[Congressional Record Volume 159, Number 161 (Wednesday, November 13, 2013)]
[Senate]
[Pages S7973-S7978]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            DRUG QUALITY AND SECURITY ACT--MOTION TO PROCEED

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to consideration of the motion to proceed to H.R. 3204, which 
the clerk will report.
  The assistant legislative clerk read as follows:

       Motion to proceed to the bill (H.R. 3204) to amend the 
     Federal Food, Drug, and Cosmetic Act with respect to human 
     drug compounding and drug supply chain security, and for 
     other purposes.

  Ms. WARREN. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. THUNE. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                               ObamaCare

  Mr. THUNE. Madam President, the question of the week is, more 
important than apologizing, will President Obama live up to his promise 
that Americans can keep the care they have and like? Democrats are 
clearly running away from embracing this law and are suggesting the 
President live up to his promise as well. Yesterday former President 
Clinton said:

       I personally believe, even if it takes a change to the law, 
     the President should honor the commitment the Federal 
     Government made to those people and let them keep what they 
     got.

  That is from former President Clinton yesterday in a interview he 
did.
  More and more we see people on the Democratic side of the aisle 
coming forward, acknowledging what many of us have been acknowledging 
for a long time; that is, this is not living up to expectations. We 
need a timeout. It is clearly not working, it is not ready for prime 
time, and it is obvious that we need to acknowledge that and come up 
with plan B.
  Senator Durbin, here in the Senate, said in an interview Tuesday that 
the cancellations of their coverage that people might face under 
ObamaCare and the statement that people could keep their plans ``should 
have been clarified.''
  Democratic Representative Kurt Schrader from Oregon thinks the 
President was grossly misleading to the American public and said:

       I think the President was grossly misleading the American 
     public.

  Senator Feinstein, who is not up for reelection, is supporting 
legislation to allow individuals to maintain enrollment in the plans 
they like.
  These mistruths are clearly affecting the President's credibility. 
President Obama's approval ratings have dipped to a record low. A poll 
from Quinnipiac University that was released shows respondents 
disapprove of the President's job performance by a 54-to-39 margin. His 
approval rating of 39 percent is worse than his previous alltime low of 
41 percent in the Quinnipiac survey done previously. Further, more 
people--52 percent--say the President is not honest and trustworthy.
  We are on the verge of another misstatement from this administration 
where they make promises to the American people that they do not meet. 
Last month the administration promised they would have healthcare.gov 
fixed by the end of November. It appears unlikely, according to today's 
Washington Post, where a headline reads: ``Troubled HealthCare.gov 
unlikely to work fully by end of November.''

  For proof that this Web site design has been a failure of leadership, 
compare it to Cyber Monday volume at amazon.com in 2012. According to 
amazon.com's press release, it sold 27 million items on Cyber Monday, 
or 306 items per second. That is how the private sector has been able 
to process huge volumes of data and requests. If we compare and 
contrast that with the rollout of ObamaCare and healthcare.com, it is a 
stunning failure--even epic in terms of the inability of that whole 
program to function with any level of competence.
  It is clear that technology exists to fix the Web site to handle high 
volumes, but, as the President has said, the health care law is more 
than just a Web site, and that is where most of us come down on this 
issue. This is a flawed policy that is causing millions of Americans to 
lose the health care they like. Most of us know someone who has had his 
or her health care canceled by ObamaCare, and it is going to get worse. 
The Associated Press reports that at least 3.5 million have received 
cancellation notices, and that number is expected to increase to tens 
of millions of people. As Americans--millions more--are losing their 
plans, only thousands are signing up through ObamaCare.
  Constituents are encouraged to visit our Web site at 
republican.senate.gov/yourstory to submit their stories about how this 
is impacting them personally. The American people deserve to have their 
stories heard, and Americans deserve to have the President and 
congressional Democrats keep their promise.
  We believe what former President Clinton said yesterday is correct; 
that is, President Obama should honor the commitment the Federal 
Government made to those people and let them keep what they have. That 
is essentially where we are today. I would simply ask rhetorically, 
what is the President going to do to address and honor the promise he 
made to the American people that they can keep what they have?
  Increasingly, more and more Democrats--and, of course, there are many 
of us on this side of the aisle who predicted this would happen a long 
time ago--realize this was an ill-conceived policy. I have maintained 
for a long time that it was built upon a faulty foundation; therefore, 
you cannot just fix a Web site or have an IT specialist come in and 
expect this to get better. This is a flawed policy, and it is already 
having profound and harmful impacts on the American people. We believe 
many more people will be harmed in the future as the insurance is fully 
implemented.
  The best we can do for the American people in order to minimize the 
impact and harm is to put off, suspend, delay--whatever you want to 
call it--the implementation of ObamaCare. Frankly, the best we could do 
in the long run is pivot away from this failed policy and move in a 
direction that actually does address some of the fundamental problems 
we have with health care in this country today.
  There is a whole list of solutions Republicans have advanced and put 
forward in the past--for example, allow people to buy insurance across 
State lines and create interstate competition so we have insurance 
companies competing with each other. Obviously, if we have competition 
and the forces of the market at work, it helps to bring down costs and 
prices.
  Another example is to allow small businesses to join larger groups to 
get the benefit of group purchasing power--to pool, if you will. That 
is something we have been proposing for some time, and it has been 
consistently defeated by Democrats in Congress. Other examples are 
reducing the cost of defensive medicine by ending the junk lawsuits 
that clog up our legal system and drive up the cost of health care, 
allowing an expanded use of health savings accounts and those types of 
vehicles that are out there for people today to put money aside for 
their health care needs; allowing people to have a refundable tax 
credit so they can buy their own insurance, which would give them more 
choices, create more competition, and, again, put downward pressure on 
the cost and price of health care in this country.
  Those are commonsense step-by-step solutions that we think would work 
so much better than having one-sixth of our entire economy, which is 
what health care represents, taken over by the Federal Government. 
Political command and control in Washington, DC, is driving the 
decisionmaking for Americans across the country. As we have already 
seen, the Federal Government does not do complicated tasks very well, 
and the Federal Government doesn't do comprehensive tasks very well.

[[Page S7974]]

  Everybody talked about a comprehensive solution to this problem. 
Clearly, we have problems in America today that need to be addressed. 
We have a lot of people who don't have health care, and that needs to 
be fixed. We have people with preexisting conditions, and that needs to 
be addressed. There are solutions to those problems that don't include 
and don't entail having the Federal Government take over one-sixth of 
the American economy, which is what happened with ObamaCare. We are 
seeing the impacts and the results of that today.
  I suggest we take a timeout and make a conscious decision to move in 
a different direction--a direction that will lead to lower costs, 
higher quality of care, allow people to keep the plan they like if they 
like it, allow people to keep the doctor they like, and keep the cost 
of health care at an affordable level.
  One thing we have seen since ObamaCare passed and is now in the 
process of being implemented is that the promise that people would see 
their health care costs go down, not up--that promise is another broken 
promise because what we are seeing in America today is canceled 
policies. As people try to get new policies, there are increased costs. 
We are seeing that in the individual marketplace. When the President 
was campaigning for his health care law, he said he would drive the 
costs down for families by $2,500 per family. Yet we have seen the cost 
per family increase since he took office by $2,500.
  We have a cloud hanging over our economy right now because of this 
massive new regulation with a massive amount of government mandates. 
Due to government-approved insurance, the workweek has been redefined 
from a 40-hour workweek to a 30-hour workweek. We have a lot 
of employers who are creating part-time jobs instead of full-time jobs. 
In order to avoid the mandates and requirements and costs associated 
with ObamaCare, employers are hiring people to get under that 30-hour 
workweek. There are a lot of people who are hired to work 29 hours a 
week. Well, Americans can't take care of their families and meet the 
needs they have in their personal and family budgets on 29 hours a 
week, so more and more people are having to get more than one job. In 
fact, some estimates show that the majority of jobs that have been 
created over the last year have been part-time jobs, not full-time 
jobs. That is the impact this is having on the overall economy.

  If we are serious about getting the economy growing and expanding 
again and creating good-paying jobs for middle-class Americans, there 
are a number of things we can do to create that kind of economic 
growth. What we have seen of late is a growth rate that hovers between 
1 and 2 percent. The economy is lethargic and sluggish compared to any 
historic average. We continue to have chronic high unemployment. If we 
factor in that the labor participation force is literally at the lowest 
level in the last 35 years, we would have to go back to the 
administration of President Carter. At that time there were fewer 
people working as a percentage of the entire workforce. If we factor 
that in, we have an economy that is in a very bad way.
  As I said, there are a whole series of things that need to be done to 
get the economy growing and expanding at a faster rate, create more 
jobs, and increase the take-home pay for middle-class Americans. We 
really need to start over with Obamacare.
  Madam President, I ask unanimous consent for 1 additional minute.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. THUNE. I suggest it starts with shutting this down and starting 
over. We need to create more options, more choices, and more 
competition in the health care economy so people can get away from the 
sticker shock we have seen with ObamaCare and get costs down. We need 
to get away from these cancellation notices that are going out and 
allow people to keep the care and doctor they have and like. Because of 
the broken promises under ObamaCare, that is not happening.
  Until we decide this was the wrong direction and pivot and go in a 
different direction, we are going to continue to see the results we 
have today--higher costs, more cancellations, people not being able to 
keep the care they like or the doctor they like. We can do better and 
should do better.
  I yield the floor.
  The PRESIDING OFFICER (Ms. Baldwin). The Senator from Minnesota.
  Mr. FRANKEN. Madam President, I would like to talk for a few minutes 
about a subject that will affect all of us at some point in our lives; 
that is, the safety of our medicine.
  If my child or wife urgently needed medicine, I would have a number 
of questions: Will my loved one get well? What is going to happen? But 
I should never have to ask a question about whether the medicine my 
family takes is safe and whether it is what the doctor says it should 
be.
  More than 1,000 patients and their families across Minnesota found it 
necessary to ask that question last year during the meningitis 
outbreak. They had to ask that question because the contaminated 
medicine they received could have caused them enormous harm. More than 
700 patients across the country got sick and more than 60 died after 
receiving these contaminated injections produced by a large-scale 
compounding pharmacy in Massachusetts that was essentially an 
unregulated drug manufacturer.
  In Minnesota we specialize in medical innovation. We have some of the 
best doctors and health care systems and biomedical pioneers anywhere 
in the world. Our Nation has an incredible capacity for innovation and 
development in this field. There is no possible explanation that can 
justify the fact that more than 17,000 vials of contaminated medicine 
were shipped to providers throughout the country. That should simply 
not be happening. That is why the legislation we are set to pass, which 
I helped to write, is so important. It will go a long way toward making 
compounded medication safer and preventing another outbreak like the 
one we had a little over a year ago.
  Many people don't know what pharmacy compounding is--including many 
patients who have received compounded medicine. Compounding is a 
traditional practice of a pharmacy where a pharmacist makes a new drug 
or takes an existing one and changes it based on a particular patient's 
needs. If a patient needs a drug and is allergic to one ingredient in 
it, the pharmacy can remake the drug, or compound it, without that 
ingredient based on a doctor's prescription. Pharmacists and pharmacies 
are regulated by the States.
  This practice of tailoring medications for individual people is 
incredibly important, and it has always been a part of practicing 
pharmacy. It will continue under the bill we have written. But that is 
not what happened in Massachusetts last year; instead, a facility 
exploited a legal loophole to make thousands of doses of a product that 
was not FDA approved and sold it to hospitals and clinics across the 
country without receiving a prescription. As I said, more than 700 
patients got sick after receiving that medicine and 64 people died. 
That is why my colleagues and I have worked so hard over the past year 
to develop the bill before us today, the Drug Quality and Security Act, 
which takes important steps for preventing this kind of outbreak in the 
future.
  I would like to take a moment to thank my friends on both sides of 
the aisle and in both the Senate and the House who have worked so hard 
on this legislation.
  I thank chairman Tom Harkin for his leadership and for the bipartisan 
HELP Committee staff process that was crucial to producing this 
legislation.
  I thank ranking member Lamar Alexander and Senator Pat Roberts for 
their commitment to getting this bill right.
  I thank the staff who worked so hard on this bill. Specifically, I 
thank members of Senator Harkin's staff: Jenelle Krishnamoorthy, 
Elizabeth Jungman, and Nathan Brown. I also thank Senator Alexander's 
staff: Mary Sumpter-Lapinski and Grace Stuntz, as well as Jennifer 
Boyer, who works for Senator Roberts. Their hard work and dedication 
helped to develop this important legislation.
  I also thank Hannah Katch, a member of my staff, who has worked 
tirelessly on this bill.
  I thank Chairman Upton and Ranking Member Waxman and their colleagues 
in the House for their work, as

[[Page S7975]]

well as the many stakeholders who have worked productively with us to 
develop and improve this proposal. In particular, I counted on input 
from the Minnesota Board of Pharmacy, the Minnesota Pharmacist 
Association, Thrifty White Pharmacy, and many other experts and 
pharmacists in Minnesota who helped us get this bill right.
  Is our legislation perfect? No. There were a number of provisions in 
the bill that we passed out of the HELP Committee that would have 
provided additional safety and quality assurances for patients, but in 
order to come to a compromise with the House of Representatives, our 
legislation changed. Although the final bill does not include 
everything I would have liked, the bill before us today will take an 
enormous step forward for patient safety.
  The bill will reinstate the law that allows the Food and Drug 
Administration to regulate large-scale compounders that have exploited 
a loophole in the law in order to act effectively as unregulated drug 
manufacturers. It will also give hospitals and health systems the 
option of buying compounded products from facilities that are inspected 
by the FDA and are complying with the FDA's quality standards. And it 
will do all of that without changing the rules for traditional 
pharmacies, which will continue to be regulated by their State boards 
of pharmacy.
  Specifically, our bill creates a new option for facilities that want 
to provide compounded drugs to hospitals and health centers. These 
entities, called ``outsourcing facilities,'' will be inspected by the 
FDA and will have high quality standards. The hospitals that buy from 
these facilities will be able to trust that the compounded medicine 
they buy from outsourcing facilities is safe.
  If a compounder chooses not to be either a traditional pharmacy or an 
outsourcing facility, the FDA will be responsible for making sure that 
compounder complies with the normal requirements for pharmaceutical 
manufacturers. Those are the options. Unlike what we saw in 
Massachusetts, these facilities will no longer be able to occupy an 
unregulated no man's land. So under the new law, there will be 
traditional pharmacies, which will continue to be regulated at the 
State level; outsourcing facilities, which the FDA will oversee; and 
pharmaceutical manufacturers, which will be regulated by the FDA, as 
they have been.
  I am also pleased that the bill we wrote on compounding is paired 
today with another bill on the drug supply chain, which is aimed at 
making sure that the FDA-approved medicine that patients receive is 
safe and has not been tampered with. By creating a national system to 
track drugs from the time they leave the manufacturer until they are 
dispensed to patients, this legislation will provide certainty that our 
medicines are what they say they are.
  My colleagues, Senators Bennet and Burr, have been working on this 
proposal for more than 2 years, and I thank them for their work and 
congratulate them on this important achievement.
  My home State of Minnesota is a model for pharmacy practice 
nationwide. Not only does our State have important protections for 
compounding pharmacies that have kept the medicine made in Minnesota 
safe, but Minnesota pharmacists have also led the Nation in developing 
innovative new ways of helping their patients get the right medicine at 
the right time.
  For example, pharmacists at Hennepin County Medical Center in 
Minneapolis found that when a pharmacist reviewed the prescriptions for 
patients with complex conditions before they were discharged from the 
hospital, those patients had fewer problems related to their medicine 
and were 50 percent less likely to be readmitted to the hospital. So it 
saved a lot of money. It cost HCMC about $112,000 for pharmacists to 
provide this service, and it saved the hospital nearly $600,000. This 
is exactly--exactly--the kind of innovation that we are known for in 
Minnesota, and our pharmacists are on the front lines of this kind of 
reform and discovery.
  The pharmacists at HCMC, and those around Minnesota, do incredibly 
important work. They provide access to needed medicine for thousands of 
patients every day. Those pharmacists and their patients must be able 
to trust that the medicine is safe and it will work. The Drug Quality 
and Security Act will take an important step toward preventing another 
outbreak like the one we saw last year, and I urge my colleagues to 
join me in passing the Drug Quality and Security Act into law.
  Thank you, and I yield the floor.
  The PRESIDING OFFICER. The Republican whip.


                               ObamaCare

  Mr. CORNYN. Madam President, in a front page story yesterday, the 
Wall Street Journal reported that fewer than 50,000 people had 
successfully used the Federal ObamaCare Web site to enroll in a private 
health plan--less than 50,000. Meanwhile, we know that millions of 
Americans are already getting a cancellation notice from their 
insurance company telling them that their current policy--even if they 
like it--will no longer be available. In other words, if you like what 
you have, it turns out you cannot keep it--as millions of people are 
finding.
  No less a luminary in the Democratic Party than President Clinton has 
said that ObamaCare should be reformed to let people maintain their 
current health insurance. And we will see some votes in the House of 
Representatives as soon as Friday on that proposition, helping the 
President keep his promise to the American people that if you like what 
you have, you can keep it, which currently has proven not to be the 
case.
  Just a month ago, Democrats of all stripes were declaring that Obama 
was the settled law of the land and condemning attempts on our side of 
the aisle to actually reform it. Now we are seeing more and more of our 
friends across the aisle contemplating serious changes aimed at fixing 
some of the law's myriad problems. Some, but not all, of the problems 
with ObamaCare have become painfully obvious--some, because I think 
most people probably think ObamaCare has already been implemented, 
when, in fact, it has only begun to be implemented.
  But we know ObamaCare is forcing people to lose their health 
insurance and/or their doctor. It may be that even in the exchanges, 
the hospital which they prefer to be treated at or the doctor from whom 
they would prefer to have their care, they will not be available on the 
exchanges.
  We also know that ObamaCare is raising health care premiums. Again, 
the President promised that if we passed ObamaCare, we would see a 
reduction in the premiums for a family of four of about $2,500. Instead 
of seeing premiums go down, we are seeing premiums go up.
  We know that Medicare and Medicaid remain on an unsustainable path, 
and we are actually seeing, in many States, the States opting to expand 
the Medicaid program, when they cannot even care for or pay for the 
people who are currently in the Medicaid program.
  We have found that organized labor has gone to the White House. They 
said that because of the incentives in ObamaCare, many full-time 
employees were now being put on part-time work in order to avoid some 
of the penalties associated with ObamaCare.
  We know that in the medical device sector--one of the most innovative 
parts of health care today--those jobs are moving offshore. They are 
moving outside of the United States, and it is stifling innovation, 
this medical device tax which is part of the pay-for of ObamaCare.
  But here is another issue that has not gotten much attention lately. 
I was a little surprised when I came across this article in the 
Atlantic magazine, but the truth is the ObamaCare structure penalizes 
people for getting married. Certain couples who do qualify for the 
ObamaCare subsidies right now would lose those subsidies if they got 
married. In some cases, the ObamaCare marriage penalty could amount to 
thousands of dollars. So just when you think things could not quite get 
any worse, you find out they do.
  As if all these problems were not bad enough, ObamaCare has also 
created a magnet for fraud and corruption in the so-called navigators 
program. You will remember, the navigators were created in order to 
help people sign up on the exchanges. But we know the navigators will 
be collecting sensitive tax and personal information--medical, both 
physical and mental health information--from folks all across the 
country as

[[Page S7976]]

they try to navigate ObamaCare. But we also know, because the Secretary 
of Health and Human Services admitted this last week, that they are not 
subject to any kind of background check, including a criminal 
background check. As a matter of fact, I think Secretary Sebelius 
surprised an awful lot of people when she admitted that people 
participating in the navigator program could possibly be convicted 
felons because there is simply no screening mechanism to bar them from 
participating in the process and no background check whatsoever.
  Then we have learned, as a result of some creative journalists, that 
navigators, including those in my home State of Texas, were actively 
encouraging people to break the law as a process of signing up for the 
ObamaCare exchanges.
  It is simply astounding that the administration is urging the 
American people to give their Social Security numbers and sensitive 
personal information to people who have not been properly vetted. 
Yesterday I called on the President to suspend the navigators program, 
and I want to reiterate that call today. He needs to end it, at least 
until basic precautions are taken to prevent identity theft and 
corruption and fraud.
  Given the lack of Federal background checks and other safeguards, 
this program is an invitation to fraud and identity theft.
  As with so many other aspects of ObamaCare, the problems with the 
navigators program are the result of politically motivated decisions. 
Do not just take my word for it. Consider the scathing indictment that 
was recently issued by Michael Astrue, who served as HHS general 
counsel from 1989 to 1992. More recently, he served as a commissioner 
for Social Security, from 2007 to 2013.
  Writing in the Weekly Standard, Mr. Astrue points out:

       Instead of hiring well-screened, well-trained, and well-
     supervised workers, HHS decided to build political support 
     for the Affordable Care Act by pouring money into supportive 
     organizations so they could launch poorly trained workers 
     into their communities without obtaining criminal background 
     checks or creating systems for monitoring their activities.

  Over the long term, we need to dismantle ObamaCare entirely and 
replace it with patient-centered alternatives that will actually bring 
costs down; improve the quality of care, by making more care 
accessible; and leaving the choices with consumers and their families, 
patients and their doctors making the decisions, not Washington, DC. In 
the short term, we need to also dismantle the navigators program before 
it unleashes a wave of fraud and corruption.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. CRAPO. Madam President, before I make my remarks, I ask unanimous 
consent that Senator Reed from Rhode Island be recognized immediately 
following my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CRAPO. Madam President, I rise today, also, to speak about a 
subject on the minds of all Americans and that is the rollout of the 
Patient Protection and Affordable Care Act or ObamaCare.
  Many of us have predicted the implementation of ObamaCare would 
result in difficulties for American families, businesses, and our still 
fragile economy.
  We spoke about the tax hikes that would come, the rising premiums, 
the canceled policies, the benefit cuts to Medicare programs for 
seniors, and other problems in the flawed law. Still, the President 
insisted that he was right and that he knew best what Americans wanted.
  Since then, countless opportunities have been provided for our 
colleagues to join us in defunding or at least delaying the 
implementation of this damaging law.
  To further sow confusion, the administration has selectively changed 
the law to suit its political advantage.
  And now that October 1 has come and gone, millions of Americans are 
becoming painfully aware of the reality of how ObamaCare will affect 
them.
  The American people are seeing the effects of ObamaCare, not based on 
the rhetoric of politicians or the debate here in Congress, but by 
their own personal experiences in dealing with it.
  The initial feedback is clear, and it is not pretty. The trillion 
dollars in new taxes that I led the fight against on the floor during 
the initial ObamaCare debate are now largely in effect.
  And as I said, and many others warned, and the Joint Tax Committee 
has actually confirmed, a significant portion of those tax increases 
are hitting squarely on the middle-income families the President 
solemnly pledged to protect. He said that people in America who make 
less than $250,000 per couple or $200,000 per individual would not see 
one dime of tax increases as a result of the act.
  Yet now we are seeing that the burden of this huge tax increase is 
falling squarely on those in what the President has defined as the 
middle class. The American people are also now experiencing for 
themselves the reality we have long warned against--that the President 
has also broken his promise that his health care plan would lower 
premiums by $2,500 on average for Americans.
  In fact, the Washington Post fact checker gave that President's 
pledge a three Pinocchios score for not being true. Yet another promise 
proven to be false is the President's pledge to the American people 
that if you like your doctor and you like your current health care 
plan, you can keep it.
  Again, the Washington Post reviewed this pledge. But this time it 
gave the President four Pinocchios saying, ``The President's promise 
apparently came with a very large caveat: If you like your health care 
plan, you'll be able to keep your health care plan--if we deem it to be 
adequate.''
  I recently received a letter from Nancy from Eagle, ID, about the 
loss of her husband's employer-provided coverage. The cancellation 
notification reads that ``due to the Affordable Health Care Act and 
unprecedented increases in healthcare costs, effective January 1, 2014 
traditional comprehensive medical insurance will no longer be 
available.'' Instead, his employer will offer two preventive health 
care plans and refer them to the exchange to purchase his insurance.
  After browsing the exchange Web site, Nancy and her husband have 
realized they will either be forced to pay $500 more a month on health 
insurance premiums or pay a lower premium rate which would result in 
limited access to providers and hospitals.
  Simply put, this is wrong. But I fear that there will be many more 
like Nancy with similar experiences. This week I was contacted by Matt 
from Meridian, ID, about his wife who receives coverage through her 
employer. They will see their premiums rise and a considerably higher 
deductible due to the increased cost to her employer because of 
ObamaCare.
  Just 1 month after the ObamaCare exchange rollout, at least 3.5 
million Americans have received insurance cancellation notices. This 
number is expected to dramatically increase in coming months. Over 
100,000 of those people live in Idaho, according to the Associated 
Press. According to media reports, the administration knew Americans 
would not be able to keep their current coverage, even though the 
President continued to push the message that people could.
  After breaking this promise, the President is now telling millions of 
Americans who have had their insurance cancelled that they should shop 
around for policies that frankly could be more costly and require them 
to change their doctors.
  Many of my colleagues in the Senate, as a response to this, are 
cosponsoring a measure known as the If You Like Your Health Plan, You 
Can Keep It Act. This act is one the Senate should immediately take up 
and pass.
  Idahoans are now learning that the flawed health care law will force 
them to change their plans and in many cases pay higher premiums. While 
this law was sold on the promise of providing health care coverage for 
the uninsured, it is creating new uninsured Americans who will be 
forced to enter the troubled Federal health care exchanges.
  At the same time, the administration refuses calls for transparency 
and hides information about enrollment numbers. It is hard for me to 
believe that in the year 2013, when we have iPhones, tablets, Twitter 
and Google, the administration has no idea or ability to release 
enrollment numbers.

[[Page S7977]]

  According to documents released recently from the House oversight 
committee, six people signed up for ObamaCare on day one. We understand 
that more are signing up now, but it could be that the administration 
has such low numbers of enrollments for their signature achievement 
that they do not want to present the accurate facts.
  Many of us in this body are concerned also about the security risks 
posed by ObamaCare. Several weeks ago, Republican members of the Senate 
Finance Committee wrote to Department of Health and Human Services 
Secretary Kathleen Sebelius, asking whether all Federal privacy and 
security standards were met prior to the launch of healthcare.gov, the 
Web site to sign up for ObamaCare.
  We have asked Secretary Sebelius to provide answers and information 
to a series of questions detailing what levels of security and privacy 
measures were undertaken prior to the launch of the Web site to 
safeguard the privacy of those Americans signing up for coverage 
through healthcare.gov. This is a serious concern that must be 
addressed.
  Additionally, because of the law, some businesses are cutting back on 
employees and on hours, making it harder for Americans to find full-
time jobs. Those who do hold on to their full-time jobs could lose 
their employer-sponsored private insurance and are instead being dumped 
into the exchange or into the failing Medicaid system.
  These are just some of the unfortunate realities we are facing with 
the implementation of ObamaCare. As these stories continue to pour in, 
I urge all of my colleagues on both sides of the aisle, along with the 
President, to carefully listen to the American people, to American 
businesses and this feedback and work together to defund and repeal 
every element that proves not to work.
  We must replace those failed policies with true reforms that are in 
the best interests of the American people and in the best interests of 
the American economy. From day one, the administration has continued to 
make excuses for why healthCare.gov is not functioning properly, even 
though they have had years to prepare and perform testing.
  The American people see now that this law is more than just a Web 
site problem; it is a train wreck. This system was not ready and the 
law looks impossible to fix. Simply put, the promises of this law are 
nothing like its realities.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.


                               The Budget

  Mr. REED. Madam President, it is clear we have honest disagreements 
about how we should address our budget. I believe the path forward 
should be fair and balanced. That is not what we have seen to date. We 
have enacted $2.4 trillion in deficit reduction, with $1.8 trillion 
coming from spending cuts. These cuts put tremendous pressure on 
important domestic investments in areas such as education, health care, 
and national security.
  I do not believe cutting domestic programs that invest in our future 
and help low- and middle-income American families is the right thing to 
do, especially when we can close egregious tax loopholes that benefit 
multinational corporations and some of the wealthiest Americans.
  Again, we have made significant progress in deficit reduction. The 
bulk of that has been cutting programs that invest in the country and 
help families. To go forward, we need a balanced approach, selective 
cuts, but we also need to close some of these egregious loopholes that 
are benefiting--not the small business man or woman living in Rhode 
Island--but multinational corporations--not working wage earners in 
Rhode Island--but some of the wealthiest Americans.
  I know some of my colleagues disagree with me. But in order to 
address our long-term fiscal challenges, the brinkmanship has to stop. 
Drawing lines in the sand and daring people to cross them has to stop. 
What we need is not to surrender our principles but to reach principled 
compromise.
  That is why we should provide immediate certainty that the shutdowns 
and the threats to wreck the economy are totally off the table. We can 
do this by agreeing to adequate top-line numbers for the appropriations 
process for fiscal years 2014 and 2015 and eliminating the job-killing 
sequester.
  Then we can move forward to a long-term debate about our fiscal 
challenges. We can then build consensus and reach this principled 
compromise. In reaching that compromise, I would urge my colleagues to 
include policies that focus on jobs and economic growth, that restore 
fairness to our Tax Code and preserve hard-earned Social Security and 
Medicare benefits.
  Looking over the last few years, the uncertainty and the brinkmanship 
according to most economists has robbed us of growth. That growth, in 
and of itself, not only would have put more Americans to work, but it 
would have contributed to deficit reduction, even more than we have 
already been able to do to date.
  If we are serious about deficit reduction, if we are serious about 
narrowing the gap in terms of equality in our society, then we have to 
emphasize not only wise fiscal policies that reduce the deficit 
directly but wise fiscal policies that encourage growth and also reduce 
the deficit.
  Let's agree to those top-line numbers. Let's also eliminate the 
sequester and let's move forward. That is why we were sent here. 
Americans want us to keep the economy moving forward and to get the 
economy working for them. They do not want to see us engage in 
procedural maneuvers that simply leave us without adequate progress on 
these issues that are extraordinarily important to them.
  We are recovering from the most recent self-inflicted wound--the 
government shutdown and near default. That manufactured crisis was 
absolutely unnecessary and it was particularly unnecessary to threaten 
the credit of the United States. A vast majority of Americans are clear 
that at a minimum we should keep the government open and we should pay 
our bills. We have always done that. Only in the last few years and 
harking back to when Mr. Gingrich was Speaker did the other side engage 
in this sort of brinksmanship.
  This does not work for Americans. They do understand we have 
differences in policy. They do understand we have to debate these 
various differences. But at a threshold level, government has to be 
working for them, not sporadically but constantly. And we cannot 
threaten the credit of the United States.
  Jumping from these manufactured crises to crises is no way to do the 
job. As I said before, there are immediate tasks before us. We have to 
have a reasonable expenditure level for our budgets for fiscal years 
2014 and 2015. Sequester must stop. Then we have to start to look at 
longer term problems that are being driven by demographics.
  We know the sequestration is harming our job growth. CBO has 
estimated that the 2013 and 2014 sequester will cost the economy 
900,000 jobs. Simply suspending or limiting the sequester, if we can 
generate 900,000 jobs, most Americans would say that is the right 
policy. If you can just do that and create jobs, then do it.
  It is obvious the sequester is not workable. The House of 
Representatives, our colleagues, have had very difficult times passing 
bills that adhere to sequestration, bills that traditionally passed 
overwhelmingly, like transportation and infrastructure bills. If we 
cannot even do that under the pressure of the sequester, then, again, 
we are back to a dysfunctional government. It might be formally open, 
but it is not helping people and it's not doing the things we have to 
do: getting economies to grow, letting States build bridges, sewers, 
and highways.
  Senator Mikulski has done an extraordinary job as the chairwoman of 
the Appropriations Committee. She has been working hard to make sure we 
bring bills to this floor that not only have the support of our 
Members, our colleagues, but also meet the needs of the American 
people.
  I have the privilege of chairing the interior subcommittee. We have 
been able, working with my colleague Senator Murkowski from Alaska, to 
propose--we have not brought it to the subcommittee or full committee--
but to propose a mark that would respond to the real needs of this 
country in terms of clean water and drinking

[[Page S7978]]

water infrastructure--which is vital to the economy of every American 
community.
  On the other side, the House is proposing a cut of $1.756 billion, 
more than 75 percent. That cut would devastate these programs and 
result in 97,000 fewer jobs. These are the good kinds of construction 
jobs, high-paying jobs, that allow families to stay above the water and 
allow communities to prosper. The workers who are putting in those 
infrastructure projects are also going to local supermarkets, local 
restaurants, paying the fees and dues to the Little League teams, and 
doing the things we expect every family should be able to do and we 
hope every family can do.
  In the Transportation bill, for example, we were able to maintain our 
promise to fund transit, airport, and highway systems. We have been 
able to set aside more than $1 billion for the popular TIGER grant 
program and a new initiative to replace bridges in critical 
transportation corridors. This is an effort that can benefit every 
State in this country in terms of infrastructure projects.
  Looking across the Capitol at the House Republican Transportation 
bill, they are cutting by $7.7 billion--even more than last year's 
sequestration level. It not only eliminates the TIGER grants for 2014, 
it reaches back to 2013 TIGER grants and cuts them by $237 million. 
These kinds of cuts are untenable.
  They also signal a very different attitude here. It was at one time 
clear that transportation was one of those issues that united us, 
Republicans and Democrats, the North, the South, the East, and the 
West, because it was something that every community needed and every 
community understood. Now we see this dichotomy, and that is unhealthy 
for our government and for our economy.
  House Appropriations Chairman Hal Rogers said last July when these 
draconian cuts forced House leaders to pull the bill from 
consideration:

       With this action, the House has declined to proceed on the 
     implementation of the very budget it adopted just three 
     months ago. Thus, I believe that the House has made its 
     choice: sequestration--and its unrealistic and ill-conceived 
     discretionary cuts--must be brought to an end.

  Even the chairperson of the House Appropriations Committee is 
signaling that sequestration is untenable and unworkable.
  On this side of the Capitol, Chairman Mikulski has been a strong 
voice echoing--not only echoing, but asserting--that position 
constantly.
  We can't get rid of sequestration with spending cuts alone. We can't 
cut our way to prosperity. Revenue has to be part of the solution.
  In fact, as we have done over the last several years, we have cut 
discretionary spending dramatically. We are down to not fat but bone, 
and so we need additional revenues.
  There is some good news. There are loopholes, egregious loopholes, 
that in and of themselves should be closed, regardless if we were 
dealing with the issues of deficit and sequestration. They are not 
appropriate, not efficient, and they do not add to the overall economic 
benefit of the country. They do benefit very narrow interests. It comes 
down to whether my colleagues on the other side of the aisle are 
willing to see these special preferences prevail or whether the 
national economy and the families across this country will benefit.
  We have to move forward. We have to emphasize things that will help 
us, for example, create more manufacturing jobs in this time and for 
the future. I think at one point we thought manufacturing was passe. We 
discovered it is not only not passe but it is absolutely vital, because 
we can't take new innovation, new discoveries, at which we are so good, 
commercialize them, and then create new products in that 
commercialization process, unless we have manufacturing.
  We learn a lot on the manufacturing floor. We have seen products we 
have developed intellectually become not only manufactured but improved 
by other countries who have the ability to manufacture, we have to get 
back to doing that.
  We have to be able to align our workforce and our education system so 
that we have the skills for the next century. Job training has to be 
competent, efficient, and adequate. All of this requires investments in 
resources, not simply cutting away and cutting away.
  Ultimately, as we understand, and as our predecessors, particularly 
my predecessor, Senator Claiborne Pell, understood, education is the 
engine that pulls this country forward. We used to assume we were the 
most educated. We were the country with the best record of college 
graduates. We were the country that advanced public education for 
everyone. We look around the world and we have slipped in terms of 
college graduates. We have slipped in terms of skills. Our public 
education system needs to be reinvigorated. Not only with suggestions 
from the sidelines, not only with new approaches, but also with real 
resources. These investments have to be made.
  It is a multifaceted approach, but I think we have to begin with only 
the simple understanding, as we go forward, we need to provide the 
economy, our constituents, and ourselves the certainty of an adequate 
funding level for the government for the next 2 years. We need to 
suspend, dispense with, postpone--whatever the appropriate term--
sequestration, because it is not going to help us grow the economy. In 
fact, it will take away about 900,000 jobs.
  Then we have to certainly make it clear we will not threaten the 
creditworthiness of the United States by defaulting on our debt.
  If we can do these things, and I believe we can, we can provide the 
certainty that our private entrepreneurs need to make real investments 
in the economy and to grow. In all of this, we have to bring a balanced 
approach. It is not only cutting, it is expenditure cuts wisely chosen, 
together with revenue wisely chosen, through closing loopholes that 
will give us a growing economy, hopefully increase opportunity, and put 
us back on the path to profound sustained economic recovery.
  (The further remarks of Mr. REED are printed in today's Record under 
``Morning Business.'')
  Mr. REED. I yield the floor.

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