us to lobby for them.

I know there are a lot of critics of this plan. We have heard them. They have talked about Medicare and what this will do to this bill. But we know what the professionals have told us. This comprehensive health care reform legislation will add 9 or 10 years of solvency to Medicare, put Medicare on sound financial footing. And that is exactly what we should do.

The bill has a bonus. The bonus is that, at a time when we are facing deficits and debt, which have to be taken seriously, this bill charts a path for us to start retiring that debt. The Congressional Budget Office says that over the first 10 years, $130 billion in debt will be relieved by this bill; then in the second decade of this bill's existence and changes, we are going to find up to $1.3 trillion in deficit reduction.

There has never been a bill considered on the floor of the Senate that has had that kind of impact on our Nation's debt. It is going to change life not only for uninsured families but even those with insurance. For some, it will give the luxury that we have as Members of Congress.

I think we are the luckiest people on Earth when it comes to health insurance. We team up with 8 million Federal employees and their families, and each year we have an open enrollment. If we don't like the way we are treated by our health insurance company in the previous year, we can go shopping, just like you would shop for a car or a refrigerator, and pick the right one for your family. We pick the right health insurance for our families. Every American should have that luxury, and we move toward creating that in this legislation.

It was several years ago that I teamed up with Senator Blanche Lincoln of Arkansas and Senator Olympia Snowe of Maine. We tried to create a program for small businesses in America called the SHOP Act. This program would give those small businesses the same shopping opportunities for health insurance as Members of Congress and Federal employees. I came up with an unlikely ally in the National Federation of Independent Businesses. They decided they wanted to join us.

When their lobbyist called and said he wanted to meet with me, I said: I can't wait to meet you. His organization had done everything in their power to defeat me in every election I had been in, and I wanted to see what he looked like.

He came in and sat down and said: We have to do something about health insurance for small business. We ended up creating an unlikely but powerful alliance of the National Federation of Independent Businesses, the realtors, the Service Employees International Union, Families USA--from both sides of the political spectrum--standing behind the SHOP bill.

The SHOP bill, with some changes, is now part of health care reform. It is an idea that has been endorsed, and it is one that I think is going to make a big difference for individuals. The bill also contains help for small businesses to pay for the premiums. Critics on the other side of the aisle say: Oh, the taxes go up, but the benefits don't start for years. They have missed it because initially we are going to be offering tax assistance to small businesses with 50 employees or fewer. Those who have an average payroll of $50,000 a worker are going to get a helping hand to buy health insurance not only for their workers but for the owner of the company.

I have seen this in my own life. I have friends who run a small business who have lost their health insurance because one employee's wife had a very sick baby. That is exactly what happened to my friend. They went out shopping for insurance on the open market and it was brutal. My friends were in their early sixties, and they couldn't buy insurance. Everything they could buy was loaded with exclusions and deductibles and copays.

Well, we are going to make sure that businesses have a helping hand with a tax credit, and that helping hand is going to allow them to buy good insurance that covers their employees.

Those on the other side talk about the tax increases in this bill. Let's be very blunt what they are. There is a .9 percent payroll tax increase for individuals making over $200,000 a year and families making over $250,000 a year. What it means is this: Roughly $2,000 a year for families making over $250,000 will have to be paid to make sure that Medicare is solvent and that this program is funded. That may affect some Members of Congress, with their spouses working. But I don't think it is unfair. It is a tax we should be willing to pay to solve major problems in this country.

There will be taxes on high-end health insurance policies, and it is a very controversial provision with some of my friends in organized labor.

But I hope we have hit the right number of $23,000 and I hope our escalator clause to try to keep up with inflation is a reasonable one. If it is not, we will revisit it. The only law ever written that didn't need amendment might have been the Ten Commandments, and I don't think this bill, as good as it is, will rise to that level. We are prepared to return to it if we need to, to make sure it works and works well, and we have the time to do that.

This is critical. I also know this bill is going to change--you will be able to see the change across America with the construction of community health clinics. One of our great Senators here, Bernie Sanders of Vermont, has been a clarion voice on behalf of community health clinics. He knows, as we all do, that these clinics, placed in cities and towns across America, are a lifeline to low-income people so that they have primary care at a fraction of the cost of a visit to an emergency room--good care. I have seen it. I have visited the Erie Clinic in Chicago, Alia Clinic in Chicago. These are good, clean, modern clinics, with people dedicated to health care and dentistry who are helping these people.

We envision 10,000 more community health clinics as a result of this bill, at least, and thousands of primary care physicians to be there to help. That will mean we will be creating, across America, a network of care and peace of mind for people who otherwise have few places, if any, to turn.

I think the day will come soon when this bill, after it is passed, will become evident to America in terms of what we set out to do and what we achieved. If history serves, as it has in the past, many of today's critics will not dwell on the fact that they voted no, but rather say I had some problems with it. I guess it worked out OK. They may be afraid to acknowledge that now. I think ultimately they will have to.

This is clearly an idea whose time has come, and it has come because we have a President with the courage, the political courage, to step up and make sure that we not back away. As Franklin Roosevelt did in Social Security, as Lyndon Johnson did with Medicare, Barack Obama, with health care reform, has challenged this Congress not to ignore a problem that has haunted the Presidencies of seven great men who have previously served in that office.

We need to do our historic duty in the early morning hours so that Americans across this Nation can wake up to the stories on the news that, finally, hope is on the way.

I said the other night when I was talking about this--Senator Dodd put Vicki Kennedy's Washington Post column in the Record, and I am glad he did so--that this has been called many things. It has an official name. I am going to call it ``Kennedy Care.'' I hope some others will too, because we do it because of the inspiration of a great friend, a great Senator, and a great statesman, Edward Kennedy, who I am sorry cannot be here to enjoy this historic moment. But he led us to this moment. As he said in one of his last columns he wrote about health care: We are almost there. In four hours, we will be there.

I yield the floor.

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