[Congressional Record Volume 163, Number 2 (Wednesday, January 4, 2017)]
[Senate]
[Pages S31-S45]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CONCURRENT RESOLUTION ON THE BUDGET, FISCAL YEAR 2017--Continued
The PRESIDING OFFICER. The Senator from Wyoming.
Mr. ENZI. Mr. President, I ask unanimous consent that the time be
equally divided between the two sides during quorum calls.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. ENZI. 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. ENZI. 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the quorum call be rescinded.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. ENZI. Mr. President, I ask unanimous consent that for the
duration of the Senate's consideration of S. Con.
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Res. 3, the majority and Democratic managers of the concurrent
resolution, while seated or standing at the managers' desks, be
permitted to deliver floor remarks, retrieve, review, and edit
documents, and send email and other data communications from text
displayed on wireless personal digital assistant devices and tablet
devices.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. ENZI. I further ask unanimous consent that the use of calculators
be permitted on the floor during consideration of the budget
resolution.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. ENZI. Mr. President, today we have a new Congress. Soon we will
have a new President. For the first time in years, hardworking
Americans will have their voices heard as we take the first steps to
repair the Nation's broken health care system--steps to remove
Washington from the equation and to put control back where it belongs--
with the patients, their families, and their doctors.
The President's health law has pushed insurance markets to the brink
of collapse. Premiums for hardworking families are soaring, while
patients' choices are dwindling. I urge my friends on the other side of
the aisle to face the facts that ObamaCare has failed to deliver on its
core promises and is hurting far more than it is helping.
I know our colleagues on the other side of the aisle share our goal
of a robust health care system for hardworking families, and I truly
hope they will work with us to find common ground that delivers more
choices and lowers costs. I welcome the input from all the Nation's
lawmakers as we endeavor to listen to the American people in this
pursuit. But first, it is important to remember how we got here so that
the actions that we will be taking this year are considered in proper
context.
After the 2008 election, Democrats controlled the Presidency and had
a majority in the House and a supermajority in the Senate. This allowed
Senate Democrats in 2009 to pass a health care plan without any
Republican support, which is exactly what they did. House Democrats had
initially approved a health care reform bill with several important
differences. So congressional Democrats needed to address these
concerns in a conference committee. But plans to iron out the
differences between the House and Senate versions were derailed in
early 2010, when Democrats lost their filibuster-proof majority with
the Massachusetts special election that resulted in placing Senator
Scott Brown in the seat formerly held by the late Senator Ted Kennedy.
He had held that seat since 1962.
With the filibuster-proof majority lost, Democrats in the House
approved the Senate-passed health care bill without any Republican
votes and sent it to the President, while vowing to use the budget
reconciliation process to address their colleagues' concerns with the
Senate legislation.
Subsequent budget reconciliation legislation was passed by Democrats
and signed into law by President Obama. Combined with the initial
health care bill, ObamaCare was created.
Now, I share this brief history of ObamaCare only as a reminder that,
while my colleagues will surely complain about using the reconciliation
process to untangle the country from this unworkable, unpopular, and
unaffordable law, they should remember they actually employed the exact
same procedure to secure the passage of ObamaCare.
Recent headlines show the ObamaCare problem is only getting worse and
discourages people from seeking so-called coverage. Last October, at
Bloomberg's The Year Ahead Summit in New York, the CEO of Aetna
discussed the issues surrounding their decision not to participate in
ObamaCare exchanges, saying:
As the rates rise, the healthier people pull out because
the out-of-pocket costs aren't worth it. . . . Young people
can do the math. Gas for the car, beer on Fridays and
Saturdays, health insurance.
Now, if you are young and healthy, ObamaCare has made it an easy
choice to opt out of health coverage. But if you are not so fortunate--
for those who must have coverage--it quickly becomes a frightening
reality. I have constituents in Wyoming who have written to me, with
worry and concern about their surging health insurance premiums. I
recently heard from a young woman who is experiencing the worst of this
law. She said:
Dear Senator Enzi,
I am writing with concerns specifically in the way that our
country is heading in respect to healthcare services.
I am a 25 year old with no medical conditions, I rarely
need a doctor visit, however as I looked into the health
insurance for me and my 8 month old son, also without health
problems, I have found insurance to be incredibly expensive.
Based on the cost of our health care last year, which
included a C-section and the birth of our son, our family
would spend less on health care if we paid for medical
expenses out of pocket and did not have health insurance.
However, in order to obey the law this is not an option.
I have researched and calculated the most cost effective
health care option for our family. We are looking at paying
almost $800 a month for our insurance, even with my husband
receiving insurance through work. This is almost 1/3 of our
family's monthly income. . . . Insurance is becoming a huge
burden for our family.
Now, that is the reality for many of our constituents across the
country. She is trying to do the right thing for her family's health,
but the law is crippling them financially. Our answer must be to not
ignore these problems. For many Americans caught up in ObamaCare's
tangled and expensive web of regulations, the situation is grim and
only getting worse by the day. It is time to act.
One of the most disturbing parts of this law is that Americans are
now paying more in taxes to pay for the very health law that is driving
up their insurance premiums. The law will saddle American households
with $1 trillion--$1 trillion--in new taxes and penalties over the next
10 years, unless Congress acts. ObamaCare's crushing regulations mean
smaller paychecks for families, while holding back small businesses
from expanding and hiring new workers. For every American, ObamaCare
has meant more government, more bureaucracy, and more rules and
regulations, along with soaring health care costs--along with soaring
health care costs.
It is time to lift the burdens and higher costs this law has placed
on all Americans. The Senate is poised to pass a repeal resolution that
will set the stage for true legislative relief from ObamaCare that
Americans have long demanded, while ensuring a stable transition in
which those with insurance will not lose access to health care
coverage.
Let me repeat that. The Senate is poised to pass a repeal resolution
that will set the stage for true legislative relief from ObamaCare that
Americans have long demanded, while ensuring a stable transition in
which those with insurance will not lose access to health care
coverage. This will allow us to move step-by-step on a new set of
reforms, listening carefully to the advice of the millions of Americans
affected and to do our best to make sure that we proceed wisely and do
no harm.
Fortunately, America now has a President committed to repealing
ObamaCare and moving toward a system that offers more choices, lower
costs, and more individual control for millions of hardworking
Americans.
The American people have endured a lot under ObamaCare and its broken
promises. As a Presidential candidate not so long ago, then-Senator
Barack Obama, a Democrat from Illinois serving here, promised Americans
they could keep their health plan if they liked it. Millions soon
learned they couldn't, and others soon wouldn't. This is because
ObamaCare has drastically reduced Americans' choice of health care
plans through a Federal takeover of the insurance marketplace. In fact,
the President's promise that ``if you like your plan, you can keep it''
has proven to be one of many unfulfilled and unattainable promises of
ObamaCare.
In Wyoming, we have seen the real impact of ObamaCare on our health
insurance market. Wyoming now only has one health insurer in the
individual market, both on and off the ObamaCare exchange. Many States
are experiencing a similar issue of having insurers leaving the
exchanges entirely. So for Wyomingites, the Obama administration's
talking points about ``choice'' were in the end just more empty
promises.
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Americans were also promised lower health care costs, but even the
administration admits that ObamaCare is failing to address costs, with
average premiums rising by 25 percent for silver-level plans on the
Federal exchange. That is in 1 year. This means that families have to
decide whether to purchase unaffordable insurance or to pay a fine. In
most cases, they are literally paying more money for less control over
their health care.
Health care costs in Wyoming continue to be among the highest in the
Nation, with other States not far behind. ObamaCare's mandates and
taxes on employer-sponsored health plans are not only leading to higher
out-of-pocket expenses but also to fewer choices and fewer services for
the 150 million Americans with employer-sponsored health benefits. Let
me repeat that: The mandates and taxes on employer-sponsored health
plans are not only leading to higher out-of-pocket expenses but to
fewer choices and services for the 150 million Americans with employer-
sponsored health benefits.
According to the nonpartisan Kaiser Family Foundation, individual
employees who have job-based insurance have seen their out-of-pocket
expenses climb by hundreds of dollars year after year. Employees
working for small businesses now have deductibles of over $1,800 on
average. Since ObamaCare became law, several large employers have
stopped offering benefits to part-time employees altogether.
Over the past 50 years, our Nation has made great strides in
improving the quality of life for all Americans, but these
transformative changes are always forged in the spirit of bipartisan
compromise and cooperation. These qualities are essential to the
success and longevity of crucial programs such as Medicare and
Medicaid.
This is a crucial time for health care in America. We do not have the
luxury of ignoring the growing problems in the health insurance markets
and the crushing premiums faced by families across our country. That is
why we are doing this first. The failures of ObamaCare have
metastasized since its passage.
We must act now to repeal ObamaCare and provide relief to the
millions of Americans who have been harmed by this law. Relief will
require a stable transition period, which ensures those with coverage
today continue to have access to health care tomorrow. Unwinding this
tangle of partisan gridlock to make meaningful changes will not be
easy. Our goal is to create a health care system where Washington makes
fewer decisions and families are empowered to control their own health
care with more choices and lower costs.
This is where we find ourselves today. Congress and soon the new
President will be in a position to begin the process of repealing
ObamaCare. Passing this resolution is just the first step on a path to
repair health care for millions of hard-working Americans whose
experiences with ObamaCare have meant broken promises, higher costs,
and fewer choices.
This is the budget resolution we are debating now. As far as the
budget part of it, all this is, is a statement of where we are at the
moment. This budget went into effect last October. It has been changed
a few times in the meantime, and this is a reflection of the changes
that have been made up to this point.
The difference is in title II, which is where the reconciliation can
take place. You will notice that it is a very simple title. There is
not much to it. It requires that the Committee on Finance of the Senate
shall report changes in laws within its jurisdiction to reduce the
deficit by not less than $1 billion for the period of fiscal years 2017
through 2026. The Committee on Health, Education, Labor, and Pensions
will report changes in laws within its jurisdiction to reduce the
deficit by not less than $1 billion for the period of fiscal years 2017
through 2026. There is no specificity in this as to how the
reconciliation will take place. That is up to the Finance Committee and
the Health, Education, Labor, and Pensions Committee on the Senate side
and the Energy and Commerce Committee and the Committee on Ways and
Means on the House side to come up with the reconciliation bill, which
has to pass a lot of Senate rules in order to be done, but you will
notice that there isn't any specificity in here on how to do that.
That comes later. That will be another budget debate we will have,
but it sets the stage so that can be done. Hopefully, it will be done
quickly and we will be able to find solutions for the hard-working
Americans whose experiences with ObamaCare are broken promises, higher
costs, fewer choices. I hope our Democratic colleagues will join us in
this effort so that we can come up with solutions so that Americans can
afford the insurance they want and need.
I remember when we started this debate, I think there were 30 million
people uninsured. Today, I think there are 30 million people uninsured.
It is a different 30 million, though: The 30 million who couldn't get
insurance now have insurance, and 30 million people who had insurance
now can't afford their insurance. It is time for us to take care of
both 30 millions and not just one. We will have that opportunity if we
pass this concurrent resolution to fix ObamaCare.
I yield the floor and reserve the remainder of my time.
The PRESIDING OFFICER. The Senator from Vermont.
Mr. SANDERS. Mike Enzi, the Senator from Wyoming, is a friend of
mine. He comes from a beautiful rural State--Wyoming. I come from a
beautiful rural State--Vermont. That is probably the end of our
commonality. We look at the world very differently, and I hope that in
the course of this debate, the American people will see the very
profound differences we have not only on health care, not only on tax
policy, not only on the deficit, but on many other important issues.
What we are looking at right now is a budget process whose ultimate
goal is to remove health insurance from tens of millions of Americans.
Let's be clear. Today, the United States of America is the only major
country on Earth that--I live 50 miles away from the Canadian border.
Many of us have visited Europe. We are the only major country on Earth
that does not guarantee health care to all people as a right. It is
something I passionately believe in. I believe that health care for all
is a human right. I had hoped we would work together to figure out what
is a complicated issue as to how we can move forward to guarantee
health care to all people in a cost-effective way, but that is not what
we are debating today.
Let's be very clear. The Republican plan--their budget plan--lays the
groundwork for ending the Affordable Care Act, which will remove tens
of millions of Americans from the health insurance they get. There is
nothing wrong with change. We can always improve.
I hope that during the course of this debate, my Republican friends
who want to repeal the Affordable Care Act will come down and tell us
what their plan is, how, in fact, they are going to provide quality,
cost-effective health care to all Americans. Well, you know what. They
all voted against the Affordable Care Act. Senator Enzi is right--we
did not get one Republican to vote for it. They have had 8 years to
think about how they are going to come up with a new plan, and I would
hope but I do not expect one Republican to come to the floor and say:
Oh yeah, we are going to throw 20, 30 million people out of their
health insurance. This is our new plan. This is how we are going to
provide health care to those people.
They have no ideas. Their theme is to repeal and then delay. Someday
they are going to come up with a new plan. You don't destroy a house
without having another house in which people can live. You don't throw
30 million people off of health care without having a plan to provide
health care to those people.
Under the Republican proposal--something many Republicans have been
talking about for years--they want to end Medicare as it presently
exists, a program that is life-and-death for millions of seniors. They
want to voucherize Medicare, give people a check, and then let them go
to the private insurance market and get the best deal they can.
Imagine that you are an 85-year-old senior citizen who has been
diagnosed with cancer and you get your check for whatever it may be. We
don't know what it will be--$7,000, $8,000, $9,000.
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You go to the insurance company and you say: I have $9,000. I am 85. I
have been diagnosed with cancer. I want you to take care of me. Give me
an insurance program that will take care of my medical needs, my
hospital needs.
The insurance agent will laugh in your face because $9,000 or $8,000
will last you, at most, for 1 week.
That is their plan.
I have been all over the country, and right now the American people
are outraged at the high cost of prescription drugs in this country--
let's be clear--because of the power of the pharmaceutical industry and
their lobbying and their campaign contributions--a power that exists,
by the way, not only influencing Republicans but too many Democrats as
well. We pay the highest prices in the world for prescription drugs. In
fact, one out of six Americans who goes to a doctor to get a
prescription for an illness cannot even afford to fill the
prescription. Yet, under the Republican proposal, if you eliminate the
Affordable Care Act, the doughnut hole fix, which now helps seniors pay
for their prescription drugs, will be eliminated and prescription drugs
for seniors could rise by as much as 50 percent.
By the way, at a time when we have more income and wealth inequality
than any other major country on Earth, when the very rich are getting
richer while the middle class shrinks, the Republican proposal not only
throws 20 to 30 million people off of health insurance, not only raises
the price of prescription drugs for seniors, not only moves forward to
privatize Medicare, but, shock of all shocks, our Republican colleagues
want to give massive tax breaks to the top 2 percent.
Among many other negative impacts that the repeal of the Affordable
Care Act will have will be one that will impact heavily rural States,
such as Wyoming, Vermont, and other rural States around this country;
that is, as a result of the repeal of the Affordable Care Act, rural
hospitals could be forced to close their doors--not getting the funding
they need--leaving millions of Americans with nowhere to turn for
critical medical care.
I look forward to this debate. Nobody here thinks the Affordable Care
Act is perfect. Nobody believes that at all. The goal is how we repair
it, how we improve it, how we expand health care to more Americans, how
we end what has been the case for decades in this country--that we pay,
by far, the highest prices in the world per capita for health care.
Maybe we should understand that we are the only major country in the
world that allows private insurance companies to profit off of people's
illness.
The proposal being brought forth by the Republicans is not only
poorly thought out, it really is not popular. It is not what the
American people want. Go to your hometowns and ask people--at a time
when the top one-tenth of 1 percent owns almost as much wealth as the
bottom 90 percent, when the top 1 percent is earning 52 percent of all
new income, go out and ask your constituents whether we should give
huge tax breaks to the top 2 percent, and they don't think that is a
good idea.
According to a poll released this month by POLITICO and Morning
Consult, 80 percent of the American people think the Federal Government
should be spending more money on Medicare. Only 10 percent think we
should be spending less. Seventy-one percent of the American people
think we should be spending more on Medicaid.
So 84 percent of the American people think the Federal Government
should be spending more on Social Security. In other words, the
proposal we are seeing from the Republicans today is way, way out of
touch from where the American people are.
There is another issue out there that I find extremely interesting.
Senator Enzi mentioned--and, of course, he is right--that within a
couple of weeks we are going to have a new President. Donald Trump will
be inaugurated as President, and it is interesting that we listened to
what Donald Trump said during the campaign. The Democrats heard what he
had to say during the campaign, what he campaigned on, and more
importantly, Republicans, listened and heard what their leader had to
say about these issues. This is what Donald Trump said, and he didn't
say it once in the middle of the night. He didn't say it in an
interview. This was a central part of his campaign. This is what he
asked millions of elderly people and working-class people to vote for
him on. These are the principles that Donald Trump ran and won the
Presidency on. On May 7, 2015, Donald Trump tweeted: ``I was the first
and only potential GOP candidate to state there will be no cuts to
social security, Medicare and Medicaid.'' On April 8, 2015, Mr. Trump
said: ``Every Republican wants to do a big number on Social Security.''
That is not Bernie Sanders talking; that is Donald Trump talking.
They want to do it on Medicare, they want to do it on
Medicaid and we can't do it. It is not fair to the people
that have been paying in for years.
That is not Bernie Sanders--Donald Trump, our soon-to-be President.
On March 29, 2016, Mr. Trump said:
You know, Paul [Ryan]--
Paul Ryan is the Republican Speaker of the House--
wants to knock out Social Security, knock it down, way down.
He wants to knock Medicare way down and frankly . . . you're
going to lose the election if you're going to do that. I am
not going to cut it, and I am not going to raise ages and I
am not going to do all of the things they want to do, but
they want to really cut it and they want to cut it very
substantially, the Republicans, and I am going to do that.''
What Mr. Trump said was exactly right. Here are the ``they.'' This is
the day. They want to cut Social Security. They want to cut Medicare.
They want to cut Medicaid. Mr. Trump was right, and millions of people
voted for him on the belief that he would keep his word.
Well, it seems to me that Mr. Trump right now has to do one of two
things. No. 1, if all that he was talking about was campaign rhetoric,
then what he is obliged to do now is to tell the American people: I was
lying. Yes, I said that I would not support cuts to Social Security,
Medicare, and Medicaid, but I was lying. It was a campaign ruse. I just
said what came to my mind to get votes. I have no intention of keeping
my word. If that is what he believes, if that is what the case was, let
him come forward and say that. But if that is not what the case is, if
he was sincere, then I would hope that tomorrow or maybe today he could
send out a tweet and tell his Republican colleagues to stop wasting
their time and all of our time and for Mr. Trump to tell the American
people that he will veto any proposal that cuts Medicare, that cuts
Medicaid, and that cuts Social Security. What we are talking about
right now--let us be clear: no debate. That is exactly what this goal
is. That is what this budget proposal is. It is to move toward the
voucherization and privatization of Medicare, to make massive cuts in
Medicaid and throw millions of people off health insurance.
So there is a lot of responsibility on Mr. Trump's shoulders, but I
would hope that he could save us a whole lot of time by telling the
American people that he was sincere in what he said during the
campaign, that he was not lying. If that is the case, we can end this
discussion, get into the serious business of how we create a quality
health care system guaranteeing health care to all people in a cost-
effective way.
With that, I yield the floor.
The PRESIDING OFFICER (Mr. Toomey). The Senator from Texas.
Mr. CORNYN. Mr. President, there has been a flurry of activity this
week with the beginning of the new year and the beginning of a new
Congress--the 115th Congress--and we have a lot of work to do.
This election that we just went through on November 8 was surprising
in many ways, gratifying in many ways. Personally, I think the best
thing about it is that it gives us an opportunity to start anew, to
deal with the problems that the American people were, frankly, not all
that happy with either of the political parties about in terms of the
solutions that we were to offer. I would hope that it would also give
us an opportunity to hit the reset button when it comes to working
together to try to find political consensus to solve some of these big
problems.
I mentioned yesterday our friend, the chairman of the Budget
Committee, and his 80-20 rule, which I told him I have used time and
again to make the point that just because you disagree on some things
doesn't mean you can't get
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anything done. To the contrary, people of widely divergent ideological,
philosophical, and political beliefs can work together by simply trying
to find common ground. That is possible. That, in fact, is the way our
Constitution created our government to force us to do that, because
what we decide here impacts a lot of people--well over 300 million
people in the United States alone. But if there was one consistent
complaint that I heard from my constituents back in Texas and that we
heard in the national media and beyond, it is about the failure of the
promise of ObamaCare. We made a solemn commitment to the American
people that if they provided us with the majority we needed to do it
and if they provided us a President who would sign it, we would repeal
ObamaCare and we would replace it with affordable health care that
would be of their choosing, as opposed to a top-down mandate, a one-
size-fits-all, which is the failure of ObamaCare.
In a previous life, I was attorney general of my State, the State of
Texas. We had a huge division of trial lawyers called the consumer
protection division. What we did is we sued people who committed
consumer fraud--people who promised one thing but delivered another. I
can't think of a bigger case of consumer fraud than ObamaCare, which
was sold under false pretenses: If you like what you have, you can keep
it. If you like your doctor, you can keep your doctor. If you are a
family of four, your premiums will go down by an average of $2,500.
None of that has proven to be true.
The reason why ObamaCare is so unpopular is that people have seen
their premiums skyrocket. People have seen their deductibles grow to
the point where they are effectively self-insured, which is not having
insurance at all. Many people have simply seen insurance companies pull
out of the insurance market, leaving them with little or no choices in
terms of where to buy their health care.
So many remember the PR campaign of the President and Democrats, with
which they sold ObamaCare to the American people, and, as I said,
promised better coverage, more choices, and lower prices.
That means now that ObamaCare has failed to deliver that. It is
incumbent on us to try to repeal it, which we will do, and to replace
it with more affordable coverage that people will choose and that fits
their needs better. The bad news of ObamaCare picked up throughout last
summer into the fall. As I mentioned, insurance companies were losing
money and were unable to operate and deliver health care under the
tight grip of ObamaCare. But the real losers weren't the insurance
companies. It is the tens of thousands of Texans who were forced to
find new insurance at higher prices--not insurance they would have
chosen on their own, but which they were forced to accept because there
was no alternative.
So instead of helping rural Texans--the Senator from Vermont talked
about rural residents in his State--I would submit that for people
living in rural areas across the country, the implementation of
ObamaCare hurt most of our rural country by dwindling the number of
choices to one health care option for the year. That sounds like the
opposite of more choices and better coverage to me. But we can't forget
that behind these numbers and headlines are real personal consequences
for families across the country.
So today I want to provide just a snapshot of some of the thousands
of letters that I received in my office about ObamaCare and the burdens
that it is placing on the backs of the people I represent in Texas. One
Texan wrote telling the story that I have heard time and again. She
said her insurance plan was discontinued--so much for ``if you like
what you have, you can keep it.'' But she did what she had to do, and
she switched to a more expensive plan--one with a higher monthly
payment and one with an $11,000 deductible. What good is health
insurance if you have to spend $11,000 out of your own pocket before
the insurance begins to kick in? It is nearly worthless.
Well, nothing about that says affordable health care. Unfortunately,
this individual is like many folks across the country, full of
questions and with nowhere to turn to find any relief for their
families or their small business.
Another one of my constituents had a similar complaint. He wrote to
me that he was searching for yet another health insurance plan for the
third time in as many years after his was canceled. He went on to
highlight this in this letter, which I received from a constituent on
November 23, 2015. He said:
I seem to remember the President saying something about
liking your insurance and being able to keep it. For myself
and my family, it has been just the opposite. We loved our
insurance prior to the passage of the Act and since have been
forced to purchase much more expensive insurance with much
higher deductibles.
Well, this Texan is right, but unfortunately, his experience was not
isolated. It was shared by millions of people across the country for
whom ObamaCare was a false promise. It is not as if he had the freedom
to choose. The choice was made for him, and this was the fundamental
flaw of ObamaCare. In a country as big and diverse as ours, this notion
of ``one-size-fits-all'' and that somehow the people who live and work
inside the beltway are smarter than the rest of us and we can figure
out what is good for them and a choice they would not themselves make
is just simply implausible. It is not true. This constituent ended his
letter by asking the Congress:
Do anything. Do anything within your power to reverse this
terrible health care trend. I need relief.
After this historic election, after the promises we made that have
given us the opportunity to govern in the majority, with a President in
the White House who will work with us, I believe we have a clear
mandate to repeal this terrible law and make it a relic of the past. We
will do that by adopting the budget resolution submitted by Chairman
Enzi of the Budget Committee.
It is not just Republicans who have pointed out the defects of
ObamaCare. Many of our Democratic colleagues have pointed out the law's
failed promises as well--from an op-ed entitled ``How to fix the
Affordable Health Care Act,'' which was written by a Democrat, to
statements on the Senate floor, to legislation introduced to ``fix the
glitch.'' Even in campaign ads, many of our Democratic colleagues have
themselves been outspoken advocates for changing ObamaCare. The senior
Senator from Missouri, pointing out the ``huge problem ObamaCare has
been in her State'' came up with an entire list of necessary changes.
I, for one, would be happy to start with her list and say let's try to
use this as a core of issues that we can then try to build consensus
around to begin to make that replacement and make it on a bipartisan
basis.
We have seen that attempted fixes, unsupported by the Obama
administration and vastly insufficient, continually have been met with
frustration by Democrats and Republicans. I pointed out yesterday that
when the Democrats voted through ObamaCare, they had 60 votes. They had
60 Senators. Today they have 48.
At one point, certainly back in 2009 and 2010 when ObamaCare passed,
they had a majority in the House of Representatives. Well, they lost
that. Now they have lost the White House itself. I just don't know how
much longer, how much more needs to be said or done for them to get the
message that this is not working because I believe they are paying a
political price for it as people are searching for accountability for
what they have to deal with day in and day out.
The senior Senator from Indiana said that he supported the Affordable
Care Act to help working and middle-class families have access to
health care, but he said that doesn't mean the law is perfect, and it
doesn't mean we don't still have work to do.
I was delighted to hear the Senator from Vermont, Mr. Sanders, say he
agrees ObamaCare is not perfect. My request of him and others is to
work with us to try to replace it with something better.
I recognize that neither side is going to be able to get everything
they want. That is just not the way this place works. Indeed, the
single failure of the Obama administration is to try to do things on a
go-it-alone basis because we are going to see those Executive orders
that he issued unilaterally rescinded on the first day President-Elect
Trump takes office. All the massive regulations that have been issued,
we are going to use the Congressional
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Review Act to rein those in or to defund those through the
appropriations process. In order for legislation and policy to be
sustainable, it is going to have to be bipartisan. I realize our
Democratic colleagues are disappointed with the outcome of the election
on November 8. That is an understatement. At first they started out in
denial: It just can't be true. The next stage was met with anger. Well,
they are angry about it, and they are going to obstruct everything the
new majority, working with the White House, tries to do, but I would
hope they would move past that denial and past that anger and do what
the Senate was always designed to do; that is, to work on a bipartisan
basis, as our friend and colleague from Wyoming demonstrated to us
working on the Health, Education, Labor, and Pensions Committee with
the liberal lion of the Senate, Teddy Kennedy. Let's try the 80-20 rule
and see how it works. It will work.
The senior Senator from West Virginia, Mr. Manchin--this is another
Democrat--has said he would vote to repeal ObamaCare. He said that we
should be working together to identify which parts of the law are
broken and need to be fixed. We may learn that some parts of the law
can't be repaired and we should eliminate those parts entirely. This is
our Democratic friend and colleague from West Virginia, Senator
Manchin.
I think that is a great place to start because no matter which side
of the aisle you sit on, you can see the Affordable Care Act is not
working, certainly not as sold to the American people. The choice of
the Democrats now is whether to obstruct or whether they will actually
work with us, as we should have done in the first place, to come up
with something more sustainable that would address costs and preserve
individual choice.
It is interesting. It is not just our Democratic colleagues, many of
whom voted for ObamaCare. I remember during the Presidential campaign
that former President Bill Clinton made some pretty interesting
comments. This would have been on October 5, 2016. I am reading from a
CNN story here. It said:
Speaking at a Democratic rally in Flint, Michigan, the
former president ripped the Affordable Care Act (ACA) for
flooding the health care insurance market and causing
premiums to rise for middle-class Americans who do not
qualify for subsidies.
Here is what he said:
So you've got this crazy system where all of a sudden 25
million more people have health care and then the people who
are out there busting it, sometimes 60 hours a week, wind up
with their premiums doubled and their coverage cut in half.
It's the craziest thing in the world.
Former President Bill Clinton said that in Flint, MI, on October 5,
2016.
He is right, but that is what you get when you try to do things in a
partisan, unilateral fashion. We should learn from our collective
mistakes and try to do better, and shame on us if we can't do better
than ObamaCare with all of its failed promises.
By repealing ObamaCare, Congress is doing more than just delivering
on a promise we made to the people who put us here. We are providing a
way forward for millions of people across the country who have been
hurt by ObamaCare and are looking for relief.
I look forward to making ObamaCare and the many burdens it has placed
on American families a thing of the past in this new year. That is what
we will do when next week we pass this budget resolution, and then
reconciliation instructions will be sent to the relevant Senate and
House committees. They will then report back with the replacement, and,
yes, it may take some time to transition into that replacement because
it has taken us 6 years to get into the mess, into the ditch we find
ourselves in now. When your truck or car is in the ditch, the first
thing you need to do is get out of the ditch. Sometimes that takes a
lot of hard work.
We are going to have to work as hard as we can. I would hope our
colleagues will work with us, not just to resist for resistance's sake,
not just to take a partisan position because they feel they are
required to do so because of their allegiance to the policies of the
Democratic Party. Let's do what this institution has always been best
known for; that is, to try to find some way to work together on a step-
by-step basis to produce reform which will make health care more
affordable and still preserve those choices for individuals and their
families, not a one-size-fits-all government mandate which simply has
failed in this tragic experiment known as ObamaCare. We can and we will
do better.
I yield the floor.
The PRESIDING OFFICER. The Senator from Michigan.
Ms. STABENOW. Mr. President, first let me comment on what my friend,
the distinguished Senator from Texas, said. If my car goes into a
ditch, the first thing I don't do is dismantle the car. That doesn't
help me get anywhere in terms of transportation.
First of all, let me speak on process before talking about the
substance of what we are really talking about and how it affects
people. We have a bill in front of us that creates a process for the
majority to be able to unravel and repeal essentially our whole health
care system. You pull a thread and it goes through not only employer-
based care, patient protections, people who have insurance, Medicare,
Medicaid. All of it begins to unravel. Interestingly, also in this
bill, in the text it adds $1 trillion to the deficit--$1 trillion to
the deficit in the bill that our colleagues just voted to proceed to
pass.
We need to be very clear on this: If colleagues want to work with us
to fix problems and improve health care, we can start this afternoon.
It is almost 3:30. By 4 o'clock we could put together a group of
people. I am sure our distinguished Democratic leader on the Budget
Committee would be happy to sit down and work together on ways to make
health care reform better and make health care more affordable and make
it more available to people. If that is what we want to do, count us
in, but that is not what we are talking about here. We are talking
about this crazy idea that no one in their real life would do.
It is like deciding you want a new house, so you tear down the old
house. That is the easy part. Then your family is homeless. Then you
say: Well, gosh, you know, maybe I better have a plan to get a new
house for my family and figure out a way to pay for it, to be able to
afford it.
Nobody would do that. Nobody would start by saying: We are going to
rip apart the entire health care system and create chaos. We are going
to undermine Medicare. We are going to undermine Medicaid. We are going
to take away patient protections for everybody who has insurance
through their employer, and then we will figure out later what we are
going to do to replace it, if anything.
I know there is a division on the Republican side. Certainly Members
in the House don't think it should even be replaced at all.
It is interesting. We are talking about one-sixth of the economy that
would be destabilized. There is no question that if you do a repeal and
insurance companies don't know what is coming--I have talked to
hospitals, and they don't know what is coming--behavior will begin to
change. Rates will begin to go up. Different decisions will be made
because, as businesses, they will not know how to plan. Their investors
will not know how to plan.
There is no question about it. When you repeal without creating
certainty in the marketplace, you begin a process that results in
chaos.
We have an interesting example, one that I have been involved with
for a lot of years, where we wanted to change just one piece of the
health care system, the reimbursement system for doctors.
I was in the House when they passed Medicare changes. We put in place
a new policy. We were going to write a new policy to reimburse
physicians for quality instead of quantity. It makes sense. It took 18
years to get agreement. We got agreement last year. It doesn't even
take effect for 4 years.
Everybody here knows about this thing called the doc fix. It is an
inside term--or SGR, which is even more insider. The truth is, we were
trying to change just one thing and could not get agreement to do it
for 18 years.
Anyone who thinks that there is going to be a repeal without an ACA
extender going on has not looked at past processes.
What is most important, though, is what this means to real people.
This
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really is about a plan of ripping apart the health care system. There
is nothing in its place immediately so we don't even know what will be
coming. This is going to make America sick again.
We are talking about a process and a plan that for real people is not
a political game. It is not smoke and mirrors. It shouldn't be about
politics. It is about the moms and dads who go to bed at night and say:
Please, God, don't let the kids get sick. Now, many of them--close to
30 million counting everybody with new coverage--don't have to say
that. They can say a different kind of prayer because they can go see
the doctor.
We know that when you unravel that system with nothing responsible in
its place, we are talking about making America sick again. We want
affordable care, not chaos. This plan goes from affordable care to
chaos. We talk about some parts of what we passed in health reform, but
there are a lot of things we don't emphasize that I think are important
to recognize in this debate.
First of all, what we pass in terms of changes in quality care
affects every single American with health insurance. A lot of people in
my State are fortunate to have employer-based insurance. We have a lot
of folks at the collective bargaining table fighting every year to make
sure they keep their insurance--150 million people across the country.
All of them have benefited from the patient protections we put into
health reform. When we take those away, then immediately the insurance
companies will be back in charge. If you get sick, you can get dropped.
Right now they can't do that. If you are sick or if your child is sick,
right now you can't be blocked from buying insurance. We call it a
preexisting condition. But before health reform, insurance companies
were doing that every single day--a child with juvenile diabetes,
someone with cancer or Alzheimer's disease.
I think about a very good friend of mine who just found out her
grandson has leukemia. He is 2 years old. He is going through
treatment. We pray he is going to be able to get through it
successfully. He is going to have a preexisting condition for the rest
of his life. With this repeal, there is no guarantee he will ever be
able to get insurance. On top of that, if he has to have treatments
that go on for some period of time, caps will be reinstituted on the
amount of care you can get, the amount of treatment per year, dollar
amount, or amount of visits you can get, and there is no guarantee that
this little boy will be able to get the treatment he needs so that he
can live a healthy, successful life going forward.
In talking with pediatric cancer doctors a couple of weeks ago, it
was so amazing and gratifying to me to hear them talk about children
whose lives have been extended, whose quality of life has been extended
because of the fact that they are able to fully treat these children
and insurance companies can't put caps on how much they will pay or how
many treatments. Now there is a whole other range of protections for
everybody.
One of the fights I was proud to lead in the Finance Committee when
we passed the ACA was to make sure that the basic insurance package
every company has to provide has to include maternity care. That seems
like a no-brainer. People were shocked that it didn't. Before we passed
health reform, 70 percent of the insurance companies--the policies you
buy in the private market didn't include maternity care. In fact, women
were viewed as having a preexisting condition because they might get
pregnant, might have a baby. That is not true anymore. Women are not
rated differently than men, and maternity care is now available
regardless of the kind of insurance you have. That is a pretty good
deal. Right now I have a son and a daughter with growing families, and
I can tell you that is a very big deal in my family.
There is a whole range of things. We all know about young people who
are able to stay on their parents' insurance. They get out of college
and they are wrestling with a huge debt, and one thing they don't have
to worry about is whether they can stay on their parents' insurance
until they can find a job. That goes away with repeal.
Something I care deeply about is mental health. We have all worked
together on opioids and substance abuse treatment. Because of what we
did in health care reform, insurance companies cannot discriminate if
it is mental health or substance abuse treatment rather than physical
health treatment. Prior to what we passed, they could charge much
higher copays, higher premiums, but not anymore. So the whole body--
above the neck as well as below the neck--is now being treated equally
with our insurance reforms.
So there are a multitude of things--preventive health services with
no copays, such as cancer screenings for mammograms and contraception.
I was talking to someone who said she thought it was so wonderful that
her drugstore wasn't charging her for copays anymore on her
contraception. I said: Well, you know, that is actually the law. That
was changed when we passed the Affordable Care Act.
So there is a whole range of things that relate to reviewing premium
increases, if you get removed from your insurance, you have the right
to appeal. There is a whole range of things. So that is under the first
step. Everybody will feel it when insurance companies are back in
charge and, through this vote and the subsequent actions, patient
protections are repealed for everybody.
Secondly, this includes cuts in Medicare and Medicaid. Through what
we did in health reform, we closed the gap on the high costs of
prescription drugs. We called it the doughnut hole. That was in the
process of being closed. If you have a lot of medicines and a lot of
costs, you suddenly get to a point where there is a gap in coverage and
you have to pay the full cost. That goes away and the doughnut hole
comes back.
What we did added 12 years of solvency to the Medicare trust fund to
keep it strong longer. That goes away. Wellness visits for seniors--
every year they are able to go in and get a physical without a copay--
that goes away. So Medicare is undermined. Then, unfortunately, when
you add the incoming nominee as Secretary of Health and Human Services
and couple that with the proposals that the Speaker has had and others
that I am sure we are going to see to turn Medicare into a voucher--you
go into the private market. Here is your voucher. Good luck. That is
part of what the new regime is promoting, which only adds to this.
Eighty percent of Medicaid spending is seniors in nursing homes. And
we know that the majority of those who--many who have gotten care, in
addition to the exchanges, have been folks who have been working hard
every single day in minimum wage jobs and who couldn't afford or find
insurance before. Now they are covered if their State or their Governor
is willing to do that. We have a whole bunch of folks who are working
hard every day at minimum wage who at least know they have access to
health care and a doctor.
Interestingly, this helps our hospitals, whether they are rural
hospitals upstate or up north in Michigan or whether they are our great
urban hospitals, safety net hospitals in Detroit and other areas,
instead of people walking into the emergency room and not having
insurance and having the cost put on everybody who does. Because of the
Medicaid expansion, when a working person comes in with Medicaid, they
are able to pay for their own care rather than having everybody else
with insurance carry the brunt of that, which is the way it was prior
to that.
So there are Medicare and Medicaid cuts.
Next, we do know that altogether, counting Medicaid and people using
the new exchanges, we have about 30 million people who will be kicked
off of their insurance, folks who, like anybody else, want to have
health insurance for their families. Can we design that in a better
way? I would love to work with you on that. I am not going to kick them
off first. I don't want to say: We are going to rip your insurance
away. We are going to rip the small businesses I have talked to--rip
their insurance away. And then, by the way, don't worry, further down
the road we will figure out something else. We don't know what it is,
we don't know what it will cost, but trust me.
I wouldn't be trusting that would happen if I were counting on that
for my insurance.
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The fourth item is that there is no question that costs will go up by
destabilizing the marketplace. We know the cost of prescription drugs
will go up as a result of taking away the extra help for prescription
drugs. There is no question that costs are going to go up for everybody
else who has insurance.
When we look at this, I don't know how anybody looking at this
outside of a political lens or a rigid ideological lens could say this
makes any sense. It doesn't make any sense.
We have a President-elect who is coming in who said that he would not
do anything to hurt Medicare or Medicaid or Social Security. Yet the
first thing on the floor definitely undermines Medicare and Medicaid.
We have a President-elect who said he wants to bring down the cost of
prescription drugs. Yet, by undermining Medicare prescription drug
coverage, those prices are going to go up. People who have the most
medical needs and need the most medicine are going to see their costs
go up.
What would be better would be if the new incoming HHS Secretary would
be given the ability to negotiate through Medicare for prescription
drugs--something we have all fought for, for a long time. Let's allow
drug reimportation. Our leader on the budget--and I have as well--put
seniors on buses in the past to demonstrate the differences in cost
across the bridge between Windsor and Detroit, the cost of the same
drug, with the very same safety provisions. That would bring down
costs. Taking away Medicare coverage and increasing the gap in coverage
is exactly the wrong thing to be doing if, in fact, the incoming
President really means it when he says he wants to bring down drug
prices.
So there are a number of things we care deeply about on health care.
As someone who has worked on this for years--in fact, it was health
care and health policy that first got me into politics, leading an
effort to save a nursing home in my community. I care deeply about
this. I am one of the folks way down deep in the weeds on this. But we
don't improve a health system by ripping it out by its roots, by
undermining the whole system without figuring out what comes next. That
only happens if you really don't care what comes next because if you
care, that is not a responsible position.
So, Mr. President, and my colleagues, I feel very strongly that with
everything we know that has been made available to strengthen quality,
to give people back their own decisionmaking instead of the insurance
companies on basics like providing care for themselves and their
families, the strengthening of Medicare and Medicaid, the coverage that
has been made available, we know there is a way to work together to
make things better, and this is not it.
Mr. SANDERS. Will my colleague from Michigan yield for a moment?
Ms. STABENOW. I will be happy to.
Mr. SANDERS. I want to thank my colleague for her very thoughtful
presentation talking about the implications of simply repealing
ObamaCare.
The assumption that many of my colleagues seem to start from is that
before ObamaCare, the health care system was great in America, that
everybody had health care in a cost-effective way and then ObamaCare
came along and all of these problems arose.
What the Senator from Michigan just told us--and I want people to
remember it--8 years ago, if you were diagnosed with cancer and you
walked into an insurance company, they would say: Why would we give you
insurance? We will lose money on you. Your cancer may recur.
You are a woman and you want maternity coverage? What do you think is
going on? Why should we do that?
You are a family with a kid who is 21 years of age and you want his
insurance on your policy? Well, you couldn't have it.
I think what the Senator from Michigan pointed out is not that anyone
thinks the Affordable Care Act is perfect--nobody thinks it doesn't
need improvement. But to simply throw out all of the benefits, for 30
million people to be thrown off of health insurance--during the budget
hearings a couple of years ago that Senator Enzi chaired, I asked a
question of my colleagues when this idea came up, and I would ask it
again to my good friend from Wyoming. What are the studies you have
seen in terms of the number of people who will die when they lose their
health insurance? How many thousands of people will die because they no
longer have health insurance and they cannot go to the doctor and the
hospital? The studies I have seen suggest that many thousands of people
will die. That is common sense. If you throw 30 million people off of
health insurance, they are going to die. How do you go forward
providing a death penalty to thousands of people without having any
solution to it?
Further, I would add to the excellent points made by the Senator from
Michigan. Senator Enzi and the Senator from Texas before him talked
about the impact of health care problems in rural areas. I come from a
rural area. Michigan has large parts of the State that are rural. The
Senators from rural areas on the Republican side have said they want to
make sure their constituents in rural areas can see a doctor. That is
certainly a modest proposal. Of course they should be able to see a
doctor.
If that is the case, my Republican friends should understand what the
Federation of American Hospitals and the American Hospital Association
said about repealing the Affordable Care Act. These are major hospital
organizations. According to a very recent report, what they said is
that a repeal of the Affordable Care Act will mean a reduction in
payments to rural hospitals of over $165 billion over a 10-year period.
According to the hospital associations, rural hospitals will suffer an
additional loss of $289 billion from their inflation updates.
This is a report from the Federation of American Hospitals and the
American Hospital Association, major health care institutions in
America. They said in their report: ``This reversal of health coverage
would represent an unprecedented public health crisis.'' Furthermore,
they said: ``The magnitude of reductions would threaten hospitals'
ability to serve patients.''
So when we talk about the needs of rural Americans, I would hope my
colleagues listen to what the Federation of American Hospitals and the
American Hospital Association have to say.
With that, I yield the floor.
The PRESIDING OFFICER. The Senator from Kentucky.
Mr. PAUL. Mr. President, the more things change, the more they seem
to stay the same. Republicans won the White House. Republicans control
the Senate. Republicans control the House. What will the first order of
business be for the new Republican majority? To pass a budget that
never balances, to pass a budget that will add $9.7 trillion of new
debt over 10 years.
Is that really what we campaigned on? Is that really what the
Republican Party represents?
Our first order of business will be a budget that never balances, a
budget that adds $9.7 trillion to the debt, and they tell us: Oh, but
it is not a budget. If you listen, they will say: No, no, it is a
vehicle to repeal ObamaCare.
Yet I have the title in front of me, which says a concurrent
resolution for the budget of 2017. We have special rules when you pass
the budget so that we may be able to repeal ObamaCare, and I am all for
that. But why should we vote on a budget that doesn't represent our
conservative view? Why would we vote on a budget that adds $9.7
trillion to the debt? Because we are in a hurry, we can't be bothered.
It is just numbers. I was told again and again: Swallow it. Take it.
They are just numbers. Don't worry. It is not really a budget.
Yet the legislation says it is a budget. The numbers say we will add
$9.7 trillion of new debt.
So I say: If they are only numbers, and if the numbers that are in
the budget don't matter, why don't we put numbers in that balance? Why
don't we put a vision into the budget that represents what Republicans
say they are for?
Republicans say they are the conservative party. Are we? When George
W. Bush was President for 8 years, the national debt went from $5
trillion to $10 trillion. The debt doubled under a Republican President
and a partially Republican Congress. Yet the words were these: Well, he
had Democrats to deal with, and if we could ever take all three
branches of government, things would be different.
The Republicans took over the House in 2010. They still didn't
control the
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Senate, but they said: If we only controlled the Senate, we could be
the conservative party again.
We have had an election. The conservative party--the supposedly
conservative party--won. Republicans control the House, the Senate, and
the Presidency, and the first item of business for the Republicans will
be to pass a budget that never balances--a budget that will add $9.7
trillion to the debt over 10 years.
This sign could have been put up for Obama's first budget. Every
Republican railed and said: $10 trillion--President Obama will add $10
trillion. And he did. President Obama doubled the debt again.
It went from $5 trillion to $10 trillion. The national debt went from
$5 trillion to $10 trillion under George W. Bush, and then it doubled
again under President Obama. It went from $10 trillion to nearly $20
trillion.
What are we looking at here? More debt, under a solidly unified
Republican Congress and a Republican President.
So you might scratch your head and say: The more things change, the
more they stay the same. Is it all smoke and mirrors? Is there really a
difference? Are Republicans different than Democrats? It is a pretty
important question. We are in such a hurry to repeal ObamaCare. I am
all for it. As a physician, nobody thinks that ObamaCare has been worse
for the country. Nobody more than me thinks it is a terrible piece of
legislation that has not helped the country and that has inflated our
costs and not helped. Yet do we have to add nearly $10 trillion of debt
in order to get at it?
So as this moves forward, I will offer a replacement. I will offer my
own budget. I will offer to strike and remove $10 trillion worth of
debt, and I will offer my own budget that balances within 5 years. How
do we do it? We give the authority to make the cuts where they should
be, where they are most wasteful in government, and we offer this
budget by simply freezing expenditures. You don't have to cut any
expenditures.
Every department of government could get what they got the last year.
If you think some departments of government need more money, cut other
departments of government. Frankly, there are some departments of
government you could eliminate and you would never know they were gone.
If the Department of Commerce were gone, a few corporate executives
would not be able to fly around on government jets. They could fly
around on their own jets. You would never know the whole entire
Department of Commerce was gone.
You can cut spending. You can actually get to the balance by not
cutting anything. So here is what happens. If you freeze the on-budget
spending, within a little over 5 years, your budget balances.
I remember a time when there were the moderates who were for freezing
spending, and the real conservatives were for cutting spending. Now
nobody is for cutting spending. When I bring it up that you can
absolutely not balance the budget if you are not willing to look at
entitlements, do you know what I am told by many well-meaning
Republicans? Don't write it down. Don't put it on paper because people
will be upset with you if you explain that to save Social Security, to
save Medicare, you will have to reform these entitlement programs. They
say: Let's just talk about waste. Let's just talk about fraud and
abuse. And I do, and we should eliminate all of those. But guess what.
If you eliminate all of the budgetary spending that we vote on--this is
called the discretionary spending. This would be the military and all
the rest of the nonmilitary. It is about $1 trillion, not including the
entitlements--Social Security, Medicare, and Medicaid. If you did just
the military and the nonmilitary and you reduced it 10 percent a year
for 10 years, and you virtually wiped out all discretionary spending,
you still don't balance the budget.
So, really, you are not a conservative if you are not willing to look
at all government spending. The budget cannot be balanced and the
budget will never balance unless we look at entitlements.
What does that mean? It means that because of demographics--we had
big families 60 years ago, with three, four, five kids to a family. Now
we have less than three kids to a family--probably two kids to a
family. So you had all the baby boomers born right after World War II,
and they are all retiring--60 million of them. So we have this huge
population boom, and you don't have as many workers. So the
demographics aren't working. Then you add to that the fact that we are
living longer.
When Social Security was started, the average life expectancy was 65.
It worked pretty well as a pension plan because you died. But now it is
great. We are living on average to 80, and if you make 80, you may well
make 90. What a great thing--longevity. But it is not working. Social
Security is not working. We spend more on recipients than we bring in
with the tax.
Medicare is even worse. The average taxpayer pays about $100,000 over
their lifetime in Medicare taxes. The average recipient takes out
$350,000. How big a problem is this? Medicare is $35 trillion to $40
trillion in the whole.
It is inexcusable that we are not talking about how we fix Medicare.
It is inexcusable that we are not talking about how to fix Social
Security. If we don't fix them, there is going to be a cliff. Within
about a decade, the cliff is so severe that everyone on Social Security
will suffer a 20-percent decline in their monthly check. It will happen
all at once if we don't fix it. Can we fix it? Yes, we have to talk
about it.
What we are doing today is kicking the can down the road. We have our
focus on ObamaCare, but we are taking our focus off the debt. As bad a
problem as ObamaCare is, as much as it has disturbed, destroyed, and
distorted the health care market, it may be that the debt is a bigger
problem.
So it is not a popular stand that I take today. I will be the only
Republican to vote against the Republican budget. That won't be
popular. But I ran for office. I left my medical practice. I am away
from my family. I spend long hours traveling here because I am
concerned about the debt.
We borrow $1 million a minute. The debt threatens the very foundation
of our country. Yet here we are. The Republican Party controls the
House, the Senate, and the White House, and in their haste, they put
forward a budget that is going to add this much debt.
This is what the debt has been doing. Here is 1980. We see the
growth. It has become exponential--the growth of the debt. This should
worry every American. But here is the Republican 10-year budget that we
are getting ready to pass. It is virtually a vertical line of
accumulation of debt.
People will say: But how could we ever cut any spending? I will give
you a couple of examples of where your government spends money and you
tell me whether or not we ought to look long and hard at cutting
spending.
There was a grant given for autism. I have a great deal of sympathy.
I know children with autism. The grant was for $700,000. But do you
know what they spent it on? They spent it on studying Neil Armstrong's
statement. Remember Neil Armstrong? He landed on the moon and said:
``That's one small step for man, one giant leap for mankind.''
Well, your government, in its infinite wisdom, wanted to know: Did he
say ``one small step for man'' or ``one small step for a man''? Your
government spent $700,000 studying the preposition ``a.'' Did he say
``a man'' or just ``man''--$700,000. Money that should have been spent
on autism was spent on something frivolous.
Is anybody going to fix it? No. Every year, all of the spending bills
are globbed together in a 2,000-page bill--and not one iota of reform.
My colleagues may remember that Senator Proxmire from the 1970s used
to have something called the ``Golden Fleece Award.'' Every one of
those things he complained about in the 1970s happens now but tenfold
greater. Nobody fixes it. We don't pass individual spending bills. We
do continuing resolutions, which means we continue doing the same thing
we have done over and over.
Again, $700,000 was spent studying Neil Armstrong's statement. Do you
know what their conclusion was? We are not sure. They spent $700,000,
and they are still not sure whether he said ``a man'' or ``one small
step for man.''
We spent $500,000 studying whether or not, when you take a selfie, if
you are smiling in the selfie, does it ultimately make you feel better?
We spent $500,000.
[[Page S40]]
So what do we do? Do we give these people less money? Teach them a
lesson. Give them less money, and maybe they will conserve the money.
Maybe they will eliminate waste if they have less money next year than
they had this year--or what I am proposing: Freeze the spending. Is
anybody proposing that? No. We say: They spend a half a million dollars
on selfies; give them more next year.
So the Republican budget will increase spending every year. It
increases spending at about 5 percent a year. So spending goes up. They
say it is the baseline, and they say we are cutting off the baseline.
No, no. The baseline goes up 5 percent a year. Spending will increase
over the 10-year period. The red line is spending.
Part of that is what the Republicans are proposing. They are going to
stay on the spending curve. If we stay on the spending curve, they will
continue to spend $700,000 studying Neil Armstrong's statement; they
will continue to spend half a million dollars on selfies. They spent
another half a million dollars on a climate change game. They spent $45
million to build a natural gas station in Afghanistan--$45 million. The
first problem: Nobody in Afghanistan has a car that runs on natural
gas. They discovered this after they built the gas station. The gas
station was 86 times cost overrun. The original estimate was about half
a million for the gas station, but lo and behold, somehow it cost $45
million. If your government had 86 times cost overrun, would you give
them more money or give them less money? I, frankly, think we should
give them less money. If you give them more money, they will not waste
it less; they will waste it the same or worse. They should be given
less money.
Mazar-e Sharif is a city in northern Afghanistan. We built an $85
million embassy there and we signed a 10-year lease, and then somebody
looked at the place and decided that since there were tall buildings
surrounding the entire entity, people would shoot down into the
courtyard and kill our diplomats, and they said the building could
never been occupied--after they spent 85 billion, after they signed a
10-year lease. How will they get better? Were the people who made this
decision fired? No. They are Federal employees, and you never fire
Federal employees. Will they make wiser decisions because we give them
less money? No. We give them more money.
You would be excused for being upset if you went and voted and said
``I am going to vote for the conservative party'' and if you went and
voted and said ``I am going to vote for the party that is going to
balance a budget.'' Wouldn't you be upset? Wouldn't you wonder which
party that is?
This is the spending curve. We are going to add $9.7 trillion in 10
years, and yet they say: Oh, no, this isn't really a budget.
I have it in front of me, though. It is a budget.
There is no reason why Republicans couldn't have put forward a budget
that doesn't add all the red ink. We are at $20 trillion. We are going
to nearly $30 trillion under the Republican plan. My goodness, what
happened? Where is the conservative party? Where are the conservatives
in Congress who would say enough is enough? Now they say: We just have
to be done with this. Don't distract the little people. Don't let the
people of the country know we are voting on a budget. We are going to
call this the vehicle to repeal ObamaCare.
Well, that is not what it is. It is a budget. And we have special
rules for dealing with the budget that allow us to repeal ObamaCare,
which I am all for, but this is a budget.
They say: Well, how can we get the votes? No Democrats will vote for
this budget. This is a Republican blueprint. Not one Democrat will vote
for this.
So this is what Republicans are for. This is the blueprint the
Republican Party says they are for--$10 trillion worth of new debt. I
am not for it. That is not why I ran for office. That is not why I am
here. That is not why I spend time away from my family and my medical
practice. It is because debt is consuming our country. There is a time
and a place to debate ObamaCare, and I am more than willing to debate
that. But this is a budget. This is the vote on a budget.
They say: Oh, it is just a gimmick. It is just a game. The numbers
don't mean anything.
Well, if the numbers don't mean anything, put honest numbers in there
or put conservative numbers in there.
I, for one, will put forward a conservative opposition to the
Republican majority's budget. I will put forward a budget that freezes
spending and balances the budget over a 5-year period. Would there be
some agencies that would get less money? Yes. But it would force us to
go through the government and pick and choose what is good spending and
what is not good spending.
We have a waste report that we put out. If you look on our Facebook,
you can find our waste report. I listed four or five of the most
egregious. There are hundreds and hundreds, if not thousands, of things
we shouldn't be spending money on. I will give another example.
We have sold $100 billion worth of weapons to Saudi Arabia. They were
wanting to spend money giving F-16s to Pakistan. You pay for them and
give them to them.
There is riddled throughout the Pentagon--look, the Pentagon has
never been audited. You are surprised? The government has never been
audited. The Federal Reserve is not audited. The Pentagon is not
audited. So what is the Pentagon's response to being audited? The
Pentagon says to us: We are too big to be audited. I don't know about
you, but that makes me kind of angry, that a part of our government,
even a necessary part such as national defense, says they are too big
to be audited. Meanwhile, we have $85 million embassies built that will
never be occupied and $45 million gas stations that will never be used.
I think it is time that we say enough is enough. Don't give
government more money; give them less. The government hasn't been a
good steward of your money.
The question is often asked: Are the people who spend your money, are
the people involved in government inherently stupid? It is kind of a
debatable question. I think they are mostly well-intentioned. I don't
think they are inherently stupid, but I do think they don't get the
right incentives. Because there is no profit motive in government,
because there is no rationale or motive to conserve, money is spent,
and because of sheer laziness and ineptitude, we continue to pass the
spending bills--glommed together, thousands of pages--without reform.
But I won't be party to that. I won't vote for spending bills that are
not individualized and don't have reforms in them. I won't vote for
budgets that never balance.
So while I may be a lonely voice on this issue, I will continue to
bring up to the American people that it is important not to add more
debt, that it is important to slow down the accumulation of debt. It is
important that we have a $20 trillion debt, and I am not willing to add
$10 trillion more in debt. So at the appropriate time, I will introduce
an amendment that will strike and replace this budget, and in its place
I will put forward a conservative vision for the country--a vision of a
balanced budget that balances within 5 years.
Every Republican in the Congress who has been here for a while has
voted for a balanced budget amendment. Interestingly, the balanced
budget amendment--which would be an amendment to the Constitution--has
within it a provision that the budget would balance within 5 years. And
even when Republicans get around to saying ``Oh, we will have some
gimmicks to balance in 10,'' 10 is not what the amendment says. Why
bother voting on an amendment if you are not serious about it?
Republicans are completely in charge. It is a Republican document; it
is a document I disagree with; and at the appropriate time, I will be
introducing a replacement that will balance within 5 years and provide
a conservative view for the country.
The PRESIDING OFFICER. The Senator from Wyoming.
Mr. ENZI. Mr. President, I suggest the absence of a quorum, and I ask
unanimous consent that the time be divided equally.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
[[Page S41]]
Mr. DURBIN. 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.
Mr. DURBIN. Mr. President, we are discussing the budget resolution.
It is an interesting time to do it in the month of January. The fiscal
year, the spending year for the Federal Government, starts October 1.
We have tried, with no success, to pass appropriations bills--12 of
them--that would meet our obligation to fund the government for the
entire fiscal year. We have had two continuing resolutions, which are
temporary spending bills. And here we are again discussing a budget
resolution.
But it isn't really about the budget; it is about the Affordable Care
Act, known as ObamaCare, a law passed 6 years ago with the goal of
providing affordable health insurance for all Americans. I voted for
that bill. It is one of the most important bills I have ever voted for,
and I believe that, despite shortcomings, it has achieved its goal and
it has done it in a way that most American families would agree they
want to see.
As an example, there are very few families in America who have every
member of the family in perfect health. In the old days before the
Affordable Care Act, if you happened to have a child who had survived a
cancer situation, a spouse with diabetes, and you went to buy a health
insurance plan, you ran into a problem: They might not want to insure
your family because of that sick child, or they might want to charge
you a premium way beyond your reach. So in the Affordable Care Act,
ObamaCare, we said: As a health insurance company, you cannot sell
insurance in America and discriminate against a family or person
because of a preexisting medical condition.
From where I am sitting, my own personal life experience and my
family's experience, thank goodness. We had members of our family with
serious health issues. I worried about that all the time as a husband,
as a father. The Affordable Care Act gave me and every other American
the peace of mind that health insurance companies could not
discriminate against us or our families because of a preexisting
condition.
There was also a practice where they would put a limit on how much
coverage you could buy in a health insurance policy. So many people
thought: I have a great health insurance policy. It has a $100,000
limit. I will never hit that number; I am a healthy person.
The next accident, the next diagnosis, and that healthy person
realized that $100,000 in today's world of health care costs--you could
eat that up in a minute and find yourself without any health insurance
protection. What happens to you next?
You have been diagnosed with cancer. You start treatment. It is
expensive, and now your health insurance policy has reached a point
where it doesn't cover you anymore. What then are your options? Stop
treatment? Exhaust your savings? Throw yourself on the mercy of a
hospital and hope for the best?
We ended that. ObamaCare ended that. They can no longer put limits on
health insurance policies because none of us--not one of us--knows what
kind of health crisis we might face or a member of our family might
face tomorrow. That is important.
A third provision in ObamaCare, which most families would understand
in a hurry, involved what to do with that recent college graduate. What
are you going to do with that daughter whose graduation you are so
proud to go to, and then it dawns on you that she doesn't have a full-
time job yet and that the part-time job she has doesn't have any health
insurance benefits.
I remember calling my daughter and saying to her: Jennifer, I know
you had health insurance as a student. What is your situation now?
Oh, Dad, I am fine. I am healthy. I am not worried.
I am worried, as a father, something is going to happen to her and
she will have no health insurance protection.
Do you know what ObamaCare did? ObamaCare said I could keep my
daughter under my family health insurance plan until she reached the
age of 26. Peace of mind for 2, 3, 4 years while that son or daughter
is starting their professional life, their life of employment. For
thousands in Illinois and across the United States, more peace of mind
that health insurance would be there when your family really needed it.
We also said we don't think you ought to discriminate against people
when you sell them health insurance just because, for example, you
happen to be a woman. Yes, the health insurance premiums charged women
were higher than those for men. Obviously, women can have challenges in
their lives but so can men. We said you cannot discriminate in health
insurance premiums under ObamaCare between men and women.
These are issues that affect the real world--what people pay for
insurance, whether they qualify for insurance, and whether insurance
will be there when you need it. That is what ObamaCare did. By
providing helping hands to those in lower and middle-income categories,
we extended the reach of health insurance under ObamaCare to cover 20
to 30 million more Americans. We currently have the highest percentage
of Americans with health insurance in modern history.
We had another provision too. We said: If you happen to be a senior
citizen under Medicare and you are paying for your prescription drugs,
that can be expensive. Under the old law, before ObamaCare, there was a
gap in coverage, and you might spend $1,000 or $2,000 out of your
savings account each year just to keep taking your meds. We closed the
gap so you had continuous coverage under Medicare as a senior.
Important? You bet it is. A lot of seniors ended up retired with
limited savings wanting their meds, their prescriptions, so they can
remain strong and independent as long as possible. Don't we want them
to? So that, in a brief summary, will contain four or five of the main
features of ObamaCare, the Affordable Care Act--more Americans with the
guarantee of health insurance than any time in our modern history in
the United States of America.
How important is it to have health insurance? If you have ever been
the father of a very sick child and you didn't have health insurance,
it is a life experience you will never forget. I know. I lived through
it. At that time, I thought, if I don't do anything else the rest of my
life, I am always going to have health insurance, and I did. At some
sacrifice to my wife and me, but we made sure we had it because for a
period of time when we had no health insurance, I felt like I had let
my family down and I let my daughter down. I didn't want it to happen
again.
I don't want anybody else to go through that. We want to make sure
health insurance is there for all of us. Some people say: If you are
rich, you ought to get it, but if you are not, tough luck.
I don't think so. I think health care and health insurance protection
should be a basic right in this great Nation of America. That was the
driving force behind passing ObamaCare, passing the Affordable Care
Act.
The Republicans hate the Affordable Care Act like the devil hates
holy water. They despise it. Over 60 times they voted to repeal it in
the House of Representatives. It drives them into a rage. The first
thing they say is, we can't wait to get a new President and abolish
ObamaCare.
The obvious responsible question to them is, And what happens the day
after you abolish it? What happens when it comes to preexisting
conditions? Can health insurance companies now discriminate against
people again? What happens when it comes to the limits on how much a
health insurance policy would pay? Are we going to be back in the day
when there isn't enough coverage when you and your family desperately
need it?
What happens to those kids fresh out of college if they can't get on
your family health insurance plan? Do you want to go out and buy an
individual policy for that son or daughter who is still looking for a
job? How about the seniors? Are they going to go back to the time where
they have to pay out of pocket for their prescription drugs? I think
those are all legitimate questions.
Do you know what the answer is on the Republican side? Trust us. We
are just going to abolish this program, and someday, not today and not
soon, but someday we will come up with another
[[Page S42]]
idea. That is irresponsible. They are replacing affordable care with
chaos. They are saying to the American people: Just trust us. Someday
we will dream up a plan.
You know what, they have had 6 years to come up with a plan, 6 years
to come up with an alternative to the Affordable Care Act. They have
been unable to do it. It is difficult. It is painful.
You know what is ironic, the Affordable Care Act is based on a
Republican model of health insurance. This was what the Republicans
suggested years ago: Use private insurance companies and make it
available to all Americans. That is what we did. A lot of Democrats
felt there was a better way: Why don't we make a Medicare Program for
every American a nonprofit program that is there. We couldn't get it
done. We didn't have the votes, and the Republicans wouldn't help us.
In the first step of the new year and the new Congress, the new
Republican majority in the Senate wants to abolish the Affordable Care
Act, wants to put millions of American families at the mercy of health
insurance companies. They must think we are suffering from amnesia and
that we had forgotten what that was all about--sitting on the phone for
hour after weary hour with some adjuster who may or may not be in the
United States, trying to argue about whether your son or daughter can
go into a hospital, whether your wife can receive the medical treatment
the doctor asked about.
That is what it used to be, and that is what it is going to go back
to when we abolish the Affordable Care Act and don't replace it with
something that is as good or better. That is the first step in the
Republican program, make 20 to 30 million Americans more vulnerable
when it comes to their health care. That is not the end of it.
I live in a State that has the great city of Chicago, Cook County
regional area, but downstate we are very rural, smalltown America. I
know from my congressional experience and from my life as a Senator
representing that State, there are downstate hospitals that cannot
survive without the Affordable Care Act. In my State, some of those
hospitals are the major employers in their communities and the only go-
to place for someone seriously ill or injured.
The Republicans have yet to suggest any suggestion at all about how
we are going to keep those hospitals open. They are starting to contact
me now--the hospitals as well as the clinics and the health care
providers, and they are asking: The Republicans really aren't going to
do this, are they? They are not just going to abolish it and leave us
with this chaos to follow.
Sad to say, that is exactly what they are going to do. Senator Rand
Paul of Kentucky wrote an article today and said he thought it was
wrong on the Republican side to do that. He said: The responsible thing
to do is to have an alternative before you abolish the Affordable Care
Act. Good for him. That is common sense. You would expect it from a
party that says it is conservative in its approach to government. What
they are suggesting with the Affordable Care Act is not conservative.
It is destructive. It is catastrophic. It is irresponsible.
I hope my colleagues will join me. We need two or three Republicans
to join us to stop this effort. Let us sit down together, Democrats and
Republicans, take the Affordable Care Act and make it more effective,
fix the problems that are part of it--and there are some--make sure we
keep our promise to the American people that they will have access to
affordable, quality health care. Keep these providers covered by the
Affordable Care Act in business in rural areas and inner cities and all
across our Nation. That is our responsibility.
DACA
Mr. President, 16 days from now, and just a few steps from where the
Senate Chamber is located, we will have an inauguration for the 45th
President of the United States, Donald Trump. On that day, the fate of
more than 750,000 young people in America will be hanging in the
balance. They will be waiting to learn whether they have a place in our
Nation's future or whether they will be asked to leave.
It was 7 years ago that I sent a letter to President Obama, joined by
Senator Richard Lugar, Republican of Indiana. On a bipartisan basis, we
asked the President to stop the deportation of young immigrants who
grew up in this country. We called them DREAMers, after a bill I
introduced 15 years ago. Who are they? Babies, infants, toddlers,
children, young adults under the age of 16 brought to America by their
parents from another country, and the proper papers were not filed. You
can't hold the kids responsible. They didn't decide to come here. You
certainly can't hold them responsible for not filing the papers. They
were just children at the time.
If anybody should be held responsible, it is the parents. What do we
do about the kids who have lived their entire lives in the United
States believing this was their country, this was their future, and now
come to realize in their teenage years they are undocumented and their
future is uncertain?
We asked President Obama: Will you give these young people a
temporary opportunity to stay, study, and work in America, and he
agreed to do it. It was called DACA. It was the Deferred Action for
Childhood Arrivals Program. What it said was, if you are in that
category of a child brought to America and you are undocumented, step
forward, pay a filing fee of almost $500 so the government can process
your application, submit yourself to a criminal background check,
including fingerprints, and let us look into your background and see if
there is anything you have done that would disqualify you from staying
in the United States. If you are approved, for 2 years--renewable--you
will not be deported and you can work in America.
Many young people in that circumstance were reluctant to step
forward. Their parents had warned them their entire lives that if they
turned themselves into the government, they might be deported--in fact,
their family might be deported with them. They said: The President has
offered us this opportunity for a chance. We are going to follow this,
do the right thing, make an application. Almost 800,000 of them
qualified. They are DACA recipients. Others will be eligible in the
months ahead. DACA has been a success.
What will President Donald Trump do with these DACA students? He made
some pretty harsh statements during the course of the campaign about
immigration. I think he is reflecting on these kids as a special
category. This is what President-Elect Donald Trump said to TIME
magazine just a few weeks ago about the DREAMers, the DACA recipients.
We're going to work something out that's going to make
people happy and proud. They got brought here at a very young
age, they've worked here, they've gone to school here. Some
were good students. Some have wonderful jobs. And they're in
never-never land because they don't know what's going to
happen.
I appreciate Mr. Trump's comments, soon-to-be President Trump. I hope
he will keep the DACA Program in place, but I am working with my
colleagues on a bipartisan basis to give him an option. Senator Lindsey
Graham, Republican of South Carolina, and I have joined the lead
sponsors on what we call the BRIDGE Act. The BRIDGE Act is an
opportunity to protect these young people legally, on a temporary
basis, while Congress rolls up its sleeves and takes up immigration.
I am happy to have Senator Lisa Murkowski and Jeff Flake, Republicans
from Alaska and Arizona as cosponsors, as well as Dianne Feinstein of
California and Chuck Schumer of New York, and I hope others will
follow. I believe DACA was a lawful exercise of the President's
authority. Some disagree with that completely. Regardless of whether
you agree or disagree, I hope you will agree that these young people
should be allowed to have a bridge so they aren't deported, they don't
lose their right to work or go to school.
Incidentally, when these young DACA DREAMers go to school, they have
to pay for it right out of their pockets. They don't qualify for any
Federal assistance. It is a special effort and a special sacrifice. I
have come to the floor over 100 times over the last 10 or so years to
tell the stories of these young people. I think the stories tell a lot
more than any speech I could give.
This young man is Luis Gonzalez. Forgive me for being especially
drawn to this photo because Luis is standing in front of my college,
Georgetown
[[Page S43]]
University, wearing one of the Georgetown Hoyas shirts.
Let me tell you about Luis. He was 8 years old when his family came
to the United States from Mexico. He had a difficult childhood in Santa
Ana, California. His parents separated. He lived with his mom in a car
garage for several years. After his mom remarried, he lived with his
stepfather, who turned out to be abusive.
Luis overcame these circumstances and still was a good student. He
graduated high school in the top 1 percent of his class with a 4.69
GPA, and he passed all nine advanced placement exams that he took. He
was involved in extracurricular and volunteer activities. He was the
secretary of the school's National Honor Society, and he helped
organize an anti-bullying campaign in his local elementary school. He
was a mentor to incoming freshmen in high school. Saturdays, instead of
taking it easy, he volunteered to tutor other kids in math, and he
volunteered to help a teacher at a local school. He was active in his
church every Sunday, translated the pastor's sermon into English for
those who didn't speak Spanish, and cleaned up the church before and
after the Sunday services.
Because of his outstanding record in high school, Luis was admitted
to Georgetown University. He is currently a sophomore majoring in
American studies and minoring in government. He continues to use his
spare time to help others. He is a member of the provost committee for
diversity and co-chair of Hoya Saxa Weekend, a program that brings
students from underrepresented communities to Georgetown. Luis is a
leader of Strive for College, a program that mentors students in the
inner city high schools. His dream is to be a high school teacher,
which isn't surprising given the strong commitment he has already
shown.
He wrote me a letter and here's what he said:
DACA gave me the confidence and security I've not had
before. I lived in fear and the shadows. Thanks to DACA,
however, I've been able to do things I otherwise wouldn't be
able to do like travel through an airport or working on
campus. I've always felt that I am an American, but having
DACA allowed me to stop living in constant fear and
uncertainty. Now these fears have come back again.
If DACA is eliminated, Luis could be forced back into the shadows.
The day after DACA, Luis will not be able to travel or work on a
campus. He will lose his legal status, and he could be deported back to
Mexico, a country that he hasn't lived in since he was 8 years old.
Luis and other DREAMers have a lot to give America. Would we be
stronger if we deport him, take this man's talent, drive, and energy
and banish him from this country? I don't think so.
I hope President-Elect Trump will understand this and will continue
the DACA program. If he decides to end DACA, then I hope this
administration will work with Congress to pass the BRIDGE Act into law
for Luis and for thousands of others who will be counting on it.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Arizona.
(The remarks of Mr. Flake pertaining to the introduction of S. 28 are
printed in today's Record under ``Statements on Introduced Bills and
Joint Resolutions.'')
Mr. FLAKE. I yield the floor and suggest the absence of a quorum.
Mr. ENZI. Mr. President, I ask unanimous consent that the time in the
quorum call be equally divided between both sides.
The PRESIDING OFFICER. Without objection, it is so ordered.
The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Lee). Without objection, it is so ordered.
Mr. WHITEHOUSE. Mr. President, I want to comment and say a few words
about the use of the budget reconciliation process to facilitate an
effort to repeal but not replace ObamaCare, the Affordable Care Act. I
serve on the Budget Committee. During the course of multiple hearings
during the previous year before the election, we heard the most adamant
stories from the Republican side about how dire our Nation's debt
situation was, how dire our Nation's deficit was.
Member after Member on the Republican side spoke as if the end of the
Republic was at hand. Yet the policies from the Bush administration
that kept driving that debt and that deficit they protect. They blamed
President Obama for the effect of Bush policies that took place during
President Obama's years, while defending those Bush policies the
President had actually tried to correct. In many respects, their
concern about the budget was a little ironic since they were defending
the Bush policies that created this debt and deficit explosion in the
first place.
Nevertheless, be that as it may, you had this phalanx of Republican
Senators in a state of very high animation about our debt and deficit.
You would think that in this Congress, with control both over the House
and the Senate and a Republican President-elect looming, they might use
the budget reconciliation process to do something about the debt and
the deficit.
After all, there was a lot of big talk last year, and here is the
budget reconciliation process. As we see, it is not being used to do
anything about the debt or the deficit, it is being used to open an
effort to repeal but not replace ObamaCare. The problem is, when you do
that, you do some pretty bad things to the debt and to the deficit.
Before the Affordable Care Act was passed, Medicare officials
projected out-year costs for Medicare in 10-year increments. After the
experience of the Affordable Care Act, they went back and they redid
those projections, and they dropped the cost of Medicare dramatically.
Those outyear costs, dramatically reduced, are an important, valuable
step toward lower debt, balanced budgets, and less of a national annual
deficit. Repealing ObamaCare will undo that.
It was pretty clear from Budget Committee hearings that that
reduction in anticipated Medicare costs in the outyears was related to
the work that had been done in the Affordable Care Act as well as the
changes in experience that we are seeing. That is one budget buster
which shows that this reconciliation effort is going in the wrong
direction.
In Rhode Island, I watched this issue pretty closely because I want
Rhode Island to be a leader in delivery system reform. I want ours to
be one of the most efficient health care systems in the country, and I
worked very hard over many years to put the pieces in place in Rhode
Island to help make that come to pass. So I talked to people like Dr.
Kurose, who runs one of our largest primary care practices, and Dr.
Puerini, who runs another very big Rhode Island primary care practice,
and I saw that both of them had taken advantage of the Affordable Care
Act to make themselves accountable care organizations, ACOs, and they
have used the powers and they have used the shared savings under those
programs to change the way they deliver medicine.
What they show is that their price, their annual cost of service per
patient, is actually going down. They are delivering care more
efficiently and they are getting to illnesses earlier. They are not
just churning the wheel of bill and pay, bill and pay, bill and pay;
they are actually managing their patients' health. We hit this
wonderful sweet spot where the patients are healthier and the patients
are way happier because they are getting better service, and the cost
per patient in these practices is coming down. So if that is taken
away, we reverse that effect. It is plausible to think that those costs
will start going back up again. Why would we want to undo a method that
has helped local practices improve the quality of care, reduce the cost
of care, and serve their patients better? The ACO program is part of
the Affordable Care Act.
The last thing is that around here, we try to defend Medicare. One of
the achievements of the Affordable Care Act was that it extended the
solvency of Medicare out to 2028. Undo this bill and there will be a
direct hit on Medicare's solvency. It will come roaring back.
So when you put what the Republican Senators on the Budget Committee
said with such vehemence and alarm about the debt and the deficit
beside the use to which they have put the reconciliation process, which
was designed to be used to reduce the debt and the deficit, and you
look at how
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that actually plays out through the health care system--increasing the
costs of what would have been accountable care organizations, if that
gets undone; lifting back up, presumably, Medicare costs that in the
outyears were reduced because of this; and shrinking the time that
Medicare stands as solvent--if that is not a hit on Medicare, I don't
know what is.
The other piece in this process that bears on this is that during the
period that these very dramatic concerns were being expressed about the
debt and the deficit, the same party that was enunciating those
concerns and those threats to our American society and solvency was
defending all of the loopholes in the Tax Code. We tried and tried to
find a loophole that our Republican friends would be willing to let go
of, and we couldn't find a single one that I recall. Even President
Trump is interested in trying to get rid of the carried interest
loophole that lets hedge fund billionaires pay lower tax rates than
brick masons, but could we get an agreement on that from our colleagues
on the other side? No. They wouldn't touch it.
I hope that as we go forward, we can find a way to bring tax
expenditures lined up with appropriated expenditures under the purview
of the committee, but so far we have been unable to do that despite
repeated bipartisan testimony that a tax expenditure is just the same
as an appropriated expenditure in so far as it affects the debt and
deficit--no difference--bipartisan testimony, clear on the record. The
difference is that behind a great many of these lucrative tax loopholes
that are baked into the Tax Code and that survive year after year after
year is a special interest, whether it is somebody trying to depreciate
their private jet more rapidly than an airline can depreciate passenger
aircraft, whether it is the carried interest loophole that puts, very
likely, the billionaire getting out of his limousine in front of his
New York apartment in a lower tax rate than the guy holding the
umbrella over his head, the doorman. How fair is that? But that is the
status of the tax law. We couldn't get anybody to budge on that because
there are obviously big, powerful interests who don't want to see that
messed with. Why should they pay taxes like ordinary people when they
are superwealthy immortals who can buy themselves politicians?
So the ironies of the party that declaimed about debt and deficit
with such vehemence through so many hearings, with so much blame on
President Obama even though it was carried-forward Bush policies they
were defending that were driving so much of that debt--to have that
group of people now come and use the reconciliation process designed
and intended to address the debt and the deficit instead to try to
repeal but not replace ObamaCare in ways that I think can be very
fairly projected to raise Medicare costs, reduce Medicare solvency, and
undo a good deal of the savings that doctors and taxpayers have shared
from hard-working practices like Rhode Island Primary Care Physicians
and Coastal Medical in Rhode Island, which have relied on the ACO
provisions in the Affordable Care Act to get those savings--who wants
to undo that? It makes no sense, and least of all, it makes no budget
sense because those outyear health care costs will come home into the
budget in those outyears. Of course, you compound that with the fact
that no tax loophole is to be touched. No tax loophole can be
addressed. No revenue can be generated by closing the carried interest
loophole, closing the private jet deduction, closing the tax benefits
for the fossil fuel industry, which is making more money than any
industry has in history and hardly needs the support of the poor
American taxpayer. But, no, big special interests have big tax breaks,
and they are going to be protected at all costs. That is really where
we are on this.
I understand we used reconciliation to move ObamaCare. It did, in
fact, do the job of reducing the deficit, I believe. Undoing it goes in
the opposite direction, but there is a certain ``what is good for the
goose is good for the gander'' equivalence about using that to undo
what we did. I get that. But if we are really serious about addressing
the debt and deficit, then we shouldn't be using the reconciliation
process, which is designed to reduce them both, to attack a health care
program whose effect has been to reduce them both. That is where we
stand right now.
In the months ahead, I hope we will be able to look at tax
expenditures. More money goes out the back door through tax
expenditures than gets spent on some of our biggest programs. It is a
huge loophole, and within it are a lot of very unattractive special
interest special provisions--loopholes in the worst sense of the word.
We don't want to touch them because nobody dares to touch the special
interests behind them.
So that is where we are. I hope we can make real progress on the debt
and the deficit and stop defending private jet reductions, stop
defending fossil fuel subsidies, stop defending billionaire special tax
breaks, and actually put the debt and the deficit that America faces
first rather than having conversations about that being window dressing
until you get a Republican President, and then you go completely
haywire, using the reconciliation process to undo health care laws,
raise Medicare costs, and undo the ACO program that has been so
effective in my State.
I see the junior Senator from Utah is presiding, and I know that Utah
and Intermountain have some of the best health care work being done on
delivery system reform, and it would surprise me very much if the
leaders at Intermountain in Utah were excited about undoing the
delivery system reform provisions of Obamacare. The Innovation Center
at the Centers for Medicare Services, the ACO provisions, the
provisions for shared savings between doctors and the taxpayer when
savings accrue because of better practices, the changes toward better
models of payment--I would be very surprised if they were very
enthusiastic about undoing those.
But, as I said, this is where we are, and I will close my remarks,
and I hope that soon, once this exercise is over, we can actually get
serious about closing loopholes and reducing the debt and reducing the
deficit--the nominal cause of the Republicans on the Budget Committee.
I yield the floor.
The PRESIDING OFFICER. Who yields time?
Mr. WHITEHOUSE. Mr. President, 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. WHITEHOUSE. 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. WHITEHOUSE. Mr. President, I ask unanimous consent that the time
be evenly divided between the two sides during the quorum call.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. WHITEHOUSE. With that understanding, I suggest the absence of a
quorum, with the time divided equally between the two sides.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. BROWN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Perdue). Without objection, it is so
ordered.
Mineworker Pensions and Health Care
Mr. BROWN. Mr. President, 70 years ago United Mine Workers president
John L. Lewis, a lifelong Republican, sat down with the Democratic
Secretary of the Interior, Julius Krug. They struck a deal to end a
national strike. They promised health and pension benefits for miners
in exchange for a lifetime of hard work. It is a promise that the
Federal Government has kept ever since.
For 70 years, no matter the President, no matter the party in control
of the Senate, we have kept that promise. That changed, unfortunately,
in December. This body left for vacation. It left tens of thousands of
mine workers to face an uncertain future, not knowing if the pensions
and health care they had earned for themselves--and in many cases for
their widows--over a lifetime of hard work would be there for them in
the future. This is shameful.
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Senator Portman, my Republican colleague from Ohio, and I and Senator
Manchin and Senator Capito, a Democrat and a Republican from West
Virginia, and Senator Casey--a number of us--said: We should not leave
Washington to go home to our families until we take care of mine worker
families.
Congress has the power to stop these cuts and to live up to this
pledge. We had a bipartisan solution that would have passed if it had
been brought to the floor. But instead, Congress broke its promise to
these miners and their families. Congress stole the health care they
had earned by passing a continuing resolution that failed to address
the pension problem, and it stole the funds that were still left in
their health care plan to pay for a 4-month fix--4 months, 4 months.
Who can make health care decisions when you don't know if you will have
health care coverage 4 months from now?
These working people don't deserve to live with this kind of
uncertainty. I have heard my colleagues, particularly on the Republican
side of the aisle, always talk about predictability. Government should
never inject more uncertainty into the lives of individuals, never
should inject uncertainty into the lives of business people as they
make investment decisions.
But that is what we have done with these mine workers. We have made
their lives less certain, less predictable, and their health care so
unpredictable. This is the health care these workers fought for, the
health care they sacrificed raises for. Keep in mind that at the
bargaining table, workers will be willing to accept less wages today in
exchange for health care and pensions in the future. That is what
collective bargaining is often about. That is what is so important.
This is health care they sacrificed raises for. It was the health
care we promised them. My colleagues know their stories of hard work
and sacrifice. We know these stories because over the past year, these
miners traveled here by the busload. They rode long distances. They
gathered in the heat and in the cold for hours outside this building to
make their voices heard.
They worked decades in the mines--hard back-breaking work. But that
work had dignity. It was dangerous work--work where some of them were
killed on the job, work where many of them developed health problems
later. Many of them died younger than people who dress like we do and
have jobs like this. Their widows have been denied these pensions and
health care. They clocked in every day, these workers. They knew the
conditions they faced. Many of them now suffer from black lung or other
illnesses. They accepted a lifetime of hard labor because they valued
their jobs, they valued their work, and they believed that good-paying
union jobs were their tickets to the middle class.
These miners believed in the covenant we used to have in this country
that promised if you work hard your whole life, if you put in the
hours, if you save a little and do your part, you will be able to help
your children go to college. They believed that would give their kids a
chance at a better life perhaps than they had. They believed that if
they upheld their end of the deal, if they put in the work to power our
country by mining coal used for a generation of electricity, their
government would do the same. In December, Congress told them they were
wrong. I don't accept that. These workers sacrificed their lungs and
their backs to keep our lights on. It is shameful that Congress,
despite all intents and purposes, has stolen what they earned. These
miners should have spent Christmas with their grandkids, not worrying
about whether they could afford their medicine.
We aren't giving up. We had a bipartisan solution in December. We
will keep fighting until mine workers across Ohio and this country have
the full health care and retirement security that we promised them.
They kept faith with us and powered our country. It is time to keep
faith with the workers in our industrial heartland and to right this
wrong.
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. BROWN. 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. BROWN. Mr. President, I ask unanimous consent that the time
during the ensuing quorum call be divided equally between the two
sides.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. BROWN. 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. McCONNELL. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
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