[Congressional Record Volume 163, Number 23 (Thursday, February 9, 2017)]
[Senate]
[Pages S1001-S1004]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Senator Luther Strange

  Mr. SHELBY. Mr. President, I would like to take a few minutes this 
afternoon to talk about some of the events that happened here in the 
past 24 hours.
  Less than 24 hours ago, we confirmed my colleague--former colleague 
now--Jeff Sessions to be Attorney General of the United States. After 
he was confirmed, he resigned as Senator and has been sworn in as 
Attorney General of the United States this morning.
  The Governor of Alabama, Gov. Robert Bentley, subsequently appointed 
Luther Strange, who is our newest Senator. He was our attorney general 
until a few hours ago--a second term as attorney general. I want to 
tell you a little bit about our newest Senator from Alabama here in the 
U.S. Senate.
  He is someone I have known for about 35 years and someone I have 
spent a lot of time with, off and on. I know his wife Melissa. I know 
his sons. We have traveled together. As the Presiding Officer would 
appreciate coming from Georgia, we have had time to be in Georgia and 
other places hunting quail, ducks, geese, and doves together. You get 
to know somebody pretty well, as the Presiding Officer knows.
  I believe this was a great appointment by our Governor. This is 
someone who will hit the ground running. He is going to be involved in 
the issues. He is a team player. He is going to work with us in the 
Republican caucus and work for what is in the best interests of the 
State of Alabama and the Nation, which we all need to do.
  He is a graduate of Tulane University, undergraduate and law school, 
and you might be able to tell he may have been a basketball player in 
his youth and probably still would be.
  I look forward to working with him. I am going to miss Senator 
Sessions, who is now our Attorney General, someone I worked together 
with for 20 years. I have been here 30 years, so together, as I said 
yesterday, we have 50 years.
  Luther Strange is going to hit the ground running. He brings a lot of 
knowledge, a lot of integrity to this job, and I look forward to 
working with him for the people of Alabama and for our great Nation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. KAINE. Mr. President, I thank the Chair for allowing me to retake 
the floor to speak about the nomination of Congressman Price to be HHS 
Secretary, and to read stories from Virginians who are afraid about 
repeal of the Affordable Care Act.
  Mark Priest, Alexandria, VA:

       I am a self-employed entrepreneur and consultant. Since I 
     work for myself I do not have access to a special pool from 
     an employer that would make health insurance more affordable. 
     Starting in 2014 I was insured through the ACA and I was able 
     to find an affordable policy to cover myself. I think that 
     there is a mistaken notion that if you are employed, you 
     automatically have access to affordable health insurance. The 
     ACA isn't just for the unemployed. I work hard and I am a 
     small business owner. The ACA makes it possible for me to 
     afford health care.

  Constance Burch, Fort Valley, VA:

       I am a 53 year old single female who is self employed as a 
     Voice and Piano teacher. I have always prided myself on being 
     able to care for myself and provide the basic necessities. 
     Before the ACA I had to pay over $450 a month for health care 
     on a net income of $19,000. This meant some months having to 
     use credit cards for other necessities such as food and 
     gasoline to get to my lessons. Thanks to President Obama, 
     that all changed and based on my income, my fee was reduced 
     to $33 a month. I literally cried for joy that someone 
     finally did something to help those of us who work hard and 
     deserve the same quality health care that the more fortunate 
     are able to have. It is fair and quite honestly it was the 
     first time in my life that I truly felt that the government 
     actually did something to help me personally and those in the 
     same position.

  Deb Fuller, Alexandria, VA:

       I rely on the ACA for my health insurance because 
     otherwise, I would not be able to get it. My job, writing K12 
     textbooks and other educational material, has largely been 
     outsourced, and full-time permanent positions with benefits 
     are nearly nonexistent these days. The majority of the work 
     is as a ``flexible workforce'', which is the fancy term for a 
     freelancer or contract employee. Having the ACA means I can 
     continue working these contracts instead of trying to figure 
     out how to completely change professions because I need a job 
     that provides health insurance. Before the ACA, my saint of a 
     doctor went back and forth with health insurance companies 
     trying to convince them that I wouldn't cost them too much 
     money in the long run. They literally looked for anything to 
     deny me coverage. One rejection letter mentioned cold sores 
     in the litany of reasons why I was completely uninsurable. 
     Ninety percent of the population has cold sores. Now, 
     insurance companies make back their money on me because I pay 
     them vastly more than they cover because I don't get sick 
     that often or visit the doctor that often outside of routine 
     checkups. I also have peace of mind that if I am out on 
     horseback riding or hiking on a trail, I won't be put in the 
     poor house because I landed in a heap and had to go to the 
     ER.

  Lauren Carter, Lovingston, VA:

       My 39 year old son has cerebral palsy and a blood clotting 
     disorder. His ``preexisting conditions'' started at 
     conception. Three years ago, he lost his full-time job with 
     health insurance benefits. The ACA allows him to continue 
     receiving medical care and purchase his lifesaving 
     medications. He supports himself through multiple part-time 
     jobs, but employer-based insurance is just not an option for 
     him at this time.

  Shannon Linford, Leesburg:

       My name is Shannon Linford, I'm 24, and from the age of 10, 
     my life has been a series of doctors office visits. I suffer 
     from over a half dozen chronic illnesses, physical and 
     mental, and require frequent checkups and take up to 15 
     prescriptions a day. I have spent the last 14 years balancing 
     illness with my attempts to build a life. That would not have 
     been possible were it not for the provisions of the ACA that 
     prevent insurance companies from denying me service for my 
     illnesses or allowing me to stay on my parents' insurance 
     until I am 26. I've had to take a detour from pursuing higher 
     education due to these illnesses, as well as getting a job, 
     and instead spend the days I'm well enough volunteering with 
     nonprofits that advocate for others with illnesses like mine. 
     My team of doctors and I work together personally to create a 
     plan that is best for me. We are exemplifying health care at 
     its best. They know me by name, they know each other by 
     name--across disciplines, they work and collaborate together. 
     I would not have this luxury were it not for the ACA. If 
     insurance companies could deny me coverage due to my 
     preexisting conditions I was born with, my family and I would 
     go into bankruptcy trying to give me basic care. My health is 
     finally under good management. I'm going into remission with 
     my depression thanks to new experimental treatment with my 
     psychiatrist. Things are looking up, thanks to the provisions 
     in this remarkable legislation. Revoking this law would be 
     criminal and would destroy lives, destroy futures. Thank you 
     so much for your hard work.

  Anna M., Vienna, asked that I not use her last name:

       Without the ACA, I would likely be dead. I live with 
     bipolar disorder, an incurable mental illness that causes my 
     moods to swing uncontrollably from intense anxiety to 
     crushing depression. I began seeking help five years ago and 
     once spent two weeks in an intensive outpatient hospital 
     program because I was suicidal. I got help, but later lost my 
     job and my insurance, making my disorder a preexisting 
     condition. Thankfully, the ACA prevents my new insurance from 
     refusing coverage, and I was able to continue treatment. I 
     will need to control my bipolar disorder with medications and 
     therapy for the rest of my life. Without treatment, I am at a 
     higher risk for long-term unemployment, becoming homeless, 
     incarceration, and dying by suicide. With treatment, I work 
     full-time, pay my taxes, volunteer for local charities, and I 
     am a loving daughter, sister, and friend.

  Katie Rugg in Henrico:

       I was paying half of the cost of my rent and health 
     insurance every month and still having to pay for services 
     every time I went to be seen. I never knew how much things 
     would cost when I needed to be seen, either! So I was paying 
     an outrageous amount for health insurance and also afraid to 
     go see a doctor if I had any issues because it was going to 
     cost me more money than I had on top of everything else. I 
     was already living paycheck to paycheck, with a full-time 
     professional job in my field and a masters degree, and 
     seriously considering going without any insurance at all. 
     When the ACA was passed, my employer offered a discounted 
     option through the affordable care exchanges. I

[[Page S1002]]

     decided it was worth trying. It cut my monthly costs by more 
     than half and it pays for services at 100 percent of the 
     Medicare fee schedule. The cost is deducted directly from my 
     paycheck, and every provider that I have seen has been happy 
     with the prompt and predictable payment, even if it requires 
     some explanation at first. The way it works is that I would 
     pay the difference if there was any between the cost of 
     service and the Medicare fee payment. So far, any additional 
     cost to me, besides occasional lab work, which has been very 
     minimal. And my regular chiropractic care has been completely 
     covered. It has been phenomenal, like the difference between 
     day and night for me. Not only did this option allow me to 
     feel comfortable going in to see a doctor when I had an issue 
     instead of when I had to and was already sick, it also helped 
     me put some money away into a modest savings. Most 
     importantly, with housing costs continuing to rise and my 
     paycheck staying absolutely static for 3\1/2\ years, I was 
     finally able to buy my own house through a first-time 
     homeowners Assistance loan. It took a year of looking and 
     saving aggressively, but I have done it. I have done it! 
     Losing my ACA insurance would be devastating. I have come too 
     close to homelessness with the financial pressures I face in 
     this economy. I don't want to lose now what I have worked so 
     hard to gain. Thank you, Sen. Kaine, for what you are able to 
     do to help people like me.

  JoAnne Loiselet, Clifton:
  Clifton, VA.

       My story is I'm sure like many other women. I was a stay-
     at-home mom and in 2009 my husband, who owned his own 
     business, and I separated and ended up divorced 3 years 
     later. He is not required to keep my children insured and he 
     cancelled their health insurance without me knowing it. The 
     company I started working for doesn't offer health insurance, 
     and we went without, until the ACA went into effect. Our 
     pediatrician didn't charge me for office visits and only for 
     vaccines. When needed, we borrowed money to help pay the 
     bills. If the ACA gets repealed, what would we do? What would 
     happen if my son breaks his arm or my daughter breaks her 
     leg? How could I pay for that? I make $50,000 and live in 
     Fairfax County and I could end up in bankruptcy. We have a 
     right to have insurance and live with peace of mind.

  Laura Kreynus, Mechanicsville:

       My daughter was diagnosed with Crohn's Disease in April of 
     2013. That September, my husband was diagnosed with 
     Parkinson's Disease. We are farmers, we raise food for 
     America. As such, we are independently insured. Prior to 
     finding a plan through the ACA in January of 2015, our 
     monthly insurance premiums were increased to nearly $3,000 a 
     month--yes, a month. On top of that, our health care 
     insurance had an annual cap on prescription coverage of 
     $5,000. The Humira that my daughter takes to combat Crohn's 
     retails for $3,800 a month, and that is not the only 
     medication she needs. So basically, after one month, we reach 
     the prescription coverage cap, meaning we would have to pay 
     $3,800 a month for her medication on top of $3,000 a month in 
     premiums. Who has an extra $6,800 a month to pay for this? 
     This is way more than we earn every month. With the health 
     insurance plan we got through the ACA, our premiums for 2015 
     were $1,500 a month, less than half of what we would have 
     been paying. But the real saving grace was no prescription 
     cap, so my daughter's medications are covered with a copay 
     after we reach the deductible. This is still a lot of money, 
     but at least we can treat our daughter's disease and 
     hopefully keep her healthy. And even though our premiums have 
     gone up $2,000 a month under the ACA, at least we still have 
     insurance. Under the Republican Senate's repeal of the 
     preexisting condition provision, we will not be able to get, 
     much less afford, any insurance in the future. This will have 
     devastating consequences to my daughter's health. She is only 
     15 years old. She deserves a chance in life. I have not even 
     touched on how no our insurance will affect my husband's 
     Parkinson's Disease. We are upper middle class income 
     Americans. I am not asking for a handout. We are paying more 
     that 25 percent of our income for health care related 
     expenses. And I can't imagine the affect this has on people 
     with less resources than we have. Do you know what happens if 
     you get sick or a disease and you don't have or can't have 
     health insurance or medical treatment? You die. Seriously, 
     health care costs are out of control in America and health 
     care is a basic right, and people are dying.

  Cynthia Elliott, Hillsboro:

       Gov. Kaine, Without the ACA, I and many other younger 
     seniors whose jobs do not provide health care would simply be 
     without until Medicare kicks in. I was paying $1,000 a month 
     for HMO care. Until I couldn't. But with the ACA, I was able 
     to get coverage for a reasonable $300 a month. And this one 
     includes dental care! It is simply a lifesaver for me.

  Mary Lloyd Parks, Richmond:

       We have excellent insurance coverage (though expensive) 
     through my husband's partnership in a large law firm, and 
     we've been grateful. We have two daughters, now 21 and 23. 
     Our oldest has cystic fibrosis. The Affordable Care Act has 
     allowed her to stay on her health insurance policy through 
     college, and now in her first year as an Urban Teachers 
     fellow in Washington, DC where she is teaching first grade 
     and studying at night to get her master's degree in 
     elementary and special education. While her health is 
     currently good, the medicines she requires to maintain her 
     health are extremely expensive and without our insurance, she 
     would not be able to afford them. The prescriptions cost 
     thousands of dollars every month. We are quite fearful that 
     when she turns 26, her preexisting condition--a very 
     expensive and lifelong disease that requires routine 
     hospitalizations and even lung transplants--would make her 
     virtually uninsurable. We are counting on the ACA to be in 
     place when she can no longer be insured as a member of our 
     family. She has chosen a profession that may not allow her to 
     afford the care she needs, and she was born with a chronic 
     serious illness that would be a pre-existing condition that a 
     future insurer could use to deny her coverage or to charge 
     her prohibitively high premiums.

  Just four more.
  Carry Hawes from Midlothian:

       Sometimes people forget how much is encompassed in the ACA. 
     If not for the ACA, my husband would be dead. Diagnosed with 
     a fatal liver disease in 2007, he needed a liver transplant 
     and he ended up getting two. On July 19, 2012, he received a 
     new liver at UNC hospital. He regained his life and we were 
     able to move home to Richmond to take new jobs and begin a 
     family, knowing that his preexisting condition would be 
     covered under the ACA. We were able to live without fear that 
     an employer would deny us coverage because he was high risk.

  Sammye Newman, Richmond:

       Before the ACA became law, I was paying more than $1,200 a 
     month for health insurance. Quitting altogether was one 
     alternative, but it would have meant paying possibly double 
     for health care, procedures and lab tests because I would no 
     longer be eligible for the negotiated prices contracted by 
     the health insurance company. Still, I was almost out of 
     money. Then the ACA was passed. My rates fell to between 
     $50 and $60 per month for better policies than I had 
     before making the switch. At 62 years of age, I am faced 
     with health care needs that continue to increase. As a 
     cancer survivor (21 years and counting!), it is imperative 
     that I be proactive regarding health care. In fact, having 
     a good doctor under an affordable employer-sponsored 
     health care plan is what saved my life 21 years ago. 
     Please, don't allow this lifeline to be abolished!

  Heidi S., of Richmond, asked me not to use her last name:

       Thanks to the passage of the ACA, I was able to stay on my 
     parents' health insurance plan until I turned 26 years old. 
     This policy change allowed me to go back to school at 24 
     years old to pursue a Masters degree, during which time I was 
     diagnosed with a malignant melanoma. The mole was not of 
     concern to me at all and was found during a routine check-up. 
     If I did not have access to my parents' health insurance 
     during that time, I surely would not have had access to the 
     pathologists and surgeons who diagnosed and removed the 
     cancer before it had the chance to spread. While no one knows 
     what would have happened if this tumor not been removed, I 
     truly feel that I owe my life to the ACA.

  Finally, Christopher Woodroof from Bedford, VA:

       Dear Senator Kaine, In September of 2011 I began receiving 
     Social Security Disability Benefits, not from an injury, but 
     from an illness I was diagnosed with 12 years ago, a rare 
     blood disorder caused by a mutated gene in my bone marrow. I 
     worked as many years as I could, but eventually I became 
     unable to. The company I worked for insurance plan had a 
     $10,000 deductible, so for me having to go to the hospital 
     twice a month for most of the twelve years, it has taken all 
     of my savings and retirement I had accumulated to cover my 
     medical bills. Seven years ago we had to cancel my wife's 
     health insurance due to the high cost. Due to the high cost 
     of medical care, my wife would not see her doctor at times 
     she really needed to. The amount of disability I receive 
     barely covers our basic needs, so she felt we could not 
     afford a doctor bill. Under the Affordable Care Act, she 
     qualifies for a decent policy that cost us $30 a month. This 
     has enabled her to start seeing her doctors again and made 
     her prescriptions for asthma affordable and obtainable again. 
     This coverage is a lifesaver for us and I'm not sure how [we] 
     could handle losing it. Please convince your colleagues in 
     the Senate to show some compassion for those who worked hard 
     all their life, only to lose everything because they became 
     ill. Thank you for your service and all you have done for 
     Virginia and the American people. God bless you. With kindest 
     personal regard, Chris Woodroof.

  This is not a game. This is not politics. This is not a debate. These 
are the lives of dozens of Virginians sampled out of 1,600 stories that 
have been sent to me in the last 3 weeks, all saying to this body one 
thing: Do not repeal the Affordable Care Act. Do not jeopardize the 
health care of 30 million people. Do not jeopardize the peace of minds 
of parents going to bed at night and making them wonder what will 
happen if their child gets sick tomorrow or if they lose their job.

[[Page S1003]]

  We can improve, and many of these letters point out things we need to 
do to improve the Affordable Care Act. But we shouldn't even be 
contemplating a repeal of a law that provides so much good to so many. 
This is one of the main reasons, when we vote later today, I am going 
to be opposing someone who wants to repeal the Affordable Care Act--
Congressman Tom Price, as he has been nominated for HHS Secretary.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I rise this afternoon to speak about the 
nomination of Tom Price to be the next Secretary of Health and Human 
Services.
  I wish to start this afternoon with a couple of names--just five, and 
I will use just first names--five Pennsylvanians whom I will refer to 
in my remarks. I am certain I will get to the first two, and I hope to 
get to all five. First is Anthony; second is Rowan; third is Rebecca; 
and fourth and fifth are Hannah and Madeline, two sisters whose story 
inspired me and continues to inspire me today. I will start with 
Anthony because I think his circumstance and that of his family are 
good reminders of how important the Medicaid program is to families 
across the country.
  Anthony's mom wrote us a letter. I will read pertinent parts of it to 
summarize his circumstance. His mom writes in the opening part of the 
letter:

       My son, Anthony, was born at 25 weeks and he weighed one 
     tiny pound. We were overcome with medical bills which 
     Medicaid thankfully paid for us. Since his birth he has had 
     multiple health crisis, seizures, sleep disorders just to 
     name a few.
       Most recently, Anthony was diagnosed with Autism spectrum 
     disorder, Tourette's syndrome, severe obsessive compulsive 
     disorder, and Dyspraxia.

  All of those in the life of one young boy--
  She says:

       Last spring, we were faced with the decision of putting him 
     in a residential treatment program. If not for his Medical 
     Assistance--

  The name of the program for Medicaid in Pennsylvania--

     this would have never been an option for us.

  In other words, they wouldn't be able to get him into a residential 
treatment program. Ultimately, Anthony's family chose to get him 
intensive outpatient treatment, which Medical Assistance also covered. 
Anthony's mom Corey ultimately decided to stay home and care for 
Anthony, so she had to leave the job at which she had worked for 20 
years. She said:

       If we lost coverage, we would not be able to provide the 
     support he needs. We are sure of that.

  Toward the end of the letter, she says:

       My son Anthony is currently attending school almost 
     regularly and functioning the best he has for a very long 
     time thanks to the services he received from his medical 
     assistance. It gives me hope and encouragement that he will 
     someday grow up to be a contributing member of our next 
     generation.

  That is Anthony's story of all of the benefits he and his family have 
derived from Medicaid or, as we call it in Pennsylvania, the Medical 
Assistance program.
  The second Pennsylvanian I will talk about is Rowan. I spoke about 
Rowan on the floor just a number of days ago. I am quoting from Rowan's 
mom's letter. Pamela wrote:

       Rowan was diagnosed with Autism Spectrum Disorder in March 
     of 2015.
       He was extremely hyperactive and since he refused to nap, 
     he was a severe distraction. I cannot stress enough that we 
     had zero other options for our family. For months, I would 
     receive calls about Rowan being aggressive to other children. 
     This broke my heart. No parent wants to hear that their child 
     is hurting other children.
       Late January 2016, I applied for Medicaid [Medical 
     Assistance]. After Rowan was awarded MA, we were able to 
     obtain wrap-around services.

  Then she talks about a behavioral specialist consultant, a 
therapeutic staff support worker, and all the help that came with those 
individuals.

       Specifically she helped to alleviate his aggression and 
     combat his over-stimulation. The wrap-around services have 
     been a Godsend.

  Ultimately, Rowan benefited from a social skills program.

       This program is a social skills program specifically for 
     Autistic children ages 3-21. I enrolled Rowan in November. 
     Rowan has benefited immensely from [this program]. Thankfully 
     it is covered in full by MA.

  Then she concludes, in part:

       Our family would be bankrupt or my son would go without 
     therapies he sincerely needs.
       Overall, we are desperately in need of Rowan's Medical 
     Assistance and would be devastated if we lost these benefits.

  So we have two young boys in Pennsylvania. Their stories are told by 
their moms, and they are telling us: Don't cut Medicaid. Don't destroy 
Medicaid, as some proposals have been not just debated here in 
Washington, not just theorized about; these are policies that Members 
of Congress have voted in favor of.
  But now it is a little different. Now it is not just voting in favor 
of so-called block-granting--a very benign term, ``block-granting.'' I 
would rather use the word ``destroy,'' but we can debate that. This is 
a live issue now because we have people who are still proposing block-
granting, and we have a President who--at least one member of his 
administration said he would sign such legislation or at least support 
it. That gets to the point of my basic disagreement with what 
Representative Price has not only supported but led the fight on in the 
House of Representatives.
  I disagree totally with his budget proposals to block-grant Medicaid 
for the reasons that I just outlined--because of Rowan and Anthony and 
lots of children in Pennsylvania like them, children with disabilities, 
children who happen to come from low-income families, seniors who want 
to get into nursing homes. All of those concerns are uppermost when I 
consider his nomination.
  What I was hoping he would say to me in our meeting in my office--a 
very cordial meeting where we debated a little bit--and then after my 
questions to him both in the Health, Education, Labor, and Pensions 
Committee, and the Finance Committee, the committee from which his 
nomination originated--I was hoping he would say: I was for block-
granting Medicaid and changing Medicare and making all those proposals 
as a House Member, as a leader in the debate about the budget. But I am 
going to be in different place now, and I am not going to push those 
ideas. I am going to have a different position, and we are not going to 
go in the direction of doing that any longer, so I want to separate 
from what I was proposing as a Member of the House. I have no 
assurances that his advocacy or position on these issues will be any 
different.
  Now we have the administration embracing the very issues that in the 
campaign the candidate said he was against. The Presidential candidate 
said that he wouldn't touch Medicare; he wouldn't touch Medicaid. You 
know the statements I am referring to.
  When we talk about Medicaid and why it is such an important issue in 
this confirmation process, what are we talking about? In addition to 
Rowan and Anthony and children like that, we are also talking about the 
fact that 45 percent of all the births in the United States of America 
are paid for by Medicaid. A lot of people don't know that, but that is 
the truth. One in five seniors receives Medicare assistance through 
Medicaid. That is one of the reasons so many seniors are concerned 
about not just what happens to Medicare, but what happens to Medicaid.
  Another reason for seniors to be concerned: Two-thirds of nursing 
home residents are covered by Medicaid. So when we talk about block-
granting, which leads to massive cuts to Medicaid, we had better be 
concerned about it because it means nursing home residents are 
adversely affected.
  Medicaid covers 40 percent of all the children in the country with 
health care--40 percent. For poor children, 75 percent get their health 
care through Medicaid, and 60 percent of all children with disabilities 
are covered by Medicaid--60 percent.
  How about if you live in a rural area? Let me give a sense of what 
the circumstance is for Pennsylvania. We have 67 counties, 48 of them 
are rural, and a lot of people in those communities are covered by 
Medicaid. By one recent estimate, more than 278,000 rural 
Pennsylvanians are covered by Medicaid. We know that hospitals in rural 
areas depend upon Medicaid. In 15 rural Pennsylvania counties, 
hospitals were the top employer. Guess what program supports those 
programs, keeps the doors open: Medicaid.

[[Page S1004]]

  On and on, we could talk about job loss that results from cutting 
Medicaid. So if we are serious about helping children with disabilities 
and protecting seniors, we should think long and hard before voting for 
the block-granting of Medicaid.
  One final point just with regard to Pennsylvania Medicaid.
  If Medicaid were to be block-granted, as many legislators have 
supported and voted for, if that happens and if the Affordable Care Act 
were repealed without a replacement, Pennsylvania alone--one State--
would lose $80 billion over 10 years. This is a 38-percent reduction in 
funding for Pennsylvania. I am going to fight anyone who tries to take 
$80 billion away from Pennsylvania for health care.
  I would hope that if Representative Price were confirmed, he would 
abandon those reckless, extreme ideas to block-grant Medicaid because 
of the consequences for seniors, for children, and for individuals with 
disabilities.
  I don't have a chance to get too far into Medicare today. If I can, I 
will a little later. I will try to come back to some of the stories 
people have written to us about the impact of the Affordable Care Act 
on their lives.
  Let me quickly go through some points about Medicare. We know that in 
a State like ours, one of the oldest States in the country, about 2\1/
2\ million Pennsylvanians rely on Medicare to help them pay for health 
care costs. Thank goodness we have Medicare in place. What we would not 
want to have happen in Pennsylvania is the enactment--and as I said 
before with regard to Medicaid, now this is a live issue. You have 
Senators and House Members in both Chambers who have already voted for 
budgets that would do the following: change Medicare into a premium 
support program or a voucher program, which means basically you give 
seniors a fixed amount of money to buy their insurance and then say: 
Good luck buying your own insurance, buying your Medicare insurance.
  I don't think there are very many people in my home State who think 
that is a good idea.
  Of course, none of this has been on the table because these budget 
votes go by and people vote for the budget, and then it doesn't go any 
further, so no one feels the urgency to oppose it. Now we have, 
apparently, people in both Houses in agreement with President Trump to 
have him sign legislation which would change both Medicare and 
Medicaid.
  I think these are among the many reasons why I would vote against 
Representative Price in his confirmation vote. After a lot of review of 
his record, after a lot of review on what his proposals would mean if 
they were to become law--and now we are at a point in our history where 
these issues are no longer theoretical; they are live issues. These are 
matters that could be the subject not just of debate but the subject of 
enactment into law.
  I will try to return later to go through some other issues with 
regard to the nomination.
  At this time, I will yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CASEY. 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. CASEY. Mr. President, before I recommence my remarks, I see the 
senior Senator from Oklahoma, Mr. Inhofe. I want to make sure that if 
he is prepared to take the floor, I will yield.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. Mr. President, I thank the Senator from Pennsylvania, and 
the answer is, yes, I am prepared.