[Congressional Record Volume 162, Number 134 (Wednesday, September 7, 2016)]
[Senate]
[Pages S5310-S5324]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WATER RESOURCES DEVELOPMENT ACT OF 2016--MOTION TO PROCEED--Continued
The PRESIDING OFFICER. The Senator from Utah.
ObamaCare
Mr. HATCH. Mr. President, I rise to speak once again on the failures
of the so-called Affordable Care Act and what they mean for hard-
working families and taxpayers.
This is far from the first time I have come to the floor to talk
about ObamaCare. Indeed, over the past several years, I don't think I
have spoken as often about any other topic, and I am not alone. Since
the time the Democrats forced the Affordable Care Act through Congress
on a series of pure party-line votes, my Republican colleagues and I
have been speaking about the poor judgment and shortsightedness that
has unfortunately defined the trajectory of this law from its drafting
to its passage and now well into its implementation. Quite frankly, we
have had plenty of ammunition. It seems like we are treated to at least
one new ObamaCare horror story every week.
My friends on the other side of the aisle have done their best to
downplay our criticisms and minimize every negative story written about
the problems with ObamaCare. In fact, just this morning the Senate
minority leader came to the floor and pronounced the Affordable Care
Act a success, but the American people have long recognized the truth:
ObamaCare isn't working and it never will. This isn't a matter of
opinion. This is not just political rhetoric in an election year. By
its own standards--and the standards of those who drafted, passed, and
implemented the Affordable Care Act, ObamaCare has been a historic
failure.
Case in point, the American people were promised that ObamaCare would
bring down health costs, but in reality costs are continuing to go up.
Over this summer, as we moved ever closer to the next open enrollment
period for the ObamaCare insurance exchanges, we have learned that
insurers throughout the country have submitted requests to raise
premiums by an average of 18 to 23 percent over last year's premiums.
For some plans, the requested rate hikes are significantly higher than
that average, coming in at more than 60 percent according to some
recent reports.
Consider the following expected rate increases. In California,
policyholders can expect a 13-percent average increase in premiums,
which more than triples the increases seen in the past 2 years. In
Florida, they can expect a rate increase over 19 percent on average
over this year. In Nebraska, they can expect an average increase of 35
percent, with some rates increasing by nearly 50 percent. In Wisconsin,
rates are expected to increase on average by as much as 30 percent.
These numbers are more staggering when you consider that when the law
was passed, the Congressional Budget Office projected rate increases of
only 8 percent at this point.
By some estimates, premiums for silver plans--the standard metric--
are expected to increase 11 percent, more than they have at any point
since ObamaCare was implemented.
While some of my colleagues have claimed that the evidence of massive
premium increases is mostly anecdotal and that tax credits help blunt
the overall cost increase, they simply cannot ignore the facts.
Premiums in the ObamaCare insurance exchanges are going up in markets
throughout the country, and according to CBO, the Congressional Budget
Office, 12 million individuals are estimated to have to pay the full
price next year because they either are not eligible for credits or
they would choose to purchase coverage outside the ObamaCare exchanges.
What is more, the middle class is increasingly bearing the brunt of
these increased costs.
As the Wall Street Journal recently reported, middle-class families
are spending 25 percent more on health care costs, which reduces their
spending on other necessities. David Cutler, the health care economist
from Harvard, is quoted in the article as saying, when it comes to
health care, it is `` `a story of three Americas.' One group, the rich,
can afford health care easily. The poor can access public assistance.
But for lower middle to middle-income Americans, `the income struggles
and the health-care struggles together are a really potent issue.' ''
Our focus should no longer be on the question of whether premiums are
going up. We should instead be trying to figure out why it is
happening. In the end, there are a lot of reasons why Americans are
paying more for health insurance under a new system that was supposed
to help them pay less, but the overall explanation is actually pretty
simple: The President's health care law was poorly designed, and they
know it.
Recall when my friends were drafting and passing the Affordable Care
Act, they claimed that the system they were putting in place--complete
with higher taxes, burdensome mandates, and draconian regulations--
would entice more people into the health insurance market. With the
larger pool of insured individuals, my colleagues on the other side of
the aisle argued that insurers would be able to keep pace with all the
new requirements imposed under the law without passing costs on to
patients. We now know that these projections were, to put it nicely,
foolhardy. From the outset, enrollment in the ObamaCare exchanges has
lagged behind the rosy projections we saw when the law was passed. As
time has worn on, more and more people have opted to pay the fines
rather than purchase health care on the exchanges.
In February 2013, CBO projected that more than 24 million people
would be enrolled in the exchanges. As of this
[[Page S5311]]
past March, the actual number was less than half of that number.
My colleagues, in their desperate attempts to defend the health care
law, tend to focus solely on the number of uninsured people in the
United States--a number that has, admittedly, gone down in recent
years. However, what they tend to leave out is the fact that the vast
majority of newly insured people under the law haven't purchased
insurance through the exchanges. They have enrolled in Medicaid, a
fiscally unsound program that provides less than optimal coverage
options for patients. In fact, there are over 30 million people without
insurance, which was the reason we enacted the law--or at least that
was the argument. Today there are at least 30 million people without
insurance.
The Washington Post recently ran an article on the enrollment
shortfalls in the exchanges, plainly spelling out the issues. They
said:
Debate over how perilous the predicament is for the
Affordable Care Act, commonly called ObamaCare, is nearly as
partisan as the divide over the law itself. But at the root
of the problem is this: The success of the law depends
fundamentally on the exchanges being profitable for insurers,
and that requires more people to sign up.
Long story short, people are not signing up on the exchanges in the
numbers that were promised. As a result, health insurance plans have
been forced to adhere to the law's burdensome mandates and regulations
without the benefit of an expanded and healthier risk pool. So as we
have seen in recent months, plans in many of the exchanges have
reported massive losses, leading a number of major insurers in
important markets throughout the country to terminate their plans
altogether. The result: patients and consumers are being left with
fewer and fewer options.
According to a recent study by the Kaiser Family Foundation, nearly
one out of every three counties in the United States is likely to have
only one health insurance option available on the exchanges in 2017.
Another third of U.S. counties will only have two options available.
Thus, what had been approximately 35 percent of the counties with two
or less options on the exchanges is likely to double to around 67
percent.
Furthermore, more than 2 million individuals are expected to have to
change plans for 2017 as a result of insurers leaving States, which is
nearly double compared to those who had switched carriers at the end of
last year.
You don't need a Ph.D. in economics to know that, generally speaking,
fewer options means higher costs for consumers and lower quality
products being offered. That is exactly what the American people are
dealing with when it comes to health insurance. This includes people
from my home State of Utah. For example, one of my constituents, Mr.
Chris Secrist, wrote to me. He said:
Since the new health care law was forced on us my premiums
along with my deductibles have skyrocketed. With my premium,
deductible, and ``out of pocket'' expense . . . my total out
of pocket expense for insurance now tops $20,000 per year . .
. can anyone . . . explain how this can be considered
``affordable health care''?
Over the August recess, I met with the Utah board of directors of the
Leukemia & Lymphoma Society, and there I heard from many Utahns about
the skyrocketing cost of care over the past 3 years. These constituents
repeatedly emphasized that they had initially hoped ObamaCare would
help them, but in their experience, it had only made things worse and
much more expensive.
The downward spiral of ObamaCare is a circle that cannot be broken
without some kind of intervention. While there are a number of ideas
out there to address these problems, there are really only two major
paths we can take. We can enact reforms that are patient-centered and
market-driven or we can expand the role of government in regulating,
mandating and, in the end, paying for more and more of our health care
system.
Republicans in Congress, myself included, have proposed plans that
would take us down the first path toward more patient-centered reforms.
My friends on the other side, when they are not doubling down on the
status quo under ObamaCare, are advocating for even more government
involvement. Case in point, the Democrat's nominee for President has
outlined a number of ``reforms'' she would like to add to the
``progress we've made'' under ObamaCare. Each of her proposals amounts
to an expanded role for the Federal Government, including the renewed
idea of the so-called ``public option'' or a government-run plan.
In other words, in this election season, the Democrats' answer to the
failure of ObamaCare is more government control of our health care
system.
It is funny, beginning in 2009, when the health care law was being
finalized, I argued that Democrats intended to keep expanding the role
of the Federal Government in health care to the point where they could
argue that the only workable option after a series of failures would be
to create a single-payer health care system; in other words, socialized
medicine.
Some pundits and even my colleagues declared that I was paranoid,
that I was trying to scare people into opposing ObamaCare. Yet 7 years
later, those claims look relatively prescient, if I do say so myself.
Faced with the failure of ObamaCare to live up to its many promises,
my colleagues are not arguing for a change in direction. Instead, they
are clamoring for more authority to dictate the terms of what had been
a private health care marketplace before. In a world where the
government dictates both the products on the market and the prices at
which they are sold, the eventual result is a marketplace in which the
government is the only available provider. In other words, while many
of my friends on the other side will deny they want to create a single-
payer or socialized medicine health care system in the United States,
that is the direction they have us headed.
Fortunately, the march toward a single-payer system is not a fait
accompli. We can take action to right this ship now. We can control
costs. We can take government out of the equation and give patients and
consumers more choices. Of course, to get there, more of my colleagues
on the other side will have to acknowledge the failures of the current
approach and agree on the need to plot a new course.
Perhaps once the upcoming election is over, we can begin to make
progress on these issues. It is my hope that with the current
administration in the rearview mirror, people will be more willing to
acknowledge the failures of the ObamaCare status quo. I recognize that
the coming election may embolden those who support even more rigorous
government involvement in the health care sector to try to take us
further down the path of a single-payer system. If that is the case, we
are looking at an even more contentious environment than the one we are
in now.
Don't get me wrong. I want to see more bipartisanship around here. I
want us to find more opportunities to work together and get past the
blind partisanship that currently fuels so much of what we do here and
that caused 100 percent of the Democrats and not one Republican in
either House to support ObamaCare. But make no mistake, if the next
administration or the next Congress tries to take us further down that
path, they are going to have a heck of a fight on their hands. It is a
fight that I personally am prepared to win so that we can eventually
have a health care system that works for everyone.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Ms. HEITKAMP. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Unanimous Consent Requests--Executive Calendar
Ms. HEITKAMP. Mr. President, I come to the floor today after spending
the last 7 weeks traveling the beautiful State of North Dakota and
working with communities on issues that matter the most to them,
whether it is agriculture, opioid abuse--any number of issues involving
urban and rural housing. But one common message occurs at every stop:
Why can't Congress get its job done? Why aren't you doing what you are
supposed to be doing?
So the people of North Dakota and I think the people of this country
have a simple message: They want us to do
[[Page S5312]]
our job. They are sick and tired of politics getting in the way of work
getting done, and they don't understand why even the most basic issues,
the most simple issues, issues where there are vast majorities that
support them, get hung up in partisan politics.
That got me thinking about three numbers that really sum up the
inability of my friends in the majority to do their job. Those numbers
are 90, 175, and 20.
Let's start with 90. Ninety is the current number of judicial
vacancies across our various Federal courts in the United States.
Thirty-two of those vacancies have been deemed judicial emergencies.
That means that justice is being severely delayed in those
jurisdictions. Every day, Americans and American businesses have to sit
and wait for resolution and certainty when we are capable of getting
the job done, when we actually believe we have qualified nominees ready
to take the bench and hear those cases.
The majority has brought to the floor and confirmed only 20 circuit
and district court judges during this Congress--20. How does that
compare? Well, if you look at the last 2 years of the George W. Bush
Presidency, the Senate Judiciary Committee, which was then chaired by
Senator Leahy, actually approved nearly three times as many. In fact,
68 judges were approved during that time period--68 judges compared to
20. Last year the majority matched the record for confirming the fewest
number of judicial nominees in more than half a century. That is just
11 nominees for the entire year.
These are not records that any of us should be proud of, not when we
hear from judges, lawyers, and our constituents about the backlog of
cases in the Federal courts and around this country.
Right now, 31 nominees still have yet to either have a hearing or a
vote in the Senate Judiciary Committee. Some of these nominees have put
their lives on hold and are ready to serve their country in some of the
highest positions a lawyer can hope to achieve. They are putting their
lives on hold and delaying their economic viability, waiting to find
out.
That leads me to the second number. The second number is 175. That is
the number of days since the President nominated Merrick Garland to the
U.S. Supreme Court. My friends in the majority will come down and claim
they absolutely could not give him a hearing because of something
called the Biden rule--something which I have never voted on and which
I did not know existed. I went looking in the rule book to try to find
out where this Biden rule exists, and I have yet to track it down. But
I do know that when we talk about statements on the floor attributed to
then-Senator Joe Biden and now-Vice President Joe Biden, we ought to
look at not what he said but what he did when he chaired the all-
important Senate Judiciary Committee. So when we look at this from the
lens of actions speaking louder than words and if we look at what Joe
Biden was able to accomplish when he chaired the committee, he gave a
hearing to every single nominee who came before him, whether that
nominee was nominated by a Democratic President or a Republican
President.
That brings me to my last number, which should be the easiest of all
to address. That number is 20. Twenty is the number of circuit and
district court judges who have had a hearing, who have been reported
out of the Senate Judiciary Committee on a bipartisan basis--in fact,
18 of them were unanimous--but they are still awaiting an up-or-down
vote in the Senate.
I think it is unusual that I should even have to come to the floor to
explain how ridiculous this is. These nominees are all
noncontroversial. They are noncontroversial enough to have received a
hearing and been voted out of the committee with Republican and
Democratic support. That means the majority of the committee that we
charge with fully vetting these nominees found all of the nominees
qualified to serve a lifetime appointment on the Federal district court
bench. Well, 12 were nominated over 300 days ago and 6 others were
nominated over 200 days ago, and still they wait. Several of these
judges were nominated and have the support of both their home State
Democratic and Republican Senators. Several of these judges were
nominated by and have the support of all of their Senators. It is just
unheard of that they should have to wait, given that we have gone
through the process.
One of those nominees I want to particularly point out is a woman by
the name of Jennifer Puhl. Jennifer Puhl is from Devils Lake. Her
family is a huge and important part of the community there. Her dad
runs a small business, a plumbing business, and she worked her way up
through the ranks and currently serves as an assistant U.S. attorney in
North Dakota. She was appointed by a Democratic President, but she
served initially and received her initial appointment as an assistant
U.S. attorney from a Republican appointee. She is highly qualified and
completely noncontroversial; yet she waits and yet the Eighth Circuit
waits for another person to sit on the bench and carry the load of that
important circuit court.
So I think it is time to do our job. I think it is time to move these
20 nominees and to get the court fully functioning.
I make this point because when we look at the role Congress plays in
the judiciary, we have a very significant role, given lifetime
appointments, that we would, in fact, provide advice and consent. But
beyond that, the judiciary is an incredibly important part of our
checks and balances. When we don't have a functioning judiciary, we do
not have a functioning democracy. I think it is very important that we
look at this in the light of our responsibility to make sure these
three branches of government are fully functioning and doing their job
and able to do their job because we have people in place.
So I ask unanimous consent that the Senate proceed to executive
session to consider the following nominations: Calendar Nos. 359, 362,
363, 364, 459, 460, 461, 508, 569, 570, 571, 572, 573, 597, 598, 599,
600, 687, 688, and 689; that the Senate proceed to vote without
intervening action or debate on the nominees in the order listed; that
the motions to reconsider be considered made and laid upon the table
with no intervening action or debate; that no further motions be in
order to the nomination; that any related statements be printed in the
Record; that the President be immediately notified of the Senate's
action and the Senate then resume legislative session.
The PRESIDING OFFICER. Is there objection?
The majority leader.
Mr. McCONNELL. Mr. President, reserving the right to object, the
Senate has treated President Obama very fairly with respect to his
judicial nominations. By comparison, at this point in President Bush's
Presidency, the Senate had confirmed 316 of his judicial nominations--
316. As of now, the Senate has already confirmed 329 of President
Obama's judicial nominees. In fact, the Senate has already confirmed
more of President Obama's judicial nominees than it did during the
entirety--the entirety--of President Bush's 8 years in office.
So at this point I am going to object to the request, but I am
prepared to enter into an agreement to process a bipartisan package of
four more judicial nominations that would include a California judicial
nomination, two Pennsylvania judicial nominations, and a Utah judicial
nomination. This would presumably be agreeable to the senior Senator
from California, the junior Senator from California, and to the senior
Senator from Pennsylvania, along with the junior Senator from
Pennsylvania and both Utah Senators.
So I am going to ask the Senator from North Dakota to modify her
request as follows: Mr. President, I ask unanimous consent that the
Senate proceed to executive session to consider individually the
following nominations, at a time to be determined by the majority
leader in consultation with the Democratic leader: Calendar Nos. 364,
460, 461, and 569; that there be 30 minutes for debate only on each
nomination, equally divided in the usual form; that upon the use or
yielding back of time on the respective nomination, the Senate proceed
to vote, without intervening action or debate, on the nomination.
The PRESIDING OFFICER. Is there objection?
The Senator from New Jersey.
Mr. BOOKER. Mr. President, reserving the right to object, as the
junior
[[Page S5313]]
Senator from New Jersey, this is difficult for me because one of the
judges the Republican leader is suggesting be skipped is the judge who
has been waiting for the longest time. Judge Julien Neals has been
waiting since February of 2015. He is someone who came out of the
committee with bipartisan support and someone who has deep
qualifications. In addition to this, he is suggesting that we skip
another judge named Ed Stanton, who is the U.S. attorney for the
Western District of Tennessee.
I bring out those two judges who are next on the list. They are the
two longest waiting judges for the district court--one from May and one
from February. I single those two out not just because one of them is
from New Jersey but, if you look at the list of the next 15 judges,
these are the only two African Americans on the list. The two longest
waiting district court judges and the only two African Americans are
the two who are being singled out, among others, to be skipped over in
what the Republican leader is suggesting.
I know that for my colleagues in the Republican Party this is not a
conscious thing. I know this is a coincidence and that it is not
intentional that the two longest waiting judges--the only two African-
American judges on this list of 15--are being skipped over, but I do
feel it is necessary to point out this fact. At a time when this Nation
is looking at this judicial system as needing to confront judicial
bias, at a time when judicial organizations of all backgrounds are
pointing out the need for diversity on the Federal court, what is being
suggested right now is that we come up with a bargain to skip over the
two longest waiting district court judges, who happen to be the only
two African Americans on the list of the next 15. That, to me, is
unacceptable, especially when you look at the qualifications of these
two judges and especially if you look at their wide bipartisan support
within the Judiciary Committee. The perception alone should be
problematic to all of us in this body.
So I would like to object to this offer, especially given the
tensions that exist right now in our country, the urgency for diversity
on the bench, and the clear qualifications of these men, and, finally,
the fact that they have been waiting since May and February of 2015.
Thank you.
The PRESIDING OFFICER. Is there objection to the request of the
majority leader?
Mr. BOOKER. Yes, there is objection. I object to the modification.
The PRESIDING OFFICER. Objection is heard.
Is there objection to the request of the Senator from North Dakota?
Mr. McCONNELL. I object.
The PRESIDING OFFICER. Objection is heard.
The Senator from Wisconsin.
Ms. BALDWIN. Mr. President, before I returned home for the August
recess, I came to the floor to call on the Senate to take up pending
judicial nominations. Once again, today I join my colleagues in calling
for action on the crisis that is facing our Federal courts.
We had an unusually long recess--what is called the August recess,
but it actually started in mid-July. We have a brief period of time
when we are back in session before we are about to have yet another
recess prior to the elections. I understand the Senate has been in
session fewer days than the Senate has been in session in some
decades--60 years.
I feel it necessary that we step up and deal with this crisis in the
Federal courts and do our jobs. I call on my colleagues in the majority
to do our jobs.
The obstruction that we have seen with regard to filling judicial
vacancies is harming our Federal courts and our Nation, our economy,
and individuals who come before those courts to seek justice.
In this current Congress, only 22 judges have been confirmed by the
Senate. As we have discussed today, we currently have 90 vacancies on
the Federal courts. Thirty-two--one-third--have been declared judicial
emergencies. Yet before the Senate right now, we have Presidential
nominees for these vacancies--27 in number--that are available for our
consideration. Each of those names has garnered a bipartisan majority
from the Judiciary Committee. A bipartisan majority has supported those
Presidential nominees. Each and every one of them deserve a vote in the
full Senate. The American people fully deserve a functioning Federal
judiciary--whether the Supreme Court, our circuit courts, or the
district courts.
From my home State of Wisconsin, we have a longstanding vacancy on
the Seventh Circuit Court. This longstanding vacancy is absolutely
unacceptable. This traditional Wisconsin seat on the Seventh Circuit
Court has been vacant for more than 6 years. This is the longest
Federal circuit court vacancy in the country. Today marks the 2,435th
day--that is 6 years and 8 months--of this vacancy. The people of
Wisconsin and our neighbors in Illinois and Indiana deserve a fully
functioning court of appeals.
During this long vacancy, the Seventh Circuit has been considering
issues that face people of our State as well as our country. These
issues include women's health, labor rights, campaign finance, marriage
equality, and, most recently, voting rights. These are important
issues, and the people of Wisconsin deserve better than an empty seat
when judgments are being made on such consequential issues.
We have a highly qualified nominee for this seat. Don Schott was
nominated by the President on January 12. He has strong bipartisan
support. Both Senator Johnson and I have returned our blue slips, a
part of the process to advance one of these nominees. A bipartisan
majority of the Wisconsin judicial nominating commission recommended
and supported his consideration by the President.
Don Schott also received the support of a bipartisan majority of the
Senate Judiciary Committee when they voted to advance his nomination.
Don Schott is very well qualified. He has the experience and the
temperament to be an outstanding Federal court judge on the circuit
court, and his nomination deserves a vote. The people of the State of
Wisconsin deserve to have this traditionally Wisconsin seat filled.
Nine judicial nominees who have been previously approved by the
Senate Judiciary Committee prior to Don Schott still haven't had their
up-or-down vote either by the Senate, and they deserve it. As is the
tradition of this body, we vote on these nominees in the order they
appear in the Executive Calendar. As such, I will request that the
Senate Republican leader schedule votes on each of these nominees, as
well as on Don Schott.
Mr. President, I ask unanimous consent that the Senate proceed to
executive session to consider the following nominations: Calendar Nos.
359, 362, 363, 364, 459, 460, 461, 508, 569, 570, 571, 572, 573, and
597; that the Senate proceed to vote, without intervening action or
debate, on the nominations in the order listed; that the motions to
reconsider be considered made and laid upon the table with no
intervening action or debate; that no further motions be in order to
the nominations; that any related statements be printed in the Record;
that the President be immediately notified of the Senate's action and
the Senate then resume legislative session.
The PRESIDING OFFICER. Is there objection?
Mr. McCONNELL. Mr. President, reserving the right to object, I have
already pointed out that President Obama has already had more judges
confirmed than President Bush in his entire 8 years.
I offered a counter UC that would confirm four of the judges. I will
not repeat the modification that I offered earlier.
Therefore, I object.
The PRESIDING OFFICER (Mr. Toomey). Objection is heard.
The Senator from Hawaii.
Ms. HIRONO. Mr. President, there are currently 27 pending nominations
on the Executive Calendar and 90 total judicial vacancies. More than
half of these nominations have been waiting since 2015 for a
confirmation vote.
Hawaii's own Clare Connors was nominated to the Federal bench 1 year
ago tomorrow. She is one of the nominees who would be skipped under the
Republican leader's compromise offer, which is not a fair offer any way
you look at it. Claire's resume is extensive and impressive.
[[Page S5314]]
In her time as a U.S. assistant attorney, Clare prosecuted Hawaii's
most extensive mortgage fraud case. The case involved 15 criminals who
were making it harder for Hawaii's families to obtain mortgages. This
is only one example of Clare's nonpartisan commitment to public
service.
During her career, Clare has worked for Attorney General John
Ashcroft and Attorney General Eric Holder. She is impartial, she is
qualified, and she deserves a vote.
If Clare is not confirmed, the Hawaii district court seat would be
left vacant for over a year. People who appear before our courts don't
want to know or care if their judge is a Democrat or a Republican. They
just want to know that when they get their day in court, there will be
a competent and qualified judge sitting there. This goes double, of
course, for the highest Court in the land, the Supreme Court, which,
because of an unfilled vacancy, has resulted in a number of 4-to-4
votes. That is not how the U.S. Supreme Court should operate. We need
to do our jobs.
Mr. President, I rise today, therefore, and ask unanimous consent
that the Senate proceed to executive session to consider the following
nominations: Calendar Nos. 359, 362, 363, 364, 459, 460, 461, 508, 569,
570, 571, 572, 573; that the Senate proceed to vote without intervening
action or debate on the nominations in the order listed; that the
motions to reconsider be considered made and laid upon the table with
no intervening action or debate; that no further motions be in order to
the nominations; that any related statements be printed in the Record;
that the President be immediately notified of the Senate's action and
the Senate then resume legislative session.
The PRESIDING OFFICER. Is there objection?
Mr. McCONNELL. Mr. President, reserving the right to object, I
previously stated on two occasions that President Obama has already
gotten 13 more judges confirmed than President Bush in all of his 8
years as President. I offered a counter consent that was objected to
that would have confirmed a district judge in California, two district
judges in Pennsylvania, and a district judge in Utah. That was objected
to, so I will spare the Senate the counter UC I offered earlier because
I know it will be objected to. But with regard to the consent that has
just been requested, I object.
The PRESIDING OFFICER. Objection is heard.
The Senator from Massachusetts.
Ms. WARREN. Mr. President, Republicans who control the Senate are
setting new records for obstruction by slowing the pace of judicial
nominations to a crawl and leaving courts across this Nation
overburdened and understaffed.
I have listened as Senator McConnell has asserted that he is acting
fairly on judges because more Obama judges have been confirmed than
total George W. Bush judges. Here is my question: What kind of game
does he think this is? At this point in time during the Bush
administration, there were 42 judicial vacancies. Today, there are 90.
At this point during the Bush administration, there were 13 judicial
emergencies--vacancies in courts that are severely shorthanded and
overburdened with cases. Today there are 32--more than twice as many
vacancies, more than twice as many emergencies.
Senator McConnell says, well, he just doesn't want to do his job, and
neither do other Republicans. And we all know why. Republican leaders
in Congress have made it abundantly clear that they want Donald Trump
to be President so that he can appoint judges who will bend the law to
suit his own interests and those of his wealthy friends, and if that
doesn't work, then Republicans will settle for paralyzing the judicial
system so that it cannot serve anyone at all.
Judicial nominees stand ready to provide American individuals,
families, small businesses, and entrepreneurs with the justice they are
guaranteed by our Constitution. One of those nominees is Inga
Bernstein, a highly regarded Massachusetts attorney who has spent years
serving families, teachers, and workers. Ms. Bernstein is not
controversial. She is supported by both Republicans and Democrats. Give
Ms. Bernstein her vote. In fact, give these 10 noncontroversial
nominees their votes.
Mr. President, I ask unanimous consent that the Senate proceed to
executive session to consider the following 10 nominations: Calendar
Nos. 359, 362, 363, 364, 459, 460, 461, 508, 569, 570; that the Senate
proceed to vote without intervening action or debate on the nominations
in the order listed; that the motions to reconsider be considered made
and laid upon the table with no intervening action or debate; that no
further motions be in order to the nominations; that any related
statements be printed in the Record; that the President be immediately
notified of the Senate's action and the Senate then resume legislative
session.
The PRESIDING OFFICER. Is there objection?
Mr. ALEXANDER. I object.
The PRESIDING OFFICER. Objection is heard.
Ms. WARREN. Mr. President, it is disgraceful that Republicans are
blocking confirmation of these judges. It is even more disgraceful that
18 additional nominees haven't even had hearings yet, including Merrick
Garland, who has now waited longer than any Supreme Court nominee in
the history of the United States to receive a confirmation vote, while
our highest Court continues to deadlock on issue after issue of
importance to this Nation.
All we are asking for is the Senate Republicans to stop playing
politics and do their job.
I yield the floor.
The PRESIDING OFFICER. The Senator from Tennessee.
Mr. ALEXANDER. Mr. President, to keep appropriate balance here in the
Chamber, the Senate has treated President Obama fairly in terms of his
judicial nominations. As the majority leader has pointed out, by
comparison, at this point in President Bush's Presidency, the Senate
had confirmed 316 of his judicial nominations. As of now, the Senate
has already confirmed 329 of President Obama's judicial nominations. So
President Obama is ahead of President Bush by that count. In fact, the
Senate has already confirmed more of President Obama's judicial
nominees than it did during the entirety of President Bush's 8 years in
office.
Senator McConnell offered an agreement to process a bipartisan
package of four more judicial nominations that would include a
California judicial nomination, two Pennsylvania judicial nominations,
and a Utah judicial nomination, but Democrats objected.
The PRESIDING OFFICER. The Senator from New Jersey.
Mr. BOOKER. Mr. President, I rise again to continue the plea to move
forward when it comes to fulfilling the vacancies now pending in our
courts. I don't know about the Constitution saying anything about a
tit-for-tat--what one President got another should get--but to me the
obligation of the Senate is clear, and that is, we have an obligation
to do our job and to fill vacancies.
During this Presidency, significantly more vacancies have come up
because of retirements and other reasons. As we have already heard from
the Senator from Massachusetts, not only are there double the
vacancies, but the judicial emergencies being talked about now, which
have nothing to do with party, are real. Around our country right now,
there are many districts that are in crisis because of our failure to
do our job.
Relying on a tit-for-tat partisan understanding reflected nowhere in
our Constitution is unacceptable when we are not supporting the proper
functioning of the judiciary.
We have nominations on the floor, ones that have passed out of the
Judiciary Committee in a bipartisan fashion. One of those nominations--
to fill a vacancy in the U.S. District Court for the District of New
Jersey--is Julien Neals, who is a well-qualified nominee and who has
had to wait for over 19 months on his nomination--19 months. On this
list, he is the longest waiting judge. Judge Neals has served as the
chief judge of Newark Municipal Court, worked in private practice, and
served his community as corporation counsel and business administrator
for the city of Newark. The President nominated Judge Neals to the
Federal bench over a year and a half ago. A hearing was held on his
nomination in September 2015. The Judiciary Committee favorably
reported his nomination by voice vote in November of 2015.
The delay in confirming this nomination is unfair to the people of
New Jersey, who expect their justice system to
[[Page S5315]]
be working in its full capacity. But we know this isn't just a burden
for New Jerseyans; States across this country are being forced to
shoulder the Senate's failure to confirm judges, precipitating a
massive judicial crisis in our country.
Continued judicial vacancies means that current Federal judges will
be overworked and understaffed. Continued judicial vacancies means the
American people must wait a year or two or longer to receive justice in
a case. This goes counter to the very ideals we pledge allegiance to,
this idea of liberty and justice for all. Without judges on the Federal
bench, justice is denied for the woman who was fired on account of her
gender. Without judges on the Federal bench, justice is denied for the
transgender individual who is seeking to access a restroom or other
public accommodation. Without judges on the Federal bench, justice is
denied for the criminal defendant who deserves a speedy trial before a
jury of their peers--fundamental constitutional ideas. The longer the
Republican leadership delays filling our country's judicial vacancies,
the longer justice is denied for Americans across our country.
I ask the Senate to promptly vote on the next two nominees who would
be up, nominees from Tennessee and New Jersey. The Western District of
Tennessee nominee, Edward Stanton, is a former U.S. attorney and has
been pending for over 16 months. It is important for me to point out,
especially after the suggestion from the Republican leader that we skip
these first two judges, the longest waiting judges--I know there was no
intention here, but I think it is important that we point out that in
the compromise suggested by the majority leader, these are the only 2
African-American judges in the next 15.
So here we have two of the longest waiting judges, two qualified
judges, two judges who passed out of the Judiciary Committee, two
judges who deserve Senate action and who are also African-American
judges who can help create diversity on our Federal judiciary so that
it better reflects our society as a whole.
Given all of that--the totality of the crisis in our country, the
urgency that is explicitly addressed in our Constitution that the
Senate do its job--I now ask unanimous consent that the Senate proceed
to executive session to consider the following nominations: Calendar
Nos. 359 and 362; further, that the Senate proceed to vote without
intervening action or debate on the nominations in the order listed and
that, if confirmed, the motions to reconsider be considered made and
laid upon the table.
The PRESIDING OFFICER. Is there objection?
Mr. CASSIDY. On behalf of the leader, I object.
The PRESIDING OFFICER. Objection is heard.
The PRESIDING OFFICER. The Senator from Tennessee.
ObamaCare
Mr. ALEXANDER. Mr. President, the Americans I have talked with are
tired of ObamaCare rhetoric. They are worried about the ObamaCare
reality. And what is the reality today? The reality is that ObamaCare
is unraveling at an alarming rate. There appears to be a very real
danger that without structural changes there may be entire States with
no insurer willing to sell plans on their ObamaCare exchanges in 2018.
We are talking about 10.8 million Americans who buy health insurance
for themselves or their families on the ObamaCare exchanges created in
each State as a result of the law passed in 2010. What we are saying is
there are whole States where these 10.8 million Americans may have no
options to purchase health care with ObamaCare subsidies. This
unraveling is happening sooner than anyone thought and will require us
to act both in the short term and in the long term.
If we don't take action in the short term, many Americans will have
fewer options and no relief from skyrocketing premium costs. If we
don't take action to address the longer term structural failure of
ObamaCare, we could have a complete collapse of the individual
insurance market. Again, what we mean is that you may be living in a
State where you cannot buy health insurance if you rely on an ObamaCare
subsidy.
The reality of ObamaCare today is alarming even for those of us who
have been critical of the law and its thousands of pages of
regulations. Before ObamaCare even became law, Republicans warned
President Obama and we warned Democrats in Congress that ObamaCare was
bad news for Americans.
In February of 2010, more than 6 years ago, I spoke for Republicans
at a White House summit on health care and warned President Obama that
premiums for millions of Americans with individual insurance would rise
under his proposal. I was right about that. Republicans warned that
ObamaCare would increase the cost of health care, that people would
lose their choice of doctors, that policies would be canceled, that
people would lose jobs, that taxes would go up, and that Medicare
beneficiaries would be harmed. We were right about all of that. Today
an alarming number of health care insurance companies are leaving
ObamaCare exchanges. Americans are being forced to pay much more in
premiums for the same health plans next year. This might be what
Republicans predicted, but it is happening even faster than we
imagined, and no one is happy about being right.
Unfortunately, I don't need to look any further than my home State of
Tennessee to see how bad things have become. When Tennesseans woke up
on August 24 and read the front page of our State's largest newspaper,
they saw this headline: ``Very Near Collapse.'' The story wasn't about
a bridge or about a foreign dictatorship. ``Very Near Collapse'' was
our State insurance commissioner's description of the ObamaCare
exchange in Tennessee, which more than 230,000 Tennesseans--almost a
quarter of a million Tennesseans--used to buy health plans last year.
What does ``Very Near Collapse'' mean in the real world? This
November, when Tennesseans are signing up for 2017 ObamaCare plans,
there will be fewer plans to choose from, and they will be much more
expensive. That is what it means. This picture will be the same for
many Americans across the country.
Next year, Tennesseans will be paying intolerable increases--on
average, between 44 and 62 percent more for their ObamaCare plans than
they paid last year. Even for a healthy 40-year-old, nonsmoking
Tennessean with the lowest price silver plan on Tennessee's exchange,
premiums increased last year to $262 a month. Next year, it is $333 a
month. And if you, the policyholder, don't pay all of it, then you, the
taxpayer, will because a large portion of ObamaCare premiums are
subsidized with tax dollars. Surely, it is not a valid excuse to say
that just because taxpayers are paying most of the bill, that justifies
having a failing insurance market where costs are so out of control
that we may soon have a situation where no insurance company is willing
to sell insurance on an ObamaCare exchange.
Tennessee had to take extreme measures to allow these increases
because insurance companies told the State: If you don't let us file
for rate increases, we will have to leave. And if that happens,
Tennesseans might have only one insurer to choose from. That is what is
happening in States all over the country as ObamaCare plans and rates
get locked in for next year.
According to the consulting firm Avalere Health, Americans buying
insurance in one-third of ObamaCare exchange regions next year may have
only one exchange to choose from. People buying on ObamaCare exchanges
will have only one insurer to choose from in the entire State in five
States next year: Alabama, Alaska, Oklahoma, South Carolina, and
Wyoming, according to the Kaiser Family Foundation. The same Kaiser
Family Foundation report found that a growing number of States that
have multiple insurers have only one insurer selling policies in a
majority of counties.
Tennessee is one of those States. Last year, Tennesseans could choose
ObamaCare plans between at least two insurers in all 95 counties in the
State. For the 2017 plan year, next year, it is estimated that 60
percent of Tennessee's counties will have only one insurer offering
ObamaCare plans--in other words, no choice.
North Carolina is also experiencing a dramatic reduction in options
under
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ObamaCare. Next year, 90 percent of counties in North Carolina are
estimated to have only one insurer offering ObamaCare plans, up from 23
percent of counties last year. A similar picture exists in West
Virginia, in Utah, South Carolina, Nevada, Arizona, Mississippi,
Missouri, and Florida.
Just last week, the Concord Monitor, a newspaper in New Hampshire,
published an article with this headline: ``Maine health insurance
cooperative leaves N.H. market, reeling from losses.''
The story goes on to describe how the Maine-based Community Health
Options insurance plan will no longer be operating in New Hampshire
after experiencing over $10 million in losses in the ObamaCare exchange
over just the first two quarters of this year alone. This move will
leave 11,581 individuals in the Granite State looking for new health
plans.
Politico reports that one Arizona county is ``poised to become an
ObamaCare ghost town''--those are Politico's words--because no insurer
can afford to sell health plans on the ObamaCare exchange. That leaves
9,700 people in Pinal, AZ, with no ObamaCare plan options in 2017.
Millions of Americans need relief from ObamaCare. Here is the action
that is needed: First, Americans need immediate relief from the cost of
health insurance and the lack of options on the ObamaCare exchanges. We
could do that by giving States more flexibility to give individuals and
their families options to purchase lower cost private health insurance
plans outside of ObamaCare, and we could do that now. I intend to offer
legislation that would provide that relief. That is only to deal with
the emergency of next year.
Second, we need big, structural change in order to avoid a near
collapse of our Nation's health insurance market. If there is a
Republican in the White House next year, we need to repeal ObamaCare
and replace it with step-by-step reforms that transform the health care
delivery system by putting patients in charge, giving them more
choices, and reducing the cost of health care so that more people can
afford it. But if there is a Democrat in the White House, broad
systemic, structural changes will still be necessary.
Republicans didn't create this problem, but we are prepared to solve
it. Democrats want to spend more taxpayer dollars to prop up the
exchanges. They want to expand the role of government in your private
health care decisions.
In an article last month in the Journal of the American Medical
Association, here is what President Obama wrote: ``I think Congress
should revisit a public plan to compete alongside private insurers in
areas of the country where competition is limited.''
Of course, the President's proposal means more money and more
government, but Republicans know and Americans have seen over the last
6 years that more money and more government are not the solution; they
are the problem. We saw the problem ahead of time. We warned about it.
We criticized the poor regulations that made a bad law even worse. Now,
we are ready to take action. We are ready to do something about this
emergency--both for next year and for the longer term.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. CASSIDY. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. CASSIDY. Mr. President, I rise to speak about ObamaCare and the
incredibly negative impact it is having on millions of Americans. Let's
just speak about its impact upon the middle class. There was a recent
article in the Wall Street Journal, dated August 26, which spoke about
how ObamaCare is pushing the burden of health care costs to the middle
class. It speaks about how deductibles have risen 256 percent, but
wages have only increased 32 percent. It also goes on to say how folks
are spending 32 percent more on health care, but they are having to cut
back on groceries, restaurants, entertainment, and clothing. Everything
else is being cut back as health care consumes more and more.
ObamaCare was supposed to change health care. The President promised
that premiums would fall $2,500 per family. The logical question is,
Why didn't that happen?
I have a good example. A physician friend I know who happens to be a
neurologist in Baton Rouge texted me. She had a couple in her office
who were paying $1,600 a month for insurance. They have a $10,000
family deductible. They are middle class and don't get a subsidy. Let's
think about this. They are paying $1,600 a month and have a $10,000
family deductible. Let's do a little quick math. That is roughly
$16,000 a year plus $3,200, which comes to $19,200 a year, if my math
is correct. When we add $10,000 for a deductible--let's say they both
get in a car wreck and they are taken to the emergency room at the same
time--they will be out $29,000 before they see a benefit from their
insurance. They will have to pay $29,000 before they see a benefit from
ObamaCare which is supposed to hold down costs.
These are statistics and anecdotes. Let's speak in a different sense.
Let's speak about premium hikes. Premiums are up 31 percent this year
in Louisiana, but premium increases are rising as high as 67 percent in
Arizona. There is a 69-percent premium increase in Tennessee, and that
is consistent across the Nation.
As it turns out, there is one county now which doesn't have any
insurance company providing coverage, but there are many other counties
in our Nation in which there is only one insurance carrier. I can tell
you, the less competition you have, the higher costs will go. As this
continues, competition decreasing--and insurance companies like Aetna,
Humana, and Blue Cross are pulling out of the exchanges in some
States--we can expect these premiums to continue to rise.
The situation we are in is that people are either going to be
insurance poor or they will be forced to go without insurance. There is
an incredible irony. The bill which passed, the Affordable Care Act,
had the stated goal of making health care affordable. It is becoming so
unaffordable that people are going without insurance. I think this will
only worsen.
Up to today, ObamaCare has received $10.5 billion in Federal tax
dollars as subsidies, and there were a series of co-ops set up. The co-
ops were going to foster competition. As it turns out, 16 out of the 23
co-ops have gone out of business, health expenditures are on an alltime
rise, and the subsidies are going away--some of them have been ruled
illegal by the Federal courts--and so only the beneficiary will be
paying the premiums. Despite $10.5 billion in subsidies, insurance
companies have lost $2.7 billion. Again, if these subsidies go away
because they are illegal, we can expect premiums to rise even more.
I am a big believer that if you are going to criticize something, you
should offer an alternative. I would like to point out that this
Republican and another Republican have offered an alternative. We call
it the World's Greatest Healthcare Plan. We have kind of a cheeky title
to draw attention to it, but it is serious legislation. Under the
World's Greatest Healthcare Plan, we change the paradigm of ObamaCare.
If under ObamaCare the presumption is that government knows best and
folks in Washington can make better decisions for the folks in Baton
Rouge, New Orleans, Lafayette, Shreveport, the Presiding Officer's
hometown in Pennsylvania, or any other place in the Nation, and knows
what to tell them and what they should buy--therefore how much they
should spend--under the World's Greatest Healthcare Plan, we take the
opposite approach.
We assume that the woman in the household--usually it is a woman. I
am a physician so I know this. Usually, the woman makes 95 percent of
the decisions on health care for a family--let's use the feminine--so
she knows what is best for her family. There is kind of a humorous
anecdote. On the campaign trail 2 years ago, I had two different women
speak to me in a very memorable way. One of them came up and said: You
know, I am 58 and my husband is 57. Our two boys are 18 and 19. Unless
my name is Sarah and my husband is Abraham, we are not having more
children, we do not need pediatric
[[Page S5317]]
dentistry, and I do not need obstetrical benefits, but that is
included in my policy, which I am forced to pay for, and my husband and
I are paying $28,000 a year for insurance.
Another woman from Jefferson Parish walked up to me and said: My name
is Tina. I am 56 years old, and I had a hysterectomy. My husband and I
are paying $500 more a month for insurance--$6,000 more a year--and I
am paying for pediatric dentistry and obstetrics. I do not need these
benefits, but I sure as heck would like to have my money.
Washington is making the decision that these two women in Louisiana,
and women across the Nation should pay for benefits they don't need,
therefore paying far more. By paying far more, they have less to spend
on other things they might need to purchase, for example, flood
insurance in my State, clothing, restaurants, entertainment, a night
out in their own State, wherever that State might be, but they cannot
make that decision.
Under the World's Greatest Healthcare Plan, we take the power away
from Washington and give it to the family. We allow them to choose the
benefits they wish, those they need, making the decisions between
pocketbook and health care that they are uniquely qualified to make. By
the way, we also do away with the individual mandate. We know that
individual mandate. It is the ObamaCare provision saying that you shall
buy insurance or the Federal Government will fine you.
Under the World's Greatest Healthcare Plan, we take all the money a
State would receive from the Federal Government for health care and we
allow the State to give a credit to each individual in that State who
is eligible, and that would be most folks. The State legislature would
have the option to say that everyone in the State who is eligible is
enrolled unless they choose not to be--unlike ObamaCare, where you have
a 16-page online form where you have to get on and have your W-2 and
check it off. If you don't have a W-2 with you and are a poorer person
and have to go to the library for your Internet access and you go home
by public transportation to get the right form and have to take public
transportation back, it is not going to happen. Under our plan, you are
enrolled unless you choose not to be. We expect to have 95-plus percent
enrollment.
We don't provide the bells and whistles of ObamaCare, but what we do
is give first-dollar coverage. Instead of a $6,000 deductible per
individual or a $10,000 deductible per family, every family will have a
health savings account with which they have first-dollar coverage. If
they need to take their daughter to the urgent care center to have an
earache treated, they have first-dollar coverage. There is not a $6,000
deductible to work through. They have a pharmacy benefit and a
catastrophic coverage on top. If they are in a car wreck and admitted
to the hospital, they will be protected from medical bankruptcy by that
catastrophic coverage.
Another thing we do by giving power to the patient is price
transparency. Under ObamaCare we have seen prices rise and rise and
rise even more. Part of the problem is the consumer has no power. She
does not have the ability to know that if a doctor orders a CT scan for
her child--if she goes to this place and pays cash, it is $250 or if
she goes to that place, it is $2,500. I picked those numbers, by the
way, because the Los Angeles Times had an article a few years ago and
found that the cash price for a CT scan in the L.A. Basin varied from
$250 to $2,500, and there would be no way someone would know. With the
World's Greatest Healthcare Plan, the power of price transparency is
given to that mom so she knows where she can take the child for the
best cash price and the highest quality and balance that with her
budget. If the family wishes to really take matters into their own
hands, they can put their family credits all together in a pool and buy
a group policy for their family or they can give it to their employer
as the employee's contribution for an employer-sponsored plan and
buying into the richer coverage that employers typically give.
I could go on, but, if you will, the premise I learned as a physician
is that if you give the patient the power, she will make the right
decision for her family, both for their health and their pocketbook--
unlike ObamaCare, which says: Family, you are not as wise as folks in
Washington. We are going to tell you what you have to buy, therefore
what you have to pay, and if prices escalate even more and you decide
you can no longer afford insurance, we are coming after you to make you
pay a penalty. It is wrong, I think it is un-American, and it is
certainly bad for families.
The principle under the World's Greatest Healthcare Plan, which I
like to say in a phrase is giving the patient the power, but the
academic literature would call it the activated patient--someone who is
now fully engaged in managing her and her family's health care. Not
only does that result in lower costs, statistically it gives you better
outcomes.
There is a physician Congressman on the other side in the House of
Representatives who tells a story of someone he worked with. They went
through a health savings account, and the manager came up and said: Dr.
Fleming, I don't particularly care for this plan because it doesn't pay
for my inhaler. He said: Well, your health savings account can pay for
your inhaler, I suppose, if it is not covered by your pharmacy benefit,
but if you stop smoking, you don't need an inhaler, and he walked away
not thinking about it. She later approached him and she said: Dr.
Fleming, let me tell you. He said: Yes? She said: You are right. He is
thinking: What was I right about? She said: I stopped smoking and no
longer need an inhaler. That is a personal story, if you will, of that
which statistically is demonstrated. If people become engaged in their
health care, they are not only healthier, but they save money. Under
the World's Greatest Healthcare Plan, we take that Republican principle
of believing in the power of the individual to shape her life and her
family's destiny in a much more positive way than you would expect from
a bureaucrat telling you to be passive and to otherwise obey.
I will return. Unfortunately, the President's health care law, the
Affordable Care Act or ObamaCare, is crushing the middle class with
ever-higher premiums, higher deductibles, higher copays, an inability
to pay, and becoming insurance poor as they cut back on everything else
to avoid paying the penalty for the needed health insurance.
Republicans have offered an alternative. One alternative is the
World's Greatest Healthcare Plan, and in our alternative we give the
patient the power. I suggest that would be an important area of
compromise; that we all see that giving the patient the power, the
individual American the responsibility, is a better way to go.
I yield the floor.
The PRESIDING OFFICER. The Senator from West Virginia.
Mrs. CAPITO. Mr. President, I wish to thank my fellow Senator from
Louisiana, Mr. Cassidy--Dr. Cassidy--for his really creative ideas--the
World's Greatest Healthcare Plan and the way he frames it, in terms of
his years of practice and the sincerity with which I know he has
practiced in all kinds of health care settings and has done a lot of
work with folks who never could or never would have afforded health
insurance. So I thank the Senator for what he is doing and for working
with us to try to solve this issue.
I rise today to join many of my colleagues in sharing the realities
of ObamaCare. We have heard a lot about this. In my home State of West
Virginia, for many, this law has been nothing short of devastating.
While the number of people insured has increased because of the
expansion of Medicaid in my State, the way these policies were put into
place has created possible catastrophic fiscal cliffs for States. My
State, by the way, last fiscal year was over $300 million in the hole
because of other issues, and now they are looking at this fiscal cliff
of having to pay the full rate of Medicaid expansion.
There is now a segment of our population that is falling through the
cracks when it comes to health reform. They make too much money to
qualify for aid or subsidies and end up paying the full cost of
increasing individual coverage premiums. These working families are
being faced with sky-rocketing premiums, copays, and deductibles. Talk
to any health care
[[Page S5318]]
center. Talk to the hospitals. This rising amount of deductibles is
influencing their bottom line because they are not chasing the
uninsured. They are chasing now people's deductibles. In my State and
across this country, we have little, if any, choice in insurers.
I know we have all heard that often-repeated phrase, and I will say
it again. It is the claim that if you like your doctor, you can keep
your doctor. This has been pure fiction. The provider and hospital
networks have shrunk and insurers have shifted away from options to
give patients the choice they were promised and that they counted on,
and they are now being pushed into much more restrictive plans.
One of our local papers recently ran a story about a West Virginian
in just this situation, a small business person who labeled this plan
accurately, calling it the ``Un-Affordable Care Act.''
Since ObamaCare, my premiums have increased at least $450
per month in the last couple of years. The plan I had was
can-
celed. . . .
So if you like your health care, you can keep it. His was canceled--
false statement. He had to enroll in a new plan. His premiums are
currently over $1,350 a month. Between the high deductible and meeting
the out-of-pocket maximum, this West Virginian has to pay 20 percent--
all out-of-pocket--and the situation is likely to get worse.
In West Virginia, we, like many other States, are currently waiting
to see what our premium increase is going to be for 2017. It hasn't
been approved yet by the State insurance commission. The question is
not whether there will be an increase; that is a given. The question
is, How enormous will it be?
If nearby States are any indication, there is much to be concerned
about. In the State of Tennessee, the State insurance commissioner
recently sounded the alarm saying that the ObamaCare exchange in
Tennessee is very near collapse. Rates there are skyrocketing to
between a 44- and 62-percent increase. Sadly, the story is the same
whether one is in Arizona, New Hampshire, Iowa, Nebraska, or West
Virginia. All too often, these rate increases are coming with much less
coverage as well.
I recently spoke with a West Virginia small business person who has
absorbed the cost of increased premiums for their employees, realizing
they can't afford it but, at the same time, that employees are getting
much less coverage, higher deductibles, and higher copays. Attempting
to switch to a lower cost plan comes with its own perils. The average
bronze plan deductible in 2016 was $5,700. This is assuming you have
choices.
A recent analysis by the Kaiser Family Foundation found that one-
third of all counties in the United States will only have one ObamaCare
insurer next year. This is up dramatically from the 7 percent of
counties in 2016, and it is largely the result of major insurance
companies scaling back or withdrawing their participation on the
marketplaces. Unfortunately, there is nothing that indicates that this
trend will not continue. Many counties are becoming ObamaCare ghost
towns.
In Pinal County, AZ, 10,000 people bought exchange coverage this
year, but no insurers are planning to offer plans on the exchange next
year. What are they supposed to do? I fear this scenario could all too
easily play out in West Virginia. Traditionally, over the course of
ObamaCare, we have only had one insurer for the entire 55 counties.
This year we happen to have 1 insurer for 45 of the 55 counties.
This lack of competition in the marketplace is not new for our State.
This has been the reality for the vast majority of our residents, and
now we are seeing it just expanding all across the country. This lack
of choice, along with unaffordable premiums, copays, and high
deductibles, has prompted most Americans to reject ObamaCare plans and
not even join.
Nationwide enrollment in ObamaCare exchanges is only half what was
originally planned. We owe it to those we represent to do better. We
have heard Senator Cassidy talk about his ideas. We have great ideas on
this side of the aisle to improve it, and we have asked and voted many
times to throw out ObamaCare and start over. I think that is the
direction we need to go, because Americans deserve a health care system
that works for them, every day, from year to year. It is becoming
clearer and clearer that ObamaCare is not that plan.
Thank you, Mr. President.
I yield the floor.
The PRESIDING OFFICER. The Senator from Nebraska.
Mrs. FISCHER. Mr. President, I wish to thank my colleague from West
Virginia for her comments on this health care law, as well as my
colleague from Louisiana.
I have just returned, as we all have, from our time in our State and
traveling in our State. I know my colleague from West Virginia heard
the same stories that I heard in Nebraska. People are worried. They are
afraid. They are very concerned about their futures and what they are
going to see this fall with regard to this health care law. So I thank
my colleagues for their comments that they have given today on this
very important issue.
I, too, rise to address the stark reality of President Obama's failed
health care law. The evidence of its failure continues. The latest
example is the relentless increase in premium rates across our country.
In Nebraska, health care plans under ObamaCare will see premium rates
rise more than 30 percent. Nearly every week, I hear new stories of the
pain caused by this law. It breaks my heart because it has led hard-
working people to the brink of despair. We have sunk to the point where
some Nebraskans, like many Americans across our country, are now asking
themselves: Why bother?
Karen in central Nebraska shared that most of her paycheck goes to
her plan's premium and deductible costs. She is faced with two terrible
options: quit her job to qualify for more government subsidies or opt
out of insurance coverage and then pay the penalty.
Meanwhile, Peter, a small business owner in western Nebraska, faces
the gut-wrenching decision of raising prices to offset the rising
premiums and other unaffordable costs of his ObamaCare plan.
Stephen in eastern Nebraska, another small business owner, bluntly
told me: ``Enough is enough.'' For Stephen, it made more sense to pay
the penalty than to budget for his ObamaCare plan. If that wasn't
enough, Stephen's longtime family doctor, the medical professional who
he trusts, is no longer in his network. So now Stephen has to travel
just to see an in-network provider.
Because of a law forced upon them, Americans are left with difficult
choices. Mothers and fathers are being forced to choose between what is
in the best interest of their families and what health insurance costs
they are going to be able to afford.
Hard-working Americans are keeping less of their paychecks. They are
spending more on these uncontrollable health care costs. They can no
longer afford and, in many cases, they no longer even have the option
to see the doctor they trust. They are not saving money, and they are
not better off. They are living a real American nightmare.
Nebraskans are all too familiar with the failures of ObamaCare. The
co-op established for Nebraska and Iowa was one of the first ones to
fail, and that was in December of 2014. In my letter at the time to
then CMS Administrator Tavenner, I sought answers. I received an answer
much later from Acting Administrator Slavitt. His response was
disappointing, and it clearly demonstrated what we have known for a
long time now: The government is incapable of successfully
administering health care coverage. These Nebraskans were left with few
options and very little support because of the government's
shortsightedness in continuing a doomed co-op.
We have witnessed similar disasters with other ObamaCare co-ops
across the country. They keep failing. They include Colorado,
Connecticut, Illinois, Michigan, New York, and Oregon, to name a few.
At a cost to taxpayers of more than $1.7 billion of the original 23 co-
ops, only 7 now survive. That is a failure rate, people, of more than
60 percent. The surviving seven are now being evaluated for their
financial health, but one thing is clear: To prop them up through the
next enrollment period only to delay their really inevitable failure
would be incredibly dishonest to the American people.
Nebraskans are a trusting people. We like to give people the benefit
of the doubt, but there is no doubt any
[[Page S5319]]
longer. ObamaCare was built on certain promises and those promises have
been broken.
It is time for the government to be honest with the American people.
It is time to come clean, face up, and act responsibly. We have already
taken some positive steps to get our people out of this mess--steps
which the vast majority of the Members of this Senate have approved.
The medical device tax and the Cadillac tax are clear examples. The
majority of this Chamber agreed on a bipartisan basis that delaying
these taxes was a necessary step to alleviate some of the harm that has
been caused by this health care law. In voting to delay these taxes,
the Senate chose the American people over a failed law. That was a good
day, and that was a good vote. We must take more actions like that in
the future--action, not just talk--actions that will help the American
people lighten this law's heavy load and bring families back from that
brink. We must keep doing this until Americans like Karen, Peter, and
Stephen are no longer forced to make those unreasonable choices.
At the same time, I want solutions for those Nebraska families still
struggling to find quality and affordable health care. But let's be
honest. These solutions are not more bailouts and tax subsidies. No
more one-size-fits-all Federal mandates. We must all conclude that
ObamaCare is a clear failure. We must, once and for all, scrap it and
then replace it with patient-centered solutions. I want to have that
conversation, and I am ready and willing to do so.
Thank you, Mr. President.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. CARDIN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Gardner). Without objection, it is so
ordered.
Ellicott City, Maryland, Flood
Mr. CARDIN. Mr. President, the first order of business in this return
to session is for us to pass an appropriations bill to keep the
government open on October 1. I know that people are physically at work
in order to make that a reality.
I was on the floor yesterday talking about the need to fund Zika. To
me, that is urgent. We have to get that done now. I explained then that
there are real risks to the general population of Maryland and Colorado
and every State in this country from the Zika virus.
Today I am going to talk about two episodes--two disasters--that
occurred in Maryland during the recess. I mention that in this context
because we need our Federal agencies fully functioning and fully funded
in order to deal with the things that just happen in America.
In my own State we had two horrible disasters during the recess, and
I would like to talk a little bit about that.
Marylanders are heartbroken by the devastation that has hit our
community in Ellicott City. My condolences go out to the family and
friends who lost loved ones in the tragedy.
I want to especially thank the first responders who worked tirelessly
to save lives and property after the historic flooding in Ellicott
City.
Ellicott City is a historic Maryland treasure, founded in 1772 and
known for its vibrant business community and its culture of kindness
and resilience. It suffered significant flooding throughout the intense
rainfall on the evening of July 30, 2016. The National Weather Service
predicts that a rainfall of this magnitude should statistically occur
once in every 1,000 years. Six inches of rain poured down on Ellicott
City--an amount of rain that normally falls over the course of one
month--in the period of only 90 minutes.
Shortly after the storm hit, I toured Ellicott City with Howard
County Executive Allan Kittleman, officials from the Maryland Emergency
Management Agency, MEMA, and other Federal, State, and local officials.
The devastation is truly frightening in terms of damage to property,
businesses, homes, vehicles, and infrastructure in Ellicott City.
As the Baltimore Sun reported, Saturday, July 30, began unremarkably
for a summer day in the mid-Atlantic, with thunderstorms expected.
Joseph Anthony Blevins was out on a date night with his girlfriend
Heather Owens, and he suggested they stop at Main Street in Ellicott
City. They had just left a matinee at a movie theater in Laurel and
were heading home to Windsor Mill. With a roll of her eyes, she agreed
to stop in the city's historic district.
Let me continue with the Baltimore Sun's reporting of this story:
It was raining when [Heather Owens and Joe Blevins] pulled
into a parking lot off Main Street around 7:30 p.m., and they
sat in the car to wait out what they expected to be a short
downpour. They didn't know that the weather service had
issued a flash flood warning for much of central Maryland
about 12 minutes earlier. When they realized the rain was not
going to let up, they decided to go home. They pulled back on
to Main Street, but within five minutes, their car began
floating. The car struck a guardrail and plunged into the
swollen Patapsco River.
Owens was able to get out of the passenger side window, and
thinks she grabbed something, perhaps a branch of a tree on
the river bank, as the current pulled her downstream.
She looked for Blevins and saw him in the river, gasping
for air and reaching in vain for something to hold on to. She
scrambled up the rocky bank onto nearby railroad tracks,
heading toward houses on higher ground to get help. The
rushing waters had torn her pants and shoes off, but she
survived with a fractured jaw. . . . Residents and first
responders later looked unsuccessfully for Blevins. Blevins,
38, died during the flooding, leaving behind Owens and his
three children.
A confluence of meteorological and geographical factors turned this
hard summer rain into a destructive torrent. In less than 2 hours the
river rose 14 feet above its normal flow. Shops and restaurants that
line Main Street were swamped and flooded as water rushed down the
street and rose underneath it. The Tiber, usually just an inch or two
of water running through a reinforced channel below some of the
buildings, swelled during the storm.
You can see a little bit here of the damage that we are talking about
in this photograph. I had a chance to see this firsthand, and it was
incredible that buildings had been completely washed away. The river
normally flowed underneath that and has for a long time, but because of
construction and because of the amount of water that fell, the water
was funneled into Main Street, and it became a force of itself going
down Main Street, as well as the river rising below it, causing major
destruction.
Jessica Lynn Watsula also died in the flood. Again, as the Baltimore
Sun reports, she was a 35-year-old mother who lived in Lebanon, PA, and
had gone to Portalli's in Ellicott City that night with three women for
a girls' night out.
Watsula dropped off her 10-year-old daughter at her
brother's home and drove two hours from Pennsylvania for
dinner and painting Saturday in Ellicott City--a chance to
share an evening with her sister-in-law and two other
relatives.
As the four women left Portalli's Italian restaurant on
Main Street in the historic district, a wave of flood water
began to sweep their car away. They got out and clung to a
telephone pole as waist-high water rushed over them.
Watsula was swept away and died in the flood.
As we mourn the loss of Joseph Blevins and Jessica Watsula, let me
thank the citizens of Ellicott City who undoubtedly saved many lives
with their heroic actions during this historic and deadly flood.
I am pleased that our congressional delegation has moved quickly to
facilitate the emergency help for families, communities, homeowners,
and small businesses to recover from this disaster.
I want to recognize and praise the Federal agencies who stepped up to
the plate and worked hand-in-hand with our State and local officials.
Let me start by thanking the Small Business Administration and
specifically SBA Administrator Maria Contreras-Sweet for her tremendous
help to the people of Ellicott City. The SBA's survey of Ellicott City
found more than the 25 structures--with 40 percent or more of uninsured
damage--required to recommend an SBA physical declaration. At least 60
homeowners, renters, and businesses in Ellicott City and surrounding
areas sustained major damage or were destroyed. More than 80 structures
sustained minor damage as well.
In this case, the Federal disaster declaration from the SBA was
necessary to ensure Howard County business owners got the physical
disaster loan assistance and economic injury disaster
[[Page S5320]]
loan assistance they need to repair or replace real estate, personal
property, equipment, or inventory damaged or destroyed in the
disturbance. I know many of these shopowners. These are not chains;
these are small business people who have set up their own unique
businesses providing retail services in a way that reminds us of how
retail used to be in this country. Main Street in Ellicott City is Main
Street America. These people are very resilient, but when you have this
type of damage and you know how long it is going to be before you can
return the structure to its use, it requires a helping hand.
I was pleased that the SBA came through for the citizens of Ellicott
City by approving a formal disaster declaration which will allow the
homeowners, businesses, and nonprofit organizations impacted by this
epic storm and resultant floodwaters to apply for economic injury
disaster loans, which provide low-interest assistance to help
businesses meet their financial obligations and pay ordinary and
necessary operating expenses.
The SBA has repeatedly proven its willingness and ability to help
Marylanders struck by crisis. I express my sincere thanks to the SBA
for the assistance extended to our neighbors in need, and I will
continue to work with Team Maryland, including Senator Mikulski and
Congressman Cummings, to identify additional resources to aid Ellicott
City. The Maryland delegation has come together to support the State's
request for a Federal disaster declaration for Howard County after the
deadly and devastating flood in Ellicott City.
Given the massive impact this flooding had on our State and our local
resources, I have joined my colleagues in the Maryland delegation in
writing a letter to the President urging him to approve the Federal
disaster declaration at the request of our Governor, Larry Hogan.
I also acknowledge the extraordinary help from officials from Region
III of the Federal Emergency Management Agency and in particular
MaryAnn Tierney. Region III offices are headquartered in Philadelphia
but include the State of Maryland. So I appreciate Administrator
Tierney coming down for a site visit to oversee the joint preliminary
assessment. She was there immediately. I met with her. She understood
the urgency and the importance of being on the ground. I was pleased to
have the opportunity to meet with her and others during her site visit
to Ellicott City. I thank her for her coordination with State and local
officials in responding to this disaster.
Flower Branch Apartments Explosion and fire in Silver Spring, Maryland
Mr. President, I also want to share with my colleagues another major
disaster that occurred in Maryland over the Senate recess. On August
10, a massive explosion and fire took place at the Flower Branch
Apartments in Silver Spring, MD. Seven individuals died in the
catastrophe, which caused dozens of injuries and displaced over 100
residents.
I was at this scene also. We lost life. People lost their lives, and
I am going to mention their names. I was surprised to find that there
were survivors when I took a look at the amount of damage that was done
by this explosion. The first responders showed me parts of the building
that were found hundreds of yards away, mangled by the force of the
explosion. There was immediately a fire that consumed the rest of the
premises. As the Washington Post reported, the destruction was so
devastating that authorities were unable to immediately determine how
many people died. There was difficulty in making identifications.
Among the victims were two little boys, Deibi Morales and Fernando
Hernandez, who had become friends as their mothers undertook new lives
in the United States; a couple, Augusto Jimenez and Maria Castellon,
who built a house-cleaning business; and a retired painter, Saul
Paniagua, who doted on his grandchildren. We mourn all their lives, and
we extend our deepest condolences to their families.
I toured this site recently with Montgomery County Executive Ike
Leggett and other Federal, State, and local officials, including
officials from the Montgomery County, MD, Fire and Rescue Service. Our
hearts go out to the families who have been impacted by this horrible
tragedy in Montgomery County.
I want to thank the first responders, State and local officials, as
well as a wide range of nonprofit, faith-based and community groups who
have answered the call to help victims, families, and loved ones begin
to put their pieces back together as best they can. It was heartwarming
to see the community outpouring to help those who were homeless
immediately as a result of this disaster and to provide whatever they
could.
They provided help to the first responders. The temperature was over
100 degrees during the period of time this occurred. There were
oppressive temperatures and very difficult working conditions. The
community came together to help the first responders. We had a team
come in from out of town who is expert in this type of accident to help
us in dealing with this tragedy.
I thank everybody for their help in trying to do what we could to
help those who are fighting and helping to locate the survivors and to
those who were victimized by this explosion.
At the Federal level, I commend the work of the Bureau of Alcohol,
Tobacco, Firearms and Explosives in helping with the investigation of
this massive explosion and fire.
I am pleased that the National Transportation Safety Board has
launched a formal investigation into this incident, and that is because
there is an expected gas line issue involved in the explosion. I am
hopeful that the National Transportation Safety Board investigation
will uncover the causes of the explosion and fire and hold individuals
accountable for any wrongdoing, as well as lead to additional safety
recommendations as to how to help prevent these types of devastating
explosions in the future.
We should also examine our outreach and education efforts to the
immigrant community to make sure that all residents are aware of the
rights and government services available to them. This community is an
immigrant community. For many, English is not their first language. It
was an additional challenge to make sure they understood that we were
there to help and that we wanted to make sure we did everything we
could to make sure they were properly taken care of.
Again, I thank the Federal, State, and local government agencies that
helped the citizens of Ellicott City and Silver Spring respond to these
terrible disasters. Working with our nonprofits and faith-based
communities, we can recover and rebuild from these tragedies.
As I said in the beginning, this is just another example of why it is
critically important that we do our job here and that we pass the
necessary appropriations bills so that our Federal partners can help
our State and local governments help those who are victimized by these
types of disasters, that they knew they have the Federal agencies fully
tooled, fully budgeted to help them respond to these tragedies.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. COATS. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Ending U.S. Aid Used for Palestinian Acts of Terrorism
Mr. COATS. Mr. President, in June I spoke on the floor about the
appalling practice of the Palestinian Authority to reward terrorists
and encourage more terrorism against Israeli citizens and Americans. My
purpose then was to draw attention to these payments and especially the
fact that U.S. taxpayer money was being used in this disgusting way. I
had hoped that others would share my outrage. Unfortunately, that has
not yet occurred, although I think it will.
Already, the country of Norway has raised this issue through its
Foreign Minister. Just recently, a German parliamentarian of the Green
Party raised this issue. Countries are becoming aware of the fact that
they are subsidizing terrorist acts by Palestinians against Jews and
against Americans in Israel and that aid money which is going to that
country from our countries--from a number of foreign countries--is
being used for that purpose.
[[Page S5321]]
Let me give some of the facts regarding that. I want to repeat these.
Some of this is a repeat of what I said in June, but I think this is so
unconscionable, such inhumane behavior that we are subsidizing, that we
need to understand what it is and we need to take action to make sure
this does not continue.
Since 1998, the Palestinian Authority, which I will refer to as the
PA, has been honoring and supporting Palestinian terrorists serving
criminal sentences in Israeli prisons and rewarding the families of
those terrorists, those who have committed these criminal acts,
rewarding their families with financial support based on the severity
of the crime.
As we have learned through some documentation obtained, this system
has now been formalized and expanded by President Abbas's Presidential
directives. Palestinian terrorist prisoners are regarded by the PA as
patriotic fighters, as heroes, and actually as employees of the
government of the Palestinian Authority. While in prison, they and
their families are paid premium salaries and given extra benefits as
rewards for their terrorist actions. When they are released from
custody, the terrorists then become civil service employees.
Shockingly, monthly salaries for both incarcerated and released
prisoners are on a sliding scale, depending on the severity of the
crime and the length of the prison sentence. Thus, the more heinous the
crime, the longer the sentence, and a longer sentence entitles the
criminal and his family to a much higher premium salary. For example, a
Palestinian prisoner with a 5-year sentence because they committed a
criminal act against an Israeli or an American citizen or someone who
is not a Palestinian receives about $500 per month, whereas a more
serious criminal, say serving a 25-year sentence, perhaps for murder,
receives $2,500 a month. It is an incentive to do an evermore criminal,
heinous act against a human being. They are paid on a sliding scale
basis. That, by the way, is six times the average income of a
Palestinian worker. Where else in the world does a prisoner receive
such benefits that actually increase with the severity and violence of
the crime? U.S. Federal prisoners, for instance, earn between 35 cents
and $1.15 per hour and certainly not on a sliding scale and certainly
not to that level.
In May of 2014, Palestinian President Mahmoud Abbas issued a
Presidential decree that moved this payment system from the PA to the
PLO, the Palestinian Liberation Organization. The openly acknowledged
reason for this shift was to sidestep the increasingly critical
scrutiny of this payment system by foreign governments--including us,
the United States--that are contributing so much of the money that
keeps the PA afloat. So they were receiving criticism, and there were
inquiries by countries providing aid, including ours, including our
State Department, and including some legislation that was enacted by
the Congress. They created a shell game. They simply took the money
that was given to the Palestinian Authority, and because there was
criticism of their use of it as to these payments, they shifted it to
the PLO through a shell game process that they thought we would not
discover, and we did. Fortunately, we did.
Unfortunately, given these facts, given the fact that we now know
what is happening with American taxpayer dollars and some of our
allies' taxpayer dollars, there should not be any question in terms of
what is happening and what we ought to do, but apparently many of our
leaders have been intentionally turning a blind eye to this practice in
the hopes that we will ignore what is going on.
This nefarious scheme has been going on now for 18 years and almost
no one has been saying anything about it. That is why I am on the floor
today, that is why I was on the floor in June, and that is why I will
be on the floor again to continue to bring these facts to light so we
can take action to prevent this from happening.
Where is the outrage--outrage over the fact that a government is
deliberately encouraging and financially rewarding its citizens to
engage in a criminal act.
This administration has explicitly avoided criticism of the PA on
this matter, and it is ignoring the misuse of taxpayer money and
helping the PA reward its terrorists to honor its martyrs. It is time
they stood up, acknowledged the facts, and put an end to this. How can
this silence be consistent with our antiterrorist efforts and
counterterrorist efforts? How can this silence be ignored?
One answer is that the administration has ignored the misuse of
taxpayer dollars simply because it doesn't want to stir the pot. There
are problems in the Middle East. We are dealing with a number of them.
I am just speculating, but maybe the conclusion is let's not raise
another issue that could cause further conflict in the Middle East.
Yet there are worse things here than just silence because not only
does the State Department decline to actively oppose these terrorist
payments, they even offer false excuses for the outrage, excuses no
rational person would believe. For instance, the Department of State's
Bureau of Counterterrorism said in a recent report that this payment
system was ``an effort to reintegrate [released prisoners] into society
and prevent recruitment by hostile political factions.'' This is simply
an absurd interpretation of the terrorist rewards programs, and its far
more sinister motives are obvious to anyone who is paying attention.
At the same time, we must admit that this payment scheme has gotten
little or no attention in the Senate. For 18 years, the PA has been
using American taxpayer money to reward terrorists. Yet until I spoke
about it in June, I am not aware this subject has even come up on the
Senate floor in any of the recent years. We should be holding hearings
on this issue in appropriate Senate committees, as there have been
recently in the House of Representatives, and thank goodness for that.
More of my colleagues should be demanding that we stop financing such a
scheme and we should enact legislation to impose that solution, if
necessary.
I can only speculate why outside groups that support Israel are also
hesitant to press Congress to take action. Some may be reluctant to
impose more pressure on a financially weak and dependent PA, believing
that it would deprive Abbas of what little remains of his authority and
status as a negotiating partner, thus making a negotiated settlement
even less likely.
Even some Israeli officials may share this view and have worked for
years to act as a brake on efforts by Congress to cut off aid,
presumably to preserve the PA's stability as a West Bank security
provider. Well, we have seen where that has gone--nowhere.
Despite possible consequences, we simply cannot give the PA a pass to
support, to condone, and even reward terrorism, no matter what the
consequences might be. The Palestinian Authority does not deserve
immunity just because of its fragility. These payments provide rewards
and motivations for brutal terrorists, plain and simple. To provide
U.S. taxpayer money to Abbas and his government so they can treat
terrorists as heroes or glorious martyrs is morally unacceptable.
To tolerate such an outrage because of concern for Abbas's political
future or preserving the PA's security role amounts to self-imposed
extortion. If the PA's fragile financial condition requires U.S.
assistance, then it is their policy--not our policy--that needs to
change.
We need an immediate response to this outrage.
First, I am working with my colleagues to end American financial
support for incarcerated terrorists or the families of these so-called
martyrs. We will identify the amount of money that flows from the PA to
the PLO for this purpose and cut U.S. assistance by that amount, at the
very least.
Legislation to that effect is now in both the House and the Senate
versions of appropriations bills, and we must work together to ensure
that this language survives any future omnibus or continuing
resolutions and is repeated in future appropriations bills.
If this partial cutoff of U.S. aid is not sufficient to motivate the
Palestinian Authority to end this immoral system of payments to
terrorists, we should propose a complete suspension of financial
assistance until they change their policy.
I am aware that suspending assistance to the Palestinians will have
other consequences that we and Israel
[[Page S5322]]
will have to address, but I believe the pressure that we and other
like-minded governments could apply to this matter will bring President
Abbas and other Palestinian officials to their senses.
In any case--whether it does that or not--the moral imperative is
clear: Payments that reward and encourage terrorism must be stopped and
must be stopped now.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Minnesota.
Prescription Drug Prices
Ms. KLOBUCHAR. Mr. President, I rise to bring attention to an urgent
issue affecting all Americans. Actually, the No. 1 issue I heard about
when I was home--and especially at our State fair, which, by the way,
is the biggest State fair in the country because we don't count Texas
because they are open for a month. But there were 2 million people, a
record crowd, 1.9 million to be exact.
I went out there most of the days, and I was able to talk to folks
right where they were. The issue they are talking about is the high
cost of prescription drugs in our country. The price of insulin has
tripled in the last decade. The price of the infectious disease drug
Daraprim has increased 5,000 percent overnight. The antibiotic
Doxycycline went from $20 a bottle to nearly $2,000 a bottle in just 6
months. Of course, the price for an EpiPen--which received so much
attention over the last few weeks, which is used to treat life-
threatening allergies, my daughter carries one wherever she goes--shot
up nearly 500 percent since 2007.
It seems every week we hear another disturbing report of drug
companies focused on profits. According to a 2016 Reuters report,
prices for 4 of the Nation's top 10 drugs increased more than 100
percent since 2011. The report also shows that sales for those 10 drugs
went up 44 percent between 2011 and 2014, even though they were
prescribed 22 percent less.
I continue to hear from people across my State and the Nation about
the burdensome cost of prescription drugs. There are heartbreaking
stories about huge pricetags that are stretching families' budgets to a
breaking point. This is just an example. I brought these examples home
with me from the State fair and then brought them to Washington. These
are from just a few days at our State fair booth, where people came up
and filled out cards about their stories of increasing drug prices.
These are just a few of the emails we have received since August 25 and
calls we have received in our office every single day.
For example, take the Dwyer family from Cambridge, MN. At 11 years
old, Abby was diagnose with a rare form of leukemia. A few years later,
her older brother Aaron was diagnosed with stage III lymphoma.
Thankfully, both Abby and Aaron are doing much better, but the family
faced astronomical out-of-pocket expenses during their treatment. Abby
is on a drug with an average wholesale price in the United States of
$367 per day, which is double the average price in other countries.
Another example is a family from Elk River, MN. Due to their son's
allergies, they must buy four EpiPens a year--two for home, one for
school, and one for daycare. That is not overdoing it. I can tell you,
having had a child with allergies since she was 4 years old, you don't
just buy one. You have to buy one for school, then you also have to
maybe buy one for grandma's house, and then one gets lost--so you end
up not buying just one EpiPen. In reality, most families are buying
four to six, which are two packs, three packs, sometimes even four
packs. This family from Elk River, MN, buys four EpiPens a year: two
for home, one for school, and one for daycare.
This year the family paid $533 for a two-pack, even after using
Mylan's coupon. They shouldn't be forced to spend over $1,000 each year
just to make sure their son is safe every single day.
I recently heard from a family in Lakeville, MN, whose daughter was
diagnosed with type 1 diabetes. She needs insulin on a daily basis.
This means paying $100 a month for Humalog, which is a fast-acting form
of insulin. This significant financial burden is on top of all the
other costs they pay for their daughter's diabetes, including test
strips, an insulin pump, and a glucose monitor.
Unfortunately, these families are not alone. A recent study showed
that one out of four Americans whose prescription drug costs went up
said they were unable to pay their bills. One out of five were forced
to skip doses of their medication. Seven percent of people even missed
a mortgage payment due to rising prescription drug costs. That is just
not right, and our country must do better.
I think one of the most frustrating things about it, having heard
about the EpiPen--all because of my role with this all during the last
few weeks--is that I got screen shots of photos of this exact same
product in Australia for $150 from someone who saw it online.
In Great Britain, I was on a show broadcast out of Europe, and there
the host had it right there on the screen at 150 bucks. In fact, the
Canadian prices--Minnesota being so close to Canada--are, on average,
50 percent of American drugs across the board.
Of course, the burden extends beyond patients, the States, and the
Federal Government. Programs such as Medicare, Medicaid, and the State
Children's Health Insurance Program, or SCHIP, paid roughly 41 percent
of the Nation's prescription drug costs. When drug prices increase with
abandon, American taxpayers are left footing the bill. So people who
think, well, I don't need one of those EpiPens, they are paying for it
because Medicaid is buying them because SCHIP is buying them and
because Medicare is buying them.
Just last week, we learned that the company that manufacturers EpiPen
and perhaps other companies have found ways to make taxpayers pay even
more. Mylan marketed EpiPen like a brand-name drug, right? We heard
about it this week because they just--and we will appreciate that--
introduced a generic version. However, their other version, their
marketing version, controlled at least 85 percent of the market. They
would claim they were having some innovations, and that is how they
justified that enormous price increase from $100 to about $600 from
2009 to the present.
However, through the Medicaid Program--so, remember, they are
marketing it not as a generic. Everyone knew that because they just
introduced a generic. Well, in the Medicaid Drug Rebate Program they
wrongly classified--we found out this week, when I sent a letter with
Senator Grassley and Senator Blumenthal, that they wrongly classified
EpiPen as a generic drug to the government. To the government, they
claimed it was a generic drug. This classification means that Mylan has
been paying lower rebates to Medicaid, increasing the burden on
taxpayers.
So you think, OK, misclassification, what does that mean? Well, I can
tell you what that means.
In Minnesota alone--because I specifically asked about Minnesota--in
1 year, my State overpaid an estimated $4.3 million. Why don't we
multiply that out by all the States in the Union and all the years it
has been happening? At this point, we do not know the total amount
taxpayers have overpaid on EpiPen or how many other drugs from other
companies are misclassified. That is why I have called on the
Department of Health and Human Services to conduct a nationwide
investigation to determine how much the misclassification of, first,
EpiPen has cost States and the Federal Government, and, two, to
identify other misclassified drugs from other companies.
Take these examples from the Canadian International Pharmacy
Association. In the United States, a 90-day supply of ABILIFY, a drug
used to treat depression and other mental health disorders, costs
$2,621. In Canada, a 90-day supply of the exact same drug is only $467,
which is over 80 percent cheaper.
So you see these examples of these high-priced drugs. I think one of
the things we need to do--and I don't know how those are classified--is
to see how these are being classified for Medicaid purposes.
Working with the Department of Justice, HHS should use all the tools
it has to recover any overpayments. We have asked specifically about
EpiPen. Well, Mylan paid almost $120 million--I don't think this has
been that well
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known--back in 2009 to correct a misclassification of drugs. That was
in 2009. Now we find out with EpiPen, which is about 10 percent of
their profits, that this has been misclassified for years and years and
years.
Misclassification is just one way the government and, as a result,
taxpayers are paying more than necessary for prescription drugs. One
thing is absolutely clear: We must act now to make the cost of
prescription drugs more affordable for all Americans. There is not one
silver bullet that will fix the problem across the board, but there are
some commonsense solutions to address the problem. Today I am going to
offer four such solutions, any one of which would provide real relief,
but the best way is to do all of them.
The first is this. I mentioned Canada a few times. In fact, I just
mentioned some of the Canadian prices for the drugs. In Minnesota we
can see Canada from our porch. They spend a lot less money than we do
on prescription drugs. As I mentioned, last year average prescription
drug prices in Canada were less than half as expensive as they were in
the United States--a price gap that has expanded significantly over the
last 10 years. I mentioned a few of them--Abilify. There is Celebrex,
an anti-inflammatory drug, which costs $884 in the United States for a
90-day supply. In Canada it is $180. That is nearly 80 percent less. I
mentioned EpiPen, at $623. Of course, now we are going to get the
rebate and the generic introduced after a public outcry, which is not
the way it should be working. A two-pack in Canada costs 62 percent
less, at $237.
These staggering differences are why I introduced bipartisan
legislation with Republican Senator John McCain to allow Americans to
safely import prescription drugs from Canada. The Safe and Affordable
Drugs from Canada Act would require the FDA to establish a personal
importation program that would allow Americans to import a 90-day
supply of prescription drugs from an approved Canadian pharmacy.
Now, there may be other safe drug suppliers in other countries. I
think we know that. But we thought, in order to get the noise down,
let's focus on one country, our neighbor and one of our best trading
partners, and why not just go with the friendly people of Canada for an
experiment to see how this works to allow some competition by allowing
these drugs in from Canada.
To provide needed safeguards, the FDA would publish an online list of
approved Canadian pharmacies so people know where they can purchase
safe drugs. These approved pharmacies would need to have both a brick-
and-mortar and an online presence, and they must have been in business
for at least 5 years. Also, these pharmacies would not be permitted to
resell products purchased outside of Canada. The drugs from Canada
would need to be dispensed by a licensed pharmacist and be required to
have the same active ingredient, route of administration, and dosage
form and strength as an FDA-approved drug.
There would also be safeguards to ensure that the personal
importation program is not subject to abuse. Patients must have a valid
prescription from a doctor. Certain types of drugs, including
controlled substances, would not be permitted.
This is a safe and commonsense step that would save families real
money and inject greater competition. We are about competition in this
country. That is how we bring prices down. We have a friendly neighbor
to the north that clearly has lower priced drugs than ours, and that is
why Senator McCain and I have joined, along with Senators Susan Collins
and Angus King of Maine and many others, to say: Let's do this. That is
one solution.
A second solution is this: Pay for delay. This is of one of those
things that, when I told our citizens in Minnesota about this at our
State fair, they could not believe it. Beyond the drug importation
legislation, we can crack down on illegal pay-for-delay deals that
prevent less expensive generic drugs from entering the market.
Pay-for-delay agreements occur when a brand-name drug company--a
pharmaceutical company--pays a generic drug competitor--a potential
competitor--not to sell its products. This is going on in the United
States of America.
My booth at the State fair is next to Bob's Snake Zoo, and sometimes
people come out yelling and screaming because they get a little scared
from the snakes, but this is scarier than that. In fact, pharma
companies are paying generic companies to keep their products out of
the marketplace.
That is why I have introduced the Preserve Access to Affordable
Generics Act with Republican Senator Chuck Grassley of Iowa. This gives
the Federal Trade Commission greater ability to block these anti-
competitive agreements.
By allowing generic drugs to enter the market more quickly, the
government would save money through the purchase of lower cost generic
substitutes. That is why it is estimated that limiting these sweetheart
deals would generate over $2.9 billion in budget savings over 10 years
and save American consumers billions on their prescription drug costs.
Who can be against this? You literally have two competitors, one
accepting money and one paying them off to keep their products off the
market. The Supreme Court heard a case which made some difference. The
SEC has a bunch of open cases, but it has been agreed at hearing after
hearing that Senator Grassley and I have held that this would be a
smart thing to do. Remember, it would save the government $2.9 billion,
but it would also save the consumers.
The third good idea is allowing Medicare to negotiate prices. This is
another thing where Minnesotans and Americans cannot believe this is
the case, but in fact the combined incredible market power of the
seniors of America has not been unleashed in terms of getting good
deals for the seniors of America.
Under current law, prescription drugs for Medicare beneficiaries are
provided through private prescription drug plans. The plans are
responsible for crafting benefit packages and negotiating with
pharmaceutical companies for prices and discounts. The Department of
Veterans Affairs and Medicaid can currently negotiate drug prices with
pharmaceutical companies, but the law bans Medicare from doing so. This
makes no sense, and it is a bad deal not just for our seniors but for
all taxpayers.
That is why I introduced the Medicare Prescription Drug Price
Negotiation Act. This legislation would allow Medicare to directly
negotiate with drug companies for price discounts. The Federal
Government would leverage its large market share to negotiate better
prices for more than 30 million seniors--that is market power--covered
under Medicare Part D.
Last and finally, there is the CREATES Act. I worked on this bill
with Senator Patrick Leahy, Senator Grassley, and Senator Mike Lee to
introduce the bipartisan Creating and Restoring Equal Access to
Equivalent Samples Act. That is a mouthful, but what it would do is to
put an end to strategies that delay generic competition and cost
American consumers billions of dollars.
To receive approval from the Food and Drug Administration, a generic
must test its products against the brand name product to establish
equivalence. You would want that. Without access to brand name samples,
there can be no generic product.
For a long time, generic companies would simply buy these samples
from a wholesaler. Now, some brand name companies prevent generic
companies from obtaining samples, or the brand name company simply
refuses to negotiate safety protocols with the generic company. In
either case, the longer the brand name company can delay the generic
company's approval, the longer the brand name maintains its monopoly.
The CREATES Act would allow a generic drug manufacturer facing one of
these delay tactics to bring an action in Federal court in order to
obtain the needed samples or stop a branded company from dragging its
heels on negotiating safety protocols. The bill would also allow a
Federal judge to award damages in order to deter future delaying
conduct.
The Congressional Budget Office estimates that this bill would save
the government $2.9 billion over 10 years. The savings to consumers and
private insurance companies would likely be far greater.
So let's review this, as my colleagues come to the floor. Solution
No. 1 is to
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allow for safe drugs from Canada. It would bring down the prices and
would bring in competition. This is a bipartisan bill--Democrats and
Republicans--that I have with Senator John McCain.
Solution No. 2 is to allow for more generic competition by passing
the CREATES Act, which I just mentioned. That bill is with Senators
Leahy, Grassley, Lee, and myself. That is a bipartisan bill that allows
for samples to go quickly to the generic companies so they can actually
create the drugs that will compete and bring the prices down.
Solution No. 3 is to stop those pay-for-delay deals that are
unbelievable. That would bring in, according to CBO estimates, $2.9
billion over 10 years, by saying to the generics and the pharma
companies: You can't pay each other to stop competition. Competition
helps consumers.
And here is the final idea, which I think is the biggest idea:
negotiation under Medicare Part D. This would finally take the kind of
negotiation we see at the Veterans Administration, which has brought
down the prices for the veterans of America, and harness the bargaining
power of 39 million seniors so that we get better prices.
These are four ideas, and three of them have Democratic and
Republican sponsors. I want to vote on these proposals because I
believe, based on what I saw at our State fair booth--again, with just
a few days of the cards we received--that these anticompetitive
practices have to stop and we need to bring down the prices of
prescription drugs for the hardworking Americans in this country.
I yield the floor.
The PRESIDING OFFICER (Mr. Lee). The Senator from Oklahoma.
Mr. INHOFE. Mr. President, first of all, being one of the managers of
the bill, the WRDA bill that we are all anxious to consider, along with
Senator Boxer--she and I as well as the leadership, are in agreement,
that we should take this bill and consider it. I do have a talk I want
to give concerning the bill but with the understanding that I have been
asking for amendments to come forward from the Republicans primarily.
She has done the same with Democrats. I believe there are a number of
amendments that have come forward. However, the way we are going to run
this is that any amendments that are going to be considered, No. 1,
must be germane and, No. 2, have to be acceptable by both managers of
the bill--Senator Boxer and myself.
With that, I ask that we move forward on this bill and yield to the
leadership.
The PRESIDING OFFICER. The Senator from California.
Mrs. BOXER. Mr. President, I am in full agreement with the remarks of
my chairman, Senator Inhofe. Once again, I think we have proven we can
get this done. We can get infrastructure done. I think the way the
agreement came together with the two leaders is excellent. We are going
to go to the bill and any amendments have to be looked at by the two
managers, and we have to agree before those amendments go into the
managers' package.
With that, I yield the floor.
The PRESIDING OFFICER. The Democratic leader.
Mr. REID. Mr. President, we have given everyone our amendments. There
are seven. I think that everything can be worked out on all of them.
There is one that is relevant to the underlying legislation that is
offered by the Senator from Connecticut, Mr. Blumenthal. I am not sure
that I want to go into this deal where both of you have to approve that
amendment. I think he should at least be allowed to have a vote. We
have agreed that a half-hour debate on it is plenty, at least on that
one. If you can't work something out, I want to have a vote on
Blumenthal. That doesn't sound unreasonable. On six of them, Senator
Boxer can do what she thinks is appropriate. On Blumenthal, if you
can't work something out to his satisfaction, I want a half-hour debate
and a vote on it.
The PRESIDING OFFICER. The majority leader.
Mr. McCONNELL. Mr. President, I think we have a broad bipartisan
agreement here that we would like to pass the bill. Nobody wants to be
unreasonable. We have heard from both the chairman and the ranking
member that whatever interest there is in the bill is related to the
bill. What I am going to propound here is an opportunity for us to get
onto the bill and to move forward. I think this is as close to a good-
faith situation as I can imagine, and I hope we trust each other enough
to go forward and complete a bill that almost everybody seems to be in
favor of. I don't know how to reassure my good friend, the Democratic
leader, but I hope I have.
Mr. REID. Mr. President, I do not understand why we can't have the
two managers agree that they will do their best to work out these
amendments of ours and of theirs. But if we can't, I want to at least
have a vote, and you can vote it down if you have to, but I want to
make sure that Blumenthal is protected. If we can't work something out,
then we have a vote on it--one vote.
Mr. McCONNELL. All I would say is there may well be some votes. I
would recommend people talk to the chairman and the ranking member, and
let's process the bill.
Mr. REID. Why can't we have a vote on Blumenthal? That is all--one
vote, 30 minutes. If you work it out to satisfaction, we don't need to
have that vote. What could be more reasonable than that?
Mrs. BOXER. Mr. President, my understanding about this amendment is
that it is a jurisdictional dispute between Democratic Senators. I
think the best way to go is to see if we, Jim and I, can do what we
have done before when we have had conflict among our colleagues. We
worked it out with Senators on the other side of the aisle last time we
did WRDA. We should have a chance. I don't think that----
Mr. REID. If I can interrupt my friend from California----
Mrs. BOXER. I will stop.
Mr. REID. I don't object. Let's go ahead with the bill.
Mr. McCONNELL. Mr. President, what is the pending business?
The PRESIDING OFFICER. The motion to proceed to S. 2848.
Mr. McCONNELL. I know of no further debate on the motion to proceed.
The PRESIDING OFFICER. Is there further debate?
Hearing none, the question is on agreeing to the motion to proceed.
The motion was agreed to.
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