S6838 CONGRESSIONAL RECORD — SENATE September 24, 2013 stand and fight for the American peo- Mr. CRUZ. Mr. President, my second tions. Lord, make them this day senti- ple to stop this train wreck that is request is: nels on the walls of freedom worthy of ObamaCare. And the answer to my I ask unanimous consent that if a the power and responsibility they exer- friend’s question is: Of course not. cloture motion is filed on the under- cise. Guide and sustain them in the Small businesses all over this country lying measure, that cloture vote occur great unfinished tasks of achieving are getting hammered by ObamaCare, during Friday’s session of the Senate, peace, justice, and understanding and the real loses are not even to the notwithstanding the provisions of rule among all people and nations. small business owners. The real losers XXII. We pray in Your great Name. Amen. are the people, the teenaged kids who The PRESIDENT pro tempore. Is The PRESIDENT pro tempore. The would get hired, the single moms who there objection? majority leader. would get hired, the African Ameri- Mr. REID. Reserving the right to ob- Mr. REID. Mr. President, we all ad- cans, the Hispanics who are suddenly ject, we are going to have a cloture mire the Senator from Texas for his finding themselves without a job or are vote at 1 o’clock and any consent wanting to talk. With all due respect, I being forcibly reduced to 29 hours a agreements after that I will be happy am not sure we learned anything new. week and denied the opportunity to get to listen to them. At this stage, I ob- He had talked about it before on a to that first rung of the economic lad- ject. number of occasions—in fact, end- der, which would then get them to the The PRESIDENT pro tempore. Objec- lessly. It has been interesting to watch, second, the third, and the fourth. tion is heard. but, for lack of a better way of describ- Millions of Americans are hurting Mr. CRUZ. Well then, it appears I ing this, it has been a big waste of under ObamaCare. It is my plea to this have the floor for another 90 seconds or time. body, to the Democrats, that they lis- so, and so I simply will note for the The government is set to shut down ten to the unions that are asking on American people who have been so en- in a matter of hours. In just a few days behalf of millions of Americans who gaged that this debate is in their the government will close. And it is a are struggling to repeal ObamaCare, hands. Ultimately, all 100 Senators—all shame. We are standing here having that we not have a system where the 46 Republicans, all 54 Democrats—work rich and powerful or big corporations wasted perhaps 2 days—most of yester- for you. The pleas from the American day and a good part of today—when we and Members of Congress are treated to people—certainly those in Texas—are a different set of rules than hard- could pass what we need to pass very deafening. The frustration that the quickly and send it back to the House working Americans. President Obama United States Senate doesn’t listen to has granted illegal exemptions to big of Representatives. They are waiting the people is deafening. So I call on all for us to act. businesses and Members of Congress. I 46 Republicans to unite, to stand to- don’t think the American people It seems that in recent years, rather gether and to vote against cloture on than trying to get things done, we have should be subject to harsher rules. the bill on Friday or Saturday; other- So my plea to this body is that we a mindset in some people’s minds to wise, if we vote with the majority lead- listen to the American people, because delay and stall and try not to get any- er and with the Senate Democrats, we if we listen to our constituents, the an- thing done. I have talked about this be- will be voting to allow the majority swer is: Defund this bill that isn’t fore. I do believe that what we have leader to fund ObamaCare on a straight working, that is hurting the American here with the so-called tea party is a party-line vote of 51 partisan votes. people, that is killing jobs and forcing new effort to strike government how- The American people will understand people into part-time work, that is ever they can, to hurt government. driving up health insurance premiums that. Voting to give that power to the Any day that government is hurt is a and that is causing millions to lose or majority leader, I would suggest, is not good day for them. It is, as I said be- to fear they will lose their health in- consistent with, I believe, the heartfelt fore, the new anarchy. surance. commitment of all 46 members of this We should get this matter back to As the time is wrapping up, I will conference who oppose ObamaCare. the House of Representatives as soon close by noting that at noon we will The only path, if we are to oppose as we can. They may want to change have a prayer. I think it is fitting this ObamaCare, is to stand together and something in this, and we believe that debate conclude with prayer, because I oppose cloture. I ask my friends on the if they have to do that—I don’t think would ask that everyone in this body Democratic side of the aisle to listen to they should, but if they feel they have ask for the Lord’s guidance on how we this plea. to, get it back to us. Each hour we best listen to our constituents, listen The PRESIDENT pro tempore. Pur- waste is one less hour we will have an to the pleas for help that are coming suant to the order of February 29, 1960, opportunity to look at this. Our rules from our constituents. the hour of 12 noon having arrived, the are different from the rules in the The final thing I will do is to make Senate having been in continuous ses- House. So this has been untoward, and two unanimous consent requests I men- sion since convening yesterday, the I would hope we don’t have to waste tioned, and the majority leader may or Senate will suspend for a prayer from more time prior to sending it to the may not agree to them. The first is: the chaplain. House. I ask unanimous consent that the f Under the Senate rules, there are lots cloture vote at 1 p.m. be vitiated and PRAYER of opportunities to waste time, and that at the conclusion of my remarks The Chaplain, Dr. Barry C. Black, of- that is what we do around here now— the motion to proceed to the resolution fered the following prayer: we waste time. be agreed to. The Presiding Officer has been here The PRESIDENT pro tempore. Is Let us pray. longer than any other Senator, and he there objection? Eternal God, our refuge and strength, Mr. REID. Reserving the right to ob- may the fact that this Chamber has re- has seen how Senators have worked to- ject, my friend has had an opportunity verberated with a marathon of speak- gether over the years to get things to speak. I will speak for a longer time ing help us to remember to direct our done, not to stop things from hap- period in a few minutes about state- thoughts and words toward Your pening. ments he has made in the last several throne in continuous prayer for our Na- I haven’t been here as long as the dis- hours. But he has spoken. tion. You have challenged us to pray tinguished Presiding Officer, but I have At 1 p.m. the Senate will speak, and without ceasing, for the fervent pray- been here quite a while. I came to the we will follow the rules of the Senate. ers of the righteous avail much. Congress in 1982. I have seen the work I have said very clearly on a number of During this challenging season, give of Democrats and Republicans. I look occasions that we should be moving our Senators the wisdom to make full back with such pleasure that Senator quickly to get this to the House as and complete their commitment to Hatfield and Senator Danforth, an soon as we can. serve the American people. Equip our Episcopalian from Missouri—both Re- I object. lawmakers with the power to clearly publicans—worked to get things done. The PRESIDENT pro tempore. Objec- discern right from wrong so that integ- The late John Heinz was taken from tion is heard. rity will govern their words and ac- us far too quickly in an unfortunate

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00076 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6839 plane accident, but he was a Repub- In just 50 minutes, it will be time for released today. About the best they lican Senator who worked to accom- common sense to prevail. I still have could claim was that some premiums plish things for this country. hope that we can avoid a government would be lower than projected. Let me John Chafee. If he did now what he shutdown, but every hour we waste on say that again: Some premiums would did for me in my reelection in 1992, he this floor diminishes the hope of that. be lower than projected. Note that I would be booted out of the Republican Mr. REID. Mr. President, I ask that didn’t say ‘‘lower’’ but ‘‘lower than Party. Do you know what he did then? following Senator MCCONNELL’s re- projected.’’ Basically, this law is a He was chairman of the Environment marks, the time until 1 p.m. be equally complete mess. and Public Works Committee. I sat on divided, with the two leaders control- So Washington Democrats may have his committee. He came to me and ling the time. been able to brush the American people said: HARRY, I want you to get re- The PRESIDENT pro tempore. With- off back in 2009—just brushed them elected, and I am going to help you get out objection, it is so ordered. off—but they have no choice but to reelected. We will do some hearings in The PRESIDING OFFICER (Ms. deal with reality now. We have seen Nevada, and you are going to wind up BALDWIN). The Republican leader is how this has worked out over the last conducting those hearings. That is how recognized. 4 years. we used to work together to get things Mr. MCCONNELL. Madam President, It is hard to blame them for looking done. He liked the work I did on the I wish to start by acknowledging the back at their ObamaCare vote with a committee. He was a Republican, but work of my colleague, the junior the lot of regret. But here is the good news. he worked to get things done. He was a Senator from Texas, who held the floor Later this week the Senate will take patriot. He was a hero on the coldest for nearly a day speaking passionately up the House-passed CR. If the House- war, the Korean war. Brady’s book about an issue that unites every single passed CR passes, it will keep the gov- written about the Korean war was Republican: ObamaCare is wrong for ernment from shutting down without mostly about John Chafee. America and needs to be repealed. The increasing government spending by a It is unfortunate that so much time Senator from Texas has focused on the penny and—and—defund ObamaCare. is now spent wasted, not accomplishing dangers of this law, explaining once So for all those Democrats who anything. That is what this has been again why we are all on this side of the shanked it back in 2006, here is your about—wasting time. The American aisle committed to overturning it. opportunity for a mulligan. Here is people know. They have been called Later this week every Republican will your chance to finally get on the same upon by the junior Senator from Texas unite to vote against any amendment page with the American people because time and time again: the American to add funding for ObamaCare. the American people overwhelmingly people, the American people. I will tell This afternoon I would like to call on oppose this law, and you can’t open a you something. The American people my colleagues across the aisle to once newspaper these days without being know that every hour that he has spo- again listen to their constituents and struck by some new reason you should ken or speaks pushes us another hour actually join us in this effort. I would be opposed to it too. closer to a Republican government like to ask Senators to take their Remember, it is more than just our shutdown. minds back to Christmas Eve 2009. constituents who are opposed to I have witnessed a government shut- Some of us remember it very, very ObamaCare. Small businesses are op- down. The gross national product was well. In the early hours of the morning, posed. Even big labor bosses are sour- hammered by tens of billions of dollars the majority leader rammed through a ing on it. All we need is five Democrats quickly. We had a meeting this morn- massive 2,700-page takeover of the U.S. to show enough courage to stand ing, and Bob Rubin, former Secretary health care system against the will of against their party and with the Amer- of Treasury, talked. He said: I was the American people, against the prin- ican people on this vote. That is here, I know all about that shutdown. ciples of open and accountable govern- enough to pass the bill—enough to He said: But the world had more con- ment, and, I would argue, against their keep the government open and to keep fidence in the United States then than better judgment because the people ObamaCare funding out of it—before they do now. who voted for this bill didn’t have to this train collides with reality. With the government being ham- listen to all the speeches I was giving I urge my Democratic colleagues to mered every angle by the anarchists, back then to realize it would never, join us, the members of my conference he doesn’t know how badly we would be ever do what the President said it who are already united in our opposi- hurt with another government shut- would. But they in the end obeyed the tion to ObamaCare. Democrats, on the down. He thinks it would be worse than orders of the Washington Democratic other side of the aisle, can help us get the first one. leadership anyway, and now our friends this job done. If anyone has any doubt that there on the other side are seeing the results I yield the floor. are Republicans rooting for a shut- of their votes. The PRESIDING OFFICER. The as- down, they should just turn on the tel- ObamaCare is just as bad as many of sistant Democratic leader. evision. It is not all Republicans, and us said it would be, and it is about to Mr. DURBIN. Madam President, I we know that, but they can look at TV get a lot worse. This train is picking up came to the floor several times while and see that there are some working to speed, and there is a bridge out ahead. Senator CRUZ was speaking and ad- almost singlehandedly force us into a It is sort of like one of those Wile E. dressed questions to him about his po- shutdown because, remember, a bad Coyote cartoons, except this isn’t sition on ObamaCare. What I asked day for government is a good day for funny because these are people’s lives him about were specific provisions in the tea party. we are talking about. We are talking ObamaCare and whether he thought he We could finish this bill within a about the college graduate who is faced agreed with them. He made it very matter of hours, but instead we find with a choice between exorbitant pre- clear at the end he doesn’t want any ourselves being pushed closer and clos- miums and government tax penalties. part of ObamaCare. What he has said is er to another shutdown. I know the We are talking about the working mom basically the provision in ObamaCare majority of my Republican colleagues forced to scrape by with less hours and which says you cannot discriminate recognize this strategy for the foolish- smaller paychecks. We are talking against a person or family offering ness it is, and I am glad to see them about the small businesses that are un- health insurance if they have a pre- speak up. Two dozen have spoken say- able to grow and hire more Americans. existing condition, that provision in ing, among other things, that it is the And that is not even getting into the ObamaCare Senator CRUZ and the tea dumbest idea he had ever heard. An- concerns about glitches that could ex- party Republicans object to. other said they were being forced into pose personal information to fraud or Is there one of us alive who doesn’t a box canyon and he could see no way about Americans losing the health care have someone in their family with a out. One Senator said it was political they like and want to keep. preexisting condition—asthma, diabe- suicide. So I am glad to see them speak Even the administration is having a tes, cancer survivors, high blood pres- up for common sense. Actions speak terrible time spinning this law. Just sure, high cholesterol? Think of all louder than words. look at the cherry-picked report they those possibilities. It could be your

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The Senate health insurance policy will pay. Why has been appealing to his fellow Repub- refuses to discuss it. They do not want did we include that in the bill? Because licans to stick with him, but many of to discuss it because they do not want tomorrow morning’s diagnosis of some- them, as Senator REID said earlier, un- to enter into a legislative process that one you dearly love could mean they derstand this is not a good message for you would think would be perfectly are in for surgery or cancer therapy America. We should not be threatening sensible. The bill was passed, what, in that could cost hundreds of thousands to shut down the government over an 2009? It is now about to hammer us and of dollars and you may not have the issue. We should not be threatening the negative impacts are quite clear. It coverage if your plan does not have the when it is clear that they do not have is about to hammer us and they refuse protection of ObamaCare. Senator the votes on the floor to achieve that. to bring it to the floor. So the House CRUZ and the tea party Republicans Yet they are going to take us right to funded the U.S. Government. They sent would repeal that protection. the brink. I think it is wrong. Whether a bill to the Senate that funds the U.S. Senator STABENOW in the State of they are going to default on America’s Government except it does not fund the Michigan just held a press conference. debt for the first time in history or ObamaCare part, requiring us to con- She tells me that over 60 percent of shut down our government, it is going front this issue once again. health insurance policies in America to hurt America’s economy. We need to What does the majority say? What today do not offer maternity care, ma- create jobs and build a strong econ- does the President say? They are say- ternal benefits for the baby and moth- omy. This kind of desperation scenario ing we will shut down the government. er—over 60 percent. The ObamaCare is going to hurt businesses and it is We will never pass anything that al- provision requires every policy in going to kill jobs. That is not good for lows us—that makes changes in this America to protect new moms and America’s future. bill. We will not send back a com- their babies, every policy. Senator Let’s work together. There are ways promise. We will not agree to have to improve this bill, ObamaCare. I am CRUZ and the tea party Republicans hearings and discuss how to fix it and would repeal that provision. willing to sit down at a table any day make it better. No. Absolutely. We are Let me tell you what else it includes. in the week to explore those in a con- going to use the brute power of the ma- In ObamaCare we say if you have a structive, positive way. But simply jority party in the Senate to deny that threatening to shut down the govern- young son or daughter fresh out of col- process. I do not think that is right. lege looking for a job and they can’t ment unless ObamaCare comes to an Let me say it is not a little bitty find one or only a part-time one or one end sadly does not speak well of those matter. My friend here has the tough- that doesn’t offer benefits, you can who support it and it certainly doesn’t est job in Washington, being majority keep your son and daughter on your address the serious issues we face in leader of the Senate. I respect Senator this country. family health insurance plan up to age REID. But recently in Nevada he was I yield the floor. 26. That is peace of mind for a lot of The PRESIDING OFFICER. The Sen- asked: Do you believe in a single payer parents. My wife and I have been ator from Alabama. for health care America? And the quote through that, raising our kids. Senator Mr. SESSIONS. Madam President, we I saw was: Yes, yes, absolutely yes. CRUZ and the tea party Republicans have had, I think, a national discussion Yesterday in the Budget Committee would abolish and repeal that protec- and the American people have begun to the ranking Republican on that com- tion for family coverage. focus on what is imminent and that is mittee—one of our esteemed Demo- I will also tell you that today, across that the implementation of the cratic colleagues when this matter America, they are announcing the mar- ObamaCare legislation is going to be a came up, said: ‘‘I support single payer ketplace insurance plans under disaster. It is not prepared. As Senator system.’’ In the Budget Committee—earlier in ObamaCare. In my State it has been BAUCUS, the chairman of the Finance announced that the rates for families Committee, said: It would be a train the year Senator SANDERS said this bill for health insurance are 25 percent wreck. That is where we are headed. is not going to work. The only thing below—below—what was expected. The Democratic majority has abso- that is going to work is a single payer. What it means for many families lutely refused to allow any serious ne- Senator SANDERS, as we know, is across Illinois and across America is, gotiation, amendments, legislative re- known, at least in the past, as a Social- for the first time in their lives, there form to fix the problems with the legis- ist and has run as a Socialist. The lead- will be competition offering them lation. That is the fundamental prob- er in the House, NANCY PELOSI, has said health insurance for their families. For lem we have here. she believed in a single payer. But the first time ever. Repeatedly I asked Senator MCCONNELL recalled how President Obama, in 2003, clearly said Senator CRUZ about a friend of mine, 62 this bill was first passed by the Senate he favored a single-payer health care years old, a hard-working lady in on Christmas Eve nearly three years policy for America. What does that southern Illinois. She has worked her ago—and it was against the will of the mean? Who is that payer? I asked Sen- whole life. She is not lazy. She is try- majority of the American people. I re- ator CRUZ that. He said: Of course the ing everything she can. She never had member Senator Scott Brown in Mas- payer is the U.S. Government. What health insurance 1 day in her life and sachusetts ran against the health care they are proposing, what they desire, she is 62. This gives her a chance for to fill the vacant seat, Senator Ken- what they intend to impose on the health insurance, and I have asked nedy’s seat. He campaigned and said: American people—because they had a Senator CRUZ, would you repeal that Elect me in liberal Massachusetts and I brief shining moment, they had 60 Sen- provision? He said yes. am going to kill the health care bill. ators in this body and they rammed That to me is what the debate comes Republicans hadn’t been elected to the through a fundamental change in the down to, 50 million Americans without Senate in Massachusetts in decades— health care policy of this country—and health insurance, others with health and he won. He was prepared to kill the the American people do not want it. insurance that is not there when you legislation, providing that single vote Senator CRUZ did not waste time. Sen- need it. These are people who are look- that would deny them the 60 votes they ator CRUZ raised this issue in a way I ing to us to make sure that the mar- had to have for passage. They were able hope resonates throughout this coun- ketplace works for them and make sure to rush it through before he could take try, just how serious it is, the health that competition works for them. That office and move it in that fashion. It care question facing our country. It is is what this is about. The sad reality is had problems that could not have been fundamentally the biggest change in that Senator CRUZ and the tea party fixed otherwise and they were able to government and the size of government Republicans would rather shut down do that. we have had in decades, I guess at least

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00078 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6841 since Medicare; maybe bigger than allow it. We are going to fight it, fight fordable Care Act. We mounted an op- Medicare. And they say it is paid for. it, fight it, and we are going to demand position in 2009. Don’t worry, it is all paid for. that this legislation come back so it It is a matter of record that the Sen- The American people know this can- can be improved and made to work. It ate Finance Committee considered the not be so. How can you do all that and is not working now. It is a train wreck, Affordable Care Act over several weeks not cost money? We have a score from and it is hampering this economy. and approved the bill on October 13, the Congressional Budget Office over Allan Meltzer, the famed economist, 2009. At that time members of the Fi- the life of this bill. They have testified yesterday at the Budget Com- nance Committee submitted 564 gimmicked it up to make it look as mittee. Mr. Meltzer said he first testi- amendments, 135 amendments were though there is an advantage in the fied before Congress in 1949. He was so considered, 79 rollcall votes were short term, but it is not. Over the long good and so clear. I think he is 91 years taken, and 41 amendments were adopt- term, the Government Accountability old. There is no doubt that he is one of ed. Office told us that it is going to add at the most distinguished economists over Then the Senate Health, Education, least $6 trillion to the debt of the the last 50 years. He has written a Labor, and Pensions Committee ap- United States over the next 75 years. number of books. He said 77 percent of proved the Affordable Care Act by a That is close to how much our unstable workers being hired part time is di- vote of 13 to 10. After a month-long de- Social Security will add to the deficit rectly attributable to ObamaCare. He bate, 500 amendments were considered, of America. So we have Social Secu- said it is bringing down employment and more than 160 Republican amend- rity, we have Medicare that is even a rates. It is creating uncertainty in the ments were accepted. Then it came to larger unfunded mandate than Social economy, of which there is no doubt. I the floor of the Senate. Security over the next 75 years, and we don’t think anybody can deny that. The Affordable Care Act was on the are adding another $6 trillion to it? People are losing jobs, and they are floor for 25 straight days, including And the American people do not want working at part-time jobs, and it is weekends, between Thanksgiving and it. hammering the economy, creating un- Christmas of 2009. There were 506 This was a recent paper from the certainty, lack of growth, and it is amendments filed, 228 of which were Republican, 34 rollcall votes were held. University of Chicago economist Casey going to continue to do so, and rates Most of the rollcall votes resulted in Mulligan who found that by 2015, a lit- have gone up. party-line votes, including a motion tle over a year from now, the work dis- We can improve the current system which I had to commit the bill to the incentives in ObamaCare will have es- of health care. There is no doubt about sentially erased all gains in labor pro- Finance Committee for a rewrite. that. But I am telling you, we do not The final passage of the bill—because ductivity over the last decade. need to have a system of health care in of our insistence in exercising every We know this legislation is ham- America that is run by the U.S. Gov- mering the American economy. Do you reasonable parliamentary procedure we ernment. We do not need to do that. could—took place on Christmas Eve of not listen to colleagues? I traveled my We can all disagree about the right 2009, much to the discomfort of many State in August. I had several meetings procedures to move forward in this of my colleagues. We fought as hard as with small businesses. It just pours body. Senator CRUZ stood courageously we could in a fair and honest manner, out. Business are trying to keep their in order to highlight this issue, and it and we lost. One of the reasons we lost number of employees below 50 so they has served a valuable national purpose. was because we were in the minority. will not be impacted. They are putting I thank him for it. In democracies the majority almost al- people on part time. It is time for all of us to confront the ways governs and passes legislation. Let me say we have never seen this reality that this is not working. It is I was extremely proud of the effort in America. It has never happened to hurting America. It has to be fixed, and that we on this side of the aisle made us before in our history, in my knowl- we are going to insist on it as time to attempt to defeat what we thought edge, nothing close to it. We have had goes by. was a measure that was not good for marginal job gains since January, ham- I thank the Chair and yield the floor. America. I think it was an interesting pered fundamentally by a lot of things, The PRESIDING OFFICER. The Sen- and educational debate. but ObamaCare being one of them— ator from New York. I see my friend from Illinois is here. clearly one of them. But more dramati- Mr. SCHUMER. Madam President, I On several occasions he and I had de- cally, 77 percent of the jobs that were ask unanimous consent that the Sen- bates on the floor of the Senate, in created in this country since January ator from Arizona be given 15 minutes which, of course, I won every one. were part time, caused many ways by and that I have 5 minutes after him. The fact is this legislation was hard the ObamaCare matter. Clearly, we The PRESIDING OFFICER. Is there fought and went through the legisla- have been told repeatedly that busi- objection? tive process. I didn’t like the end of it, nesses are hiring people part time to Without objection, it is so ordered. but I am proud of the effort we made avoid the mandates of this terrible, dis- Mr. SCHUMER. Madam President, and, frankly, the other side of the aisle astrous legislation. So they have de- not 15 minutes of our time, 15 minutes allowed that debate to take place. We cided: In for a penny, in for a pound, as of their time. finally finished up on December 24, James Carville said, I guess. We are The PRESIDING OFFICER. The mi- 2009, at 7:05 a.m. So to somehow allege going to stick and we are not going to nority does not have 15 minutes. that many of us haven’t fought hard allow it to come up for improvement, Mr. REID. He can use whatever time enough does not comport with the ac- we are not going to allow it to come up he needs from us. tual action that took place on the floor for debate. The PRESIDING OFFICER. Without of the Senate. I know Republicans have all indi- objection, it is so ordered. Many of those who are in opposition cated they support a way to deal with Mr. SCHUMER. Madam President, a right now were not here at the time preexisting illnesses in America. We point of information. I am in order and did not take part in that debate, can work on that. We can do a deal, after the Senator from Arizona? and I respect that. But I would like to legislation so that young people can The PRESIDING OFFICER. That is remind them that the RECORD is very stay on parents’ policies longer. Those correct. clear that this was one of the most things are all possible. What about peo- The Senator from Arizona. hard-fought and fair, in my view, de- ple not getting jobs? What about people Mr. MCCAIN. Madam President, I bates that has taken place on the floor getting part-time jobs with no health won’t take a lot of time here on the of the Senate in the time I have been insurance? This is not a waste of time. floor. The floor has been well used over here. Write it down: This is just the begin- the last day or so. Then I would remind my colleagues ning. As John Paul Jones said: We have I would like to make sure my col- that in the 2012 election, ObamaCare, just begun to fight. leagues—especially those who were not as it is called—and I will be more po- We are not going to allow this coun- here in 2009—understand that there are lite, the ACA—was a major issue in the try to socialize medicine. That is what many of us who are opposed to campaign. I campaigned all over Amer- the goal is, and we are not going to ObamaCare, as it is called, or the Af- ica for 2 months everywhere I could,

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00079 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6842 CONGRESSIONAL RECORD — SENATE September 24, 2013 and in every single campaign rally, I that something that I think I had to Thirty hours after that, we will vote said: We have to repeal and replace respond to. on the motion to proceed and then we ObamaCare. Well, the people spoke. I do not begrudge Senator CRUZ or will talk about bringing this bill to a They spoke, much to my dismay, but any other Senator who wants to come close. Senator REID has made it clear they spoke and reelected the President and talk as long as they want or as that he wants to move this through as of United States. long as they can, depending on the quickly as possible in an orderly fash- That doesn’t mean that we give up rules of the Senate, but I do disagree ion so everyone has a chance to state our efforts to try to replace and repair strongly to allege that there are people their positions on the important issues ObamaCare, but it does mean that elec- today who are like those prior to World that are before us. tions have consequences and those War II who didn’t stand and oppose the What I feel about it is very basic. elections were clear in a significant atrocities that were taking place in First, we have a responsibility to fund majority. The majority of the Amer- Europe. this government. One of my assign- ican people supported the President of I have an open and honest disagree- ments is chairman of the Defense Ap- the United States and renewed his ment with the process of not agreeing propriations Subcommittee. It is an stewardship of this country. to move forward with legislation, awesome assignment. Almost 60 per- I don’t like it. It was not something which I agree with, that was passed cent of all of the domestic discre- that I wanted the outcome to be, but I through the House of Representatives. tionary spending of the U.S. Govern- think all of us should respect the out- Comparing that to those who were the ment goes through this one sub- come of elections which reflects the appeasers, as Senator CRUZ described committee. It funds our Department of will of the people. them, is an inappropriate place for de- Defense and our intelligence agencies. We just went through a long many- bate on the floor of the U.S. Senate. Any failure or any reduction or delay hour—I can’t call it a filibuster be- I thank my colleagues. we have in bringing this matter for- cause a filibuster is intended to delay I yield the floor. The PRESIDING OFFICER. The Sen- ward can jeopardize their important passage of legislation. There was no activities securing the safety of our doubt that there was a time certain ator from Illinois. Mr. DURBIN. Madam President, how Nation. that time on the floor would have to I see my colleague Senator SCHUMER expire. So I guess the kindest depiction much time is remaining? The PRESIDING OFFICER. There has returned. I can say is that there was an extended are 15 minutes remaining for the ma- I yield the floor. oratory that took place for many hours jority and no time remains for the mi- The PRESIDING OFFICER. The Sen- on the floor of the Senate, which is the nority. ator from New York. right of any Senator to do. I respect Mr. DURBIN. Senator SCHUMER is Mr. SCHUMER. Thank you, Madam that right, and obviously the longevity going to come to the floor shortly. As President. I thank my colleague from of the discussion was something that soon as he arrives, I will yield to him. Illinois for his courtesy and I thank was certainly admirable. But during I would like to respond to Senator the Senator from Arizona for his out- the course of that discussion conducted MCCAIN’s remarks. Senator MCCAIN’s standing remarks, as usual. by my friend from Texas, he said: father, grandfather, and son—I am sure For 21 hours, we have heard the Sen- If you go back to the 1940s, Nazi Germany. there are other family members as ator from Texas hold forth. What has Look, we saw in Britain, Neville Chamber- well—have made an extraordinary con- he accomplished? He has alienated lain, who told the British people, ‘‘Accept many of his own colleagues. He has the Nazis. Yes, they’ll dominate the con- tribution to this country, and I know he has a great deal of pride in that. I taken 21 hours unnecessarily, although tinent of Europe, but that’s not our problem. he is entitled to speak when he wants, Let’s appease them. Why? Because it can’t be am proud to count him as a friend and done. We cannot possibly stand against fellow colleague in the Senate. We have because the vote would have occurred them.’’ debated at least to a draw on several whether he said 10,000 words, 1 word or Then he went on to say: occasions, and I respect him very much no words. So as Leader REID said, this I suspect those same pundits who say it even when we disagree. We started in was not a filibuster. But, most of all, can’t be done, if it had been in the 1940s we Congress with Senator REID and Sen- he has shown the American people would have been listening to them . . . and ator MCCAIN and I together in the what he is willing to do. they would have been saying, ‘‘You cannot House in 1982. I hope his statement is We all know the Senator from Texas defeat the Germans.’’ taken for face value. We respect very has very strong views about I resoundingly reject that allegation. much all of those who have stood and ObamaCare. Fair enough. That is why That allegation, in my view, does a fought for America, and though we we have a Senate. There is a time and great disservice for those brave Ameri- may have many differences politically a place to debate them. But he, in his cans and those who stood up and said: on the floor on issues, we will never view that he is right and everyone else What is happening in Europe cannot question those who have risked and is wrong, is willing not only to hold stand. When the ship was turned back given their lives in defense of this forth on the Senate floor in a meaning- and the passengers on that ship were great Nation. less exercise, but, more important, sent directly to the gas chambers, At the risk of taking more time than urge his colleagues to hold the Amer- when Czechoslovakia fell and the I should, at the conclusion of this de- ican people hostage until everyone slaughter continued, there were many bate, we will have an important vote agrees with his view. He wants to hold who raised their voices. Then there on the floor of the Senate. It is a vote the cancer patient hostage who will were those who went to war because of on cloture on the motion to proceed. not get NIH treatments if the govern- the barbaric and great threat to civili- Basically, what it says is this: Shall we ment shuts down. He wants to throw zation and everything we stand for. proceed to consider the bill that was the construction worker out of work Amongst them were my father and sent to us by the House of Representa- who is doing a job that is federally grandfather. tives? funded and will not be funded if the I do not agree with that comparison. The bill sent to us by the House is government shuts down. He wants to I think it is wrong, and I think it is a not one I agree with. I hope we can tell the recipient of Social Security disservice to those who stood and change it. But I certainly believe it that they may not get their checks if shouted at the top of their lungs that would be a serious mistake for us not there aren’t enough people at the cen- we cannot appease and that we must to give the 60 votes necessary to pro- ters to send those checks and make act and we did act. It is a disservice to ceed to debate on this bill. That would sure they get to the right place because those who did act. literally bring us to a point where the he wants to shut down the government. I spoke to Senator CRUZ about my government faces a shutdown. I don’t The Senator from Texas has pas- dissatisfaction about his use of this want that to occur. Whatever one may sionate views. Fair enough. But when language, and he said he only intended have as a position on the Affordable the Senator from Texas thinks he is so it to be applied to pundits and not to Care Act or any other provision, I hope right that he can trample on the rights Members of the Senate. I find that a we have a resounding, positive, bipar- not only of his own colleagues who are difference without a distinction. I find tisan vote to proceed to the debate. in a bit of a tizzy about what he has

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00080 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6843 done, but, far more important, on the Without objection, it is so ordered. we can expedite this. We have a lot to needs of the American people, some- CLOTURE MOTION do. We should get there as quickly as thing is wrong. The PRESIDING OFFICER. Pursuant we can. In this country, we have always es- to rule XXII, the Chair lays before the As I have indicated before, every chewed ideologues—people who are so Senate the pending cloture motion, hour that we delay is an hour closer to sure they are right they don’t listen to which the clerk will state. shutting down the government. There anyone else, they don’t care about any- CLOTURE MOTION were all kinds of articles written today one else, and they don’t care about the We, the undersigned Senators, in accord- about the disaster of that. Closing the damage they cause as they pursue their ance with the provisions of rule XXII of the government will hurt our gross domes- goal. That seems to be what the Sen- Standing Rules of the Senate, hereby move tic product by tens of billions of dollars ator from Texas is doing. I was ap- to bring to a close debate on the motion to just like that. palled last night when he tried to make proceed to Calendar No. 195, H.J. Res. 59, a This is leading up to the real battle the analogy to World War II and Hitler. joint resolution making continuing appro- we have of raising the debt ceiling; As somebody who lost brothers in the priations for fiscal year 2014, and for other that is, to have the government pay its Holocaust, to compare the two was ab- purposes. bills which we have already incurred. Harry Reid, Barbara A. Mikulski, surd. I know my colleague from Ari- So I hope everyone would keep that in zona mentioned that as well. Carl Levin, Patrick J. Leahy, Elizabeth Warren, Charles E. Schumer, Richard mind. Again, as I said at some length I was also surprised he used the book J. Durbin, Christopher A. Coons, Chris- earlier, we have wasted enough time of ‘‘Green Eggs and Ham’’ as he read to topher Murphy, Edward J. Markey, the American people the last few his daughters, because anyone who Patty Murray, Tim Kaine, John D. months. Let’s start moving forward knows that book knows the moral of Rockefeller IV, Bill Nelson, Angus S. and get things done rather than just that book is to try something before King, Jr., Benjamin L. Cardin, Kirsten stalling, stalling. Everything is a big you condemn it. You might actually E. Gillibrand. slow walk. We have to get past that. like it. The main character in ‘‘Green The PRESIDING OFFICER. By unan- The PRESIDING OFFICER. The Sen- Eggs and Ham’’ resisted eating green imous consent, the mandatory quorum ator from Indiana. eggs and ham. Maybe if he were a Sen- call has been waived. Mr. COATS. Madam President, I cer- ator, he would speak on the floor for 21 The question is, Is it the sense of the tainly do not think we have been wast- hours. But then when he tasted green Senate that debate on the motion to ing time. We have been talking about eggs and ham, he actually liked them. proceed to H.J. Res. 59, making con- an issue that is on the minds of every Maybe as the President’s health care tinuing appropriations for fiscal year American as we are careening toward bill goes into effect, Senator CRUZ may 2014 and for other purposes, shall be implementation of the ObamaCare actually find that he and his constitu- brought to a close? health care plan. ents actually like it. The yeas and nays are mandatory We have heard from Senator CRUZ So the bottom line is very simple. under the rule. and others, and you will be hearing There is a time and a place, as the The clerk will call the roll. from all of us on the Republican side of Scriptures say. We will certainly de- The legislative clerk called the roll. the aisle as to why we object to bate ObamaCare in the 2014 elections. I The yeas and nays resulted—yeas 100, Obamacare and why we are working so would note we did in the 2012 elections nays 0, as follows: hard to open the door to repeal, to re- and not a single Democrat who voted [Rollcall Vote No. 205 Leg.] place, to correct the inequities that for ObamaCare in this Senate lost. YEAS—100 exist in this particular legislation. We Every single person who was up for of- Alexander Franken Murkowski have had discussions about this in our fice had voted for ObamaCare and was Ayotte Gillibrand Murphy caucus. We are all prepared to come not defeated, even though that issue Baldwin Graham Murray and to speak. was used against them over and over Barrasso Grassley Nelson I give Senator CRUZ credit for being again. If we want to have that debate Baucus Hagan Paul Begich Harkin first through the door. He chose to use again in 2014, fine, we welcome it. By Portman Bennet Hatch Pryor all of the 30 hours. That is his right as the way, we welcome it in 2016 as well. Blumenthal Heinrich Reed Blunt Heitkamp a Senator. He brought to the attention If the Senator from Texas wants to Reid Boozman Heller of the American people the very issue Risch have a debate on the floor of the Sen- Boxer Hirono which we are debating. I think he made ate about ObamaCare, fine. But don’t Brown Hoeven Roberts Rockefeller some very persuasive arguments. I hold—not just this body because his ex- Burr Inhofe Rubio wish to address some of those in a ercise was meaningless—don’t hold the Cantwell Isakson Cardin Johanns Sanders minute. American people hostage simply be- Carper Johnson (SD) Schatz He also said we need to start listen- Schumer cause he is so sure he is right and ev- Casey Johnson (WI) ing to the people. Listening to the peo- eryone else is wrong. Chambliss Kaine Scott Sessions ple is what all of us in the Republican Don’t hold the Social Security recipi- Chiesa King Coats Kirk Shaheen Party are doing. We have heard their ent hostage. Don’t hold the road work- Coburn Klobuchar Shelby concerns. The majority leader of the er hostage. Don’t hold the person who Cochran Landrieu Stabenow House famously said of Obamacare: depends on inspectors who inspect our Collins Leahy Tester Coons Lee ‘‘After it is passed we will learn what is food or patrol our borders hostage. De- Thune Corker Levin Toomey in it.’’ It was passed without any Re- bate ObamaCare all you want, but Cornyn Manchin Udall (CO) Crapo publican support. We have now seen please don’t threaten to shut down the Markey Udall (NM) Cruz McCain what is in it and how it is being fully Vitter government because you can’t get your Donnelly McCaskill Warner rolled out. way. Durbin McConnell I take seriously the majority leader’s I yield the floor. Enzi Menendez Warren The PRESIDING OFFICER. The ma- Feinstein Merkley Whitehouse point about moving this legislation Fischer Mikulski Wicker along, so we can get this back to the jority leader. Flake Moran Wyden Mr. REID. Madam President, I would House instead of sending it back Mon- ask if it is in order for me to ask unan- The PRESIDING OFFICER. Three- day, the day our government runs out imous consent to yield back the re- fifths of the Senators duly chosen and of money at midnight, and we can give mainder of our time and start the vote. sworn having voted in the affirmative, the two chambers the opportunity to The PRESIDING OFFICER. That the motion is agreed to. go back and forth and debate. I think would take consent. The majority leader. that is important. Mr. REID. I ask unanimous consent Mr. REID. Madam President, we now So I will shorten my remarks in that that be the case. start 30 hours. I would hope we can regard. While I was not here when Con- I renew my unanimous consent re- yield back the vast majority of that gress passed the health care law and I quest. time. I have no problem with Senators was not here when this law was written The PRESIDING OFFICER. Is there being allowed to speak under what the in the backrooms restructuring one- objection? rules are postcloture. But I would hope sixth of our entire economy, I was

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It will not of legislation that tried to take one- news, I think the stories are the same. stop ObamaCare. The Congressional sixth of our entire economy and struc- I can speak for the people of Indiana. A Research Service, at the request of ture it into a law which, as we are find- sound majority of, Hoosiers see this Senator COBURN, who will be speaking ing now, just simply is not working. bill as a disaster—a disaster for their next, has given us a nonpartisan report I have testimonials from people. I economy, a disaster for their medical that simply says the majority of the have been all over the State of Indiana. future. It is not working. funding for ObamaCare is not under During my campaign year of 2010, this We read about it every day. The ex- our control. It is mandatory. It is auto- was the biggest issue. This was the changes have not been put in place. matic. The 13 or 14 taxes in this bill issue. I visited with providers and hos- There are exemptions and waivers that don’t get stopped, so the American peo- pitals and patients and those receiving are shamelessly given by the White ple keep getting taxed for this law, and benefits in our health care system. House to people who get their ear, leav- significantly more than half of it—I I can guarantee you I would not be ing others in the lurch. There are think Senator COBURN will be able to here today if the people of Indiana promises that have been broken repeat- go into more detail on this—we can’t thought Obamacare was a good idea, edly what this law will do, what it will even affect. that this was in their best interests provide, how it won’t hurt, and how So, No. 1, whatever we do here will going forward. I have continued to there will be no negative impact. The not stop ObamaCare from moving for- travel across the State, meeting with broken promises are too long to recite. ward, which is why some of us have people, health care providers, and citi- I am keeping a collection of them. It is tried to look at, OK, what is the next zens on the street. Their messages have pages of promises of what this law step, what is the next alternative? We poured in by the hundreds every day would do. ‘‘Fabulous’’ was one of the don’t have the votes to defeat it. We during the last few weeks on this issue words. None of those promises have would need 13 Democrats to come that we are debating right now. been kept. across the aisle to support a sure veto I recently have spent the weeks back That is why we are here fighting hard by the President should 5 of our friends in Indiana talking to people about this. to address this issue, but we can’t do it decide to support us in this effort. The So it is very important that we not when we are a minority. We can’t reality is that we will need 13 Demo- just simply rush this through or waste achieve it. It is a hard truth. It is a re- crats to override a Presidential veto, time—wasting time is certainly not the ality. Without five people crossing the and I don’t think we are going to get case. I take a backseat to no one in aisle, Republicans are not going to be those. In fact, I am sure we won’t. terms of my desire to replace this bill able to go forward. In the meantime, a What does a government shutdown with something far more sensible. I government shutdown is on the verge mean? Let’s discuss this. have offered a number of proposals, of occuring. I attended a deployment ceremony which I think would be more sound, I wish to talk about shutting down about a month ago in Indiana where we sensible, cost-effective, quality, effec- the government. It hasn’t been talked sent some of our brave men and women tive health care proposals that many about here. We haven’t looked at what to Afghanistan. If we shut down the others have also put forward. To sim- the end result of a shutdown will be. government, their spouses at home will ply say there is nothing we can change, As we determine, as we work not get a paycheck. Trying to hold there is nothing we can address is to through, as we decide how to move for- down the home, maybe raising two or deny the very conclusions of many of ward tactically to achieve what we three children, paying the bills, with a our colleagues who originally voted for want to achieve, keep in mind that the husband over in Afghanistan in harm’s this legislation or who are still sup- President of the United States has not way, putting his life on the line for our porting this bill, the so-called train said: Gee, Americans, I am sorry, that defense—they don’t get paid. That is a wreck coming down the line. We have Affordable Care Act was a big mistake. consequence of a shutdown. to fix this. We have to make adjust- Give me a pen, let me sign this bill Veterans lining up for the benefits ments. We have to modify this law. that repeals this, and let’s start over. they deserve and the care they need Yet, when we get the opportunity We will work together, and we will do when they come home from the battle- where we have the opportunity to do it in a bipartisan manner this time. field are going to be standing in a long that, the door is slammed shut. It is all I haven’t heard that coming out of line waiting for their applications to be or nothing, my way or the highway as the White House, and I don’t expect to processed. someone said. hear that coming out of the White People waiting for Social Security That is the story that came from the House. I have heard exactly the oppo- checks and Medicare checks and Medi- White House. site. And I haven’t heard that message care reimbursements—even though What I wish to share—and I know my from our friends across the aisle in- those will be coming, as we have colleague from Oklahoma is going to stead we have heard exactly the oppo- learned from past shutdowns, the staff go into more detail—is how even as we site. won’t be there to process them on a have worked through this issue and The reality is that we have to deter- timely basis. had a difference of opinion in terms of mine how we would go forward. Some We have a major naval facility in In- how to best achieve this, the goal is to of us would like to take a vote. We diana. Six thousand people work at replace Obamacare. The reality we would like to put Members on record as Crane. They are doing cutting-edge have to live up to and recognize is a to whether they support funding work on electronic warfare and preven- hard truth: Republicans are a minority Obamacare. We would like that record tion of IED casualties. They are the go- here in the Senate. We are united, to be put forth to the American people, to place for commanders who need every one of us, 46—46 is short of 51, and in the next election they can de- something tomorrow. We have engi- and it takes 51 in order to make a cide whom they want to send back to neers and contractors down there with change. Congress. Do they want to send some- Ph.D.s and master’s degrees from Pur- We have seen no evidence whatsoever body back here who supports due University, Rose-Hulman, and a that any Democrat is willing to cross ObamaCare or do they want to send number of schools around the country. the aisle and join with us in trying to somebody back here who opposes I have heard from the Chief of Naval bring some constructive changes to ObamaCare? Operations, Marine Corps, Army, Air this law. We are going to need at least The reality is that we are not going Force—this is the go-to place for our five of them to cross that aisle and join to go for a year with a government armed services to fulfill a commander’s us in a vote if we are going to make a shutdown. I wish to speak a little bit request on how to save the lives of the

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When the commander be willing to consider some com- path to addressing this issue. calls in and says ‘‘I need this next promise? If we are not willing to come up with week. My guys are dying. I need a way That got my attention because I have some alternative for which we can get to stop it,’’ he will be told ‘‘Sorry, the offered a compromise. If the repeal bipartisan support in order to keep this government is shut down.’’ failed and we couldn’t get the Demo- government going so we can pay those Our defense contractors who work in crats to come across the aisle, couldn’t spouses whose husbands or wives are in those areas talked to me about how get the President to change his mind, the line of duty overseas serving this critically important it is to have this which I didn’t think we could, maybe country, how can we tell them they are capacity to save American lives, to there some options or things we could not going to get paid? You have to stay help us as we address conflicts around accomplish. on duty, you can’t come home and take the world and provide a defense for the I joined with the Congressman from another job, you can’t take off your American people. Those people will not southern Indiana, TODD YOUNG, and in- uniform. They are overseas putting be paid; they will not be at work. troduced the same bill that passed the their lives on the line. There are some major drug manufac- House of Representatives in a bipar- As ambassador to Germany, I spent turers and medical device companies in tisan vote. I introduced it here in the time at Landstuhl, the hospital in Ger- Indiana. They have products waiting to Senate. The Senate minority leader many that cares for all the wounded be approved by the FDA, lifesaving liked it. It calls for a 1-year delay in and critically wounded troops, just products, improving-health products. the individual mandate. hours after an IED has taken off their Those will not be processed if we shut The President has already said he is legs or their arms. In visiting those down. going to give employers a 1-year delay. soldiers, I can’t help but think how we I could go on and on. If he is going to give employers a 1- tell them they are not going to get I wish to add one more. The last time year delay to work out the messy de- their pay because Washington says we had a shutdown we had 10,000 Medi- tails of all of this and to try to come to that if a goal is not achieved now, that care applicants. We hear about 10,000 a better resolution—acknowledging a is it. The government is shut down. baby boomers every day. In the last failure of the bill and a failure of the So I am just asking my colleagues, shutdown the number was far less than administration to get this put into before we make a decision on this now, this, but today, because 10,000 Ameri- place how is it fair to impose it on indi- to consider those spouses at home rais- cans are retiring every day—those ap- viduals when he is giving employers a ing kids while their husband or wife is plicants in our past shutdown were all break? on the front line of duty. Better think turned away. So people who have been A lot of people are getting kicked off about those veterans coming home who paying into Medicare, people who have their employer’s insurance because of need help, who have brain injuries or been waiting to enroll when they turn the definition of a full-time worker. wounds that need to be addressed. You 65—it will all be put on a hold. A government shutdown suspends the That is another issue where amend- need to think about those people turn- hiring of local law enforcement and ments have been offered on a bipar- ing 65 and retiring and who want to border security officials. We had a tisan basis, but we will not be able to apply now for Medicare because their great debate, a long debate, a conten- discuss it. company has dropped them. You need tious debate, and an important debate This 1-year delay for individuals will to think about those individuals out about how we need to tighten our bor- give us an opportunity to vet and work there who will be mandated while em- der and get more agents on the border through these important issues. This ployers get a break. You need to think to deal with our immigration problem. compromise is the next best thing be- about all the consequences here before That will all be suspended. cause we can’t achieve the best thing, we rush to some kind of false judgment Before we rush to judgment on how which would be defunding. that a shutdown isn’t going to really we ought to go forward, I would sug- If it turns out that we can’t fund affect us. It is. The President is not gest that we think about this. I would Obamacare, at some point we are going going to take the microphone and say: suggest that we think about the fact to have to look at some type of com- Folks, I am so sorry. I am so sorry I that whatever we do here doesn’t stop promise. I think, Senator PAUL asked a brought this health care law forward. Obamacare implementation. Whatever legitimate question. Shouldn’t we be This thing isn’t working. I am hearing decision we make has consequences. looking at some type of compromise it, too, I am hearing it back home. So, We do need to fund this government, that keeps this issue alive, gives us a yes, let’s reopen the government and and we know we are not going to shut chance to continue to debate this law repeal and replace the health care law. down this government for the next 3 and other attempts to change, modify, I wish he would, but we know he won’t years and 4 months until we get a new reform, repeal, replace, whatever, and say that. President, so something has to give. ultimately put it in front of the Amer- I am asking my colleagues to weigh I didn’t sleep through Senator CRUZ’s ican people in 2014 and say: Where do all these things before we come to a 30-hour discussion. First, I commend you want to go with this? final conclusion on this and let us not him for bringing the issue up here and Well, people say we did this in 2012. be lured into the seduction of saying his passion about it. This isn’t a ques- In 2012 much of Obamacare had not this vote will determine whether or not tion of whether we are for or against, been implemented. People didn’t un- we will ever be able to deal with this this is a question of tactics, how we derstand what was in it. There is still Obamacare issue. And this is not even can best achieve our goal. I paid atten- great confusion about this law, but we a substantive vote. It is not even a vote tion. I wasn’t here because obviously are learning more every day. By 2014— on the issue itself. It is simply a vote he was going to hold the floor for the now that this is being implemented, we on moving forward to debate. It is full 30-hour time. This is why I am are learning a lot. What we have nearly impossible to explain our proce- speaking now instead of yesterday or learned we don’t like. It is even worse dural motions around here But this last evening. All I could have done last than we thought, worse than our worst isn’t an up-or-down vote on evening was ask a question. I tuned in. nightmares. ObamaCare, this is a procedural vote. I didn’t hear everything. I did get some The American people will have a I know Senator CRUZ would like to sleep last night, but I listened to a fair chance to decide at the poll whether turn it into ‘‘the vote’’ in order to pre- part of what he said. they want to continue going forward vent something else from happening. I One of the things that caught my at- with ObamaCare or whether they want personally think that is a tactic that tention was when Senator RAND PAUL something different. won’t work, but we share the same

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00083 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6846 CONGRESSIONAL RECORD — SENATE September 24, 2013 goal. I am not criticizing Senator get furloughed and not paid, as well as Affordable Care Act, because repealing CRUZ. He has energized people, he has cyber security professionals, aviation or defunding it would mean millions of brought this issue forward, and I sup- mechanics, and I mentioned army Americans who will be able to access port that. But let’s think about the end nurses. affordable care through health insur- game and let’s think about what may We won’t take new applications for ance exchanges would lose that ability. or may not be accomplished by our de- Medicare as people become eligible for It will mean that nearly 7 million cisions and let’s make sure we weigh Medicare. In 1996, 10,000 seniors a day young adults would lose coverage they the consequences of our next action who were becoming eligible for Medi- have been able to gain through their and its impact on the American people. care were turned away every day dur- family’s insurance policies. It would I yield the floor. ing the government shutdown. There mean seniors would be stripped of The PRESIDING OFFICER. The Sen- will be 2.4 million Federal workers who Medicare coverage for certain preven- ator from Virginia. won’t get paid in a government shut- tive care, and also Medicare coverage Mr. KAINE. Madam President, I also down, hurting their families. Many of to reduce prescription drug costs. It rise to speak on the continuing resolu- those get furloughed, so whether it is would mean small businesses will lose tion. We are coming up on the 150th an- meat inspectors or cancer researchers tax credits they can access if they in- niversary of the most famous speech or folks who are negotiating trade sure their employees. And this is a per- ever given in America, the Gettysburg deals to improve the economy, they sonal one to me—I have experienced Address, delivered by Abraham Lincoln will not be able to do the work the Na- this in my family—that people with a in Gettysburg, PA, in November of 1863. tion needs them to do. health history will once again be free In that address, President Abraham And private businesses, such as the to be turned away by insurance compa- Lincoln, the founder of the modern Re- Newport News Shipyard, the manufac- nies because they have a preexisting publican Party, talked about the mean- turers of the most sophisticated manu- health condition. Consumers who are ing of the battle and stated that all factured items on Earth find that their getting rebates from insurance compa- Americans should resolve that ‘‘gov- contracts are put in question and their nies who overcharge them will stop ernment of the people, by the people employees are, therefore, put at risk. getting rebate checks. In the States and for the people shall not perish from A shutdown is a huge blow to our that have decided to embrace the Med- the earth.’’ economy and jobs. Make no mistake, icaid expansion of the Affordable Care That is what we are debating today. these economic consequences of a shut- Act, an estimated 5 million people who Should the American government be down are negative. Yesterday the are now on the verge of being insured defunded and shut down? Should our Budget Committee held a hearing. We will have that protection taken away government perish? The answer to this had both majority and minority wit- from them. question is easy and obvious: Of course nesses—economists. I asked each of So for all those reasons I oppose re- not. Of course not. them: Would a government shutdown peal. If a shutdown threat to the American under current circumstances hurt the Last year, I told my voters in Vir- government were external, because of economy? They all answered: Yes. I ginia that I opposed efforts to repeal an act perpetrated by an enemy or an- asked them: Is even the threat of a the Affordable Care Act, and I had an thrax put in the mail and sent to us, shutdown harmful to the economy? opponent who pledged to repeal the Af- the American people would rally with They all answered: Yes. fordable Care Act. The voters heard every ounce of their energy to battle And furthermore, the economic con- both of those positions and they re- against a government shutdown. That sequences of a shutdown are even mag- jected repeal and they embraced to is what is so amazing. There is a pro- nified by the economic consequences of keeping it in place and improving it. posal on the table by a faction of Con- a potential default on America’s debt. Last year, the President of the gress themselves to shut the govern- Some are threatening default on Amer- United States campaigned on con- ment down. Not an external enemy but ica’s debt if we don’t defund tinuing the Affordable Care Act and a proposal by Members of Congress, a ObamaCare. This is also economically being open to improvements. He cam- faction in both Houses, to shut the gov- irresponsible—not paying our bills for paigned against someone who said it ernment down. the first time in 237 years as a Nation. should be repealed or defunded, and the Last night on the floor of the Senate, America paid its bills when Wash- American public, by a large majority, I presided and then I took to my feet ington was burning during the War of said we don’t want repeal, we want to and asked the Senator from Texas a 1812. America paid its bills during the continue forward and to reform and im- basic question: Will you vote against Civil War. The entire world knows they prove. the funding and continuation of gov- can bank on the full faith and credit of The American public does not want ernment if you do not get your wish on the United States. Our Constitution repeal. The American public does not the defunding of ObamaCare? And his says that the validity of public debt of want defunding. The American public answer was very simple: Yes. Yes. In the United States shall not be ques- does not want default. The American his view, and in the view of others who tioned. public does not want shutdown. They support this position, after 237 years of Those who threaten to repudiate our are open to reform and improvement. our national life, if you do not get your fiscal obligations or to shut down our Let me be clear: We should be open to way on one issue that is important to government are engaging in economi- reforming and improving the Afford- you, it is acceptable to shut down the cally destructive behavior. able Care Act or any other part of our American government. It is painfully obvious we should not health care delivery system or any Needless to say—and the Senator shut down government, that we should other thing we do as government. We from Indiana did a good job of saying not default on our fiscal obligations. need to be open to reform and improve- it—the consequences of shutdown are So why are we even having a discussion ment. severe. The 26 days of shutdown in 1995 about shutdown and default? What has The Senator from Indiana was wrong and 1996 cost taxpayers $1.4 billion by brought us to a place where these un- in one particular thing. Many in this the estimate of the Congressional thinkable actions are being discussed Chamber, including Democrats, have Budget Office. and even promoted by some in both already voted for ACA reforms as part As Senator COATS mentioned, our Ac- Houses of Congress? Simple. Some of the budget we passed in March. But tive-duty military are required to stay Members of both Houses are opposed to the minority party has stopped us from on duty, but they do not get paid. the Affordable Care Act. They are com- putting that budget into a conference Their paychecks get delayed and then mitted to repealing it or defunding it now for more than 6 months. There is a we have to come back and try to figure at all cost, even accepting a govern- significant group of people in this body out a way to pay them late. They and ment shutdown or default on the debt who would love to talk about reform their families don’t deserve that treat- of this Nation. and improvements but who reject shut- ment. What do we say to those who hold down and default. Many civilians working in our mili- that view? First, to be plain, I oppose This gets to the nub of the issue. tary, army nurses, for example, might those who want to defund or repeal the Last night I asked the Senator from

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00084 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6847 Texas about reforms he was interested not perish—not for 1 year, not for 1 now. Except they have a staph infec- in, and he laid a number of them out on month, not for 1 week, not for 1 day, tion in their knee, a methicillin-resist- the floor. He had some I liked and some not for 1 hour, not for 1 minute. Gov- ant staph infection in that knee. But I thought were good. I asked the Sen- ernment shall not perish on this Earth. because we don’t listen to all the facts ator: Have you prepared any legislation Mr. President, I yield the floor. and we didn’t do all the studies, they to make these reforms? And he an- The PRESIDING OFFICER (Mr. don’t recognize that that staph infec- swered: I don’t currently have a reform HEINRICH). The Senator from Okla- tion has already infected the heart proposal but I am going to work with homa. valve. my staff to come up with some reform Mr. COBURN. Mr. President, I have The knee is what is red and hot and ideas. spent a lot of time in the last few what they are complaining about, but This gets to the nub of the issue. weeks and listening last night to the the good physician will do the tests, There is a right way to approach Senator from Texas make a big point the studies, the listening, and the exam health reform. Though I disagree with that Members of Congress in his opin- and find out what the real problem is. it, there is also a right way to ap- ion were not listening to the American The staph infection in the knee came proach a repeal of the Affordable Care people. I have a lot of experience lis- from the staph infection in the heart. Act or defunding the Affordable Care tening. As a physician that is what I If you don’t go after treating the heart Act. Here is what you do: If you have a got paid to do. of the problem, it doesn’t matter if you better idea, introduce a health reform I think the motives of Senator CRUZ cure the knee; the patient is going to bill with your own ideas and try to and some of his allies in the Senate are be dead. convince your legislative colleagues pure. Their tactics are tremendously That is what we have had put upon us that you have a better answer or par- erroneous, in my opinion, but I want to by some of my colleagues. They have ticipate in debate about the budget or draw a picture for you in a minute been misdirected in terms of what the about an appropriations bill and make about this idea of listening and what it real problems are. your argument about the appropriate means. I would say nobody fought harder level of funding for the Affordable Care Even though I disagree with their against the Affordable Care Act as a Act. tactics, I admire their spirit and their practicing physician than I did. I was The Senator from Texas and every vigor. Having delivered 4,000 babies, I still practicing, being a Senator at that legislator has the ability to raise what- have had a lot of sleepless nights. I time. I was still delivering babies on ever reforms or whatever funding or have gone 2 or 3 days with 2 or 3 hours the weekends in Oklahoma. defunding ideas they want in these of sleep over that period of time to care Senator MCCAIN said it was a fair ways. Make your case, argue your posi- for people. process. It wasn’t a fair process. The tion, try to convince your colleagues, But I would make this point: As a one bill that actually would have and then accept the outcome. But do physician, the first thing you are solved our health care problems never not threaten to shut down the govern- taught in medical school is to listen to got a vote on the floor of the Senate. It ment of the United States if you don’t your patient and they will you what is is called the Patient’s Choice Act. The get your way, if you are not able to wrong with them. So we do have to majority leader wouldn’t allow a vote convince your colleagues that you have spend time listening to our constitu- on that amendment. It was a complete a better answer. Do not threaten to de- encies. substitute. It actually fixed the real fault on America’s fiscal obligations if But doctors don’t just listen to the problems, and did so without putting you don’t get your way, if you can’t patient. They observe the patient, they the government between you and your convince your colleagues that you have examine the patient, they do tests on doctor. But let me go back. a better answer. the patient, and then can combine all What Senator REID, the majority There is absolutely no reason to jam that listening with all the other data leader, has said is right. What is the your plan to overturn a law passed by they have collected, and then they Affordable Care Act about? It is about Congress, signed by the President, and make a decision about giving advice to ultimately getting to a single-payer affirmed by the Supreme Court, into that patient. They give what is called system where the government controls the very gears of the American govern- informed consent. all of health care. So Senator CRUZ and ment. Do not let your opinion on one That is the big story that hasn’t been Senator LEE aren’t wrong about wor- issue threaten not only government op- told to the thousands and thousands of rying about it, aren’t wrong about erations but the economy of the United people from Oklahoma who have called wanting to change it. But we have a States. my office. They haven’t been given in- whole lot bigger problems than the Af- In other words, let’s talk about re- formed consent. They have been sold a fordable Care Act. It is just one of form. Let’s talk about improvements. bill of goods. When I have young in- them. Let’s do it the right way, not the terns and young staff in my office tak- I want to spend a little bit of time wrong way. Let’s separate those discus- ing significant calls from people who talking about what this debate has sions out from all the threats of shut- have been misled, there is no way you taken our attention away from. The down or default. If we are willing to do are going to talk them out of a posi- real problem in our country right now that, I think we will be able to get tion that outside interest groups and a is that we are bankrupt. Our total un- somewhere. small number of people inside the Sen- funded obligations of the Federal Gov- To conclude, I want to go back to ate have planted. So I want to spend a ernment are $124 trillion. The entire where I started. I ask my Senate col- few minutes addressing this. Then I net worth of the entire country is only leagues, avoid all the brinkmanship want to go back to the patient for a $94 trillion. We are $30 trillion in the and promptly approve a continuing res- minute, because in my broad experi- hole and growing that hole. What that olution to fund the continuation of ence of treating everything from new- means is we are leaving a legacy of American government. Strip away the born babies to grandmas to broken pauperism and debtor’s prison to our separate issues that should be debated bones to gall bladders to you name it, children and our grandchildren. and considered separately, and let the I have gained a little bit of experience So while we have had this big debate, House vote on the simple question of on how you judge inputs of informa- nobody is focused on the fact that whether they believe that American tion. Washington is still lying about the government, after 237 years, shall con- What we have had outlined—and I numbers up here, including the bill tinue. We have come far, we have want those people who call my office to that came across from the House. I am achieved so much, and we have much listen to this. What we have had out- going to spend a little bit of time going work still to do. lined is a group of people who said through that so we can refocus on the Government by, of, and for the people somebody has a terribly swollen knee, infected heart instead of looking at the is not perfect and it will never be per- and if you don’t fix it they are not infected knee. fect. But I am resolved—and I hope all going to be able to walk, and that we I am very glad they have raised the my colleagues are resolved—that gov- have got to fix it right now. Nothing issue. The problem is we are double- ernment by, of, and for the people shall else matters. We have to fix it right minded and double-speaking when we

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00085 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6848 CONGRESSIONAL RECORD — SENATE September 24, 2013 talk about the numbers. Let me show You can say—as NANCY PELOSI, the lion a year. We have 21 homeless pro- this for a minute. minority leader in the other party, has grams, 7 different agencies, 2.9 billion. Congress, the President, the House, said—there is not anything else left to We have transportation services for and the Senate voted for the Budget cut in discretionary spending. Of transportation of disadvantaged per- Control Act. We made a promise. We course, that belies the fact that the sons, 80 different programs in 8 dif- said we recognize we have some prob- Government Accountability Office has ferent agencies spending $2 billion a lems. The first thing we can do is we listed 165 different sets of duplicative year. Job training and employment, we can start addressing some of those spending, wasteful duplicative spend- have 47 job training programs for the problems through discretionary spend- ing—that is $250 billion a year—that if nondisabled. We have 6 veteran job ing. You had all of these claims that the Congress would do its job you could training programs and we have over 50 we made all these savings, over $2 tril- save half of that. So instead of doing job training programs for the disabled, lion. Well, here are the real numbers. this, we can be doing this. spending $18 billion for the nondisabled The real numbers are, in 2011, the base What does that mean? That means and a total of $21 billion combined. discretionary spending was $1.062 tril- your children have a brighter future. What we did as the oversight in the lion. By the time you add up the emer- That means we don’t waste money. We State of Oklahoma was to look at that. gency spending, the troops, spending clean up the fraud and corruption in What GAO says on this particular one for the war, we spent $1.221 trillion. In the Federal Government. That is what is all of these programs overlap one an- 2012, as we worked this Budget Control it means. other except for three. They all do the Act through, the base spending was There are points of order that can be same thing, except there is no metrics $1.043 trillion. Real spending, when you raised against this bill and I am hope- on any of them to see if they are actu- add in everything else that was spent ful we will do it because we violate the ally giving somebody a family-stabi- through emergencies and everything Budget Control Act. If 60 Senators lizing, long-term job or the skills for a else, we spent $1.198 trillion. This is the want to say we don’t care what we long-term job. discretionary spending. In 2013 through promised you before, we have to spend We have 82 different teacher quality the Budget Control Act, the base ac- more money, then they will vote. They programs run by 10 different agencies cording to that was $988 billion. With have to have 60-plus votes to waive not at the Department of Education all the extra things we allowed, emer- that budget point of order. I predict that we are spending $4 billion a year gency spending, war spending, et they probably will because we cannot on. Food safety, military and veterans cetera, we spent $1.145 trillion. help ourselves. I will not, but we are health, economic development, 80 dif- According to the CBO, reading what going to spend more money than what ferent programs, $6.5 billion a year. the law is and the promise to the we just last year promised the Amer- I can go on. I will not. I will not bore American people, this next year it is ican people we would do. you. There are two other pages, 165 sets supposed to be $967 billion. If you add Of course, that doesn’t address any of of different duplication, over $250 bil- what is expected in war and discre- the real problems that are facing our lion, and here is what Congress has tionary spending through emergencies, country, which are the mandatory pro- done. We have addressed 8 percent of it. it is to be $1.114 trillion. grams. I want to give just a short fla- There have been hearings. That doesn’t So what have we done? By forcing a vor of some of the programs. I will just mean we have had an answer for it. We discussion about the wasteful spending, take green buildings, for example. have addressed 8 percent of them. we have set us on a path to slowly ac- I ask unanimous consent to use an When we look at the activity of Con- tually cut actual discretionary spend- oversized chart on the floor. gress, of doing real oversight to solve ing, something we are going to have to The PRESIDING OFFICER. Without the problems, to truly eliminate dupli- do if we are not going to have our kids objection, it is so ordered. cation, to truly eliminate fraud, to in debtor’s prison. Mr. COBURN. If you just look at this, What is the bill we have coming over nobody in their right mind would cre- truly eliminate waste, most Members here? The bill we have coming over ate this. But of course Congress is not of Congress are not interested in doing here is $985 billion. So it is $18 billion in its right mind. We would not have a that. They do not get the glory, but it bigger than what we promised you just $750 billion deficit if we were in our is our oath, it is our responsibility to last year. Besides that, it is even $18 right mind. Here it is for all the green do that. Yet we fail to do it. billion higher because we have got fake building programs in the country. I heard the Senator from Virginia pay-fors in there, so it is actually $18 We have in this different depart- mention the debt limit. I am going to billion higher than that and something ments that are running a multitude of say again something I said in 2009. We we call CHIMPS, where we assume programs that all do the same. A co- do not have an income problem in this something that we have assumed the gent person would say if it is good to government, we have a spending prob- year before but didn’t count it the year have green building programs, why lem. Do you realize the average Amer- before and will count it again this don’t we have one? Why don’t we cre- ican spends one-quarter of their life year. It is the type of accounting that ate a czar of green building programs, working to fund the Federal Govern- anybody in a publicly-held company in put him in charge, and let’s have one ment. Think about that for a minute. this country would go to jail for. They set of grants, one set of incentives and You are going to spend one-quarter of would be convicted and go to jail. But one bureaucracy that runs it. But we your life working to fund it, if you what we agreed to in the Budget Con- have not done that. count the unfunded liabilities that we trol Act is 2014 would be the last year Let me just go through, for a mo- have and count the 25 percent of GDP of discretionary cuts; then every year ment, this series of duplications that where we are on spending today, you after that it would rise by 2.5 percent, the Government Accountability Office are going to spend one-quarter of your i.e., the estimated rate of inflation, and has outlined and just see if you think life funding that. that we could change the mix and we we are doing our job. See if you think If I remember correctly, and if I read could get there. But we are not doing we are doing the oversight we should the Constitution correctly, this little that. be doing. book, what our Founders talked about Just to show, the spending is still Here is the first group. We have 15 was limited government, not a govern- going to rise. The discretionary spend- unmanned aerial aircraft programs, of ment that consumes 25 percent of your ing is still going to rise. Here it is in which we are going to spend $37 billion labor to run it, not a government that terms of baseline and actual, and you over the next 5 years. Why do we have ignores the 10th Amendment or ignores can see we are not cutting spending 15? Maybe we need one for each branch the enumerated powers. anymore after this year. It is going up. of the service and they could sub- I introduced the Enumerated Powers Which begs the question: What are contract what they deliver to Home- Act. It is a simple act. It has 37 cospon- we doing with this continuing resolu- land Security if we need those for sors. What it says is, before you intro- tion? We are breaking our word that we homeland security or for the intel- duce a bill on the floor of the Senate, gave you last year and the year before. ligence agencies. Why do we have 15? you have to reference the area of the We can’t help ourselves. We are ad- We have 18 different food programs Constitution that gives you the au- dicted. running through 23 agencies at $26 bil- thority to legislate in that area. Sad to

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Our ership that does anything except point do you actually believe what the Con- Government is limited only to the ex- out what is wrong with the other side. stitution says about a limited role for tent to which it can borrow right now. What we need is leadership that Federal Government? Do we vote to en- We have tons of structural deficits in brings us together, that compromises, sure that the 10th Amendment that our our economy today. We have a job def- that works to identify and solve the Founders added is brought up-to-date icit in terms of creating jobs. We have problems. and is revered? Unfortunately, that is a skills deficit in terms of matching The second question I think ought to hardly ever a concern in the Senate. the skills to the jobs that are avail- be asked is: Are you more interested in I have been here over 9 years. We able. We have a demand deficit because the short-term political game as a leg- don’t worry about the enumerated pow- of the overbearing overreach of the islator than you are the long-term ers. We want to fix those, and in our Federal Government and the regula- problems of this country? I am a term- good desire to fix things, we trample tion that is imposed upon the citi- limited Senator. I set my term limit the Constitution. So now we are $17 zenry. We have a deficit of watching when I first ran. I have a little over 3 trillion in debt. We have $124 trillion in out for those who cannot watch out for years to go. I will never run for an- unfunded liabilities, and that is grow- themselves. other office the rest of my life. I would ing every day. We have programs that are supposed like to think that most of my thought So the one thing this debate we have to do it, but when you go back and read has been about long term since I have had the last few days in the Senate has our Founders’ vision and read the Fed- been in the Senate, not short term—of caused us to not focus on is the very eralist Papers and read what this most actually solving problems, the long- thing that is the real problem facing wonderful government that was ever term problems, not the short-term this country, which is ineffective lead- created was designed to do, first and problems. ership. It is fixing the wrong problem. foremost it was designed to be limited I talked about our structural deficit. It is the heart, not the knee. It is the because our Founders knew that when We have to get after it. We have to get heart that is infected, and we have to it became 25 percent of your labor, after it now. If you look at the polit- address fixing the heart before we can your liberty was diminished, your free- ical dynamic, right now is the only ever hope to cure the knee. dom was diminished. Of course, that ul- time between now and the next Presi- I thank the Presiding Officer for his timately is what the fight is over, the patience, and I thank the Senator from dential election that it will be positive Affordable Care Act—what will it ulti- Missouri for his patience. We don’t for Republicans and Democrats to join mately cost and how much freedom have one problem in front of this Na- hands together to solve the problems of will you have when we give you some- tion we can’t fix. If we restored con- Medicare, Social Security, Medicaid, thing that some need, what will you fidence, we would be growing at 4 per- and our structural deficit. We have less give up when you receive that. cent a year right now. If people had the than 31⁄2 months to come to an agree- I will end with just the following. I hope that we were going to do what is ment to do that because the political think there are four questions the right, not what is expedient, and in the dynamics will never allow that to hap- American people ought to be asking best long-term interests for all of us— pen until after the next Presidential Members of Congress right now. There not me as a Republican and not just are four critical questions. I think too election because everybody will be Democrats—and we had that kind of often we fail in answering these ques- pointing fingers. leadership, we could get out of our Wouldn’t it be nice if we had the tions. Here they are. funk, we could get out of our debt, and leadership that saw Republicans and Are you leading in such a way as to we would be the America we had when Democrats come together, com- restore confidence in ourselves, our I was growing up. Government, and our institutions? Are promise, fix these problems? Even if I yield the floor. you trying to unite us or are you try- you lose your election, fix the problem Mr. HARKIN. Mr. President, we find ing to divide us? for the country, fix the problem for the ourselves in yet another ‘‘Alice in Won- I already described we are bankrupt. children, fix the problem for our grand- derland’’ moment here in the Senate. How do we get out of it? The only way children. We are again on the brink of a govern- we get out of it is working, coming to- But the selfishness of careerism ment shutdown for no reason other gether with real leadership that draws drives us to do what is politically expe- than the House Republicans’ absolute us together, that says, hey, folks, no dient and what is popular rather than obsession with repealing the Affordable finger-pointing here, there are lots of what is right. Care Act. Their strategy isn’t anything mistakes made. How do we solve these The third question: Are you willing new. They are running the same old problems and how do we do it together to look at this institution of govern- plays out of the same old playbook without making somebody else look ment and ensure that we are not wast- that they have used for 3 years. None of bad? How do we restore confidence we ing, duplicating or being defrauded in these attempts have worked, but fail- know we need? the programs that we authorize ure is no deterrent if all you care about I wish to tell a story. I did townhall through a congressional continuing is scoring political points with your po- meetings in August, and I went to resolution? The answer to that ques- litical base. Miami, OK. There is a wonderful plant tion is we are being defrauded every The House has voted 42 times to re- there that grows mushrooms and vege- day. We have waste every day that we peal or defund the Affordable Care Act. tables. It is a big operation. The owner are not working on, and we have dupli- You would think after the first 41, they of the plant, Virgil Jurgensmeyer, cation like crazy from the GAO that we might get a sense that it is just a waste came to my townhall meeting. He is are not even attempting to fix. I have of time. But, no, the House is at it probably my age, maybe a little older. to take my hat off to the President. If again, risking the widespread economic He said: Tom, I am spending $60 or $70 we look at his budget, he took more of damage that a government shutdown thousand a month buying from my the GAO recommendations that they would cause just so they can indulge competitors right now to fill my or- made and put them into his budget their political obsession yet one more ders. I could create a couple of hundred than we have even considered in both time. I sort of half-facetiously said last jobs with my own. It is not a big city. the House and the Senate. At least he weekend that the good news is that the But I don’t have the confidence in the is listening to someone. They actually obsessive-compulsive disorder is cov- future of the country right now to in- acted on them in his budget for the fis- ered under ObamaCare—just in case vest $5 million and go to the bank to cal year 2014. these House Republicans might care to borrow that to create those jobs be- The question on this third question use it. cause I don’t think we have it together is: Do you have the political courage to Defunding the Affordable Care Act as a country anymore. fix what is wrong and compromise on would deprive Americans of all of the

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00087 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6850 CONGRESSIONAL RECORD — SENATE September 24, 2013 law’s benefits, such as historic con- who are covered under that ban on pre- doughnut hole step by step until 2020 sumer protections, affordable coverage, existing conditions. when it all disappears. and cheaper prescription drugs, just to Instead of helping all Americans pre- I just received this from Iowa. The mention a few. vent illness or disease by providing pre- Affordable Care Act in Iowa is already Work on the insurance marketplace, ventive services, such as colonoscopies, helping seniors on Medicare. Seniors on which will be open for business, as we repeal would allow insurers to charge Medicare saved $76 million on prescrip- know, next Tuesday, would stop. As a expensive copays. Sometimes they can tion drugs because of the Affordable result, individuals and small businesses pay as much as $300 for these essential Care Act in Iowa—just in Iowa, $76 mil- would no longer be able to enroll in af- services. lion. If we adopt the House bill, it fordable comprehensive health insur- I just talked to a friend of mine who takes that away. It reopens that ance through the marketplace, nor recently went in for his annual check- doughnut. There are 6.6 million seniors would they receive possible tax credits up. He got an annual checkup and ad- all across the country who have al- to help them with their premium pay- vice on how he should handle his ready saved more than $7 billion in dis- ments. health care, and there were no copays counts on drugs purchased in the In addition, the planned expansion and no deductibles under the Afford- doughnut hole. Repealing this would for Medicaid would be canceled. Seven able Care Act. increase senior drug prices by $5,000 a million Americans who are projected Repeal under the House bill would de- person over the next 10 years. Why to enroll in the marketplaces next year prive States and localities of vital would we want to do that? and 9 million through expanded Med- funding to combat chronic diseases The House bill will roll back the un- icaid would lose their coverage. such as cancer, diabetes, and heart dis- precedented investments we make in Over the next decade, the number of ease. Thanks to health reform, the Pre- Medicare fraud prevention. This is an- uninsured would rise by at least 25 mil- vention and Public Health Fund is sav- other little-known aspect of what we lion Americans. As if 25 million more ing lives and cutting costs by sup- put into the Affordable Care Act. We uninsured was not bad enough, this bill porting such programs. increased criminal penalties, we from the House would cancel all of the Cutting off funding would imme- launched innovative new technologies hard-earned, long-awaited consumer diately stop States’ work in building to detect and pursue fraudulent activi- protections that are in the law to pro- the health insurance marketplaces. I ties, and we put more cops on the beat tect every American with insurance, just mentioned that it will start next to preserve Medicare funds for bene- such as coverage for preexisting condi- Tuesday. These will be transparent, ficiaries—not the quacks and the fraud tions and coverage of young people on easy to understand, one-stop shops so manipulators. Taxpayers of this coun- their parents’ policies to age 26. individuals and small businesses can try saved $8 for each $1 we put into So we would kind of go back to the purchase affordable coverage. It starts that program. If you put $1 into it, we bad old days when insurance companies next Tuesday. These marketplaces are saving $8. Why would we want to were in the driver’s seat and telling have been endorsed by experts all repeal that? But the House bill would you what kind of health insurance you across the political spectrum because repeal it. were entitled to and when and charging for the first time they will create a It would hurt seniors’ access to you outrageous prices for it. Instead of real marketplace for health insurance. health care in rural areas. I come from protecting all Americans against arbi- Individuals and small businesses have a rural State. The Presiding Officer trary limits on coverage, repeal of the the same purchasing power and choice comes from a very rural State. We put Affordable Care Act would take us that only big companies enjoyed be- Affordable Care Act incentive pay- back to the days when insurance com- fore. Again, this will have a direct ments paid to rural primary care pro- panies could terminate your coverage pocketbook impact. viders in the Affordable Care Act. The just when you are the sickest. This Premium rates are coming in from House bill would take that away. would hurt families like Danny and marketplaces across the country, and As I mentioned earlier, we put provi- Lisa Grasshoff from Texas who were they are much lower than projected. In sions in the Affordable Care Act for unable to find coverage that would pay fact, my home State of Iowa released seniors to get preventive care and for their son’s hemophilia treatment rates last week that independent ex- wellness visits with no copays and no until the Affordable Care Act banned perts say are some of the lowest in the deductibles. In 2012 more than 34 mil- lifetime limits. More than 105 million country—in the marketplace. Well, the lion American seniors got free preven- Americans are currently protected by House bill would take that away. It tive services in Medicare. this provision, more than 105 million would stop that. Why would we want to CBO tells us that the improvements who are protected under the Affordable do something like that when we are we put in the Affordable Care Act to Care Act. providing a really good deal for con- the Medicare payment policy coordina- Instead of allowing young people to sumers? tion and efficiency will extend the life start a new job or new business or go Most importantly, these exchanges of the Medicare trust fund by another off to school and stay on their parents’ are a centerpiece of a system that will decade. policy until they are age 26—which bring coverage, as I said earlier, to Republicans are always saying: Well, they can do now under the Affordable more than 25 million Americans who Medicare is going to go broke. OK. In Care Act—repeal would make them otherwise would be uninsured and liv- the Affordable Care Act we did things fend for themselves in a chaotic insur- ing with the oppressive fever of being that the experts say will extend the life ance place that offers too little cov- one illness away from bankruptcy or of the Medicare trust fund by another erage for too much money. More than 3 not knowing if they can afford a doc- decade, and they want to repeal that. million young Americans are currently tor’s visit for their child. Why would It just doesn’t make sense. covered and are taking advantage of anyone want to stop this? Why would Finally, we come to the most inex- this protection. They would lose it anyone tell States: Stop what you are plicable part of this debate. Repub- under the House bill. doing to serve your citizens. That is ex- licans have played the Washington All 105 million Americans protected actly what the House bill does. stage politically for all it is worth. We from a ban on lifetime limits would If we pass that House bill, Congress saw an example of that last night when lose it under the House bill. will turn its back on America’s seniors, one of our colleagues on the other side Now, instead of protecting 130 mil- tossing out hard-won improvements in kept the Senate in all night long. I lion nonelderly Americans who have Medicare benefits. It would take us think the Senator from Texas started preexisting conditions—such as high back to the days when Medicare pre- off yesterday at around 2 or something blood pressure, diabetes, heart dis- scription drug coverage had a giant like that—please excuse me if I didn’t ease—denial of coverage repeal would gap. We all know that as the doughnut pay a lot of attention to it—he started put the insurance companies back in hole. It is in the middle, exposing mil- at 2 in the afternoon, and it went on all the driver’s seat. They would be pick- lions of seniors to the full cost of drugs night. He kept the Senate here and ing and choosing whom they want to just when they need the most assist- went on this morning until about noon- cover. There are 130 million Americans ance. Now, health reform closes that time, I guess.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00088 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6851 I respect every Senator’s right to erage when they got sick, cut them off square one. The answer is to move come to the floor and speak right at that point, deny them benefits, ahead. Let’s open these marketplaces. unhindered, just as I am doing now. and making insanely big profits doing Let’s get people signed up. If things Pretty soon another Senator will speak so. need to be fixed and changed in the fu- unhindered, and that is one of the Those are the old days. It seems to ture, that is our job here. It is our job beauties of the Senate. I think we also me my friends in the Republican Party to fix these things and make sure our have a responsibility to be at least a want to go back to those days, but we laws are correctly interpreted and ben- little cognizant—just a little bit—of don’t. The vast majority of the Amer- efit people. how we are burdening others. ican people say, No, we want to move It is as though some people have the So, yes, a Senator spent all night forward with a health care system that idea that all we have to do is pass the here. I wonder if that Senator ever covers everyone and doesn’t leave any- law and sit back and everything will stopped to consider how much it cost one out. take care of itself. That is not true. No the taxpayers to keep this place lit, to Again, as I said, my friend’s obses- law is like that. We need to implement keep the clerks and the people here; all sion with repealing this health care bill them. But we need to do it with good the police, all the safety people here is not based on budget or something. will and in a spirit of compromise and and around outside, just to keep this Sometimes I wonder what it is based in a spirit of—not everyone knows all place running, so one person could on. If someone were to ask me, Senator the answers, but in a spirit that what speak all night. I wonder if he ever con- HARKIN, do you think the Affordable we are attempting to do with the Af- sidered that. Care Act is the end-all and be-all, that fordable Care Act or ObamaCare, if you As I say, I don’t deny anybody’s right it is absolutely perfect, I would have to will, is to move us in a direction where to speak. But I have to wonder about refer to what I said when we first people will be healthier, where people responsibility, being responsible to the passed the bill, and it came under my will have affordable, quality coverage body and to the public at large. committee, the HELP Committee. I that can’t be taken away because they Imagine my surprise when that same said I like it as I would like a starter get sick, or be denied because they Senator who kept people here all home. We might have to add some have a preexisting condition; kids can night—who kept the lights lit and cost rooms, we have to add a door here or stay on their parents’ policies for a de- the taxpayers I don’t know how many there or change some of the designs of cent length of time after they get hundreds of thousands of dollars, at this or that, but it was like a starter through school, and all of the things I least—voted for the very bill he was home, to be filled in over months and spoke about. These are good, solid talking against. It was a 100-to-0 vote years ahead, change with changing foundations for a good health care sys- today. Some things are hard to grasp conditions and circumstances, and as tem in America. around this place. I am sure the public we learned more, as we went ahead, I think my friends on the other side out there watching this will say, Wait that maybe things would have to be who want to repeal this are simply on a minute, he spoke all night against changed in the Affordable Care Act. the wrong side of this debate. I am al- this bill and against the Affordable But the foundation was solid. It has a ways reminded of what William Buck- Care Act, against ObamaCare, and a solid foundation, and a solid structure ley once said. He was sort of the father few other things too, but then turned of making sure that we had a health of the modern conservative movement around and voted for cloture on the care marketplace to cover all, that it in America. He once said the role of a motion to proceed. As I said, some wasn’t controlled by a few; that every- conservative is to ‘‘stand athwart his- things are pretty hard to understand body, no matter how poor, would get tory yelling, Stop!’’ around this place. I guess one has to health insurance and those who are the Knowing the late Mr. Buckley, I am define it in terms of pure politics, poorest would get a government sub- sure he probably had a smile on his sometimes just pure politics. sidy to buy into that insurance. face when he said it. Again, here is where he talked about We wanted to make sure we had good It seems as though that is what some the most inexplicable part. My friends preventive programs, wellness pro- people are saying: We just want to stop on the other side are making great and grams, to keep people healthy and out all of this. solemn speeches about the debt and the of the hospital in the first place, to I have said many times since we first deficit, warning us, bringing us within change from what I have always said started the Affordable Care Act debates hours of a government shutdown, all in we had in America: We did not have a here several years ago, and since we the name, they say, of fiscal discipline. health care system, we had a sick care first started working on this, if people But as a condition for agreeing to fund system. If you get sick, you get care, have a better idea, come forward and the government, what do they demand? but in America we have never had let’s take a look at it and see what we The repeal of the best deficit-reducing much of anything to keep us healthy in come up with, but I haven’t seen that measures we have ever had. The non- the first place. As I have said many yet. partisan Congressional Budget Office times, in America it is hard to be I want to close by referring to a cou- confirms that the Affordable Care Act healthy and easy to be unhealthy. We ple of letters I got from Iowans. They reduces the deficit by more than $100 need to change that around. We need to make it clear what this is all about. billion in the next 10 years, and over $1 make it easier to be healthy and harder Angela from Edgewood writes that trillion in the next 10 years. to be unhealthy. she has ‘‘a family history of cancer and So, again, let me see if I get this The Affordable Care Act takes steps now I have been able to have the straight. The Republicans propose to in that direction, providing free mam- screenings that I need.’’ She asks me reduce the deficit by increasing the mograms, cervical cancer screenings, how she can volunteer to spread the deficit. Well, again, as I say, some colonoscopies, by providing wellness word to others. Well, I just did. things are kind of hard to understand checkups for people every year, by put- John from Des Moines says that ‘‘be- around here. ting in place community trans- cause of the ACA—the Affordable Care I think it is time to stop the silly formation grants where communities Act—I have been able to start my own games. We had our debate. We worked could begin to think of how they can business, I have been able to purchase hard on the Affordable Care Act. This structure communities to promote coverage and am looking forward to debate is not about deficit reduction, it wellness, good activities, and better the exchanges.’’ is not about the Nation’s fiscal health, diets. So the choice is to go forward, to it is about tearing down health reform So, yes, it is like a starter home. Do work together to make whatever need- at any cost. Tear it down, get rid of it, I think some things will have to ed improvements need to be made, to go back to the way it was when power- change in the Affordable Care Act in come together as a united American ful health insurance companies had the future? I am sure that is true. But people and to create a reformed health control to raise your rates whenever that doesn’t mean tearing down the care system that works not just for the they wanted to, to not give people structure and digging out the founda- healthy and wealthy but for all Ameri- health coverage if they had a pre- tion and throwing it all away and cans. That is what this battle is about. existing condition, to deny people cov- going back to where we were before—to That is what this is all about. That is

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00089 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6852 CONGRESSIONAL RECORD — SENATE September 24, 2013 why we don’t need to shut the govern- Senator HARKIN referred to this as a whelmingly, Missouri voters said no, ment down. Let’s act responsibly. Let’s starter home. I don’t know exactly and that was when it was more popular pass a short-term continuing resolu- where this goes, but I do know that the in any polling than it is right now. tion without defunding the Affordable majority leader said over the last few People have looked at this and they do Care Act or all of this other nonsense days, Well, what this really is is a sin- not want to go there. dealing with the debt ceiling increase, gle-payer system. I am not for that. As Missourians, in August of 2010, had a and then let’s get down to the hard far as I know, nobody on my side of the vote on the ballot, and 71 percent said work of working together to make sure aisle and many people on the other side we should not participate—71 percent— we fund the government next year as of the aisle aren’t for that, but that is and that was, again, when the law was we bring this session of Congress to a where the Senate majority leader says more popular than it is now. That was close later in November or December. this goes. I don’t want to go there. the first time people had a chance to Hopefully, in the next couple of days So what can we do to make the vote on this. the Senate will act and we will let the health care system work better? I wish In November of 2012, Missouri voters House know we are not going to defund to talk about that a little later too be- voted again. This time the direction to the Affordable Care Act. cause there have been plenty of ideas the legislature and all State agencies The PRESIDING OFFICER (Mr. about what could make this better. Ap- and the Governor was: Do not establish COONS). The Senator from Missouri. parently, when it comes to not moving a State exchange unless the legislature Mr. BLUNT. Mr. President, I have forward with the Affordable Care Act, agrees. There was some disagreement had the chance to listen for almost a the administration believes it can de- as to whether the Governor could do better part of an hour to my two neigh- cide what not to move forward on, but that on his own. Missouri voters said: bors, Senator HARKIN and Senator the Congress can’t. It can decide what We do not want you to do that on your COBURN, one from Oklahoma and one to essentially repeal. Part of this act own. So in our State, as in a majority from Iowa, both of whom, as many of was called the CLASS Act, long-term of the States, it has not happened. The us know, have totally different views of health care provisions that about a implementation will is not there be- why we are here and what is going to year and a half or 2 years ago, the Sec- cause people do not believe this plan happen based on what we do in the next retary of HHS said what I said, but in will work. The elements of this that improve few days and the days that follow after the committee, when this bill came up, what happens in a competitive market- that. when I was on the House Commerce place could still be there in other First of all, why are we here? The Committee that dealt with this, essen- changes we could make. This is incred- new spending year starts a week from tially saying this long-term plan won’t ibly unpopular around the country. yesterday. It starts next Tuesday. Has work. ‘‘Oh, no, it will work and it will People are frustrated by it. People are the Senate passed a single appropria- provide lots of money.’’ Secretary tions bill? No. Why are we doing this looking for ways to end moving into Sebelius—even though it is the law— the Affordable Care Act; that it simply again? Why are we so committed over said, about a year and a half ago, this will not work. Senator COBURN ex- the last 5 or 6 years to management by will not work, so we are not even going crisis? plained earlier why they would not to try to do it. work. Charles Krauthammer, one of I think in the last 6 or 7 years now, The President said recently—or I the leading conservative commentators the appropriations process has not guess the Secretary said recently—that in the country today, said about one of worked one time. It wasn’t too many the small business plans that were sup- years before that when we passed all of the plans this week: It will not work. posed to be available on January 1, The President’s health care plan is fall- the appropriations bills for the year 2014, will not be available. The Presi- that ended September 30 and began Oc- ing under its own weight. When some- dent said: We are not going to have any thing such as that is happening in poli- tober 1 in July—all of them, individ- penalties for the business requirement ually. That is how the government tics, you do not rush in to stop it from in 2014, but we are still going to have happening. If you do not think the law worked and was supposed to work. Here the individual requirement. should be implemented anyway, let we are a week away, and why are we Interestingly, the President also people see that this will not work, and here? Why does everything have to ride said: In normal circumstances, I would we are seeing that. from crisis to crisis? That is why peo- go to the Congress and say change the I am for defunding the plan. I am for ple are frustrated, people are upset. law, but these are not normal cir- starting over again. I believe most Senator HARKIN, my good friend, we cumstances. I do not believe there is a Americans would like to see us start are both frustrated and upset. We Presidential prerogative to decide over again and take the best health would like to see this process work. whether you are in normal cir- care system in the world and make it The Appropriations Committee would cumstances or not. If the law needs to work better. like to see the process work. Why do be changed, let’s change the law. If Anybody who was defending our sys- we go from standing on one edge of the parts of it need to be repealed, let’s re- tem as perfect got into a trap they cliff, and the next time people pay any peal it. If parts of it need to be post- should not have gotten into because it attention, we are on the edge of an- poned, let’s postpone it. was not perfect. It was largely an acci- other cliff again? We need to work to- Here we are, only 6 days from the be- dent of a couple of decisions made in gether to make this process work. ginning of a new spending year. We are the 1940s, where health care and health There has been, as Senator COBURN also 6 days from what will be a criti- insurance became way too dependent pointed out, some significant disagree- cally important moment for a lot of on where people worked, where people ment on where the current debate families—a lot of individuals, employ- did not have the ownership they needed could take us. One side believes that at ers, people who are going to be looking in health care, and where we did not some point—one side of the debate be- at these exchanges, and they do not have the competition that we needed to lieves that at some point the President seem to be ready. buy across State lines, to shop for a of the United States would sign a bill It had been hoped that there would better product, to do all those things. that eliminated the health care plan be available information out there so But this is a plan where, again, the that he now calls ObamaCare, so I am that for weeks we could have sort of law is the law, unless it applies to the going to call it that too, as he has, and what is called the dry run, where peo- administration, apparently. The Con- Senator HARKIN has alternated using ple could see if this works, where they gressional Research Service—no par- that term. I don’t believe the President could compare plans. That is just not tisan organization—recently found would sign that bill. I do believe he is there, and we know it is not there. that the administration has missed 41 President and I do believe he has to In Missouri, where I live, people have of 82 deadlines. sign a bill for the bill to happen, and so been concerned from the very first If you are a batter in professional we have to at some point decide what about what they saw as a flawed law. baseball, that is a pretty good average, can we do to make this process under- In fact, our State was the first State in .500. It is not very good if you are try- stood in a better way by the American the country to actually vote on wheth- ing to figure out how to implement the people. er we wanted to be part of this. Over- law. They missed 41 of 82 deadlines.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00090 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6853 The employer mandate requirement, mitment was made? Those plans are Americans deserve commonsense the White House has said, is unwork- not there anymore. It was one of the health care solutions, where doctors able now and announced its delay. How main selling points of this plan: If you and patients are in charge, not govern- in the world we could defend saying like your health care, you can keep it. ment bureaucrats, not people at the that employers do not have to meet It just turned out not to be true at all. IRS. their requirement but individuals have Not only has this not made health When you have a health care bill that to pay a penalty if they do not have in- care more affordable, but family pre- adds thousands of new IRS workers and surance—how can any of my friends de- miums have gone up by more than does not add a single new doctor or fend that? We ought to, at the very $2,500 since this became the law—even nurse, you probably missed the boat in least, postpone the individual mandate though it was the law and we are mov- what you are trying to do with health for as long as we postpone the em- ing toward it, not implementing it. care. ployer mandate. If individuals are pay- Nearly three in four small businesses There are lots of better ideas out ing a penalty and employers that the say they plan to cut hours or let em- there: More individual ownership, fair law says are supposed to offer insur- ployees go because of the President’s tax treatment. The tax treatment we ance are not offering insurance and health care plan. People who have have had for decades now, where you do they are not paying a penalty, there is more than 50 employees are doing ev- not pay income tax on a benefit you something wrong with a government erything they can not to have more get at work, but if you get insurance that decides that is the appropriate than 50 employees because that is one on your own, you do that with dollars way to do this. of the criteria where they are penalized you have paid taxes on—now one way Despite the employer mandate delay under this law. or the other, make that equal. Either announcement, we still see businesses Meanwhile, in April of 2013, the ad- say nobody gets a tax benefit for the beginning to react because they know ministration said it would delay a pro- money that is used to buy insurance or or they believe this is eventually likely vision that allowed employees to pick everybody gets the tax benefit. Let to start. Businesses, big and small, are their own plans in States that have the people shop across State lines. Let peo- trying to look at: If somebody does not Federal exchange—States such as ours. ple find what they need that meets the have to have insurance if they do not It is not going to happen. Another needs of their family. work more than 30 hours, maybe we delay. You are going to have more single, should have more employees who work In July of 2013, the administration young adults without insurance. Why less than 30 hours because our compet- delayed enforcement of the employer are you going to have more? Not be- itor might decide that companies that mandate for a year. In July, the admin- cause of the provision that allows peo- have always provided insurance and as- istration announced it would signifi- ple to stay on their family’s policy— sistance for families and spouses decide cantly scale back the requirements for that actually added people to the in- the law now does not say we have to do new State-based insurance market- surance roles—but because of the pro- that, so we are not going to do that places to verify income. When you vision that says that the most expen- any longer. scale back the requirements to verify sive people you insure cannot be The law initially anticipated 3 mil- income, you are also scaling back the charged more than three times that of lion people who currently had insur- burden that people have to provide in- the least expensive people you insure. ance would lose that insurance. It is formation in order to get assistance. Young, healthy people are going to going to be a lot higher than that. The I assume that means more people will look at insurance rates higher than same people who were saying 3 million get taxpayer assistance. But it also rates they have ever seen on the indi- are today saying somewhere between 8 means the cost of that assistance is vidual market before, and it will make and 15 million, and that number is going to be higher, for many reasons. a difference. going to go up. All we have to do is cal- That is one of them. Another one is There is plenty that can be done culate what has just been announced in that people are going to be on the ex- here. My colleagues on the other side the last few days to know that is going change that everybody anticipated face an important decision this week. to go up. would still be getting workplace-based They can stand with what is now the The Cleveland Clinic hosted Presi- health care. overwhelming majority of Americans dent Obama in July 2009, during the In August of 2013, the Department of who have rejected the direction we are height of trying to convince Americans HHS—Health and Human Services—de- headed and say: Let’s defund this. Let’s this was going to work. He talked layed the signing agreements with in- start over again. The one thing we about how the Cleveland Clinic was an surance companies that was supposed have in front of us that would allow us example of cutting-edge technology. to have specific amounts available in to start over is the House bill that we But what they recently cut in cutting- August. I wrote a letter at the time just voted to move forward on that edge health delivery—what they re- that said: It is very important that you would defund ObamaCare and let us cently cut—were 44,000 employees, and meet this deadline because people need start over again or my friends on the they said it was because of the Presi- to begin to think about the decision other side can decide that the Presi- dent’s health care plan. The same orga- you want them to make beginning Oc- dent and Senator REID are right, that nization the President went to, to talk tober 1. Senator REID’s idea that this leads us about how that organization runs and The Department of Labor delayed a to a single-payer system is where we why we should have his health care limit on out-of-pocket spending for want to go, that the President’s idea plan, announced they are terminating beneficiaries from 2014 to 2015. Again, that he can change this law however he 44,000 employees because of the health apparently, if you want to delay the wants to and the Congress is not in- care plan. law, if you want to decide that you are volved is right. This is a plan where people who were not going to enforce the law, that is I will strongly urge all of my col- for it—and I was not for it, I have not OK. But for those of us who say: Let’s leagues to join me in voting against been for it, I just simply do not believe have a permanent delay, let’s not fund any attempts by the majority leader to it will work—people who were for it this and now go back and start with a restore funding for this flawed law and overpromised, and now they are under- process where the House passes a bill, to work with all of us, working to- delivering. the Senate passes a bill, the two bodies gether, as we work to replace it. That famous statement made over come together and talk about the dif- With that, I suggest the absence of a and over again: If you like your health ferences—that never happened with quorum. care plan, you can keep it—nobody be- this law. The PRESIDING OFFICER. The lieves that anymore. In fact, ask the My friend from Iowa said: It is a clerk will call the roll. employees at General Electric or IBM starter home. But there is no remod- The assistant legislative clerk pro- or UPS or Walgreens or Home Depot or eling process to start up for the starter ceeded to call the roll. thousands of smaller businesses than home, and we are seeing what happens Mr. MCCONNELL. Mr. President, I those: What about keeping the health there. Unfortunately, there are too ask unanimous consent that the order care plan you like—the day that com- many examples of this. for the quorum call be rescinded.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00091 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6854 CONGRESSIONAL RECORD — SENATE September 24, 2013 The PRESIDING OFFICER. Without cuts over the next 10 years to help pro- Mr. MCCONNELL. One of our con- objection, it is so ordered. vide a subsidy for people who are not stituents—I was going to mention here Mr. MCCONNELL. Mr. President, I old. a letter—the Senator probably got it ask unanimous consent that the Sen- I mean, it is coming out of Medicare. from the same constituent I did—to un- ator from Kentucky and I be allowed to It can provide subsidies for people who derscore how the rising cost is impact- participate in a colloquy. are not old. What is the Senator’s take ing people outside the health care pro- The PRESIDING OFFICER. Without on where this all heads? vider world, regular people in business. objection, it is so ordered. Mr. PAUL. When you look at the big This from a follow constituent of ours Mr. MCCONNELL. Mr. President, I picture of this, when we say: Well, we who writes: would say to my friend from Kentucky, want to provide health insurance for My father began his Kentucky Fried I have had over 50 hospital town hall everybody, which I think is a noble Chicken business with the colonel himself, meetings in our State over the last cause, you look at what we have. The and with the colonel’s family. We proudly year and a half. The Senator and I have government already provides Medicare served Colonel Sander’s original recipe for 40 done a couple of these together. As a for everybody over 65. But Medicare is years. It saddens me, however well inten- health care professional yourself, look- $35 to $40 trillion short. tioned, that this law will undermine my abil- Why? It is nobody’s fault really. We ity to provide employment. It will deplete ing at it from a hospital and health resources that could otherwise be used to care provider’s point of view—which are living longer and a lot of people are grow my business. retiring. So we have a big baby boomer the Senator and I both had, either he The Senator and I both have heard generation. But Medicare is $35 trillion in his profession or me by being in from a lot of Kentucky business people short. So we are instituting a brand these hospitals a lot the last couple of indicating, as this KFC franchisee un- new entitlement. It is very big, the big- years, and have learned a good bit— derscores, the impact of this on the pri- what does the Senator think is the gest we have had in 50 years. But we are going to pay for it by shifting vate sector. most devastating impact of ObamaCare Mr. PAUL. I met with a group today. money from Medicare that is already on the provider world? I have here today 68,000 American sen- $35 trillion short. That alone should Mr. PAUL. I talk to a lot of doctors. ior citizens who signed a petition from give people pause. I have been in town halls with the Sen- Conservative 50-plus Alliance, saying ator at the different hospitals. The hos- The other thing that I think should give people pause is we cannot get peo- they want to delay it, dismantle it, pitals are concerned that if everybody defund it, do anything, just try to slow goes on Medicaid they will go out of ple to sign up for this free program. The President is going to spend tens of down this monstrosity. business. Many hospitals’ bottom line We have also heard from folks who millions of dollars on TV promoting it, is driven by—they can take care of the work for UPS, one of our biggest em- poor through Medicaid, but they rely hiring people to come knock on your door to sign up for something that is ployers in Louisville and Kentucky. on private insurance to make a profit. Some 15,000 spouses are losing their in- Hospitals in most communities have to free. You know something is disorganized surance coverage from UPS that they make a profit to stay in business. So when people will not take something had chosen. It was great coverage. UPS the rural hospitals, particularly in that is free. is a great company. Great benefits. But small areas, some of them have already Mr. MCCONNELL. This bill was also they are forced to cut back because of gone bankrupt in Kentucky. But they sold, as we both recall, as doing some- ObamaCare. are very concerned about people being thing about health care costs. I was We hear from individuals throughout shifted from private insurance to pub- just noticing here that HHS’s own ac- the State. We have received thousands lic assistance. tuaries revised their projections just and thousands of letters. One couple I The President said, though, that it last week to say that ObamaCare will met recently was actually profiled on will be free, but it has a cost. We all actually increase health care costs by Fox News, the Anionic family, where pay for it through higher taxes. The $621 billion out across the economy. Is they said: We have to buy our insur- other way we pay for it is we have to there any way, I would say to my col- ance. We are self-employed, we do con- ration care or ration what we pay for league, Dr. RAND PAUL, how this could sulting work, we were paying $300 a care, so we have to limit what we pay possibly hold down costs? month, and we are going to $900 a hospitals. Mr. PAUL. No. In fact, I think there month. This is exactly the opposite. Hospitals are already being forced to were problems in health care. But as a One of the real things that we had that see less. They have been for a while. physician for 20 years, what I heard was working in our health care that But even more so now. It is the same most was about the cost of health care. should be expanded, if we were in with doctors. How do doctors respond? People came to me and said it is so ex- charge of talking about this, is health Doctors, some respond by saying: I am pensive. Or if they are a small business savings accounts. People could save for maybe only going to see a couple of owner they said: Our insurance costs things that were not covered by their Medicaid patients or no Medicaid pa- too much. That was their main com- insurance, straightening your kid’s tient. Then when everybody is on Med- plaint. This does nothing to control teeth, cosmetic, elective kind of sur- icaid or the vast majority is on Med- costs. In fact, Obama does the opposite. gery, your deductible, meeting a lot of icaid, they are going to be waiting in ObamaCare is a collection of mandates. things for your tax-free account. to see a doctor. I was talking earlier. It is the dif- We had made it bigger and bigger Mr. MCCONNELL. Speaking of Med- ference between freedom and coercion. over time. ObamaCare makes it small- icaid, I remember reading that our We will coerce insurance companies er. If you have got a kid with autism or Governor got teared up when he an- and customers to buy only certain spina bifida, or special needs, you need nounced that he had decided to accept kinds of insurance. People say: It is to save that money tax free so you can the additional Medicaid mandate, good. My kids will be covered when help your child with all of extra stuff which the Supreme Court actually had they are in college and when they get you need to do for your child. said was optional. I remember having a out of college. That is good. But it is The President has narrowed that. teared-up feeling too, but for a dif- not free. It is going to cost you more Also health savings accounts helped to ferent reason. I gather what will hap- money. So if you are the working class bid prices down. Because when you pen in our State is there are going to or the working poor, you are struggling have a higher deductible, you call up be between 3- and 400,000 new people to buy insurance, it is going to cost the doctor and you say: How much will with free health care cards rushing to- you more. that be? Or you ask the pharmacist: ward the emergency rooms. What I We always hear he is for the middle How much does that cost? That simple have heard in a number of my town class. The middle class are going to pay question, of asking how much some- hall meetings is they cannot handle more for their insurance. They already thing costs is concern on the part of the Medicaid load that they have now, had insurance, and they are going to the consumer and drives prices down. not to mention all of those new people pay more across the board. So really But we have gotten rid of that. who are headed their way, coupled with there are a host of problems and this Mr. MCCONNELL. The other thing the $750 billion in health care provider bill does nothing to control costs. that is clearly happening here is that

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00092 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6855 all indications are, we have a record friend from Kentucky—than it was on We have to do something that says to number of part-time employees in our the day it was passed. Is it not reason- the President—and that is why I think country now. Employers are able to conclude that is because of this needs to be pursued all the way to downsizing in order to try to get below what it does? the Supreme Court—rebukes the Presi- the 50-employee threshold. Of course, Mr. PAUL. Absolutely. It is the con- dent and says you are not a king. You even as they do that, they are not nec- tent. But it is because there has been are the President, and the legislation essarily unaffected by the rising costs no input. ObamaCare is 100 percent the comes from Congress, not from you. of health insurance premiums. But we President’s bill, 100 percent the work of Mr. MCCONNELL. We have another are looking around at some way to try the Democrats, with no input from our example of this that affects our State. to prevent the worst case scenario side. I think people actually do—when The President, even when he had a 40- here, all of this disruption in our econ- you go home, they do want to establish seat majority in the House and 60 votes omy is actually the reason we have so dialogue. They do want us to work to- in the Senate, couldn’t get cap and many part-time workers; is it not? gether a little bit. There has been no trade through the Congress. Mr. PAUL. Yes. The thing is, there working together on ObamaCare. It is Yet last Friday he has announced he was a French philosopher by the name theirs. The President got it exactly is going to do it anyway. All indica- of Bastiat. He talked about the seen wrong the other day. It is hard to in- tions are there won’t be another coal- and the unseen. You may be able to—I form the people this way. fired generation plant built ever. am sure the President is going to show He said: Republicans want 100 per- It is a perfect example of what the us the person who gets insurance. That cent of what they want or they are Senator is talking about, a kind of ex- is the ‘‘seen.’’ That will be the good ef- going to shut down government. I ecutive arrogance, that if I can’t get fect of this. The unseen will be the per- think it is the opposite. He wants 100 what I want through Congress, I will son who does not get the job. But you percent of what he wants. He doesn’t just do it on my own and see you in do not know their name because they want any compromise. We have a bill court, or whatever limited options we never got the job—the person that was before us. There is a discussion about have left. going to be the 51st employee or the ObamaCare. Why not? Nearly 80 per- If he really believes he has the power 52nd employee or the part-time worker cent of us voted and said the medical to delay ObamaCare, why not delay it that had 34 hours going to 29 hours. devices tax is going to be a disaster for for everyone, not just businesses. That is the unseen. innovation in the medical industry. It Mr. PAUL. I think that is what peo- I do not question the motives of the is a bad piece of this bill. We should re- ple see as unseemly. They see: Well, President or the other side. I think peal it. gosh, if there are problems, is it right they want to help people, but they did Why not have a vote on that? To my for him to just give exemptions to his not think this thing through. So even understanding there will be no vote on friends? their side now is scratching their head. any amendments to make ObamaCare You see a line of people going to the The author of the bill is calling it a any better. White House that were big contributors Mr. MCCONNELL. The President train wreck. The Teamsters said, ‘‘We of his. It is as if you can buy access to himself seems to be kind of conceding did not know we are going to have to good law. that some things aren’t working out pay all of those taxes on our health in- The President changed the law only well. He decided to delay the employer for people who gave him money. Can he surance. Warren Buffet, former Presi- mandate for a year. Apparently, he has give out grants and loans to people who dent Clinton, all of these people are been meeting with some of his union are his contributors? I think this is questioning. This is really going to allies to figure out what he can try to what sort of belies this tale when he hurt some of the people you tried to do for them. help. I believe the 100 percent view of the says: I am for the middle class. That is one of my concerns. I know Republicans is that if we are going to Well, I don’t see the middle class. I there has been a lot of talk about pro- have a delay for business, why not have don’t see my neighbors or any of my cedure around here. So we ought to a delay for everybody? Obviously, we friends getting any special deals at the have the ability to amend this to make would like to defund the law entirely. White House. In fact, I see them bear- it less bad—that is the way I like to de- There is a math problem on that in the ing the brunt of people who do get spe- scribe it—and make this bill less bad Senate. There are 54 Democrats and 46 cial deals. for the American people. There has Republicans. But couldn’t we all agree I don’t like, if you have really good been a lot of dialogue on our side but on delaying this train wreck? The train health insurance, placing a tax on you, there has not been much on theirs. Are wreck, by the way, was what the Demo- a special tax. Many of the unions will they willing to talk about fixing cratic chairman of the Finance Com- get that. I will stand here and fight ObamaCare and making it less bad for mittee in the Senate, one of the au- tooth and nail not to have a special tax the American people. thors of the bill, called it. on the unions. Mr. MCCONNELL. The Senator was Mr. PAUL. I think there is also Some might be surprised by that. It not here yet, but is the Senator fully something important about how we is not for me a union-nonunion thing. aware of how this bill passed in the change ObamaCare. If a law has prob- It is about is it good for America, is it first place? Not a single member of our lems and we incorrectly pass the law good for Americans. party in either the House or Senate that has the least blemishes, it should Some executives have good insur- voted for it. They brought us into ses- come back and we should re-debate and ance, too. Should we have a special tax sion the day after Thanksgiving in 2009 fix it or try to make it less bad. I think on something that is good? It doesn’t and we were not allowed to leave for a it is the best way to put it. seem like the right thing to do. month. We were here 7 days a week for The thing is that it is illegal, it is Mr. MCCONNELL. Here at some a month. And we managed to eke it unconstitutional, and it is unprece- point, regardless of differences of opin- out. They had 60 Democrats, there were dented to do this on his own. ion that we have had on our side over 40 Republicans. They eked it out with To my mind, win or lose this week, procedure, what is likely to happen not a vote to spare on Christmas Eve, this is an important philosophical bat- here at some point is we are going to as a result of things like the tle, bigger than ObamaCare. It is as big have a 51-vote vote on defunding Cornhusker Kickback, a special deal and as broad as the country is. That is ObamaCare, something we have not for Nebraska, the Louisiana Purchase, whether or not the Congress writes the been able to achieve here in the last 4 a special deal for Louisiana, the Gator law and the President executes the law. years. Four Democrats, who had second Aid, a special deal for Florida, all while If the President gets to vote, write, thoughts, who had an opportunity to the President, the Vice President, and and execute, that is a type of tyranny. take a look at the carnage of the last former President Clinton were up here Montesquieu talked about the separa- 4 years, could actually pass a bill that telling me: Believe me. They are going tion of powers. He said when the legis- defunds ObamaCare. to love it by the fall. lative power becomes the executive I remember, I say to my friend and Here we are 4 years later. It is more power, that is a type of executive tyr- colleague, standing at this very chair, 4 unpopular today—I would say to my anny. years ago, looking at the other side

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00093 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6856 CONGRESSIONAL RECORD — SENATE September 24, 2013 and saying if only one of you, only one, ance, a third of the people without Tempe, was recently featured on the would come with us, this bill wouldn’t health insurance were young, healthy, local news because he is being forced to pass. and actually made more than $50,000 a decide about whether to offer health I also said, however, if none of you year. They weren’t getting health in- insurance to his employees working do, every single one of you is respon- surance because it was too expensive. more than 30 hours a week or paying sible for its passage. Had any Democrat What did we do to help them? We the penalty from the Federal Govern- on the other side, any one of them, said made health care more expensive. ment. Again, it is likely that employ- this is a bridge too far, I am not going Mr. MCCONNELL. I think this law ees will be laid off or not hired. to do it, it wouldn’t have passed. has no chance of working. I don’t be- He doesn’t want to cut back his em- Consequently, every single one of lieve that, even if we are unable to ployees’ hours. That doesn’t help his them is responsible for its passage, but defund it here in the next few days, business. I am sure it doesn’t help his they have a second chance now, an op- that we are necessarily stuck with it. I employees. Like other business owners, portunity for a do-over. At some point have been here a while, and you have he doesn’t have any other option. here this week they will have a chance been a long-time observer through your Sadly, these stories are not isolated to cast a real vote on an up-or-down father’s career and your own. I think it incidents. Companies like Trader Joe’s basis. I have watched this for 4 years, is pretty safe to conclude that things and Home Depot have recently an- and I don’t think we ought to go for- that can’t work don’t stick and don’t nounced they will end health benefits ward. last. We are, after all, a representative for part-time workers next year, and those employees will be directed to the It will be interesting to see if party democracy. People complain, discuss, loyalty will be so great that none of new insurance marketplaces. and tell us how they feel. SeaWorld announced that it will be these folks will be able to bring them- I don’t think this law can possibly cutting back employees’ hours as well. selves to admit that they made a mis- stand. It is pretty hard to predict ex- UPS will no longer cover the health in- take 4 years ago. actly the day upon which it ends, but it surance for some 15,000 employees’ Mr. PAUL. I think one of the dis- is cracking. spouses. appointing things about the debate We have Jimmy Hoffa, the President Just when we need a full bore, full- both then and now is that we are talk- of the Teamsters, saying you are de- time economy, America is becoming a ing about something all Americans stroying the 40-hour work week, and part-time economy. These are the ef- want. They want affordable health their Cadillac health care plan. Don’t fects of ObamaCare. care. They want most people to have you think ObamaCare can’t possibly I believe that it is helpful to have insurance. They want everybody to work? this debate come sharply into focus as have insurance if we can do it. Mr. PAUL. No. I think once the bill it has been over the past 24 hours. Like But we have made it a partisan bat- has come due at the State level, you many of my colleagues, I have opposed tle—not we—but Congress and the de- are going to have a real uproar on your ObamaCare from the beginning. I think liberative process has become very par- hands because there is a printing press every Republican in the House and in tisan, when in reality there are prob- in Washington that runs 24 hours a day the Senate has done so. ably things on which we could agree, printing money. In the State capitals I voted to do away with this legisla- even the problems with ObamaCare. they don’t have a printing press, they tion more than 30 times. Earlier this I think half of the other side half are limited—at least to a certain ex- month I introduced S. 1490, a bill that agrees that there are problems and tent—on their borrowing. would delay by 1 year all of the provi- they ought to be fixed. When the Medicaid bills come due in sions of the Affordable Care Act that Because of some kind of stubbornness Kentucky, our State and other States, are supposed to take effect on January that we are getting 100 percent of what I think there will be another war on 1, 2014, or later. we want or we are willing to risk shut- the question of ObamaCare. The ques- I believe we all know the President ting down the government, that is tion then will be do we throw out the has already decided to delay the em- what we get from the other side. It is Governor who increased our Medicaid ployer mandate. Doesn’t it make sense their way or the highway. They want by 50 percent and bankrupted our State to delay the rest as well? How can you all of ObamaCare or they want the gov- in the process? tell individuals there is still a mandate ernment to shut down. Mr. MCCONNELL. I thank my col- for you to buy insurance but to tell I think in reality there are a lot of league from Kentucky for the oppor- employers you are going to get a year good things that we could actually tunity to exchange some views here break. come together and work on because about the impact of this on our State As lawmakers, we have a responsi- ObamaCare never addressed price. and our country. bility to our constituents. We have to Eighty-five percent of the public had I yield the floor. do everything we can to make sure that this train wreck of a law doesn’t insurance and their price is going up. The PRESIDING OFFICER. The Sen- continue to wreak havoc. As we con- We do need to get together and talk ator from Arizona. tinue to discuss the need to delay this about how to try to bring cheaper Mr. FLAKE. I came to the floor to onerous law, I hope that Senators will health care to people in our country. urge my colleagues to do everything we join me in devoting the same time and Mr. MCCONNELL. The tragedy of can to ensure that ObamaCare is de- energy to fix the fiscal problems facing this, correct me if I am wrong, but we layed, guaranteeing the least-harmful this country. passed a 2,700 page bill on a totally par- pass forward for patients, providers, In this debate we are told we have tisan basis. We have about 20,000 pages and taxpayers. two choices. We have a continuing res- of regulations now issued. We all have stories from our home olution with a price tag of about $986 I used them in a speech recently. States that highlight what many of us billion—about $20 billion more than the They were 7 feet tall. We had to put have said was going to happen when law allows—or we risk a government them on a dolly to get it out on the po- the Federal Government began its shutdown. It is disingenuous to tell our dium. takeover of the Nation’s health care constituents that these are the only I would ask my friend and colleague system. two choices, a shutdown or a CR that from Kentucky, didn’t I read the other Because of ObamaCare, a constituent busts our budget limits. day, that even after we do all of the of mine in Arizona who owns a number The majority leader is going to 2,700 page bill, the 20,000 pages of regu- of restaurants is eliminating the entry- amend the CR to get what he wants. lations, there still may be 25 or 30 mil- level job of busboy because he can no Shouldn’t other Members be afforded lion people uninsured? longer afford to employ busboys and the opportunity to offer amendments Mr. PAUL. Yes. I don’t think it has pay the new health care expenses for as well? Wasn’t this the promise the actually fixed the problem. I think we his other employees. Eliminating a res- majority leader made to the Senate were at 45, so I don’t think it fixed half taurant-wide position is a decision that when we made changes in January? the problem. he had to make because of ObamaCare. The Senate should be given the op- The other interesting thing is of the Another Arizonan, Michael Monti, portunity to vote on a continuing reso- people who didn’t have health insur- who runs a historic restaurant in lution that respects the Budget Control

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00094 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6857 Act and funds the government at the sider Social Security. In 1935, one Sen- Rather, we are full steam ahead on $967 billion level for next year. Passing ator said Social Security would ‘‘go a implementing the Affordable Care Act. a bill above that limit—above the limit long way toward destroying American In 6 days, the health exchanges—or set by law—will cause a second round initiative and courage.’’ Another Mem- marketplaces—will open for business of sequester cuts in January. Why ber of Congress said, ‘‘The lash of the and the Affordable Care Act kicks in. would we do this? Lurching from fiscal dictator will be felt.’’ What does that mean? For the major- crisis to fiscal crisis is no way to run a These are criticisms of landmark leg- ity of Americans, nothing. Really. De- country. islation, monumental laws that are spite all the scare tactics, despite all You can say what you want about it, now vital to the very health and wel- the rhetoric, nothing will change for but the Budget Control Act has pro- fare of our Nation. While criticized in the millions of Americans who already vided us at least some meaningful cuts their conception, Social Security and get health insurance from their em- in spending we wouldn’t make other- Medicare are now considered the most ployers, from Medicare, Medicaid, or wise. Last week, the nonpartisan Con- successful large-scale Federal pro- from the Veterans’ Administration. gressional Budget Office reported our grams in our Nation’s history. But for those almost 50 million debt is on track to total 100 percent of I am confident history will treat the Americans who don’t have health in- our Nation’s output in 25 years. Inter- Affordable Care Act in a similar fash- surance, they will now have access to est on the national debt will consume ion. I am confident the complaints of affordable care and peace of mind. 14 percent of our annual budget in 10 those who have gone so far as to call Thanks to Federal tax credits and sub- years’ time, up from 6 percent today. the Affordable Care Act ‘‘a crime sidies, for the first time millions of Those projections demand we take a against democracy’’ or a ‘‘centralized working-class families will pay less harder look at our spending and, at the health dictatorship’’ will soon be than $100 a month for health insurance. very least, we should be allowed to drowned out by the voices of the Amer- And for the most vulnerable among us, ican people whose lives are better off. vote on a fiscally responsible con- they will receive care through an ex- Why? Because of the Affordable Care tinuing resolution that meets the $967 panded Medicaid. billion budget threshold. Act. No one—no one—can be denied health Already the ACA has done more than Mr. President, I yield the floor. insurance any more. That is unless any other laws of the past century to The PRESIDING OFFICER. The Sen- some in the House have their way. expand health coverage. In the past 3 ator from Montana. Their intention—fully spelled out in years, the ACA has provided 71 million Mr. BAUCUS. Mr. President, I ask the continuing resolution before us—is Americans free preventive services. unanimous consent that after I finish to undermine and defund America’s More than 6 million seniors have re- speaking, the Senator from Maryland health care law. For years, we have Senator MIKULSKI would have the floor ceived discounts on vital prescription drugs. More than 3 million young peo- been trying to solve the problem of ris- for 15 minutes, and then Senator ALEX- ing health care costs. For years, we ANDER from Tennessee be yielded the ple have peace of mind in knowing they are allowed to stay on their parents’ have been trying to help working fami- floor for 20 minutes. lies gain access to comprehensive cov- The PRESIDING OFFICER. Without health plans until they turn 26. I am especially proud of the fact that erage that doesn’t make them go bank- objection, it is so ordered. rupt or deplete their household budg- Mr. BAUCUS. Mr. President, I rise now no child—no child—can ever be de- ets. Past Presidents, Congresses, and today, as I often do, with a quote. It nied health coverage because of a pre- other policymakers have tried to fix comes from a conservative leader existing health condition. All that, and this problem time and again. And we speaking out about a new health care the full benefits of the law have not yet sit here today with a solution—the Af- law. He said: taken effect. The Affordable Care Act is not a per- fordable Care Act. For the first time, We are against forcing all citizens, regard- every American will be guaranteed less of need, into a compulsory government fect law, but neither were Social Secu- program. rity or Medicare when they passed Con- health coverage. It will no longer be legal for health insurers to deny some- He went on to call the pending legis- gress. Adjustments may need to be one coverage for a preexisting condi- lation ‘‘socialism.’’ He went on, saying: made to improve the ACA, as well to make it stronger, make it better. It tion, such as breast cancer or preg- Our natural, unalienable rights are now nancy. Before the ACA, being pregnant considered to be a dispensation of govern- would be easier to make improvements ment, and freedom has never been so fragile, if everyone on Capitol Hill partici- was a preexisting condition, if you can so close to slipping from our grasps as it is pated. But we are not getting that believe that. That is what the health at this moment. chance from half of the Congress. In- insurance industry thought. That is Those are frightening words. When stead, opponents are making every ef- wrong. And with the passage of this were they spoken? Not spoken in 2010 fort to destroy the Affordable Care Act, act, that is no longer the case. Preg- or 2011. Not spoken in 2012 or 2013. fighting to take away its many bene- nancy is no longer a preexisting condi- Rather, these words were spoken in fits from America’s families and busi- tion. But the House wants to stop this 1964. And who do you suppose spoke nesses. and continue limiting consumer pro- them? Ronald Reagan. President Last week, the House passed a con- tections and access to affordable care. Reagan was speaking out against Medi- tinuing resolution to pay for the gov- The ACA also provides free preven- care, which became law the following ernment for the remainder of the year. tive service, such as wellness visits and year. But that bill before us today included mammograms. Since the law passed, 71 Now fast forward 20 years and things amendments to end all funding and to million Americans have received pre- were quite different. President Reagan eliminate the Affordable Care Act. I ventive benefits such as these for free. said in 1984: want to be very clear here: We are not But the House wants to take this Millions of Americans depend on the Medi- going to let that happen. We are not away. care program to help meet their health care going to go back to the status quo. We Under the ACA, insurers can no costs. We must ensure the long-term sol- are not going back to a broken system longer impose lifetime or annual limits vency of the Medicare program, and I’m con- where more than 50 million Americans on care. This means more than 105 mil- fident we can find the right solutions in a bi- lack health insurance. We are not lion Americans no longer have a cap or partisan manner. going back to a system that allows the a limit on their coverage. No longer What do you suppose happened in costs of medical care to overwhelm a can insurance companies say: No, no, that 20-year period to change President family and force them into bank- no. No more. Reagan’s mind? The hysterics ended, ruptcy. We are not going back to a sys- But the House wants to take this people gave the new program room to tem that allows the simple lack of in- away too. breathe, and it worked. Medicare gave surance to contribute to the death of Approximately 3.1 million young America’s seniors access to health care thousands of Americans each year. We adults have gained coverage through they had never had before. are not going back or returning to the an ACA provision that allows them to The same pattern emerges when we status quo. No, we are not going to do stay on their parents’ health insurance look farther back into history. Con- that. plan until the age of 26.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00095 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6858 CONGRESSIONAL RECORD — SENATE September 24, 2013 We have all heard so many comments fordable Care Act is the law of the her, that is a high compliment, and I about this provision from so many con- land. The Supreme Court upheld it. It deeply appreciate it. stituents in our States. But no, the is the law. Ms. MIKULSKI. So, Mr. President, House wants to take that away as well. People fear what they do not know. I here we are. We are having a national I am concerned about the effects of understand that. But let’s all take a debate on the Senate floor about the House continuing resolution not deep breath. As one Republican Sen- whether we should provide access to only on health care reform but also on ator recently noted, it is ‘‘not ration- health care to all Americans and be seniors in Medicare. Leader REID and I al’’ to think the Senate will vote to re- able to do it in a way that is fiscally wrote a letter last week to Health and peal, delay, or defund the ACA. You prudent and modernizes the way we de- Human Services Secretary Kathleen know what. He is right, it is not ration- liver health care to emphasize value Sebelius and asked her what impact al. We won’t go back to the status quo. health care over volume health care. the House CR would have on the oper- This is complex legislation, and I am And we are having this debate even ation of Medicare. Specifically, we open to strengthening the law to better though we passed the legislation in asked how the CR would affect the serve the American people, just as this 2010. I thought that when you passed a beneficiaries’ access to care. Last Fri- Congress did with Social Security and bill and it was signed into law, it was day we received a response, and it con- Medicare. Wouldn’t it be better if both the law of the land but, no, here we go firmed our fears. The House bill would parties worked together to improve the again. We are trying to take legislation have much broader and more harmful law, something that is here with us? It that was passed and undo it by implications for the Medicare Program is not going to be repealed. Let’s work defunding it. I don’t know what we are and for seniors. to improve it. That is what the Amer- doing here. In her letter, Secretary Sebelius said ican people expect of us. They do not First there was an attempt to the CR would ‘‘severely impact the want the government to shut down. delegitimize President Obama. He has Medicare program.’’ She goes on to They do not want America to default won two elections. The American peo- note the House CR would eliminate on its debt over the ACA. ple said: We want Barack Obama to be funding for Medicare prescription drug A recent poll by CNBC found the vast our President. When he ran the second coverage, forcing seniors to pay more majority of Americans—59 percent—op- time, we passed the health care initia- for their prescriptions. pose defunding the Affordable Care Act tive. That was another affirmation The Secretary also said the House CR at the cost of a government shutdown that there was public support for that would disrupt payments to doctors and or debt default. Almost 60 percent said bill. cut off annual wellness visits, forcing no, don’t do that, that is not smart. Now here we are, on the eve of the seniors to pay out of pocket for preven- We all have a responsibility to lead. funding for fiscal year 2013 expiring, tive services. The Affordable Care Act is the law of and there is a manufactured crisis In addition, Medicare beneficiaries the land. We all need to work together bringing the government to the brink may be forced to drop their Medicare to make it work for families and busi- of a shutdown because a few in the Advantage plans and enroll in tradi- nesses who depend on it instead of other party are sore losers. They lost tional fee-for-service. It is clear the using it as a political football. the election. They lost the battle to House CR would have dire con- Enough is enough. It is time for the get the votes when they had the oppor- sequences for the more than 46 million hysterics to end. People need to give tunity to vote and amend and change Americans who rely on Medicare every the ACA room to breathe and a chance the Affordable Care Act. So now here day. to succeed. If we do so, I am confident we are, and I think it is an outrageous In her letter, Secretary Sebelius also America will be better for it and we use of the Senate’s time, and we need stressed the severe impact the House will all be on the right side of history. to be able to move on with the serious CR would have on children and work- Mr. President, I yield the floor. business of governing the country. ing families and the most vulnerable The PRESIDING OFFICER. The Sen- I worry about unemployment in our among us. ator from Maryland. country. I worry about the fact that The ACA expanded Medicaid, allow- Ms. MIKULSKI. Mr. President, I rise our children are no longer achieving ing States to cover low-income adults to speak about ObamaCare. the best in the world. I worry about my for the first time. The House CR would When we passed the law, it was called small to midsized business having ac- end this coverage, sending this vulner- the Affordable Care Act. And before he cess to capital. able population back to the emergency leaves the floor, I would like to com- I know many here called this bill a room for treatment and putting hos- pliment the Senator from Montana on job killer. Do you know what is a job pitals on the hook for providing care. the important and crucial role he killer? Our behavior in the Senate. The ACA also expanded access for serv- played in passing the Affordable Care This gridlock, deadlock, hammerlock ices to people with disabilities and Act. It was through his excellent stew- on the Senate means we cannot do the other long-term care needs. The CR ardship in the Finance Committee, business of the country in an orderly would put an immediate stop to these where we could expand access to health and predictable way. Therefore, when programs and send people with disabil- care, modernize the way we do it to go businesses need to plan what are going ities back to the nursing home. from volume medicine to value-based to be the rules of the game coming out The Affordable Care Act also ex- medicine and to be able to expand our of the U.S. Government, they are not tended the Children’s Health Insurance access in a way that also was fiscally going to know. So if they are planning Program for 2 additional years. The prudent. He also led the way in expand- what they should do about their busi- House CR, you guessed it, reverts back ing the children’s health initiative. ness—should they expand? What should to prior law, ending vital funding for I know later on he is planning in his they do—they need certainty. As long this program at the end of this month. life a new future for himself. I want as we play brinkmanship politics, we The House CR would also leave 6 mil- him to know that while he is thinking cannot have certainty. lion children without access to cov- about living a different life, he really One thing is certain, though: We defi- erage—no doctor appointments, no pre- impacted the lives of many people. I nitely should keep ObamaCare. I am scriptions, no cast to heal the occa- thank him personally in a heartfelt happy to call it ObamaCare because I sional broken arm. way for the way he has improved the think Obama does care. But I think all For 3 years, a group of Republicans lives of people and particularly the of us here who are Democrats certainly in the House has wasted taxpayer lives of children and women in this in the Senate and many on the other money, time, and resources trying to country. side of the aisle also support the fact stop the act, over and over again. They The PRESIDING OFFICER (Mr. that we want to increase universal ac- have tried to repeal this law 40 times. BROWN). The senior the Senator from cess. So let’s go to what the legislation They even took their argument all the Montana. meant. way to the Supreme Court. Of course, Mr. BAUCUS. Mr. President, I deeply When we passed the Affordable Care we all know what the Supreme Court thank and am humbled by the senior Act, No. 1, it provided access to health said. The Supreme Court said the Af- Senator from Maryland. Coming from care for more people. When we passed

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00096 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6859 that bill, 42 million Americans did not high blood pressure could lead to a In a very short time, the majority lead- have access to health care. So that stroke or to death. So we helped get er will offer an amendment to the CR means that here in the United States better health care and better value for sent over by the House. I want to get of America, if you needed a doctor, our seniors. rid of this brinkmanship, slam-down, that didn’t mean you would have one. Then there is the prescription drug showdown politics. The amendment we If you needed a prescription drug, it benefit. The prescription drug benefit— will be offering will strike the provi- didn’t mean you could afford to buy called Part D—had something in it sion to defund ObamaCare. It will one. In many instances, this was a called the doughnut hole. The dough- strike the provision that was put in on hardship on many families. nut hole was hard to swallow because the debt ceiling which means that the Also what the Affordable Care Act it meant that once a senior’s drug way they want to structure it—what did is it ended abuses of health insur- costs exceeded a certain amount, they the House sent over—is we pay China ance companies. When we passed that went into not a doughnut hole but a first and Americans at the end of the legislation, people were denied health dark hole and they had to pay for the line. care on the basis of a preexisting condi- full cost until they reached a cata- I then want to set into motion work- tion. That often meant that for chil- strophic threshold. For many people ing with our Democrats—it is not only dren in the United States of America, with chronic conditions—not only us Democrats—to have a CR. if they had juvenile diabetes, if they those dramatic things like cancer but a The PRESIDING OFFICER. The Sen- had cerebral palsy, their families chronic condition like diabetes—they ator has 1 minute. couldn’t get health care insurance be- could reach that doughnut hole pretty Ms. MIKULSKI. I want to have an cause these children had preexisting quickly. But that is exactly what en- amendment to strike the defunding of conditions. ables you to manage your blood ObamaCare, strike the language on the If you were a woman, it was even sugar—working with your doctor, fol- debt limit, and move the date for the worse. Pregnancy was considered a pre- lowing a program of diet and exercise, next continuing resolution from De- existing condition, and in some in- but you still need medication to help cember 15 to November 15 so that we stances where a woman had a pre- control that blood sugar. If you don’t can get to a situation where we focus mature birth and a C-section, she was get that medication, you then could be on completing our budget, getting an denied health care because that was headed for worse problems related to omnibus, and eliminating sequester for considered a preexisting condition. In diabetic neuropathy, to vision loss, to 2 years. eight States, if someone was a victim the need for dialysis. You need to be in I want to get rid of the theatrical of domestic violence, that was counted a program that you can follow and that politics and get into the real business as a preexisting condition and they you can afford. That is why closing the of running and helping govern America didn’t have access to health care. Now, doughnut hole was so important. It in a way that provides jobs, economic what is that? saves lives, and it saves money. opportunities, and ensures our national So in the Affordable Health Care Act I could go on to other examples about security. we changed that law, so we created the what is in the Affordable Care Act. Mr. President, I yield the floor. opportunities that the punitive prac- There were many advances in terms of The PRESIDING OFFICER. The time tices of insurance companies would not women, and there were many advances of the Senator has expired. be a barrier to being able to get health in terms of children. But I want people The senior Senator from Tennessee is insurance. to know—because I am getting a lot of recognized. Then there was this other issue of vitriolic tweets that somehow or an- Mr. ALEXANDER. Mr. President, lifetime caps. That means that if you other Maryland isn’t being served. will the Chair please let me know when had a condition and you hit a lifetime When I looked at the data from our 15 minutes has expired. I have 20 min- cap, then tough luck for you. What own State’s health commissioner, utes. I would like to know when 15 happens if you have a child with hemo- 48,000 young adults in Maryland were minutes has expired. philia? That is a hard thing for that able to go on their parents’ plans and The PRESIDING OFFICER. The Sen- child to face the rest of his or her life, have health insurance while they look ator may proceed. and for the family. Don’t you think for a job or finish their education. Mr. ALEXANDER. Mr. President, there should be no caps on a benefit? Also, 485,000 Marylanders on Medicare once after I made a speech my late What happens if you are struggling were able to get that annual checkup, friend Alex Haley, the author of with cancer and you hit a cap? It and 72,000 Marylanders were able to ‘‘Roots,’’ came up to me and said: doesn’t mean your need for treatment participate in eliminating the dough- LAMAR, may I make a suggestion. ends; it just means your insurance nut hole. That saved them on the aver- I said: Of course. company won’t pay for it. Well, we lift- age $700 a year, for a total of $51 mil- He said: When you speak—instead of ed the annual lifetime caps. lion that was pumped back into the ‘‘making a speech,’’ would you say, For us women, the double insult of Maryland economy to do other things ‘‘let me tell you a story,’’ and someone paying more for health insurance sim- and create jobs for other people. might actually listen to what you have ply because we were women was re- So when they say they want to to say. So I do have a little speech on pealed. In the Affordable Care Act, defund ObamaCare, what is it they the new health care law to make. But there is no gender discrimination. We then want to replace it with? Do they before I make a speech, let me tell a found in our hearings that women paid want to go back to Big Insurance and story that I think applies to the new 2 to 10 times as much for their health their punitive practices of denying cov- health care law. It is a story about two insurance as men of the same age and erage for a child with a preexisting famous and patriotic Tennesseans who health status. We didn’t think that was condition? Let them call the parent of went to Texas. fair, and we changed it. a juvenile diabetic or a child with cere- The two men are Sam Houston and We also improved health care for sen- bral palsy. Do they want to defend the Davy Crockett. In the early part of the iors. No. 1, we added new Medicare ben- part where young people can’t stay on 19th century, Sam Houston was the efits, such as free cancer screenings. their parents’ plan until they are 26? Governor of Tennessee. He resigned Early detection means better treat- Do they want to make that phone call that position because of a problem with ment and a better chance of surviving and say: We know you are working his marriage. He went to Arkansas, that dread ‘‘C’’ word. It also provided hard to find a job or finish your edu- lived with Indians, and he went to an annual free checkup where someone cation. Oh no. Do they want to elimi- Texas. Congressman Davy Crockett could go and could get an identifica- nate the caps on benefits? Do they went for a different reason. He got tion of those silent killers early on. So want to eliminate closing the doughnut crossways with President Andrew if you have high blood pressure, if you hole? No. They just say they want to Jackson, who recruited a one-legged have high blood sugar and we found eliminate it. veteran of the War of 1812 to run those early, we could intervene before Well, I want to eliminate this from against him and he lost his race for they either moved to a deadly situa- the CR, so let me tell you where I come Congress in 1834. He later went to the tion or worse. We know undetected in as the chair of the full committee. courthouse steps in Madison County,

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00097 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6860 CONGRESSIONAL RECORD — SENATE September 24, 2013 TN, and said what every defeated can- have 46 on the Republican side. Every fine who is a good conservative and didate has always wanted to say to one of us has voted against ObamaCare who is not a good conservative. It is a such voters. He said: I am going to repeatedly. Every one of us would do so little bit like being in Sunday school Texas and you can go to hell and he again. Every one of us would vote to and somebody new comes into class went to Texas. That is historic fact. I repeal it. But in my view, the right and says: I am a better Christian than am not using bad words here. tactic is not to shut down the govern- you are and if you don’t agree with me So we had these two famous Ten- ment. It won’t work, ObamaCare would get out of the church. nesseans, patriotic, brave men, both of just keep going, and we would have You might say: Grandma is a Quaker whom went to Texas. They had the shut down the government. and Uncle Sam is a Baptist and we all same goal in mind, the independence of What does that mean? What does a try pretty hard in our faith. It is not Texas, but they had different tactics. government shutdown mean? Not ev- up to us to judge which one of us on the Former Congressman Davy Crockett erything would shut down, but here are Republican side is a better conserv- said: I think I will go to the Alamo. some of the things that would or could ative than another. Everyone who Some people said: Davy, if you go to happen: The 3.4 million Active-Duty looks around knows among Repub- the Alamo, you will get killed. He went military who would have to report to licans, most of us are conservatives, to the Alamo anyway and he did get work—whether at Fort Campbell in but we have different kinds. We have killed, but we remember him for his Kentucky and Tennessee or in Afghani- neoconservatives, we have bravery and we remember the Alamo. stan—would not be paid for their serv- paleoconservatives, we have fiscal con- Sam Houston took a different tack. ice as long as the government is shut servatives, we have social conserv- He withdrew with his men to San down. At home, their spouses could atives, we have cultural conservatives, Jacinto. He was heavily criticized by suddenly find the Department of De- we have Ross Perot conservatives—we some people in Texas at that time for fense schools closed. What are they have opened the door over the last 40 withdrawing. Some said it was a re- going to do for childcare, or with a years to every kind of conservative, treat, but he waited until the Mexican check arriving too late to pay the and it has made our party bigger and General Santa Anna was in a siesta mortgage? Social Security checks more successful because we have toler- with his troops, he attacked, defeated would continue to be paid, but the of- ated different points of view. his troops, and he won the war. fices might be closed. Same for more So I am not for shutting down the Today we celebrate both men. We than 20 million of our veterans who re- government for all those reasons. It think of them both as patriots, as ceive benefits; they might come late. will not work. When the government great Americans, and we remember the Two million Americans fly everyday. has been shut down before the Con- Alamo. But we celebrate Texas Inde- There would likely be fewer TSA gressmen could not buy their plane pendence Day on March 2, 1836, when agents, fewer air traffic controllers, tickets back to Washington fast Sam Houston won the war. leading to long lines at the airports in enough to open the government be- The moral of the story is that some- Nashville and New York and Chicago. cause the voters were absolutely out- times in a long battle, patience is a How do you think those 2 million peo- raged. It would shift the blame for valuable tactic. That is why I am in ple are going to feel about that? ObamaCare, which ought to be the ref- Sam Houston’s camp on this one. I am The national parks would close. Head erendum in 2014, to should you shut not in the shut down the government Start might close and many of the down the government or not shut down crowd, I am in the take over the gov- 110,000 people at our National Labora- the government? We should not be in ernment crowd. Americans should elect tories could be furloughed. this business of saying I am a better more Republican Senators and then ul- The last time the government shut Christian than you are or I am a better timately a Republican President and down was nearly 20 years ago. Back Jew than you are or I am a better con- then I am going to delay, dismantle, then, 200,000 people applied for pass- servative than you are. We ought to re- and replace the new health care law ports and couldn’t get them during the spect each other’s point of view. which we call ObamaCare with a law shutdown. There are 200,000 Ten- Instead, what should we do? First, we that actually reduces health care costs nesseans going to college this fall who ought to delay implementation of the for Americans. want or are in the process of getting a new health care law. My colleague My first reason for not shutting down new student loan and they might not from Tennessee, Representative MAR- the government is that it will not get it on time. SHA BLACKBURN whose conservative work. The problem is even if we were Your gun permit might not come credentials I’ve never heard anybody to vote to shut down the government, through, neither might your FHA loan. question, and Senator JEFF FLAKE according to the way some people The last time we had a government from Arizona wrote an editorial the argue—and I understand their passion shutdown, it cost the taxpayers $1.4 other day—I ask unanimous consent and I respect it—ObamaCare would just billion extra dollars, according to the for it be printed in the RECORD fol- keep going like the Energizer bunny. Congressional Research Service. lowing my remarks—saying the health The reason Senator COBURN, the Sen- So I am in the Sam Houston camp on care law must be delayed. ator from Oklahoma, has pointed out is this issue in that I want to show a lit- There is good reason for that. It is that 85 percent of the funding for tle patience in trying to win the war. If coming too fast and the chairman of ObamaCare is mandatory spending. we shut down the government, the Finance Committee said it is going Mandatory spending is the type of ObamaCare keeps going, it costs the to be a train wreck. The logical thing spending that just keeps going. So taxpayers a lot of money, and incon- to do is delay it for 1 year. The Presi- money for the exchanges, money for veniences a lot of Americans. Who do dent has already delayed many provi- the subsidies, and the individual man- you suspect is going to get blamed for sions of the health care law. The em- date would continue. What would we this? We will have suceeded in shifting ployer mandate has been delayed for 1 have achieved? We would have shut the blame for passing ObamaCare from year. The requirement that insurance down the government, but most of the Democrats, who did it unani- companies report to the IRS informa- ObamaCare would keep going. If that is mously, to the Republicans for shut- tion about health insurance products not enough, the President has author- ting down the government. You would has been delayed for 1 year. The ability ity in the law to declare some services think the Democratic National Com- for small employers to provide employ- essential. I assume, since this is his mittee might have come up with that ees with multiple health insurance signature issue and he is President for idea, not the Republican National Com- plan options in something we call the another 3 years, that he would declare mittee. That might not be a good pub- small business SHOP exchange has most of ObamaCare essential services. lic policy position, but it is a fact and been delayed for 1 year. The ability for So where would we be? As long as we people are observing it. state Medicaid programs to send elec- have a Democratic majority in the Then there are people who say to be tronic notices to beneficiaries, that is Senate and President Obama in the a good conservative, you have to vote delayed for 1 year. The start of the White House, it takes 67 votes in the to shut down the government. I have Basic Health Program, delayed for 1 Senate to repeal ObamaCare and we been listening to these people who de- year.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00098 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6861 Other provisions have been delayed suggested why don’t we go step-by-step ers in Tennessee and other States for 1 year and there are regulations to begin to reduce health care costs? across this country to elect more Re- that the administration has simply not We suggested at the President’s health publican Senators, or Democratic Sen- had time to issue. So why not delay the care summit working with him in a bi- ators who agree with us, and that will entire law for 1 year? That would give partisan way to do that. give us a chance to dismantle, delay, the administration time to at least get We can still do that. We can delay it. and repeal the health care law, which ready it would give the American peo- We can dismantle the parts of it I was an historic mistake. ple a chance to have a referendum on talked about. Then what do we do? This is nothing new. We counted it the law in 2014. So that is the first Step No. 1, make Medicare solvent so up. Republicans mentioned 173 times in thing we could do. seniors can depend on it. Senator the health care debate our step-by-step The second thing we could do is begin CORKER and I have a proposal which plan to reduce health care costs. We to dismantle the law. By that I mean will do that, offer seniors more choices still stand ready to put it into place. we should repeal all of the job-killing, and at the same time reduce the Fed- The best way to repeal Obamacare is premium-hiking taxes, especially the eral debt by nearly one trillion dollars not to shut down the government. The medical device tax. This is a particu- over the next 10 years. Medicare needs best way to do it is to take over the larly onerous tax that is 2.3 percent on to be solvent because we have many government, elect some more Senators, the revenues of those companies and it Tennesseans who depend on it to pay and elect a President. Put it in a bill. drives up the cost of medical devices their hospital bills, and it is going That is our constitutional system. We that tens of millions of Americans use. broke in a few years if we don’t take all admire the Constitution. We carry We should also and repeal the man- steps to do that. it in our pockets, and we talk about it. dates on individuals, families, and job No. 2, give Governors more flexibility We have a constitutional system, and creators that drive up premiums. But with their state Medicaid programs. we have to follow those rules if we that is not all we should do. Medicaid has gone from 8 percent of want to make legislative changes. We have a responsibility to say what the State budget when I was Governor I greatly respect the passion and the we would do as Republicans if the vot- in the 1980s to 26 percent today. It is endurance of those Senators who argue ers were to trust us with the govern- soaking up money that ought to go to that we should shut down the govern- ment. If they were to give us more Sen- higher education. Governors would like ment if we don’t get our way imme- ators who would vote to delay, dis- to keep tuitions from going higher, but diately on the health care law. I re- mantle, and repeal ObamaCare, what they cannot and the main reason is spect that just as I remember the would we do with it? Or if in a couple Federal Medicaid mandates get in the Alamo and respect our great Ten- of years they were to give us a Repub- way so we need to make Medicaid more nessean Davy Crockett who went to lican President, what would we pro- flexible. Texas. But on this one, when it comes pose? I said when the health care debate to tactics, I am in General Sam Hous- We can do a pretty good job of saying was going on that every Senator who ton’s camp. I think we will have to what we don’t like in ObamaCare. show patience to win the war. In the Three years ago, I was asked by Sen- votes for it ought to be sentenced to go home and serve as Governor for 2 years meantime, let’s delay ObamaCare, let’s ator MCCONNELL and Speaker BOEHNER to lead off for the Republicans at the to implement it. That may be one rea- dismantle it, and let’s show the Amer- President’s Health Care Summit. I son we have so many Governors who ican people that we have a better plan took the opportunity to outline for the are having a hard time balancing their with better steps to replace what is in President some of the problems with budgets with all these federal man- the law now with a step-by-step plan to his proposal that we saw at that time. dates. reduce the cost of Americans’ health It turned out that we were pretty pre- No. 3, strengthen innovative work- care. That is the plan I am voting for scient in what we were saying because place wellness programs. The adminis- today and the rest of this week and the most of the problems we predicted have tration has a regulation that needs to rest of this year and next year, until happened: increased premiums, more be repealed that restricts the ability of we get the job done. spending, more taxes. We said a 2,700- employers to say to employees: If you I thank the Presiding Officer. There being no objection, the mate- page bill, more or less, probably has a live a healthy lifestyle, you can have rial was ordered to be printed in the lot of surprises in it. The bill cut Medi- lower insurance premiums. care by one-half trillion dollars, not to No. 4, let small businesses pool their RECORD, as follows: make Medicare solvent, but to spend resources and offer a lower cost insur- [From The Tennessean, Sept. 24, 2013] on a new entitlement even though ance plan for their employees. TENNESSEE VOICES: HEALTH CARE LAW MUST Medicare is going broke within several No. 5, provide families the oppor- BE DELAYED years according to the Medicare trust- tunity to purchase insurance across (By U.S. Rep. Marsha Blackburn and U.S. ees. If Medicare goes broke, people will State lines. Sen. Jeff Flake) not be able to depend on it. No. 6, expand access to health sav- As we approach the Oct. 1 deadline when We said the new law would mean ings accounts and catastrophic health the Affordable Care Act begins to go into ef- fect, it becomes more and more evident that there will be about one-half trillion insurance plans, which would give peo- ple an opportunity to buy cheaper in- the president’s health care law is not ready dollars of new taxes, and millions of for prime time. Americans’ premiums would go up. surance rather than more expensive in- Through our congressional oversight and Today, the newspapers are filled with surance. the feedback we get from businesses and stories of rising premiums. So that is No. 7, incentivize the growth of pri- families around the country on a daily basis, what we said at the President’s Health vate health insurance exchanges. we have seen just how frustrated people are Care summit 3 years ago. Now we have No. 8, make it easier for patients to with the impact ACA is having on their an obligation to say what we would compare prices and the qualities of lives. It has become very clear that this law doctors. is unworkable. A recent CNN poll shows sup- like to do instead. port for the president’s health care law wan- I said to the President at that time: No. 9, incentivize States to reform junk medical malpractice lawsuits. ing, with only 39 percent of Americans now Mr. President, the President’s—your in favor of it, down from 51 percent in Janu- proposed health care law is an historic I have talked about one way to delay ary. mistake because it expands a health ObamaCare, two ways to dismantle it, With the Obama administration’s decisions care delivery system that already costs and nine steps to move from expanding to delay several parts of the health care law, too much instead of taking steps to re- a health care delivery system that al- including the employer mandate, it is clear duce its costs. The law is a mistake be- ready costs too much. By introducing that even the White House now recognizes cause it attempts to be comprehensive, more choice and competition into our what the rest of America already knows: health care delivery system, we can ‘‘Obamacare’’ is a train wreck. and it is too big a bite to chew, too Businesses small and large across our much to swallow, and too much to di- acheive the goal of reducing costs for states have shared stories about the burdens gest at one time. most Americans. That is a strategy, an the Affordable Care Act is placing on them. That is turning out to be right. That agenda and a plan that will earn the Couple that with the most recent jobs num- is why we have all these delays. So we confidence of enough independent vot- bers from the Bureau of Labor Statistics,

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00099 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6862 CONGRESSIONAL RECORD — SENATE September 24, 2013 and it is difficult not to conclude that the people we are capable of working with provided a free checkup. Indeed, his in- law is having a dampening effect on the one another or we can continue to yell surance covered his ability to go and country’s economy. at each other to score political points, That is why we have introduced legislation have his checkup in the evening so he that would delay all ACA provisions and refuse to be realistic about the need to didn’t even have to take a day off from taxes for one year. H.R. 2809/S. 1490 seek to find common ground, and shut down work. postpone all provisions of the Affordable the government and stop paying our He went in, had a checkup, and the Care Act taking effect on Jan. 1, 2014, or bills—the bills for which we are respon- doctor found a mole on his back and later by one year from the date of enact- sible. Clearly, I prefer the responsible said: This doesn’t look so good. I think ment. way—the way that can add thousands I should take it off. Delaying the law is a necessary step in our of additional jobs for the folks back efforts to get it off the books and replace it A week later when he went back to with real health care solutions that work for home who want and need them. American families and businesses. It builds When I first spoke on the Senate have the stitches out, the doctor said: on efforts already taken by the House and floor this spring, I discussed my strong I think you should sit down. You have Senate to delay both the individual and em- belief that government can help create a pretty serious form of cancer. ployer mandates. In fairness to American the conditions necessary for businesses The young man went to the hospital taxpayers, the best thing we can do right to expand and hire more workers and and had an operation which removed a now is to implement a one-year delay so we for the American workforce to be bet- hunk of his back. He had stitches under can continue to chip away at this disastrous ter ready to hit the ground and be mov- law. his arm. The lymph nodes were taken Postponing ‘‘Obamacare’’ gives us the best ing on day one. I am offering three out, and fortunately they found that chance to defund it. If we delay the law, the straightforward, bipartisan, common- the cancer had not yet spread. He administration will be unable to collect new sense things that we can do right now didn’t have to have chemotherapy or taxes, provide subsidies or expand Medicaid, to help the economy. radiation. He was OK. all things that put taxpayers further on the We should pass the bipartisan AMER- hook. ICA Works Act introduced by my The other young man didn’t have in- As Republicans continue to work to imple- friend Senator KAY HAGAN from North surance, so he didn’t go to the doctor ment real health care solutions for Ameri- and have a checkup. He had the mole cans, our legislation is the right step to Carolina and supported by Senator take. In fairness to taxpayers, our best op- DEAN HELLER and me. We are training on his neck, but he didn’t really notice tion today is to delay the law’s implementa- the next generation of employees to it or pay much attention to it. tion for one year and continue to work to have the skills that employers need. Six or 8 months later he noticed a enact policies that put patients and doctors We should finish our work on a 5-year lump in his neck. He still didn’t pay in charge of health care and do not require bipartisan farm bill that the President any attention to it. He didn’t have in- trillions of dollars of taxpayer money. can sign into law. American farmers surance and didn’t really want to spend I yield the floor. deserve that certainty. The PRESIDING OFFICER. The Sen- the money to go to the emergency We should also cut redtape to encour- room or go to the doctor, so he didn’t ator from Indiana is recognized. age private investment in infrastruc- Mr. DONNELLY. Mr. President, when pay much attention to it and he let it ture. I am working with Senators go. I was working in Indiana last month, PORTMAN and MCCASKILL on a bill that there was one thing I heard everywhere would cut redtape to improve the per- Six months later the lump was so I went: Congress should spend less time mitting process for big infrastructure large that he finally went to the doc- fighting and more time focusing on cre- projects so we can help private indus- tor, and they biopsied it and found that ating jobs. try create jobs in Indiana, Ohio, and it was metastasized malignant mela- We have made significant progress in across the country. noma. He had chemotherapy, radiation, Indiana since seeing unemployment Fights to and possibly beyond the and surgery, but a year later he died. rates north of 20 percent in some of the brink about whether to have the gov- counties in our State just a few years That story means a lot to me because ernment up and running and whether I am the first guy. Forty years ago, ago, but there is a lot of work yet to be to pay the government’s bills, our bills, done. Too many Hoosiers are still look- when I was a staff member in this in- in a timely fashion have a devastating stitution, I went and had that checkup ing jobs. effect on confidence and on our still-re- For all of the fighting here in Wash- because I had insurance. They found covering economy. However, when we ington, back home in Indiana everyone the mole, they did the surgery, and do the responsible thing and actually is on the same page. They want good- here I am today. do our jobs, we can help the economy paying jobs so they can take care of and we can help our constituents and I have often thought about that and their families, send their kids to col- maybe as a result give them reason to wondered, why me? Just luck—but also lege, and retire with dignity. That is have a little bit more confidence in because I had insurance. I can say with what Hoosiers want, and most think this institution and in our country’s certainty that if I had not had that in- Congress can do something to help in government. surance, I would not have gone to that that regard, even if that something is Sharon O’Brian of Crawfordsville, IN, checkup. If I had not had the checkup simply this: Don’t make things worse. told me in an email: I am sure many when I did within months or perhaps a What, instead, do many of my con- Hoosiers feel as I do. There needs to be year and a half, I would have been stituents think they are getting from compromise between the parties in gone. the legislative branch? George order to begin solving the many prob- Smeltzer from Nineveh, IN, sent me an I have a similar story about a daugh- lems facing our country today. e-mail. He said: ter of a friend of mine, Dick Gould up Let’s start solving, not creating, in Maine. Dick had a daughter named Enough is enough already! Washington is problems for our country. Let’s help like a bunch of children playing at recess Cindy who was diagnosed with severe and all fighting for one toy. Unfortunately, create jobs, let’s get to work, and let’s asthma at the age of 3. All her life she the toy is the American people. I’ve news for build America. battled it. She lived in a very rural you, most average Americans are not liberal I yield back. part of Maine. She didn’t have a lot of The PRESIDING OFFICER. The Sen- lefts’ or conservative rights,’ we are some- money and could never afford insur- where in the middle and we are tired of being ator from Maine is recognized. smashed around like ping pong balls in a par- Mr. KING. Mr. President, I want to ance, but she fought the asthma as best tisan game of ‘‘politics.’’ begin with a story about two young she could. She did the best she could, We are at a critical point in our on- men, both 29, both married with a cou- but she couldn’t afford the expensive going economic recovery. In the next ple of kids, and both contracted cancer treatments. week this Congress will decide whether the same day—malignant melanoma, Finally, not long ago, at the age of to keep the Federal Government open the kind of cancer that comes from a 53, Cindy Gould died, leaving a hus- and operating. In the weeks ahead this mole. Unfortunately, it is not uncom- band, children, and grandchildren, one Congress will decide whether to con- mon in our society. One of those young of whom she hadn’t ever met. Why did tinue to pay the government’s bills— men had insurance. In fact, he had an she die? Because she didn’t have insur- our bills. We can go one way, the re- insurance policy that provided preven- ance. She couldn’t afford to go in and sponsible way, and show the American tive care, and under that policy they have the care she needed.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00100 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6863 Why are we having this discussion America have less than 50 employees. first time. There is an emphasis on pre- here in the Senate this week about They are not affected by ObamaCare at ventive care. health care? The answer is pretty all. In fact, they are probably benefited I go back to my own story. Preven- clear. There are 50 million people in by it because whether or not they tive care saved my life. It was a heck of this country who have no health insur- choose to buy health insurance, their a lot cheaper than the care that was ance. The estimates are that between employees can get health insurance provided to the fellow who didn’t have 20,000 and 30,000 of those people die through the new health exchanges, and insurance because he didn’t catch it in each year—like Cindy Gould—because that is probably a benefit to those busi- time. He ended up in the emergency of the lack of health insurance. Why nesses. But 96 percent of the businesses room. He ended up having surgery, doesn’t that bother us? Why aren’t we the law doesn’t apply to. Ninety-eight chemotherapy, and radiation, and ulti- spending days and nights here talking percent of the larger companies—200 mately futilely, but that treatment about how to solve this problem in- employees and more—already provide cost a lot more than my treatment did stead of how to dismantle the most sig- health insurance to their employees. because I was insured and had preven- nificant health care program that has So the law doesn’t apply to them. Nine- tive care. come to this country in years? Why? ty-four percent of the smaller firms, It also allows kids to stay on their I have a theory about that. It is be- from 50 to 199, already provide health parents’ policies until they are 26. This cause those deaths are invisible. They insurance to their employees. is a big deal, because it allows kids to happen one at a time in Greenville, So this idea that somehow take jobs and do things and travel and ME; in Portland, ME; in San Diego, CA; ObamaCare is taking over the health work but not have to focus on whether and El Paso, TX, so nobody knows. It is care industry in this country is non- they have health care. They can stay not listed in the obituary: Died because sense. Eighty percent of the people are on their parents’ policies until they are of no health insurance. largely unaffected by it. They are ei- 26. That is happening right now all I would submit that if those 25,000 ther the 50 percent who are covered by across America. people—which is a conservative esti- their employers now or the 22 or 23 per- There are no lifetime caps. mate—in this country all died at the cent who are under Medicare now and 7 As I mentioned earlier, we are the same time and in the same place, we or 8 percent under Medicaid. But that only country in the world where people would be turning the world upside leaves 15 percent uncovered, uninsured, get wiped out by health care costs. No- down to solve the problem. Just imag- unprotected, and that is between 45 where else is that even remotely an ine that kind of loss in a small town in million and 50 million people. issue the way it is here. the Presiding Officer’s State each This is not a government takeover. Finally, a person can’t be denied year—25,000 people a year. There is no place in America one can health insurance because of preexisting On September 11, 2001, we had a trag- go and sign up for ObamaCare. If one conditions. That is crucial, because edy in this country, and 3,000 people goes onto an exchange, they get insur- there are millions of people across this died. It was a terrible day. What have ance from Anthem or Blue Cross or country, through no fault of their own we done as a result of that day? We Health First or Aetna. One doesn’t get but because of the vagaries of health, turned our society upside down, we ObamaCare, one gets insurance cov- who have problems they were born protect ourselves at airports, and we erage from private insurance compa- with or that came on in their youth spent money for screening and protec- nies, just as we have done in this coun- and under the old rules, they can’t get tion. We spend $70 billion a year just on try for most of the 20th and 21st cen- insurance. Now they can’t be denied in- intelligence in order to protect our- turies. It is not a government take- surance. That is going to make a lot of selves from another September 11. Yet, over. difference to people in this country. quietly and insidiously, every year Here is what it is: It is a mechanism Because of that—and I watched Sen- over 20,000 people die because they to make it easier and cheaper for those ator CRUZ last night, and he talked don’t have insurance. people who are uninsured to find a way about this. If you are going to require Another 700,000 families lose every- to get insurance: to go online to a insurance be issued to people even if thing because of medical bills. We are health exchange, which is nothing but they have preexisting conditions or the only country in the world where I suppose one could call it the Amazon some kind of illness, then you also that happens. We are the only country or e-Bay of health insurance where peo- have to mandate that everybody buys in the industrialized world where peo- ple can see what their options are, it; otherwise, nobody would buy it ple are prone to lose everything be- make their choices. They get support until they are in the ambulance on the cause they are swamped with medical from the rest of us if they are within way to the hospital. If a person didn’t bills. That is ridiculous. Would we certain income levels, and it makes have to buy fire insurance before the watch someone die in our front yard? health insurance affordable. fire, everybody would buy it when they Of course not. We would call 911. We It is based upon the free market prin- saw the flames coming up from their would call the doctor. We could do ciple of competition, and that group house. I think Senator CRUZ, the Sen- CPR. We would do whatever we could rates are better than individual rates, ator from Texas, used that image last to keep them alive. But we are quietly and the essence of the system is a mar- night. To me, that makes common as a society watching over 20,000 people ketplace where people can buy private sense. a year die, and we are arguing about health insurance. It also makes common sense because the details of how to solve this prob- It is also insurance reform. It repairs it is a matter of personal responsi- lem. and improves and mandates some im- bility. I always thought that was a con- To me, it is a moral question. There provements in the way health insur- servative principle. I remember in the is a lot of economics involved. There ance works, to avoid some of the real 1970s and 1980s it was a conservative are a lot of questions about costs and glaring problems that most people have principle that people should take re- we will talk about that. But, fun- identified with and many people have sponsibility for themselves. damentally, it is a moral question. The run up against. One is a limitation that Right now in our society, if a person moral question is, Are we going to health insurance companies have to is sick, and if a person has no insur- stand by and watch people suffer and spend 80 percent of the money they ance, they are treated. The hospital die because of ideology and politics? No take in on health care. In other words, cannot turn you away. What that other country in the world has an- there is a limit on profit and overhead. means is we all pay. That person is in swered yes to that question, and that is I think all of us feel that is reasonable. effect a free rider. They have insur- the question that is before us. That is already happening, and, in fact, ance; it is all the rest of us. I think it So what is this thing called some people are getting refund checks is a basic principle that they should ObamaCare, the Affordable Care Act? from their insurance companies be- take care of their own responsibility. What is it? The first thing to say is cause they were spending too much on People act as though this is some what it is not. What it is not is a tre- overhead and profit. kind of radical notion. We have had—I mendous impact on American business. Under the insurance reforms of the don’t know about the State of the Pre- Ninety-six percent of the businesses in bill, women are treated equally for the siding Officer and other States, but in

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00101 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6864 CONGRESSIONAL RECORD — SENATE September 24, 2013 our State we have had mandatory about too much regulation. I am wor- ment can hold it hostage because of automobile insurance for as long as I ried that they will overdo the regula- one particular piece of legislation that can remember and nobody questions it, tions somewhere in the government as they don’t like. because it is a responsibility. You need they implement this, and I think that This is an economic but it is also a to be responsible for yourself. As I say, is something we need to pay close at- moral issue. It is about trying to help this was always a conservative prin- tention to. There are problems such as people deal with the shadow of health ciple until lately, and all of a sudden it the 30-hour workweek versus 40 hours. care hanging over them. It is not per- isn’t. It reminds me of the old line of Those are the kinds of things I think fect, but it corrects some of the most Mort Sahl, the comedian back in the we need to pay attention to and we glaring defects in the private insurance 1950s, who said, ‘‘If you maintain a con- need to fix. There has never been a per- system, and it provides an opportunity sistent political opinion in this coun- fect piece of legislation, perhaps, other to millions of Americans to escape the try long enough, you will eventually be than those Ten Commandments on day-to-day shadow of a health care ca- tried for treason.’’ Mount Sinai, but we need to try to fix tastrophe. And here we are; what was once a things and not just say, Oh, well, we To those who want to fix it, I stand conservative principle is now anath- are going to tear the whole thing apart ready to help. To those who have ideas ema. But I think it is all about per- and start over. I am a little skeptical and suggestions, I stand ready to lis- sonal responsibility and providing for on the starting over part because I ten. To those who want to destroy it, yourself. haven’t seen any inclination to do so. however, I stand in your way. And to I understand,—I have seen press re- As I mentioned, the larger health those for whom the shadow has finally leases that there are people going care problem is cost. We are now spend- been lifted, I stand at your side. around the country telling young peo- ing 18 percent of our gross domestic I thank you, Mr. President. ple not to sign up for coverage. I think product on health care—by far the I yield the floor. that is outrageous. It is unbelievable. highest number in the world. Japan is The PRESIDING OFFICER (Mr. And they are sentencing some of those at about 11, and everyone else is at 8 or BLUMENTHAL). The senior Senator from people to death or to severe injury be- 9 percent. We are spending twice as Texas is recognized. cause they are not going to have health much per capita as anyone else in the Mr. CORNYN. Mr. President, as we insurance when they are going to need industrialized world and our results discuss our efforts to support an effort it. aren’t that good, by all kinds of inter- that started in the House to defund All young people are immortal. I was national standards, including infant ObamaCare in this legislation, I want when I went in for that checkup when mortality, longevity, customer satis- to start by congratulating my col- I was 29 years old. They think they are. faction. We are in the 15, 17, 20, 25th in league Senator CRUZ on his remarkable But to tell people not to get insurance the world, and we are paying twice as 21-hour performance. I promise I will when it is available, particularly when much. not try to duplicate that, at least not There is also this cost problem is it is available at low cost, I think is right now. But I do admire his passion what is killing our budget. All of the something that should weigh on the and his energy, and I think probably debt and deficit problem we are pro- conscience of whoever is funding and more than anyone in recent memory, jecting in the Federal budget is based developing that campaign around the he has done more to raise this issue to upon health care costs: Medicare, Med- country. the American consciousness and in- icaid, and public employees. That is So what is the Affordable Care Act? spired people by his passion. where the deficit is. It is not in the na- It is a mechanism to buy insurance. I want to say that I share his deter- tional parks, it is not in Head Start, it No. 2, it is reform to the insurance in- mination to stop ObamaCare before it is not even in the Department of De- dustry in terms of what the require- does any more damage to our country. fense. It is health care costs, and we ments are; and No. 3, buried in it are The two of us represent 26 million peo- need to talk about that and work on it pilot programs that may turn out, in ple in the State of Texas, and we have and do something about it. heard countless stories of how the my view, to be the most important I think these pilot programs within President’s health care law is already part of the project, the most important the Affordable Care Act are showing hurting not just individuals and fami- part of the bill, because they encourage amazing promise just in the last couple lies and small businesses, but hurting changes in the way we deliver health of years that they have been in place. care. A note on process, and then I will the economy. As I will mention in a minute, the yield the floor. I have never known of I heard the distinguished Senator real problem with health care is cost, a time when the repeal of a particular from Maine saying the President’s and these pilot programs that are being piece of legislation has been used, has health care law is working pretty well. used around the country, including in been held hostage, in order to keep the But I have to say, even though I dis- Maine, are already having some spec- government running. We have had ar- agree with him about ObamaCare actu- tacular results. I talked to two people guments about budgetary matters at ally working, it strikes me that one from our two major Maine hospitals the ends of budget periods, and there point is irrefutable; that is, ObamaCare this morning. They are seeing a 60-per- was a shutdown in the 1990s about is hurting the economy and hurting job cent reduction in emergency room use spending and budgets, but I have never creation. We have heard at least from and a 70-percent reduction in rehos- heard of a time when a group tried to some of the major organized labor or- pitalization because of what is called use a bill and say we are going to re- ganizations in America—people like the Accountable Care Organization peal this bill or we are going to shut Richard Trumka, who said that Structure that they have put in place down the government. ObamaCare is killing the 40-hour work- for Medicare patients in Maine. In the 1950s and 1960s, the south- week. It is making full-time work into They are seeing better care at sub- erners were dead set against civil part-time work. That is one reason he stantially lower costs, and this is the rights legislation. They filibustered and other labor organization leaders kind of pilot and innovative program and tried to stop it, but it ultimately went to the White House recently and that is also in the Affordable Care Act was passed in the 1960s, and was a asked the President for a special opt- that nobody ever hears about or talks proud moment for this body and this out or waiver. about that I think, as I mentioned, institution. They never said: But we I believe the only solution is to dis- may turn out to be the most important are going to shut down the government mantle ObamaCare in its entirety. part of the bill. if you fund it or enforce it. They had Some have said: After Senator CRUZ That is it: limits on insurance provi- too much respect for the institution. got through speaking today, after his sions, greater access to insurance. I They had too much respect for the im- remarkable 21-hour performance, the think we need to calm down around portance of the continuity of govern- debate is over. To them I would say, here about what this bill does. ment over and above any issue, no mat- the debate has only just begun. We will It is not perfect. It is complicated. It ter how passionately they felt about it. be here in the Senate for the remainder does have some implementation issues I hope this weekend we can let go of of this week debating the effort to that I am worried about. I am worried this idea that a minority of the govern- defund ObamaCare.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00102 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6865 My friends across the aisle have re- by injecting the IRS into the imple- businesses form risk pools, particularly peatedly said that because Republicans mentation, it will further damage an across State lines, to provide more want to protect the American people already broken Medicaid program, and choices and more competition when it from ObamaCare, we want to take it will prompt even more doctors to comes to keeping down health care health insurance away from millions of stop treating Medicare patients. costs. And we support abolishing oner- Americans. Nothing could be farther The closer we get to full implementa- ous mandates. from the truth. tion of ObamaCare, the more we learn Why should you have to buy health Democrats argue that Republicans about its myriad problems and its un- coverage that includes coverage you do have not put forth any alternatives to intended consequences. For example, not need or want? For example, if you ObamaCare. That is false. It is time to the ObamaCare exchanges are supposed are a young man, why should you have set the record straight. to open next Tuesday. But most people to buy a mandatory health plan that When it comes to health care reform, still do not know how much money has maternity coverage in it? It does Republicans have three main objec- they will be paying for insurance. not make a lot of sense. tives, all of which are filed under Meanwhile, a front-page story in USA And, yes, we support giving more ObamaCare. One, we want to reduce Today talks about a little noticed pro- Americans choices when it comes to costs. The President said this was one vision of ObamaCare which threatens how to pay for their health insurance of his goals in ObamaCare. He promised to cost some families thousands of dol- using pretax dollars—things like tax that the average family would see a re- lars in health insurance and leave up to free health savings accounts. duction in their health care costs of 500,000 children without coverage. We also believe that making price in- $2,500. What are the facts? We have For that matter, even if ObamaCare formation more transparent will create seen health care costs go up by an av- is fully implemented on schedule, the the kind of discipline that comes with erage of $2,400 for that same family. We Congressional Budget Office projects a market. For example, if people know want to expand quality insurance cov- that about 31 million Americans will what their health care costs are going erage, and we want to improve access still not have coverage. I thought to be, and they see what their choices to care. ObamaCare was designed to make sure are, they know that the competition The President has put most of the ap- everybody had coverage. So it seems to that comes through market discipline ples with his health care plan in the me it has failed again in its stated ob- will improve not only the price—it will same sack, which is Medicaid. In Med- jective. bring it down—but it will improve the icaid in my State, only about one doc- My friends across the aisle like to quality of service. Perhaps the best recent example of tor out of every three will see a new say that Republicans are opposed to ex- that is the Medicare prescription drug Medicaid patient because it only reim- panding health insurance coverage. plan, which has now come in 40 percent burses doctors about 50 percent or less But, as I have just told you, we are ac- below projected cost, because now sen- of what they charge other patients. So tually for replacing ObamaCare, which iors have choices when it comes to they simply have had to refuse to see would provide people with more access their prescription drugs, and those new Medicaid patients. to affordable health care. plans compete based on price and qual- So we want to reduce costs, we want In reality, what we are opposed to is ity of service. That is benefiting the to expand quality coverage so that you policies that reduce health care choices consumer and providing a lower price. own your own insurance policy, and we and dramatically disrupt people’s ex- And, yes, we do support tighter curbs want to improve access to care. isting health care coverage. We are op- on frivolous medical malpractice law- In order to achieve those objectives, posed to policies that raise taxes by suits, which drive up the costs of med- we first have to remove ObamaCare more than $1 trillion on people like the ical liability insurance and drive doc- from the table. We know what the evi- medical device manufacturers that I tors out of business. In Texas, we have dence has been in the years since mentioned a moment ago, which hurts had a wonderful pilot program. And I ObamaCare first passed in 2010. innovation, which hurts people’s access tell you, we have seen doctors move to ObamaCare is already causing em- to the best quality of health care. And, Texas because they want some predict- ployers to drop health coverage. So if yes, we are opposed to policies that kill ability when it comes to their medical you like what you have, it turns out full-time jobs in favor of part-time liability exposure and the costs of their you cannot keep it. It is already caus- work. And we are opposed to policies malpractice insurance. That, in turn, ing doctors to leave Medicare, for the that cause insurance premiums to go provides people with better access to same reason. As I mentioned, they are up rather than down. doctors. leaving Medicaid. It is already causing It is true, we are opposed to policies And, yes, we believe that you can use insurance providers to reduce con- that put government bureaucrats be- State high-risk pools to insure people sumer choice. We saw a story in the tween you and your doctor when it with preexisting conditions. In other New York Times just a couple days ago comes to deciding what access to words, the idea that you need to em- about that. We know it is already caus- health care you and your family ought brace the behemoth called ObamaCare ing businesses to lay off workers and to have. And we are opposed to policies just in order to cover people with pre- turn full-time work into part-time that cause physicians to refuse to see existing conditions is simply false. You work. Medicare patients. do not. We can do it much cheaper and It is already causing medical device We are opposed to policies that weak- more effectively by supplementing the manufacturers to close existing fac- en our health care safety net. And we State high-risk pools so people with tories here in America and to move are opposed to policies that massively preexisting conditions can get access their businesses offshore because of the expand the power of the Internal Rev- to health care. taxes that target that particular part enue Service—that is currently racked We support States having a lot more of the health care industry. in scandal—getting involved in imple- flexibility to manage Medicaid—some- And it is already causing many phy- menting your health care plan. thing that can only happen now based sicians to consider early retirement, So again, we are for reform that upon a special dispensation from the causing a restriction in access to cov- helps bring down the cost and improves Federal Government. erage, because unless you can find a access to quality health care in a way If we are able to help people coordi- doctor to accept you, you do not have that does not interfere between the nate their health coverage, we can do a effective access to coverage, even doctor and the patient. The kinds of better job of making sure that even though you may have something called health care reforms that we are for are people on Medicaid get access to health Medicaid or Medicare. those that deal with cost, coverage, care at a lower cost. If and when the law is fully imple- and access. As I said, we support introducing mented, ObamaCare will drive up indi- For example, we support equalizing competition into Medicare so that pa- vidual insurance premiums, it will the tax treatment of health insurance tients and physicians could work to- cause millions of Americans to lose so that individuals and employers are gether to hold down costs, just as they their existing health care coverage, it put on the same footing, unlike today. have done in the prescription drug pro- will jeopardize medical privacy rights We support letting individuals and gram that I mentioned a moment ago.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00103 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6866 CONGRESSIONAL RECORD — SENATE September 24, 2013 So here is the bottom line: We have solutions that will address A number of Ohioans have benefited ObamaCare is not the only way to ex- that. So if we can find five Democrats in a whole host of other ways. So we pand access to quality health care. In to join us, perhaps those Senators who know this health care law already is fact, it may well be the worst way to are running for reelection in States working, we know it will continue to expand coverage because it raises costs that Mitt Romney carried by double work. When I hear people in Wash- and it reduces patient choices, and you digits, the Senate would have voted to ington, DC, who dress like this, who all have to depend on the tender mercies defund ObamaCare. It is that simple. enjoy pretty darn good health insur- of the Federal Government when it in- Plenty of our colleagues have ac- ance, paid by taxpayers, then I see my tervenes between you and your doctor knowledged the harm ObamaCare is legislature in Columbus, legislators when it comes to your choices. doing to our health care system, and to also who have health insurance, not By contrast, we believe that health our broader economy. Now they have a even expanding Medicaid, not even al- care reforms such as those I have out- chance to do something about it. Now lowing people, children especially and lined just a moment ago would allow us they have a chance to actually vote seniors and disabled people, and often to expand access to quality health care with Republicans to stop this law be- people who have low-wage jobs—deny at a lower price without interfering fore it is fully implemented. them health insurance, I think some- with the doctor-patient relationship. Four years after Senate Democrats thing is dreadfully wrong. Mr. President, before I conclude—be- voted to enact ObamaCare on a party- Mr. President, I want to talk for a cause I know there are other colleagues line vote—no Republican voted for it, moment about something else in who want to speak—I want to explain all Democrats voted for it—the con- health care. Ancient cultures have once again why I support moving ahead sequences of ObamaCare are plain for been using plant extracts and other with this legislation that is now before all of us to see. By proceeding to the mixtures with antimicrobial properties us. House bill, we are forcing each Member to aid in healing for more than 2,000 I note that 100 Senators just voted of this Chamber to take a stand either years. We are probably most familiar for cloture on the motion to proceed to for or against their constituents when as Americans with the Scottish sci- the continuing resolution which con- it comes to a failed health care bill, entist—I believe Scottish—Alexander tains the defunded provision passed in one of the most unpopular laws in the Fleming who developed penicillin, the House. I am committed to history of the country. which became a very common drug I know where I stand on ObamaCare. defunding ObamaCare for the reasons I used kind of from the 1940s on. said. But I also believe that we ought I know where all of my Republican col- Last week the Centers for Disease to avoid a Government shutdown. I be- leagues stand. All of us stand united in Control and Prevention called anti- lieve that to deny cloture—unlike the our desire to protect the American peo- microbial resistance ‘‘one of our most vote we just had, 100 to 0—to vote ple from this failed public policy. serious health threats.’’ I would urge our colleagues across against cloture on the very resolution Antibiotics and other antimicrobials the aisle to think again, listen to their we are for that came from the House have been, in essence, a victim of their constituents, including people such as that would defund ObamaCare is a lit- own success. We used these drugs so Richard Trumka and organized labor tle hard to explain. widely for so long and sometimes not and help us save America from this It may well prompt the government always wisely, and sometimes indis- shutdown, which I think benefits no failed public policy disaster. I yield the floor. criminately, that the microbes they one, and it could possibly damage our The PRESIDING OFFICER. The Sen- are designed to kill have adapted to economy, which as I said earlier is ator from Ohio. them, making the drugs less effective fragile indeed. Here is the ultimate Mr. BROWN. I ask unanimous con- or in some cases totally ineffective. irony. If we are to shut down the gov- sent that after my 5 or 6 minutes, the I stand before you today to remind ernment because we refuse to pass a Senator from New Hampshire be recog- you of the need for a comprehensive continuing resolution to keep the gov- nized. strategy to address microbial resist- ernment operating, ObamaCare still The PRESIDING OFFICER. Without ance. Each year, about 2 million Amer- gets funded. That is because it has objection, it is so ordered. icans contract bacterial infections in mandatory spending, in other words Mr. BROWN. Mr. President, I would hospitals, and 20,000 of these people die automatic spending, that even if the remind my colleagues, after hearing because the microbes causing their in- government shuts down, ObamaCare Senator CORNYN’s speech and also the fections are resistant to frequently still, by and large, gets funded. very articulate words of Senator KING used antibiotics. You do not have to take my word for talking about a personal story—that One of the most commonly reported it. Dr. COBURN, Senator COBURN, has this is full of personal stories of people antimicrobial resistant infections is asked the Congressional Research who get preventive care or they don’t something called MRSA, an acronym Service for their authoritative opinion. and the difference that makes in peo- for methicillin-resistant staphy- They said even if the government were ple’s lives, the quality of their lives lococcus aureus. MRSA is a strain of to shut down, ObamaCare will continue and their life expectancy. staph infection resistant to penicillin to be funded. So I support whatever I remind my colleagues that in my and other related antibiotics. Once strategy is likely to help us defund and State alone, about 1 million seniors thought to be contracted solely in hos- ultimately dismantle ObamaCare, but have gotten preventive care and var- pital settings by older patients, MRSA in my view, shutting down the govern- ious kinds of tests, senior citizens in is now affecting young, healthy people ment is not the best strategy, because Medicare, at no cost, with no copay in our schools and communities. With- it would not work. According to the and no deductible. About 1 million in the last few years, we have heard far Congressional Research Service, Ohio seniors have gotten that benefit too many media reports of high school ObamaCare would continue to be fund- from the Affordable Care Act. and college age students losing their ed. About 100,000 Ohioans in their lives to these infections. To be clear: Republicans are united twenties have been able to join their The statistics continue to be trouble- in our desire to defund ObamaCare. The parents’ health plan until they are age some. A recent study from the Univer- bill before us does exactly that. So if 26 and get insurance. People in their sity of Chicago revealed that more peo- we proceed to the bill, my hope is that twenties who do not have insurance ple are checking into hospitals with five Democrats—maybe the five Demo- otherwise have it through something MRSA than those with HIV or influ- crats who voted for ObamaCare in its called the medical loss ratio, which for enza combined. We cannot ignore that. first instance but have been listening every dollar of premium in health in- Molly Brudnick of Shaker Heights, a to their constituents as I have, people surance you pay, 80 to 85 percent of Cleveland suburb, contracted MRSA such as Richard Trumka and organized that must go directly into patient care after back surgery. She should have labor who have said: The promises you rather than profits and executive sala- been concentrating on recuperating made, this simply is not performing as ries and marketing. That has forced in- from her surgery. Instead she spent 6 advertised. We need something to be surance companies to write refund weeks on IV antibiotics in a nursing done to ObamaCare. checks to tens of thousands of Ohioans. home. She had to complete 3 months of

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00104 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6867 rehabilitation, with nursing care to ness, whether it is listening to someone versal concern and worry about the im- tend her wounds. Molly’s story is far who is having their hours cut because pact of ObamaCare and the increasing too common in my State and the Pre- their employer is trying to meet a 29- costs that people are seeing in health siding Officer’s State of Connecticut hour requirement. care as a result of ObamaCare and and across the country. In fact, right now in New Hampshire fewer choices that people in New It does not have to happen. As this there is only one insurer that was ap- Hampshire are going to have. epidemic—if you call it that—con- proved to offer health policies on New Here is some of the mail I have re- tinues to spread, the financial costs Hampshire’s ObamaCare exchange. In ceived from some of my constituents and the loss of life will continue to order to prevent premiums from sky- about this law. rise. A 2012 study at Columbia found rocketing—and by the way, people in Dave in Manchester wrote me that he that each drug-resistant infection cost New Hampshire will be paying higher and his wife are in their forties. This is $15,000 more to treat than other infec- than the national average for pre- what he had to say: tions which are not antimicrobial re- miums under ObamaCare. But to pre- Our premiums went from quarterly in May sistant. That is unacceptable. Curing vent them from skyrocketing even fur- to monthly as of June. No birthdays or MRSA is one piece of the puzzle in ther, this lone New Hampshire insurer changes in health. Our monthly bill went from $497.39 for myself to $572.67, a jump of eradicating the superbugs that are re- has been essentially forced to limit its over 15 percent. My wife had her bill go from sistant to antibiotics. network of providers to exclude 10 of $572.67 to $801.84, a jump of over 40 percent. In response to this health crisis, I our 26 hospitals. Dave says he makes approximately join the CDC in urging enhanced atten- What does that mean for the people $31,000 a year after taxes and that tion and resources devoted to anti- of New Hampshire? Several of the hos- health care takes up half of it. microbial resistance. In 2008, I, along pitals have been excluded as a result of Caroline from Grafton wrote: with Senator HATCH, the senior Sen- ObamaCare from this exchange and did Our school district and surrounding ones ator from Utah, introduced the STAAR not make the list for coverage. They are cutting back paraprofessional jobs to 29 Act, Strategies to Address Anti- are, for example Concord Hospital, hours. Many of these people were full time. microbial Resistance Act. I thank Sen- which serves residents in and around Instead, they hired several part-time people ator HATCH for his leadership as we our State capital, and that is not one to cover the once full-time positions. This begin to see the epidemic of anti- of the providers in the network; Ports- law of unintended consequences is dev- microbial resistance develop. mouth Regional Hospital in Ports- astating for those whose hours and benefits have been cut. Now they are no longer enti- The STAAR Act is a multiple- mouth. The largest city on our sea- tled to benefits; many of these individuals pronged approach to revitalized efforts coast, Portsmouth Regional Hospital have worked for 15 years or more as full tim- to combat superbugs and prevent out- serves the surrounding areas. Not in ers. breaks of MRSA and other drug-resist- the network. John from Middleton wrote: ant infections. The STAAR Act estab- Other hospitals in New Hampshire I am 61 and retired. I buy my own health lished a government task force to di- that are not in this network: Frisbie insurance privately. Since the Affordable rect efforts to combat microbial resist- Memorial Hospital in Rochester; Care Act, I have had to change my insurance ance. The bill provides for more re- Southern New Hampshire Medical Cen- carrier because they left the State. I changed search on drug-resistant bacteria and ter in Nashua, where I live; Monadnock my coverage because it became too expen- explores strategies to ensure the devel- Community Hospital in Peterborough; sive, and I have had three increases in my opment of new anti-infective drugs. Valley Regional Hospital in Claremont; premiums. It also ensures that antimicrobial and Alice Peck Day Hospital in Leb- Chris from Nashua wrote: drugs will be prescribed and used judi- anon. As a small business owner and self-insured, ciously. We have made far too many This problem is especially chal- I am very worried about my costs going up. advances in modern medicine to lose lenging for people in New Hampshire My broker mentioned that we may see a 200 percent increase in our monthly rate. the fight against microbes. I look for- who live in rural areas. It is particu- ward to working on measures to pre- larly unfair to them. For example, Nancy lives near a hospital that was serve our existing arsenal of antibiotic Upper Connecticut Valley Hospital in left out of the exchange. Ten of our and other antimicrobial drugs and to Colebrook did not make the cut. What hospitals, which is a huge amount in ensure that new drugs are developed does that mean that Upper Connecticut our State of New Hampshire, almost a which can effectively fight superbugs. Valley Hospital in Colebrook did not third of our hospitals, have been left I plan to reintroduce the STAAR Act make the cut? If you live in Colebrook out of the exchange. Nancy wrote: soon. I will work with my colleagues to or Stewartstown or Columbia, and you I want to continue to have my medical see it moved to passage. need maternal care, you have to drive care with the doctors, nurses, therapists, et cetera, whom I know and trust and with I yield the floor. to Berlin. If you have to drive to Berlin whom I have an established relationship. The PRESIDING OFFICER. The Sen- from some of those areas, this round Again, what do I do? This is what the Afford- ator from New Hampshire. trip can take you 3 hours. able Care Act did for me. Ms. AYOTTE. Mr. President, I rise What does that mean when you need We have seen recently that the head- today to talk about what is happening maternal care? If you have to drive lines of what is happening with the im- in my home State of New Hampshire as over an hour or an hour and a half to pact of ObamaCare tell the story. In a result of ObamaCare. When I ran for get to the hospital, I have to tell you, my home State of New Hampshire the Senate in 2010, one of the reasons I the north country in the winter can be today, from the Associated Press: decided to do so is because when I saw some tough driving. One thing I know ‘‘Health overhaul premiums in NH ObamaCare had been passed, I worried about the residents of our north coun- above average.’’ about what was going to happen with try, they are resilient, they are tough, The National Telegraph: ‘‘Decision to this law. they are wonderful people. But they eliminate Nashua hospital from health We saw it could offer less competi- should not be put through this as a re- exchanges causes confusion.’’ tion, limit peoples’ choices, limit their sult of fewer choices under ObamaCare. The Union Leader: ‘‘Companies look choices on who would be their physi- I have been making trips across New for new ways to pay fees coming from cian, and also change their insurance Hampshire directly talking to my con- ObamaCare.’’ policies and raise costs in a health care stituents, including to business owners. Concord Monitor: ‘‘Concord hospital system that costs too much to begin The message I have heard from them is not part of provider network for with. very clear. In fact, it has been raised ObamaCare exchange plan in New Sadly, we are now seeing all of these with me on almost every stop that I Hampshire.’’ fears come true with ObamaCare. Un- made in New Hampshire in August Nationally, the headlines are telling fortunately, I have seen it firsthand in where I had the chance to talk to peo- the story as well. A Politico recent ar- my home State of New Hampshire. In ple from throughout all our State. ticle: ‘‘ObamaCare: One blow after an- fact, I have heard it from my constitu- This is not an issue that is being other.’’ ents, whether it is at a townhall, raised because I am a Republican or a USA Today: ‘‘Family glitch in health whether it is visiting with a small busi- Democrat or an Independent. It is uni- law could be painful. It could leave up

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00105 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6868 CONGRESSIONAL RECORD — SENATE September 24, 2013 to 500,000 children without coverage you have one shop, to open up a second to people is the President has made the and cost some families thousands of shop? decision that the employer mandate is dollars.’’ The flaws in this law are not only going to be delayed until 2015. With re- Washington Post: ‘‘One week away, that it reduces choices for consumers, gard to individuals, they have not been ObamaCare’s small business insurance but it is reducing the choices that peo- given a similar delay. How do we jus- exchanges not all ready for launch.’’ ple in this country have for jobs, which tify treating businesses better than in- CNBC on Main Street: ‘‘ObamaCare is wrong. dividuals with a law that is going to hurts hiring: Staffing.’’ I think the best critiques that we force many people into a position USA Today: ‘‘Pew poll: Health care have seen of the law actually came where they are paying higher pre- law faces difficult future.’’ from President Obama’s supporters, miums? They may, unfortunately, lose There are many more I can go and they are the Teamsters Union, the the hospital they prefer to go to in my through here. It has been one bad story United Food and Commercial Workers home State of New Hampshire, or the after another because of the reality of International Union, and Unite Here. physician they have that trust and re- implementing this flawed law. They recently wrote the President lationship with. The private sector impact of and said: I would ask my colleagues on the ObamaCare: We all want our economy We can no longer stand silent in the face of other side of the aisle, how is it that to do better than it is doing right now, elements of the Affordable Care Act that will we can treat businesses differently to provide jobs and opportunity for destroy the very health and well-being of our than individuals here? Why don’t we people in this country, to make sure Members, along with millions of other hard- join together and delay the individual working Americans. everyone in this country can live the mandate, at least until 2015, as busi- American dream. Yet the Affordable They have also expressed concerns nesses are being treated by the Presi- Care Act is hurting job creation and that this law will destroy the 40-hour dent now in his delay of the employer job hiring in this country. work week. mandate? Increasingly, employers are cutting As Senator CORNYN from Texas said: I hope on the other side of the aisle benefits and shifting the burden of As Republicans, we are united in repealing we can work together and listen to the health insurance coverage to their em- this law. We are united in wanting to defund American people who loud and clear ployees. We have seen in the recent im- this law and wanting to make sure that we can replace this law with commonsense re- are expressing the worries, the con- pact of this law that the Cleveland cerns, and the impact this law is hav- Clinic is probably the best example. forms that drive down health costs, increase competition for insurance companies, and ing on them. It has not been, unfortu- The President went to the Cleveland give people more choice, while making sure nately, a good impact. Clinic during his campaign and cited it that we do not interfere with the doctor-pa- Finally, I wish to say in terms of the as a model in terms of how health care tient relationship. If you like your doctor, strategy of shutting down the govern- could be delivered in pitching his you can keep your doctor, which we are now ment, I don’t support it also because it health care law. Yet the Cleveland seeing is not true, unfortunately, under is not going to work. The Congres- ObamaCare. Clinic recently announced, as one of sional Research Service has said that Ohio’s largest employers, that it would I will do everything I can to make even if we shut down the government, cut jobs and slash 5 to 6 percent of its sure we repeal this law, to make sure there has been mandatory spending budget to prepare for President Barack that we can ensure that people have baked into this law, so ObamaCare can Obama’s health reforms. choice, that they can keep their doc- mostly continue. Walgreen’s recently announced it is tor, and that health care is affordable To those who are asking us to take dropping health insurance coverage for for people in this country. that step, I would say that even if we 160,000 workers and will instead give However, I do not support shutting were to do so, we will not achieve the them payments to purchase insurance down the government in order to purpose of fully defunding ObamaCare through private exchanges. Time War- defund this law. While some of my col- or stopping ObamaCare from hurting ner and IBM plan to move retirees from leagues have urged us to shut down the average Americans. employer-administered health plans to government—and they haven’t said it I hope we can work together to make private exchanges. in this term, they have said they don’t sure that we don’t continue to hurt We have seen similar stories from want to shut down the government— Americans, such as my constituents companies like Home Depot and Trader but the reality is they have asked us to who are going to have to drive much Joe’s. They are going to end coverage vote against a bill that is coming over longer distances to go to the hospital for part-time employees. UPS is drop- from the House that will defund in the ObamaCare exchange in New ping coverage for employees’ spouses. ObamaCare, but will continue the fund- Hampshire. They are paying higher In terms of the impact on jobs, what ing for the government. If we were to premiums because of ObamaCare and I have heard from companies in New vote as a block against ending debate have less choice. I would hope we could Hampshire, from the smallest to the on that bill, then the result could be to work together to ensure that average largest, is they want to do right by shut down the government. Americans don’t continue to be harmed their employees. The rising cost of pre- While Americans are opposed to by this law. miums and the questions that have ObamaCare, what we have seen in a Finally, this piece of legislation was been raised by ObamaCare have put poll as recently as today is that 80 per- a signature of the President’s policies. them in a position where they can’t do cent of Americans say threatening a It was something when he got into of- what they want to do for their employ- government shutdown during budget fice he pushed right away to pass. The ees and their health care. In many in- debates is not an acceptable way to ne- impact that many of us feared about stances they are forced, because of gotiate. I believe we should make sure this law—less competition, higher higher costs, to not hire that next em- that we repeal this law. costs, interfering with keeping the doc- ployee. I join in what the senior Senator tor you want, hurting jobs—we have If you think about the structure of from Texas said, and I would hope that now seen come to fruition. So why this law, that it applies to those with my Democratic colleagues would listen would we at this point try to shut down 50 employees or more, some are not to what their constituents are saying the government? Why would we at this going to open that next business, or about the negative impacts of this law point give the President a lifeline? To that next restaurant, because they do and that they would join us, join Re- quote the President’s own former Press not want to fall under this law. publicans, in ensuring that we do Secretary on ‘‘Meet the Press’’ this What kind of law would we pass here defund this law, that we work together, weekend: to deal with the issue of health care that we make sure that, by the way, that actually makes it more difficult businesses aren’t treated better than If you think about this from the White House perspective, you’ve had three fairly to hire people, that actually thwarts individuals in where we are right now forgettable weeks at the White House, right? the private sector’s desire to expand with the implementation of this law. About to lose a vote on Syria; immigration businesses or if you have one res- One of the most absurd things that I reform looks dead; you’re sinking in quick- taurant, to have a second restaurant; if don’t even know how you can explain sand, and here your enemies throw you the

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00106 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6869 rope and want to get in the quicksand in- This group of Senators argue that we covered, again thanks to the Affordable stead of you. should take away health insurance Care Act. Why would we put ourselves in a po- from more than 20 million Americans. I am not going to try and persuade sition where we would shut down the They urge us to take away cheaper pre- those Senators about the value of government over a law that is the scription drugs and free preventive ObamaCare, even though repealing the President’s signature piece of legisla- care for more than 6 million seniors. Affordable Care Act would, according tion and hand him a lifeline on this They argue for kicking millions of to the independent Congressional issue and, in the process, hurt average young adults off their parents’ health Budget Office, raise the budget deficit Americans, such as our military, that insurance coverage, and they argue for by about $110 billion over 10 years. could be impacted by a government a return to the days when insurance While I am not going to question the shutdown, such as our veterans that companies could deny Americans sincerity of the Senators who argue could be hurt by a government shut- health care because of a preexisting that denying the American people down, such as air travel that could be condition. those benefits is a good idea, I do ques- impacted by a government shutdown. Are arguments over the elements of tion the willingness of those who are By the way, the last time we shut the Affordable Care Act in order? Of willing to close down this government down the government, it cost us more course they are. But what should be to achieve their goal, to create legisla- to reopen the government—$1.4 billion out of order, what should be off the tive and governmental anarchy in pur- more—than it would have cost to just table is the tactic that opponents of suit of their goal as acceptable. I be- run the government. So from a fiscally the Affordable Care Act are employ- lieve the tactic of shutting down or conservative perspective it doesn’t ing—at least some of those opponents. threatening to shut down the govern- make any sense either. As we just heard from Senator AYOTTE, ment to get their way on an issue is ap- I urge my colleagues on the Repub- she is an opponent of the Affordable palling, and that is what the basic lican side to be united in repealing and Care Act who is not going to vote for question is before us. replacing ObamaCare, and let’s work this tactic, and I commend her for it. I have a number of issues that are together to do that. Let’s work to- In order to eliminate the Affordable important to me. So does every Mem- gether while keeping the government Care Act, some of these opponents ber of this Senate. I believe very going forward with responsible spend- would deny our military members their strongly in universal background ing levels. Let’s not forget we are $17 paycheck, some of them would shut checks for firearms purchases. An opin- trillion in debt. Let’s not let that de- down our NIH clinics, they would halt ion poll shows a large majority of the bate get sidelined by this debate of Small Business Administration assist- American public agrees with me. ObamaCare. ance to small businesses, and they Should I threaten to shut down the Finally, to my colleagues on the would close Head Start classrooms. All government if we don’t pass universal other side of the aisle, you have been of that and many more government op- background checks? Should I threaten hearing many of the same stories from erations would grind to a halt if this to delay pay to our men and women in your constituents. How can we treat group had their way in order to elimi- uniform, to close classrooms and businesses differently than individuals? health clinics and research labs, to Why wouldn’t you agree to something nate health care reforms that would waste billions of dollars by creating an- such as a delay of ObamaCare for 1 bring insurance to millions of Ameri- archy in the government if I don’t get year for individuals similar to the cans and protect coverage for those my way on universal background delay businesses have been granted by who already have it. That is not just a policy failure. In the President? Why would you want to checks for firearms purchases? my book, that is a failure to under- I believe strongly we should close off- continue to fund a law right now that stand the role of an elected official in shore tax loopholes that cost the is already hurting people in terms of Treasury hundreds of billions of dol- their choice for their doctor and driv- a democratic government. This system lars, and I am hardly alone in that be- ing up costs and hurting job creation? does not function when Members of I know we can resolve these issues Congress threaten to shut down the lief. Should I threaten to default on the and I know the American people expect government and bring about legislative public debt and to damage the full us to. I think we can do this in a way anarchy if they do not get their way on faith and credit of the United States if that helps address health care costs, a particular policy. we don’t pass a bill to close those off- coverage, and in a more responsible So I am not going to try to persuade shore tax loopholes? way than ObamaCare has done, allow- those Members on the value of I hold these beliefs and others with ing people to keep the doctor they have ObamaCare, even though already, the same passion as those Senators chosen and allowing people to have thanks to ObamaCare, the number of who oppose the Affordable Care Act, greater choice through competition. young adults without health insurance but threatening a government shut- I yield the floor. has fallen by nearly 1 million, and a down and chaos unless I get my way is, The PRESIDING OFFICER. The Sen- higher percentage of young adults have I believe, inconsistent with our respon- ator from Michigan. coverage today than at any time since sibilities as Senators. So, yes, I feel Mr. LEVIN. Mr. President, folks back 1999. very strongly about background checks home will often come up to me after I am not going to try to persuade and tax loopholes and a host of other the Senate has gone through some cri- those Senators on the value of issues, but I can’t imagine threatening sis or complex procedure and they will ObamaCare, although already inflation government shutdown or default on our ask me: What just happened? Usually I in health care costs has slowed to the debt if I don’t get what I want. can give them an explanation. But I lowest level in half a century. While The effects of a government shut- hope nobody asks me about what we the causes for this good news are com- down would be devastating to our men have seen last night and today because, plex, many health care experts believe and women in uniform, who would be to me, it is inexplicable. the Affordable Care Act’s focus on told they must stand at their post A Senator holds the floor overnight quality and coordination of care is al- without pay. It would be devastating to delaying what turns out to be a 100-to- ready having a measurable impact. patients with deadly diseases who de- 0 vote on cloture on the motion to pro- I am not going to try to persuade pend on clinics that would close their ceed to this bill. I am not sure I can ex- those Senators of the value of the Af- doors, and researchers who must leave plain that back home, so let me try to fordable Care Act, even though more their labs. The mere cost of shutting describe what I expect to see in the than 6 million seniors are paying less down and then restarting government days to come. for prescription drugs because the Af- operations would run to several bil- The question before the Senate this fordable Care Act is closing the dough- lions of dollars. A shutdown could cut week is whether some Members of the nut hole in drug coverage and even gross domestic product by a percentage Senate will succeed in disrupting much though the nonpartisan Congressional point or more, putting us back into a of the Federal Government if they do Budget Office projects that by 2016, 25 recession. not get their way in one matter on million Americans who otherwise When the Founding Fathers launched which they feel passionately. would have no health insurance will be this experiment in democracy, most

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00107 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6870 CONGRESSIONAL RECORD — SENATE September 24, 2013 observers—at least many observers— cide what doctor they go to, what hos- hundreds of millions of dollars by re- expected it to fail. They did so in part pital, what clinic. They decide what ducing waste, fraud, and abuse. But we because they doubted that democracy health care plan or what health care also need to provide the right incen- could exist in a large and complex na- policy to choose. tives and more flexibility. tion. Montesquieu declared that in any But ObamaCare changes that. It Take Medicare, for example. Right large democracy ‘‘the public good is brings government into running the now in my home State of North Da- sacrificed to a thousand private health care system in a way we have kota, on a relative basis we have lower views.’’ never experienced before in the United cost health care than many other The Founding Fathers designed Con- States, a level of government involve- States, and at the same time that we gress so it could represent the interests ment far beyond what we have ever had have lower costs in North Dakota, we of large States and small States, of before. The proponents of ObamaCare have better outcomes. On a compara- populace and rural areas, of North and say otherwise, but that is just not the tive basis, we have very high-quality South. The task they gave to Congress case. Government will set up exchanges medical care. So think about that— was to prove that Montesquieu was and operate those exchanges, and it ac- lower costs, better outcomes. But wrong. It was here that our ‘‘thousand tually limits the number of policies under Medicare, for that performance private views’’ were to be weighed and and options that can be offered on we are not rewarded. We don’t get more considered, and from those delibera- those exchanges. At the same time, the reimbursement, we get less reimburse- tions public policies aimed at the pub- government also prescribes coverage ment. That makes no sense. Think lic good were to emerge. that must be offered in policies, driving about it. So a State with low costs and The form of our government was de- up costs and again reducing options— better outcomes gets lower Medicare signed to guard against any one faction choices—for consumers. reimbursement than a State with high Furthermore, ObamaCare kicks in ef- from succeeding in attempts to sac- costs regardless of outcomes. Then you fectively October 1—the start of the rifice the public good to its own con- get more reimbursement? Think about fiscal year, next week—but clearly nei- cerns. At every turn, the Founders de- that as a system, rewarding higher ther the Federal nor State govern- signed our constitution to defend costs, penalizing lower costs. That is ments are ready to go. That has been against extremism, to help all-too- the exact opposite of what we should very well publicized, and, of course, flawed elected officials transform what have. that is why the administration has de- could be the anarchy of a large Nation Those are the kinds of things we layed the employer mandate for a year. with varied opinions into a coherent The question then is, Why hasn’t should be reforming, and we should re- whole. President Obama also delayed the indi- form them in a way that creates the The tactics we are seeing in this de- vidual mandate? Why would you delay right incentives. Take Medicaid. Medicaid, the same bate, and the tactics threatened in the the mandate for big companies across thing. Here, you have way too much of debt ceiling debate we will soon face, this country but then not at the same turn the Founders’ vision on its head. time delay the mandate for the Amer- a Federal one-size-fits-all. Why not We are told that unless we give in to ican people, for individuals across this give the States more flexibility so that the demands of one faction, that Amer- country? they can respond to the circumstances ica will be plunged into shutdown, re- That is just one of the many incon- in their State, find ways to improve cession, default, and catastrophe. Two sistencies in the law and in the admin- care, and reduce costs and make sure hundred twenty-six years into our ex- istration of this law. That is why I sup- those States benefit when they do that periment in democracy this faction of port anything we can do to either so that they have the right incentives. Congress is trying to prove defund or delay ObamaCare, and that is These are the kinds of health care re- Montesquieu right. They would, indeed, why our entire Republican caucus sup- forms that make sense, common sense. sacrifice the functioning of our govern- ports doing anything we can to defund These are the kinds of health care re- ment to advance one of their own or delay ObamaCare. Granted, we have forms that empower people. These are views. some different ideas on tactics, how the kinds of health care reforms we I oppose the efforts to defund best to do it, but we are absolutely need. ObamaCare, and I believe that pre- united in our effort to oppose Republicans will vote to defund serving health care reform is vitally ObamaCare. ObamaCare. We need some Democrats important to millions of Americans. The reality is that instead of to join us for the sake of health care, Defeating this attempt to close down ObamaCare, we should be encouraging for the sake of our economy, full-time the government unless zealots get their more choice and more competition in employment versus part-time employ- way is important to the very func- health care, not more government con- ment. ObamaCare is hurting our econ- tioning of our democracy. It is deeply trol. That means things such as tort re- omy and hurting job creation. So for destructive to our ability to function form to help reduce the cost of health the sake of health care in this country as a democracy for Members of this care. It also means encouraging more and for the sake of our economy, it is Senate to threaten to bring down the competition among health insurance what the American people want. They walls around us unless they get their companies across State lines and ex- want us to fund this continuing resolu- way, and, hopefully, they will not suc- panded health savings accounts. Ex- tion and they want us to defund ceed. panded health savings accounts, com- ObamaCare, and I ask our colleagues to I suggest the absence of a quorum. bined with high-deductible insurance join us in this effort. The PRESIDING OFFICER. The policies, will encourage young people Mr. President, I yield the floor. clerk will call the roll. to buy health insurance because their Mr. COONS. Mr. President, here we The assistant legislative clerk pro- insurance premiums will be much more are again. On Monday, September 30, 5 ceeded to call the roll. affordable. Again, more competition, days from now at midnight, absent Mr. HOEVEN. Mr. President, I ask more choice, more participation by some agreement and cooperation be- unanimous consent that the order for people of all ages, and as a result, a tween the parties in the Chambers here the quorum call be rescinded. system that is sound, a system that in the Congress, the entire Federal The PRESIDING OFFICER. Without truly encourages and empowers indi- Government will begin shutting down. objection, it is so ordered. viduals. That is how we empower peo- Here we are again, another day, an- Mr. HOEVEN. Mr. President, in the ple to take control of their medical other fiscal crisis, another politically United States we have the best health costs—not with a government-run sys- manufactured crisis—another politi- care in the world. We have the best tem but by empowering individuals. We cally manufactured crisis that is doctors, the best nurses, the best hos- empower health care providers with threatening to tear at the economic pitals, the best clinics—across the tort reform, and we empower con- fabric of our whole country. board, the best health care. I believe sumers with more choice, more com- It would be hard to believe if it were that is because we have a health care petition, and more options. not totally, completely believable. I system where individuals make deci- At the same time, we need to reform have been in the Senate now just under sions about their health care. They de- Medicare and Medicaid. We can save 3 years but this is my third of these

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00108 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6871 crises. I was actually up in the chair I am not going to debate the merits John, you are right. Mr. President, presiding that night back in 2011, when of the Affordable Care Act at enormous he is right. This gridlock, this repeated we narrowly averted a shutdown, just length again. It is law. It needs to be manufactured crisis environment is minutes before funding expired. modified. It needs to be amended so it embarrassing. I am on the Budget Com- I was here with all the other Sen- can work more smoothly and more ef- mittee, and under the leadership of our ators on New Year’s Eve this past year fectively. But, frankly, the law needs Chair, Senator MURRAY, we passed a where we stopped just short of going to be implemented. Every minute this budget earlier this year. Not only did over the fiscal cliff. Chamber spends reliving the settled de- the Senate budget responsibly reduce Here we are again. From shutdown to bates of the past is a minute we are ig- the deficit, not only did it fairly re- default, from the debt ceiling to the noring the 11 million Americans out of place the sequester, but it actually in- fiscal cliff, now back to threatened work, the 31,000 Delawareans currently vested in economic growth. We took it shutdown and another default crisis looking for a job. Each minute this up here on the Senate floor and passed weeks away and with, of course, unem- Chamber spends on a futile effort to it here, too, so not just out of com- ployment still standing above 7 per- strip middle-class Americans of their mittee but out of the Senate. We cent—7.3 percent. access to affordable health care is a stayed up all night voting on amend- In my home State, Delawareans don’t minute we are ignoring so many chal- ment after amendment, for hour after understand how we keep ending back lenges: infrastructure, a generation of hour, and in the end it is one of the up in this place. We have a saying in students ill-prepared for the challenges most functional things we have done Delaware that our politics are domi- of the future, communities ripped this year. The Senate passes a budget, nated by what we call the Delaware apart by tragic, senseless gun vio- the House passes a budget, and then we way, which means doing what is right lence—there are so many other chal- come together to reconcile the dif- even when it is hard. It means coming lenges and tasks before us. It is ferences. That is how it has been done together to make tough choices, Re- insanely frustrating. for 200 years. And this year, finally, publicans and Democrats listening to Is this what we signed up for? Is this after years of criticism that we hadn’t each other and finding principled com- why all of us worked as hard as we did passed a budget, we had our chance to promise. to get here, knocked on doors and cam- return to regular order, so there we It means being civil and playing by paigned across our States for months are, ready to go, budget passed—and the rules, putting what is good for our and months? Is this it? Is this gov- nothing. House Republicans will not people ahead of what is good for our erning? If Congress spent half as much even come to the table and a few Sen- politics. It does not look to me as if we time on manufacturing policy and on ate Republicans are blocking the door. have been able to muster much of that manufacturing jobs as we seem to They literally will not even come to Delaware way here in Washington. spend on manufacturing political cri- the table to negotiate and resolve our Last week the Senate considered the ses, our country would be in far better budget differences and lay the ground- bipartisan Shaheen-Portman energy ef- shape. It cannot pass laws but Congress work for moving forward. It is insanely ficiency bill. Energy efficiency is about has become very good at manufac- frustrating. as commonsense and nonpartisan as turing crises. Einstein once said the definition of you can get. It is not about fossil fuels I am not running for President and I insanity was doing the same thing over or renewable energy, it is about mak- don’t have to impress the tea party so and over and expecting a different re- ing smarter choices and reducing our maybe I am missing something here. sult. He was not wrong. I believe at energy consumption. The bill had sup- But we do have to be better than this. this point the House has repealed the port on both sides of the aisle. It was We just have to. There is too much at Affordable Care Act 42 times. Doing the supported by business and labor and stake for our States, for our country, same thing over and over and expecting the environmental community, the Na- for our families, for the economy, for a different result is the definition of in- tional Association of Manufacturers, the world. sanity. the Natural Resources Defense Council, This morning the Steering and Out- I am on the Appropriations Com- the International Union of Painters reach Committee had a dozen econo- mittee and, under the able leadership and Allied Trades. A very broad range mists come in and offer their insights of our Chair Senator MIKULSKI the of folks and organizations all over our on what would happen if the govern- committee has passed 11 appropriations country endorsed that bill. ment really does shut down 5 days from bills. The House Appropriations Com- I myself did work in energy effi- now. If we do then default on our na- mittee has passed 10 of theirs. We took ciency when I was in the private sector tional debt the next month, what up one of these vital appropriations at a manufacturing company and then would happen to the 11 million Ameri- bills that allows the Senate to work its again when I led Delaware’s largest cans still looking for jobs? What would will and to form and shape Federal pro- county as county executive. I saw the happen to our resurgent American grams and Federal spending. Earlier real impact energy-efficiency tech- manufacturing industry and the half this summer we took up one of these nologies and strategies did have on the million jobs that have been created appropriations bills, the bill to fund bottom line, for the private sector and there? Their answers were not encour- the Departments of Transportation, public sector, for families and busi- aging—in fact, depressing, really. Housing and Urban Development. But nesses, and it is significant. What was clear is that these political Republicans on this floor were so afraid There is so much opportunity to showdowns in this Chamber exact a of returning to regular order, of having make a real difference for our econ- real cost on our economy. They hurt a responsible, reasonable, regular omy, for our planet, for our commu- the ability of business owners to plan working process to move forward on nities in energy efficiency. That Sha- ahead. They inject incredible unneeded spending on this government and our heen-Portman bill gave us a chance to uncertainty into our markets. They economy, it was blocked. It was tap into it. It would have given mil- generally erode our Nation’s credibility blocked, prevented from even being de- lions more Americans a chance to ben- and leadership on the world stage. But bated. efit and was scored at creating 136,000 we keep ending up right here. I will ask again: Is this working for new jobs—but we blew it. One of my constituents, John Hen- anybody? Instead of debating energy policy, derson from Frederica, DE, wrote me Back in June of this year the Senate taking up and amending and reforming last week and said: passed a bipartisan farm bill. Great and passing that bipartisan energy effi- The strength of our economic recovery is work was done by Senator STABENOW, ciency bill, the Senate was then on the line and government’s ability to make Chair of the Agriculture Committee, dragged down into a petty partisan po- people’s lives better is in jeopardy. Congress along with her ranking member and litical battle over the Affordable Care needs to confront our problems responsibly, Senators from both side of the aisle. Act, a law that, by the way, was de- but when some lawmakers dig in their heels The Agriculture Committee did signifi- and threaten to seriously damage America if bated in both Chambers and passed, every one of their demands isn’t met, our cant work to reform American farm litigated before the Supreme Court and Government can’t function. This isn’t the policy, such as moving away from com- upheld, was central to the last Presi- time for a game of chicken. It’s time to gov- modity subsidies and toward crop in- dential election and was sustained. ern. surance. That alone would have saved

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00109 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6872 CONGRESSIONAL RECORD — SENATE September 24, 2013 taxpayers $23 billion. We all hear that take advantage of widespread confu- said, such as expect trouble and worry is important. We need to reduce our sion over the Affordable Care Act—also about con artists. Here are some other spending and make our programs more known as ObamaCare—to take advan- things that some of the supporters effective. This was a great bipartisan tage of widespread confusion to steal have said—people who supported the bill. It would have modernized our agri- Americans’ credit cards, Social Secu- adoption of this law in the first place. cultural policies and strengthened pro- rity numbers, and other personal infor- They said: It will destroy the founda- grams that help farmers, ranchers, and mation.’’ tion of the 40-hour workweek that is small business owners, and created My goodness, how can that happen? the backbone of the American middle jobs. It happens for a number of reasons. One class. These, of course, are union folks House Republicans will not negotiate is because of all of these so-called navi- who are saying: Hey, this is going to with us on that bill either. They passed gators, people who are hired by the end up forcing millions out of their a bill that guts the nutrition assist- government or people posing as those multi-employer plans. It will create ance program, food stamps—cuts it by hired by the government to help folks unstoppable incentives for employers $40 billion, but will not work with us sign up on the exchange. When they fill to reduce weekly hours for workers. We on a full farm bill. The current law also out the paperwork or fill out the com- see that all across the country. expires at the end of the month. If we puter forms, the information they are Just last week the Cleveland Clinic— do not pass a modernizing farm bill by going to send in is to go to the data a wonderful health care institution and the end of this year, our Nation’s agri- hub—tax information, income informa- one of the major employers in the culture policies will revert to those of tion, employment information, patient State of Ohio—announced that because the 1940s. record information, Social Security of the health care law and because of If it sounds familiar, it is because we number, welfare information, family the cuts in reimbursement, the Cleve- are in the exact same position on the size, demographic data—and then land Clinic is going to cut hundreds of farm bill as last year. Is this working where does all this information go? millions of dollars from their budget for anybody? It is certainly not work- No. 1, to the Department of Justice. and actually reduce their workforce be- ing for America. Also to the Social Security Adminis- cause of the President’s health care Delawareans, whom I hear all the tration. Also the Department of Home- law and the things they are learning time, are enormously frustrated. I hope land Security to check citizenship. Of about the law as time goes on. we are able to reach a deal and I hope course the Social Security Administra- It is interesting to see a union leader we are able to keep the government tion will validate birth, validate the say: In its rush to achieve its passage, running. I hope we come back next person is not dead, validate the Social many of the act’s provisions were not week and refocus on our economy and Security number. The Department of fully conceived. People on this side of refocus all this energy on manufac- Justice will check on criminal history. the aisle were telling Members of this turing and jobs and on manufacturing The Health and Human Services De- body that very thing a number of years jobs, not on manufacturing crises; partment, another recipient of the in- ago before the law was passed in this helping American businesses grow and formation, will check enrollment or body on a sole party-line basis. helping our private sector create jobs. eligibility for entitlement programs, Yesterday, President Obama, once Americans deserve better than this. collects and analyzes medical data. again, tried to bring in help, and he They deserve better. Then of course the IRS, who are the provided essentially the warmup act I yield the floor. folks who are the enforcers of the for an infomercial with President Bill The PRESIDING OFFICER. The Sen- Obama health care law—the enforcers Clinton, the so-called secretary of ex- ator from Wyoming. will, along with the Treasury Depart- plaining stuff, because the President Mr. BARRASSO. Mr. President, I ment, verify employment stats, indi- has failed to explain benefits of the come to the floor today, just 6 days vidual income stats, determine pre- health care law to the point that it now before the Obama health care law mium subsidies, all with the potential would actually convince the American exchanges go into effect, to point out for significant fraud and all because of people it was good for them. Currently, that even those who may support the a lack of providing the privacy safe- the President is under water in the law say with regard to the exchanges, guards that the law mandates this ad- polls regarding his leadership on health expect trouble. It was interesting that ministration to provide. Yet the ad- care, and this health care law con- today the District of Columbia—their ministration is not doing so. A number tinues to be very unpopular with the health exchange announced it is not of us have been asking for months to American people. going to be able to be ready to go Octo- see what is involved with these so- More people think their costs will go ber 1 for those seeking information re- called navigators. What kind of edu- up and their benefits will go down than garding tax credits, for those asking cation do they need? What kind of the other way around. So they are about Medicaid coverage. People will background checks are there? We still looking at their own quality of care still be able to submit applications on- have not been able to get the informa- and what it means to them: paying line but apparently they need to then tion we are seeking. more, getting less, something that the have this information go to so-called We want to know: Do these people American people don’t want. experts with an eligibility determina- have to have a driver’s license? Do they So in an effort to try to provide some tion not to be made until sometime in have to be of a certain age? Do they solace to the American people, this is November. have to have a high school diploma? Do what the President said yesterday in I applaud the District for pointing they have to have a criminal back- New York: Make your own decision this out, that this is what they found ground check? Yet this administration about whether it is good for you. What because what they attributed the delay will not give out that information we are confident about is when people to was a ‘‘high error rate’’ discovered about those individuals. Even the cen- look and see they can get high-quality during testing. I am delighted that sus takers have to have completed a affordable health care for less than they were actually doing testing, dis- certain level of education and have a their cell phone bill, they are going to covered this high error rate and made criminal background check. sign up. that decision. But as people take a Yet this administration is not asking I would say if you use that criteria, look at the upcoming exchanges as of those who were supposed to be the you are going to have very few people they open, I believe these exchanges navigators handed very confidential in- signing up for your health care law. open doors to fraud and to identity formation, of course, subject to fraud According to the 2012 report issued theft. The reason I say this is we are and identity theft when you give that by the Cellular Telecommunications hearing this actually reported from sort of information—and I say to peo- Industry, the average monthly cell supporters, again, of the health care ple all around the country it is time to phone bill was about $47. So make your law. beware next Tuesday when the ex- own decision—less than your cell phone I will quote someone who has worked change is open. bill. So what the President is saying is in support of the law in Chicago who I just quoted a couple of things that that for less than $47 a month, people says that, ‘‘Fraudsters are poised to supporters of the health care law have will be able to receive insurance.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00110 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6873 The interesting thing is that, of their community. They are not going Care Act or to defund it. Health care course, the President says that is with to be able to keep the health care plan reform has taken years and years to the subsidies. But for many people the they have. do, and we finally got it done. Millions subsidies are not in any way going to So it is interesting to see in a Blue of Americans are on the cusp of getting reduce the cost of their insurance at Cross/Blue Shield in New Hampshire, health insurance for the first time. all, and it may not go up as high as one of the Nation’s largest insurers has Republicans are desperately trying to many people had feared, but it is still put a plan together that is consistent block this from happening. Senator going to be higher than they are pay- with the health care law, and it has REID couldn’t be more clear: We are ing now because of the sticker shock created a furor. The reason it has cre- not going to delay health care for the that is coming. ated this furor is that it excludes 10 of people of this great Nation. We are not This is today’s Wall Street Journal. the State’s 26 hospitals from the health going to go back to the days when peo- This is coming out of the administra- plans it is going to sell through the in- ple with a preexisting condition were tion: surance exchange. left to die without health care. We are Prices Set For New Health-Care Ex- The insurance exchange, regardless not going back there. Yet it continues. changes. of what the President promises, is The Republicans are so adamant Across the country, the average premium going to be something which poten- about it that a very large group of for a 27-year-old nonsmoker, regardless of tially causes fraud, abuse, and loss of them are threatening to shut down the gender, will start at $163 a month for the the care that you have, the doctor that government of this great country. lowest-cost ‘‘bronze’’ plan. you have, and the hospital that you Again, it is not like they didn’t do this That is just about four times the av- have. before. The Republicans did this before. erage of a monthly cell phone bill. So The article points specifically to the It was a disaster for the people. People could the President of the United State of California. In California, it got hurt. They didn’t get paid. Business States be mistaken? says the statewide Blue Shield devel- was disrupted, Social Security and Let’s look around the country. They oped a network specifically for con- Medicare were disrupted, veterans’ ben- say: sumer shopping in the insurance ex- efits were disrupted, and parks were Likewise, the least-expensive bronze policy change. shut down. People were hurt as a result would rise to $195 a month in Philadelphia The executive vice president of Blue of that, and it cost a fortune for the for that same 27-year-old, from $73 today. Shield of California said the network taxpayers. But somehow Republicans for its exchange plans had 30,000 doc- So it would go from $73 up to $195. feel they can play games, and I think it tors or 53 percent of the doctors in the Let’s look at my home State of Wyo- is a shame. State. So they only include about half ming. I am still reading from the front My colleague Senator CRUZ spoke for page of today’s Wall Street Journal. the doctors, not all the doctors, and a very long time and said he would In Cheyenne, Wyo., the lowest-cost option they said the new network you get speak until he dropped. He said that would be $271 a month, up from $82 today. through the exchange in California—re- over and over: I will speak until I drop. This just goes to prove that when member this is a State-run exchange If he were to drop and suffered some that the President has touted as a suc- Washington comes up with something, kind of health episode, which he appar- cessful exchange—‘‘did not include the it does not one-size-fits-all across this ently was willing to risk, he would five medical centers of the University country, and in rural States around the have had health care because he is in- of California or the Cedars-Sinai Med- country there are huge problems re- sured. If he had to be lifted off the floor ical Center near Beverly Hills’’ that lated to the very fact that one size of the Senate and driven to a nearby are all well known for their excellent doesn’t fit all. hospital, Senator CRUZ would have had reputation. It is a place that patients In spite of the President’s compari- great health care. Why does he want to son to a cell phone bill, what we are want to go for care. So go to the exchange in California, stop that for millions and millions of seeing is that people all across the sign up for something the President hard-working Americans? Only he can country are going to be paying exces- has promised you, and then if you need answer that. sive amounts of money for insurance in to use that insurance card, you will I could only say that as I listened to spite of the President’s promises that if learn that you are not welcomed and some of his interviews, it sounds like you like what you have, you can keep your card is not accepted at the five what he is feeling in his heart is if this it. We know that is not the case for medical centers at the University of goes into effect, the people might like many people, as the unions have spo- California or the Cedars-Sinai Medical it and then woe is us. Because there is ken of, and we know that what the Center near Beverly Hills. an ideological split here in the Senate President promised of lowering insur- That is what we have under this where we have Senators and House ance premiums by $2,500 per family by health care law, and that is why we Members who don’t think there is any the end of his first term never mate- need to repeal it and replace it with pa- role for the Federal Government to rialized and the costs continue to go tient-centered care so patients can get play in making people’s lives better. up. the care they need from a doctor they Some say military spending, fine; high- So this health care law has turned choose at a lower cost. way spending, fine. But when it comes out to be terrible for patients, the pro- I yield the floor. to lifting people up and giving them a viders, the nurses, and doctors who The PRESIDING OFFICER (Mr. quality of life and helping to do that, take care of them, and it is going to be HEINRICH). The Senator from Cali- oh, no. terrible for taxpayers. fornia. So Senator TED CRUZ is fortunate. If There was an interesting story on the Mrs. BOXER. Mr. President, I lis- he talked until he dropped on the floor, front page of the New York Times on tened to colleagues predicting doom he would have had the best health care, Monday: ‘‘Lower Premiums to Come at and gloom, and it brings back what I he would have been on his feet and Cost of Fewer Choices.’’ In new plans, have read about what happened when super fine. There are a lot of people out insurers often leave out many pro- Medicare was brought to this country there who are dropping because they viders. I think that is the key: leave by the Democrats and what happened put off going to the doctor because out many providers. Because what we when Social Security was brought to they have a condition and they have no are seeing is that in many locations this body and to the House after the insurance, and when they drop they around the country, hospitals have Great Depression. have to go to an emergency room been excluded, doctors have been ex- I am going to go into that in a little where they can be patched up—and by cluded, and there is going to be signifi- bit, but somebody said this earlier and the way, taxpayers pay for that. cant explaining to be done when people it reminded me that one of the defini- So here is the thing. We have the Af- realize that they are not going to be tions of insanity is doing the same fordable Care Act, which Republicans able to continue to go to the pediatri- thing over and over and expecting a call ObamaCare, so that is fine— cian that their children have been different outcome. ObamaCare, Affordable Care Act, what- going to since birth. They are not The Republicans in the House have ever we want to call it. It is based on going to be able to go to the hospital in voted 42 times to repeal the Affordable a Republican-suggested model of

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00111 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6874 CONGRESSIONAL RECORD — SENATE September 24, 2013 health care where we use private insur- I wish to spend some time showing the slowest rate in over 50 years—50 ance, we go to an exchange, and there my colleagues how the Affordable Care years. And that is because more people is a lot of competition. I am excited Act is already working, so I have some are getting covered and we don’t have about it, frankly, because in my home charts to go over quickly. to treat people at the end game or in State of California, we are on board: In my State over 1 million Califor- an emergency room because we are al- coveredca.com. People type in nians are already newly insured. This ready seeing people get more health coveredca.com, and they find out how includes in my State 400,000 young coverage. Insurance companies now they can get health care. Some people adults who are now on their parents’ have to justify a premium hike. Before, will apply and get a Medicaid card, the policies. If the Republicans have their they could double premiums, but now working poor. The middle class will be way and they defund or repeal they have to justify it and make sure able to move forward and go to the ex- ObamaCare or the Affordable Care Act, 80 percent of the premiums they get changes, and many will get a subsidy what is going to happen to those young are spent on the policyholders. to help them if they are in the middle adults? They will be kicked off of their So in 2014—and we are around the class. parents’ policies. Is this why Senator corner from that—unless Senator CRUZ Here is the thing that really shocks CRUZ stood on the floor for hours and and his Republican friends have their me. Republicans act as if this health hours until he would drop—to hurt way, there will be no more extra care bill, this Affordable Care Act, young adults, 3 million of them nation- charges for preexisting conditions. ObamaCare, just came down off the wide? Right now it is just children who have ceiling and dropped on the floor and be- Seventy-one million Americans are that benefit, but in 2014 everybody gets came law. It took a long time. Senator getting free preventive care, such as it. BAUCUS worked and worked and checkups and birth control and immu- In 2014, no longer can insurance com- worked. We took many Republican nizations. I don’t know how many of us panies charge women more than men amendments. We passed the bill. It be- heard Senator KING from Maine today for their coverage. This is a huge issue. came the law of the land 3 years ago. talk about his own experience when he There was gender discrimination. They took it to the Supreme Court worked here as a young man and had Being a woman was considered a pre- and said it was unconstitutional. The insurance, so he got a preventive care existing condition. A woman who was Supreme Court said it was constitu- checkup, which came with his insur- abused by her spouse or by her boy- tional. And now that it is about to go ance. They found a melanoma. Had he friend, and she walked in and the insur- into play, Republicans are willing to not gone to the doctor and had they ance company found out, that was con- shut the government down to stop it. not seen that mole that turned can- sidered a preexisting condition because It was the centerpiece of the 2012 cerous, he said he would not be here she might get beat up again. So she election. We all know that. anymore. Health insurance saved his was told: Take a hike. That can’t hap- Mitt Romney said: If I am President, life. pen anymore. I am getting rid of that law. So I wish to rhetorically ask Senator The people of the country said: OK. They cannot impose dollar limits on CRUZ and the Republicans supporting What are you going to put in its place? the amount of health care spent on you Well, let’s see. We will allow insur- him in this body and in the House, why in a single year. Right now, if you have ance to go across State lines. would you take away free preventive a serious illness, they can say: Sorry, Well, what does that do for me if I care and immunizations from 71 mil- you reached your annual cap. have a preexisting condition? lion Americans and consign them to a So where are we now? ObamaCare, or They wanted to replace it with noth- status where they are absolutely sit- the Affordable Care Act, is already in ing. The American people are smart. It ting there without any protection be- effect. Republicans want to stop it be- doesn’t mean this law is perfect and we cause they have no health insurance? cause in 2014, when those exchanges can’t make it better, but let me tell Let’s see what else we have already open, they know people are going to my colleagues, many of us served under achieved that the Republicans want to like what they see. I am telling my col- many Presidents. I am looking at my repeal. They want to repeal 17 million leagues, when I go home and I go to colleague from Maryland who served a kids with preexisting conditions, such community health care centers, people long time in the House. I served with as asthma and diabetes, who can now are so excited. And not enough of them five Presidents, a couple of whom I no longer be denied coverage. If my know about it, but when they find out didn’t agree with, and I did everything colleagues ever saw those pictures of a how easy it is—if they qualify for Med- I could to fight against the legislation child gasping for air, my colleagues icaid, they just get their card and they they liked that I felt was bad. But once know those kids need coverage, they are covered, and they no longer have to it passed, I didn’t try to shut down the need help, and they need to be able to sneak into the emergency room when a government. I tried to work with ev- get that help and get the medication problem gets so drastic. And all the erybody, and I am not an exception. when they need it. others will have options. They will be That is what we used to do around Insurers can’t cancel health insur- able to choose from a platinum plan, a here, all of us. Suddenly, it is: My way ance because someone gets sick. How silver plan, or a bronze plan. We are or the highway. I am taking my Teddy many stories did we hear as very excited about this law. bear, my blankie, and I am going home Congresspeople and as Senators where Senator CRUZ says he will stand on because I don’t like the health reform people went to get insurance and they his feet until he drops to stop my peo- act. It doesn’t suit me. said: Sorry, 25 years ago you had a sus- ple and your people from getting Some of them are so angry about it, picious mole, and therefore we are not health insurance? He has met his they are trying to take away the em- going to insure you—or you have high match in us because we can stand until ployer contribution from their own blood pressure or 10 years ago you had we drop. But we don’t have to do that staff. What an outrage—hard-working cancer. No more. And how many times because we have the votes, and the rea- people who love their country, who have you heard the stories where peo- son we have the votes is this is what work here. ple were kicked out of their insurance the last election was about. Now, let me tell my colleagues, because they hit a lifetime cap? That is In closing my presentation, I wish to Earth to the Republicans: A, you lost no more. Republicans want to repeal share with my colleagues a very brief the election not only for President but all these benefits, and Senator CRUZ history of what happened when Social in the Senate, where colleagues who was willing to talk until he dropped so Security was proposed. It is so inter- supported the Affordable Care Act got these benefits could be taken away esting. elected; B, President Obama was re- from our constituents. In 1935, after the Great Depression elected, Mitt Romney lost. Health care I heard my friend from Wyoming, and our great-grandparents were lying reform was a major issue on the cam- Senator BARRASSO, say that health in the street and had nothing and peo- paign trail. So wake up, smell the costs are rising and they are rising like ple were jumping out of windows be- roses, put a smile on your face, and never before. I guess he missed it when cause they had nothing—they had lost know you tried, but don’t shut down President Clinton told the country their homes, they had lost their jobs, the government. Enough already. that health care costs are growing at they had lost their savings, and there

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00112 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6875 was no safety net. This is what Presi- lived in poverty in the midst of the Senate Majority Leader Bob Dole dent Franklin D. Roosevelt said when Great Depression—half. Today, 57 mil- bragged in 1996, ‘‘I was there, fighting he signed the act in 1935: lion Americans receive Social Secu- the fight, voting against Medicare. . . . We can never insure one-hundred percent rity, and it lifts 14 million elderly because we knew it wouldn’t work in of the population against one-hundred per- Americans out of poverty. It is the 1965.’’ cent of the hazards and the vicissitudes of most successful and the most popular And PAUL RYAN’s budget ends Medi- life. But we have tried to frame a law which antipoverty program. care as we know it today. will give some measure of protection to the The Republicans said it was uncon- So all this brings us to the moment average citizen and to his family against the stitutional. They said it was socialism. we are in. Now Republicans are trying loss of a job and against poverty-ridden old age. This law represents a cornerstone in a They said it was a sham, a disaster. to defund the new health reform law. structure which is being built, but it is by no They are back here saying the same Speaker JOHN BOEHNER said: Passage of means complete. thing, just as we are on the cusp of de- health reform is ‘‘Armageddon’’ be- Franklin D. Roosevelt spoke about livering a benefit to so many—probably cause the law will ‘‘ruin our country.’’ the safety net in 1935. Just think about 50 million Americans. They said it about Social Security, that. This is my last discussion about they said it about Medicare, and now Let’s see what happened in the de- Medicare. they are saying it about the Affordable bate. Let’s look at what happened in When President Lyndon Johnson Care Act. the debate. signed the Medicare Act, he said: The Republican Party Platform, in Representative William Ditter, a Re- No longer will older Americans be denied 2012, said: publican from Pennsylvania, took to the healing miracle of modern medicine. No [ObamaCare] was the high-water mark of the floor and said: longer will illness crush and destroy the sav- an outdated liberalism, the latest attempt to ings that they have so carefully put away impose upon Americans a euro-style bu- . . . security for the individual, whether over a lifetime so that they might enjoy dig- reaucracy to manage all aspects of their worker or aged, will be a mockery and a nity in their later years. No longer will lives. sham if in the attainment thereof we . . . young families see their own incomes, and So I felt it was important to put into allot to our people the role of puppets of a their own hopes, eaten away simply because the RECORD the historical context of socialistic state . . . they are carrying out their deep moral obli- Where have we heard that before? He gations to their parents, and to their uncles, the battle we face today. I try to tell called Social Security part of a social- and their aunts. my kids and my grandkids, when we istic state. This was President Lyndon Johnson fight these battles, we sometimes for- We cannot provide a sense of security by in the 1960s. Some of us actually were get the context, that it is not that programs for the destruction of wealth. . . . around in the 1960s. We remember it. much different than what went before We cannot assure to the people a sense of se- And this is what the Republicans said us. We look different certainly. The curity by measures threatening their invest- about Medicare. Listen carefully. This women here were not around here then. ments of life savings. is a history moment here. We are look- But the fact of the matter is, they are Could this guy have been more ing at what the Republicans said every the same battles. It is about what is wrong? He calls Social Security social- time we were about to get a new ben- the role of the national government of ism and said it was going to destroy efit for the people of this Nation. the greatest country in the world. I wealth when, in fact, it preserved our Sixty percent of Republicans in the certainly, for one, believe making life people in their old age. Senate and 50 percent of House Repub- better for our people and doing it in a Now, here is another—Representative licans voted against Medicare. Rep- smart way, in a fiscally responsible Jenkins of Ohio, a Republican. He talks resentative Durward Hall of Missouri, a way, is the way to go. about Social Security this way: Republican, said: We will have to make our changes to This is compulsion of the rankest kind. Do . . . we cannot stand idly by now, as the the Affordable Care Act if we see we not be misled by the title. The title says Nation is urged to embark on an ill-con- can make it better. And we invite our ‘‘Old-Age Benefits’’. Shame on you for put- ceived adventure in government medicine, Republican friends to work with us. I ting such a misleading and unfair title on the end of which no one can see, and from was one who did not vote for the drug such a nefarious bill. Old-age benefits? Think which the patient is certain to be the ulti- benefit because I did not like that big, of it! Oh, what a travesty!. . . . Mr. Chair- mate sufferer. man, what is the hurry? Nobody is going to fat doughnut hole that came in there, get a dime out of this until 1942. . . . what is This is what the Republicans said. which put people on the spot. They had the hurry about crowding an unconstitu- And Senator Milward Simpson of Wyo- to stop taking their medicine. They tional proposition like this through the ming, a Republican, said: could not recover money. But we House today? I am disturbed about the effect this legisla- worked with our friends, and we ended Honestly—honestly—this is what we tion would have upon our economy and upon that. And, by the way, we did it in this hear them say about affordable health our private insurance system. . . . bill, the Affordable Care Act. care: Socialism, unconstitutional. It is Well, of course, what we found out is So, yes. Working together, yes. But a sham. We have plenty of time. We this turns out to be one of the most standing up until we drop in order to should delay it. successful programs. stop important benefits from going to History is repeating itself right in Medicare is a success. Before Medi- America’s families? That is wrong. front of our eyes. care became law, a majority of seniors I yield the floor. Now it did not stop then. had no health insurance. Today, nearly The PRESIDING OFFICER. The Sen- In 2005, Republicans continued to at- all seniors are receiving guaranteed ator from Maryland. tack Social Security. President George health care benefits. Mr. President, 8 Mr. CARDIN. Mr. President, first let W. Bush and Congressman PAUL RYAN out of 10 seniors age 65 and older feel me thank Senator BOXER for putting wanted to do away with Social Secu- the program is working. With few ex- into the RECORD the history of how we rity as we know it. We all remember ceptions throughout history, Medicare fought for Medicare, how we went that. They proposed abolishing Social has been more successful than private through a lot of the health care fights, Security and replacing it with private insurers at holding down costs. And we and what we have stood for in pro- accounts in the stock market. We all still have to fight for Medicare. We tecting the American public for afford- know how safe that is. I am a former still have to fight. able, quality health care. I applaud her stockbroker. You do not buy stocks In 1995, Dick Armey, the Republican and agree with the comments she has when you are ready to retire. That is House majority leader, said, Medicare made. their plan. Had this become law, sen- is ‘‘a program I would have no part of I think it is very interesting to point iors retiring in 2008 would have lost up in a free world.’’ A bit of an overstate- out the contrast to the passage of the to $26,000. But we stopped them and we ment—Dick Armey. Affordable Care Act that has been law did not allow it to happen. That same year, after leading an ef- now since March 23, 2010. It went Lastly, let’s look at Social Security’s fort to raise premiums and costs for through hearing after days of hearings success. seniors, Newt Gingrich predicted that in the House and in the Senate. It went Before Social Security became the Medicare was ‘‘going to wither on the through days of markups in the com- law in 1935, half of America’s seniors vine.’’ mittee, where hundreds of amendments

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00113 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6876 CONGRESSIONAL RECORD — SENATE September 24, 2013 were offered in both the House and the the House. We are not going to do that. back to how it used to be: no guaran- Senate. We had a long debate on the We are not going to pass that. Every- teed coverage, no guaranteed benefits, floor of the Senate and the floor of the body knows we are not going to pass no guaranteed value. House. We reconciled the differences that. But I think the American people There is another aspect to this, one between the two Houses. It went need know what would happen if that that I am very proud of. The United through the regular process. We spent did pass and we did defund the Afford- States will at last join the industri- as much time on that bill, I think, as able Care Act. alized nations in the world and say we have spent on any major bill. And I could talk a lot about provisions that we are going to make affordable yet there were differences. The bill was that have already taken effect. I could health care available to every person, passed and signed into law. talk about the fact that in my State of every American in our country. I think When we expanded Medicare—and I Maryland, 46,000 families have taken that is an important point. I have was in the House at the time on Medi- advantage of putting their children on 800,000 people in my State of Maryland care Part D. I also voted against it. their health insurance policies to age who do not have health coverage Most Democrats voted against it. We 26. If you repeal the Affordable Care today—800,000. voted against it for the reason the Sen- Act, those 46,000 families will have to Now, come October 1, next Tuesday, ator just said—the coverage gap, the find another way to take care of the they are going to be able to go to the doughnut hole, that we knew seniors health insurance for their children. Maryland Health Connection and get would still not be able to afford cov- I could talk about the fact that come health coverage. But guess what. They erage. There was no public option, as January, we will eliminate lifetime are going to have a variety of plans they can choose from. They can make the Senator remembers. caps on health insurance. How many Mrs. BOXER. Right. families have had to go through bank- their decision. But a large number, Mr. CARDIN. It was all private insur- ruptcy because they cannot afford over 85 percent—87 percent—of the peo- ance. They did not pool the total pur- health coverage? They may have insur- ple who will be going to the Maryland chasing power to reduce the cost of ance, but their caps put them into Health Connection, it has been esti- prescription drugs—another matter bankruptcy. Well, that is gone. If you mated, are going to be entitled for help in paying for those premiums—87 per- that we felt very strongly that we were repeal the Affordable Care Act, we are cent. overpaying. And we are overpaying for back to the arbitrary limits. We talked about the individual man- How many families have told us prescription drugs, as a result of that dates. What we provided was an afford- about preexisting condition restric- change. able option so everyone can be in the Mrs. BOXER. Absolutely. tions that are in their health insurance system. We want universal coverage Mr. CARDIN. By the way, it was not policies? We have already corrected because we think it is the right policy. paid for. It was estimated to cost $400 that for children. That is already the Everybody should be covered. We want billion, and there was no offset of cost. law. Come January, there will be no universal coverage because we think it further preexisting conditions. Women So we were worried it would have an is wrong for someone who has health will not be discriminated against in impact on the affordability of the Fed- insurance to pay for someone who does health premiums. Pregnancies will no eral Government to pay the bill. So we not have health insurance because they all voted against it. Many of us did. longer be considered a preexisting con- use the health facility and do not pay Mrs. BOXER. That is right. dition. Being a victim of domestic vio- for it, and we pay more as a result of Mr. CARDIN. And it became law. lence will no longer be considered a that. Hospital costs are more, physi- Senator BOXER is absolutely right: preexisting condition. cian costs are more. We think every- When that bill passed, we came to- I could cite, and I am sure the Pre- body should pay their fair share. gether and said: Let’s make it better. siding Officer could too, examples in But we make it affordable. Eighty- We lost the battle on the floor. It be- our own States where people have not seven percent will be entitled to help. came the law. Let’s try to make it been able to get full coverage. I have a Those who go through the Maryland work. And we did that, Democrats and family in Montgomery County that had Health Connection and are enrolled in Republicans. to take out two insurance policies and Medicaid obviously are going to get Mrs. BOXER. That is right. pay two separate premiums for the their help. We have expanded that cov- Mr. CARDIN. We are now into 3 years family because of preexisting condition erage. Those who go into the ex- under the Affordable Care Act, and all restrictions. That is history. If you changes—and Maryland is one of those we get from the Republicans is repeal pass the resolution that came over States that the State will be operating after repeal after repeal—no effort to from the House, that is all gone, we are the exchanges. deal with legitimate problems of imple- back to how it used to be. The overwhelming majority will be mentation that we would like to work I know we talk a lot about afford- entitled to some help in the payment of together to do. ability. I want to talk a moment about those premiums. If the House-passed Mrs. BOXER. Right. that. Because before we passed the Af- resolution were to become law, and it Mr. CARDIN. What a difference. In- fordable Care Act, we got letter after is not going to become law—the pur- stead, they are using the process of letter from individuals and businesses pose for sending it over here was to holding hostage the Federal Govern- about their premiums going up. They make it hostage in the closing of our ment from being in operation in order had to cut back coverage, and they re- government. If it became law, that help to advance their extreme agenda. quired the employee to pay more. The would be gone. These uninsured have It has been nearly 20 years ago when benefits were less, and the premiums no prospect of getting health coverage, the Government shut down because the were higher. We were seeing double- and the inefficiencies of our system Republicans decided it would be better digit cost increases in health care. continue, the use of emergency rooms, to close government to prove their Well, now we have a quality product, the lack of preventive care continues. point. Well, they were wrong then. We a guarantee that essential benefits are The Senator from California Mrs. recognized the cost of a government going to be in there. We have protec- BOXER talked about the Medicare sys- shutdown and the inconvenience to the tion that at least 80 to 85 percent of the tem. Let me take a moment about the American people and the damage to premium dollar must actually go to Medicare system, because this is very our economy. Yet Monday night we run benefits. If it does not go to benefits, important. The so-called doughnut the risk of another government shut- you get a rebate, you get a refund. In hole, that prescription drug gap of cov- down because the Republicans are hold- my State of Maryland, 44,000 Maryland- erage, is being closed as a result of the ing hostage the continuation of govern- ers are getting rebates because their passage of the Affordable Care Act. ment to try to move forward their ex- premiums were too high. The average How many seniors fell into that dough- treme agenda. rebate is $143 a family—$13 million in nut hole and literally could not afford Let me talk a little bit about this. rebates. their prescription drugs? We closed Let me talk about what it would mean With the House-passed continuing that in the Affordable Care Act. In my if we were, in fact, to pass the con- resolution, that is gone. Those protec- State of Maryland, 50,000 seniors bene- tinuing resolution that was passed by tions are no longer in the law. We are fited from that—50,000 seniors. If we

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00114 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6877 pass the bill that came over from the an agreement by Monday night? That mean, who are we not going to pay? House, those 50,000 seniors would be is possible. That is possible. We are They have already done the work. They calling our office every day finding out going to send back a continuing resolu- have already provided the services. what happened to that coverage they tion to the House. We do not know They have responsibilities. They ex- lost. You better believe our phones whether they are going to accept it. pect us to pay our bills. would be ringing about why are we tak- What happens? Well, I can tell you It does not work. We have been ing away their benefits. this. I represent the State of Maryland. through this before in the last Con- It is even more who are benefiting I represent a lot of Federal workers. I gress. We saw. It hurt America’s rep- from the preventive health care serv- tell you something, they have been utation. We came close. We did not go ices. They do not have to pay copay- through furloughs, they have been over the cliff. But just coming close ments. About half a million Maryland- through pay freezes, they have been presented a huge problem for this coun- ers are eligible for that benefit—who put to the test. They have been asked try. If we actually go over the cliff and are taking advantage, 34 million na- to do a lot more work with less work- do not pay our bills, it will be very tionwide. They would lose that preven- ers. We have less per capita workers costly to the American taxpayers. In- tive health care service that they have than we have had in modern times on a terest rates will go up on our national today as a result of the passage of Af- per capita basis of Federal workers. debt. It will go up. That will cost the fordable Care Act. That is gone if the They have been asked to do more with taxpayers more money. For what? An- House-passed resolution were to be- less. They have already contributed other self-inflicted crisis by the Repub- come law. greatly to reducing the deficit. licans to advance their extreme agen- Probably even more serious than Once again, come Tuesday morning, da. that, and Senator BOXER alluded to it, they are going to be asked in some We have the votes here to pass what the passage of the Affordable Care Act cases to show up for work not knowing we call a clean CR, a clean extension of improved the solvency of the Medicare whether they will get paid, in other paying our bills. We have the votes system for a decade. You repeal the Af- cases, to stay home not getting paid, here. There is a majority of us prepared fordable Care Act, you are back with trying to figure out again how they are to vote for that. We have said that. We whether Medicare itself will be a sol- going to pay their bills. They have rent have shown that. But, instead, it is vent program. payments and mortgage payments and being held hostage to an extreme agen- I could go on and on. We have provi- food payments. Guess what. That is da and trying to shortcut the regular sions in the Affordable Care Act that going to have a major impact on our process. What is the regular process? are working to prevent fraud within economy. Make no mistake about it, it The regular process is we do our work, the Medicare system, saving taxpayers will hurt our economy. We have been dollars. That is gone. We help to make they do their work, the House, the Sen- through this. We have seen this movie sure that the Medicare Advantage ate go to conference, work it out. before. It hurts our economy. It hurts Yes, there is a Republican-controlled plans are properly paid. That is gone. our country. This is a self-inflicted cri- House. Yes, there is a Democratic-con- All of that is repealed if the House res- trolled Senate. We do not have 60 votes olution were passed, which it will not sis. This is totally avoidable. If that but we have a majority. In the White be. I will make it clear. It was sent happens, yes, people will be terribly in- over to us with a strategy to put the convenienced. House is President Obama. So that is You ask the 10,000 people a day who government operations in jeopardy. what the voters gave us. Our responsi- elect to enroll in Medicare and there is There are many on the other side who bility is to work with that. no one there to enroll them in Medi- We did. The House passed a budget. I believe it is a good idea to close the care. What are they going to do? You did not like the budget. I did not like government. That is their objective. ask the person who needs a passport their budget. But that is a democracy. Even the Republicans admitted this strategy would not work to actually and cannot get a passport, what are They passed their budget. We passed a defund the Affordable Care Act. they going to do? I can go through a budget here. Our Republican friends I think we should at least talk about whole host of things. In 1995 and 1996, I said we probably will not do it. We did what impact it would have. I hear my think it was estimated 9 million people it. We did not pass that last week, we colleagues talk frequently about small who had planned to go to national passed that months ago. And what we business. I have had a lot of forums parks did not go to national parks. said is, okay, let’s go to conference, with small businesses in Maryland. I It is a cumulative effect. Why are we work out the difference. It will not be must tell you, yes, small businesses are doing this? To advance our agenda? No, everything I want, it will not be every- concerned about whether they can af- it is not going to pass. Why are we not thing the Republicans want. That is ford the cost of their employees and using regular order? This is costly to how the process works. health benefits. They are concerned our economy, it is costly to American Republicans will not sit down and about it. That is a legitimate issue. families. It is causing a slowdown in talk with us. They will not let us go to But let’s talk about what are the cir- the recovery of our economy. An even conference. They will not let us work cumstances without the passage of the greater concern is that in a couple of out a budget. So when you look at why Affordable Care Act. Well, they are on weeks, middle of October, we are talk- we have not been able to reach a budg- their own. They do not have large mar- ing about going through this again per- et by October 1, it starts with the fact kets. They have to pay more than large haps on whether we will pay our bills. that we have not been able to sit companies have to pay. They do not The limit that we have deals with around a table to work out our dif- have a lot of options. whether we can pay the expenses that ferences because the Republicans will Under the exchanges, under Mary- have already been incurred. This is not not let us go to conference. That is a land Health Connection, they will get about new spending. This is about fact. So we have got to get to con- different opportunities that they did money that has already been spent, ference. We have got to get that done. not have before, more affordable cov- will we pay the bill when the bill is re- In the meantime, do not hold the erage that they did not have before. ceived? government hostage, or paying our There are credits available to help In the House-passed resolution, they bills hostage, because all that does is them pay for their health insurance. If said: Well, we will prioritize. We will create additional costs, hurts Amer- you have less than 50 employees, there pay some but not all. I do not know ica’s reputation, hurts our economic is not a single new mandate in this law how you can do that. Administratively, recovery. It does not at all advance a for a small business. So this is good I do not know how you can do that. final resolution of an orderly process in news for small companies. That is gone You certainly are going to make it which we work out the problems of this if the resolution that passed the House much more difficult to deal with those country. were to become law. It is not going to that are not in the priority category. I urge my colleagues to put Amer- become law. My Republican colleagues So we become a selective deadbeat? We ica’s interests first, stop the games we know it is not going to become law. say we are not going to pay contrac- are playing and threats we are making. I think it is important to point that tors, we are not going to pay doctors, We are coming too close. Too many out. What happens if we do not get to we are not going to pay workers? I people we are again telling: We do not

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00115 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6878 CONGRESSIONAL RECORD — SENATE September 24, 2013 know whether you are going to get a the real unemployment rate is much, They had the votes. They passed it. It paycheck next week. What do you do if much higher. was a partisan vote. It was without a you are a worker or contractor and you There are about 22 million Americans single Republican vote here or in the do not know if you are going to get a who are unemployed today. If you fac- House of Representatives. It was a paycheck next week? tor in those who have quit looking for party-line vote. I think that is now You are already cutting back on your work and those who are under- why the American people have rejected commitments. This is already hurting employed—who are working part time it. They know that it was a partisan our economy. Every day we wait it instead of full time—the unemploy- piece of legislation passed without any hurts our economy. That is why a host ment rate goes up to well over 10 per- input from the other side and without of us are upset that we had to waste cent. the ideas and alternatives that might yesterday. It would have been nice to You have a lot of Americans looking have made more sense in terms of ad- be able to use yesterday to resolve this for jobs. At the same time, the jobs dressing the health care needs the issue. Every day we wait costs our that are being created in the economy American people said they wanted to economy, it costs our country. Let’s are part-time jobs. see addressed. pass the necessary legislation to keep What is happening? A lot of Ameri- But that being said, it is not only us government operating and pay our cans, who would love to be working full who come down and talk about this. bills. Let’s sit down as we should and time to be able to provide for their We have now seen, as this thing has work out the budget problems in a way families, are now being forced into been slowly implemented, some of the that is befitting the tradition of the part-time jobs. impact. Some of the taxes have kicked Senate. In fact, 60 percent of the jobs created in. You are starting to see some of the I yield the floor. this year are part-time jobs, not full- additional costs that we said would im- The PRESIDING OFFICER. The Sen- time jobs. pact middle-income families in this ator from South Dakota. If you look at the labor participation country when it comes to the cost of Mr. THUNE. Mr. President, I ask rate, it is at the lowest level that we their health insurance. unanimous consent that at the conclu- have seen in 35 years. You have to go You don’t have to look very far to sion of my remarks, the Senator from back to the administration of Presi- see the people who are writing stories Connecticut, Mr. BLUMENTHAL, be rec- dent Jimmy Carter to find the time about that. ognized. when the number of people in the In fact, instead of listening to only The PRESIDING OFFICER. Without workforce, as a percentage of those Republicans who come down here on objection, it is so ordered. available to be working, is as low as it floor and talk about this, you can look Mr. THUNE. We are going to have a is today, 63.2 percent. at the headlines of the newspapers vote here in the next few days, depend- The economic data just rolls on and across this country. These are just this ing on how the schedule and the cal- on. This is a very sluggish, very weak, last week. We are not talking about a endar works out, on whether to defund very anemic economy. long period of time, these are headlines ObamaCare. That is a vote that I think When you ask people and ask busi- from the last week. many of us in this Chamber want to nesses why that is, why are you not The National Review Online: ‘‘Sorry, have. I know many of our colleagues on hiring full-time workers, why are you Mr. President, There Is ‘Serious Evi- the other side, the Democrats, would hiring part-time workers, why are you dence’ Obamacare Is Bad For Economic prefer not to have that vote. But it is reducing the size of your workforce or Growth.’’ time for us to go on the record and to not hiring people that you otherwise The Associated Press: ‘‘Census: No indicate to the American people, who might hire, why is this issue of take- sign of Economic Rebound for Many in are very fed up with this law, and home pay going down relative to what the U.S.’’ frankly have not had a good oppor- it was when the President first took of- The Hill: ‘‘Franchise owners come to tunity yet to see much of it being im- fice, the answer, in most cases, comes the Hill to plead for ObamaCare re- plemented, because much of the imple- back pretty simple: It is ObamaCare. It lief.’’ mentation will occur in the next few is the cost, the mandates, the require- Washington Times: ‘‘Georgia Health months—but we are going to get to ments, and the uncertainty associated Care Company Cuts 101 Employees Due that vote here in the next few days, with the President’s health care law, to Obamacare.’’ one way or the other. The pressure is and some other concern, I might add— Reuters: ‘‘Cleveland Clinic announces on. The pressure is on Republicans and government regulations. But policies job cuts to prepare for Obamacare.’’ Democrats to stand and to indicate one coming out of Washington, DC, are WSB–TV: ‘‘Emory Healthcare to cut way or the other about whether they making it more difficult and more ex- 100 jobs partly because of Obamacare.’’ are willing to stand with the American pensive for our small businesses and Lancaster Online: ‘‘How part-time people and against ObamaCare, which job creators to create the jobs that are workers are feeling the pain of is having a harmful impact on so many necessary to keep our economy going. Obamacare.’’ different levels across the country. This is why you have this sluggish You can go on and on with only the I want to point out, if I might, a few economy and this chronically high un- headlines talking about the impact on of those impacts. Obviously, many of employment rate, part-time jobs rather jobs and the economy of this us here in the Chamber are very con- than full-time jobs, and lower take- ObamaCare legislation, which is in the cerned about the economy, about jobs home pay. This is the slowest recovery process now of being implemented. and about creating a better economic we have seen, literally, in the last 50 I think the other thing that we have future for the people we represent. years. This is the economy that we are said all along would happen—and that We are suffering through a very slug- in the midst of right now. is what we are seeing happen as well— gish, anemic economy, with growth As we talk about ObamaCare—and is that health insurance costs are going rates that are hovering in that 1 to 2 my colleagues and I come down here, up, not down. If you look at the data— percent range, but certainly not a and I was here when we voted on it and these are some of the news stories range that gets Americans back to back in 2009 and 2010—I was on the that I have mentioned, these are head- work or increases the take-home pay floor on a regular basis talking about lines from just the last week. for middle-income Americans. why I thought this was going to be a National Public Radio: ‘‘Health Care If you look at the economic data, it disaster for jobs, for the economy, for Costs Are Projected To Outpace Eco- is pretty sobering. We have had this health care costs. I was offering up nomic Growth.’’ chronic high unemployment rate that amendments, alternatives that we Associated Press: ‘‘Premium con- has been sustained for several years in thought would be better. We think cerns lead some small businesses to a row, 7.5 percent. If you add in the there are many that would work much temporarily sidestep health law.’’ number of people who have quit look- better in terms of actually making I could go on. But the point, very ing for work or are underemployed, in health care more accessible and more simply, is that the validators of the other words they want to work full affordable to more Americans, but we things that we are seeing here are out time but they are working part time, were unsuccessful. there every single day in the media.

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00116 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6879 There is a study that came out, or I crease his premiums by 146 percent and One of the biggest examples of that— should say a report that came out from for a 40-year-old woman 96 percent. and they probably were the biggest ad- HHS, which was supposed to give us a The evidence keeps piling up out vocates of this—were the labor unions. new idea, or a glimpse of what the pre- there. It is in the news stories, from If you look at what the labor unions miums are going to be under the ex- the people, and the businesses who are now saying, there was a letter a changes when they are fully up and were talking about the impact that it few weeks back from three of the larg- running. That is supposed to be some- is going have on them. The analysis est unions in the country, including time next week. that is being done actually compares the Teamsters union, led by Jimmy The Health and Human Services de- what this is going to do in the ex- Hoffa. partment issued some information changes—the premiums are going to be They said that ObamaCare would about that yesterday. at the exchanges—with what people are shatter benefits for their members. What is ironic about it is that with actually experiencing today. It is not They said it would create nightmare less than a week to go before these ex- some hypothetical like the HHS num- scenarios. They said that it would de- changes are supposed to go online, it is bers suggested; you find that it is like stroy the foundation, the backbone, if a 15-page report and a press release a picture. A picture is being painted of you will, of middle-class families, and that summarizes some of the premium a very serious situation for middle- that is the 40-hour work week. data. class families who were hoping, hoping, The reason they are saying that is What they did is HHS compared what when all the promises were made, that because, as I mentioned, the number of the Congressional Budget Office pro- they were going to see their health in- jobs that are being created in America jected rates might look like in 2016 to surance costs go down, not up. An today are primarily part-time jobs. its own findings. It didn’t compare it to exact opposite effect is happening. Why? Because small businesses have what it cost last year. It didn’t com- We can go through, again, State by incentives to hire part-time workers. pare it to the reality that most Ameri- State and look at the various analyses. One, if they hire above 50 employees, cans are experiencing in terms of the But I think the point is that instead of they are covered by the mandate that health care costs that they deal with having health insurance costs go down says they have to provide government- on an annual basis. We are not getting as a result of ObamaCare, they are approved health care to their employ- any information that gives us any in- going up, and they are going up dra- ees. sight into what these costs are actu- matically. Two, the full-time employee hour ally going to be. In this CMS estimate by the actuary, limit is 30 hours. More and more, em- Fortunately, there are others who that just came out a few days ago, ployers are trying to stay under 50 em- have looked at this same information, there is a $621 billion increase in health ployees and trying to employ people for the data dump that was released yes- care spending in this country attrib- fewer than 30 hours a week so that they terday by the Health and Human Serv- utable solely, singularly to are not hit with these mandates under ices department, and compared it to ObamaCare. Divided by the number of the ObamaCare legislation. what insurance costs before the Afford- families in the country, as I said, that This is not a good scenario for some- able Care Act passed. In other words, is a $7,450 increase. one who is out there looking for a job we heard the promises from the Presi- Why are people rejecting this? Well, I and for someone who is looking for a dent when this was being debated, that think that is the obvious reason. They better job. It certainly isn’t going to health care costs were going to go realize, most people do, at least, that help Americans improve and increase down by $2,500 per family. Obviously, these are pocketbook issues. These are the amount of take-home pay that we are seeing the exact opposite. There kitchen table issues. These are the they receive on a weekly to monthly was a CMS study that came out just a types of things that as Americans they basis. few days ago that said health care are trying to figure out, how to pay That is why, if you look at again, costs, because of ObamaCare, actually their bills and how to keep their family some headlines from newspapers. are going go up by $621 billion. If you covered. They want to figure out how The Washington Examiner says: divide that by the number of families to save a little money for their chil- ‘‘Just 12 percent think Obamacare will in this country, a family of four, that dren’s college education, how to make have a positive impact on their fami- is $7,450 per family of four increase, not ends meet, and how to keep things lies.’’ decrease, in health care costs. That is afloat. Fox News poll: ‘‘68 percent concerned the estimate of the CMS actuaries. They are very concerned about what about their health care under the new When you look at what the informa- they are seeing and the impact of this law.’’ tion coming out of HHS suggests, and legislation on what they are having to NBC News poll: ‘‘Obamacare remains you compare it to a baseline of what pay for health care coverage. They are highly unpopular as implementation health care costs are before this be- also very concerned about what it looms.’’ comes implemented, you get a very dif- might mean for the jobs that they have Washington Post poll: ‘‘Many Ameri- ferent picture. Some of the analysis today and hopefully aspire to in the fu- cans confused about the health-care that has been done suggests that ture. Many of these are in jeopardy, be- law.’’ ObamaCare is going to increase under- cause businesses who are hit with these CNN Money: ‘‘Most employees still in lying insurance rates for younger men new mandates, these new penalties, the dark about health care reform.’’ by an average of 97 to 99 percent and these new requirements under There is anxiety, there is frustration, for younger women by an average of 55 ObamaCare. Businesses are finding it there is skepticism. I think most of to 62 percent. more and more difficult and more ex- these folks share the view that was ex- It says the worst off is the State of pensive to create the jobs that will pressed by the unions, perhaps the big- North Carolina, where individual mar- help these middle-income families gest advocates of the health care law ket rates are going to triple for women meet the needs of their families and when it passed. What we would like is and quadruple for men. We can go down try to provide a better future for their a do-over. It either needs to be fixed or the list State by State, and we get sort children and grandchildren. it needs to be repealed. of a detailed explanation of people at One of the reasons is, at the end of That was essentially the message various stages in life, such as a 40-year- the day, as people are assessing this, that was coming from the unions at a old woman. I am looking at some there is so much information, polling meeting they had in California a week charts here comparing my State of data, and survey data that corrobo- ago. South Dakota. This is the Affordable rates the anecdotal information we are It goes on and on. We are going to Care Act bronze premium versus the hearing from individuals and busi- have an opportunity to right that pre-Affordable Care Act health care nesses out there. People are increas- wrong. We are going to have an oppor- premiums that people in similar cir- ingly skeptical, increasingly sus- tunity to get that do-over and to have cumstances were faced with. For a 40- picious, and increasingly frustrated a vote. year-old man in my State of South Da- with the ObamaCare legislation. They The vote is going to occur in the next kota, it says that this is going to in- want to see a do-over. few days, and it is going to give us an

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00117 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE S6880 CONGRESSIONAL RECORD — SENATE September 24, 2013 opportunity to go on the record about I want to say at the outset that I necticut that have already been dem- whether we ought to continue to fund a hear from folks in Connecticut about onstrated. They relate specifically to program that we now know is not the need for improvements and minor the Prevention and Public Health working. And all the evidence that I changes in the Affordable Care Act, Fund. mentioned here today, all the con- which should be possible. But what Let me repeat that term: the Preven- versations we have with businesses in should be impossible is holding hostage tion and Public Health Fund. It is not our home States, with hospitals—I the work of the government to achieve exactly a household word to many mentioned earlier Cleveland Clinic, changes in the Affordable Care Act and Americans, but it should be credited, which is reducing its workforce to pre- making improvements that may be along with ObamaCare and the Afford- pare for ObamaCare. That is going on necessary but should be done sepa- able Care Act, with specific tangible all across this country. It is not too rately from keeping the government accomplishments in helping people late for us to get this right. We can open for our veterans and Social Secu- learn how to make smart decisions and correct this. There is a better way to rity recipients who may need services prevent the onset of obesity, diabetes, do this. It didn’t take a 2,700-page bill in connection with the checks they are heart disease, and cancer. These condi- and 20,000 pages of regulations to fix issued, in paying our troops here and tions and diseases have real costs and the things that were wrong with the abroad who are serving and sacrificing preventing them has real savings. So American health care system. for us, in the countless ways our Fed- we can seriously reduce not only the But now we have a government take- eral Government makes a difference in overall levels of spending on health over of literally one-sixth of our econ- people’s lives. Most importantly, the care but also save people a lot of suf- omy, massive amounts of redtape and threat of closing the government helps fering and families a lot of heartbreak. bureaucracy and regulation and the un- to create uncertainty and confusion, In my home State of Connecticut, certainty associated with that, higher which in turn undermines investment the funding from the Prevention and cost for individuals, much higher and job creation and economic growth Public Health Fund has supported vital costs—dramatically higher costs, as I and, indeed, recovery from the great care and services in three critical pointed out—and fewer job opportuni- economic recession that has so finan- areas: mental health, tobacco ces- ties for families around this country, cially crippled our Nation. sation, and women’s health care—not at least for full-time jobs, and lower The health care reform measure—the the only three that has those accom- take-home pay and a lower labor par- Affordable Care Act, ObamaCare, call plishments, but they are three. ticipation rate and sluggish economy. it what you will—has already made On mental health services, last year That is what this has wrought. That is achievements, enabling young people the State of Connecticut received near- what we need to correct and fix, and we to stay on their parents’ policies; mod- ly $900,000 from the Prevention and are going to have an opportunity to do erating, if not eliminating, many of the Public Health Fund for use by the that with a vote later this week. insurance coverage abuses I fought State’s department of mental health So, Mr. President, I know it is very against as attorney general; and and addiction services and the direct hard to acknowledge sometimes when achieving advances in health care de- care providers in the State. Let me something is not working, and it is livery reform for greater efficiency and give an example of how that money something you have invested in, some- lower cost. was used. thing that in this case a number of our As we have noted on this floor count- Community Mental Health Affiliates, colleagues voted for when it was passed less times, the Affordable Care Act was which serves more than 8,300 children, here several years ago. But in the in- passed by majorities of this body and adolescents, and adults each year in 17 terest of the American people, in the the House of Representatives and locations throughout Connecticut, re- interest of doing what is right for jobs, signed by the President. It predated my ceived some of those funds to provide for our economy, for the health care service here, but it is the law of the direct care. In particular, they are needs of American middle-class fami- land. The effort now is, in effect, to using those funds to create the Allied lies across this country, it is time for achieve through the back door what Health System, and they are doing it us to fix this, to right this wrong, and was not accomplished through the with the Hospital of Central Con- to move in a different direction. front door. It is to achieve indirectly necticut, which means having advanced So I hope we will have the votes. what opponents of the Affordable Care nursing and practical help from the There will be some of our colleagues on Act wanted to achieve directly, which Hospital of Central Connecticut to the Democratic side who will vote with is to block it, to stop it, to halt it. come to their outpatient facility to us when we get to this vote here in the That should not be the objective of this provide case management and wellness next few days and may send a very measure and certainly should not be programs and suicide prevention and clear and loud message to the Amer- achieved by a small minority, a fringe screening programs. They are helping ican people that we are listening, that extreme group of ideologs who have, in save lives and health. we hear you, we understand your frus- the House of Representatives, threat- We know that investment in mental tration, we want to fix this and get it ened to hold hostage the entire Federal health makes a difference. In fact, it right, and we want to go in a different Government. ought to be a centerpiece of a com- direction. And I think that will be a I am disheartened that some of the prehensive gun violence prevention welcome relief to Americans, who in same Senators who rightly decried the measure. We know reaching dangerous overwhelming numbers are finding this pace of our economic recovery are people, along with keeping guns out of less and less to their liking. The more themselves now undermining that goal the hands of dangerous people before they find out about it, the less they by demanding an end to the Affordable they commit acts of violence is central like it and the more concerned they are Care Act and engendering uncertainty to what we have to do to make our Na- about their future and their families. and confusion so inimical to job cre- tion safer and better. An investment in Mr. President, I yield the floor. ation and economic growth. behavioral health services is vital to The PRESIDING OFFICER. The Sen- Forums in Connecticut and my con- addressing the diseases—the psychoses, ator from Connecticut. versations and discussions with health addictions, depression, post-traumatic Mr. BLUMENTHAL. Mr. President, I care providers, our hospitals, our med- stress—and helping to reach people be- rise this evening to talk as well about ical professionals, have convinced me fore tragedy occurs. the Affordable Care Act and perhaps that one of the central achievements We know that lack of investment cut through some of the rhetoric and already of the Affordable Care Act re- makes a difference as well, not only in talk a little about specific realities and lates to preventive care, and I want to violence but in heartbreaking failures the reason to preserve its funding, talk a little while about those spe- and life-changing illnesses that are along with honoring our other commit- cifics, about the reality on the ground perhaps invisible but in children can ments in the continuing resolution in Connecticut that I have seen and transform lives for the worst. The Con- that will keep the Federal Government heard—not the predictions or prognos- necticut Children’s Medical Center re- open and working for the American tications but the realities of preventive cently came to my office and shared people. health care achievements in Con- with me what the lack of investment in

VerDate Mar 15 2010 03:16 Nov 11, 2014 Jkt 079060 PO 00000 Frm 00118 Fmt 0624 Sfmt 0634 E:\RECORD13\RECFILES\SEP2013\S24SE3.PT2 S24SE3 bjneal on DSK2TWX8P1PROD with CONG-REC-ONLINE September 24, 2013 CONGRESSIONAL RECORD — SENATE S6881 preventive health care means for them to persuade the insurance company to A joint resolution (H.J. Res. 59) making and the children who come to this chil- reverse those denials but only after the continuing appropriations for fiscal year dren’s hospital. They have seen num- family had to resort to asking their 2014, and for other purposes. bers of children arriving in a behav- neighbors to pay for their son’s med- AMENDMENT NO. 1974 ioral health crisis unmatched in our ical bills. (Purpose: To perfect the joint resolution) history—nearly quadrupled since the Story after story after story about Mr. REID. Mr. President, I have an year 2000. Last year that meant 2,300 medical insurance denials convinced amendment at the desk. children seeking care in the emergency me that the Affordable Care Act will The PRESIDING OFFICER. The department of that children’s hospital. make a difference in reforming health clerk will report the amendment. Emergency departments are not care coverage practices by the insur- The assistant legislative clerk read equipped to provide the kind of special- ance companies as well as enabling as follows: ized care that the children need who families to avoid the financial travails The Senator from Nevada [Mr. REID] pro- come to them in these traumatic life- of bankruptcy. poses an amendment numbered 1974. changing situations—in crises. And for Let me say finally, Connecticut has (The amendment is printed in today’s some kids who wait over a week for been a leader in insurance markets RECORD under ‘‘Text of Amendments.’’) placement in an appropriate inpatient with many leading insurers Mr. REID. On the amendment just re- facility, that is a crisis not only for headquartered in my home State. I am ported, I ask for the yeas and nays. them but for their family and their proud that Connecticut has been that The PRESIDING OFFICER. Is there a communities. We have seen the tragic leader that is home to many insurance sufficient second? results of failing to address those crises companies and that Access Health Con- There appears to be a sufficient sec- which affects individuals, and it is so necticut, the individual marketplace in ond. heartbreaking. Connecticut, has been working tire- The yeas and nays were ordered. I have fought for and made my life’s lessly and successfully with these in- AMENDMENT NO. 1975 TO AMENDMENT NO. 1974 work tobacco prevention and cessation surance firms to put together a ground- Mr. REID. Mr. President, I have a programs. My colleagues want to talk breaking exchange. second-degree amendment at the desk. about reducing Federal spending. Well, The Kaiser Family Foundation re- The PRESIDING OFFICER. The let’s talk about the $96 billion a year in cently found that the likely cost for a clerk will report the amendment. direct health costs that are necessary family of four in Hartford, CT earning The assistant legislative clerk read to treat diseases caused by tobacco ad- $60,000 a year for a bronze level plan as follows: diction. That is $96 billion a year in di- through the exchange will be $122 a The Senator from Nevada [Mr. REID] pro- rect health costs, with nearly $55 bil- month. That is about the cost of a poses an amendment numbered 1975 to lion of it from the Federal Govern- Starbucks coffee every day. The prod- amendment No. 1974. ment. I hope to work in a bipartisan ucts being offered through the ex- The amendment is as follows: way to reduce that figure with my col- changes are high quality, and they are At the end, add the following: leagues through the Affordable Care available even to people who have a This Act shall become effective 1 day after Act. preexisting condition. enactment. A study in the Lancet on the first In fact, the Affordable Care Act en- MOTION TO COMMIT WITH AMENDMENT NO. 1976 ‘‘Tips From Former Smokers’’—the ables health care insurance for all peo- Mr. REID. Mr. President, in relation campaign of the Federal Government— ple with a preexisting condition. No to that, I have a motion to commit found that 1.6 million additional smok- longer will people have to confront H.J. Res. 59 with instructions, which ers are making a quit attempt because their insurance companies as regularly are at the desk. of this campaign and over 100,000 have and frequently as they did. No longer The PRESIDING OFFICER. The quit tobacco since 2012 because of that will insurance companies be permitted clerk will report the motion. campaign. to engage in the egregious practices The assistant legislative clerk read The final area I think is so important they did. And hopefully, no longer will as follows: is women’s health care, and in this the services of my office, such as I did The Senator from Nevada [Mr. REID] moves area the Affordable Care Act has been when I was Attorney General and now to commit the bill to the Committee on Ap- monumental in maternity care in our as Senator, be as necessary as often. propriations, with instructions to report hospitals, in contraception coverage, in Shutting down the government is a back forthwith with an amendment num- bered 1976. health insurance provisions that make movie we have seen before. It ends a difference in women participating badly. It ends with undercutting in- The amendment is as follows: equally in our economy as well as hav- vestments, undermining job creation At the end, add the following: ing the health care they need, which in and economic growth. It is a disservice This Act shall become effective 4 days after enactment. turn saves money not just for them but to our Nation. Hopefully, with bipar- for children who are born in hospitals tisan cooperation and compromise we Mr. REID. Mr. President, on that I and who receive the kind of care they can afford it and proudly go on with ask for the yeas and nays. need in those first days of birth. The the work of this body and of the Fed- The PRESIDING OFFICER. Is there a Prevention and Public Health Fund has eral Government. sufficient second? made a difference in those lives, and it Mr. President, I yield the floor. There appears to be a sufficient sec- has made meaningful improvements to The PRESIDING OFFICER. The ma- ond. The yeas and nays were ordered. the lives and health of women and chil- jority leader. dren across this country. Mr. REID. Mr. President, I know of AMENDMENT NO. 1977 Cost savings to the Nation resulting no further debate on the motion to pro- Mr. REID. Mr. President, I have an from preventive health care are huge, ceed. amendment to the instructions at the but those economic benefits also ac- The PRESIDING OFFICER. Is there desk. crue to our families. More than half of further debate? The PRESIDING OFFICER. The all the bankruptcy cases today are If there is no further debate, the clerk will report the amendment. caused by health bills people simply question is on adoption of the motion. The assistant legislative clerk read can’t pay. I know because I see the re- The motion was agreed to. as follows: sults and try to help the families who f The Senator from Nevada [Mr. REID] pro- are affected by it. poses an amendment numbered 1977 to the One example is a family whose son MAKING CONTINUING APPROPRIA- instructions of the motion to commit, H.J. struggles with Lyme disease and re- TIONS FOR FISCAL YEAR 2014 Res. 59. ceived denials from insurance compa- The PRESIDING OFFICER. The The amendment is as follows: nies. They had to exhaust their retire- clerk will report the joint resolution In the amendment, strike ‘‘4 days’’ and in- ment savings and their health care by title. sert ‘‘3 days’’. funds as well as their college fund for The assistant legislative clerk read Mr. REID. On that, I ask for the yeas medical treatment. My office was able as follows: and nays.

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