[Congressional Record Volume 163, Number 6 (Tuesday, January 10, 2017)]
[Senate]
[Pages S184-S187]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         CONCURRENT RESOLUTION ON THE BUDGET, FISCAL YEAR 2017

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will resume consideration of S. Con. Res. 3, which the clerk 
will report.
  The senior assistant legislative clerk read as follows:

       A concurrent resolution (S. Con. Res. 3) setting forth the 
     congressional budget for the United States Government for 
     fiscal year 2017 and setting forth the appropriate budgetary 
     levels for fiscal years 2018 through 2026.

  Pending:

       Sanders amendment No. 19, relative to Social Security, 
     Medicare, and Medicaid.

  The ACTING PRESIDENT pro tempore. The Senator from South Dakota.


                           Order of Procedure

  Mr. THUNE. Mr. President, I ask unanimous consent that the Senate 
recess from 1 p.m. to 2 p.m. for the weekly conference meetings and the 
time in recess count equally against S. Con. Res. 3; further, that 
Senator Sanders or his designee control the time from 2 p.m. to 2:30 
p.m.; and finally, that there be 2 minutes equally divided in the usual 
form prior to the vote on the Flake amendment.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. THUNE. Mr. President, clarifying that recent request, I ask 
unanimous consent that the Senate recess from 1 p.m. to 2 p.m. for the 
weekly conference meetings but that that time not count against S. Con. 
Res. 3.
  The ACTING PRESIDENT pro tempore. Without objection, the modified 
request is agreed to.
  Mr. THUNE. Mr. President, last week the Senate began consideration of 
the ObamaCare repeal resolution, which is the first step in the process 
of repealing the law. It is time for repeal.
  Seven years ago, ObamaCare was sold to the American people with a lot 
of promises. The law was going to reduce premiums for families. It was 
going to fix problems with our health care system without hurting 
anyone who was happy with their health coverage. If you like your 
health plan, you will be able to keep it, people all across this 
country were told over and over again. If you like your doctor, you 
will be able to keep your doctor--also a promise and claim that was 
made over and over again. As everyone knows, every one of these 
promises was broken. Premiums for families have continued to rise. 
Millions of Americans lost health care plans that they liked. Americans 
regularly discovered that they couldn't keep their doctors and that 
choice of replacement was often limited.
  These broken promises were just the tip of the iceberg. The law 
hasn't just failed to live up to its promises, it is actively 
collapsing, and the status quo is unsustainable. Premiums on the 
exchanges are soaring. Deductibles regularly run into the thousands of 
dollars. For 2017, the average deductible for a bronze-level ObamaCare 
plan is rising from $5,731 to $6,092. With deductibles like that, it is 
no wonder that some Americans can't afford to actually use their 
ObamaCare insurance.

  I receive a lot of mail from constituents in my State struggling to 
pay for their health care. One constituent contacted me to say: ``My 
ObamaCare premium went up from $1,080 per month to $1,775 per month,'' 
a 64-percent increase, $21,300 a year for health insurance. Let me just 
repeat that, a 64-percent increase in premiums, $21,300 a year for 
health insurance. That is like paying another mortgage. That is a lot 
more than many people pay for their mortgage, and of course that is 
before any deductibles or other out-of-pocket costs are considered.
  Another constituent wrote to tell me, ``Today I received a new 
premium notice from my ObamaCare insurance. My policy rate for myself, 
my wife and my teenage son has increased by 357 percent.''
  The problems on the exchanges aren't limited to soaring costs, 
unfortunately. Insurers are pulling out of the exchanges right and 
left. Health care choices are rapidly dwindling. Narrow provider 
networks are the order of the day. One-third of American counties have 
just one choice of health insurer on their exchange.
  This is not the health care reform the American people were looking 
for.

[[Page S185]]

So it is no surprise that a recent Gallup poll found that 80 percent of 
Americans want major changes to ObamaCare or want the law entirely 
repealed and replaced or that 74 percent of American voters ranked 
health care as a very important voting issue for them in the 2016 
elections. ObamaCare has not fixed our Nation's health care problems. 
It has made them worse. The American people deserve better.
  Last week, the Senate started considering the ObamaCare repeal 
resolution, and we are continuing that process this week. This 
resolution will provide us with the tools we need to repeal the law, 
and then committees will get to work on the actual repeal bills. Then 
we will work step-by-step to replace ObamaCare with real health care 
reform that focuses on personalized, patient-centered care.
  One massive problem with ObamaCare is the fact that it puts 
Washington in charge of health care decisions that should be made at a 
much lower level. The ObamaCare reform the Republicans pass will focus 
on fixing this. We are going to move control from Washington and give 
it back to States and the individuals. Health care issues don't have 
one size-fits-all solutions. It is time to stop acting like they do.
  States should have the power to innovate and embrace health care 
solutions that work for the individuals and the employers of their 
States. Individuals should be able to make health care decisions in 
consultation with their doctors, not with Washington, DC. Another thing 
we are going to focus on is breaking down the ObamaCare barriers that 
have artificially restricted choice.
  As I said earlier, ObamaCare has defaulted to a one-size-fits-all 
solution when it comes to health care, and that means that many 
Americans have found themselves paying for health care they don't need 
or want. We need much more flexibility in insurance plans. A thriving 
health care system would offer a wide variety of choices that would 
allow Americans to pick a plan tailored to their needs, that would be a 
competitive system that gives people in this country more choices, and 
inevitably what happens in those circumstances, that pushes the cost 
down.
  We also need to give Americans the tools to better manage their 
health care and control costs. Of course, any reform plan has to make 
sure small businesses have the tools they need to provide the employees 
with affordable health coverage. ObamaCare has placed huge burdens on 
small businesses that have made it difficult for them to thrive and 
even to survive. It is time to lift these burdens and free up these 
businesses to grow and create jobs.
  Our health care system wasn't perfect before ObamaCare. We all 
acknowledge that, but ObamaCare was not the answer. Instead of fixing 
the problems in our health care system, it just made things worse. 
Republicans are ready to implement the kind of health care reform the 
American people are looking for: more affordable, more personal, more 
flexible health care coverage that meets their needs and is less 
bureaucratic.
  The American people are ready for health care reform that actually 
works, and that is exactly what Republicans are going to give them 
starting right now.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. BARRASSO. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. BARRASSO. Mr. President, I would like to congratulate my 
colleague from South Dakota for his comments. I am hearing the same 
thing in Wyoming that he has been hearing about the ObamaCare health 
care law and the impact on people in his State. I am hearing the same 
thing. I heard it this past weekend in Wyoming talking to people about 
what impact ObamaCare has had on their lives.
  It is very interesting because people all around the State of Wyoming 
are talking about the fact that their costs have gone up and choices 
have gone down. Many who had insurance that worked for them lost that 
insurance all related to a law passed in the House and the Senate and 
signed into law by President Obama.
  Tonight, in Chicago, President Obama is going to give a farewell 
address. I am assuming he will talk about ObamaCare, and I am assuming 
he paints a very different picture than the American people have seen 
and are living with. The President is using scare tactics about what 
Republicans plan to do. No matter what President Obama wants, the 
American people have spoken. They have voted, and 8 out of 10 people 
say that what this costly and complicated health care law has done to 
them, they would like to see it either significantly changed or 
repealed and replaced. They know better than to believe what the 
Democrats are continuing to tell them because they have been living 
with it every day.
  Seven years ago, Democrats made one false claim after another when 
they were trying to sell this law to the American people. Democrats 
said: If you like your doctor, you can keep your doctor. They said: If 
you liked your health care plan, you could keep your health care plan. 
That one was labeled the Lie of the Year a few years ago. They said 
premiums for the average family would go down by $2,500. None of it was 
true. Now Democrats are out telling more tales about ObamaCare. All of 
these new stories are going to be just as false as the ones they told 
us all in the past. For one thing, Democrats have been saying that 
millions of Americans are going to lose their health insurance if we 
repeal the ObamaCare health care law.
  In a letter just last week, Senators Schumer and Sanders said that 
Republicans are planning to take health care coverage away from more 
than 30 million Americans. It is not going to happen. The Democrats 
absolutely know it is not going to happen. It doesn't stop them from 
saying it.
  The fact is, this should never have been about health insurance in 
the first place. As a doctor, I will tell you this should have been 
about health care and patients. Republicans are going to make sure that 
is where the focus is from now on. The number of people with good 
health insurance coverage under ObamaCare actually has been a lot less 
than what the Democrats are claiming. That is because lots of people 
who bought ObamaCare coverage only did it because the health care law 
forced them to give up the insurance they already had and liked and 
worked for them. I have heard many stories from people in Wyoming who 
had insurance. It worked for them. They chose it because it was best 
for them and their family, and they lost it because the President said 
it wasn't good enough for him. These are people who were hurt by the 
broken promises and by President Obama's well-earned award of Lie of 
the Year.
  With the health care law, most of the people who got insurance for 
the first time were actually forced into the broken system called 
Medicaid. Most of those people were actually eligible for Medicaid 
before the law was even signed, but for people who didn't have 
insurance before, a lot of them still can't afford care now because 
they may have insurance, but the deductibles are so high they can't 
afford to use it. Half of ObamaCare enrollees say they are skipping 
doctor visits in order to save money. If a family's health insurance 
doesn't cover the care they need, then the number of people covered is 
totally meaningless.
  Democrats are out there saying that if we try to replace ObamaCare 
with a better solution, that it is just going to, in their words, cause 
chaos in the health insurance industry. Where have they been? There is 
chaos everywhere because of ObamaCare. When you look at what Democrats 
did to America's health care system, what you see is chaos. Premiums 
are up 25 percent in 1 year. That is chaos. Deductibles are up by an 
average of $450 in a year. That is chaos. There is no functioning 
marketplace for ObamaCare in one-third of the country. That is chaos. 
When Americans look at this, what they see is already chaos, and 
ObamaCare caused it.
  I want to mention one of the false claims the Democrats are making, 
and it has to do with Medicaid. That is because Medicaid was broken 
long before ObamaCare. All the health care law did

[[Page S186]]

was add more people onto this broken program. One reason Medicaid is 
struggling is the same reason the rest of ObamaCare isn't working--
because Medicaid tries to impose too many rules and regulations from 
Washington. It tries to make one size fit all.
  There are different needs in every State. States know what those 
needs are, and they know much better than Washington about the people 
who live in those States. There are Republican Governors like Mike 
Pence of Indiana who understood this very important fact--and I am glad 
he is soon going to be Vice President. Governors like Mike Pence fought 
for waivers, waivers to make sure they could do what the people of 
their States needed. Every Governor should have that kind of freedom to 
look out for the best interests of the people in their home States. 
They shouldn't have to ask permission from some unaccountable, 
unelected Washington bureaucrat before making improvements to their own 
Medicaid Program. Giving States the freedom to come up with better 
solutions is just one of the things Republicans are going to do to 
replace ObamaCare with real health care reform. States need and deserve 
to have that freedom, and people should be free to buy the health 
insurance that meets their needs, not what meets the needs of the 
President of the United States.
  People shouldn't have to pay more for coverage that isn't a good 
value for them. That is why so many people aren't even signing up in 
the first place and would rather pay the penalty--a penalty that, in my 
mind, is still unconstitutional. Families should have more flexibility 
to save for their own medical care. That is a way to make sure they are 
not stuck with empty coverage they can't afford to use. People 
shouldn't be mandated to buy this overpriced, unusable insurance or 
face a penalty from the IRS. It is one of the most outrageous parts of 
the entire health care law. To me, it is the first thing that has to go 
on the chopping block.
  Republicans are going to repeal damaging and destructive ideas like 
ObamaCare's many taxes, mandates, and penalties. Then we are going to 
walk through better solutions one-by-one, step-by-step. I hope some of 
the Democrats in Congress will join us.
  The Democratic Senators must be heading home on weekends and 
listening to people who have been impacted the way I described the 
people of Wyoming believe they have been impacted by the health care 
law. They have to realize there are things we must do better and more 
freedoms that must be given to the American people.
  The American people have suffered long enough with the chaos created 
by ObamaCare. It took years for health insurance markets to get this 
bad, and it is going to take time to get things fixed.
  This resolution we have submitted to repeal ObamaCare is the start.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I thank my colleague from Wyoming, the 
doctor, the Senator who has been involved in health care all of his 
adult life and particularly since he got to the Senate. He has been 
looking at alternatives to what we have and will play an intricate part 
in any replacement that we do.

  We know what the problems are, and we are in the land of denial right 
now with the Democrats making speeches about the fearmongering of what 
might be changed. This isn't the point at which it gets changed. This 
is the point at which it gets set up so that it can be changed, and I 
look forward to actually doing the repeal and the replacement under the 
guidance of Senator Barrasso from Wyoming.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Michigan.
  Ms. STABENOW. Mr. President, let me first say to the distinguished 
chairman of the Budget Committee that we look forward to seeing the 
replacement as well because that is really the key right now. People 
across the country are saying: Wait a minute. You are going to unravel 
a system. You are going to repeal and take away the health care that I 
have and the patient protections that I have, and we don't even know if 
it will be better.
  Why in the world would that be done if the new system wasn't going to 
be better than the old system?
  Right now we don't see anything. We see 6 years of repeals coming 
from the House and Senate and no plans. We still don't see a plan, and 
we have no idea. More importantly, there are millions of people with 
insurance who are either getting patient protections or affordable care 
they couldn't get before or have Medicare strengthened or Medicaid 
support, and no one knows what will happen next. Doctors, nurses, 
health care providers--no one knows what is going to happen next. I 
think it is the most irresponsible approach to addressing one of the 
basic needs for all of our families that we could ever have. So we know 
that in the end, when you pull the thread, essentially, you unravel the 
whole system. That, minimally, creates instability in the entire 
economy. There is no plan being held up that would improve health care, 
which we are all for. I am all for making the health care system more 
affordable for families, strengthening health care. Let's do it. 
Unravelling and creating chaos in the health care system--no. It makes 
absolutely no sense, and we know that it is just going to make America 
sick again.
  I want to share a couple of stories. First, we hear from Mary of 
Dundee, who owns a small business and has a 20-year-old daughter with a 
preexisting condition. For her, coverage--but, also, what we call the 
Patients' Bill of Rights--is absolutely critical. That is part of the 
Affordable Care Act that affects everybody with insurance. Seventy-five 
percent of Americans get their insurance through their employer. In the 
past, they could get dropped if they got sick, if they had diabetes or 
had a child with juvenile diabetes or had a heart condition or high 
blood pressure. Women who were of childbearing years could be viewed as 
having a preexisting condition. In the past, insurance companies had 
total control to decide who got coverage, when they got dropped, what 
would happen when you got sick and needed medical care. That changed 
with a Patients' Bill of Rights in the Affordable Care Act. There are a 
whole range of protections to make sure the insurance you pay for every 
month actually provides the medical care when you need it for you and 
your family.
  Let's start with Mary's story. She wanted to express her concern 
about repealing the Affordable Care Act, and I appreciate very much the 
fact that she shared her story with me. She says:

       My family and I have purchased our coverage through the 
     [ACA] marketplace for 2015, 2016, and 2017. This opportunity 
     has allowed us to become self-employed. . . .

  They could open their own business. They weren't tied to their job 
because of the need of health insurance. They now have opened their own 
small business in Dundee, MI.

       Prior to the ACA, I was working to provide coverage--

  How many times have we heard that? I have heard that even in my own 
extended family--

     then I lost my full time status and as a part-time employee, 
     the hours I worked barely covered my portion of my employer 
     provided healthcare.
       By enrolling for coverage through the marketplace, I was 
     able to pick the coverage needed for our family at an 
     affordable price . . . not knowing what the future held 
     becoming self employed. We have three daughters. Our oldest 
     has life threatening allergies and asthma. I did not need to 
     worry that we would be denied coverage due to preexisting 
     conditions.
       As Congress proceeds to dismantle the ACA, I am concerned 
     for my oldest daughter who is in her sophomore year at the 
     University of Michigan-Dearborn. She is 20 years old. . . . 
     Will she continue to have coverage through our insurance 
     until she is 26 as the ACA provides? If not, what kind of 
     coverage will she be able to afford due to her preexisting 
     conditions? Why put more obstacles in the way of our young 
     adults?

  That is a really good question, Mary. It makes no sense to do that.
  She goes on to say:

       The ACA, we're sure, has faults . . . and like everything, 
     could be improved, but to scrap it and not use it at least as 
     a ``seed'' to grow and improve is beyond my understanding. To 
     suggest that there is nothing to keep is absurd and 20-30 
     million Americans enrolled . . . agree with us.

  I agree with you as well, Mary. Thank you for sharing your story.
  The coverage in the Affordable Care Act and the strengthening of 
Medicare and Medicaid are critical, as are the patient protections--the 
Patient Bill of Rights that affects people who buy insurance now, who 
finally got control

[[Page S187]]

back from insurance companies that made every single decision. Being 
able to know that, if, in fact, you get sick or your child has a 
serious health condition, they won't be denied care for the rest of 
their lives, and also being able to have them on your insurance as they 
start off in life--there are so many protections. The caps on 
treatments and the number of treatments and services provided have been 
eliminated. The Patients' Bill of Rights is absolutely critical.
  I want to take just a moment to speak about another piece of this, 
which relates to the Patients' Bill of Rights as it relates to women. 
In the past, the majority of plans--about 70 percent of the insurance 
plans in the private sector that a woman might try to choose and 
purchase--wouldn't cover basic maternity care. I couldn't believe it 
when I first heard that. Wait a minute. It wouldn't cover basic 
maternity care? Now every plan has to cover basic maternity care. It 
makes sense. No longer is just being a woman a preexisting condition. 
That is part of the Patients' Bill of Rights.
  The capacity to now get preventive care, a mammogram, cancer 
screenings, and other types of preventive care is done without a copay. 
So we want people to go and get that checkup and, if there is a 
problem, to be able to tackle it early. That is most important because 
it is better for the person, but it also means there will be less cost 
to the health care system if you can catch something early. So the 
Patients' Bill of Rights is really critical to that.
  There is something else that is also in here that is appalling to me 
and goes directly to the question of women's health care, and that is 
the fact that this bill repeals Planned Parenthood services and, 
basically, guts health care for women across Michigan and women across 
the country. For 75 percent of the women who use a Planned Parenthood 
clinic in Michigan, their visit will be the only health care they get 
all year.
  We have rural counties in northern Michigan where the only health 
care clinics doing preventive care--cancer screenings, basic services, 
OB/GYN visits--are the Planned Parenthood clinics. So many women across 
Michigan will see their access to health care denied if this passes and 
Planned Parenthood loses its funding. There were 71,000 patients, the 
majority of them women, in Michigan in 2014, who received care--breast 
exams, Pap smears, prenatal visits. Again, tying this all together, we 
want to cover maternity care, but we also want healthy moms and healthy 
babies, and that means prenatal care. We have communities in these 
small towns, as well as in the big cities. But it affects small towns 
and rural communities around Michigan, where women are going to be 
denied services, and it is the only clinic that is there.
  I want to share a story from Laurie in Jonesville about the 
Affordable Care Act and her particular situation. She said:

       I have had type I diabetes for 54 years and when I needed 
     to retire early at the age of 62 because of complications 
     related to diabetes, I looked at the ACA for health 
     insurance. . . . I couldn't afford COBRA.
       I was able to buy health insurance at what I consider an 
     affordable price with a small copay for my medications, the 
     most expensive one being insulin at a retail price of $296 a 
     month. As you know, my preexisting conditions of type I 
     diabetes, heart disease and a visual impairment, both 
     complications of diabetes, would have been uninsurable 
     without the ACA. I would have been uninsurable.

  That is without the Patients' Bill of Rights, which says she has a 
right to be able to purchase health insurance.

       In June of 2016 I was diagnosed with breast cancer, luckily 
     diagnosed at Stage 1 in a routine mammogram. Without the ACA 
     I wouldn't have been able to afford the mammogram or the 
     subsequent treatment without depleting our life savings. I 
     quickly reached my maximum out of pocket cost and while some 
     people would complain about having to pay that, not me! My 
     total bill so far is over $150,000. . . .

  That is for her cancer treatment.
  There is the combination here of repealing Planned Parenthood funding 
for health clinics that allow someone like Laurie to go in and get a 
mammogram rather than waiting until she has a level of breast cancer 
that cannot be effectively treated or might otherwise cause loss of 
life. She was able to catch this early because she was able to get a 
screening--a mammogram--the kind of treatment that women in small towns 
all over Michigan have the capacity to do now because of the reasonable 
copays for care and partly because there is no copay for that mammogram 
but also because they have a clinic available in their community where 
they can get the care. All of this fits together--the access to 
preventive care for women, the health care clinics that are available 
around Michigan and around the country, and the Patients' Bill of 
Rights, which says you have a right to care. This is not just about the 
insurance company basing every decision on the fact that they want to 
make more money rather than cover you. You have a right to make sure 
that when you get sick, you don't get dropped, and, if you have breast 
cancer or diabetes, you have a right to have access to affordable 
health care.

  So I would hope that our colleagues would join together, stop this 
craziness of trying to repeal health reform and protections for every 
single American, and, instead, sit down together and look at how we can 
make it better.
  Our Republican colleagues will find willing partners in making the 
system more affordable and better, but we will continue to be the 
strongest possible opponents of ripping the system apart and creating 
chaos for American families.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Wyoming.


                            Amendment No. 52

  Mr. ENZI. Mr. President, I call up amendment No. 52 and ask unanimous 
consent that it be reported by number.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  The clerk will report the amendment by number.
  The senior assistant legislative clerk read as follows:

       The Senator from Wyoming [Mr. Enzi], for Mr. Flake, 
     proposes an amendment numbered 52.

  The amendment is as follows:

(Purpose: To strengthen Social Security and Medicare without raiding it 
 to pay for new Government programs, like Obamacare, that have failed 
 Americans by increasing premiums and reducing affordable health care 
  options, to reform Medicaid without prioritizing able-bodied adults 
   over the disabled, and to return regulation of insurance to State 
                              governments)

       At the end of title III, add the following:

     SEC. 3___. DEFICIT-NEUTRAL RESERVE FUND RELATING TO 
                   PROTECTIONS FOR THE ELDERLY AND VULNERABLE.

       The Chairman of the Committee on the Budget of the Senate 
     may revise the allocations of a committee or committees, 
     aggregates, and other appropriate levels in this resolution 
     for one or more bills, joint resolutions, amendments, 
     amendments between the Houses, motions, or conference reports 
     relating to protections for the elderly and vulnerable, which 
     may include strengthening Social Security and Medicare, 
     improving Medicaid, housing reform, and returning regulation 
     of health insurance markets to the States, by the amounts 
     provided in such legislation for those purposes, provided 
     that such legislation would not increase the deficit over 
     either the period of the total of fiscal years 2017 through 
     2021 or the period of the total of fiscal years 2017 through 
     2026.

                          ____________________