October 30, 2019 CONGRESSIONAL RECORD — SENATE S6263 confer on President Trump the most As Senate Republicans have said over of title 5, United States Code, of the rule basic rights of due process or, seem- and over and over again, we support submitted by the Secretary of the Treasury ingly, alter Chairman SCHIFF’s unfair protections for Americans with pre- and the Secretary of Health and Human process in the House Intelligence Com- Services relating to ‘‘State Relief and Em- existing conditions. And the adminis- powerment Waivers’’. mittee in any way whatsoever. tration has made it very clear that this There being no objection, the Senate Chairman SCHIFF can continue doing waiver program poses no threat—no proceeded to consider the resolution. this behind closed doors without the threat—to those protections. The Ad- Mr. MCCONNELL. I suggest the ab- President’s participation, so long as he ministrator of the Centers for Medicare holds at least one public hearing at sence of a quorum. & Medicaid Services has stated that ‘‘a The PRESIDING OFFICER. The some point. He is not even required to section 1332 waiver cannot’’—cannot— clerk will call the roll. make all the evidence he obtains pub- ‘‘undermine coverage with people with The senior assistant legislative clerk lic. He alone gets to decide what evi- pre-existing conditions.’’ proceeded to call the roll. dence goes in his report. And the reso- What is more, as the White House has Mr. SCHUMER. Mr. President, I ask lution doesn’t even give the President already made clear, Democrats’ resolu- unanimous consent that the order for any rights in the public hearing that it tion has zero chance of becoming law. the quorum call be rescinded. requires Chairman SCHIFF to hold. This is just another political mes- The PRESIDING OFFICER. Without The resolution merely seems to con- saging exercise with no path to making objection, it is so ordered. template that maybe—maybe—some- an impact. RECOGNITION OF THE MINORITY LEADER day in the future, at some other phase I urge my colleagues to reject this The PRESIDING OFFICER. The of this, due process might—might—fi- resolution, keep fighting to lower pre- Democratic leader is recognized. nally kick in, but only if the House Ju- miums for the American people, and APPROPRIATIONS diciary Committee feels like holding protect those with preexisting condi- Mr. SCHUMER. Mr. President, even hearings and calling its own wit- tions. as we consider the package of appro- nesses—in other words, no due process priations on the floor this week, we now, maybe some later, but only if we f must also think about how both parties feel like it. MEASURE PLACED ON THE can reach an agreement on all 12 bills ‘‘No due process now, maybe some CALENDAR—H.R. 4334 later, but only if we feel like it’’ is not we need to pass before Thanksgiving. It Mr. MCCONNELL. Mr. President, I is way past time for Democratic and even close to fair. ‘‘No due process now, understand there is a bill at the desk maybe some later, but only if we feel Republican appropriators to sit down due for a second reading. like it’’ is not a standard that should and hammer out bipartisan agreement The PRESIDING OFFICER. The ever be applied to any American, and it on allocations to the various agencies, clerk will read the title of the bill for should not be applied here to the Presi- known as 302(b)s. That is how we got the second time. dent of the United States. this done in the past. Democrats and I understand that many House Demo- The senior assistant legislative clerk Republicans in Congress have success- crats made up their minds on impeach- read as follows: fully negotiated two budget deals. The ment years ago, but our basic norms of A bill (H.R. 4334) to amend the Older Amer- key to those agreements was that the justice do not evaporate just because icans Act of 1965 to authorize appropriations President allowed Congress to do its for fiscal years 2020 through 2024, and for work and stayed off to the side. I be- Washington Democrats have already other purposes. made up their minds. lieve that, again, if left to our own de- Mr. MCCONNELL. In order to place vices, Congress could work out an f the bill on the calendar under the pro- agreement to fund the government. HEALTHCARE visions of rule XIV, I would object to As everyone remembers, the Presi- Mr. MCCONNELL. Mr. President, on further proceeding. dent’s meddling and erratic behavior one final matter, our Democratic col- The PRESIDING OFFICER. Objec- caused the last government shutdown— leagues do apparently have time to tion having been heard, the bill will be the longest in our Nation’s history. push for show votes on messaging reso- placed on the calendar. The best way to avoid another shut- lutions with no chance of becoming f down would be for the President to law. This week’s installment is a keep out of the appropriations process RESERVATION OF LEADER TIME Democratic effort to limit the flexi- and for Republicans to stop the games bility that Governors of both parties The PRESIDING OFFICER. Under and get serious about negotiating in a have utilized to lighten the burdens of the previous order, the leadership time bipartisan way forward. ObamaCare. States have jumped at the is reserved. I believe there was a meeting yester- opportunity to use waivers to reduce f day, and there may be some progress. I the costs associated with ObamaCare’s think some progress was made. Let’s CONCLUSION OF MORNING continue moving in that direction, the mandate. In the States that have taken BUSINESS advantage, premiums decreased signifi- four corners of the Appropriations cantly. The PRESIDING OFFICER. Morning Committee—House and Senate, Demo- In 2018, the Trump administration ex- business is closed. crats and Republicans—and put to- panded this policy with an even more f gether an agreement we can all sup- flexible interpretation of this part of port. PROVIDING FOR CONGRESSIONAL ObamaCare. The goal was to give TRUMP ADMINISTRATION DISAPPROVAL UNDER CHAPTER States even more of what they had Mr. President, on the whistleblower, 8 OF TITLE 5, UNITED STATES been asking for, even more latitude to as the House of Representatives con- CODE, OF THE RULE SUBMITTED preserve consumer choice and lower tinues its impeachment inquiry as to BY THE SECRETARY OF THE premiums. But notwithstanding all the whether the President jeopardized na- TREASURY AND THE SECRETARY evidence that says this is the right di- tional security by pressuring Ukraine OF HEALTH AND HUMAN SERV- rection for the American people, our to interfere with our 2020 locations, the ICES RELATING TO ‘‘STATE RE- Democratic colleagues want to roll White House, their allies in Congress, back the Trump administration guid- LIEF AND EMPOWERMENT WAIV- and the media have resorted to des- ance and limit States’ flexibility. ERS’’—Resumed picable tactics to falsely discredit indi- Since this position is virtually im- The PRESIDING OFFICER. Under viduals who have provided the House possible to explain on its merits, our the previous order, the Senate will re- testimony. Democratic colleagues have instead sume consideration of S.J. Res. 52, Yesterday, LTC Alexander Vindman, turned to a familiar talking point: the which the clerk will report. an Active-Duty Army officer serving false claim that Republicans are trying The senior assistant legislative clerk on a detail in the White House, testi- to undercut protections for Americans read as follows: fied before Congress. Since Lieutenant with preexisting conditions. Sound fa- A joint resolution (S.J. Res. 52) providing Colonel Vindman’s testimony was an- miliar? But, of course, that is not true. for congressional disapproval under chapter 8 nounced and especially in the past 24

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00003 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.002 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE S6264 CONGRESSIONAL RECORD — SENATE October 30, 2019 hours, he has been vilified by individ- health insurance now, most of whom These urgent questions go to the uals in the media and elsewhere. Al- are under 6—innocents. When they heart of America’s national security, though he has served our country for have bad health, they need help. That and we need them answered today. more than 20 years, although he is a re- breaks your heart. The effect of all this I suggest the absence of a quorum. cipient of the Purple Heart after being sabotage is very, very real. The PRESIDING OFFICER. The wounded while serving in Iraq, he has Now, think about this issue, about clerk will call the roll. been called derogatory terms, and some protections for Americans with pre- The senior assistant legislative clerk have even gone so far as to call him a existing conditions. Think of a mom or proceeded to call the roll. spy and question his loyalty to the dad who has a son or daughter and they Mr. THUNE. Mr. President, I ask United States. discover that he or she has cancer. unanimous consent that the order for These attacks are outrageous. They They go to the doctor, and the doctor the quorum call be rescinded. are unacceptable, and they are not un- says: Look, I have this very expensive The PRESIDING OFFICER. Without like the attacks the President and his medication or this expensive treatment objection, it is so ordered. allies have levied against the whistle- that will help cure your child, but the The majority whip is recognized. blower whose account first alerted Con- insurance policy doesn’t cover it. DEATH OF ABU BAKR AL-BAGHDADI gress to the President’s misconduct The family doesn’t have enough Mr. THUNE. Mr. President, ISIS took with Ukraine. The President has pub- money to pay for it, and they watch a big hit over the weekend when U.S. licly suggested the whistleblower is their child suffer. That should not hap- forces raided ISIS leader Abu Bakr al- treasonous and a spy. Baghdadi’s compound in Syria. Al- Separately, recent public reports sug- pen in America. We want to prevent it from happening. Baghdadi died in the raid after he deto- gest that a Republican member of the nated a suicide vest in a final act of House Intelligence Committee is ac- That is why we hope our colleagues will join us in this CRA to overturn cowardice, killing three children with tively trying to expose and leak the him. The second in command was con- whistleblower’s identity. This is so, so what the administration has done that firmed killed in a second military wrong. Disclosing or causing to be dis- would allow that terrible example to go strike hours later, leaving the organi- closed the identity of a whistleblower forward. zation temporarily leaderless. is such a breach of faith of our whistle- Let me continue on healthcare for a Over the past few years, ISIS has blower laws, which are designed to see minute. Despite making explicit prom- spilled a river of blood across the Mid- that the truth gets out. Anyone seek- ises to defend protections for Ameri- dle East. Its brutality has set it apart ing the release of the whistleblower’s cans with preexisting conditions in even among other terrorist organiza- identity is frustrating the truth and is campaign ads—I even heard some speak tions. Torture, rape, enslavement, cru- potentially in violation of Federal law. about it as recently as yesterday—Re- Not only that, the disclosure of the publicans have voted to undermine cifixions, beheadings, and the delib- whistleblower’s identity may result in these protections in Congress on sev- erate targeting of whole populations reprisals and threats to their personal eral occasions. There is no getting based on their religious beliefs—the safety and the safety of their families. around the fact that junk insurance list of crimes is long and often nearly Today, I am sending a letter to the plans offer a way around these impor- unspeakable. Secretary and Chief of Staff of the tant protections and drive costs up for The world is a safer place today be- Army asking them to provide us with everyone else. cause of al-Baghdadi’s death. This im- what actions the Army is taking to en- Do Republicans want to use taxpayer pact will only be temporary unless we sure that Lieutenant Colonel Vindman dollars to fund these junk plans and dedicate ourselves to ensuring that is afforded appropriate protections. add to insurance company profits? ISIS is permanently defeated. The successful raid on al-Baghdadi’s Lieutenant Colonel Vindman and whis- I hope not, but we will see today. compound is a reminder of the fact tleblowers like him are standing up for Today, my Republican colleagues face that our military may be called on at the Constitution they swore an oath to a test. They can vote to defend a moment’s notice to head halfway defend. Their lives and families must healthcare protections for Americans around the world to fight evil. The men not be put in jeopardy by an out- who need it most or they can stand and women of the U.S. military stand rageous attack or disclosure. with President Trump and vote to on guard 24 hours a day, 365 days a HEALTHCARE allow these junk health insurance year, ready to put themselves between Mr. President, now on healthcare, plans with so many devastating effects today the Senate will hold a vote on a us and danger. on so many families flood the market. This past weekend, I had the honor of resolution to repeal a Trump adminis- SYRIA tration rule promoting junk health in- helping to welcome home 112 South Da- Mr. President, finally, on Syria, we surance plans, which offer a way kota Army National Guard soldiers of were informed yesterday that after around protections for Americans with the 147th Forward Support Company multiple requests, the Senate will fi- preexisting conditions. The adminis- and Bravo Battery of the 147th Field nally receive an all-Member briefing by tration has worked to make it easier Artillery Battalion. These citizen sol- the administration on the situation in for States to use taxpayer dollars to diers were in Europe for nearly a year subsidize these junk insurance plans, northern Syria this afternoon. I am working with our NATO allies and in- many of which don’t cover essential glad the briefing is taking place, but it creasing unit readiness. benefits, like maternity care, preven- is regrettable that it has even taken As Members of Congress, we have no tive screening, and mental healthcare. this long. more fundamental responsibility than These junk plans leave families vulner- Secretary Pompeo also will not par- ensuring that our men and women in able and are nothing but a boon to ticipate, which is profoundly dis- uniform are prepared to meet any health insurance companies. appointing, given that we must hear threat. We do that by providing timely For nearly 3 years, Republicans in from the Secretary of State at times and adequate funding for the current Congress and the Trump administra- and on issues such as this. and future needs of our Armed Forces. tion have sabotaged Americans’ Nevertheless, those members of the That means funding the military healthcare. Funding to sign up Ameri- administration who will be there today through regular order appropriation cans for health insurance has been must answer several important ques- bills—not through temporary funding eliminated. Programs to help low-in- tions. What is our strategy moving for- measures that leave the military in come Americans afford insurance has ward on northern Syria? How are we doubt about funding levels and unable been canceled. President Trump’s going to protect troops and our na- to start essential new projects. budgets have threatened deep cuts to tional interest? And, most impor- Unfortunately, our efforts to fund Medicare and Medicaid. Now, the tantly, exactly what is our plan to en- the military in a timely fashion have Trump administration is suing to re- sure the enduring defeat of ISIS and to been stymied by Democrats who peal the entirety of the healthcare law. make sure that those who are still im- blocked the Senate from passing the Yesterday—just yesterday—new data prisoned don’t escape and those who Defense appropriations bill in Sep- showed that 400,000 fewer kids have have already escaped don’t hurt us? tember before the end of the fiscal

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00004 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.003 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE October 30, 2019 CONGRESSIONAL RECORD — SENATE S6265 year. We are now a month into the new The senior assistant legislative clerk in how they spend Federal dollars. fiscal year, and Democrats are still in- proceeded to call the roll. Twelve States have already used that dicating that they intend to block this Mr. ALEXANDER. Mr. President, I provision in law to lower rates. There year’s Defense appropriations bill. ask unanimous consent that the order are 12 waivers from States that have Let me briefly review what Demo- for the quorum call be rescinded. been approved by the Trump adminis- crats are blocking. They are blocking The PRESIDING OFFICER. Without tration, and premiums have gone down funding to support a pay increase for objection, it is so ordered. in all 12 States as a result of this ac- our military men and women. They are Mr. ALEXANDER. Mr. President, at tion. This is what the Democrats want blocking funding for weapons and 12:15 p.m., the Senate will vote on a to stop. They want to stop States from equipment that our troops need right Democratic proposal to overturn a using this provision which the Demo- now. They are blocking investment in Trump administration guidance from crats invented in 2010 to lower insur- the equipment and technology that our the Department of Health and Human ance rates. That is why it is a scary military will need to defeat the threats Services that would lower insurance fairytale that only on Halloween any- of the future. They are blocking fund- rates all across America. Seems like a body could imagine could come up ing for missile defense, for research strange thing to do, but to justify that, with. and development, for ships, planes, and the Democrats have come up with a Now, 7 of the 12 waivers that were ap- combat vehicles to update our aging scary fairytale that has no basis in proved by the Trump administration fleets, and they are blocking funding truth, that suggests that somehow this were under an Obama definition of Sec- for our allies, including $250 million in effort to lower insurance rates would tion 1332, and 5 have been approved military assistance for Ukraine. jeopardize the protection for pre- since the new guidance that is the sub- Let me just repeat that last point. existing conditions that all Americans ject of the vote today. For any State to Democrats, who are currently trying to have according to the law. Of course, get a 1332 waiver, the Centers for Medi- impeach the President for allegedly de- that can’t happen because the law care and Medicaid Services has to ap- laying Ukraine funding, are currently doesn’t permit it. So I want to talk prove it. Seema Verma is the Adminis- blocking $250 million in assistance for about that a little bit today. trator of that agency. She has made it Ukraine. Now, I am pretty sure that is What the Senate Democrats want to very clear, No. 1, that none of the 12 the definition, if you look it up, of both overturn is a Trump administration waivers that have been approved jeop- irony and hypocrisy. guidance regarding what is called a ardize preexisting health condition Toward the end of the summer, it section 1332 waiver. Now, a 1332 waiver looked like Democrats might actually protections for anybody. In other was part of the Affordable Care Act of words, the waivers did lower rates for be willing to work with Republicans to 2010 that Democrats passed. No Repub- pass this year’s appropriations bills. some people, but they didn’t hurt any- lican voted for it. So you had the Af- one’s ability to buy insurance who had Both Democrats and Republicans fordable Care Act, which says, among agreed to a bipartisan deal laying out a preexisting condition. Just because it other things, that every American who helped some people didn’t mean it hurt funding levels for both defense and has a preexisting health condition is nondefense spending, but, apparently, other people. protected. That means that if I have a Seema Verma went on to say very that was as far as Senate Democrats preexisting health condition, and I were prepared to go. Now that it has clearly: want to buy insurance, I have a right To be very clear, the 2018 guidance— come time to honor the spirit of that to buy it. I can’t be charged any more agreement and get this year’s Defense for it because of my preexisting health The one we are talking about today— appropriations bill done, Senate Demo- condition, and I am covered if I get does nothing to erode ObamaCare’s pre- crats are balking. sick. That is what we mean by protec- existing condition provisions, which cannot Democrats would like us to believe be waived under Section 1332. tion for preexisting conditions. That is they are serious about legislating; that in the Federal law. No American can be In other words, the law the Demo- their yearslong obsession with im- denied that protection. crats wrote in 2010 does not allow peaching the President isn’t dis- In the very same law, the Affordable States to waive the preexisting condi- tracting them from doing their job. Care Act, Democrats wrote another tion. Seema Verma goes on to say: Well, they are going to have a chance provision to give States more flexi- ‘‘Section 1332 does not permit States to to prove that in the very near future. bility in how they spend ObamaCare waive Public Health Services Act require- If Democrats are actually serious ments such as guaranteed availability and about legislating, if they are serious money with the hope that they might be able to lower rates for Americans renewability of health insurance, the prohi- about meeting their responsibilities, bition on using health status to vary pre- then they will work with Republicans who have health insurance. That would miums, and the prohibition on preexisting to move forward on the Defense appro- be a good thing because in Tennessee, conditions exclusions. Furthermore, a sec- priations bill and to get this legislation and across the country, really, since tion 1332 waiver cannot be approved that to the President as soon as possible. I ObamaCare passed, rates have gone up might otherwise undermine these require- hope that is what they will choose to 163 percent. Those rate increases espe- ments. This administration stands com- cially hurt people who make a little bit mitted to protecting people with preexisting do. conditions.’’ As Chairman SHELBY noted on the more than $50,000—say a songwriter in floor last week, Congress’s failure to do Nashville or a farmer like Marty, The bottom line is, 12 States have al- its job and fund our military is making whom I ran into in the Chick-fil-A out- ready used section 1332 waivers to re- the military’s job more difficult, and side Nashville, who said: I can’t afford duce premiums. More States want to that, as Chairman SHELBY noted, is un- health insurance. I have to pay $15,000 come up with other ideas to do the acceptable. It should be unacceptable or $20,000 because I don’t get any same. In none of the 12 States were pre- to all of us. It is time to get our men ObamaCare subsidy. existing condition protections jeopard- and women in uniform the funding States are trying to take advantage ized for one single person. Seema they need and the pay increase they de- of this provision of the Affordable Care Verma says it cannot be, under the serve. It is time to get this year’s De- Act—ObamaCare—that says States law, and if any of the other States have fense appropriations bill done. It is may have some flexibility in how they some sort of new proposal—she time for the Democrats to stop stalling spend Obamacare money. The law also wouldn’t approve it. and foot-dragging and blocking, and for says states cannot jeopardize pre- There is no doubt there is a good rea- them to work with us to make sure our existing conditions protections for any- son why so many Governors may want men and women in uniform have what body. 1332 waivers. In fact, many of the they need to protect Americans and Now, the best evidence that what we States that have already been granted keep us safe. are talking about is a scary fairytale is waivers have Democratic Senators as I yield the floor. that 12 States already have used a 1332 well as Democratic Governors. Many I suggest the absence of a quorum. waiver. Remember, this is the provi- States are trying to reduce health in- The PRESIDING OFFICER. The sion in the Federal law that was de- surance rates because ObamaCare has clerk will call the roll. signed to give States more flexibility driven those rates so high. In the four

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00005 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.005 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE S6266 CONGRESSIONAL RECORD — SENATE October 30, 2019 bipartisan Health Committee hearings Let me give you an example of what earlier, is a scary fairytale dreamed up I chaired in September of 2017, vir- this guidance that we are talking for Halloween. tually, every witness told our com- about today would mean. In 2017, Iowa I hope that all Senators—especially mittee that the process of applying for submitted a waiver application that from those States who have seen the a 1332 waiver was too cumbersome, too would have restructured the premium 1332 waiver work so well—will vote not inflexible, and expensive for States to subsidies. That is the money Iowa gets to overturn the guidance that gives use. from Washington under ObamaCare. more Americans a chance to pay lower In the fall of 2017, provisions to im- According to Iowa Governor Kim Rey- healthcare premiums. prove that waiver application process nolds, Iowa’s waiver would have given I yield the floor. were included in bipartisan legislation 18,000 to 22,000 Iowans access to more The PRESIDING OFFICER (Mr. that was proposed by 12 Republican affordable insurance. These were SASSE). The Senator from Wisconsin. Senators and 12 Democratic Senators. Iowans who made too much to qualify UNANIMOUS CONSENT REQUEST—S. 1556 At one point, the distinguished Senator for Federal subsidies and were left be- Ms. BALDWIN. Mr. President, I rise from New York, the minority leader, hind by ObamaCare’s skyrocketing to join my colleague Senator MARK Senator SCHUMER, said it was such profits. This might be a farmer in Iowa WARNER and the entire Senate Demo- good policy that every Democrat ought making $55,000 a year and, with no sub- cratic caucus to force a vote on his res- to vote for it. sidy, paying $15,000 or $20,000 for an in- olution to protect Americans with pre- In 2018, Senate Democrats blocked surance policy. The rates would be existing health conditions and stop the that bipartisan legislation, which lower under Iowa’s proposal. Trump administration from using would have, by the way, lowered insur- Under the old guidance, Iowa’s inno- American taxpayer dollars to promote ance premiums by 40 percent over 3 vative waiver couldn’t be approved. junk insurance plans that don’t even years, and it became clear Democrats Now, with the new guidance—the one have to cover people who have pre- were refusing to change even a word of you seek to overturn today—Iowa can existing health conditions. ObamaCare. work with Administrator Verma to get The difference between the two sides I encouraged Secretary Azar and the the kind of creative waiver so 18,000– administration to take a look at the of the aisle here is really clear. The 22,000 more Iowans can afford health section 1332 waiver and, within the cur- Senate Republicans have worked with insurance. To be clear—to emphasize— rent law, do whatever they could to President Trump to pass repeal plans just as with the other 12 examples that give States more flexibility. Fourteen that would take people’s healthcare have been approved, no new waiver can Governors wrote the Secretary seeking away and allow insurance companies to be approved that would take away the help to make 1332 waivers work so they charge more for people with pre- right of any Iowan who has a pre- could start lowering premiums in their existing health conditions. existing health condition to buy insur- State. When their effort failed legislatively, In October of 2018, the Trump admin- ance at the same price as if that person instead of working in a bipartisan way istration issued new guidance with didn’t have a preexisting health condi- to lower healthcare costs for working much needed flexibility so States can tion and to keep insurance coverage families, President Trump and his ad- use 1332 waivers. Democrats who vote when that Iowan gets sick. ministration spent 2 years working to It is simply a scary Halloween fairy- at 12:15 to overturn this guidance are sabotage our healthcare system. The tale drummed up by the other side—for taking a tool away from their States, a Trump administration’s sabotage has reasons I can’t imagine since so many tool that many States want, to lower made it harder for people to sign up for of their States are benefiting from 1332 health insurance rates and, in every quality, affordable coverage, and there waivers—to take away from States the single case, without jeopardizing pro- are more Americans who are uninsured ability to reduce health insurance tection for preexisting conditions. today than when President Trump took That was the whole purpose of the costs. As I said earlier, any waiver that office. 1332 waiver. That is why Democrats put is approved—as 12 already have been— The Trump administration is even in it in the Affordable Care Act. That is to help some people get lower cost court to support a lawsuit to overturn why 13 States have approved those health insurance cannot hurt another the Affordable Care Act completely, waivers and 12 have been approved just person in that State by taking away which will take away guaranteed for one type of solution called reinsur- their right to buy insurance at the health protections and raise costs for ance. That is when States take some same price that covers their pre- Americans with preexisting health con- money and put it in a reinsurance pool. existing condition. States with 1332 ditions. If they succeed, insurance com- A State can take the sickest people in waivers include these States with panies will again be able to deny cov- that State and put them there. When Democratic Senators who will be vot- erage or charge higher premiums for the sickest people are out of the other ing today: Hawaii, Maryland, Min- nearly 130 million Americans who have pool, it lowers rates for the people who nesota, New Jersey, Oregon, Wisconsin. preexisting health conditions. are left. States can do reinsurance with Do they really want to take away from Meanwhile, this administration has Obamacare money. States lower health their State the ability to lower health expanded what we call junk insurance insurance rates for these people in the insurance premiums in a way that plans. These are plans that can deny pool. You make sure the people who doesn’t jeopardize preexisting condi- coverage to people with preexisting are sickest have insurance, and you tions? That is pretty strange. Then health conditions and don’t have to don’t take away anyone’s right to buy there is Colorado, Montana, Delaware, cover essential services like prescrip- insurance who has a preexisting condi- Rhode Island, Alaska, North Dakota— tion drugs, emergency room visits, and tion. the same. maternity care. In each of the States, health insur- I think this just gets back to the I ask my friends on the other side of ance premiums have gone down as point that Democrats have elevated the aisle to think about this for a mo- much as 43 percent in some cases. ObamaCare to the 67th book of the ment. President Trump supports over- North Dakota has seen the average Bible, and they can’t change a word of turning the law that provides protec- ObamaCare premium decrease 20 per- it, even though they wrote the 1332 tions for people with preexisting health cent; Colorado, 16 percent; Delaware, 13 waiver in the Affordable Care Act to conditions while he expands these junk percent; Montana, 8 percent; Rhode Is- give States the flexibility to reduce plans that don’t provide those protec- land, 6 percent. You want to overturn a healthcare premiums, which 12 States tions. This is what the Senate Repub- guidance that attempts to give States now have done. Democrats also wrote, licans support. This is their plan. more of that same kind of flexibility to in the Affordable Care Act, that you Last year, we forced a vote on my lower insurance premiums without af- cannot take away from any American legislation to block President Trump’s fecting the ability of any American to the right to buy insurance at the same expansion of junk insurance plans that buy insurance with preexisting condi- price if you have a preexisting health don’t have to cover people with pre- tion protections? There is no reason condition. That has been reaffirmed by existing health conditions. The final States shouldn’t be able to have that the Trump administration. It is in the vote tally was 50 to 50, with the entire flexibility. law. To suggest otherwise, as I said Senate Democratic Caucus and one

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00006 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.007 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE October 30, 2019 CONGRESSIONAL RECORD — SENATE S6267 Senate Republican voting in support of able in my home State of Wisconsin, the navigator program and helps to en- my legislation. Those who say they reads: ‘‘This plan has a pre-existing sure that Americans have better access support healthcare coverage for people limitation provision that may prevent to the affordable healthcare coverage with preexisting health conditions coverage from applying to medical con- that they need and want. The ENROLL should support the No Junk Plans Act. ditions that existed prior to this plan Act passed the House of Representa- Today, I want to take another vote. effective date.’’ tives earlier this year. We should also Mr. President, I ask unanimous con- Another junk plan from Golden Rule pass it in the Senate so that Americans sent that the Committee on Health, says that the plan doesn’t comply with can more easily enroll in quality Education, Labor, and Pensions be dis- the guaranteed essential benefits pro- healthcare coverage. charged from further consideration of vided by the Affordable Care Act. Mr. President, I ask unanimous con- S. 1556 and that the Senate proceed to To quote directly from the plan, the sent that the Committee on Health, its immediate consideration; that the description reads: ‘‘Even if you have Education, Labor, and Pensions be dis- bill be considered read a third time and had prior Golden Rule coverage and charged from further consideration of passed; and that the motion to recon- your preexisting conditions were cov- S. 1905 and that the Senate proceed to sider be considered made and laid upon ered under that plan, they will not be its immediate consideration; that the the table with no intervening action or covered under this plan.’’ bill be considered read a third time and debate. It is abundantly clear that these passed; and that the motion to recon- The PRESIDING OFFICER. Is there plans don’t cover protections for people sider be considered made and laid upon objection? with preexisting conditions. the table with no intervening action or The Senator from Tennessee. The people of Wisconsin did not send debate. Mr. ALEXANDER. Mr. President, in me to Washington to take away peo- The PRESIDING OFFICER. Is there reserving the right to object, the Sen- ple’s healthcare. I want to protect the objection? ator from Wisconsin is exactly correct. guaranteed healthcare coverage that The Senator from Tennessee. Every Senate Democrat has voted to millions of Americans depend on. I Mr. ALEXANDER. Mr. President, in take away a low-cost insurance option want to help more families get the reserving the right to object, in 2017, from what the Urban Institute says is quality, affordable healthcare they the Centers for Medicare and Medicaid 1.7 million Americans. These people need. Services found that navigators were can’t afford other kinds of insurance. UNANIMOUS CONSENT REQUEST—S. 1905 not cost-effective in enrolling people in That is what they want to take away, Despite the sabotage that I have de- health insurance. and she is attempting to do that once scribed from this administration During the 2017 open enrollment pe- again. I have plenty of constituents against the Affordable Care Act, in riod, navigators received over $62.5 mil- who have a right to get their insurance Wisconsin this year, things are getting lion in Federal grants while enrolling but who can’t afford it. This is the only better with the new Governor. Thanks 81,426 individuals. That is less than 1 kind of insurance they can buy. to strong leadership from Governor This kind of insurance was good percent of those enrolled in the Federal Evers and the investments his adminis- enough for the George W. Bush admin- exchanges, which comes out to a cost tration is making, Wisconsinites will istration. It was good enough for the of $767 per enrollee. In other words, the have more choices and more affordable Clinton administration. It was good taxpayer is paying $767 per enrollee for rates for quality health insurance enough for the Obama administration each person enrolled. The CMS also plans this year. Wisconsinites in every right up until the last few days, and it found that nearly 80 percent of the corner of the State will be able to find should be good enough under the navigators failed to reach their enroll- healthcare plans this year that include Trump administration. ment goals. According to the Urban Institute, all essential benefits like prescription I object. the Trump short term plan rule does is drug coverage, maternity care, emer- The PRESIDING OFFICER. Objec- give 1.7 million Americans an oppor- gency room visits, and mental tion is heard. The Senator from Wisconsin. tunity to buy short-term insurance healthcare at more affordable prices. Governor Evers is providing funding Ms. BALDWIN. Mr. President, I am while they move from one job to an- for more health insurance navigators disappointed to see my Republican col- other or while they look for a different and is conducting awareness campaigns league again object to the legislation situation. According to the Urban In- in the State so that families in Wis- that will help more Americans access stitute, those 1.7 million Americans consin will have the information they quality, private health insurance, Med- would otherwise go uninsured, and that need to sign up for quality and com- icaid, or the Children’s Health Insur- is what the Democrats are for. I object. prehensive healthcare plans. That is ance Program. This is especially harm- The PRESIDING OFFICER. Objec- why enrollment navigators are so im- ful to families in rural communities tion is heard. portant. We need to keep up the fund- who already lack access to in-person The Senator from Wisconsin. ing for navigator programs so that assistance for shopping and enrolling Ms. BALDWIN. Mr. President, obvi- more people can find affordable in quality, affordable health insurance ously, I am disappointed with the ob- healthcare plans that meet their needs. coverage. jection. Navigators help millions of Americans, So let me lay plain for everyone what I would point out that these junk including those in rural communities, we are seeing here from the Repub- plans are often called short-term plans, sign up for quality healthcare cov- licans and this administration. but the change that was made by this erage. Today, the Republicans objected to administration was to go from a 3- The Governor of Wisconsin under- passing my ENROLL Act, which would month sort of transition plan that, as stands the importance of navigators, provide funding for healthcare enroll- my colleague indicates, could be used but Washington has failed to step up. ment assistance to help people find when one changes employment or other Unfortunately, since President Trump high-quality, affordable plans that short-term use, and now they are avail- took office, his administration has would actually meet their healthcare able and renewable for up to 3 years. slashed Federal funding for the navi- needs. These plans do not preserve the protec- gator program by 84 percent. Trusted Today, the Republicans objected to tions under the Affordable Care Act to navigator programs, like those in Wis- passing my legislation to stop the ex- cover people with preexisting health consin, have had their funding cut by pansion of junk insurance plans that conditions and essential health bene- nearly 75 percent since 2017, meaning don’t even have to cover people with fits. fewer people in Wisconsin have re- preexisting health conditions. You don’t have to take my word for ceived the support they need to obtain The Republicans are working to it. We can read directly from the fine affordable coverage. make it harder for one to sign up for print on the actual plans that are being That is why I introduced the EN- high-quality, affordable healthcare. debated. ROLL Act this year with my good This administration is encouraging One of these junk plans from Com- friend from Pennsylvania, Senator Americans to buy junk insurance plans panion Life, which is currently avail- CASEY. This bill restores funding for that don’t provide the health coverage

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00007 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.009 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE S6268 CONGRESSIONAL RECORD — SENATE October 30, 2019 that they need and that can deny cov- that is free and transparent. It has said: By the way, we can have it ready erage to people who have preexisting evolved over the years to where it has in 10 minutes. health conditions. become as bloated and dysfunctional as That is the way things worked in the Finally, the Republicans and the the Federal Government that runs tril- real world. Trump administration are supporting a lion-dollar deficits. Any of us that run businesses where lawsuit that would overturn the entire ObamaCare decisions are made by you have transparency, competition— Affordable Care Act and take healthcare industry executives and take LASIK surgery for instance. It is healthcare away from literally mil- Federal Government bureaucrats, in- the only part of healthcare that actu- lions of American families. stead of by patients, employees, and ally works. Do you know why? Insur- The choice for the American people mostly employers who are the only ance companies aren’t involved. Pro- could not be clearer. I am working with ones that really have skin in the game viders deal with patients, consumers. my Democratic colleagues to help when it comes to our healthcare sys- Ten, 12 years ago, $2,000 to $2,500 an make things better for the American tem. eye, done with a scalpel. Now the tech- people. Sadly, the Senate Republicans I believe the underlying principles of nology is better, and you can get it are helping the Trump administration ObamaCare were right on. No one done for $250 to $500 an eye. That is the make things worse. I will not give up should go broke because they get sick way things should work. this fight. or have a bad accident. The solution is not more of what we I yield the floor. I believe that you cover preexisting tried that has failed. It certainly isn’t I suggest the absence of a quorum. conditions with no caps on coverage. Medicaid for All. How can that work The PRESIDING OFFICER. The Kids staying on the plan until they are when, if you are honest about how clerk will call the roll. 26? Fine. But it didn’t work from the much it is going to cost, it would near- The legislative clerk proceeded to beginning, and it won’t be an afford- ly double the size of our Federal Gov- call the roll. able—it was the Affordable Care Act. It ernment. Plus, why would you turn Mr. BRAUN. Mr. President, I ask turned into the un-Affordable Care Act, something like that over when we can’t unanimous consent that the order for and it is not a solution in the long run. even get it right in the Veterans’ Ad- the quorum call be rescinded. The solution will be to get the indus- ministration, where about 10 million The PRESIDING OFFICER. Without try out of the doldrums and to realize patients are covered, not 330 million? objection, it is so ordered. that when 80 Senators weigh in with an That would be jumping from the frying S.J. RES. 52 idea of how to fix your business, the pan into the fire. It would be a dis- Mr. BRAUN. Mr. President, we are cat is out of the bag. You have a prob- aster. We can’t afford it. Of course, no going to vote on a CRA later this after- lem. Sadly, in a place like this, which one around here ever asks the question noon, and this has been the issue domi- you can see can get sidetracked in so about how you pay for anything. We are going to completely exhaust nating D.C. and did in my campaign: many different ways and then never the Medicare trust fund in 6 to 7 years. the cost of healthcare. really craft solutions that last in the Employers and employees have been I am going to vote against the CRA, long run, that is kind of what we are up paying into that since the 1960s. That and I am not going to go into the par- against now. will probably be the first reality check ticularities of it. I just want to tell you The bills that have come through this place has—maybe along with the how it works on Main Street USA and from three different committees—pri- fact that foreign countries and every- kind of my perspective of how we real- marily Finance and the one I am on, one else are not going to keep lending ly solve healthcare in a way that is Health, Education, Labor, and Pen- us money to finance trillion-dollar going to be affordable and last for a sions—do some good things. Senator deficits—which, by the way, will hit long time. RASSLEY G and I did an op-ed this week $1.5 trillion in 6 to 7 years, when the in- I just finished visiting all 92 counties about negotiating drug prices in a way terest on the debt is going to be more in Indiana talking to Hoosiers, young that is going to bring them down. than we are paying for defense. and old, small businesses to farms. Ev- These bills have real things that will In conclusion, our healthcare system eryone is concerned about where is work. I am disappointed that they are needs radical change, but it needs to be healthcare cost going in the future. not aggressive enough, but we need to changed in a way that takes the power We don’t seem to, here, have a real start somewhere. from the industry and government and good plan for it. As a Main Street en- The drug companies have been noto- gives it back to the patient/consumer, trepreneur that took it on myself a few riously involved in—after they do such like it works in the real world. years ago to create a sustainable, af- a good job coming up with a solution, I will use this example: I know that fordable plan, most people think it ab- a remedy, then hand it over to a bro- in my hometown, if you are buying a solutely can’t happen using free mar- ken distribution system that ends up— big-screen TV—which, by the way, ket principles. I will go into a few de- and I will tell a little story. costs about one-fourth to one-third of tails of how that works in my own When I was uninsured, after I had to what it did 10 years ago, kind of like business. get off my great company’s insurance LASIK surgery—I know people in my ObamaCare was addressing an issue that was based upon wellness, not re- hometown would probably drive 50, 60 that has been boiling up for a long mediation, and my employees and pa- miles to save 50 bucks on a thousand- time. I took on the insurance compa- tients were encouraged on dollar one to dollar purchase. We don’t do that. The nies to fix it in my own company back shop around and find solutions—that healthcare consumer has atrophied. in 2008—covered preexisting conditions, worked. Here, the industry does every- They talk about they love employer- no caps on coverage. thing it can to not make it work. This provided insurance. Well, that is be- But ObamaCare was a solution that should have been a simple thing to do. cause the consumer pays for very little was never going to work. It was Big Luckily, I don’t have many prescrip- of it. Healthcare in cahoots with Big Govern- tions. I knew it was a generic that I will give a few details of what can ment. Never have I seen that result in should cost 15 to 20 bucks. I had six or happen when you are innovative, when something less expensive and more ef- seven places to choose from in my you incorporate the concepts of skin- fective. hometown. I went to the first one that in-the-game, doing more than asking I believe in free markets driving the would have been the most convenient others to pay for it. In our own plan, solutions, and the healthcare industry and fumbled around for 2, 3, 4 minutes. people enter their deductible less than is who I blame for being in this pickle. They kept asking me what my insur- they did 11 years ago because the in- That sounds unusual coming from a ance plan number was. I said: I have centives were put in place. But I found free market guy that doesn’t believe in none. I am uninsured. I want your best a way to do it uniquely, where most government. deal. CEOs didn’t want to take the risk. But not all markets are free. One of It came back $34.50. I believe in insurance for everyone. I the most disappointing things is when I made another call to a place that I believe in access. You heard me earlier. my own Republican colleagues mistake know has been on the leading edge. It In this day and age, preexisting condi- the healthcare industry for being one took them 10 seconds, $10, and they tions—that ship has sailed. I backed

VerDate Sep 11 2014 00:20 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00008 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.010 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE October 30, 2019 CONGRESSIONAL RECORD — SENATE S6269 that up with actions in my own busi- some Senators who listened to the pun- ways. If you support protections for ness. But I don’t believe that you can dits and the naysayers at the time who preexisting conditions, you can’t sit by take more of what is proven never to wanted the bill to fail. Kay tuned out and let this administration dismantle work and try to get it to be where it is all of that and listened to people from them. You have to stand up and defend twice the size of our current govern- her home State, like Tim and Marilyn, these protections because, as you ment. instead, and because she did, more than know, folks in Virginia are depending Republicans can lead on healthcare 4 million North Carolinians with pre- on them and constituents in your but only if we stop acting as apologists existing conditions have protections in States are as well. for a healthcare industry that is dys- law today. They have the peace of mind Very shortly, each Member of this functional and broken to the core, and Kay wanted so badly for Tim and body will have a chance to go on the then you set yourself up, for politicians Marilyn and every one of her constitu- record with this resolution of dis- here—and a public that generally falls ents. approval. for it—that that is going to be the so- Democrats are going to be talking a I fear some Members of this body lution. lot about healthcare this week, and in have forgotten what it was like before On our first foray into surrendering particular, we are taking a very impor- the ACA, when an unexpected surgery that right to the government through tant vote on upholding those protec- or a diagnosis of a chronic illness could ObamaCare, it yielded what it was pre- tions that Kay fought so hard for. So mean a one-way ticket out of the mid- dle class. dicted to—higher costs and fewer op- especially throughout this week, I will Unfortunately, this is not a hypo- tions. be thinking about Kay. I will be think- thetical. Earlier today, a group of us The only prescription for our ailing ing about the difference her love for had a press conference where a young healthcare system is consumer-driven, her State has made in the lives of peo- woman from my State came forward, transparent competition. I look for- ple across North Carolina and our and not only did her child have an ward to unveiling more of those ideas, country. I will be grateful, as so many enormous medical condition, but her and that is why I will vote against the others are, for her amazing friendship, husband was then diagnosed with CRA this afternoon. her wisdom, and her willingness to lymphoma, and she was diagnosed with I put the challenge and the onus on stand up for what is right. brain cancer. the back of the healthcare industry to I yield the floor. Without the protections of the ACA, get with it before you have a business I suggest the absence of a quorum. she testified she would not be able to partner that you are not going to The PRESIDING OFFICER. The afford healthcare coverage. like—the Federal Government. clerk will call the roll. The PRESIDING OFFICER. The Sen- I yield the floor. The legislative clerk proceeded to ator’s time is expired. The PRESIDING OFFICER. The Sen- call the roll. Mr. WARNER. Mr. President, I ask ator from Washington. Mr. WARNER. Mr. President, I ask unanimous consent for an additional 3 Mrs. MURRAY. Mr. President, I ask unanimous consent that the order for minutes. unanimous consent to speak as in the quorum call be rescinded. The PRESIDING OFFICER. Is there morning business. The PRESIDING OFFICER (Mr. objection? The PRESIDING OFFICER. Without DAINES). Without objection, it is so or- Without objection, it is so ordered. objection, it is so ordered. dered. Mr. WARNER. I will speed this up. REMEMBERING KAY HAGAN S.J. RES. 52 Let me also point out that, recently, Mrs. MURRAY. Mr. President, while Mr. WARNER. Mr. President, it has one of my constituents, a man named I am so sad to be here, I am always been just over 2 years since the Senate Jesse, received a $230,000 medical bill glad to have the opportunity to recog- voted down legislation that would have for his back surgery. Unbeknownst to nize Senator Kay Hagan. repealed the Affordable Care Act. If we him, he purchased one of these so- There are certain people who carry had voted down the Affordable Care called short-term junk plans only to with them a warmth and kindness that Act, that would have also erased the discover that he now fell into the cat- lift up others, even in places that are protections for Americans with pre- egory of having a preexisting condi- not always warm or kind and even existing medical conditions. tion, and this plan didn’t cover his when the going gets tough. Kay was ex- In the time since then, two things challenge. Jesse is 1 of the more than 3 million actly that kind of person and one of have happened. One, my colleagues Virginians with a preexisting medical the best examples I can think of. She from across the aisle have read the condition. Nationwide, more than 130 wasn’t only that—not at all. As an- writing on the wall. They recognized million Americans have preexisting other mom in the Senate, I saw how that the American people support the medical conditions like diabetes, asth- deeply she was dedicated to her fam- protections for preexisting conditions ma, or cancer. ily—her husband, Chip, and her chil- on an overwhelmingly bipartisan basis; Before the Affordable Care Act, an dren, Jeannette, Tilden, and Carrie. and, two, the Trump administration re- insurance company had every right to Kay was smart, witty, and fierce, and leased the rule that we are discussing deny these individuals coverage, she was an unwavering champion for today—a rule that would allow tax- charge them unaffordable premiums, or North Carolina families and commu- payer dollars to subsidize these short- terminate their plans. We cannot go nities. term junk plans that actively under- back to those days. Nine years ago almost to this week, mine the insurance market and jeop- Unfortunately, this administration Kay came to the floor to advocate for ardize the one very popular part of the has used every tool at its disposal to health reform, and she did it as she al- ACA, protecting folks with preexisting destabilize the market in the hopes ways did—by putting North Caro- conditions. that it will come crashing down so linians first. I know that my colleague, Senator they can finally repeal the ACA. Kay came here and she shared the BALDWIN, was here earlier, and Senator The rule we are talking about here story of Tim and Marilyn, a family BROWN, Senator WYDEN, and Senator today is a perfect example, among from Mooresville, NC. They had racked MURRAY. They have outlined in some many others, of what this administra- up tens of thousands of dollars in debt detail the challenges around these junk tion has done. They have defunded because Marilyn’s preexisting condi- plans, or some refer to them as short- cost-sharing payments that reduce pre- tion meant her only option was a high- term plans. The truth is, these plans miums in the marketplace. They have cost, high-deductible plan. Kay called don’t have to cover things such as shortened the enrollment period and powerfully for protections for pre- emergency room visits, maternity care, cut the budget for outreach naviga- existing conditions. or other essential benefits, and they tors—all folks who have helped Ameri- Nearly a decade has now passed since once again allow insurance companies cans find a plan that works best for the Affordable Care Act became law, so to discriminate against Americans them. not everyone remembers how, in that based on their medical history. Look at the recent case. The Texas v. fight, every single Senate vote With all due respect to my Repub- United States lawsuit that could be de- mattered, and there were certainly lican colleagues, you can’t have it both cided this very week would, overall,

VerDate Sep 11 2014 02:18 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00009 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.012 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE S6270 CONGRESSIONAL RECORD — SENATE October 30, 2019 strike down the health insurance sys- tale. Protection for preexisting condi- or mental healthcare, those that need tem as we know it, with no replace- tions when you buy health insurance is comprehensive health insurance cov- ment plan in place. the law. Nothing in the 1332 waiver erage will be forced into a high cost The truth is, if these protections for guidance changes that. plan, or stuck with an insurance plan people with preexisting conditions are I urge my colleagues to vote no. that can deny benefits for whatever going to survive, we have to have a sta- Mr. LEAHY. Mr. President, today we reason. These consumer protections ble insurance market. will vote to reject yet another attempt were at the heart of the ACA and are We can and should have legitimate by the Trump administration to sabo- why Vermont and a number of other debates about 1332 waivers. Certain tage the Affordable Care Act, ACA. The States have enacted State laws to States have used those in a very pro- President has tried to do everything maintain these critical protections for ductive way, but that is not what we within his power to dismantle the law. those with preexisting conditions. are talking about today. He has tried to repeal it through Con- Throughout their numerous attempts The Trump administration’s rule is gress twice and failed both times. When to sabotage the ACA, this administra- not a good-faith effort to bring down that did not work, his administration tion has made dubious claims that they costs or drive innovation. It is a direct joined Republican State attorneys gen- support protections for Americans with effort to undermine the stability of the eral in a lawsuit that would strike preexisting conditions. Certainly, their insurance market and is an attack on down the ACA with no plan to replace well-established record clearly and un- the viability of protections for Ameri- it, one of the reasons Congress rejected equivocally refutes this claim. Today, cans with preexisting conditions. his initial repeal efforts. Now, this Senate Republicans can show the Again, I know we are going to vote President has decided to unravel the American people that they do genu- on this CRA action very shortly. I urge ACA through other means. inely want to protect Americans with my Republican colleagues to support it We have seen efforts to destabilize cancer, diabetes, arthritis, substance so folks with preexisting conditions the health insurance market by not use disorders, behavioral health dis- can go about their daily lives knowing making cost-sharing payments, reduc- orders, or any of the other preexisting they will be protected. ing funding to help enroll individuals conditions that States would not have Thank you. I appreciate the courtesy in plans, or by allowing insurers to sell to cover under this rule. of my colleagues giving me those extra less comprehensive plans through This vote is about the more than 130 couple of minutes. short-term coverage or association million Americans with a preexisting With that, I yield the floor. health plans. This administration has condition who need strong protections. The PRESIDING OFFICER. The Sen- also welcomed waivers from States It is about who we are as a nation and ator from Tennessee. that want to restrict Medicaid cov- how we care for our people. Congress Mr. ALEXANDER. Mr. President, I erage by conditioning benefits on must ensure that all Americans have ask unanimous consent for 2 minutes. whether or not someone has a job. access to comprehensive, high-quality The PRESIDING OFFICER. Without Throughout its ongoing efforts to health insurance plans that meet their objection, it is so ordered. sabotage the ACA, the Trump adminis- needs at an affordable rate. The pas- Mr. ALEXANDER. Mr. President, I tration issued its rule to allow States sage of Senator WARNER’s the Protect know it is Halloween, and it is time for to discriminate against Americans Pre-Existing Conditions Congressional trick or treat, but I urge my colleagues with preexisting conditions. This rule Review Act resolution would be a step not to be tricked by this scary fairy- gives States new options for pursuing a in the right direction. We must not tale dreamed up by the Democrats that section 1332 ‘‘state innovation waiver’’ send our country back to the days would suggest that the section 1332 under the ACA. Section 1332 of the law when insurance companies could dis- waiver that give States more flexi- gives states additional flexibility to criminate against people with pre- bility, which they wrote, somehow implement State-specific improve- existing conditions. We must not go jeopardizes protections for people with ments that expand coverage, reduce backward. preexisting health conditions, which costs, and provide more comprehensive The PRESIDING OFFICER. All time they also wrote. Both are in the 2010 benefits. I am proud that Vermont was is expired. ObamaCare law. the first State to apply for a waiver The clerk will read the joint resolu- Preexisting health conditions are when the application process first tion for the third time. protected. The law says so. The law started in 2016. The joint resolution was ordered to does not allow any 1332 waiver, which Now this administration wants to be engrossed for a third reading and is the subject of what we are voting on significantly change the enforcement was read the third time. in a few minutes, to change that. of the four important guardrails en- Twelve States have had their 1332 acted by Congress that waiver pro- The PRESIDING OFFICER. The joint waivers approved by the Trump admin- posals must meet in order to be ap- resolution having been read the third istration, and in no case did it affect proved. These guardrails ensure that time, the question is, Shall the joint preexisting conditions. the waivers must offer comprehensive resolution pass? Seema Verma, who has to approve all plans at an affordable rate that protect Mr. ALEXANDER. I ask for the yeas of these waiver applications from the patients with preexisting conditions and nays. Department of Health and Human and do not increase the Federal deficit. The PRESIDING OFFICER. Is there a Services, says the law doesn’t permit Under this rule, States can increase sufficient second? any change in preexisting condition costs for vulnerable populations and re- There appears to be a sufficient sec- protections, and if somehow a waiver duce their quality of coverage. That is ond. asked for it, she would not approve it. unacceptable, especially for this Presi- The clerk will call the roll. What my Democratic friends are vot- dent who promised on the campaign The senior assistant legislative clerk ing for today is to take away a tool trail that ‘‘everybody is going to be called the roll. from States that has been used to re- taken care of.’’ The intent of the 1332 Mr. DURBIN. I announce that the duce rates by 43 percent in Maryland, provision was to let States innovate, so Senator from Colorado (Mr. BENNET), 20 percent in Minnesota, and 15 percent long as they continue to cover the the Senator from New Jersey (Mr. in New Jersey. It has been used in Ha- same number of people and maintain BOOKER), the Senator from California waii, Wisconsin, Colorado, Minnesota, the consumer protections set forth in (Ms. HARRIS), the Senator from Delaware, Rhode Island, Alaska, and the law. Vermont’s waiver is consistent Vermont (Mr. SANDERS), and the Sen- North Dakota. with the ACA and seeks to expand cov- ator from Massachusetts (Ms. WARREN) Why would you take away a flexi- erage to improve healthcare outcomes are necessarily absent. bility option that you wrote to give for all Vermonters. The PRESIDING OFFICER. Are there your own voters lower health insurance By allowing States to permit the sale any other Senators in the Chamber de- rates? of health insurance plans that do not siring to vote? I know it is Halloween, but don’t be cover essential health benefits such as The result was announced—yeas 43, tricked. Don’t believe this scary fairy- maternity care, emergency room visits, nays 52, as follows:

VerDate Sep 11 2014 02:18 Oct 31, 2019 Jkt 099060 PO 00000 Frm 00010 Fmt 0624 Sfmt 0634 E:\CR\FM\G30OC6.015 S30OCPT1 dlhill on DSKBBY8HB2PROD with SENATE October 30, 2019 CONGRESSIONAL RECORD — SENATE S6271 [Rollcall Vote No. 337 Leg.] Mr. THUNE. The following Senator is McConnell (for Shelby) amendment No. YEAS—43 necessarily absent: the Senator from 950, to make a technical correction. Baldwin Heinrich Rosen Louisiana (Mr. CASSIDY). The PRESIDING OFFICER. The Sen- Blumenthal Hirono Schatz Mr. DURBIN. I announce that the ator from Texas. Brown Jones Schumer Senator from Colorado (Mr. BENNET), HEALTHCARE Cantwell Kaine Shaheen the Senator from New Jersey (Mr. Mr. CORNYN. Mr. President, so far, Cardin King Sinema Carper Klobuchar Smith BOOKER), the Senator from California the 116th Congress has been full of a Casey Leahy Stabenow (Ms. HARRIS), the Senator from Min- number of dubious measures, as I Collins Manchin Tester Coons Markey nesota (Ms. KLOBUCHAR), the Senator might characterize them, by our Udall Cortez Masto Menendez from Vermont (Mr. SANDERS), and the friends across the aisle as it relates to Van Hollen Duckworth Merkley Warner Senator from Massachusetts (Ms. WAR- our healthcare system. Durbin Murphy REN) are necessarily absent. For starters, our Democratic col- Feinstein Murray Whitehouse Gillibrand Peters Wyden The PRESIDING OFFICER (Mr. ROM- leagues in the Senate and the House Hassan Reed NEY). Are there any other Senators in and on the Presidential campaign trail are hailing Medicare for All as the gold NAYS—52 the Chamber desiring to vote? The yeas and nays resulted—yeas 88, standard for healthcare in America. Alexander Gardner Portman I was here during the debates over Barrasso Graham Risch nays 5, as follows: Blackburn Grassley Roberts [Rollcall Vote No. 338 Leg.] the Affordable Care Act, and I remem- Blunt Hawley ber President Obama’s saying, if you Romney YEAS—88 Boozman Hoeven Rounds like your policy, you can keep it and Braun Hyde-Smith Rubio Alexander Graham Reed that if you like your doctor, you can Burr Inhofe Baldwin Grassley Risch Sasse keep your doctor. Neither one of those Capito Isakson Scott (FL) Barrasso Hassan Roberts Cassidy Johnson Scott (SC) Blumenthal Hawley Romney proved to be correct and true. Yet, Cornyn Kennedy Blunt Heinrich Shelby Rosen here, our Democratic colleagues have Cotton Lankford Boozman Hirono Sullivan Rounds simply given up all pretense and have Cramer Lee Braun Hoeven Rubio Crapo McConnell Thune Brown Hyde-Smith Sasse embraced a Medicare for All Program Cruz McSally Tillis Burr Inhofe Schatz that would outlaw some 180 million Daines Moran Toomey Cantwell Isakson Schumer Enzi Murkowski Wicker Capito Johnson Americans’ private health insurance Ernst Paul Young Cardin Jones Scott (SC) policies. In other words, the policy you Fischer Perdue Carper Kaine Shaheen get through your employer as part of Shelby Casey Kennedy the fringe benefits of your employment NOT VOTING—5 Collins King Sinema Bennet Harris Warren Coons Lankford Smith would no longer be available under Booker Sanders Cornyn Leahy Stabenow Medicare for All. This is, of course, so- Cortez Masto Manchin Sullivan cialized medicine, which ensures long The joint resolution (S.J. Res. 52) Cotton Markey Tester was rejected. Cramer McConnell Thune waits for substandard care. Yes, it is true that I have heard some f Crapo McSally Tillis Daines Menendez Toomey say: ‘‘Well, it is Medicare for All. Who CLOTURE MOTION Duckworth Merkley Udall would want it?’’ and others say: ‘‘No. I Durbin Moran Van Hollen am for the public option.’’ Both of The PRESIDING OFFICER. Pursuant Enzi Murkowski Warner to rule XXII, the Chair lays before the Ernst Murphy Whitehouse these are slippery slopes into a single- Feinstein Murray Wicker payer, socialized medicine healthcare Senate the pending cloture motion, Fischer Perdue Wyden system that will deny consumers the which the clerk will state. Gardner Peters Young The senior assistant legislative clerk Gillibrand Portman choices they might prefer to make for themselves rather than to leave the read as follows: NAYS—5 government to make those choices for CLOTURE MOTION Blackburn Lee Scott (FL) them. Not only would this trigger a lot We, the undersigned Senators, in accord- Cruz Paul ance with the provisions of rule XXII of the of disruption, it would also lead to NOT VOTING—7 Standing Rules of the Senate, do hereby sharp increases in taxes to fund this, move to bring to a close debate on amend- Bennet Harris Warren roughly, $30 trillion pipedream. ment No. 948 to H.R. 3055, a bill making ap- Booker Klobuchar Last month, Speaker PELOSI man- Cassidy Sanders propriations for the Departments of Com- aged to take this debate on healthcare merce and Justice, Science, and Related The PRESIDING OFFICER. On this to the next level. It seems like control- Agencies for the fiscal year ending Sep- vote, the yeas are 88, the nays are 5. ling people’s healthcare alone isn’t tember 30, 2020, and for other purposes. Three-fifths of the Senators duly cho- enough. Now they want to run the drug Richard C. Shelby, Mike Crapo, John sen and sworn having voted in the af- industry too. Forget about choice. For- Cornyn, Roy Blunt, Thom Tillis, Shel- firmative, the motion is agreed to. ley Moore Capito, Roger F. Wicker, get about competition. Forget about Lisa Murkowski, Mike Rounds, Pat f innovation. One of the things that has Roberts, John Boozman, Marco Rubio, characterized the American healthcare John Barrasso, Kevin Cramer, Richard COMMERCE, JUSTICE, SCIENCE, system is the lifesaving innovation of Burr, James E. Risch, Mitch McCon- AGRICULTURE, RURAL DEVELOP- drugs. The Democrats want to now nell. MENT, FOOD AND DRUG ADMIN- have the Federal Government deter- The PRESIDING OFFICER. By unan- ISTRATION, INTERIOR, ENVIRON- mine what the formulary is, what imous consent, the mandatory quorum MENT, MILITARY CONSTRUC- drugs are available to you. They want call has been waived. TION, VETERANS AFFAIRS, to set the prices and ensure the bureau- The question is, Is it the sense of the TRANSPORTATION, AND HOUSING crats rather than families are at the Senate that debate on amendment No. AND URBAN DEVELOPMENT AP- center of our healthcare system. They 948, offered by the Senator from Ala- PROPRIATIONS ACT, 2020 are churning out partisan healthcare bama, Mr. SHELBY, to H.R. 3055, a bill The PRESIDING OFFICER. The bills, one after another, and taking making appropriations for the Depart- clerk will report the bill by title. their party further and further to the ments of Commerce and Justice, The legislative clerk read as follows: left with every move. Science, and Related Agencies for the A bill (H.R. 3055) making appropriations I would like to think, ultimately, fiscal year ending September 30, 2020, for the Departments of Commerce and Jus- cooler heads will prevail in the Senate, and for other purposes, shall be tice, Science, and Related Agencies for the where we have been working on bipar- brought to a close? fiscal year ending September 30, 2020, and for tisan bills to bring down healthcare The yeas and nays are mandatory other purposes. costs. For example, the Senate’s Judi- under the rules. Pending: ciary, Finance, and HELP Committees The clerk will call the roll. Shelby amendment No. 948, in the nature have each passed bipartisan packages The legislative clerk called the roll. of a substitute. of bills to end surprise billing so as to

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