January 5, 2017 CONGRESSIONAL RECORD — SENATE S75 AFFORDABLE CARE ACT work of implementing our laws, keep- cuses to process these nominees in a Mr. SCHUMER. Mr. President, first, I ing our Nation safe from terrorism, fair but thorough fashion. It certainly appreciate the remarks of my col- protecting the environment and civil shouldn’t be the case, as seems to be league the Republican leader. I under- rights, promoting clean energy and af- planned now, that six hearings—several stand the Republican leader’s discom- fordable housing—on and on. Every on very important nominees—all occur fort. There is a cry from his side to re- facet of public life is governed by a on the same day and on the same day peal, but it has been 6 years and they very powerful Cabinet official. as a potential vote-arama. That is have no plan to replace. Repeal with- It is only right that we in the Sen- mostly unprecedented in the modern out replace leaves 20 million Ameri- ate—and by extension the American era of Cabinet considerations, hap- cans who have had health care in the people—get to thoroughly vet their pening only once in history. That is not the standard, but right now that is lurch; leaves college students who are baseline acceptability for these jobs. the case on January 11. 21 to 26 and have been on their parents’ That means getting their financial There are Members who sit on mul- plan in the lurch; leaves women who records to make sure they don’t come tiple committees. One of our Members are now getting equal health care into public office with standing con- chairs one of the committees, Judici- treatment to men in the lurch; and flicts of interest, and if potential con- ary, but has been very active on the In- leaves those who have families who flicts of interest are found, making telligence Committee—both nominees have preexisting conditions, and now sure they have a plan to divest the as- in a single day. That is unfair, not only can get insurance but without sets in question, making sure the FBI to her, with her great knowledge, but ObamaCare couldn’t, in the lurch. has had the time to complete a full to the American people. Each member I understand the Republican leader’s background check. It means making deserves plenty of time to question discomfort. Replace is not available be- sure the independent ethics officers of each nominee, and if questions remain, cause they can’t come up with a plan. each agency can sign off on them. All of these benchmarks are standard they should be brought back for a sec- I appreciate his request to work with protocol. All were done by about this ond day of hearings. us. He has two choices. Our Republican time 8 years ago by the Obama admin- After all, they are going to hold in- colleagues have two choices: Either, istration. They are not onerous re- credibly powerful positions for poten- once they repeal, come up with a re- quirements. They are necessary re- tially the next 4 years. To spend an placement plan, and we will give it a quirements to prevent conflicts of in- extra day or two on each nominee, if it look—they haven’t been able to do it terest. takes a few weeks, several weeks, to for 6 years; they are squirming right I remind my colleagues again, every get through them all in order to care- now because they don’t have one; they Obama Cabinet nominee had an ethics fully consider their nominations, that are leaving so many Americans who agreement in before their hearing. is certainly worth it to the American need health care in the lurch—or don’t Every Obama Cabinet nominee under- people and, I would argue, to the new repeal and come talk to us about how went a full FBI background check be- administration. to make some improvements. We are fore the Senate considered their nomi- I have made these points to the ma- willing to do that. nation. For such positions of influence jority leader, and I must say he has re- I will note that yesterday the vote to in our government, it is the responsi- spectfully listened. I am hopeful we repeal without replace was totally par- bility of the Senate to guarantee that can find an agreement that alleviates tisan. My colleagues decried that the we have all the information we need on the crunch and gives Senators and vote originally for ACA was partisan. each nominee and in a timely fashion. committees the opportunity to process This is equally partisan, and it is going Truth be told, the slate of nomina- these nominations with the proper care to create huge trouble for our col- tions selected by President-Elect and oversight, with all of the proper leagues. Again, I will say to my Repub- Trump has made this process—stand- paperwork in place, thoughtfully and lican colleagues, your job is not to ard for nominees of Presidents of both thoroughly. name call but to come up with a re- parties—immensely difficult. There are I yield the floor. placement plan that helps the people several nominees who have enormous f who need help—people who are now wealth and own stock of enormous helped by the ACA but who will be left CONCURRENT RESOLUTION ON value. We have a CEO of one of the THE BUDGET, FISCAL YEAR 2017 in the lurch once it is repealed. largest oil companies in the world, a The PRESIDING OFFICER. The f billionaire financial services executive financier—oh, and another billionaire clerk will report the concurrent resolu- CABINET NOMINATIONS financial services executive. tion. The bill clerk read as follows: Mr. SCHUMER. Mr. President, I have Leaving aside for a moment what another subject I wish to talk about, that says about the President-elect’s A concurrent resolution (S. Con. Res. 3) and maybe this one will be a little setting forth the congressional budget for priorities for his incoming administra- the United States Government for fiscal year more constructive right now in terms tion, these nominees have potential 2017 and setting forth the appropriate budg- of my Republican leader’s response be- conflict of interest challenges of epic etary levels for fiscal years 2018 through 2026. cause he and I yesterday had a con- proportions. At the very least—at the The PRESIDING OFFICER. The as- structive meeting on the matter of very least—they owe the American sistant Democratic leader. processing the President-elect’s nomi- people the standard paperwork, and in Mr. DURBIN. Mr. President, the nations to the Cabinet. We are still fact we believe many of these nomi- pending business in the U.S. Senate is working out several details, but on this nees, given their financial holdings, to set the stage procedurally so the Re- issue I want to express my appreciation should go one step further and provide publican majority of 52 to 48 can repeal for the majority leader’s willingness to their tax returns. ObamaCare, the Affordable Care Act. have a dialogue and work in good faith The minority only has ethics agree- That is what we are about. That is the toward a process both sides of the aisle ments in for four of the nominees so business of the day, the week, and can live with. far. We only have financial disclosure probably the weeks to come. So we are Our caucus thinks it is absolutely es- forms from four of the nominees so far. addressing that issue and others re- sential that the Senate has a chance to We only have tax returns for four of lated to the budget. appropriately vet the nominees, and the nominees so far. None of our com- I would like to start by sharing a the American people deserve to hear mittees has been notified that any story that was told to me by a family their views and qualifications in public nominees’ FBI background check has who I represent, Richard and Mary hearings, especially for the most pow- been fully completed. Briefings have Laidman, who live in Naperville, Illi- erful Cabinet positions. We all know started, but they are far from com- nois. They told me a story, and I will Cabinet officials have enormous power plete. recount it to you. and influence over the lives of every- As I said earlier, I hope the majority My 13-year-old son Sam was diagnosed day Americans. They run massive gov- leader and I can work out an arrange- with leukemia one day after the ‘‘no pre-ex- ernment agencies that do the actual ment that works for both of our cau- isting conditions exclusions for children’’

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00003 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.002 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S76 CONGRESSIONAL RECORD — SENATE January 5, 2017 protection went into effect [under the Af- aisle and even some House Republicans America needs companies to make the fordable Care Act.] The good news is that the are saying publicly: You know, we real- decision to keep jobs here. We need all form of leukemia has, so far, been effectively ly ought to have a replacement. the good-paying jobs we can get, par- controlled by a magic-bullet drug. My son is It is not fair for us to say to America: ticularly in manufacturing. But do you currently a very robust young man and in We’re going to repeal the only protec- otherwise good health (while the drug keeps know what the repeal of the Affordable him alive). The bad news is that the drug, as tion you have. Trust us. Some day in Care Act means to jobs in Illinois? I understand it, costs [Blue Cross Blue the future we might come up with a Well, the Illinois Health and Hospital Shield] about $10,000 a MONTH! Without better plan. Care Association knows. They told us even going into the issue of ‘‘Big Pharma’’ The atmospherics have changed— that it would have a devastating im- pricing— maybe even changed with the Presi- pact on hospitals in Illinois. That in- They wrote— dent-elect. Remember a few weeks ago cludes many rural downstate hospitals, this means that it would take about $6 mil- when he said he thought that provision the major employers in their commu- lion to get my son into his 60’s. Obviously we about the preexisting conditions was a nity. They estimate that we would lose are feeling dependent on all the clauses of good idea? Well, he is right, and so is between 84,000 and 95,000 jobs with the the [Affordable Care Act] right now—no pre- the provision to make sure you don’t repeal of the Affordable Care Act. We existing conditions exclusions, no caps on have limits under the policy, the provi- could have a press conference for sav- benefits, allowing Sam to stay on our health sion that allows the Laidmans to keep insurance plan till [he reaches] age 26. ing 800 jobs at Carrier, but are they their son under their family health in- going to have a press conference and Mr. President, the bottom line ac- surance plan until he reaches the age celebrate when they are killing 84,000 cording to the Laidman family of of 26. jobs in Illinois with the repeal of the Naperville, IL, is that the Affordable Yesterday, Mrs. Kellyanne Conway, Affordable Care Act? They shouldn’t. Care Act is critical to their family’s Senior Advisor to President-Elect They should do the responsible thing. health and financial survival. That is Trump, was on a morning show, and Let’s work together. Let’s make the what this debate is about. It is not she said: ‘‘We don’t want anyone who Affordable Care Act better, more af- about talking about promises made in currently has insurance to not have in- fordable. We can do it, but the notion campaigns or slogans one way or the surance.’’ That is a good statement. of repealing it first and then promising other. It is about families like the Then, when she was asked about to get around to a substitute later in- Laidman family in Naperville who un- whether the Republicans should come vites chaos. That is going to make derstand that were it not for the provi- up with a replacement, she went on to America sick again. sions in the Affordable Care Act, their say: ‘‘That would be the ideal situa- Mr. President, I yield. son might not be here today or they tion. Let’s see what happens prac- The PRESIDING OFFICER. The Sen- may be penniless. tically.’’ ator from Maryland. That is what it was like in the old Well, I don’t know Mrs. Conway, but Mr. CARDIN. Mr. President, first I days. If you had a son with leukemia her observations square with what we want to thank Senator DURBIN for his and wanted to buy a family health in- feel on this side of the aisle, and more comments about the policy of repeal- surance plan, good luck. If they would and more Republicans are starting to ing the Affordable Care Act and not sell it to you, you probably couldn’t af- say publicly that it is irresponsible for knowing what comes next, the impact ford it. And secondly, many policies us to repeal the Affordable Care Act it is going to have on people from Illi- had limits on how much they would without an alternative. It invites nois. I am going to talk about people in pay. Listen to what she tells us: $10,000 chaos. We know what is likely to Maryland. I have received similar let- a month just for this drug that keeps occur. We know that if there is no re- ters showing that people are going to her son alive. There were policies that placement that is as good or better, be adversely impacted. had $100,000 limits on the amount they people are going to lose their health in- I want to share with my colleagues pay each year. Oh, they were affordable surance. the conversation I had with the sec- and cheap enough. What would the Illinois’ uninsured rate has dropped retary of health from Maryland. Mary- Laidman family have done if that is all by 49 percent since the Affordable Care land has Governor Hogan, a Republican they had to turn to? Act was passed. A million residents in Governor, and his secretary of health Sadly, we know thousands, perhaps my State now have health insurance met with me several weeks ago to ex- millions, of families across America who didn’t have it before the Afford- press his concerns about the impact on face that. That is why the Affordable able Care Act. Illinois seniors are sav- the people of my State of Maryland if Care Act made a difference. That is ing on average $1,000 a piece on their the Affordable Care Act were repealed. why it is inconceivable that the Repub- prescription drugs because we closed What I heard from the secretary of licans are coming to the floor, saying the doughnut hole in the Affordable health of Maryland was similar to what they want to repeal the Affordable Care Act, which the Republicans now I heard from many of the health care Care Act without any replacement. want to repeal. More than 90,000 young stakeholders from the hospital associa- They have had 6 years to come up people in Illinois have been able to stay tion to physician groups, to health care with a better idea, 6 years to come up on their parents’ health plan until age advocates, to ordinary Marylanders with a list of improvements, and they 26 under our current health care sys- who have contacted me about their have failed and failed miserably. Why? tem, and 4.7 million Illinoisans, such as concerns about what happens if we see Because it is hard. It is difficult. We the Laidman family, no longer have an- a repeal of the Affordable Care Act. found that when we wrote this law. nual or lifetime caps on benefits, and Let me just give you some examples Let me concede a point to the Repub- that protects them when there is a sick of how the Affordable Care Act is work- lican leader who was on the floor this member of their family and they need ing in my State and, as Senator DURBIN morning. I am ready to sit down. I it the most. Under our current health indicated, in his State. The uninsured think other Democrats are as well. If care system, 5.6 million Illinoisans rate in Maryland has dropped from 12.9 you want to change and improve the with preexisting conditions no longer percent to 6.6 percent. That is about a Affordable Care Act to make sure that have to fear denial of coverage or high 50-percent drop in the uninsured rate. American families like the Laidmans premiums. That benefits all Marylanders—all of Naperville have a chance for these I am going to close with this brief Marylanders. Yes, 400,000 Marylanders protections in a better situation, I reference. Remember the first thing now have health coverage who didn’t want to be part of it, and I have wanted President-Elect Trump did when he have health coverage before, and for to be part of it for 6 years. But the Re- went to visit the State where they those 400,000, that is a big deal. That publican approach has been very sim- were going to keep 800 jobs and not means they can see a doctor and get a ple: All we will propose is repeal. We transfer them overseas? He took jus- physical examination. If they are ill, will not come up with an alternative. tifiable pride in the fact that he had they can get treated and know there It is catching up with them this week jawboned the company into deciding to are doctors and hospitals that will in Washington. Have you noticed? Sen- keep at least some of the jobs in the want to take care of them because they ators on the Republican side of the United States—800 jobs. That is good. have third-party reimbursement. They

VerDate Sep 11 2014 02:30 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00004 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.004 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S77 no longer have to show up in emer- I want to go back to a 12-year-old, Mental health parity is another area gency rooms because that is the only Deamonte Driver. Deamonte Driver we have talked about at great length place they could get to. They can now was a 12-year-old who lived about 10 here. We know we still have not go to a doctor and get a physical exam- miles from here. His mom tried to get reached that goal to make sure mental ination. him to a dentist, but he had no insur- health receives the same attention as Mr. President, it benefits more than ance coverage, and she couldn’t find a any other health need, but in the Af- just those 400,000 Marylanders, who, dentist. She couldn’t find a dentist who fordable Care Act, we did amazing thanks to the Affordable Care Act, would take care of him. Deamonte things to expand access to coverage for have health coverage. It affects all Driver needed about $80 of oral health mental health and drug addiction. By Marylanders because we no longer have care. He had an abscessed tooth that expanding the Medicaid population, we the amount of cost shifting of those needed to be removed. It would have have 1.6 million Americans who now who have health insurance paying for cost $80, and he couldn’t find care in have expanded coverage for mental those who don’t have health insurance 2007 in the wealthiest country, in health and substance abuse. because they use the system and don’t America. As a result, his tooth became We have had great discussions in this pay for it. That dislocation has been abscessed and it went into his brain. He body. I am very proud of the Cures Act, dramatically changed in my State. So had thousands of dollars of health care where we expanded coverage for drug all Marylanders are benefiting from costs, and he lost his life. As a result of addiction. Now Republicans are talking having 400,000 Marylanders who now that incident, I, along with other mem- about taking a major step backward by have health coverage, but it goes be- bers of Congress, took up the cause of repealing Medicaid expansion that al- yond that. Many Marylanders who had pediatric dental care to make sure lows access to coverage for mental health insurance didn’t have adequate every child in America has access to health and drug addiction. To me, that health insurance. They had restrictions pediatric dental care. That is included is something that is unthinkable. Yet on preexisting conditions. They had in the Affordable Care Act as an essen- we are moving on that path by the leg- caps on their policies. It didn’t cover tial health benefit. islation that is before us. Let me share a letter I received from preventive health care. They now have Before the Affordable Care Act, very Lillian from Baltimore. In 2008 she lost quality health coverage. few health policies included pediatric All of that is at risk. All of that is at dental; therefore, families were at risk her job. She has a history of abnormal risk because of what we are talking as to whether they would actually use mammograms. She could not get cov- about doing, if I understand correctly. dental services because they did not erage. She could not get an insurance Quite frankly, I am still trying to fig- have the money to pay for them. That company to cover her because of the ure out what the Republicans are doing was changed under the Affordable Care preexisting concerns. She wrote: The to the Affordable Care Act, but if I un- Act. That is at risk. That is at risk be- Affordable Care Act has worked. I have coverage. derstand it, they are going to repeal it, cause, if I understand what is being No preexisting conditions. No longer and they are not going to tell us right suggested here, we are going to repeal is being a woman considered a pre- the Affordable Care Act and the essen- now how they are going to replace it. existing condition in America. Are we tial health benefits. We can’t allow any So everything that is included in the now going to turn our backs on the more tragedies like Deamonte Driver Affordable Care Act is at risk. women of America and allow these dis- I will give you one more example of in America, and yet we will be putting criminatory practices that existed be- costs because I think this is an impor- our children at risk if we repeal the Af- fore the Affordable Care Act to come tant point. Under the Affordable Care fordable Care Act. back? I will tell you, I am going to Act, if an insurance company wants to There was another provision I fight to do everything I can to make increase rates more than 10 percent, worked very hard to get into the Af- sure that does not happen, and I would fordable Care Act that I think is ex- there are certain procedures they have hope my colleagues on both sides of the tremely important. We now have a Na- to go through, certain public disclo- aisle feel the same. But you are march- tional Institute of Minority Health and sures. We have a much more public ing down a path that puts women at Health Disparities at the National In- process, but the number of claims of risk, that puts Americans at risk. those who wanted to increase their stitutes of Health. We have agencies We know about the caps that were in policies by 10 percent have dropped that deal with minority health and the law before the Affordable Care Act. from 75 percent before the Affordable health disparities in all of our health What do I mean by caps? That is the Care Act to now 14 percent nationally. care agencies thanks to the Affordable maximum amount your health insur- We have seen one of the lowest growth Care Act. That means we are now ac- ance policy will pay you. Some 2.25 rates in health care costs in modern knowledging that historically we have million Marylanders had caps on their history. Yes, the Affordable Care Act not done right for minority health in policies before the Affordable Care has helped us do that. Why? Because America. We looked at a lot of the re- Act—not just the 400,000 new people individuals who had insurance now search dollars; they were not spent in who have come into the system, 2.25 have coverage for preventive health areas that minorities were impacted million Marylanders will be impacted care and are saving us money. Those by. We see that access to care in cer- if we eliminate the protection against who didn’t have health care coverage tain communities is much more chal- arbitrary caps. now have health care coverage, and lenging because of minority status. We The tragedy about caps is that when they are seeing doctors, and they are are looking at these issues and taking you really need coverage, that is when saving us money because if they have a action. you are impacted. You get insurance to disease, it is being caught at an earlier The Institute sponsored a study in cover you. You discover you have can- stage, being treated in a more aggres- my home city of Baltimore. That study cer. It is extremely expensive to treat sive way, and they are saving more in- showed that depending on what ZIP cancer in an aggressive way. All of a tensive health care costs. All that is Code you live in, your life expectancy sudden, you are in the middle of treat- benefiting the people of Maryland and could be as different as 30 years—a gen- ment and you reach your cap. What do our country. eration. Just your ZIP Code. We are you do? What do you do? There are Senator DURBIN mentioned several taking steps to change that in Balti- real, live examples from before we people in his State—a person in his more thanks to the National Institutes passed the Affordable Care Act. We are State—and letters. I want to talk and the Institute on Minority Health going to go back to those days in the about people in Maryland whom I have and Health Disparities. Are the Repub- United States of America? That is talked to over the last several years licans telling us that is not needed what repealing the Affordable Care Act about the impact of the Affordable anymore, that we are going to repeal means for 2.25 million Marylanders who Care Act and why they are so con- our efforts to look at minority health are being put at risk. cerned about the policy now of repeal- and health disparities? That is uncon- Rebecca from Baltimore told me ing the Affordable Care Act. scionable. Yet, if I understand cor- about her daughter Eva, who is 18 I want to go back to 2007. That is a rectly, that is the course we are going months of age and has severe con- date that Marylanders know very well. to follow. genital heart defects and has gone

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00005 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.006 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S78 CONGRESSIONAL RECORD — SENATE January 5, 2017 through numerous operations. If caps land. I could talk about all of them, than they did before the Affordable are in place, she cannot get adequate but I have been to the Greater Baden Care Act. That is a fact. But we do hear care for her 18-month-old daughter. Medical Services center several times. about the individual market within the Those are real, live examples of people It is located in Prince George’s County. exchanges and how that has gone up by who are impacted by the Affordable They also have a center in St. Mary’s a significant amount, mainly because Care Act. She also told me: Thank you County. I have been to them many of the way it was originally rated. We for the 26-year-old provision where you times. I have seen their new facilities have heard about that. But perhaps can stay on your parent’s policy. At thanks to the Affordable Care Act. I what many people don’t know is that least she knows Eva will be able to have seen the building in which they in my State and around the Nation, 75 stay on her policy until she is 26. provide mental health services and pe- percent of the people who qualify for I heard from Nichole, who is a 22- diatric dental care and actually adult private health insurance within the ex- year-old student at Towson University. dental care also. They provide those changes are eligible for credits. In She could not get affordable health services to the community thanks to other words, we are helping them with coverage and was able to stay on her the Affordable Care Act. They told me the affordability of their health care. parents’ policy. That is an important that in the very first year alone of the In my State, that was $200 million a provision which is being repealed by Affordable Care Act, they were able to year to help Marylanders pay for the Affordable Care Act. reduce their uninsured rates by 20 per- health insurance. That will be gone I helped work on the provision in the cent, meaning they get a lot more with the repeal of this Affordable Care Affordable Care Act that provides pre- money coming in and they can provide Act. That is wrong. ventive care coverage—immunizations, many more services. All of that will be I received many letters from small cancer screening, contraception, no gone if the Affordable Care Act is re- business owners. One of the proud parts cost sharing. That saves money. Pre- pealed. I can’t be silent about that. of the Affordable Care Act is that it ventive health care saves money. It This center is providing incredible helped our small business owners. makes our health care system more services. It is one thing to have third- Why? If you ran a small business, you cost-effective. That is why we decided party coverage; it is another thing to wanted health insurance for your em- to put a focus on preventive health have access to care. We provided both ployees because you wanted to keep care and expand it dramatically. Now, in the Affordable Care Act. We are not them well. You were discriminated 2.95 million Marylanders benefit from going to go back. against before the Affordable Care Act. the preventive health care require- I heard Senator DURBIN talk about You didn’t have a big pool. God forbid ments of the Affordable Care Act that Medicare. I just want to underscore one of your employees gets really sick is included in every health policy. That this. This is not just about those under during the year; your insurance pre- will be repealed, if I understand cor- 65. It is about our seniors. It is about mium goes through the roof. That is rectly what the Republicans are at- those on disability who are covered by what was happening before the passage tempting to do on their repeal of the Medicare. of the Affordable Care Act. Are we Affordable Care Act. We don’t have a We heard about the doughnut hole. going to go back to the days where we replacement. We don’t know what it is We all understood. We were getting nu- tell small companies: You really can’t going to look like. It is not easy to fig- merous letters from people who fell get health insurance because if some- ure out how to put the pieces back to- into that doughnut hole. Guess what. one gets sick, you lose your policies ba- gether again. Those letters are tailing off dramati- sically. That is what we are talking There is a provision in the Affordable cally. Why? Because the Affordable about. Act that deals with prevention and Care Act closes the doughnut hole for Annette of Bel Air, MD, wrote to me. public health funds and that provides prescription drug coverage. In my own She said she has saved significant dollars to deal with some of the real State of Maryland, 80,000 Marylanders money as a small business owner as a challenges we have out there—obesity, benefited in 2014 from the Affordable result of the Affordable Care Act. Tim tobacco abuse. My State is getting Care Act and better coverage for pre- from Laurel, MD, told me that in his funds so that we can deal with healthy scription drugs, amounting to $82 mil- small business, he saved $7,000 a year eating that will not only provide a bet- lion, averaging over $1,000 per bene- thanks to the Affordable Care Act. The ter quality of life for those who have ficiary benefit. Those over 65 have bet- reason is simple: You have broader weight issues but also lead to a more ter coverage for prescription drugs. pools, and you get the same type of cost-effective health care system. That You repeal the Affordable Care Act, rates larger companies get now. You will be gone with the repeal of the Af- and all of a sudden seniors figure out will lose that with the repeal of the Af- fordable Care Act. they have to pay another thousand dol- fordable Care Act. Let me talk for a moment about lars a year for prescription drugs. In Let me tell you about one of the health centers because I know we made my State, they don’t have the money tragedies of this that will happen im- that a priority in the Affordable Care to do that. You are going to again hear mediately, affecting America’s com- Act. Qualified health centers are cen- about prescription drugs left on the petitiveness and entrepreneur spirit. ters that are located in, in many cases, counter at the pharmacy because of the We know that a lot of people who work challenging communities where it is repeal. for big companies have great ideas, and hard to get doctors and hospitals to lo- Guess what. It even does more than they want to start out on their own. I cate. We provide access to care for peo- that. The Affordable Care Act provided have seen that over and over again in ple who have limited means. The Af- greater solvency for the Medicare sys- the biotech industries of Maryland. I fordable Care Act did two things that tem. I have heard my Republican col- go down the 270 corridor, the 95 cor- are extremely important in regard to leagues say: We are not going to do ridor. I see small entrepreneurs who health centers. First, it provided some anything to hurt Medicare. Repealing used to work for one of the giant de- significant new direct resources for the Affordable Care Act hurts Medi- fense contractors, and now they are those programs. Secondly, because care. It hurts the coverage and it hurts pulling out and coming up with new they are in challenging neighborhoods, the solvency. I don’t want to be part of ideas, doing things in a great way. they have a much higher number of that. I would hope my colleagues don’t That is what makes America a great people who have no health coverage want to be part of that. Yet repealing nation. That is how we create jobs and who go into these centers; therefore, the Affordable Care Act does that. how we deal with innovation. their third-party reimbursement is Let me talk for a moment about af- Here is the situation. You are a 30- much lower than other health centers fordability. It is one thing to have cov- something-year-old, ready to leave that are located in better neighbor- erage; it is another thing whether you that company and go out on your own. hoods or more affluent neighborhoods. can afford that coverage. We heard all Your spouse has cancer. What do you The Affordable Care Act has worked of these stories about the increased do? You are not going to be able to get in expanding dramatically the capac- premiums, and we know, of course, coverage. You are locked into that job. ities of these qualified health centers. that insurance premiums in America That will be a consequence of the re- We have 18 that are located in Mary- have gone up at a slower growth rate peal of the Affordable Care Act. We are

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00006 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.007 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S79 dealing with real people and real peo- Mr. KAINE. Mr. President, I ask gram that affects millions of people ple’s lives. It is irresponsible to repeal unanimous consent that the reading of and a repeal being fast-tracked that the Affordable Care Act and not tell the amendment be dispensed with. would strip health care from millions that young entrepreneur what he or The PRESIDING OFFICER. Without of Americans. she can expect. That is what is at objection, it is so ordered. I will come back to the health points stake. The amendment is as follows: in a second, but I want to address how There is one last point I want to talk (Purpose: To prohibit legislation that makes we got to where we are on the budget about, and that is the Patients’ Bill of America sick again) question that was in the province of Rights. I helped draft the Patients’ Bill At the end of title IV, add the following: the Budget Committee. I think it is a little strange that half- of Rights. It was not easy to pass the SEC. 4ll. DON’T MAKE AMERICA SICK AGAIN. way into Fiscal Year 2017, which began Patients’ Bill of Rights. We were able (a) IN GENERAL.—It shall not be in order in to get it in the Affordable Care Act. We the Senate to consider any legislation that in October 2016, we are going to be set- were able to get in the right that—you makes America sick again, as described in ting budget levels now. A budget reso- go to an emergency room. Under a pru- subsection (b). lution is a tool to set forth the guide- dent layperson standard, you did the (b) LEGISLATION MAKING AMERICA SICK lines for spending in Congress. right thing. You find out you didn’t AGAIN.—For purposes of subsection (a), legis- We know, in the history of this body, have that heart attack even though lation that makes America sick again refers we are not always successful in passing you had chest pains. Then you wake up to any bill, joint resolution, motion, amend- a budget through both Houses of Con- ment, amendment between the Houses, or the next morning and find out your in- gress and approving that budget conference report that the Congressional through a conference process, but at surance company is not paying the bill Budget Office determines would— because you didn’t have that heart at- (1) reduce the number of Americans en- least some progress is usually made; tack. We changed that in the Afford- rolled in public or private health insurance for example, both Houses doing their able Care Act. coverage, as determined based on the March budget resolutions. As you know, that Are we going back, eliminating those 2016 updated baseline budget projections by did not happen in 2016. Last year, our protections, the right to appeal deci- the Congressional Budget Office; GOP counterparts in each House de- sions or are we going to repeal that (2) increase health insurance premiums or cided, for the first time in the modern part of the Affordable Care Act? Are we total out-of-pocket health care costs for budget era, not to hold a hearing on going to go back to medical loss ratios, Americans with private health insurance; or the President’s submitted budget, not (3) reduce the scope and scale of benefits to have any activity on a budget in the where insurance companies can make covered by private health insurance, as com- obscene profits and not rebate those pared to the benefits Americans would have Senate, either in the committee or on excess profits to their policyholders received pursuant to the requirements under the floor. when we have millions of people receiv- title I of the Patient Protection and Afford- To begin, I have to ask, if the budget ing rebates today? All of that is gone able Care Act (Public Law 111–148; 124 Stat. wasn’t important enough for us to con- with the repeal of the Affordable Care 130) and the amendments made by that title. sider last year, why is it now so impor- Act. (c) WAIVER AND APPEAL.—This section may tant for us to be taking up a budget? Mr. President, I could go on and on, be waived or suspended in the Senate only by The answer is obvious. We are debating an affirmative vote of three-fifths of the but I see my colleague Senator KAINE a budget for the sole purpose—the sole is here and others who want to speak Members, duly chosen and sworn. An affirm- purpose—of setting in motion a process ative vote of three-fifths of the Members of on this issue. the Senate, duly chosen and sworn, shall be to repeal health care coverage for tens Let me conclude with this. This is required to sustain an appeal of the ruling of of millions of Americans. This is really the wrong way to go about this. I heard the Chair on a point of order raised under about an attack on people’s health the leader say that for 6 or 7 years—for this section. care. 6 or 7 years—Democrats have been try- Mr. KAINE. Mr. President, I rise to I and many of my colleagues have ing to work with Republicans to make offer this amendment, amendment No. said there is a significant need to make improvements to the Affordable Care the law even better. 8, with Senator MURPHY and other Sen- We have never passed a major law ators, to the budget resolution we are Act and, more generally, to our health that didn’t need to be revisited. We un- care system. currently considering, and the purpose derstand that. We have been working Mr. President, you were a chief exec- of amendment No. 8 would be to create to try to improve the law—not repeal utive of a State, just like I was. I a point of order against considering it—improve it, build on it, make it bet- learned something in my first year as any legislation that would either strip ter, and we have gotten no help from Governor of Virginia, which was, when Americans of health insurance cov- Republicans, not any help whatsoever. I looked at all the bills that were put Republicans have blocked efforts to erage, make health care more expen- on my desk for signature, amendment, improve this law. Instead, they are sive, or reduce the quality of health or veto at the end of my State’s legis- stuck on this repeal without knowing coverage. lative session, three-quarters of the what the replacement is going to be. Our amendment creates a high hurdle bills were not new legislation or not re- That is wrong. We should be working to any legislation that would make peals of legislation; three-quarters of together to improve our health care America sick again, and basically that the bills were improvements of existing system, but to pass a repeal, to put is what we are trying to do. If we are law. That is the work of a legislative Americans at risk will lead to uncer- going to either strip coverage from body. Overwhelmingly, it should be im- tainty, which will lead to insurance people or make health insurance more provements to existing law. The Af- companies abandoning the market, giv- expensive or reduce the quality of fordable Care Act needs significant im- ing consumers less choice rather than health coverage for Americans that provement, just as other health care more choice. To hurt millions of Amer- they currently have, we shouldn’t laws do, just as virtually everything we icans is wrong, and I urge my col- make that easy to do. We should have do needs improvement. leagues to reject this approach. a high hurdle in place so we consider it There is no reason, while we ac- I yield the floor. before we do it. knowledge the need for improvement, The PRESIDING OFFICER. The Sen- The point of order is necessary be- to repeal a law outright without hav- ator from Virginia. cause the entire purpose of this budget ing a sense of what the replacement AMENDMENT NO. 8 resolution is not to really address the will be because, by doing so, what we Mr. KAINE. Mr. President, I call up budgetary matters facing the country. do is create chaos in the economy, amendment No. 8, which I send to the I say that as a member of the Budget chaos in the health insurance market, desk on behalf of Senator MURPHY, me, Committee. In fact, the budget process and especially chaos in the most inti- and other Senators as well. was basically ignored in the last Con- mate and important area of people’s The PRESIDING OFFICER. The gress. lives, their health. clerk will report. This budget is only before us to set Actually, on that subject, there was a The bill clerk read as follows: up a pathway to pass a fast-track re- wonderful letter that was sent on Janu- The Senator from Virginia [Mr. KAINE] peal of the Nation’s most consequential ary 3 by the American Medical Associa- proposes an amendment numbered 8. health care program in decades, a pro- tion to the congressional leadership on

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I want to put that number, 30 mil- We continue to embrace the primary goal Just 2 days ago, the key spokes- lion, into a context because numbers of the law to make high-quality, affordable person for the President-elect can just sound big and mysterious. health care coverage accessible to all Ameri- Kellyanne Conway said: We don’t want Here is what 30 million people is. The cans. We also recognize that the ACA is im- anyone who currently has insurance to number of people who would lose perfect, and there are a number of issues not have insurance. health insurance because of an ACA re- that need to be addressed. She is not setting a threshold of 1 peal is equal to the combined popu- Continuing the quote: million people or 100,000 people or 10,000 lation of 19 States: Wyoming, Vermont, It is essential that gains in the number of people or 10 people. She is saying the North Dakota, Alaska, South Dakota, Americans with health insurance coverage threshold is this: We do not want any- Delaware, Montana, Rhode Island, New be maintained. one who has insurance to have that in- Hampshire, Maine, Hawaii, Idaho, Ne- The letter concludes, from the Amer- surance jeopardized by actions of Con- braska, West Virginia, New Mexico, Ne- ican Medical Association, the largest gress. vada, Utah, Kansas, and Arkansas. organization representing American This is what a repeal of the Afford- Nineteen States’ combined popu- physicians: able Care Act, without a replacement lations, that is 30 million people, and Consistent with this core principle, we be- plan, will mean. It will have three sig- that is who is going to lose health care lieve that before any action is taken, nificant consequences, and then I want coverage if we go forward with a repeal through reconciliation or other means, that to finish with some personal stories. without a replacement. would potentially alter coverage, policy- First, a repeal with no replacement Eighty-two percent of these 30 mil- makers should lay out for the American peo- will inflict a significant wound on the ple, in reasonable detail, what will replace lion who would become uninsured are current policies. Patients and other stake- American economy. Health care is one- working families, 38 percent will be be- holders should be able to clearly compare sixth of the American economy, one- tween the ages of 18 and 34, and 56 per- current policy to new proposals so they can sixth. You cannot inject uncertainty cent are non-Hispanic Caucasians. make informed decisions about whether it into one-sixth of the American econ- Eighty percent of the adults becoming represents a step forward in the ongoing omy without having significant nega- uninsured are people who do not have process of health reform. tive effects on our Nation. college degrees. There will be 12.9 mil- The amendment Senator MURPHY and Congress should be in the business of lion fewer people who have Medicaid or I propose is designed to accomplish ex- increasing certainty, not increasing CHIP coverage in 2019 if the repeal goes actly the goal, exactly the goal the uncertainty, and if we go into the big- through. These are some sobering sta- AMA has specified in the letter of Jan- gest sector of the American economy tistics. These statistics show that, at a uary 3. with a repeal, without any replacement minimum, what we are doing here is We would create a 60-vote point of strategy, it is the equivalent of, ‘‘I am very, very consequential and very, very order against any legislation that now going to jump off a cliff and I will important and should not be rushed would, first, reduce the number of figure out how to land once I am in into in a partisan 51-vote budget rec- Americans who are enrolled in public midair.’’ This will be economic mal- onciliation process. or private health insurance coverage, practice to affect that many people. I want to conclude and tell a couple so there would be a 60-vote point of Second, the effect of the repeal of the of stories from Virginians of people order against any proposal that would Affordable Care Act is sort of an under- who are going to be impacted by this. reduce coverage for Americans; second, the-table tax cut for the wealthiest When we essentially recessed in the the point of order would also lie Americans. Millionaires, if the Afford- Senate on December 9—between then against any plan that would increase able Care Act is repealed—there are and now—I went around the State and health care premiums or total out-of- two taxes on high earners that are part talked to people. I heard a story that I pocket health care costs for Americans of the financing of the Affordable Care want to share, and then I will tell a with private health insurance; and, Act, and these taxes on high-earning couple of quick ones. third, the point of order would lie Americans would expire, and this is I met with Ashley Hawkins, a young against any proposed plan on the table hundreds of billions of dollars over 10 mother in Richmond, a mother of two that would reduce the scope and scale years of a tax cut. Millionaires would kids. We sat around a conference table of benefits offered by private health in- get 53 percent of the tax cuts from a re- in a federally chartered community surance because the ACA was not only peal, which is more than double the health center in Richmond and talked about affordable care and it was not same group’s share of the 2001 and 2003 to stakeholders. Ashley told her story. only about coverage, it was also about tax cuts that were done during the She had a preexisting health condition. the quality of care. Bush administration. Before the Affordable Care Act, health Could your coverage discriminate Just to put that in some context, insurance was unaffordable. After the against you because you are a woman? Americans in the top 0.1 percent eco- Affordable Care Act passed, she could Could your coverage expire once you nomically would get an average tax cut suddenly get insurance. get diagnosed with an illness and now of $197,000 if the Affordable Care Act is Ashley owns a small business. She have a preexisting condition? repealed. That is one way to sort of runs a nonprofit group that provides These bill of rights protections for look at this repeal without a replace- community arts education that serves patients were an important and inte- ment. It is essentially a tax cut for the others. Because of the ACA, she has gral part of the Affordable Care Act, wealthiest, financed by reductions of been able to sign up on exchanges and and the budget point of order that we health care on the people who are most get health insurance. Because of her in- would put on the table would establish in need. come, she can receive subsidies to a 60-vote threshold for considering any Third, the impact that is the most make that health insurance affordable. legislation if it triggered one of those significant is the impact on the health She makes $45,000 a year. three concerns: reduction in coverage, care of average Americans. The Urban Without health insurance, the recent increase in cost, reduction in quality. Institute did a study in December and hospital bill for the birth of her young- The point of order actually goes right said: If there is a repeal with no re- est child would have been close to to promises that the President-elect placement or a repeal with a delayed $16,000. With the Affordable Care Act, has made. In September of 2015, Presi- replacement to something that we she receives a subsidy, and she is able dent-elect Trump said: know not what it will be, there will be to access high quality health insurance I am going to take care of everybody. I 30 million Americans who will lose for her and her two kids for $280 a don’t care if it costs me votes or not. Every- their health insurance. About 20 mil- month. That is the difference between

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00008 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.013 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S81 not being able to afford to go to a hos- I are self-employed, and we could never Republicans want to call it replace and pital and deliver a child and to be able afford insurance. Because we couldn’t we want to call it reform or improve- to afford, as a small business owner, a afford insurance, we decided that we ment, I don’t care what we call it. We health insurance policy that covers her couldn’t have children. We couldn’t pay should have the AMA, hospitals, pa- and her two kids for less than $300 a a hospital bill. This is what the Afford- tients, and Members of Congress from month. able Care Act has meant to them. We both parties around the table to lay This is what she said as we sat often talk about life and death issues down what are our concern, what are around the table and talked about in the sense of illnesses, sicknesses, our problems, and talk about how to what it means to have affordable insur- cancer diagnoses, and preexisting med- fix them. There is so much we can do. ance. She said: ‘‘It has to do with self ical conditions. They can be life or There is so much we can improve. But esteem and security and well-being.’’ death issues, but they can also be life by pushing an immediate repeal Having health insurance is about se- issues, in the sense of this couple who through a partisan budget process, we curity, even when you are not sick. Ob- wrote and said that because they could won’t have the opportunity to work to- viously, when you are sick or when you now get insurance as self-employed in- gether to build on that common are delivering a child, health insurance dividuals with subsidies to make it af- ground. is needed. But when you are a mother fordable, they are now going to start a This is not a game. Sometimes we of two children, even if you are at the family because of the Affordable Care get into a budget vote-arama, and it peak of your health and even if your Act. They could start a family. has a little bit of a game aspect to it. children are at the peak of their Finally—and I will always remember I have been here until 2 a.m. or 3 a.m. health, you would go to bed at night— this because this gives me great moti- when amendments are put on the table, and Ashley described this—wondering: vation—as I was getting outside of my there are 1-minute presentations of What will happen tomorrow if my child native Virginia and exploring other why it is good or bad, and we have a gets sick? What will happen tomorrow States on an interesting 105-day sum- vote. It has a little bit of a feeling of a if I am in an accident? Not having mer vacation as part of a national tick- game. This is not a game. This is life health insurance for a parent is a con- et, I went to the Iowa State Fair. I told and death. tinuous agitating voice in your mind, this story once before on the floor, but Is there anything more important to an anxiety creator, about what is going I am going to tell it again. A grand- someone than their health, because to happen to my family if we get sick father came up with a little boy in his their health forms the foundation of or get in an accident, which is some- arms. I said: What is that child’s name? their relationship with their spouse or thing that happens to virtually every Jude. Jude, the patron saint of lost their loved ones or their children? family. It has to do with self-esteem, causes. There is St. Jude Children’s Re- Health is what keeps a parent up at with security, and with well-being. search Hospital in Memphis, a place night worrying about the family. Without the protection for people with where children have been able to go to Health is what keeps a child worrying preexisting conditions, without the get medical care. about an elderly parent. This is the subsidies in the marketplace, people I knew there must be a story. I said: most important thing to any person in like Ashley will go back to not being Hey, Jude, tell me about Jude. Jude this country, regardless of party, re- able to afford coverage for their fami- was a 31⁄2-year-old who was diagnosed gardless of State, regardless of polit- lies. with a congenital heart defect and by ical persuasion. The worst thing we can After the Affordable Care Act passed, age 31⁄2—as his grandfather told me the do on a value of such importance is to I happened to be in a position where I story, now mom and dad were coming rush and create chaos in the lives of was trying to buy health insurance in around me as well—Jude had to have millions of people. the open market without an employer multiple heart operations at the Chil- So I conclude by saying that the subsidy for the first time in my life. dren’s Hospital in Omaha. The grand- amendment that Senator MURPHY, I, When I say I was doing this, what I father said to me that Jude would not and others offer would seek to protect mean is that my wife was doing all the have been able to have those oper- what we have—protect coverage, pro- work because she is the one who does ations and Jude would be uninsurable tect costs, protect quality—by making all the work. She talked to two insur- for the rest of his life if it were not for it harder to enact legislation that ance companies who said: Hey, sorry, the Affordable Care Act. would strip these important items Anne, we can’t afford your entire fam- Then Jude’s father put his hand on away from tens of millions of Ameri- ily because of preexisting conditions. my shoulders. He was a big guy. He cans. One company would not cover me. One said to me: You have to tell me that We should be sitting down at the company would not cover one of my you will do everything you can to table to talk about reforms. So many children. My wife said: Hold on a sec- make sure that Jude isn’t stripped of us want to do that. But we should ond. The Affordable Care Act just away and consigned again into the not be rushing into a repeal that would passed. You can’t turn somebody down outer reaches of preexisting conditions jeopardize people’s lives. on a preexisting condition now. and uninsurable, with an uncertain fu- I urge my colleagues to please sup- In each case the insurance company ture for my son. I made a pledge to port amendment No. 8. said: I have to talk to my supervisor. him. I said: I am only one person. I Thank you, and I yield the floor. They had to call back and say: You are don’t know what, at the end of the day, The PRESIDING OFFICER (Mr. right; we are wrong. We have to pro- I can do, but I can tell you this. I can RUBIO). The Senator from Wyoming. Mr. ENZI. Mr. President, I ask unani- vide insurance for your entire family. stand up to make sure that your child mous consent that all time be consid- Can I tell you this? My family is the and other children—such as Ashley’s healthiest family in the United States. ered time on the resolution. two kids and the family that wrote me The PRESIDING OFFICER. Is there At the time my wife was making those about wanting to have children—will objection? phone calls, of the five of us, the only not be left high and dry and without Without objection, it is so ordered. time any of us had ever been hospital- the security of health insurance in the Mr. ENZI. Mr. President, I ask unani- ized was in the three occasions my wife wealthiest and, to my way of thinking, mous consent that during the periods went to the hospital to give birth to still the most compassionate Nation on of a quorum call, the time be equally our kids. We are a healthy family, and the face of this planet. divided between the two sides. we were turned down twice because of I encourage every Member of this The PRESIDING OFFICER. Is there a preexisting condition by insurance body to ask their constituents for sto- objection? companies that had to say: We are ries like Ashley’s, like Jude’s, like my Without objection, it is so ordered. wrong, and because of the Affordable family’s, and like the family in Wil- Mr. ENZI. I suggest the absence of a Care Act, now we can write a policy for liamsburg about how an ACA repeal quorum. your entire family. with no plan would impact them. The PRESIDING OFFICER. The I had a woman write me a letter—a I will go back to the purpose of the clerk will call the roll. Virginian from Williamsburg—a couple amendment. The ACA is not perfect. The legislative clerk proceeded to of years ago who said: My husband and We ought to be talking about reform. If call the roll.

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00009 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.014 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S82 CONGRESSIONAL RECORD — SENATE January 5, 2017 Mr. MURPHY. Mr. President, I ask hard to understand—it is really hard to ple with private insurance; or, No. 3, unanimous consent that the order for understand. reduce the scope and scale of benefits the quorum call be rescinded. I think about somebody like Jona- that people have. The PRESIDING OFFICER. Without than Miller. He lives in my State. He I have heard my Republican friends objection, it is so ordered. lives in Meriden, CT. He was born with say: We are going to repeal the Afford- Mr. MURPHY. Mr. President, what is cystic fibrosis. He is insured today able Care Act, and we are going to re- happening on the floor right now is ab- through the Affordable Care Act. Here place it with something better. We are solutely extraordinary. It is absolutely is what he said: not even committing you to replacing extraordinary that Republicans are For me, I was able to live a relatively nor- it with something better. We are just using the budget process, the reconcili- mal life growing up, wonderful family and saying, if you are going to replace it, ation process, in between the swearing friends, but health has always been the most let’s guarantee now that legislation is in of the new Congress and the swear- important thing in my life. I spend even in a not going to take anybody’s health ing in of a new President, to rip away good health year probably one or two hos- care insurance away who has it now from 20 million Americans health care pitalizations each year that require IV anti- biotics, I am on a whole suite of medications, who wants it, it is not going to raise insurance, to drive up rates for one- costs, and it is not going to reduce ben- third of consumers in this country who each day I take about 15 to 20 medications, some of those are pills, some are breathing efits. have some form of preexisting condi- treatments, and then there are the shots. I am going to be honest. The replace- tion—a sickness that without this law Healthcare is the number one priority in my ment isn’t coming. It is not coming, would make their rates go higher—and life, it’s more important than income, more and even if it comes, it can’t meet to throw the entire health care mar- important than anything else, being able to those three tests. There is no way there ketplace into chaos. maintain my health. is a replacement coming that is going It is absolutely exceptional what is He is insured by the Affordable Care to maintain the 20 million people who happening right now. No one in this Act today, but he also receives the ben- have insurance now, that is going to body should normalize it. No one out- efit of the insurance protections be- maintain cost controls and maintain side of this body should perceive this to cause Jonathan, without the Afford- benefits. It is not happening. be just politics as usual. able Care Act, even if he had insurance, News flash to the American public: I was here when the Affordable Care would lose it—probably a couple of This law is being repealed under a Act passed. I was in the House of Rep- months into the year—because of a budget reconciliation process that resentatives. Since then, I have heard practice prior to the Affordable Care shuts out Democrats, and it is not my Republican friends say over and Act of capping the amount of money going to be replaced by something that over and over again that they want to you would be covered for in a given is equal in quality or better. At the repeal the Affordable Care Act and re- year or in a lifetime. Jonathan would very least, we can all put our names place it. I can’t tell you the hundreds have blown through that in a heart- and our votes to a budget point of of times I have heard that phrase, ‘‘re- beat. order that commits Republicans to the peal it and replace it.’’ It is not hyperbole when he says: President-Elect Trump talked about promise that they have made for 6 ‘‘Without the Affordable Care Act, I’d that throughout the campaign, and years, which is that if they repeal this, probably be dead within months.’’ then 2 days after he won the election, they will not put a piece of legislation That is the reality for millions of on Thursday night, he went on national before this Congress that doesn’t guar- people across this country. Without television to double down on the prom- antee that everybody keeps their health insurance, they cannot survive. ise that there would be an immediate health insurance, costs don’t go up, They can’t afford their medication. replacement. He said: There will not be and benefits don’t come down. So this isn’t just about politics, this 2 hours between the Affordable Care I urge, when this comes up for a vote, isn’t just about the words on the page, Act being repealed and it being re- a positive vote from my colleagues, these are people’s lives. This is about placed with something better. and I urge my Republican friends to That is the second part of the argu- life or death, and the casualness of honor the promise they have made. ment the Republicans have made. The throwing out a law without any con- I thank Senator KAINE and others for Affordable Care Act, in their minds, cept of what comes next—I have read joining me in offering it. was deficient, despite the fact that so many quotes in the paper over the I yield the floor. there are 20 million people who have last few days of Republicans admitting The PRESIDING OFFICER. The ma- insurance today who wouldn’t have it they don’t know yet what they are jority whip. otherwise and despite the fact that going to do in its place, but they still Mr. CORNYN. Mr. President, I would there are hundreds of millions of Amer- feel the need right now, in the lame- just say, I had the pleasure of sitting icans across the country who don’t duck session, to begin the process of re- here listening to the Senator from Con- have to worry about them and their pealing this law without any concept of necticut talk about his concerns about loved ones having their insurance rates what comes next. repealing ObamaCare, and I would say jacked up because they are sick, and Why do it now? Why not take one it strikes me that their posture is that despite the fact that seniors are paying step back? Why not reach across the we sold the American people a lemon, thousands of dollars less in prescrip- aisle to Democrats and say: Let’s try and we insist they keep it. tion drugs than they were. to work to make this better. Let’s try Our position is that ObamaCare has The Affordable Care Act isn’t per- to answer the concerns the Republicans been a failure. It has been a grand—in fect—it never was—but the enthusiasm have, that President-Elect Trump has. terms of scale—experiment, a national of Republicans to take away from Let’s take some time to work through experiment that has failed. Americans their health insurance and this, reform it in a bipartisan way. No. Yesterday I talked about the fact to drive rates up for millions more is Instead, we are rushing forward with that my constituents are writing me really unthinkable. repeal, stealing health care for mil- and telling me that their premiums, in We heard over and over again that lions of Americans, plunging the health many instances, have doubled, and the priority was to repeal it and re- care system into chaos, with no guar- their deductible has gotten to the point place it. Now we are repealing the Af- antee that there is anything that is that they are effectively self-insured so fordable Care Act with no plan for going to emerge in its place. their insurance does them virtually no what comes next. We are driving for- Senator KAINE and I have a very sim- good. ward with a repeal vote with no plan ple budget point of order. Senator We will vote to repeal ObamaCare, for how we keep the health care system KAINE has talked about it. It would but obviously we are not going to leave together, how we prevent it from fall- prohibit the consideration of any legis- people hanging out to dry. We are ing into chaos, how we continue to in- lation as part of budget reconciliation going to make sure they have coverage sure the millions of Americans who that would, No. 1, reduce the number of that they choose and that they can af- rely on it. Americans who are enrolled in health ford. I welcome the assistance of our There is a cruelty to this enthusiasm insurance; No. 2, increase premiums or colleagues on both sides of the aisle to for immediate repeal that is a little bit total out-of-pocket costs for those peo- try to craft a bipartisan reform.

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00010 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.009 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S83 The biggest failure of ObamaCare was delay’s sake President-Elect Trump only the head of the Department of the fact that when our Democratic getting to fill his Cabinet, particularly Justice and has an important law en- friends had 60 votes in the Senate and these important national security of- forcement role, the Attorney General they had President Obama in the White fices? The truth is, when it comes to also has a very important anti-ter- House and a majority in the House, wanting what is best for America, we rorism national security portfolio as they jammed it down the throats of the are all on the same team. We should all well. So it is very important that peo- American people. That is really why want what is best for our country. It ple like Senator SESSIONS, the Attor- ObamaCare is unsustainable—because doesn’t do our Democratic colleagues a ney General nominee, be put in place it was purely a partisan political exer- bit of good to delay the inevitable be- on a timely basis for the safety of our cise. We need to start over by repealing cause, thanks to former Democratic community. ObamaCare and then reforming our leader Harry Reid and the so-called nu- Talking about the nomination of At- health care system so people can buy clear option that changed the Senate torney General Loretta Lynch not even the coverage they want at a price they confirmation rules, we know that 2 years ago, the senior Senator from can afford. We are going to work very President-Elect Trump’s Cabinet mem- Vermont urged a quick confirmation, carefully to make sure the transition is bers will be confirmed. It is going to saying: ‘‘Confirming the top law en- thought out, methodical, and very happen because it takes 51 votes. Just forcement position should be an urgent carefully done. delaying for delay’s sake out of par- priority of the Senate.’’ And he is NOMINATIONS tisan pique really doesn’t do anything right. Soon, Mr. President, we will be con- to accomplish any goal but, rather, As the minority party is now consid- sidering and confirming men and makes our country more dangerous and ering the political strategy of obstruc- women nominated by the President- denies the President-elect the Cabinet tion, delay, and stall tactics, what has elect to fill leadership roles throughout he has chosen. changed except that your preferred the administration. This is crucial to When President-Elect Obama was candidate did not win and our preferred ensuring a smooth transition from one nominated to office, we acted very candidate did win? That is the only President to another, and it is impor- quickly. In fact, on the day he was in- thing that has changed. tant to make sure the next President augurated—January 20, 2009—seven of Another nominee the Senate will has the people and resources he needs his Cabinet members were confirmed. consider is the President-elect’s choice to help lead our country. We were not happy about the outcome to fill the Supreme Court vacancy left I have had some of the reporters in of the election on this side of the aisle. by the death of Justice Scalia. Last the hallway say: How in the world can We wished a different electoral out- year, after the death of Justice Scalia, you process so many nominees at the come had occurred. But once the voters we promised the American people that same time, so quickly? had spoken, we accepted their verdict, the next President, whether it was a I said: It is the tyranny of the cal- and we worked cooperatively to see a Republican or a Democrat, would endar. We are going to have a new smooth transition from the Bush ad- nominate the successor to Justice President on January 20, and wouldn’t ministration to the Obama administra- Scalia. We didn’t say we would only you want—for example, the President’s tion. I believe it is our duty to do that. vote to confirm a Republican Presi- CIA Director choice, the Attorney Gen- Nearly all of President Obama’s Cabi- dent’s nominees; we said that the eral, the Secretary of Defense, the head net-level nominees were confirmed American people had a right to a voice of the Department of Homeland Secu- within the span of 2 weeks. We came in who would make that choice, recog- rity, the Director of National Intel- together, understood that the people nizing that the next Justice on the Su- ligence—wouldn’t you want all of those had spoken, and we went to work to co- preme Court could serve 25 or 30 years. key national security positions filled operate in good faith, not necessarily Here we are 15 days before the Presi- as soon as possible in case some of our because we were happy about the out- dent-elect is sworn in to the White adversaries decide to take advantage of come but because it is our responsi- House and the minority leader is al- this transition to try to threaten the bility to do so. ready threatening to deny the voices United States? Then there are some of the state- and the vote of the American people It makes sense to me that we would ments from some of our colleagues from last November by blocking any work in an orderly sort of way with our across the aisle that they now appear nominee indefinitely. colleagues across the aisle to make to be walking away from. In the spring As shocking as it sounds, on Tuesday this transition a smooth one from of 2015, Senator STABENOW, the senior night, just hours after the 115th Con- President Obama to President Trump. Senator from Michigan, said: ‘‘When a gress was sworn in, Senator SCHUMER, President Obama has said that is what President wins an election, they have the Democratic leader, was asked in an he is working to do, and you would the right to have their team.’’ She said interview on MSNBC if he would ‘‘do think it would make sense for us to be that on April 20, 2015. I hope that not his best to keep the seat open.’’ He an- a part of the solution and not a part of only the Senator from Michigan but swered with one word: ‘‘Absolutely.’’ the problem. her other colleagues remember that po- Despite months of calling for a full Su- Holding up confirmations just for sition they took then and simply recip- preme Court, all nine members, even delay’s sake is irresponsible and it is rocate in good faith during this transi- using the hashtag ‘‘We need nine,’’ the dangerous. As I speak, there is a hear- tion. Democratic leader is now threatening ing going on on the foreign cyber Senator STABENOW is right, by the indefinite obstruction. threats in the Senate Armed Services way. No matter which side you are on, Republicans were clear with the Committee. People are justifiably con- we know that the voters have spoken. American people: We would respect cerned about what our adversaries are As President-elect, he has the author- their voice in whom they wanted to doing in cyber space. But it is not re- ity to surround himself with those he pick the next Supreme Court Justice, lated to just cyber space, it is related sees fit to advise him and help him as whether it was a Democrat or Repub- to nuclear threats from countries such he serves our country. lican in the White House, and we would as North Korea, obviously the ongoing For some of our colleagues to suggest move forward with that nominee in the humanitarian crisis and civil war going that keeping the President under- new Congress. on in Syria and elsewhere, the threats staffed is somehow in the best interest I hope our Democratic friends don’t from Russia not only in cyber space of the American people is palpably slow-walk President-Elect Trump’s but also to our NATO allies in Europe, false. It is ridiculous. I mentioned the nominees. It is one thing to obstruct, and I could go on and on talking about national security nominations the but it becomes an even bigger problem Iran and its nuclear aspirations, its President-elect has indicated. One of when they intentionally try to keep ballistic missile capability. those first ones was Senator SESSIONS, President Trump from doing the job This is a dangerous world we are liv- our colleague here in the Senate, the the voters have given him the responsi- ing in, and why in the world would we junior Senator from Alabama, to serve bility to do. want to make it even more dangerous as Attorney General of the United The American people made clear in just to let our colleagues delay for States. The Attorney General is not November that they are done with

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00011 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.010 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S84 CONGRESSIONAL RECORD — SENATE January 5, 2017 business as usual here in Washington, commitments were not going to be acceptable; you ought to at least be DC. Frankly, I don’t think it was a ro- what happened. By the end of 2013, at able to drive to another community bust endorsement of either one of the least 4.7 million Americans had their and look for shoes. But that is not the political parties. We got an unconven- plans canceled because they didn’t case in 97 places, 97 counties. The vast tional President-elect, and I think the meet the law’s mandatory require- majority of our State and a couple of American people expect him to shake ments. Remember, these were plans States have no counties on the indi- this place up, and I think he will. We that 4.7 million people thought met vidual exchange that have competi- intend to work with him to make sure their individual needs, and they could tion. We went from several—every there is a positive outcome for the afford those plans. That is why they county a year ago in Missouri had at American people. I don’t think they bought them. They might not have least two companies offering insurance, are interested in political stunts or been perfect. They might have still so there was at least a competitor. delay for delay’s sake, nor do they been a stretch on their budget, but Some had more than two companies of- want us to return to the dysfunctional they decided: This is insurance I can fering insurance. Now 97 have one com- do-nothing Congress of the past. They afford, and it is insurance that meets pany. want results, and they want a path for- the needs that I can afford to meet The promise was to bend the cost ward toward a brighter future for with the insurance I can buy. curve. The cost curve bent, but it bent themselves and their families. The President’s claims about every- the wrong way. The cost curve went up; Let’s not keep from President Trump body being able to keep their policies it didn’t go down. In our State, again, the men and women he has chosen to and keep their doctor were so far from increased premiums have been as high work alongside him. That would only reality that PolitiFact rated it as the as 40 percent. make us less safe, our economy more lie of the year. I don’t like to use that In a number of States, they are in fragile, and the government less effi- language as it relates to the President the 70-percent category. In one State, cient. After all, we are paying the bills of the United States. I would say it there is a 100-percent increase—not as taxpayers. Why would we want a less must be really easy to become isolated from when ObamaCare started but efficient or less effective government? in the Oval Office, and the President from last year—in places where the In short, it will not serve the interests may get lots of information that cost of insurance for individuals and of the American people well. sounds to him as if his plan is working, families had too often already doubled, I know we are ready on this side of but the truth is that the President is and now another add-on. the aisle to roll up our sleeves and get not entitled to his own facts. He is en- I was with somebody the other day, to work. As I have learned through titled to his own opinion. He is entitled and I asked them about their insur- hard experience, the only time any- to his vision of what he thinks health ance. He was a healthy guy in his mid- 40s. His wife and two daughters were thing ever gets accomplished in the care in America should look like, but healthy. I said: What are you doing for Senate is when we work together. I am he is not entitled to his own facts. If it is not happening the way he thinks it insurance? not talking about people sacrificing He said: I am self-employed. In 2009, their principles. We ought to fight like is happening, somebody needs to tell him. But, of course, in just a few days there were four of us. We had insurance cats and dogs when it comes to our we thought met our needs. We were there will be a new President, and we basic principles. There are a lot of paying $300 a month. Now we are pay- have to deal with the chaos, frankly, things that are outside of the realm of ing $1,190 a month, and we have a $7,500 that has been created under the old principles where we can find common deductible. If two of us are sick, we law. ground and work together and build have to submit that deductible twice consensus. I think we ought to take ad- President Obama said this law would mean more choice, more competition, before we get any assistance from the vantage of this historic opportunity to insurance company—a $15,000 deduct- do just that, starting with confirming and lower costs for millions of Ameri- cans. Nobody can find those Ameri- ible if two people in the family are sick the President’s Cabinet and letting with a $1,190 monthly premium. cans. A number of Americans got on them get to work to help his adminis- This is a family that had no health Medicaid, another government pro- tration as soon as possible. care problems. This is not a response to I yield the floor. gram, who weren’t on Medicaid before. somebody who has a policy that they The PRESIDING OFFICER. The Sen- But there aren’t millions of Americans were using. This is a policy that wasn’t ator from Missouri. who have more choices, and there being used and, of course, with a $7,500 Mr. BLUNT. Mr. President, I am aren’t millions of Americans who have deductible unlikely to be used unless going to talk about the resolution we more competition for their business, that family really has a catastrophic are moving to that will allow us to re- and there aren’t millions of Americans situation occur. What I believe that peal and begin the replacement for the who have lower costs. In fact, just the family found out a few months after I President’s health care plan. opposite would be the case in Missouri, visited with them was that their policy A little over 3 years ago, President where I live. A number of insurers went up closer to $2,000 than $1,190. Obama hailed the start of the pulled out of the exchange totally. Our The average deductible for a mid- ObamaCare exchanges as a life-chang- neighboring States all have the same level plan—there are the gold plan, sil- ing opportunity for Americans. For experience and, in some cases, even ver plan, the bronze plan. For the sil- most Americans, it was life-changing, worse experience, but the competition, ver plan, the average deductible in the but it didn’t turn out to be an oppor- the choices, just aren’t there because exchange last year was $3,000. The av- tunity. It was a life-changing experi- the system doesn’t work. erage deductible in the bronze plan was ence because in many cases the insur- We have 115 counties in our State, $5,000, and it is higher than that for ance they had was no longer affordable, and in 97 of them, you have one choice; many people. what they thought met their family’s you have one insurer offering insur- To make matters worse, if you aren’t needs was no longer available, and the ance. That one insurer may offer three able to afford the few options available cost continues to go up. different plans, but there is no com- on the exchange, you pay a penalty. So When President Obama pushed the petition for whatever level you are you have no competition. You are re- health care law through Congress with- shopping for. There is only one place to quired to buy the product, and if you out a single Republican vote, he re- get that level. This would be as if there don’t buy the product, there is a pen- peatedly assured Americans that they is one shoe store in town and none of alty. It could have been as much this would be able to keep the plans they the shoes fit and they all cost too year as $2,045, but if your option is to had, that they would be able to keep much, but if you didn’t buy the shoes pay $15,000 or $20,000 for insurance that the doctors they had, and that every in that shoe store—and the chairman has this high deductible, that is what family would have a significant reduc- of the Budget Committee knows a lot many people have decided to do. tion in their health care costs. He con- about shoe stores—you would have to I have heard a lot of Missourians tinued to make every one of those com- pay a penalty for not buying shoes that from the day this was initiated mitments until the plan actually was were available at that one location. Ev- through today talking about the indi- put in place and it was obvious those erybody would think: Well, that is un- vidual challenges they have seen. For

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00012 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.017 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S85 example, Dave, a small business owner businesses instead of just one that repeal and replace would happen— in Columbia, said that the premiums business’s health savings account, bet- his words, not mine—simultaneously. for his employees have doubled. Why ter use of health savings accounts, buy- The replacement plan was coming. It would that be the case? One, the stand- ing across State lines, and things that would be fully written, ready to plug ards necessary for a policy change and, I proposed specifically on letting your in—no gap, no harm relevant to anyone two, if you’re losing all this money in family stay on your insurance a little in our country. The same words, ‘‘Com- the individual marketplace, the insur- bit longer. Frankly, that was a 4-page ing Soon,’’ have sat on that marquee ance companies make that up some- bill that adds 3 million people to insur- for 7 years now. It seems to me it is where. So his premiums have doubled. ance every year so you can stay on time to admit that the show will not At the same time, they have contin- your family policy until you are 26. open. This is a broken promise, plain ually had to raise deductibles and seri- There are four pages with a lot of white and simple. Americans are no longer ously reduce benefits. The cost goes up space. This does not have to be that looking at repeal and replace; now it is and the coverage goes down. I think complicated. There is no cost to tax- repeal and run. The consequences will that is what President Clinton said payers. Frankly, you are adding young, be serious and immediate for tens of when he said this is a crazy system. It healthy people, not much cost to any- millions of Americans, both in access is costing more all the time and cov- body but fundamentally no cost to tax- to health care and the bottom line for ering less. That is what Dave has found payers. It is just an additional way to family budgets across the country. In out in his business, and he was told look at things like buying insurance short, it is a plan that will make Amer- late last year that he should expect a across State lines would be. There are ica sick again. According to inde- 40-percent increase this year. He said: solutions here, but we have been pre- pendent analysis, nearly 30 million If that happens another time, we are no vented from moving to those solutions. Americans will lose their health insur- longer in the employee-employer pro- I urge my colleagues to support the ance quickly after repeal. The first act vided insurance marketplace. resolution that will allow us to move of a new Congress: Kicking 30 million Another location that serves our forward. We will begin to eliminate the people off the insurance rolls—that is State and happens to be headquartered chaos of ObamaCare and restore the seven times the population of my home also in Columbia is the Older Ameri- focus of health care to patients, people, State. cans Transportation System, a not-for- the doctors they want to have, and the The overwhelming majority of those profit. They provide critical transpor- places they want to go to get their 30 million Americans are not wealthy tation services to older Missourians, health care. people. They are not in a position to be and they have it other places in the I yield the floor. able to afford to go out and pick an ex- country—older Missourians to low-in- The PRESIDING OFFICER (Mrs. pensive plan once the insurance compa- come people, to underserved parts of FISCHER). The Senator from Wyoming. nies get back in the driver’s seat. Mil- our State that don’t have other trans- Mr. ENZI. Madam President, I ask lions come from working families who portation options. The costs to insure unanimous consent that at 2:45 p.m. will lose tax cuts for health insurance. their drivers have gone up by half a today, the Senate vote in relation to Millions of others toil, often working million dollars. The paperwork to com- amendment No. 8. multiple jobs, but still what they bring ply with the law’s requirements, as the The PRESIDING OFFICER. Without home is just barely enough to keep executive director told me, is so com- objection, it is so ordered. them out of poverty. plex and cumbersome, they had to Mr. ENZI. I yield the floor. For many, signing up for Medicaid spend additional money to hire a con- The PRESIDING OFFICER. The Sen- brought an end to the years when they sultant to implement a software pro- ator from Oregon. had to choose between visiting a doctor gram to help them keep up with the Mr. WYDEN. Madam President, I and putting food on the table. If repeal new mandates. It suddenly got even want to begin my remarks this morn- goes forward, Americans all over the harder to be a not-for-profit and break ing by taking stock of how the 115th country are going to face that dilemma even. Congress, led by my Republican col- once again. I think it is important to Families and small businesses leagues, seems to be coming out of the remember that the danger of repeal shouldn’t be penalized because the law gate. Here is what is coming if the does not end with Americans getting did not live up to its promise: If you budget process that began this week kicked off their insurance plans. like your health care, you can keep it. plays out: 30 million Americans from Repeal will send costs skyrocketing If you like your doctor, you can keep Portland, OR, to Portland, ME, will be for everyone across the board, even your doctor. Family costs will go down in danger of being kicked off their those Americans who get their insur- by $2,500 after this plan is put in place. health care plans; sharply rising health ance through work, including a lot of Those things didn’t happen. care costs for everybody else, even folks who say the Affordable Care Act We are in a chaotic situation now, those who get their insurance through has not touched them at all. They are and it is time to move in a new direc- their employer; broken campaign going to get a gut punch, a gut punch tion. We will have a bill before us very promises about a replacement coming with higher premiums and higher out- shortly that will allow us to begin that on day one. With this resolution, Re- of-pocket costs. When you kick tens of transition to do things that will pre- publicans in the Congress are building millions off the insurance rolls and vent Washington from getting in be- a Trojan horse of tax cuts for the most send the markets into chaos, there is tween health care providers and their fortunate in America. going to be a ripple effect. Everyone is patients. We will do things that will I want to discuss each of those issues going to feel those harmful effects, break down barriers that artificially this morning, but first let us recognize even those who have had the same plan restrict choice and prevent Americans the bottom line. What is at stake in from a particular employer for years or from picking insurance that meets this debate is whether or not America decades. Rising costs are going to eat their family’s needs that they can still is going to go back to the dark days into paychecks, crowding out the pay pay for. What a concept that would be. when health care was reserved for the raises that our people need so des- This is basically the system we had healthy and wealthy. For nearly 7 perately. before. It wasn’t a perfect system, and years and through 4 punishing cam- Colleagues, if you are watching this I will say the biggest straw man put paigns, Americans have heard and felt budget debate at home, I am sure you forward in that system was that no- the steady, partisan drumbeat of repeal are going to say: Why in the world body else had any ideas. There were and replace from the other side. Dozens would any lawmaker go forward with plenty of other ideas, ideas that would and dozens of show votes to repeal the this plan? I am going to go back to better serve American families, Amer- Affordable Care Act have been held in what I just said. In my view, this is a ican job creators, American job hold- either Chamber. There have been Trojan horse of tax cuts for the ers, people—plans that would have al- countless press conferences, speeches, wealthy and the most fortunate. lowed small businesses to band to- and hearings, even a government shut- When you look at both sides of the gether and become a bigger group to down, and the message is always the ledger, you see how exceptionally un- seek group insurance for a number of same. The President-elect himself said fair this scheme actually is. On one

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00013 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.018 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S86 CONGRESSIONAL RECORD — SENATE January 5, 2017 side, tens of millions of Americans lose American economy. It has always been My colleagues and I say no way. We insurance and suffer economic pain. the issue that Americans care the most are going to fight that unfair, imbal- That is the typical family. On the about because if you and your loved anced approach in every way we can. other side, there are substantial tax ones don’t have health, nothing else I yield the floor. breaks for those at the top of the in- much matters. So we ought to be work- The PRESIDING OFFICER. Who come scale. ing on a bipartisan basis to solve the yields time? One of the questions I am asked near- country’s health care challenges, find- If no one yields time, time will be ly every day in these halls, and I am ing ways to bring costs down for fami- charged equally to both sides. asked this by many in the press and lies, making prescription drugs more Mr. ENZI. Madam President, today I elsewhere, is whether Democrats are affordable, upholding the promise of have been listening to the diatribes going to take part in this effort and Medicare, and strengthening its guar- against the repeal resolution we are what ideas Democrats would put for- anteed benefits. working on, and I think some things ward. I want to take just a minute to When I was director of the Gray Pan- need to be answered. The Republicans are not trying to describe why that question is so off the thers at home, a senior citizens group, throw 30 million people off of their in- mark. First, you have to look at the we always said that Medicare was a surance. What we have seen over the nature of the reconciliation process promise. It was a promise of guaran- time of ObamaCare is that there were itself. Budget reconciliation is inher- teed benefits. We ought to strengthen 30 million people who were uninsured ently a partisan exercise. Inherently, it that promise, particularly updating it when we started that debate, and today is not a process that brings people to- to incorporate changes in the program there are 30 million people who are un- gether. It is a process that drives peo- that reflect the needs of the Americans insured. Now it is a different 30 million who face chronic health conditions, ple apart. It is inherently partisan. people. The 30 million people who A typical proposal that comes to the which is where the vast majority of couldn’t get insurance have insurance, Senate floor is subject to unlimited de- Medicare dollars are going. and we want them to have insurance. bate and unlimited amendments. Usu- That is what we ought to be doing, And the 30 million people who are now ally it takes 60 Senators, Members upholding the promise of Medicare, off insurance used to have insurance, from both parties to come together and working together in a bipartisan way. but they can no longer afford it. There But that is not what is happening here. pass legislation. It is very rare that a has been a huge increase in the cost of From the other side, what we have party builds that kind of supermajority health care. That is not how it was sup- on its own, so the two sides have to heard again and again is repeal and re- posed to be. The prices were supposed work together. That is the Senate at place, dozens of partisan votes pro- to come down. its best. ducing legislation that burned out in Yesterday we took the first step in I see my friend, the distinguished the Senate or met the veto pen. fulfilling the promise of repealing chairman of the Budget Committee, Now, with a new administration, the ObamaCare, which will pave the way Senator ENZI. He and I have served on Trump administration coming in, the for real health care reforms to the Finance Committee. At its best, Republicans kick off a procedural strengthen the doctor-patient relation- that is what the Finance Committee scheme that slashes taxes for the most ships, expand choices, lower health has always been about—trying to find fortunate, raises costs for typical care costs, and improve access to qual- common ground, working together to Americans, and takes insurance cov- ity, affordable, innovative health care. get a proposal that can get 60 votes. erage away from tens of millions of As I discussed yesterday, while Re- Reconciliation throws those unique people. No Democrat is going to buy in publicans will start by repealing characteristics of bringing Senators to- to that proposition. The reason they ObamaCare immediately, we will en- gether; basically, reconciliation just won’t is that the American people are sure a stable transition in which those trashes it, throws it out the window. In not going to buy into that proposition. with insurance will not lose access to my view, when you use reconciliation This scheme is going to bring on a health care coverage. This will allow us the way it is being used here, you are manufactured crisis that does harm to to move step by step to a new set of re- telling the other party you neither millions of Americans across the land, forms, listening carefully to the advice need nor want their votes. It puts a rocks our health care sector, our pro- of millions of Americans affected and one-sided proposal on the fast track to viders, our plans—all of those who making sure we proceed wisely, doing passage, tight limits on debate and make up this health care system. One no harm. amendments, a bare majority of votes side is pushing it, but the other side is There is a common misconception required to actually pass it. saying: No, let’s not create this catas- that some of my friends across the I am very concerned that what is at trophe. aisle have promoted. It is the idea that issue now is a serious misuse of the That is why, in my view, the ques- ObamaCare was a success and that re- reconciliation process. This is not a tions about Democrats signing on to peal will be tearing down a functioning simplified procedure to address a budg- flawed, bad proposals miss the point. program. That is not true. ObamaCare et issue; this is an effort to ram Everyone recognizes that the strict and has put our health insurance markets through repeal and run. Second, this is immovable strategy adopted by the on the brink of collapse in many parts not your run-of-the-mill congressional other side 8 years ago paid dividends in of the country. And what Republicans debate where you have both sides elections. But politics is different from face now is an imperative to do some- bringing their best ideas forward to governing. Politics is different from thing that the Democrats couldn’t tackle a policy issue. governing because there are serious bring themselves to do when they had For years, my Democratic colleagues life-and-death consequences to actions control, and that is to fix the problems and I have said that we are ready to that deprive Americans of health insur- they created. work on a bipartisan basis to solve this ance. Families are going to feel eco- ObamaCare became the epitome of a country’s health care challenges. I nomic pain when premiums and sacred cow for them, and any changes, think I have spent about as much time deductibles jump. as you can see, unless done by Execu- as anybody in the Senate working to I believe Americans are going to tive action, were out of the question. try to find bipartisan solutions to the speak out. They are going to rally Interestingly, President Obama re- country’s big health challenges. Back against an unfair, unbalanced bill that cently admitted in October 2016 at in 2008, 2009, we had a bipartisan pro- cuts taxes for the most fortunate, Miami Dade College that the law has posal: seven Democrats, seven Repub- while putting insurance companies real problems and that, in his words, licans. We had never had that before. I back again in the driver’s seat. What is ‘‘There are going to be people who are can tell you, we Democrats are ready at stake here is pretty simple; it is hurt by premium increases or a lack of to work on a bipartisan basis to solve whether or not America is going to competition and choice.’’ That is the the country’s health care challenges. turn back the clock and go back to President of the United States talking For me, essentially what I have tried those dark days when health care in about ObamaCare. In that same speech, to make my top priority for public our Nation was reserved for the he went on to call these issues ‘‘grow- service—health care is one-sixth of the healthy and the wealthy. ing pains.’’ I think that is a troubling

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00014 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.020 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S87 blind spot about this law that he and ance premium. They could also see no is happening with health care. If some- many of my Democratic colleagues way that they were going to be able to body wants to raise the threshold of share. Millions are facing impossibly get a benefit from that. the $1 billion for each of the two com- high health insurance premiums for For those lucky enough to be able to mittees, that would be perhaps accept- plans they may not even want to have. afford insurance, particularly in the in- able—unnecessary but perhaps accept- Costs are going up, and they can’t af- dividual market, under the new health able. If somebody wants to change the ford it. Somehow these casualties of law, premiums are expected to increase budget, we are going to have an actual ObamaCare don’t deserve relief, appar- faster in 2017 than in previous years. chance to change the budget right after ently; they are just written off as Some States will see insurance pre- we finish this process because there is growing pains by the authors of the miums rise by as much as 53 percent. I a budget for 2018. We are already a law. think that makes it truly an emer- third of the way through 2017, and My colleagues will recall ObamaCare gency. there are no spending bills approved. architect Jonathan Gruber, who was After discussing the why, it is impor- That is wrong, but that is what this paid in a number of different ways, who tant to talk about how we are going to budget reflects. That is where we are at was famously exposed in 2014 for stat- do this. Passing the repeal resolution this point in time on our spending. ing, amongst other things, that while we are currently debating today will Hopefully, we will do well on the new crafting this bill, he believed that ‘‘the allow Republicans to use the budget budget and come up with a plan that is lack of transparency is a huge political reconciliation process to untangle the going to pull the United States out of advantage’’ and that it ‘‘was written in country from this unworkable, unpopu- the hole that we are in on our deficit a tortured way to make sure the CBO lar, and unaffordable law. This is the spending, which results in huge debt. did not score the mandate as taxes.’’ exact same procedure congressional I would like to make that distinc- Mr. Gruber may have succeeded in Democrats and President Obama used tion. Deficit is our overspending. Debt masking the consequences of to secure passage of portions of is the amount that we owe that we ObamaCare to obtain passage, but ObamaCare. Let me say that again. have to pay interest on—like pouring there is no way to hide the results. This is the exact same procedure con- money down a hole—and that interest A recent poll by the Gallup organiza- gressional Democrats and President rate is going up. We get to make deci- tion showed that more Americans con- Obama used to secure passage of por- sions on about $1 trillion each year, tinue to disapprove—53 percent—than tions of ObamaCare. and the interest rate right now spends approve—42 percent—of the law and After Congress passes this repeal res- $200 billion right now by itself—that is that a majority of Americans want to olution, it can then move forward on at about 1 percent. If it goes to 5 per- see the law changed. Let me highlight reconciliation legislation that will pro- cent, which is the norm for the United that point again. A majority of Ameri- vide for the repeal of ObamaCare and States, that would be $1 trillion dol- cans want to see ObamaCare either pave the way for real health care re- lars. That is the amount we get to changed or replaced altogether. In fact, forms. I think Members are looking make decisions on. What shape will our since passage of ObamaCare in 2010, forward to an open and serious debate country would be in if we have to spend there has never been a majority of about the future of America’s health $1 trillion dollars on interest and that Americans supporting the law. A quick and its health care system and the im- is all we have to make decisions on? glance around the Nation quickly ex- portance of restoring the trust of hard- We have to do something. Health plains why. For more and more Ameri- working taxpayers. I think that is care is affecting more people in this cans, there is only a single insurer something both sides can agree on, and country than anything else. So we will from which they can select health that is what will happen. start immediately. We normally have a plans, a monopoly. In fact, on Federal This resolution we are debating does recess that would begin from the time exchanges, one in five consumers will two things. It recognizes the point in we reorganize until the time the Presi- only be able to select plans from a sin- the budget we are at considering the dent is sworn in, but Republicans rec- gle insurer. Many residents across the points of order and things that hap- ognize that this is an emergency. This country only have one choice of health pened up to this point in time. We are is something that needs to be taken insurer. That is including my home just recognizing that is where this care of. So we are going to stay around State of Wyoming as well as the entire budget is. It still keeps in place the and get it solved. State of Alaska. points of order to maintain some con- We are going to do the processes we What does this lack of competition trol over our spending, but the signifi- have to do. This is the first of the proc- mean? Prices are surging for hard- cant part is the repeal part. That is esses. There is another more important working families who now have to where we institute the reconciliation, step, which has to be the actual sav- choose between unreasonable insurance and all that is, is an instruction to two ings part in order to do the reconcili- rates or an unreasonable fine. That committees on the Senate side and two ation, and we are going to do that. doesn’t even include the deductible committees on the House side. The two We will hear all kinds of stories of problem we have. That doesn’t even in- on the Senate side were the Finance ways that people have been helped by clude the additional taxes and prices Committee—they are the ones who deal health care, and we will hear stories people are paying as a result of other with all of the taxes and the finance about how people have been hurt by things that are built into the law, and the Medicare and the Medicaid, this health care. We need to fix it for which I will go into later—not in this and they need to save $1 billion over 10 both of them. speech. years. That is peanuts around here. So I think Members are looking for- The irony of a Democrat-led effort to They will do much better than that, I ward to an open and serious debate—I help resulting in the creation of a lose- am certain. And then the HELP Com- hope, a serious debate—about the fu- lose proposition for families ran true to mittee—Health, Education, Labor, and ture of America’s health care system voters in the most recent election Pensions—also has an instruction to and the importance of restoring the when they voted for change. In Wyo- save $1 billion. That is it. trust of the hardworking taxpayers. I ming, some families would be forced to This isn’t a debate over what the hope that is something we can both pay more than 30 percent of their total changes are going to be to ObamaCare; agree on. income on premiums to obtain health this is a debate about whether we are Thank you. I yield the floor. care coverage, which often includes going to give two committees, which The PRESIDING OFFICER. Who deductibles of over $1,000. One family have jurisdiction over this situation, yields time? faced premiums of more than $1,600 per the ability to consider it and bring us If no one yields time, time will be month. That is one family, $1,600 a something. It has to conform with the charged to both sides. month. As an alternative, their tax budget requirements, and that is going The PRESIDING OFFICER (Mrs. penalty for not carrying coverage was to save some money. That is why we ERNST). The Senator from Kansas. only $1,700 for the whole year. So guess have a very low threshold, each of Mr. MORAN. Madam President, in what they did. They paid the fine be- them saving $1 billion. That is the time 2010 the American people were prom- cause they couldn’t afford the insur- when we will have the debate on what ised a number of things, but among

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00015 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.021 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S88 CONGRESSIONAL RECORD — SENATE January 5, 2017 those things was affordable, accessible, funding for NIH, or the National Insti- from coast to coast, no matter what and quality health care. They were tutes of Health. This is research that is State they live in. This will lower the promised that if they liked their health essential to saving and improving lives, premiums by spurring greater competi- care plans, if they liked their insur- growing our economy, and maintaining tion in the insurance market. ance, they could keep those insurance America’s role as a global leader, but, Third, we should extend tax savings policies. They were promised a system most importantly, it saves lives and to those who purchase health care cov- that could get more folks covered at improves health care. In addition, it erage, regardless of their employment. lower costs. saves money—the cost of health care— To assist low-income Americans, we Instead, unfortunately, the Afford- if we can find the cure and treatment can offer tax credits to help them ob- able Care Act has failed us and has for cancer, for diabetes, for Alz- tain the private insurance of their failed to keep its promises. Canceled heimer’s. One of the ways we can help choice. We also can expand access to policies, elimination of certain plans, reduce the cost of health care and care by supporting community health difficulties in identifying new plans, make it more affordable is to make centers and other primary care access massive premium increases, sky-high certain that we make the necessary in- points. deductibles, and limited options for vestments in finding those cures and Fourth, instead of limiting the doctors have really become a new treatments. choice of plans, let’s give small busi- standard for many American families. Last year, I supported, and this Sen- nesses and organizations the ability to At the end of last year, I completed ate and Congress passed, the 21st Cen- pool together in order to offer health another round of 105 townhall meetings tury Cures Act. This takes us in addi- insurance at lower premiums, similar in our State. There are 105 counties in tional directions in the way of finding to corporations and labor unions. We Kansas. On occasion—it is pretty rare those cures for life-altering diseases also need to make it possible for health but on occasion someone will say: The and, in the process, helps us to save our insurance to travel with workers when Affordable Care Act was helpful to me families’ dollars. We have also worked they move from one job to another job and my family. My response to that is: hard to try to maintain the funding for throughout their careers. I am glad, but surely we can come up Federal programs and agencies that Fifth, we ought to increase the incen- with a proposal—a plan—that isn’t so work with universities and medical tives available to individuals to save damaging to so many other people for schools to train and recruit medical now for their future and for long-term the benefits that you claim you have professionals who then go on to serve care needs by empowering them to uti- acquired under the Affordable Care particularly in medically underserved lize health savings accounts and other Act. Surely, we can come up with a areas. It is very typical of your State incentive plans. Doing so enables indi- plan that doesn’t increase premiums, and mine, Madam President, in which viduals to take ownership in their increase deductibles, increase copay- we are experiencing the constant short- health, and that is important as well. ments, eliminate plans, reduce the age of the necessary professionals to Sixth, we need not accept the idea choice of the physician you see, and re- provide the necessary health care. that costs for currently available med- duce your ability to keep the health While this is progress, with a new ical treatments will inevitably rise. In- care plan that you like. Because I am Congress, a new year, and a new admin- stead, let’s continue to support those opposed to the Affordable Care Act istration, we now have a tremendous things that bring down the cost of does not mean I am opposed to trying opportunity to provide real substantive health care by finding cures and treat- to make sure Americans have better reform to our health care system. I ments, as I mentioned, with the Na- options and more affordable care. mentioned the conversations I have tional Institutes of Health. Advancing I have also visited all 127 hospitals in had in townhall meetings. In addition lifesaving medical research and spur- our State. I have had conversations to the health care side of the Afford- ring innovation can help us accomplish with the chief financial officer, the able Care Act and the problems it has health care savings, reducing the finan- CEO, the trustees, the doctors, the created for affordable and accessible cial burden for those with diseases and nurses, and almost without exception health care, we have also had the chal- their family members who care for the conversation is about how bad debt lenges on the economic side—the job them. expenses increase, the ability for their creation side—that the Affordable Care Seventh, we need to address short- patients—people who are admitted to Act has unfortunately caused—the con- ages in our medical workforce by pro- the hospital—to pay their bills is less, versation about whether or not to ex- moting education and programs at our not more, and that is because they pand a business, whether or not to ex- universities and our medical schools can’t afford the copayments and ceed the 50-employee threshold. Those that train physicians, nurses, and other deductibles. aspects of the Affordable Care Act are health care officials and encourage Unfortunately, ObamaCare—the Af- very damaging and need to be ad- them to practice in underserved areas fordable Care Act—has taken away the dressed and cured as well. through scholarship and loan repay- freedom to make health care decisions As we as a Senate, we as a Congress, ment programs. Kansas is an example, from Americans, from us as individ- and we as a country look for a replace- as is your State, Madam President, uals, and given way too much author- ment strategy, for something dif- where those rural areas and, addition- ity to the Federal Government. Kan- ferent—significantly different than the ally, those core centers of our cities sans continue to ask me to help them Affordable Care Act—we ought to focus lack so often the necessary health care get back to their former health care on the practical reforms that embrace providers. plans, to find a better way to do this, a increased flexibility and allow Amer- Eighth, in order to curb the prevent- plan that is more affordable with bet- ican men and women to decide what is able costs that often occur through un- ter coverage. right for them and their individual necessary emergency room visits and Over the last 6 years, I have advo- family health care needs. untreated symptoms of disease, we cated for a number of changes to our As we take this matter up in Con- should provide coverage to low-income health care plan to help American fam- gress, I wish to again put forth some Americans, despite their limited finan- ilies. Even before President Obama was specific ideas I have offered over the cial means, in a financially sustainable President, we were talking about what years as a blueprint for reform that we way that ends up saving money in the we ought to do. should try to put in place. long run. For all of us, the best reduc- I had ideas of what we could do to First, we should maintain preexisting tion in health care costs is wellness, improve the chances that people across condition protections for those with fitness, diet, and nutrition. That also Kansas and around the country would continuous coverage. Individuals with means early preventive care. It means have a better opportunity to provide debilitating diseases and chronic condi- early diagnosis, and we make certain health care insurance for themselves tions who have purchased health care that Americans have access to that di- and their family members. I am proud should be reassured that their coverage agnosis and that early treatment. En- of some of the successes we have had in will not be stripped in any future suring access to quality care with a recent time. health care changes to our system. focus on preventive health is an effec- I am a member of the Senate Appro- Second, we can increase coverage by tive way to limit high-cost health vis- priations Committee and a supporter of enabling Americans to shop for plans its that place burdens on hospitals,

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00016 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.023 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S89 physicians, our economy, and our One of the things I focused on as a and now it is being incorporated in my health care system as a whole. member of the Finance Committee on own little State in our big health care Lastly, we can reform our medical li- the Affordable Care Act was the idea delivery system. It is something that ability system and reduce frivolous that we have doctors, hospitals, and works. I am not sorry that it works. I lawsuits that result in inflated pre- nurses who in some cases provide en- am glad that it works, and I am happy miums and the practice of defensive tirely too many tests and procedures to share it with my friend from Kansas medicine, where doctors order every and so forth that are needed to treat and whoever else might be interested. possible test out of fear of potential somebody just in order to cover—as I yield. lawsuit. Doing so can save tens of bil- Naval aviation used to say—our 6 Mr. MORAN. I thank the Senator lions of dollars each year and make o’clock. You didn’t want to have some- from Delaware, and I appreciate his health care more affordable for more body come up from behind you to shoot comments. He did walk in just as I was people. you down. So we talked about covering talking about that particular issue of a The bureaucracy that goes with the our 6 o’clock. Doctors, hospitals, and series of things that I believe would providing of health care needs to be nurses spend a lot of time covering the improve the cost and affordability of simplified. I have often looked behind 6 o’clock, as my friend knows. health care. I thank the Senator for the desk when I go see my family phy- I am an Ohio State boy. I am going sharing his experience in Delaware and sician and wonder what all the people to say something nice about Michigan, elsewhere and use that as an oppor- who are working there are doing. So which is really out of character here. tunity to indicate that the cost savings much of it is not about patient care In Michigan, the University of Michi- that comes from that kind of reform is but navigating the system by which gan Medical School and hospital came a positive, but we also want to make your health care bill, at least in part, up with a policy called Sorry Works. If sure those who, through no fault of gets paid. There is all the variety of in- a doctor, hospital, or nurse made a their own, are actually harmed are surance forms. I know this in my life— mistake that adversely affected a pa- made whole to the best of our ability the ability to understand that insur- tient, they apologized. The idea was to that this can be accomplished. ance document that arrives in the mail apologize, make up for it, make them Finally, I would use this as an oppor- and sits on our kitchen table waiting whole, help them get well, cover their tunity to point out that this Senate for my wife or me to figure out what financial costs and so forth. It is called ought to work in a way in which the this means. I have seen this with my Sorry Works. It is a good idea. ideas of all 100 Members are considered own parents when they were living— I met a guy who is a doctor and a in a respectful way as we try to find so- the amount of documents, paperwork, lawyer—a Republican—from Illinois lutions to the access and affordability and forms and checks for $13.19 that ar- who took the idea of Sorry Works and of health care. rived in my dad’s mailbox and trying he put it on steroids and they called it Again, I thank you for the time on to figure out with my parents: What Seven Pillars. It has been a great ex- the floor. does that mean? Why am I getting ample of what actually works to reduce Mr. CARPER. Madam President, if I this? the incidents of medical mistakes in could speak through the Chair. So much cost savings and so much hospitals and nursing homes and also I failed to mention one thing about anxiety and angst could be eliminated to get better health care outcomes. Sorry Works, Seven Pillars, and what if we had a system that was much more You reduce medical malpractice costs, we are doing in Delaware. If we have uniform in its presentation, simpli- and you also get more satisfaction that meeting between the patient who fying the way in which our health care from the patient side. had been harmed, the physician and bill gets paid by our insurance pro- We have taken that idea in Dela- provider, and they have the need where vider, by Medicare, by Medicaid, or out ware—Seven Pillars—at Christiana there is an apology and an offer to try of our own pocket. I would defy most Care, which is the big health care de- to make the patient whole—no attor- Americans to be able, unfortunately, to livery system in our State. We have neys involved—if the patient says no, I understand what is the stuff that taken that and have begun to incor- am not interested in doing that, noth- comes in the mail and what it means to porate it in the way they work. If I am ing that is said in that conversation them. your doctor and you are my patient between the two of them can be used in As we move forward with trying to and I perform a procedure on you, if a court of law, which I think is an in- replace and improve access of Ameri- you are harmed or hurt—not your teresting approach. We are anxious to cans to health care—to affordable fault, my fault—the idea is I apologize. see how it works over the next couple health care—I believe there are re- I meet with you privately—no law- of years. forms that will provide us with a good yers—and apologize for what has hap- Ironically, I was probably the only blueprint for how to start helping Kan- pened and try to make you whole. If Democrat—maybe the only member of sans and all Americans across the you lost wages, if you have pain and the Finance Committee—who was try- country who have suffered under the suffering, they pay your health care ing to get included in the Affordable deficiencies and the costs and the dam- costs and make you whole. Don’t hide Care Act provisions dealing with med- age that comes from ObamaCare. it. Don’t put it under the rug but take ical malpractice. I had this idea—not I look forward to working with my full acceptance, responsibility. That is to let a thousand flowers bloom or colleagues—Republicans and Demo- one of the approaches being used to try ideas like that—to figure out five or six crats—to find solutions to take advan- to deal with medical malpractice costs. good ideas and put them on steroids to tage of this opportunity that we have. I think it is a good one. It is not the see if they actually work on a larger The American people—many American only good one, but it is one. scale. I could not get a cosponsor on people, most American people—are I happened to be walking through the the other side of the aisle, which blew hurting under this law, and they have Chamber and heard my friend speak- my mind. It still does. I could never spoken clearly numerous times. It is ing, and I thought I would share that understand that. In the meantime, the time for us to bring to them the with you, with everyone. ideas are starting to crop up and flour- changes that improve their lives by im- When I was Governor of Delaware, we ish, and, hopefully, we can find out proving their health care, by improving used to meet with my Cabinet. We what works and do more of that. their health, and by making sure that would be talking about a particular Thank you. no American is worried about whether problem or challenge we faced in Dela- Mr. MORAN. Madam President, I or not the necessary health care that ware. I would say to my Cabinet: Some would welcome a membership on the they need or their family member other State or some other Governor Finance Committee, but I don’t have needs is outside of their reach. has actually addressed this issue. They one at this stage or with my time in Mr. CARPER. Will the Senator yield? figured out how to deal with this this. the Senate. Under either cir- Mr. MORAN. I yield. Our challenge is to find out what works cumstance—membership on the Fi- Mr. CARPER. It is great to see my and do more of that and to see if it can nance Committee or here in the entire friend from Kansas on the floor and be transferred to Delaware. Senate—I look forward to working looking forward to serving the next 6 Sorry Works is a Michigan idea. It with my friend and colleague, the dili- years. morphed into Seven Pillars in Illinois, gent Senator from Delaware.

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00017 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.024 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S90 CONGRESSIONAL RECORD — SENATE January 5, 2017 I yield my time. superior—but when Republicans say and I and PETE SESSIONS have intro- The PRESIDING OFFICER. The Sen- that you can keep your health insur- duced in the House of Representatives, ator from Louisiana. ance if you wish, and we mean it, we people will know what the cash price Mr. CASSIDY. Madam President, I mean it. If a State decided they wished is. I have found, working in a hospital hear my Democratic colleagues prais- to stay on ObamaCare, they could or if for the uninsured, that when you the ing ObamaCare. I had to smile yester- a State truly decides they want to have give the patient the information and day. I heard a colleague talking about nothing at all to do with any of this, power they need to know to make the how ObamaCare was addressing high they can totally opt away from the better decisions, you get better out- pharmaceutical costs. I had to start Medicaid expansion, from any help for comes. laughing—and kind of a bitter laugh. others in their State to purchase insur- By the way, we have been told that Tell that to a senior who is paying ance, period. Republicans don’t have a plan. The $6,000 for her medicine, which before I think this recognizes that if the mi- plans I am speaking of now are drafted ObamaCare passed was a fraction of nority leader wants to claim it is work- in legislative language—legislative lan- that. ing in New York, they can keep it, but guage, again, that would repeal We hear how great it is that clearly ObamaCare is not working in ObamaCare, put in price transparency, ObamaCare has given so many people some other States. We can talk about and return decisionmaking power to coverage. Say how great that coverage Arizona, where briefly a county did not the patient. We should repeal the indi- is to someone who has a $6,000 deduct- have a single insurance company pro- vidual mandate, repeal the employer ible—a $6,000 deductible—who does not viding insurance and where premiums mandate, prevent the Federal Govern- have $400 in her checking account. increased by as much as 100 percent. ment, the long arm of the Federal Gov- There is a friend of mine—people don’t We can look at Louisiana, my State, ernment from reaching into someone’s believe it so I put it on my Facebook where that quote I gave earlier—a fel- household, forcing them to do some- page. He got his quote for him and his low and his wife, $39,000 for 1 year’s thing they don’t wish to do. wife. They are 60 and 61 years of age. premium. There should be an alternative. Their premium for 1 year was $39,000, Clearly, ObamaCare markets are fail- Under both the World’s Greatest each of them with $6,000 deductibles. ing there. So let’s repeal ObamaCare, Health Care Plan—the bill I introduced Again, it is on my Facebook page be- give the States the power, allowing with PETE SESSIONS—or the Patient cause otherwise no one would have be- them to choose the system that will Freedom Act that I have SUSAN COL- lieved me. work for them. Now, health care cost is LINS as a cosponsor, we take all of the So when people speak about the af- important. Under our bill, we make money a State would receive had they fordable health care act, I have to health care more affordable by giving done the Medicaid expansion and those laugh. If this is affordable, what would the patient the choice, the power, if eligible to be signed up for the be unaffordable? We can clearly do bet- you will, of price transparency. Under ObamaCare exchanges, and we give ter than this. ObamaCare, we have seen prices rise that money to the State to allow them I begin this speech by calling into out of control. A lack of price trans- to give tax credits to those who are eli- question my Democratic colleague’s parency keeps providers from having to gible. defense of ObamaCare, but we can have compete which takes away the con- These tax credits could only be used common ground. I applauded and still sumer’s power of choice. for health insurance. If the patient did applaud the goals of those who support You can see this power of choice nothing, she would have a health sav- the Affordable Care Act. They wish to price transparency. Fifteen years ago, ings account, catastrophic policy with have coverage for all. Now, that is im- LASIK surgery cost $1,000 an eye or a pharmacy benefit. She could use the portant. For over 30 years, I have $875 an eye, with more for astigmatism. health savings account as first-dollar worked as a physician in a hospital for Now you can drive down the street and coverage. the uninsured. My medical practice has you see a billboard—a billboard—that Now, under ObamaCare, $6,000 de- been geared toward bringing coverage, says: LASIK surgery $275 an eye. So ductible. Under our plan, the patient to bringing care to those who other- over a period of time, when everything has first-dollar coverage, so if her wise would not have it. has increased, LASIK surgery has come daughter has an earache and she takes As I look at this issue, I have to down—the power of price transparency. her daughter to the urgent care center, thank them for their motivation but Another example I like to use is of a she can cover that visit with a health have to recognize that the Affordable woman, a physician, went for her mam- savings account that would be funded Care Act has not achieved that in a mogram. She wanted to pay cash. They with this credit. They also have cata- way which most Americans find afford- talked her out of it. No. No. No. We strophic major medical coverage, so if able. The other thing about ObamaCare don’t even know what to charge you. they get in that car wreck, take them is that it coerces Americans. It takes OK. I won’t pay cash. to the emergency room, sky-high pric- power from patients and States and They billed her insurance company. ing, they are protected from medical gives it to Washington, DC, coercing She later found that if she had paid bankruptcy. the individual with mandates and pen- cash for her mammogram, it would Under our replacement plan, we also alties, taking away her right to choose. have cost her $90. As it turns out, they give States the option to say that if That is not where the American people billed the insurance company $500. Her someone in our State is eligible, they wish to be. deductible was $100. She was actually are automatically enrolled. I smile I would like to believe Republicans out $10 because they billed her insur- when I say that covers two popu- and Democrats can find common ance company. She should have known lations, the person who may live under ground. I have introduced a replace- that price going into it. a park bench and does not have his life ment plan that would give States the One more example. If a doctor orders together to otherwise do it, and the power. I am willing to concede, the mi- a CT scan, the cash price, according to other population would be my 22-year- nority leader believes that ObamaCare an LA Times article a few years ago in old son and those like him, those is working just fine in his State of New the Los Angeles Basin, varied from $250 young folks who never think they are York. In my plan, we repeal to $2,500. Unless you are an investiga- going to get ill so they never sign up ObamaCare on a Federal level, but if a tive reporter for the LA Times, able to for insurance. Without them being in State like California or New York call up and get that cash price, you the pool, we end up with a sicker pool. thinks ObamaCare is working for them, otherwise would not know. I guess That is what has happened with God bless them. maybe it sometimes helps to have an- ObamaCare. Under my plan, a State legislature other example. Would anyone buy a car By the way, it would be easy to imag- would have the right to stay on if they did not know the price of the ine you could end up with 95 percent ObamaCare. So here Congress would car beforehand? Yet that is routinely enrollment of those eligible should the pass the legislation giving States the done with health care. State decide to go this way. The time- choice, and the State would either have Under the legislation I and Senator frame for our replacement would be the option we advance, which I think is COLLINS have introduced in the Senate, simple. In year one, say 2017 Congress

VerDate Sep 11 2014 23:59 Jan 05, 2017 Jkt 069060 PO 00000 Frm 00018 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.026 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S91 passes the enabling legislation, which Mr. HATCH. Madam President, I rise ily’s needs was ‘‘a plan with a small in year 2018 allows the State to choose today in support of S. Con. Res. 3 and list of in-network providers and no cov- between these three options; in 2019, the ongoing effort to repeal the most erage for out-of-network providers.’’ the State would implement the option harmful elements of the so-called Af- She continued, saying that under this it chooses; and by the end of 2019, we fordable Care Act. new plan, ‘‘We will have a higher de- have made the transition from repeal While our friends on the other side of ductible ($13,000 for the family), we will to replace, to implementation. the aisle have been trying to convince have to pay the full cost of any visit to Folks ask: Would I lose my coverage? the American people that there is the doctor . . . and we will not be able I am a physician. I am going to give nothing to see here and that this poor- to save as much money in our Health my perspective: a patient I might see ly named law is working according to Savings Account each month because who has breast cancer. She does not plan, the vast majority of our citizens of the high premiums, which add up to like ObamaCare. She voted for Donald know the truth: ObamaCare just $11,000 a year. . . . The premium is ba- Trump, but she is on the bubble finan- doesn’t work. sically another mortgage payment for cially. She is not sure she can afford According to the results of a recent us, only we have no property to show coverage, but she has breast cancer. As Gallup poll, 80 percent of Americans for it. This is too much.’’ bad as ObamaCare is, at least she is want Congress to either change the Af- No family should have to choose be- getting some care. fordable Care Act significantly or re- tween paying their mortgage and pay- Now she is having to put out all this peal and replace it altogether. Let me ing for their health insurance. Yet, money first, but still she is getting repeat that. Eight out of every 10 peo- with all of ObamaCare’s failures and some care. If we keep her in the prism ple in this country agree that the sta- broken promises, families throughout through which we look at this problem tus quo is unacceptable and that we the country are currently having to so that in the transition from need a major change in what is going make those kinds of choices. ObamaCare to better coverage she con- on around here. Unfortunately, it does not get any tinues to have her therapy, so at the We need a major course correction in better from here, not without a major end of this, not only does she have bet- our health care system. It is not hard change to the status quo. In fact, I ter coverage, but she has health and re- to see why this is the case. After all, think it is safe to say that if we fail to covery from breast cancer, we have under ObamaCare, the cost of health act, the worst is yet to come. There- done our job. That is our Republican insurance has increased dramatically fore, it is only fitting that we begin goal, to keep our prism as that woman and will continue to do so well into the this new Congress by repealing who is vulnerable from a sickness she future. Under ObamaCare, individuals ObamaCare and setting the stage for has now. In our transition, she does not and families are being left with fewer workable reforms that will actually lose coverage; she merely moves to bet- and fewer choices when it comes to bring down costs, provide more op- ter coverage. buying health insurance. Under tions, and let the American people— I introduced the Patient Freedom ObamaCare, patients have fewer op- and not Washington bureaucrats— Act with 12 Senate cosponsors in 2015 tions and reduced access to health care make their own health care choices. and then again teamed up with Rep- providers. Under ObamaCare, the The budget resolution before us is the resentative PETE SESSIONS in 2016 to in- American people have been hit with first step in this effort. troduce the World’s Greatest Health steep taxes, burdensome mandates, and As we all know, the resolution con- Care Plan. That is truly its name. TOM a health care system that simply does tains reconciliation instructions to the PRICE, our soon-to-be HHS Secretary, not meet their needs. relevant committees, including the first introduced his Empowering Pa- This year alone, premiums in the Senate Finance Committee, which I tients First Act to the House of Rep- benchmark plan for the ObamaCare ex- chair, to draft legislation to repeal resentatives in 2014. Speaker PAUL changes have gone up by an average of ObamaCare. So after approving this RYAN, Representative FRED UPTON, 25 percent, and in some parts of the resolution, the next step will be for the Senators RICHARD BURR, and ORRIN country, the increases have been sig- Finance Committee, the HELP Com- HATCH have also outlined plans for nificantly larger than that. In addi- mittee, as well as the Ways and Means comprehensive health care reform. tion, over the past 2 years, insurance All of these plans create a new sys- and Energy and Commerce Committees plans have been dropping out of mar- tem that returns power of choice to pa- over in the House, to get to work on kets all over the country. As a result, tients and to States. Simple provisions putting together a repeal package. This it is estimated that more than half of as I have described such as health sav- process will be more difficult than it the counties in the United States will ings accounts, instituting free market sounds. We don’t want to be reckless, have two or fewer available health in- values, if we put them into a replace- and we don’t want to inflict more harm surance plans on the exchanges—and ment plan now, we will quickly have an on the American people or our health effect upon millions. Republicans have that is this year—and about a third of care system; therefore, in addition to worked hard to lay the groundwork to them have only one available option. repealing ObamaCare, the legislation I am quite certain that every single repeal and replace ObamaCare. we draft pursuant to this budget reso- President-elect Trump has said he Member of this Chamber has heard lution will have to include a stable wants repeal and replace to happen at from a number of their constituents transition period to give us the time the same time. He promised both. We about these problems, about the prob- and space we need to provide more sen- should fulfill both promises. Our ma- lems they have faced as the Affordable sible reforms. jority leader has said we can do a bet- Care Act has been implemented. I know Under the budget resolution, the leg- ter job as Republicans covering more I have. A number of Utahns have writ- islation to repeal ObamaCare and pro- people. We have the principles, the ten to me to express their concerns vide that transition period will need to ideas, and the plans ready to go so let’s about the increases in their insurance be reported to the Budget Committee put them to use. We owe it to the premiums. For example, last month, by January 27. Then both the House American people to carry out that re- Austin from Provo, UT, told me that and Senate will debate the legislation, placement now with a smooth transi- due to the growing cost of his insur- hopefully passing it by simple majority tion so the insured population can ance plan, ‘‘I’m going to have to drop votes and sending it to the desk of the grow without anyone losing coverage the insurance and face the penalty next incoming President. Once we pass this in the process. year. I’m worried because, as a young repeal legislation, we will come to the Republicans are committed to cre- husband and father, I’m barely making most important step in the process: re- ating and passing effective health care ends meet, and I’m not sure I can af- placing ObamaCare with a health care legislation to replace ObamaCare and ford to pay the penalty for not having system worthy of the American people. to bring real coverage to all Ameri- insurance.’’ Similarly, Eryn from This will not be a simple endeavor. It cans. Now is the time to do so. Spanish Fork, UT, noted that because is going to take a great deal of work, Madam President, I yield the floor. her family’s previous insurer dropped and it will almost certainly require the The PRESIDING OFFICER. The Sen- out of the Utah marketplace, the re- efforts of people from both parties. The ator from Utah. maining plan that best met her fam- Finance Committee is going to have a

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00019 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.028 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S92 CONGRESSIONAL RECORD — SENATE January 5, 2017 major role to play throughout this is exceptionally thorough and fair, and mium costs. Who can afford that? Peo- process of repealing ObamaCare, pro- it is deeply regrettable that some of ple certainly can’t afford that as their viding for a secure transition, and re- our colleagues would try to undermine wages are flat or even declining. placing the law with more effective re- that process and not provide the in- According to the Kaiser Family forms. Our committee has jurisdiction coming Trump administration’s nomi- Health Foundation, average family pre- over all the major Federal health pro- nees the same respect and regard our miums since the Affordable Care Act grams, including Medicare and Med- committee has provided for nominees was put into place have increased by icaid. In addition, we will have juris- in the Obama administration and prior more than $4,700. Recall that one of the diction over the tax provisions, which administrations as well. As chairman, I promises of the Affordable Care Act include all of ObamaCare’s harmful take this process very seriously. I have was that costs would go down, on aver- taxes as well as the premium tax cred- made no efforts to abbreviate or short- age, $2,500 per family. Exactly the op- its provided to purchase plans in the circuit our procedures for any nominee posite has happened. In fact, there has ObamaCare exchanges. and have no intention of doing so in been an almost doubling, with a $4,700 I have spoken at length to my Repub- the future. I am certain all of our increase. I don’t think families got lican colleagues on the Finance Com- chairmen here in the Senate can say that kind of pay increase to be able to mittee about these issues, and all of the same thing. afford that. They certainly haven’t in them are ready and willing to do what- My hope is that my colleagues will Ohio. ever is necessary to put our Nation’s stop politicizing this process at every So this is a huge problem. To make health care system on a more respon- step and allow the Senate to function matters worse, we think these cost in- creases are continuing to escalate in sible path. We are going to get it done. as it has under both Republican and our State and around the country. In In that I have no doubts. Democratic administrations. My Ohio, premiums grew this year in To be sure, the first few steps in this friends on the other side may not like 2017—on average, 13 percent higher effort are going to happen quickly. the results of the recent election, but than in 2016. So there have been dou- Once again, the plan is to produce re- their disappointment of the outcome is ble-digit increases in 1 year. With two peal legislation before the end of this no justification for reinventing the plans in particular, premiums went up month. This, of course, is how it has to way we do business here in the Senate. by 39 percent in Ohio. So for some fam- be. The American people don’t have the I hope we will all take this into con- ilies it was much worse than that. We time for us to wait around on these sideration and we will start cooper- have had good leadership in Ohio with issues, and we don’t have the luxury of ating with each other and get this gov- Governor Kasich and Lt. Gov. Mary sitting back and watching the prob- ernment moving again and that we will Taylor, who is also the insurance com- lems get worse over time. The prob- support and sustain these people who missioner in our State, and because of lems facing our health care system are are qualified and good people who are that we have done a better job of try- growing by the day. We need to take being chosen by the Trump-elect ad- ing to control these costs, but in many the swiftest possible action. ministration. I think it is important parts of the country, the situation is We intend to act quickly and me- that we do these things and do them thodically to begin providing relief for getting even worse. carefully and that we treat each other Nationally, premiums are increasing the millions of Americans who are cur- with the respect that is well deserved by 25 percent just this year. In Arizona, rently suffering as a result of in this body. I hope that the petty, they are doubling. In Tennessee, they ObamaCare and the unworkable system cheap politics will be discontinued. are rising 63 percent. In Pennsylvania, it has created. As I noted, if that effort Mr. President, with that, I yield the right next door to Ohio, they are rising is going to be successful, it should be floor. 32 percent. I can go on and on. I am bipartisan. Both Congress and the in- The PRESIDING OFFICER (Mr. sure North Dakota has had similar coming administration will need to HOEVEN). The Senator from Ohio. problems, as the Presiding Officer can Mr. PORTMAN. Mr. President, I en- work together. tell us about. Some people might be CABINET NOMINATIONS joyed listening to the comments of my able to afford these higher premiums, On that point, Madam President, I do colleague from Utah about the Afford- but I think we just can’t afford it. want to note that my friends on the able Care Act, and I wanted to expand I heard Senator HATCH talk about other side of the aisle have as recently on that a little if I could. I know we having to make a choice between pay- as this morning made a number of are having a discussion right now ing your rent or being able to pay your statements and issued several demands about whether to repeal and replace premium. That is what I hear in Ohio with regard to the process for consid- the Affordable Care Act, and we are fo- as I talk to people who are struggling ering and confirming the President- cused a lot on what the timeframe and are now being hit with these huge elect’s Cabinet nominees. According to might be and what the replacement expenses. Unless we take action, there my colleagues’ statements, they want might be, which is appropriate, but we is no light at the end of the tunnel. multiple rounds of hearings on every also have to remind ourselves as to The Congressional Budget Office, nominee, which, by the way, is unprec- how we got here. which is a nonpartisan group in Con- edented. This morning, they even went We got here because the Affordable gress, and also the Joint Committee on further, issuing demands that certain Care Act has not met its promises and Taxation projected that unless we do preconditions be met before hearings has let down the people of Ohio and something to change the status quo, could even be held on a particular nom- people around the country. Millions of premiums will continue to skyrocket. ination. These tactics are, to put it these families have already had a They say they will grow by at least 5 bluntly, preposterous. My colleagues tough time experiencing really a mid- percent per year over the next decade. are certainly free to oppose any nomi- dle-class squeeze of flat wages, even de- By the way, that is far faster than they nee and to try to convince others to do clining wages, on average, over the last assume wages are going to grow so the the same. It is unfortunate that they decade or so, and now higher costs. squeeze will continue. have decided to go further by politi- That squeeze is accelerated by the cost The law was advertised as something cizing the process by which we consider of health care which has gone up dra- that would ‘‘bend the cost curve,’’ nominations. matically. meaning we would begin to see a reduc- Speaking for the Senate Finance In my own State of Ohio, the Ohio tion in the costs of health care, but Committee, I have to say that we have Department of Insurance has reported health care costs have gone up, not an established set of vetting procedures a 91-percent increase in the individual down, and on top of that, American for all executive branch nominees. Re- market in Ohio in the last 6 years, an people had to pay hundreds of billions publicans and Democrats alike have 80-percent increase for small businesses of dollars every year in taxes for this those particular procedures. That proc- that are purchasing Affordable Care new law. There are 19 tax increases in ess has been in place for decades and Act-compliant plans. This is since the the Affordable Care Act. Some of these, has traditionally been bipartisan. Affordable Care Act went into effect. like the Cadillac tax, are very unpopu- By all accounts, the Finance Com- Think about that. There has been al- lar, even among Democrats and Repub- mittee’s longstanding vetting process most a doubling of health care pre- licans. So we are hoping we can deal

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00020 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.029 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S93 with that with any kind of repeal effort down to 11 companies. We now have 20 small business person. I can tell you immediately. of our counties—there are 88 counties that I have burned a lot of time and ef- Another goal of this law, we were in Ohio—20 of our counties have only 1 fort to try to figure it out. You can go supposed to be increasing access to insurer. This is also true nationally. to consultants and pay them a bunch of health care. Let’s talk about that for a About one-third of the counties around money, and they will tell you they are second. We heard different things on the United States only have one in- not sure what it means either. This is the floor about that. About 6 million surer. Again, this leads to higher costs, one of the big issues that doesn’t get people lost health insurance they liked less choice, less competition. Quality talked about much with the Affordable as a direct result of this law going into also goes down because you don’t have Care Act; that it is really hard for busi- effect. About 6 million Americans were competition for the beneficiaries. It nesses to figure out what they are sup- told their coverage is no longer ade- also affects the issue of premiums posed to do, particularly small busi- quate because it didn’t meet the man- going up, deductibles going up, copays nesses that don’t have that kind of ex- dates so they will lose their coverage. going up, and the middle-class pertise inhouse. Those costs could go President Obama told the American squeezed. toward having more employees, they people, I am told, 37 different times So the President’s health care law could go into reinvesting in business, that if they liked their doctor, they certainly failed at its own goals that plants and equipment, but they are could keep their doctor. Of course, that were laid out in the promises that were going into trying to figure this thing turned out not to be true. When you made. It was supposed to create jobs, out. lose your health care plan and lose too, which is a different issue. What is I don’t doubt the good intentions of your doctor, you don’t feel like those the economic effect of this? Having my colleagues on the other side of the promises have been kept. more people covered is a good thing. aisle who support this legislation. We The outside fact checker called We all want that. But what is the eco- all want to see more coverage and see PolitiFact rated that as the Lie of the nomic impact on the way the Afford- health care costs go down, but that is Year for 2013. That is the outside group able Care Act was put into place? We not what is happening. that looks at what we elected officials are looking at the weakest recovery in Before the Affordable Care Act went say is going to happen and then com- the history of our country from a re- into effect, the CBO estimated that 26 pares it to what actually happens. By cession still. Unfortunately, we haven’t million Americans would be enrolled in the way, it still is not true. One in five seen the strong economic growth we a plan in 2016. That is what they esti- ObamaCare customers were forced to hoped for and had anticipated after a mated. The Congressional Budget Of- find a new insurance company for this deep recession. Some of the reason for fice said 26 million would be enrolled in year. that, in my view, is health care. Health a plan in 2016. The actual number was So the Congressional Budget Office care costs went up dramatically. Peo- 12.7 million, less than half. So, again, it that I mentioned and the Joint Com- ple are paying a lot more for health hasn’t met its own promises and pro- jections. mittee on Taxation, these nonpartisan care, not being able to get ahead, small The co-ops are another failure. There groups, now project that 27 million businesses having higher and higher Americans are still uninsured today. was a debate on the floor just before I costs. got elected about should there be a Under the status quo, if we don’t take If you look at the latest jobs report, public option so everybody would have action, they say that will be the case it is interesting. The Bureau of Labor an option to get into an exchange. We for the next decade. So this notion that Statistics tells us that 5.7 million said let’s put together these co-ops. everybody is going to get covered just Americans now are stuck in part-time They will be nonprofit. They will work hasn’t happened. By the way, that is work who want full-time work. These great. We will set up co-ops around the about 1 in 10 people in our workforce, are people who are looking for a full- country. There were 23 co-ops set up, even after hundreds of billions of dol- time job but only have a part-time job. including 1 in Ohio. We now see that 15 lars of taxpayer dollars have been Why is that? The economy is not work- of the 23 co-ops have gone insolvent. spent on the Affordable Care Act, in- ing as it should. It is not generating I will tell you that last spring, when cluding these 19 new tax increases. enough growth to create job opportuni- 22,000 Ohioans lost their health care be- A lot of people have told me: ROB, I ties full-time, but it is also because of cause the co-op went belly up, it was have health insurance, but I really these mandates under the Affordable tough because they had to scramble don’t because my deductible is so high. Care Act. I can tell you, economists and find a new health care plan quick- So, forgetting the premiums for a sec- may differ on the impact of this, but go ly. More than 860,000 Americans—peo- ond, to pay for health care, just the an- talk to people about it. ple who were encouraged by this law to nual deductible has gone out of sight. I was in Chillicothe, OH, and some- sign up for these co-op plans—had to There are some plans where a deduct- one came up to me and asked: Can you scramble to find new coverage because ible for a family might be $8, $9, $10,000 help me; because my employer is say- of a failed co-op. It is tough on these a year. That is not really health care ing I can only work 28 hours a week. I families. because you end up paying all that figured out what it was about. She was It is also tough on the taxpayer. We money out of pocket. The average de- a fast-food employee. I asked her: What did an investigation of this under the ductible for a midlevel plan for did they say? And she said it was be- Permanent Subcommittee on Inves- ObamaCare, according to the Kaiser cause of health care. What does that tigations, and we looked at what was Family Foundation, went up to $2,500 mean? It means that under ObamaCare, happening to these families and we also the year before last, 2015, to more than if you work under 30 hours a week, you looked at what was happening to the $3,000 last year, an increase of about 25 are not covered by the mandates and taxpayer. At that time, when only percent in just 1 year. You see that in the new costs, so some employers are about half of the co-ops had gone increases in deductibles and copays, going to say we are keeping you under under, rather than two-thirds, $1.2 bil- not just in the premiums. 30 hours a week. That has led to more lion of taxpayer money had already National insurers have lost billions part-time work. been spent on these co-ops. That of dollars on the Affordable Care Act In this particular case, the woman money isn’t coming back to the Treas- exchanges, and a lot of them pulled said: I have to find another part-time ury, meaning this is money that will their plans from the States. This is a job and I have kids at home and this is probably never be repaid. Again, part real problem because if you don’t have tough. And I said: Well, the answer to of the problem with our deficit is that competition or choice out there, you this, in part, is to change the health ObamaCare and the Affordable Care will not get the costs down. I see in my care law; that is, to take out some of Act is so expensive, and the co-ops in own State of Ohio we lost one-third of the mandates and requirements and particular just wasted money. Among the companies on the exchanges just make it more pro-growth and pro-job the surviving co-ops, 3 have not yet en- this year. We have gone from 17 compa- rather than the current situation. rolled 25,000 members. In other words, nies offering insurance on the ex- There are tens of thousands of new they are not enrolling enough members changes in 2016, last year, to this year pages of regulations in this new law. It even if they are surviving. So the non- having just 11—so 17 companies going forces small businesses—and I am a partisan Government Accountability

VerDate Sep 11 2014 02:30 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00021 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.032 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S94 CONGRESSIONAL RECORD — SENATE January 5, 2017 Office, GAO, issued a report in March me how this health care law has af- guing that the status quo is acceptable. which confirmed the results of our in- fected them. There is a father of five I think we have to do things not just to vestigation, and it indicates that this who wrote to me after the cost of the repeal ObamaCare but to replace the money, the $1.2 billion, has now in- family’s insurance doubled. Another Affordable Care Act with reforms that creased substantially because more of man saw his $100 deductible soar to make better sense. We had issues be- the co-ops have gone under. $4,000 while his premiums hit $1,000 a fore, but it has gone to worse, not bet- Many of those 22,000 Ohio families month. ter. It accelerated the problems. who were in the co-op had already paid I still remember the letter I received I hope that over the next couple of deductibles in the plans they thought from Dean from Sandusky. He lost his months, as we talk about this, we will they could count on. Think about it. job in 2009 as so many other Americans be able to come up with a replacement They paid hundreds of thousands of did during the recession. Because he plan that makes sense. Republicans dollars in health care costs to get up to lost his job, he had to go on the indi- and Democrats alike need to come to their deductible, and then all of a sud- vidual market to buy health insurance. the table on this because, again, I have den they found out that they had to go He picked out a plan that worked for listed today all the reasons the current to a new plan and they had to start all him and his family. He liked it and he law is not working. The status quo is over again. So it is adding insult to in- bought it. Once the President’s health not acceptable. I think it is very hard jury. They lost their plan and they had care law went into effect, that plan was to argue that it is. That means all of us to scramble to find one and then they discontinued because it didn’t meet the have a responsibility to say: OK. How found out they have all these out-of- mandates and requirements of the new do we fix this? How do we come to- pocket expenses again because al- law. He found himself high and dry. He, gether, Republicans and Democrats though they met their deductible under too, had to buy another plan that was alike—not on a partisan basis as was the old plan, they have to start again twice as expensive, and it cost him done last time—to figure out a way to in the new plan. This is not the way it more than half of his pension—because do it together? We need to come to- ought to be. It is just not fair. These that is his income. It is his pension. So gether to make sure the people we rep- families did nothing wrong. All they not only did he lose his job, but then he resent have the chance to get the did was what they were told to do, to was saddled with a plan he couldn’t af- health care they want for them and sign up for these co-ops. ford and a much more expensive cost of their families, that fits them, where I think these are just symptoms of living. He didn’t do anything wrong, they can have costs that are affordable, the problem. The diagnosis is clear. but because of a failed, mistaken ap- where they can have quality health The Affordable Care Act is a bad law, proach that Congress took to health care that is good for them and their bad economics, and bad health care care reform, he has now had to struggle families, where it can be patient-cen- policy. It hasn’t worked. I think it is to make ends meet. tered, and we can give people the af- difficult to make the other argument. Susan from Batavia also wrote to me. fordable care they deserve. The President’s health care law hasn’t She is a single mom. She lost the plan I thank the Chair, and I yield the worked, not because it didn’t have good she liked because of the President’s floor. intentions but because it tried to health care plan. She wrote and said: I The PRESIDING OFFICER. The Sen- achieve those good intentions by forc- stay in shape. I watch my diet. I exer- ator from Wyoming. ing millions of people to buy a product cise regularly. I do all the right things. Mr. ENZI. Mr. President, I ask unani- they didn’t want after losing a product I had a high-deductible, low-cost plan, mous consent that at 2:45 p.m. there be they did want, including a $2 billion but under the President’s new health 2 minutes of debate, equally divided in taxpayer-funded Web site that didn’t care law, I had to change my plan. the usual form, prior to the vote in re- work. If you recall, they had problems Her coverage, by the way, was for lation to Kaine amendment No. 8. with the Affordable Care Act Web site double the price of the premium. A sin- The PRESIDING OFFICER. Is there and unfortunately potentially exposed gle mom; tough to afford it. objection? a lot of personal information of many Another, Susan from Columbus, OH, Without objection, it is so ordered. of these individuals to hackers. wrote to me and told me that she Mr. ENZI. I yield the floor. As I talked about, even those who works for a small business of 12 em- AMENDMENT NO. 8 have insurance often have limited ac- ployees. When the health care law went The PRESIDING OFFICER. There cess to providers because the deduct- into effect, their rates went up nearly will now be 2 minutes of debate equally ible is so high that they can’t afford 30 percent in 1 year. Small businesses divided prior to a vote in relation to their health care. and new businesses cannot afford that. amendment No. 8, offered by the Sen- With higher costs and fewer choices, I cannot tell you how many small busi- ator from Virginia, Mr. KAINE. the American people, by and large, are nesses I have been to where I asked The Senator from Virginia. dissatisfied with the plan, the Afford- them: What have your premiums done Mr. KAINE. Mr. President, I have able Care Act, just as they were when over the last several years, and they spoken about this previously. The it was enacted. A CBS poll last month tell me: Double digit, ROB. Double budget that is on the floor really isn’t has shown that more people disapprove digit. If we get an increase in the low a budget; it is more of a focused attack of the law then approve of it. A Gallup double digit, that is a good thing. on health care for millions of Ameri- poll in November found that 8 in 10 Again, there is no place for that to cans. Amendment No. 8, which I have Americans want the law repealed or come from except for wages and bene- offered with Senator MURPHY and oth- significantly changed—8 in 10 Ameri- fits and cutting back on employees—in ers, is an attempt to stop the majority cans. Why? Because they have seen it. some cases, again, not expanding a from passing a health care repeal By the way, most Americans were plan that they otherwise would have through a fast-track process. The not in the exchanges, but they still felt because of this health care law. amendment does one thing: It creates a it. Think about this. When a company It doesn’t have to be this way. We budget point of order against any legis- is involved in the exchanges and losing can enact real health care reform that lation that would either reduce the money, and many of these companies uses the market forces that help to in- number of Americans enrolled in public are losing hundreds of billions of dol- crease competition, that requires in- or private health insurance, increase lars a year, what they are doing is they surance companies to compete for our health insurance premiums, or reduce are cost-shifting onto private plans, business, that allows people to get the the scope and quality of benefits pro- onto employer-based plans, and raising plan they want, looking all around the vided. the costs for other Americans. This is country for what works best for them. I ask for the yeas and nays on the part of the reason health care costs This burdensome health care law is amendment. have gone up generally, not just in the standing in the way of real reforms The PRESIDING OFFICER. Is there a exchanges but overall. right now. It is hurting families in sufficient second? I have certainly seen this firsthand Ohio and across the country. There appears to be a sufficient sec- in Ohio. Constituents have been con- The health care market was far from ond. tacting me for the last 6 years to tell perfect before this law so I am not ar- The yeas and nays were ordered.

VerDate Sep 11 2014 06:24 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00022 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.033 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S95 The PRESIDING OFFICER. The Sen- Three-fifths of the Senators duly cho- and decisively and the map was ator from Wyoming. sen and sworn not having voted in the redrawn to ensure that Israel was not Mr. ENZI. Mr. President, this amend- affirmative, the motion is rejected. endangered by its own borders, the ment is corrosive to the privilege of The point of order is sustained and weakness of which Israel’s enemies had the budget resolution, meaning that it the amendment falls. attempted to exploit. is outside the scope of what is appro- Who yields time? Of course, the defeated party, the priate for a budget resolution. Any in- If no one yields time, the time will be Palestinians, have not accepted this appropriate amendment could be fatal charged equally to both sides. outcome. Israel has time and again in- to the privilege of this resolution, The PRESIDING OFFICER. The Sen- vited them to negotiate a resolution— which would destroy our efforts to re- ator from Texas. just one that involves Israel’s contin- peal ObamaCare. In other words, a vote UNITED NATIONS RESOLUTION ON ISRAEL ued existence as a Jewish state, some- in favor of this amendment is a vote Mr. CRUZ. Mr. President, in the final thing that the Palestinian Authority against repealing ObamaCare. days of the Obama administration’s has over and over refused to acknowl- In addition, this amendment is not second term, with all eyes focused on edge or accept. germane to this budget resolution. the President-elect, the temptation to Therein lies the bottom line for This budget resolution is much more try to take a dramatic action to seal a Israeli security. The pre-1967 lines focused than a typical budget resolu- cherished policy legacy must have been proved indefensible. So rather than, as tion. The Congressional Budget Act re- almost irresistible. So it proved for the Obama administration, treat them as some sort of gold standard, Israel’s quires that the amendment to a budget President Obama on December 23, 2016, security interest has deemed them in- resolution be germane. Since this when he betrayed decades of robust bi- tolerable and any resolution to this amendment does not meet the standard partisan American support for Israel at issue should not be dictated by the required by budget law, a point of order the United Nations by abstaining from United States or the United Nations would lie. As such, I raise a point of a completely biased resolution that but rather should be negotiated and de- order under section 305(b)(2) of the Con- condemns our close friend and ally cided upon directly by the sovereign gressional Budget Act of 1974. Israel and condemns all the so-called nation of Israel and by the Palestin- The PRESIDING OFFICER. The Sen- settlement activity, defined as any ians. ator from Virginia. construction in any territory won by Secondly, the resolution falsely Mr. KAINE. Mr. President, pursuant Israel in the Six-Day War. claims that Israel’s sovereignty over U.S. policy for decades has been to to section 904 of the Congressional the eastern part of Jerusalem and stand up for Israel at the United Na- Budget Act of 1974, I move to waive areas that it controls after the Six-Day tions, a hot bed of anti-Semitism that section 305(b) of that act for purposes War, including Judea and Samaria, are of the pending amendment, and I ask discriminately condemns Israel more supposedly ‘‘occupied Palestinian terri- for the yeas and nays. than any country in the world, particu- tory’’. This is nothing short of absurd. The PRESIDING OFFICER. Is there a larly when resolutions are being of- What that means is that, under the sufficient second? fered up that are outrageously biased, terms of the United Nations resolution There appears to be a sufficient sec- that attempt to predetermine the out- that the Obama administration acqui- ond. come of negotiations, that prejudge the esced to—indeed, there are consider- The question is on agreeing to the basis for negotiations, or that try to able reports that the Obama adminis- motion. dictate terms to Israel. tration, President Obama, and John The clerk will call the roll. We have seen this pattern of appeal- Kerry actively encouraged and facili- The senior assistant legislative clerk ing to the United Nations from the tated it—the Jewish Quarter, the Old called the roll. Obama administration over and over City of Jerusalem, is illegal and illegit- The yeas and nays resulted—yeas 48, with disastrous deals—the nuclear deal imate and not justifiably a part of nays 52, as follows: with the Islamic Republic of Iran, as Israel. Under the terms of that resolu- [Rollcall Vote No. 2 Leg.] well as the U.N. Convention on Climate tion, the location of holy sites for the YEAS—48 Change, two international agreements Jewish people, including the most im- Baldwin Gillibrand Murray that significantly threaten the secu- portant holy site, the Temple Mount, is Bennet Harris Nelson rity and prosperity of the United illegal and illegitimate to be a part of Blumenthal Hassan Peters States. Both of them should have been Booker Heinrich Reed Israel. Under the terms of the resolu- Brown Heitkamp Sanders submitted to this body, the Senate, as tion, the Western Wall, where Jews Cantwell Hirono Schatz treaties. from all over the world go to pray, is Cardin Kaine Schumer But the President chose instead to deemed ‘‘occupied Palestinian terri- Carper King Shaheen try to impose them through the United Casey Klobuchar Stabenow tory,’’ illegal and illegitimate. Coons Leahy Tester Nations because he knew that they It is more than a little ironic that Cortez Masto Manchin Udall would never be ratified by the Senate, President Obama went to the Western Donnelly Markey Van Hollen even when this Senate had a Demo- Wall to place a yarmulke there, pre- Duckworth McCaskill Warner cratic majority. So the Obama admin- Durbin Menendez Warren tending to show respect to Israel, and Feinstein Merkley Whitehouse istration’s strategy, instead, has been yet his administration, in an outgoing Franken Murphy Wyden to curb American power by subjugating act of contempt, declares the Western NAYS—52 our national interests to the globalist Wall not part of the nation of Israel. Alexander Flake Perdue agenda of the U.N., a policy that he is This couldn’t be further from the Barrasso Gardner Portman now attempting to extend to Israel. truth. It was also an affront to Jews Blunt Graham Risch Here are some of the main problems around the world that the resolution Boozman Grassley Roberts with UNSC Resolution 2334. First, it is was adopted on the eve of Hanukkah. Burr Hatch Rounds an attack on Israeli sovereignty, as it For 8 days, Jews lit candles all over the Capito Heller Rubio Cassidy Hoeven Sasse falsely defines as illegal under inter- world to remember the miracle that Cochran Inhofe Scott national law building activity within happened there, and to commemorate Collins Isakson Sessions Israel’s own borders, which should be Corker Johnson the heroic battle fought by the Mac- Shelby Cornyn Kennedy an internal Israeli issue. The historical cabees that liberated Jerusalem and re- Sullivan Cotton Lankford connection of the Jewish people to the stored their right to worship freely and Thune Crapo Lee land of Israel did not begin in 1967. the rededication of the Temple in Jeru- Cruz McCain Tillis Daines McConnell Toomey Let us not forget that the Six-Day salem. How ironic it is that on the eve Enzi Moran Wicker War was a defensive war fought almost of a celebration liberating Jerusalem Ernst Murkowski Young 50 years ago by the Jewish state and rededicating the Temple in Jeru- Fischer Paul against the Palestinians and their Arab salem, the Obama administration and The PRESIDING OFFICER (Mr. CAS- enablers, who were gathering in a con- the United Nations would declare that SIDY). On this vote, the yeas are 48, the certed effort to wipe Israel off the map. Jerusalem and the Temple are not le- nays are 52. Against all odds, Israel won quickly gitimately part of Israel.

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00023 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.035 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S96 CONGRESSIONAL RECORD — SENATE January 5, 2017 How disgraceful—the United States and the Government of the United to heads of state, to friendships and re- should be not be facilitating the adop- States should not be suggesting such a lationships that we value so much: Lis- tion of a resolution that at its core at- thing. ten to the bipartisan consensus of Con- tempts to distort and rewrite recent Kerry’s speech attempted to lay out gress, and do not go along with the bit- history as well as the historical con- a historic and seismic shift toward the ter, clinging radicalism of the Obama nection of the Jewish people to the delegitimization of our ally Israel. It is administration, attempting to lash out land of Israel that goes back thousands a sign of their radicalism and refusal to and strike out at Israel with their last of years. defend American interests that Obama breath in office. Third, the resolution will also help and Kerry chose to attack the only in- As commendable as these resolutions fuel the Palestinian diplomatic, eco- clusive democracy in the Middle East— are, I believe the Senate and the Con- nomic, and legal warfare campaign a strong, steadfast ally of America— gress need to go further—that we need against Israel, particularly because of while simultaneously turning a blind to take concrete steps so that there its provision that calls on states to eye to the Islamic terrorism that grows will be repercussions and consequences make a distinction in their dealings daily. for the United Nations and the Pal- with Israel between pre-1967 Israel and Unfortunately, President Obama still estinians for their behavior. That is Israel beyond the 1967 lines, encour- has 2 weeks left in his Presidency, and why I am working with my colleague aging boycotts, divestments, and sanc- he may not yet be done betraying Senator LINDSEY GRAHAM on intro- tions against Israel and potentially Israel. ducing legislation, along with other leading to Israelis and Americans being Next week, on Sunday, January 15, Members of this body, designed to cut brought in front of the International France is convening a conference with the funding to the United Nations—de- Criminal Court. 70 other nations designed to serve as an signed to cut U.S. taxpayer funding Palestinian leaders are already prom- extension of the U.N. resolution and going to the U.N.—unless and until ising to use this resolution to push the the Kerry speech—an all-out assault on they repeal this disgraceful anti-Israel International Criminal Court to launch Israel. I am deeply concerned that resolution. a formal investigation against Israel. what is decided at this conference will We know, previously, that one way to That was not an unintended con- be used to try to further impose param- get the U.N.’s attention is to cut off sequence of this action. That was pre- eters or even audaciously to recognize their money. We know from the failure cisely the intent of the United Nations a so-called independent Palestinian of other U.N. organizations to recog- and the Obama administration—to fa- state through another Security Council nize so-called Palestine as a member- resolution. The Security Council is cilitate assaults on the nation of state after American tax dollars were scheduled to meet on January 17—con- Israel. withheld from UNESCO for doing so in veniently, 3 days before Obama and Yet even after this disgraceful United 2011 that the U.N. over and over values Nations resolution, it was clear that Kerry leave office. Let me speak a moment to our its pocketbook over its leftist values. the administration was not yet done, However unintentionally, President friends and allies across the globe. with Secretary of State John Kerry de- When the President of the United Obama’s misguided foreign policy has livering just days later a truly shame- States, when the administration of the led to an unprecedented rapprochement ful speech attacking Israel. His speech, United States attempts to encourage between Israel and America’s Arab al- very much like Kerry’s 2014 remarks you to support their positions in the lies, such as Egypt, Jordan, and the likening Israel to an apartheid state, United Nations, that can be highly per- UAE. We have also seen hopeful signs will only enflame rising anti-Semitism suasive. It has been an arena, a forum of shifting positions at the United Na- in Europe. It will encourage the that Barack Obama has flourished in, tions, as countries such as Brazil, Mex- mullahs, who hate Israel and hate even as he has shown condescension ico, Italy, and Australia have recently America, and it will further facilitate and contempt for the Congress of the signaled that they may no longer vote ‘‘lawfare,’’ the growing assaults on United States and the people of the reflexively in favor of the Palestinians. Israel through transnational legal fora. United States. Great Britain, although it voted for President Obama and John Kerry’s But to our friends and allies, let me the resolution, has recently dem- actions were designed to secure a leg- remind you: The Obama administration onstrated an unprecedented degree of acy, and in that, they have succeeded. is coming to an end on January 20. If support for the Jewish state. History will record and the world will you desire to continue being a friend to These changes represent a significant note that Barack Obama and John America, if you desire a continued opportunity for the United States to Kerry are relentless enemies of Israel. close working relationship with Amer- bolster one of our most important al- Kerry’s speech drew a stunning moral ica, then I call upon our allies: Do not lies, an opportunity we can preserve for equivalence between our great friend join in attacking Israel on January 15 the President-elect by not letting Mr. and ally Israel and the Palestinian Au- in France or on January 17 at the Secu- Obama squander it on the way out the thority, which is currently formed by a rity Council. door. ‘‘unity’’ government with the vicious The new administration—President- America should be leading the charge terrorists of Hamas. Elect Trump—has loudly condemned at the United Nations and around the Secretary Kerry declared the Hamas the U.N. resolution and the Obama ad- world to rally burgeoning support for regime and Gaza ‘‘radical’’ in the same ministration’s complicity in its pas- Israel, not trying to stab the Jewish way that he declared the duly elected sage. state in the back. Government of Israel ‘‘extreme.’’ That I would encourage our friends and al- Just over a week ago, I spoke with moral equivalence is false, and it is a lies not even to attend the January 15 Israeli Prime Minister Netanyahu. I lie. conference, or, if they do choose to at- told the Prime Minister that, despite The IDF, defending the people of tend, to oppose and stand up and speak the disgraceful actions of the United Israel, protecting people, and keeping out against any further attempts to at- Nations, America stands resolutely them safe, is not the same moral equiv- tack or undermine or delegitimize with the nation of Israel, that the alent of terrorists who strap bombs to America or Israel. American people stand with Israel, and their bodies and seek to murder inno- I want to commend my colleagues on that I believe there is a very real possi- cent women and children. both sides of the aisle for offering reso- bility that the extreme and radical ac- Kerry declared the vicious terrorism lutions to repudiate this administra- tions of Obama and Kerry will, in fact, sponsored by Hamas equal to the tion for their actions of the last few backfire. Israeli settlements in the West Bank, weeks. It says something when you see It is not accidental that they waited and he equated Israel’s celebration of Republicans and Democrats in Con- until after the election to do this. They its birth with the Palestinian descrip- gress coming together, united to say: could have tried to do that this sum- tion of this event as the ‘‘disaster.’’ This action by the Obama administra- mer, but Obama and Kerry knew well Unlike Barack Obama and John tion is beyond the pale. that the American people do not sup- Kerry, I do not consider the existence Let me underscore again to our port their attempting to attack Israel. and creation of Israel to be a disaster, friends and allies, to our Ambassadors, So they waited until after the election.

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00024 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.037 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S97 They waited until they were on their CLIMATE CHANGE ocean of all the 50. They reported on way out the door. Mr. WHITEHOUSE. Mr. President, StormTools, a program developed by Kerry, in his speech, said Israel can- this is the 152nd time I have come to Rhode Island’s Coastal Resources Man- not be both democratic and Jewish— the floor for my ‘‘Time to Wake Up’’ agement Council director Grover one or the other, but not both. speech, warning about the perilous ef- Fugate and University of Rhode Island This is an inanity that is deemed pro- fects of climate change. I am going to emeritus professor of ocean engineer- found only in Marxist faculty lounges. continue this in the new Congress, con- ing Malcolm Spaulding. StormTools Israel is Jewish, it is democratic, and tinuing to present the latest and most provides 3D maps of the potential it is and should remain both. I believe compelling scientific evidence of the flooding damage along Rhode Island’s that by revealing just how extreme changes that are coming our way driv- coast. The Journal described the they are, by removing the fake mask of en by carbon pollution. project as ‘‘one of the most sophisti- support for Israel that Obama and Nobody should take my word for it. I cated models developed anywhere to Kerry have chosen to do in the last sev- urge my colleagues to listen to their project future damage from storm eral weeks, it will help to galvanize own home State’s climatologists, their surges and sea level rise.’’ And we are support in this body and across the own home State’s university research- taking the results seriously. world for our friend and ally, the na- ers, their own home State’s public The Journal quoted William tion of Israel. health officials, and their own con- DePasquale, who is the director of Israel is not only our friend and ally, stituents who are out there fighting to planning in one of our cities, Warwick, but it is a partner of the United States. protect their communities from the RI. He said, ‘‘When I saw some of those That alliance benefits the vital na- changes that are already happening scenarios, my jaw hit the ground.’’ tional security interest of America. right before their eyes. That is what we are looking at, and Israel’s military benefits the national In Rhode Island, we have a lot of fish- Warwick is now using those maps to security of the United States of Amer- ermen, just as Louisiana has, Mr. prepare for the future. ica. The Israeli intelligence services President. The president of the Rhode The Providence Journal has also re- benefit the United States of America. Island Commercial Fishermen’s Asso- cently written about Matunuck Beach Israel’s steadfastness against radical ciation is Chris Brown. Just this past in South Kingstown. Town manager Islamic terrorism, which has declared week, he was the subject of a New York Stephen Alfred warns that if the sea war on both Israel and America, bene- Times article. ‘‘Climate change is takes out Matunuck Beach Road, 240 fits the national security interests of going to make it hard on some of those homes will be totally cut off, without a this country. species that are not particularly fond It is Israel—the thriving, one and water supply or access to emergency of warm or warming waters,’’ he told services. only Jewish state—that stands on the the Times. ‘‘We used to come right frontlines for America and, more The article features Kevin Finnegan, here’’—where he was on his boat, The who owns the Ocean Mist, a renowned broadly, Western civilization against Proud Mary—‘‘and catch two, three, the global threats we face. Our com- local establishment. The Journal said: four thousand pounds a day, sometimes The Ocean Mist has occupied the same spot mitment to Israel must be restored and 10.’’ But the whiting, the fish he was strengthened. I look forward to taking under different names since Prohibition after, have moved north to cooler ended in 1933. But the ocean has moved. action with my colleagues—I hope on waters. Where once beach bathers had to plan a trek both sides of the aisle—in the near fu- The Times reports that two-thirds of across sand to reach the water from the ture to repudiate Obama’s shameful at- marine species off the northeast coast Mist, waves now flood the supports holding tack on Israel, to repudiate the United have moved from their traditional up the tavern’s deck. Nations’ efforts to undermine Israel, ranges into deeper and cooler water. Finnegan and the town of North and to reaffirm America’s strong and John Manderson is a biologist at Kingstown are scrambling to build sea- unshakable friendship and support for NOAA’s northeast fisheries science walls. Engineer Bill Ladd, who works the nation of Israel. center, and he told the Times in that for Finnegan and who the Providence I yield the floor. article that public policy needs to keep Journal reports had his first beer at The PRESIDING OFFICER. The Sen- pace with the rapidly changing oceans, the Ocean Mist back when the drinking ator from Wyoming. where species are shifting northward in age was 18, estimates that the two AMENDMENT NO. 1 response to warming 10 times as quick- walls may only buy Matunuck Beach 20 (Purpose: In the nature of a substitute) ly as they do on the land. ‘‘Our ideas of or 30 more years against the oncoming Mr. ENZI. Mr. President, I call up property rights and laws are purely ocean. That is because, as The Inde- amendment No. 1 and ask unanimous land-based,’’ he said, ‘‘but the ocean is pendent—a local newspaper in the consent that it be reported by number. all about flux and turbulence and southern part of Rhode Island—re- The PRESIDING OFFICER. Without movement.’’ ported in December, about 4 feet of objection, the clerk will report the In Rhode Island, fishermen are get- Matunuck Beach is eroding every year. amendment by number. According to Director Fugate of the The legislative clerk read as follows: ting clobbered by that flux. Captain Dave Monti is a member of CRMC, that erosion will more than The Senator from Wyoming [Mr. ENZI], for the Rhode Island Marine Fisheries double by the end of the century. Mr. PAUL, proposes an amendment numbered 1. Council. He wrote in the Providence Rhode Island is not a big State. We (The amendment is printed in the Journal this week: cannot afford to have this much re- claimed by the ocean. RECORD of January 4, 2017, under ‘‘Text I often think about the fish and how im- of Amendments.’’) portant it is to grow them to abundance so The Independent article quotes North The PRESIDING OFFICER. The Sen- there are more fish for all to catch and eat. Kingstown Town Council president . . . In 2017 we need a fish-first agenda, or Kerry McKay, who says that climate ator from Rhode Island. someday there may be no fish left to catch. Mr. WHITEHOUSE. Mr. President, change threatens the property values Climate change, acidification, overfishing by of his community’s coastal homes, with the permission of the chairman, I world nations, and changing federal strate- would like to ask unanimous consent gies could make it the worst of times for fish which is a significant portion of the to speak as in morning business for up in 2017. . . . We need to make an effort to un- town’s revenue base. to 20 minutes. derstand what is happening to the environ- He said historical values ‘‘will have to The PRESIDING OFFICER. Without ment and the fish, and then take that second change’’ as coastal concerns rise, and resi- objection, it is so ordered. step of communicating it to others to affect dents ‘‘have to be more receptive’’ to redoing Mr. ENZI. Mr. President, would the policy. building infrastructure, such as through ele- Senator mind if it comes off of the res- That is what I am being asked. vating houses. olution time? The Providence Journal also recently He also said that homes ‘‘may not be Mr. WHITEHOUSE. I have no objec- wrote about how in Rhode Island the there’’ in 20 years, resulting in a tion to that. sea is moving higher and farther in- ‘‘major revenue loss.’’ The PRESIDING OFFICER. Without land, as it is in Louisiana, which is the Another Providence Journal article objection, it is so ordered. State losing ground fastest to the last week featured Tanner Steeves, a

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00025 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.039 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S98 CONGRESSIONAL RECORD — SENATE January 5, 2017 wildlife biologist with the Rhode Island They had a unified voice on the dan- Gobain is developing innovative tech- Department of Environmental Manage- gers of climate change. nologies to reduce pollution, generate ment, which has to tear up roads and Dr. Hayhoe said Texans are seeing clean energy, and improve air quality parking lots along the Sakonnet River changes all around them. for millions of people. as the seas rise. The Journal writes: We get hit by drought. We get hit by heat. From there, we visited the John As the barrier beach just south of Sapowet We get hit by storms. We get hit by sea level Heinz National Wildlife Refuge, which Point has narrowed—losing nearly 100 feet rise. And we’re starting to see those impacts is the Nation’s first urban wildlife ref- since 1939—the salt marsh on the other side today. . . . Texas is really at the forefront of uge and Pennsylvania’s largest fresh- has become more susceptible to flooding. this problem. water tidal wetland. Lamar Gore, the The Independent made Rhode Island’s Dr. Anderson of Rice agreed that the refuge manager, showed us how the ref- case for climate action in a December Texas climate is already changing. He uge is at risk from the saltwater editorial. They said: said: pushed in by rising sea levels. The ref- The signs are clear, if not immediately Accelerated sea-level rise is real, not a pre- uge is adjacent to the Philadelphia visible to most. diction. Its causes are known—thermal ex- International Airport, along the Dela- There are the well-documented, widely pansion of the oceans and melting of glaciers ware River. publicized shifts with global import, such as and ice sheets—and it is causing unprece- As you can see from these graphics the loss of polar ice and the growing fre- dented change along the Texas coast. reproduced from the New York Times, quency of extreme weather events. Locally, at 5 feet of sea level rise, some of the there are changes in the ecology of Narra- Dr. Dessler from Texas A&M laid out gansett Bay, and locations at which the ef- what he called ‘‘the fundamental and city goes underwater and the refuge is fects of a rising sea level—sometimes subtle, rock-solid aspects of climate science: in real trouble. Water encroaches upon sometimes less so—may be plainly seen. . . . humans are loading the atmosphere the Philadelphia airport. At 12 feet of But we encourage all Rhode Islanders, from with carbon, this is warming the cli- sea level rise, 6 percent of the city—in- coastal communities and beyond, to remain mate, and this future warming is a cluding the refuge, airport, and parts of attuned to the situation—in terms of both huge risk to our society and the envi- downtown Philly—is underwater. Pro- what the sea is telling us and what is being ronment. We should insist that our jections that parts of Philadelphia will proposed to prepare for coming changes. The one day be uninhabitable due to sea stakes are enormously high, and the broad- elected representatives rely on this sound science when formulating pol- level rise are one of the major drivers est possible effort is required to meet the for forward-looking climate mitigation challenge. icy.’’ I returned to Austin in November to and adaptation policies of Philadel- That is the message to me from phia’s Office of Sustainability. Senator Rhode Island. That is why I give these speak to the Association of Public and Land-grant Universities. President CASEY and I met with them too. speeches. Being in Pennsylvania gave me a David Dooley of the University of As I continue to push for honest de- chance to connect with Dr. Robert bate on this issue in Congress, I also Rhode Island had invited me to join a Brulle of Drexel University. He is the tour around the country to see folks on panel that he moderated with, among scholar who documented the intricate the ground in other States. I have now others, Dr. John Nielsen-Gammon, propaganda web of fossil fuel industry- been to 15 States. In the closing Texas State climatologist and pro- funded climate denial, connecting over months of 2016, I hit Texas and Penn- fessor at Texas A&M University. 100 organizations, from trade associa- sylvania. The bottom line was simple: Climate tions, to conservative think tanks, to In Texas, I joined Representative El- change is real, and the scientists at our plain old phony front groups. The pur- liott Naishtat, the advocacy group universities will be increasingly forced pose of this climate denial apparatus Public Citizen Texas, and Texas envi- to defend good science, academic free- is, to quote Dr. Brulle, ‘‘a deliberate ronmental advocates at a public event dom, and climate action. University and organized effort to misdirect the in Austin to call out Congressman leadership will have to defend their sci- public discussion and distort the LAMAR SMITH, Republican chairman of entists against the onslaught of FOIA public’s understanding of climate.’’ the House Science, Space, and Tech- requests and personal attacks that are I will wrap up with a special thank- nology Committee, for his abuse of the modus operandi for climate deniers you to one of the folks who helped or- congressional power to harass public and against the phony science fronts ganize my Texas trip: Tom Smith, who officials and climate scientists, includ- propped up by the fossil fuel industry has been director of Public Citizen of ing subpoenas demanding that States to spread calculated misinformation. Texas for more than 30 years. Known attorneys general divulge their inves- The American scientific community by his friends and colleagues as Smitty tigative materials relating to their in- faces a real threat from that operation. and known for his signature straw hat, quiries into ExxonMobil’s potentially On to Pennsylvania, I had the oppor- over his career he has testified more fraudulent climate misinformation. tunity to spend a day traveling with than 1,000 times before the Texas Leg- The committee is also harassing the my friend and colleague BOB CASEY islature and Congress—Mr. Uphill Union of Concerned Scientists, 350.org, around southeastern Pennsylvania get- Struggle indeed. He was successful, Greenpeace, and various university sci- ting a firsthand look at the effects of though, and central in creating the entists because they are exposing climate change and hearing about the Texas Emissions Reduction Program, Exxon for years of misleading the pub- work Pennsylvanians are doing to ad- which led to wide-scale deployment of lic on its understanding of climate dress it. At the University of Penn- solar and wind across Texas. A true en- change. Texans are taking notice. The sylvania’s Morris Arboretum, leaders vironmental champion, Smitty retires San Antonio Express-News, which had from Children’s Hospital of Philadel- this year. previously always endorsed Congress- phia’s Community Asthma Prevention I ask unanimous consent to have printed in the RECORD a recent tribute man SMITH for reelection, decided not Program, Moms Clean Air Force, Phy- to endorse him in this latest election sicians for Social Responsibility, and from the Texas Tribune entitled: cycle. The paper cited his ‘‘bullying on other groups talked about kids with ‘‘Analysis: ‘Smitty,’ a Texas Lobbyist for the Small Fry, Retiring after 31 the issue of climate change’’ as behav- asthma and other conditions that wors- en when temperatures and pollution years.’’ ior that ‘‘should concern all Ameri- There being no objection, the mate- levels are high. cans.’’ rial was ordered to be printed in the I joined a panel discussion with lead- In Malvern, we toured the LEED RECORD, as follows: ing scientists from Texas universities platinum North American head- to discuss their research into climate quarters of Saint-Gobain, the world’s [From the Texas Tribune, Sept. 21, 2016] change in Texas. The panel included largest building materials company. ANALYSIS: ‘‘SMITTY,’’ A TEXAS LOBBYIST FOR THE SMALL FRY, RETIRING AFTER 31 YEARS Dr. John Anderson from Rice Univer- The company is demonstrating that (By Ross Ramsey) sity, Dr. Andrew Dessler from Texas green building materials and tech- Tom ‘‘Smitty’’ Smith, a colorful lobbyist A&M University, Drs. Charles Jackson nologies can be married with stylish and liberal activist who turned Public Cit- and Kerry Cook from the University of design to produce stunning results. izen Texas into a strong voice on environ- Texas at Austin, and Dr. Katherine With operations in Rhode Island, Penn- mental, utility, consumer and ethics issues, Hayhoe from Texas Tech University. sylvania, and around the globe, Saint- is hanging up his spurs after 31 years.

VerDate Sep 11 2014 01:00 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00026 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.041 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S99 In the early 90s—the heyday of consumer The ethics reforms of 1991 included cre- able and in the best interest of our rights legislation and regulation in Texas— ation of the Texas Ethics Commission and a country. Given this, this is a day in Robert Cullick, then a reporter at the Hous- number of significant regulations on the be- which I rise with painful disappoint- ton Chronicle, gave Tom ‘‘Smitty’’ Smith of havior of the Texans contending for and ment. Frankly, I feel a deep sense of Public Citizen Texas an unofficial title: holding state office. There is always more, of Everybody’s Third Paragraph. course. Smith had a list of 13 reforms that astonishment and even a sense of cri- Smith, 66, announced his retirement Tues- year, and eight made it into law. Some of the sis. Thus, I feel a deepened determina- day from his official post after 31 years, end- remaining items remain undone 25 years tion to fight with everything I have ing a long run of organizing and lobbying on later. against the efforts of my Republican behalf of consumers and citizens on a range ‘‘All the time I’ve been working here, colleagues that I believe will harm our of issues like utilities, insurance and polit- Texas politics has been largely controlled by country as a whole but particularly the ical ethics. He was often the voice of the op- organized businesses pooling their money to- most vulnerable people in our country. position in legislative fights and in the gether and making significant contributions This is about the Republican push, media, which earned him that reporter’s epi- to key legislators,’’ Smith says. ‘‘Legislators thet. are more concerned about injuring their do- really the race—what I believe is a He’s from that part of the Austin lobby nors than they are about injuring their con- reckless race—to repeal the Affordable that doesn’t wear fancy suits, doesn’t drive stituents.’’ Care Act without putting forth any the latest luxury cars and doesn’t spend its He illustrates that with stories, like one legislation, any proposal, any plan on time fawning over and feeding elected offi- about a legislator asking, during a House de- how they intend to replace it. This is cials. Smitty has a beard, an omnipresent bate, if his colleagues knew the difference fundamentally dangerous, and it will straw hat and, often, a colorful sheaf of fly- between a campaign contribution and a hurt millions of Americans. I have ers making his points on whatever cause he’s bribe. ‘‘You have to report the campaign pushing at the time. contribution.’’ And another, when a mem- heard over the past month people Smitty has been a leading voice for govern- ber—former state Rep. Eddie Cavazos, D-Cor- rightfully saying: Well, this is how the ment intervention and regulation of big in- pus Christi, who went on to become a lob- Affordable Care Act was implemented. dustries and interests in the capital of a byist—was making a plea for cutting the in- I understand the frustrations that state with conservative, business-friendly fluence of big donors. Cavazos recalls telling have resulted from that, and people politicians from both parties who pride a story about getting simultaneous calls think this was jammed through along themselves on light regulation, low taxes from a big donor and from someone who partisan lines many years ago using and a Wild West approach to money in poli- wasn’t a political friend. He says he told his similar legislative tactics. The truth tics. colleagues, ‘‘You know which one you’re is, that is simply not the case. The Af- For the most part, Smith seems to have going to answer first.’’ disagreed strongly, vociferously, but ‘‘I’m sorry to see Smitty go,’’ Cavazos said fordable Care Act went through a long agreeably. He doesn’t wear his wins or his Tuesday. ‘‘He provided a large voice in the and arduous process and received input losses on his sleeve. Legislature that was needed—a balancing from doctors, nurses, patient groups, ‘‘The thing that I learned time after time, voice. He’s a good guy.’’ medical specialists, medical profes- story after story, is that people standing up Mr. WHITEHOUSE. Mr. President, in sionals of all types. does make a difference,’’ Smith says. ‘‘It the article, he is quoted as saying: The Affordable Care Act started with does change policy.’’ listening sessions, then hearings, then ‘‘Citizen activism does matter, and it’s the ‘‘The thing that I learned time after only known antidote to organized political time, story after story, is that people came the advice and counsel of policy corruption and political money,’’ he says. standing up does make a difference. It experts, businesses, market experts, in- His causes over the years have included does change policy.’’ surance companies, health nonprofits, food security, decommissioning costs of the Good words to end the speech by. hospitals—literally thousands and nuclear reactors owned by various Texas Thank you, Smitty. thousands of people over thousands of utilities, insurance regulations, ethics and Mr. President, I ask unanimous con- hours, often through public discourse, campaign finance laws. He’s lobbied on envi- putting forth ideas that actually ronmental issues and product safety. sent that the time during quorum calls He counts the ethics reforms of 1991 as one be charged equally to both sides. shaped and changed legislation. I of his big wins. As unregulated as Texas po- The PRESIDING OFFICER. Without wasn’t in the body then. I was a mayor litical ethics and campaign finance might objection, it is so ordered. in Newark, NJ, but I know this occu- seem today, things were a lot looser before Mr. WHITEHOUSE. Mr. President, I pied months of debate. reformers used a flurry of scandals and at- suggest the absence of a quorum. Years later, Republicans are seeking tendant media coverage to force changes. The PRESIDING OFFICER. The to undo this work with a kind of plan Smith is proud of a medical bill of rights clerk will call the roll. to move forward. They are saying that that gave consumers some leverage with The legislative clerk proceeded to they have a plan, but no plan exists. their doctors and their health insurers. Public Citizen was a key player in the cre- call the roll. I am a big believer that there are ation of the State Office of Administrative Mr. BOOKER. Mr. President, I ask things we can and we must do to im- Hearings, which took administrative courts unanimous consent that the order for prove health care in America, to im- out of several regulatory agencies and put the quorum call be rescinded. prove the Affordable Care Act, but them in a central office, farther from the The PRESIDING OFFICER. Without what I have to make clear is that it is reach of regulated industries and elected of- objection, it is so ordered. profoundly irresponsible to repeal the ficials. Smith now points to the Texas Rail- Mr. BOOKER. Mr. President, I am Affordable Care Act and not put any- road Commission, which still has its own ad- really proud to stand here, having rep- thing in place. There is no plan. ministrative hearings, as an example of a resented New Jersey now a little bit This is at a time that everyone too-close relationship between regulators, the companies they regulate and the judges over 3 years in the U.S. Senate. I have agrees—people in the Republican Party supposed to referee their differences. to say that I have developed a great re- and Democratic Party continue to talk He was an early and noisy advocate for re- spect for my colleagues on both sides of about the achievements of the Afford- newable energy, urging regulators and law- the aisle. I have a deep belief that this able Care Act, things that they want to makers to promote wind and solar genera- is a body that can do good things for maintain, things they believe make a tion—and transmission lines to carry their the American people. We don’t always real difference. Those are things I have power—as an alternative to coal plants and agree, and too many things are not get- heard Republicans praise and even say other generating sources. That looks easier from a 2016 vantage point than it did in 1989, ting done, but I have seen this body at again they want to protect. These when an appointed utilities regulator derided its best. I have seen our ability to rise things are making a lifesaving dif- alternative energy in an open meeting by to the occasion. Along the way, I have ference for millions of Americans. saying that he hadn’t smoked enough dope made friendships and found respect for Let’s be clear. The overwhelming ma- to move the state in that direction. people and my colleagues across the jority of Americans believe that we That regulator is gone now, and Texas aisle, as well as fellow Democrats. should not give the power back to in- leads the nation in wind energy. Chalk one I have witnessed occasions where surance companies to deny people up for the environmental advocates. Members of both parties have put prin- health insurance because of a pre- Smitty is leaving with unfulfilled wishes. He’d like to have made more progress on ciple before partisanship and evidenced existing condition. Let’s be clear. Most Texas emissions and climate change, on a willingness to actually embrace per- people believe that we should allow campaign finance reforms and conflict-of-in- sonal political risk to stand up for young people, young adults to stay on terest laws. what they believe is right and honor- their parents’ plans up to the age of 26.

VerDate Sep 11 2014 02:38 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00027 Fmt 0624 Sfmt 0634 E:\CR\FM\A05JA6.004 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S100 CONGRESSIONAL RECORD — SENATE January 5, 2017 We also believe that requiring health If you do not do that, you will be re- Republicans are doing is reckless, and plans cover preventive services is a sponsible for pain, suffering, chaotic the consequences are dire. profoundly important thing to do for markets, and for many Americans’ Take the American Medical Associa- individuals in this country, but it actu- health care problems. There are many tion, the preeminent association of ally saves Americans money by push- people who don’t understand this. They physicians. Mind you, this is an organi- ing people to do preventive care—mam- listen to the political rhetoric, and zation that opposed the enactment of mograms, birth control, and mental they think: Hey, you might be that one the Affordable Care Act. They have health care—without cost sharing. who, if you are wealthy enough or se- urged—this chorus of doctors has urged These are logical things that the ma- cure enough, if you are a Member of that ‘‘before any action is taken, pol- jority of Americans believe in, such as this body, in fact, this concept of re- icymakers should lay out for the Amer- closing the prescription drug coverage pealing and maybe figuring out a re- ican people, in reasonable detail, what gap, which too many seniors on Medi- placement down the road might sound will replace current policies. Patients care and people with disabilities have good. But if you are one illness away and other stakeholders should be able had to face, known as that doughnut from bankruptcy, if you know and re- to clearly compare current policy to hole. We believe in prohibiting insur- member the challenges of having a new proposals so they can make in- ance companies from charging women child with a preexisting condition, if formed decisions.’’ more money simply because of their you know that one injury, one unex- The American Medical Association gender. The overwhelming majority of pected fall could place your family in isn’t a political organization. They are Americans believe in requiring the in- peril but for the insurance you have, if thoughtful people whose fundamental surance companies to spend more on you are one of the 20 million Ameri- concern is the doctors in this Nation patient care and less on administrative cans who used to be uninsured and now and the health care of the people. An- costs, and the insurance companies you have insurance, you know how per- other respected organization rep- shouldn’t be allowed to gouge the ilous this moment is. You know that resenting American hospitals made it American people while making massive you can’t afford the recklessness of any clear. The American Hospital Associa- profits at the same time. politician—a Republican move that tion warned that Republican action of There is so much that people believe equates to jumping off a cliff and then repealing without a plan would result in and want to have preserved, and packing your parachute on the way in an ‘‘unprecedented health care cri- these are tremendous things for Amer- down. sis.’’ ica. There are bank account savings; Repealing without replacing is sim- Are Republicans listening to doctors there are lifesaving policies, all of ply irresponsible, it is dangerous, and and hospitals or are they rushing forth, which are popular with Democrats, Re- it is threatening to our country’s well- willing to risk a crisis for our country, publicans, and Independents. They are being. People—families, children, the and for what? They are a President for popular with people on both sides of elderly—will suffer. 4 years, a Congress for 2. What is the the aisle in this body. This is a moment where we need Re- rush to put forth a plan and just re- Some Republicans have said that publican leaders to tell the truth and peal? Will they listen to these experts? what they are doing will not threaten say: We want to improve our health What about the president of America’s these accomplishments, but this care system. We may not believe in leading cancer group, the American couldn’t be any further from the truth. ObamaCare, but we can’t tear it down Cancer Society? Will they listen to The way they are going about this puts unless we do the responsible thing and them? They urge Congress to ‘‘consider the health care system in a perilous po- put forth a replacement. the future of the Affordable Care Act. sition. The health care system is com- Right now, what we have is political It is critically important that cancer plicated in nuance, and to think you rhetoric that is not just rhetoric. It is patients, survivors and those at risk of can repeal something without replac- perilous. It is dangerous. It is threat- the disease don’t face any gap in cov- ing it right away shows a lack of un- ening to our Nation. This will inflict erage of prevention or treatment. . . . derstanding of what is going to happen immediate catastrophe upon families, Delaying enactment of a replacement and what the consequences will be. causing millions to lose their health for 2 or 3 years could lead to the col- What the Republicans are doing now insurance, and it will unleash chaos lapse of the individual health market is quite contrary to what the Demo- with market uncertainty and cost with long-term consequences.’’ crats did before the ACA passed in 2010. spikes. This organization is respected by Republicans are not putting forth a There is no defense for what is being people on both sides of the aisle and is proposal. They are not speaking to the done. I don’t understand it. There is no not playing partisan games. They are health care needs of all Americans. logic here whatsoever. Elections were calling out the truth; that it is a reck- They are not inviting professionals won. You now have the floor and the less Republican move to repeal without from all different backgrounds to help ability to put forth your great vision replacing. Will Republicans listen to shape a plan for America. They are not for health care in America, but doing it the American Diabetes Association? even fulfilling what I heard countless backward and repealing something and Folks with diabetes are Independents, Republicans on the campaign trail, in- not offering up a plan is truly putting Republicans, and Democrats, and this cluding our President-elect, say: They politics before people. This is a move of is an organization respected by people would repeal and then replace. They grand political theater that comes with on both sides of the aisle. They say: are just not replacing. profound public consequences affecting The Association strongly opposes going The replace part put forth by the millions. back to a time when . . . treatment for pre- mantra of many Republicans has not As a Democratic Senator, some peo- existing conditions like diabetes could be ex- materialized. It doesn’t exist. There is ple will say that this is just political cluded from coverage; when people could find no plan to replace, no statement of rhetoric, but these are not just par- their insurance coverage was no longer avail- principles, no outline of features, no tisan words. This is the truth and don’t able just when they needed it most. framework for a plan, no explanation take my word for it. Look at the words What is the Republican plan to ad- of how they would pay for the things of other more thoughtful—other very dress these concerns and to pay for they claim they like. There is no spe- thoughtful people, Democrats and Re- these concerns? Will they listen to pri- cific timeline for when a plan might publicans, businesspeople and nonprofit vate businesspeople? They, too, join in materialize or even any substantive leaders, conservative think tanks and the chorus of Americans urging that hint of what many Republican col- nonpartisan groups, speaking with a Republicans not endanger the lives and leagues plan on doing to address the chorus to the point I am making. Ex- livelihoods of millions. crisis—the crisis that will surely come perts across sectors, across industries, The Main Street Alliance. We all as a result of repealing the Affordable and across the country are taking a have main streets in our States and Care Act without giving forth any re- hard look at what a repeal will mean our communities. A group representing placement. for the American people without a re- these small businesses from across the I say time and again: Show us the placement. People from all across sec- country urges lawmakers to consider plan before you repeal this legislation. tors of our country are saying what the the devastating effect a repeal without

VerDate Sep 11 2014 02:38 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00028 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.045 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S101 replace would have on small busi- miners, people recovering from drug The senior assistant legislative clerk nesses: addiction, the poor and other under- proceeded to call the roll. Small business owners depend on healthy served communities. Mrs. FISCHER. Madam President, I and vibrant communities to keep us profit- We are America, and this is a time ask unanimous consent that the order able in the engines of economic growth. . . . that we must call, not to party rhet- for the quorum call be rescinded. Changes to our current health care system oric but to who we are and what we The PRESIDING OFFICER (Mrs. are needed, but not in the form of cuts to stand for. We cannot let this repeal ERNST). Without objection, it is so or- critical programs or through taking away without replacement happen. We must dered. our health coverage. know what the Republican plan is so TRIBUTE TO STEPHEN HIGGINS There are some Senators who are experts, market analysts, insurance Mrs. FISCHER. Madam President, I speaking out. It is not the entire Re- folks, doctors, everyone understands rise today to offer my warmest wishes publican caucus. There are some who what will happen. Americans will be to my legislative director, Stephen are saying exactly what I am saying. hurt. It is time to put our country and Higgins, as he begins the next chapter Yet we are still rushing toward a vote, the people first. There is no rush. The of his truly remarkable professional even with Republican Senators having voters gave this body 2 years. It gave career. It is a career that is character- the courage to stand up. Just yesterday the Presidency 4 years. We must now ized by unshakable dedication to the Republican Senator RAND PAUL of Ken- fight these efforts. We must resist. We common good and supreme attention tucky, before voting to proceed to this must call to the conscience of neigh- to detail. These qualities make Ste- measure, said: ‘‘It is imperative that bors and appeal to the moral compasses phen Higgins a true professional. His Republicans do a replacement simulta- of our Republican leaders to do what service is a labor of love for our coun- neous to a repeal.’’ I respect my Repub- they said they would do—put forth try and this institution in particular. lican colleague for saying what is com- your plan. Let the American people Stephen has worked in the Senate mon sense and speaking up against the know what they are going to do and do longer than all but nine of its current reckless actions being taken by the Re- not thrust millions of your fellow Members, serving this Chamber for 23 publican Party as a whole, and some country men and women off a cliff and years. Stephen still remembers his first fellow Republican Senators have joined shout promises to them as they fall: day on payroll: March 21, 1994. He him in similar statements, including ‘‘Hey, don’t worry. We will figure began with Senator William Cohen of LAMAR ALEXANDER, the chair of the something out before you hit the Maine as a counsel on the Juvenile Health, Education, Labor, and Pen- ground.’’ Where is the honor in that Justice Subcommittee of the Judiciary sions Committee. The Republican from strategy? Call the public together, Committee. There he began what would Tennessee, who noted in an interview gather your experts, put forth a become a decades-long mission: to ad- in November 2016 that when it comes to thoughtful process, and develop what vance crime victims’ rights. the ACA, ‘‘what we need to focus on you think is better, what improves A year later, Stephen joined the of- first’’—Senator ALEXANDER said—‘‘is upon what we have now, what doesn’t fice of Senator Jon Kyl of Arizona, what would we replace it with and diminish our unassailable gains that where he would distinguish himself as what are the steps that it would take we have had but build upon them. Give a committed, talented lawyer over the to do that?’’ us a plan, not empty promises. Give next 18 years, serving as chief counsel Republican Senator SUSAN COLLINS of America hope. Don’t plunge millions in Senator Kyl’s personal office and for Maine shared in an interview last into despair and uncertainty. Show de- 14 years as chief counsel on his Judici- month that she was ‘‘concerned about cency, not costly craven politics. We ary Committee staff. During that time, the speed in which this is occurring’’ know who we are as a country. Pro- Stephen played the lead role, sup- and expressed concern over what would found are the words, ‘‘We hold these porting efforts to pass a bipartisan happen to her constituents in Maine truths to be self-evident, that all men crime victims’ rights constitutional who had signed up for insurance are created equal, that they are en- amendment. The end result: After 8 through the ACA, saying: ‘‘You just dowed by their Creator with certain years of hard work, a landmark statute can’t drop insurance for 84,000 people in unalienable Rights, that among these was passed by a vote of 96 to 1. This is my State.’’ are Life, Liberty and the pursuit of one of Stephen’s proudest accomplish- I not only talk about Republicans in Happiness.—That to secure these ments. ‘‘We did something significant this body, but there are conservative rights, Governments are instituted to help crime victims,’’ he said. ‘‘We think tanks focused on our country among Men. . . . ‘’ enshrined into law the rights of crime that are speaking out now as well. The This government, this body, the victims to be informed, present, and American Enterprise Institute said in a United States Senate, led by Repub- heard.’’ To put it simply, Stephen Higgins 2015 report that ‘‘repealing the law licans here and in the House and in the helped humanize America’s criminal without a plausible plan for replacing White House, must stand for these ideals. Health care is critical to life. justice system. This work reflects his it would be a mistake.’’ sincere beliefs about that system. ‘‘The So here we have it from all over the We must stand for these ideals. Health care is critical to liberty, our freedom criminal justice system is about seek- country, people across the political from fear, our freedom from illness, our ing the truth,’’ he said. ‘‘The truth spectrum, experts, market analysts, in- freedom from deprivation. We must matters.’’ surance executives, doctors, nurses, stand for these principles. Health care For Stephen Higgins, the truth has hospital leaders, patient groups; these is critical to the happiness, the joy, the always mattered. He is a man of high people in our country who are beyond greatness of America. To secure these character and great personal integrity. politics and even beyond their opinions rights, governments are instituted, and These attributes made him exception- of the Affordable Care Act when it was we were elected to stand for the Amer- ally well-suited for work in another enacted are now speaking in a chorus ican people, by the American people, to critical realm of the Senate: judicial of conviction in one voice: Don’t repeal fight to defend our brothers and sis- nominations. ‘‘Judges hold people’s the Affordable Care Act without a clear ters. This government and actors must lives in their hands,’’ Stephen said. plan to preserve the things that are put our ideals first, not partisanship ‘‘Their decisions have life-altering con- making America healthier and more fi- and not theater. Do not attack these sequences.’’ nancially strong and secure. Don’t ideals through a rash and reckless re- Most recently, Stephen played a key recklessly rush into a politically moti- peal. Be thoughtful. Be kind. Be mag- role in the nomination of Omaha attor- vated move that would endanger the nanimous. The well-being of our Nation ney Bob Rossiter to serve as U.S. dis- health care of millions of Americans, is in the balance. trict court judge for the District of Ne- increase the costs for millions of Amer- May God bless us in this time of cri- braska, and last year, the Senate con- icans, throw insurance markets into sis. May wisdom prevail over politics. firmed Judge Rossiter unanimously. chaos, endanger our hospitals’ finan- Mr. President, I yield the floor. This was a beautiful capstone to Ste- cial stability, and put our most vulner- I suggest the absence of a quorum. phen’s Senate career. able Americans into crisis: our seniors, The PRESIDING OFFICER. The He leaves the Senate now for a new people in nursing homes, retired coal clerk will call the roll. position: managing director of the

VerDate Sep 11 2014 02:38 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00029 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.046 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S102 CONGRESSIONAL RECORD — SENATE January 5, 2017 Human Ecology Institute at the Catho- dent’s decision to turn Bears Ears into care of their ancestral land—protecting lic University of America. This is an a national monument. and preserving it for the next genera- interdisciplinary research institute The document says: tion—isn’t optional, it is a sacred duty. that will apply the rich intellectual The creation of the Bears Ears National It is part of their faith. It is part of tradition of the Catholic Church to Monument in Utah [. . .] follow[s] years of who they are. contemporary problems in our society. robust public input from tribes, local elected The same is true in many respects in As Stephen said, ‘‘I love the Senate. officials, and diverse stakeholders, and draws my own faith. As a member of the from legislation introduced in Congress. In The only institution I love more is the addition to protecting more land and water Church of Jesus Christ of Latter-day Catholic Church.’’ Sounds like a match than any administration in history— Saints, I share many of these views. made in Heaven. As he takes his new And here is the kicker— My church teaches that the Earth is a divine creation that belongs to God. post, I know Stephen will work like it President Obama has taken unprecedented all depends upon him and pray like it steps to elevate the voices of Native peoples This means that human beings have a all depends upon God. in the management of our national re- spiritual responsibility—an obligation I thank Stephen’s wife of 18 years, sources. to God—to be wise stewards over the Lauren, and their two children, James ‘‘Unprecedented steps to elevate the Earth, to conserve it for our children and Elizabeth, for loaning him to us voices of Native peoples.’’ Nothing and our grandchildren. here in the Senate, because it is a sac- could be further from the truth in this The Navajo people of San Juan Coun- rifice. I know they are proud of you, situation. Perhaps if we replace the ty have always faithfully fulfilled their Stephen, as are your parents, Joe and word ‘‘elevate’’ with the word ‘‘ex- responsibility in the Bears Ears region, Shelley, and your brother, David. ploit,’’ that sentence might apply to and so have the Utes who reside in the So, Stephen, thank you so much for the situation in Bears Ears. area. Caring for their homelands—and all you have done for my office, for the Now, there is no denying that many respecting it as their forefathers did— Senate, and for the people of this coun- Native American people supported is the cultural lifeblood of the Native try. Good luck. God bless. President Obama’s designation of the American people of Southeastern Utah. Madam President, I yield the floor. Bears Ears National Monument. But Take away their access to their land— The PRESIDING OFFICER. If no one the inconvenient truth too often ig- restrict their stewardship over the yields time, the time will be divided nored by the Obama administration Earth’s bounty for the sake of increas- equally. and its supporters is that virtually all ing the access of wealthy urbanites The Senator from Utah. of this tribal support came from Native who use the outdoors for their own pur- BEARS EARS NATIONAL MONUMENT Americans residing outside of Utah, poses—and it won’t be long before their Mr. LEE. Madam President, on Janu- not inside Utah, and certainly not culture begins to fade away. ary 20 of this year, change is coming to within San Juan County where this 1.35 The people of San Juan County un- the White House. But until that day, it million-acre designation occurred. derstand this. They have seen their appears that President Obama will des- In fact, the most prominent Native worst nightmares become reality in perately cling to the status quo and American group that advocated for a other Utah counties as a result of Pres- continue to do what he has done on far national monument in Utah is actually idential national monument designa- too many occasions: abuse his Execu- an alliance called the Bears Ears Inter- tions. That is why on December 29, the tive powers to put in place unpopular Tribal Coalition, which is made up of day after President Obama announced policies without the cooperation of several tribes, and most of its members the Bears Ears monument, a crowd of Congress and then pretend as if every- reside outside of the State of Utah. Utahns assembled to hold a protest on one somehow supports him. Yet, national monument advocates the steps of the San Juan County The most recent case in point in- routinely invoke the Inter-Tribal Coa- Courthouse. volves President Obama’s recent deci- lition as the authoritative mouthpiece Braving the frigid weather of that sion to designate as a new national of all Native Americans in the South- day, they gathered together to dem- monument some 1.35 million acres of western United States. onstrate that they—the individuals and public land in San Juan County, UT— So how did a coalition of Native the families who will be most directly the poorest county in the State of American tribes from Colorado, Ari- affected by a Bears Ears national Utah, nearly the size of Delaware. This zona, and New Mexico rise to such a po- monument—believe that the President is a small county that is tucked into sition of prominence in a debate over a has no business seizing vast stretches the southeast corner of our State. It national monument in a remote corner of land to be micromanaged and mis- includes—and the national monument of Utah? Well, part of the answer can managed by distant Federal land agen- is named after—the region’s distinctive be found in the cozy relationships be- cies. Bears Ears buttes, which mark the an- tween well-funded environmental advo- But the protesters weren’t just cestral homeland and sacred site of cacy groups, powerful outdoor retail angry. They were resolute, confident many members of the Navajo and Ute companies, and tribal organizations. about the future, and determined to Tribes who live in San Juan County, Recent investigative reporting by the keep fighting for their right to partici- UT. Deseret News shows how radical pate in the management of the land in President Obama announced the wealthy environmental organizations, their community—the land that most Bears Ears National Monument on De- supported by the outdoor recreational directly affects them. cember 28, right between Christmas industry, channeled millions of dollars Of course, environmentalists and na- and New Year’s Eve, as most Ameri- to the Bears Ears Inter-Tribal Coali- tional monument advocates want the cans were busy enjoying the holiday tion only after they realized that people of San Juan County to believe season and when he was still enjoying ‘‘hitching [their] success’’ to the Nav- that this fight is simply over, that time with his family in Hawaii. That ajo Nation was the only way they could they have lost, that there is nothing same day, his administration released achieve their longstanding goal of cre- they can do about something that af- an explanatory document that was offi- ating a national monument in South- fects them in a very real, very per- cially christened a ‘‘Fact Sheet.’’ It eastern Utah. sonal, very intimate way. In their was christened that way by the White The ability of uber-rich environ- view, President Obama’s proclamation House officials who wrote it. But, in re- mentalists to essentially buy a na- of the Bears Ears National Monument ality, it reads much more like an tional monument in Bears Ears ex- is permanent. It is irreversible, as if it elaborate book of fiction. plains why the people of San Juan were carved into stone. As one White Of all the falsehoods peddled in this County—including the Navajo resi- House official recently told the Wash- bogus fact sheet, the most egregious— dents, whose lives and livelihoods are ington Post: ‘‘We do not see that the and, in many ways, the most insult- intricately linked to the Bears Ears Trump administration has authority to ing—is the claim that the residents in Utes—stand united in opposition to a undo this.’’ San Juan County, including local mem- monument designation. But they say this only because they bers of the Navajo Nation and members For the people of the Navajo Nation are not looking hard enough. The truth of the Ute Tribe, supported the Presi- who live in San Juan County, taking is what can be done through unilateral

VerDate Sep 11 2014 05:20 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00030 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.047 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S103 Executive action can also be undone The PRESIDING OFFICER. The Sen- and Americans are just now waking up the same way. Such is the imperma- ator is recognized. to learn about the bait-and-switch nence of Executive power in our con- Mr. VAN HOLLEN. Mr. President, scheme that has been perpetrated on stitutional republic, where major pol- this is the first time I have risen to them. For more than 6 years, Repub- icy changes require broad consensus, speak on this Senate floor. I want to licans in this Senate and in the House forged through legislative compromise, start by thanking my fellow Maryland- of Representatives have said repeatedly to endure the test of time. ers for the honor of representing them that they would repeal ObamaCare but In a recent Wall Street Journal arti- in this great United States Senate. I replace it—replace it with something, cle, two prominent constitutional want to thank my colleague Mr. they said, that will be much better. scholars, Todd Gaziano and John Yoo, CARDIN, the senior Senator from Mary- Now we know, as the clock ticks down, explain this point as it relates specifi- land, for joining us. I thank the new that has been a farce. There is no Re- cally to President Obama’s use of the Senator from California, Ms. HARRIS, publican replacement bill to provide Antiquities Act to designate the Bears for joining us as well. I want to say to the kind of coverage and benefits of the Ears National Monument. The Antiq- my fellow Marylanders that I look for- Affordable Care Act, and the con- uities Act of 1906, as they explain, does ward to working every day for their sequences of that failure are going to not create an irreversible monument. benefit and for the benefit of our Na- be devastating for the country. When a President uses it, its use is not tion. I want to say to my new col- Let us take a moment to look at the necessarily indelible. leagues in the Senate—Republicans and human toll. First, there are the 22 mil- Gaziano and Yoo write: Democrats alike—I look forward to lion Americans who previously had no After studying the President’s legal au- working with all of you in the years to health insurance before the Affordable thority [under the Antiquities Act], we con- come for the good of our Nation. Care Act but are now covered through clude that he can rescind monument designa- I understand it is somewhat unusual the health care exchanges and through tions [. . .] the law’s text and original pur- for a new Member to speak so soon on expanded Medicaid. These are people poses strongly support a president’s ability the Senate floor, but what we are wit- who have been denied access to cov- to unilaterally correct his predecessor’s abuses. nessing today in the Senate is not busi- erage because they had preexisting In other words, starting on January ness as usual, and these are not ordi- conditions or their kids had preexisting 20, President-Elect Trump can use his nary times. Having served as the lead conditions—whether it was asthma, di- Executive powers to rescind President Democrat on the House Budget Com- abetes, heart conditions—so they were Obama’s designation of the Bears Ears mittee, I know that never before has either outright denied by insurance National Monument. I have asked the the Senate rushed out of the gate so companies or priced out of the market. future Trump administration to do pre- quickly to enact a budget procedure to That 22 million may be a big number, cisely that. deny the minority party—and by ex- hard to comprehend, but behind that I have also recently cosponsored Sen- tension, hundreds of millions of Ameri- number are many families like Carlos ator MURKOWSKI’s bill, the Improved cans—their rights in this United States and Isabelle Martins, who live not far National Monument Designation Proc- Senate. Yet here we are, speeding to from where I live in Silver Spring, MD. ess Act, which would require all future use the budget process to fast-track a They could no longer afford health in- Presidents to obtain congressional and so-called reconciliation bill that will surance through their employer. Short- State approval prior to designating a destroy the Affordable Care Act and, in ly before the Affordable Care Act was national monument. I have done these doing so, wipe out access to affordable enacted, Carlos was told he needed a things, and I will do more, because I care for over 30 million Americans and liver transplant to survive. His wife believe the preponderance of evidence create total chaos throughout the Isabelle said that without the Afford- proves that President Obama abused American health care system. That is able Care Act, he would never have re- his powers—the powers granted to him reckless. It is irresponsible, and it vio- ceived that lifesaving treatment. There is the case of Diane Bongiorni, under the Antiquities Act—in desig- lates the traditions of this institution. who now lives in Hyattsville, MD. She nating the Bears Ears National Monu- I may be new to the Senate, but I am previously had open-heart surgery. ment. not new to the way this Senate has This isn’t just my opinion. It is the proudly been described by its Members, When her Cobra expired, it was only be- opinion of most of my fellow Utahns, both Democrats and Republicans, both cause of the Affordable Care Act that including those patriots who assembled current and former Members. My col- she was able to get coverage and not be on the county courthouse steps in the league Senator HARRIS will attest that denied because of that earlier, relevant rural town of Monticello on December one piece of advice we all received from preexisting condition. Days after she 29. both Republican and Democratic Mem- was on the Affordable Care Act, a car- These are the people who were ig- bers of this Senate was to read the diologist told her one of her heart nored by the Obama administration. chapter in Robert Caro’s book about valves was failing and she would need These are the people who were cut out Lyndon Johnson entitled ‘‘The Desks another surgery immediately, and she of the decisionmaking process that pro- of the Senate,’’ where Robert Caro has told us that she ‘‘would have died’’ duced this particular national monu- talks about the burnished mahogany had she not had that coverage. ment designation. These are the voices tops, and he tells the story of the Sen- In addition to Diane and Carlos and that were stifled by the wealthy, out- ate through the Senators who were the other 22 million Americans who of-State, well-connected environmental protagonists in great debates through- would have been denied affordable groups that spent millions of dollars to out our history. He highlights the idea health care before the Affordable Care lock up our land for their exclusive that this Senate is supposed to be a de- Act and Medicaid expansion, there are use. liberative body that reflects on issues an additional 7 million Americans on So it is fitting to let one of them— with a thoughtful exchange of ideas. the health care exchanges today who one of the residents of San Juan Coun- Unfortunately, that certainly does not are projected to totally lose that cov- ty—have the last word today. I think describe the Senate of this moment. erage if Republicans pull the plug on Suzy Johnson put it best when she Having just arrived from the House of the Affordable Care Act. That is over 30 said: Representatives, what we are wit- million Americans who will lose access Mr. Obama, you have failed the grassroots nessing today is much more like the to affordable care directly. natives. A true leader listens and finds com- tyranny of the majority characteristic There is no doubt that in those mon ground. The fight for our land is not of that body. health care exchanges, we have seen in- over. Your name will blow away in the wind. This Senate is supposed to be dif- creases in premiums and some of the I yield the floor. ferent, but at least for now it seems copays, and we need to do something The PRESIDING OFFICER (Mr. very much like the House I just left. about it, which is why I and many of SASSE). The Senator from Maryland. As a result of the fast-track process my colleagues have put forward ideas Mr. VAN HOLLEN. Mr. President, I in the Senate, we will be overriding to address the increases we are seeing ask that the time I use be charged and roughshodding over the will of a in the health care exchanges in terms against the resolution. majority of the American population, of costs. We put those ideas on the

VerDate Sep 11 2014 05:20 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00031 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.049 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S104 CONGRESSIONAL RECORD — SENATE January 5, 2017 table, and we would welcome our Re- partly to the overall cost of Medicare. what Donald Trump said on ‘‘60 Min- publican colleagues to join us to im- If you reduce the cost of Medicare in a utes’’: prove the Affordable Care Act. You smart way, you reduce those pre- Everybody’s got to be covered. don’t fix a health care system, you miums. That is why seniors have seen Everybody. don’t fix those problems by blowing up such slow increases in their Part B pre- I am going to take care of everybody. the entire Affordable Care Act. That is miums since the enactment of the Af- Well, it is really important that the not a solution. fordable Care Act. Those will go right majority in the Senate and the House I also want to focus for a moment on back up. talk to the President—elect because the tens of millions of Americans who Second, seniors on Medicare no they are not on the same road when it are not included in that 30 million who longer have to pay for preventive comes to that commitment. When the benefit directly from the Affordable health screenings, cancer screenings, President-elect was asked about find- Care Act but who are benefitting right diabetes screenings, other kinds of pre- ing a way to keep the ObamaCare rules now from ObamaCare. They may not ventive health care because we want to that prevent discrimination based on realize it now, but mark my word they encourage them to identify the prob- preexisting conditions, he said, ‘‘I like are going to face very unpleasant and lems early and solve them for their those very much.’’ When he was asked unexpected consequences if the Afford- own health care purposes but also be- about the provision that allows chil- able Care Act is ripped apart. cause it saves money in the system. dren to stay on their parents’ insur- First, let us take a look at the over- You get rid of the Affordable Care Act, ance plans until they are 26 years old, whelming number of Americans who those seniors are going to be paying he said, ‘‘We’re going to very much try get their health care not on the health premium copays for those preventive to keep that.’’ care exchanges but through their pri- health services. Here is the dirty little secret. Many vate employer—most Members of this Prescription drug costs. Seniors—and people—Republicans and Democrats in body, most Americans. The premiums there are millions and millions of them this Chamber—know there are only a in those plans have actually risen who face high prescription drug costs— very few ways you can design a health much more slowly since the Affordable are benefiting today from the fact that care system that meets those condi- Care Act was enacted than before. The we are steadily in the process of clos- tions. One way, which many Democrats overwhelming number of Americans ing the prescription drug doughnut have historically supported, is the idea who are on those plans have benefited hole. We had an absolute crisis in this of Medicare for all. The other way is dramatically from the reduction of country where so many seniors were the ObamaCare model. It was not al- costs. Why did that happen? Because faced with the difficult choices of get- ways known as the ObamaCare model. all those people who had been pre- ting the medications they needed to The foundation for ObamaCare actu- viously denied access to health care live day-to-day and keep a roof over ally had its roots in the conservative who are in the ObamaCare exchanges, their head. That is why we are closing Heritage Foundation think tank re- they used to show up in the hospital as the prescription drug doughnut hole. ports. It was an idea long promoted by their primary care provider or, since You get rid of the Affordable Care Act, Republicans, including many Repub- they weren’t getting any care at all be- all those seniors who, on average, have lican Senators, some of them still here cause they couldn’t afford the bill, saved thousands of dollars with the Af- today. It is an idea rooted in the con- they were showing up at those hos- fordable Care Act are going to see their cept of personal responsibility, the idea pitals when there was an emergency, costs go up. that every American needs to do their when cost was most expensive. We Finally, if you enact the plan that part and help pay for their health in- don’t deny people care in an emer- has been put forward by the Speaker of surance, otherwise, if they don’t pay, gency, and then they get the bill and the House, PAUL RYAN, and by the per- they are going to force other people to they can’t pay the bill. That is why so son who President-Elect Trump has pay when they go seek that care in the many people were going bankrupt in nominated to be his Secretary of emergency room or wherever it may America before the Affordable Care Health and Human Services, TOM be. In order for that idea to work, the Act. But somebody pays. Who pays? PRICE—I encourage every American to idea that was put forward by the Herit- Well, everybody else in the system look at their plan because they want to age Foundation, the idea in pays. Everybody else who has private voucherize Medicare, and they want to ObamaCare, everyone needs to have insurance through their employer pays save the Medicare system money by coverage because it would not make a or taxpayers in States pay for the un- raising the prices and the risks on lot of sense for us to be paying out all compensated care that hospitals would every Medicare beneficiary. That is the the time if we were able to wait until otherwise have to carry. In the end, result of that plan. we got sick and then decide to pay. people’s premiums were going up really The Affordable Care Act benefits 30 That is the idea of having everyone in fast, but by providing the health care million people directly, and we need to the pool have insurance. The idea is, system through ObamaCare for those make sure we don’t put them in harm’s you don’t want to use it, but you buy exchanges, however imperfect, it has way, but it also benefits all these other that protection. If other people don’t helped those other tens of millions of people in the system, the people on the buy the protection, then the rest of the Americans. Let us look at Medicare employer-provided health plans who folks feel like they are being taken ad- beneficiaries, millions of seniors. have seen historically low premium in- vantage of, which is why everyone has Watch out. Their costs are going to creases and seniors on Medicare. to be in the pool, which is why it was Rural hospitals will be particularly rise in three and maybe four ways right an idea that came out of the Heritage hard hit by repealing the Affordable away. Foundation. First of all, their Part B premiums Care Act. So the proposed Republican In fact, I have the Heritage official that every senior on Medicare pays are action is going to hit those 30 million report right here: Critical issues—a na- going to go up. Why is that? Because as Americans, including my neighbors in tional health care system. This was part of the Affordable Care Act, we got Silver Spring. It is also going to hit back in 1989. rid of some of the overpayments, the those other tens of millions of Ameri- I want to read the three elements in excessive subsidies that were being cans who right now may not realize the the Republican plan. paid to certain providers, including extent to which they are benefiting Element No. 1, every resident in the some of the managed care providers from the Affordable Care Act. Yet our United States must by law be enrolled who were paid, on average, 115 percent Republican colleagues have not put for- in an adequate health care plan that more than fee for service. We said that ward a single plan to help either the 30 covers major health care costs. makes no sense. That is a waste of million or all the other Americans who No. 2, for working Americans, obtain- Medicare beneficiaries’ money. So we are benefiting from the Affordable Care ing health care protection must be a reformed that by saving the Medicare Act. Instead, we see a rush to generate family responsibility. system money. We also save the Medi- chaos throughout the health care sys- No. 3, the government’s proper role is care beneficiaries money in their pre- tem. That is counter to what the Presi- to monitor the health market, sub- miums because those premiums are set dent-elect has said he wants. Here is sidize needy individuals to allow them

VerDate Sep 11 2014 02:38 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00032 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.053 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE January 5, 2017 CONGRESSIONAL RECORD — SENATE S105 to obtain sufficient services, and en- of the country, just as many Senators The PRESIDING OFFICER. The Sen- courage competition. from both parties have done since. ator from New York. That sounds like a description of That is the way the Senate is supposed Mr. SCHUMER. Mr. President, I just ObamaCare. It is—which is why, of to work. That is the way the Senate want to add my commendation. It was course, it was dubbed ‘‘RomneyCare’’ was described in the Robert Caro book such a well done, brilliant, articulate, when they adopted this model for the that Republicans and Democrats alike carefully thought out speech. But it is State of Massachusetts. He adopted it told us to read as new Members before not a surprise because our new Sen- based on the Republican’s Heritage we came here. ator, the junior Senator from Mary- model. I am really glad to be here. I am ex- land, is like that. We are so excited to So here is the problem: Republicans cited to get to work on behalf of Mary- have him and our freshman class— can’t come up with an alternative. landers and work for the good of our some of his colleagues came here That is why it has not happened for 6 State and the country. I wish it could today. We wish it had been larger in years, because if you are going to come have been at a moment when the Sen- quantity, but they sure make up for it up with an alternative, you have to go ate was not hellbent on breaking the in quality, as Senator VAN HOLLEN’s to either one of two models. One is very traditions that have made it speech showed. And parenthetically, Medicare for all. The other is the idea great, the tradition of being a delibera- maybe he will be able to increase that that every American has to be in the tive body and not using right out of the quantity in one of his other new jobs. system and the idea based on personal gate, the very first thing, a process to With that, I yield the floor. responsibility, which at its start was a short-circuit the will of the minority The PRESIDING OFFICER. The Sen- Republican idea. When President party. That is not what any of us were ator from Iowa. Obama adopted it, for many months, taught the Senate was about. Mr. GRASSLEY. Mr. President, it is some Republican Senators were willing It is particularly troubling that the because of ObamaCare that the health to go along, but then the politics over- Senate is engaged in breaking that tra- insurance markets in this country are took them, and since then, we have had dition in order to undermine affordable badly damaged. They have gotten the Republicans opposing their own health care for tens of millions of worse each year. They are now near proposed model for providing health Americans and generate chaos in our collapse. care. So rather than repeal and replace, health care system. I will fight every You were told 8 years ago that if you since there is no replace, it is repeal day to prevent that from happening. like your health insurance, you can and run. I will also fight every day to try to keep it. Millions can’t. If you like your Here is the problem for our col- live up to the true tradition of the Sen- doctor, you can keep your doctor. Mil- leagues politically, but more impor- ate, which is people trying to work to- lions of Americans were not able to tantly, here is the problem for all gether for the good of the country. It is keep their doctor. You were told that Americans and all our constituents: No disappointing to be here at a time your health insurance premiums would one is going to be able to hide from the when the Senate is embarked on vio- go down $2,500. They have actually devastating consequences of undoing lating that tradition in order to strip gone up probably $3,500. Some people the Affordable Care Act, which is going Americans of their health care. I hope don’t have a choice in plans. Some to hurt not just the 30 million Ameri- we will not let that happen. I will fight counties don’t even have a plan in the cans who are directly benefiting every day to prevent that from hap- exchange. If you could get a plan, you through the exchanges and the Medi- pening and then work with my col- might not be able to afford it. If you care expansion, the Medicaid expan- leagues to try to make sure we address could afford the plan, you might not be sion, but also all those seniors on Medi- the real priorities and concerns of the able to use it because of the high co- care and the others getting health care American people. payments you have to have. So it is I thank my colleagues for joining me through their private employers. not a very good situation. As I said at the outset, it is truly sad on the floor. It took 6 years for the health insur- The PRESIDING OFFICER (Mr. SUL- to see the Senate at this point and in ance market to get as bad as I just de- LIVAN). The Senator from Iowa. scribed. It will take time for those this state, especially because of the Mr. GRASSLEY. Mr. President, be- markets to be restored. The next few terrible consequences it is going to cause—— have on the American people. Mr. CARDIN. Mr. President, may I years in health care will be challenging You know, the very first time I was ask my colleague to yield for just one if ObamaCare is repealed or even if it is ever on the floor of the Senate was in moment? not repealed. If ObamaCare is not re- 1985. I was not thinking of running for The PRESIDING OFFICER. Will the pealed, it will be even longer before office myself at that time. It was the Senator from Iowa yield? Americans have access to a functioning farthest thing from my mind. I was ac- Mr. GRASSLEY. Yes, for one mo- health insurance market and the insur- tually working—it was in the middle of ment. ance plans they want. the Cold War. I was working on na- The PRESIDING OFFICER. The Sen- When it comes to health care, every tional security and foreign policy ator from Maryland. second counts. We owe it to the Amer- issues for a moderate Republican Sen- Mr. CARDIN. Thank you. I appre- ican people who are sick or who could ator by the name of ‘‘Mac’’ Mathias ciate the courtesy. I just wanted to get sick, as well as families and busi- from the State of Maryland. take this time to welcome Senator VAN nesses trying to plan for the future, to I talked about the desks of the Sen- HOLLEN to the Senate. Senator VAN start fixing that problem right now. ate at the outset of my remarks. Sen- HOLLEN gave his maiden speech from That is the result of the election. That ator Mathias sat right there, one seat the desk that was held by Senator Mi- is what the Senate is going to do. behind the seat Senator BOOKER is sit- kulski. I know Senator Mikulski would The Affordable Care Act, which could ting in right now. be very proud of what he said here on more appropriately be called the Great to see you. the floor and very proud of Senator Unaffordable Care Act, has been a case That is where Senator Mathias sat. VAN HOLLEN being here in the Senate. of over-promise and under-delivery. The reason I happened to be sitting I look forward to working with him. People were told that their premiums next to him that day is he was working I want to tell the people of Maryland would go down and that if they liked with Senator Kennedy that day. Sen- and the people of this Nation that what their doctor, their hospital, or their ator Kennedy was at a desk back there, you heard tonight, you heard a person health care plan, they could keep all of I believe. It was the second from the who is committed to making our sys- it. The reality is much different. More aisle. It had been his brother Jack Ken- tem work, who is committed to work- than half of the country had two or nedy’s desk in the Senate before him. ing with every Member of the Senate. fewer insurance plans from which to Even though there were many desks But he will stand up for the principles choose this year. Some regions had no between the desk of Senator Kennedy and will stand up on behalf of the peo- insurance plans available at all. Even and the desk of Senator Mathias and ple of Maryland. those who were strong supporters of the center aisle between them, they Again, welcome. It is wonderful to the health care law, like the Minnesota were able to work together for the good have him here in the Senate. Governor whom I like to quote, have

VerDate Sep 11 2014 05:20 Jan 06, 2017 Jkt 069060 PO 00000 Frm 00033 Fmt 0624 Sfmt 0634 E:\CR\FM\G05JA6.055 S05JAPT1 SSpencer on DSK4SPTVN1PROD with SENATE S106 CONGRESSIONAL RECORD — SENATE January 5, 2017 said the Affordable Care Act ‘‘is no They spent maybe 8 or 9 months try- lution be agreed to and the motion to longer affordable to many Americans.’’ ing to work with the Republicans to reconsider be considered made and laid In my State of Iowa, the Affordable negotiate a bipartisan deal. But before upon the table with no intervening ac- Care Act premium increases this year that was completed, they said: Take it tion or debate. were over 40 percent for many individ- or leave it. The Republican minority at The PRESIDING OFFICER. Without uals. Few people, of course, can afford that time was not going to be dictated objection, it is so ordered. that. Families that did manage to pur- to, and we were pushed out of the The resolution (S. Res. 7) was agreed chase Affordable Care Act insurance room. to. found that they could no longer afford Then what ended up being the Afford- (The resolution is printed in today’s to use it. able Care Act was written in the big RECORD under ‘‘Submitted Resolu- One Iowan recently called my office black hole of Senate Majority Leader tions.’’) and told me that his premiums have in- Reid’s office, without the bipartisan The PRESIDING OFFICER. The mi- creased 400 percent in 3 years. He also input which has made so many social nority leader. said that his deductible went up to— programs in America successful. I f can you believe it—$14,000. Last year, would name the Social Security Act. I TO CONSTITUTE THE MINORITY one of his children had a major medical would name civil rights legislation, PARTY’S MEMBERSHIP ON CER- problem, and they had to pay for all of Medicare legislation, and Medicaid leg- TAIN COMMITTEES FOR THE ONE that care out of their pocket—not from islation, which all had broad bipartisan HUNDRED FIFTEENTH CONGRESS the insurance. The family paid $12,000 support to get them passed. In the case for the Affordable Care Act insurance, Mr. SCHUMER. Mr. President, I ask of the Civil Rights Act, a higher pro- unanimous consent that the Senate which did not pay for any health care. portion of Republicans voted for it Of course, that just doesn’t make any proceed to the immediate consider- than Democrats voted for it—just one ation of S. Res. 8, submitted earlier sense whatsoever. example. The problem is that the Affordable today. That is the tradition of the Senate The PRESIDING OFFICER. The Care Act did nothing to address the un- when you have major social legislation derlying causes of the high cost of clerk will report the resolution by that has been successful, and that is title. health care; that is, what it costs for a why the Affordable Care Act was not hospital or a doctor to purchase or The bill clerk read as follows: successful—because it was strictly a A resolution (S. Res. 8) to constitute the maintain medical equipment, purchase partisan approach that was used to medicines, carry malpractice insur- minority party’s membership on certain have it become law. committees for the One Hundred Fifteenth ance, and a lot of other costs they I yield the floor. Congress, or until their successors are cho- have. I suggest the absence of a quorum. sen. Rather than address the actual cost The PRESIDING OFFICER. The There being no objection, the Senate to care, President Obama and his col- clerk will call the roll. proceeded to consider the resolution. leagues chose to bypass real health The bill clerk proceeded to call the Mr. SCHUMER. Mr. President, I ask care reform for an unsustainable enti- roll. unanimous consent that the resolution tlement and bureaucratic mandates Mr. MCCONNELL. Mr. President, I be agreed to and the motion to recon- that have priced people out of the ask unanimous consent that the order sider be considered made and laid upon health insurance market, rather than for the quorum call be rescinded. the table with no intervening action or provide those same people with afford- The PRESIDING OFFICER. Without debate. able and quality coverage. objection, it is so ordered. The PRESIDING OFFICER. Without So we are at it now. It is time for Mr. MCCONNELL. Mr. President, I objection, it is so ordered. real health care reform, not the mis- ask unanimous consent that at 5:30 The resolution (S. Res. 8) was agreed guided policies that we were promised 8 p.m. on Monday, January 9, the Senate to. years ago that now have turned out to vote in relation to the Paul amend- (The resolution is printed in today’s be what I describe as misguided poli- ment No. 1; further, that the Senate RECORD under ‘‘Submitted Resolu- cies. It is time to deliver to Americans vote in relation to the Sanders amend- tions.’’) what we were promised. It is time to ment No. 19 at 2:30 p.m. on Tuesday, The PRESIDING OFFICER. The ma- provide accessible, affordable health January 10. jority leader. care to all Americans. But my col- The PRESIDING OFFICER. Without Mr. MCCONNELL. Mr. President, leagues on the other side of the aisle objection, it is so ordered. these committee resolutions reflect the need to work with us. They know that Mr. MCCONNELL. Mr. President, it is fact that Senator BLUNT will remain the Affordable Care Act is falling my understanding that we will have a chair and Senator SCHUMER will remain apart. They know it is unaffordable. side-by-side amendment to the Sanders ranking member of the Rules Com- As we have heard in speeches this amendment, and we will circulate that mittee until the inaugural ceremonies week, the other side is trying to dis- amendment as soon as possible. have been completed. tract attention from the Affordable f It is my understanding that following Care Act collapse by using scare tac- the inauguration, Senator SHELBY will tics, like you recently heard. It is time TO CONSTITUTE THE MAJORITY become chair and Senator KLOBUCHAR for the Democrats to step up, instead PARTY’S MEMBERSHIP ON CER- will become ranking member of the of doubling down. It is time for states- TAIN COMMITTEES FOR THE ONE Rules Committee. manship, not gamesmanship. It is time HUNDRED FIFTEENTH CONGRESS The PRESIDING OFFICER. The mi- for the Democrats to stop defending Mr. MCCONNELL. Mr. President, I nority leader. the ‘‘un-Affordable Care Act’’ and de- ask unanimous consent that the Sen- Mr. SCHUMER. Thank you, Mr. liver Americans what was promised. ate proceed to the consideration of S. President. I look forward to working with my Res. 7, submitted earlier today. We have just agreed to the com- colleagues and the Trump administra- The PRESIDING OFFICER. The mittee resolution numbers on each tion to deliver affordable health care clerk will report the resolution by committee. I would make just a couple to all Americans in the tradition of the title. of points, if I might. Senate, which is what didn’t happen in The bill clerk read as follows: Our caucus has some serious con- 2009. It was strictly a one-party pro- A resolution (S. Res. 7) to constitute the cerns about letting the Intelligence gram put before the Congress to pass. majority party’s membership on certain Committee and Armed Services Com- That is why it has failed—because so committees for the One Hundred Fifteenth mittee exclusively handle the issue of many of the people who could have Congress, or until their successors are cho- Russia’s interference in the election. made a good bill pass in 2009 were shut sen. While much of the information relat- out of the process because this body There being no objection, the Senate ing to Russia’s interference in our elec- had 60 Democratic Members and they proceeded to consider the resolution. tion can be pulled together by the In- didn’t have to pay any attention to Re- Mr. MCCONNELL. Mr. President, I telligence and Armed Services Com- publicans. ask unanimous consent that the reso- mittees, the legislative actions that

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