[Congressional Record Volume 163, Number 23 (Thursday, February 9, 2017)]
[Senate]
[Pages S1017-S1029]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                     EXECUTIVE CALENDAR--Continued

  Mr. McCONNELL. Mr. President, for the information of all of our 
colleagues, including our newest colleague from Alabama, who is going 
to have a very long first day here, if all time is used postcloture on 
the Price nomination, the Senate will have two votes at 2 a.m. Senators 
should be prepared to stay in session and take those votes tonight. If 
an agreement is reached to yield back time and to cast those votes 
earlier, we will notify Members the moment such an agreement might be 
reached.
  I thank my friend from Maryland.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. CARDIN. Mr. President, the point I was starting with is that in 
Maryland, yes, there are 400,000 people who now have coverage who 
didn't have coverage before, and they are benefiting by being able to 
get preventive health care and get affordable care, but it is all 
Marylanders who are benefiting because there is less use of emergency 
rooms and fewer people who use our health care system who don't pay for 
it, the uncompensated care.
  Many of my colleagues have read letters that they have received from 
constituents, or phone calls, and I am going to do that during the 
course of my discussion. I am going to tell you a story that I heard 
from a 52-year-old who lives in Harford County who frequently used the 
emergency department prior to the adoption of the Affordable Care Act. 
This is what this Harford County resident told me: After the passage of 
the Affordable Care Act, I began working with Healthy Harford Watch 
Program and shortly after was insured. I have been successfully linked 
to community health services and no longer depend upon the emergency 
room as my only source of health care.
  I can give many more accounts of people who had to use the emergency 
rooms and are now getting preventive health care and are getting their 
health care needs met.
  We also now have been able to eliminate the abusive practices of 
insurance companies. As I said, over 2 million people have private 
health insurance in Maryland. They are all benefiting from the 
Affordable Care Act.
  If Mr. Price has his way and we repeal the Affordable Care Act, every 
Marylander will be at risk. They will be at risk because of the 
protections that we put in the Affordable Care Act against abusive 
practices of insurance companies.
  To me, probably the most difficult thing to understand by my 
constituents was the cruel preexisting condition restrictions that were 
placed in the law prior to the Affordable Care Act. Simply put, if you 
had a preexisting condition, the insurance company would restrict 
coverage for that preexisting condition. So exactly what you needed the 
health care system to pay for, your insurance company didn't

[[Page S1018]]

pay for it. They said: Look, you had this heart condition before you 
were insured; we are not going to pay for your heart needs. You had 
cancer; we are not going to pay for your cancer treatment in the 
future. You have diabetes, and that leads to a lot of different health 
care needs. We are going to restrict your insurance coverage and not 
pay for diabetes care. That is a thing of the past with the Affordable 
Care Act.
  Once again, we are now talking about repealing the Affordable Care 
Act. We don't know what it will be replaced with, if at all. Mr. Price, 
in the House, has not given us a satisfactory explanation during the 
confirmation process of how we are going to be able to guarantee that 
everyone who has insurance and everyone who has a need for coverage 
with preexisting conditions will be able to get insurance that won't 
discriminate against that person because of preexisting conditions.
  Another aspect that was an abusive practice before the Affordable 
Care Act is that our insurance policies had caps on how many claims you 
could make in a year over the lifetime of your policy, and that would 
kick in exactly when people who have chronic needs need insurance the 
most.
  Let me give an example. Juanita, who lives in Hyattsville, MD, told 
me about her son. She said her son seemingly was in perfect health, had 
graduated from Harvard with a master's degree and was working at a 
nonprofit. Then he was diagnosed with a rare cardiovascular disorder. 
He didn't know he was going to have that. Well, that required him to 
have multiple operations, and it would have fully exceeded his lifetime 
cap in hospital stays, and he would not have been able to afford the 
care. Thanks to the Affordable Care Act, Juanita's son has full 
coverage. That is another example of a person who is at risk if Mr. 
Price is able to carry out what he said--repeal the Affordable Care 
Act--and we don't have a way to guarantee that insurance companies must 
take all comers and must eliminate the caps that we have seen in the 
policies before.
  Another area which I think has been a pretty popular part of the 
Affordable Care Act and which I heard many of my colleagues on both 
sides of the aisle say they want to keep is allowing 26-year-olds to 
stay on their parents' policies--under 26 years of age. That is a very 
popular provision. I heard many of my colleagues speak in favor of it. 
Remember, when you repeal the Affordable Care Act, that will be 
repealed. Unless we have adequate replacements, unless we have an 
improvement, that is at risk as well.
  I want to talk about another provision that was in the Affordable 
Care Act. I authored the provision. It is called a prudent layperson 
standard for emergency care. Let me take you back before the Affordable 
Care Act. This is why it is important for Congress to be careful as to 
how we pass laws. And if we repeal laws, we can go back to these types 
of practices. Before the Affordable Care Act, if you had chest pains 
and shortness of breath, you would do what I would think any reasonable 
person would do: You would be taken to the emergency room as soon as 
possible to see whether you are having a heart attack. Those are 
classic signs of a heart attack. Yet there were insurance policies that 
said that if you went to a hospital that was out of network, they 
weren't going to pay the full amount even though you went to the 
closest hospital because you had an emergency situation. That makes no 
sense at all, but that was the case.
  You went to the hospital. You did the right thing, and you found out 
you didn't have a heart attack. You went home. You were happy until you 
got the bill, and your insurance company said you didn't need to go to 
the emergency room because you didn't have a heart attack. Then you do 
have a heart attack because you can't pay the bill.

  That was the circumstance that existed before the Affordable Care 
Act, and we put into the Affordable Care Act, for all insurance 
companies, the prudent layperson standard. If it was prudent for you to 
go to the nearest emergency room, your insurance plan must cover that 
cost. That is the standard today, and I wonder whether, if we repeal 
the Affordable Care Act, we will be going back to those types of 
abusive practices.
  Before the Affordable Care Act, women in some circumstances were in 
and of themselves a preexisting condition. Are we going to go back to 
those days?
  Let me go on to another point that worries me about Mr. Price's 
position if we were to repeal the Affordable Care Act, and that is 
affordability. It is one thing to say people can buy insurance--you 
know, there is insurance out there; just buy it. It's another thing 
whether you can afford the insurance coverage.
  One of the benefits of the Affordable Care Act that I don't think has 
been fully explained to the American people is that since the passage 
of the Affordable Care Act, we have been able to keep the growth rate 
of health care costs below what we had seen before the passage of the 
Affordable Care Act. We have reduced costs for all individuals and 
companies that have health policies. The rate of growth has been at a 
slower rate because of the Affordable Care Act. And I have already 
alluded to one of the reasons--we reduced uncompensated care because 
more people are paying their bills. We kept the growth rate down.
  But there are other aspects to the Affordable Care Act that have 
helped bring down the costs, and that is, we have premium tax credits. 
In 2015, 70 percent of those who were enrolled in the Maryland Health 
Connection--that is our exchange in the State of Maryland--received 
some form of a credit. That was provided in the Affordable Care Act. We 
recognize that not everyone can afford the premiums, so we provided 
credits. If you repeal the Affordable Care Act, we may very well not 
have affordable policies for those individuals who have been able to 
get credits under the Affordable Care Act.
  I want to talk about a situation that was brought to my attention at 
several of the roundtable discussions I have held in Maryland with 
interest groups on health care, and that has to do with small 
businesses.
  Before the Affordable Care Act was passed, if I had a forum on small 
businesses--and I did. I have been a member of small businesses and 
entrepreneurship committees since I first came to the Senate. I believe 
in the importance of small businesses. That is where job growth and 
innovation takes place. It is critically important that we help small 
businesses.
  Before the passage of the Affordable Care Act, the No. 1 issue that 
would come up at roundtable discussions I had with small business 
leaders of Maryland was the affordability of health coverage for their 
employees. It is no longer an issue that they talk about because the 
Affordable Care Act has allowed small companies to have competitive 
premium costs with larger companies.
  Before the passage of the Affordable Care Act, if you were a small 
business owner and you had maybe 10 people in your employ on your 
health policy and one of those individuals unfortunately had a major 
health episode during that year, you knew that the next year you were 
going to get a major premium increase because you were rated on your 
own experiences as a small group. That is a thing of the past under the 
Affordable Care Act. Now, under the Affordable Care Act, you are in 
this big pool, and you are not discriminated against because you happen 
to have someone in your employ who needs health care.
  It also enables small business owners to hire people who have 
particular health needs. They are not going to be discriminated against 
because they hire somebody who happens to have the need for health 
insurance. Before that, small companies were very reluctant to hire 
individuals who had health needs because they knew it would affect 
their health policy.
  I want to mention one other factor that is pretty telling. Let me 
read from a letter I received from Nancy of Silver Spring. This is 
something that really gets to me, something I think we have to be very 
careful about, because the repeal of the Affordable Care Act is going 
to hurt our economy.
  Nancy of Silver Spring is a 60-year-old freelance writer/editor and 
depends upon the Maryland Health Connection exchange for her health 
insurance and the tax credit that helps reduce her premium. She is a 
healthy 60-year-old, but no insurance company will write her an 
individual policy, she knows--she tried. One of the big factors that 
helped Nancy get the courage to leave

[[Page S1019]]

her salaried, full-benefits job and go out on her own was the fact that 
the ACA was right on the horizon when she made the leap in 2012.

  Nancy writes:

       You want a world-class work force? How about giving 
     everyone access to affordable health care so we can keep 
     ourselves functioning? You want job creation? How about 
     keeping the ACA so freelancers, gig workers, and startup 
     entrepreneurs don't have to split their energy between the 
     jobs they are creating and some soul-sucking ``day job'' just 
     for the sake of keeping our health insurance?

  This is a real problem. You repeal the Affordable Care Act, people 
become what is known as job-locked. They don't like where they work, 
they know they can do better, but they can't afford to leave and lose 
their health coverage. It may be their spouse, it may be their child, 
may be their self, but they are job-locked because they don't have the 
protection of knowing they can get affordable coverage if they give up 
the insurance they currently have. That hurts our economy. That hurts 
the entrepreneur spirit. That hurts innovation. And it is something 
that is critically important that we solved in the Affordable Care Act.
  Mr. Price talks about the repeal and we will have something to 
replace it with. That is not an easy one to fix. That is not one that 
you can just say we will take care of because you have to have pools 
for individuals in small companies that are competitive. If we don't 
have the type of comprehensive coverage we have under the Affordable 
Care Act, it is very difficult to understand how that can, in fact, be 
done. So that gives me great heartburn with someone who espouses the 
repeal of the Affordable Care Act.
  We have many stories, many letters here from people who literally 
would have had to go through bankruptcy.
  In Laurel, MD, Mark tells me about his son Timmy, who developed a 
rare genetics syndrome called Opitz G/BBB. Timmy's medical expenses 
would have reached his family's lifetime maximum of $1 million when he 
turned 3 months old. When Timmy finally made it home, the ACA covered 
and continues to cover his cost of medical equipment. The law covers 
all of Timmy's specialist appointments, surgeries, and hospital stays.
  Recently, Timmy was sick and coughing up blood. Mark and his wife 
took him to the emergency room without fear that he would incur debt he 
would never be able to pay. Without the Affordable Care Act, Mark's 
family would likely be in bankruptcy.
  Go back before the Affordable Care Act. Look under bankruptcies. Look 
up what the major reason was for bankruptcy. It was people's inability 
to pay their medical bills in the United States of America. That is 
something we don't want to go back to.
  I started my comments by talking about pediatric dental. The 
Affordable Care Act provides essential health benefits so that every 
person who is insured, every person who is in our system, is guaranteed 
certain benefits. That affects nearly 3 million Marylanders who are 
protected by the essential health benefits in the current law. They 
include such things as maternal benefits and newborn health care, 
mental health and addiction.
  Mr. President, you have been the leader of this body on dealing with 
mental health services and addiction services, and I applaud you for 
your efforts, but quite frankly, if we lose the essential health 
benefits, private insurance companies aren't going to cover these 
costs.
  We have an epidemic nationwide on drug addiction. We have seen opioid 
misuse lead to heroin, lead to fentanyl. The death rate in Maryland is 
up about 20 percent every year. We have doubled and quadrupled the 
number of ODs the last 5 or 6 years, and the numbers are still going 
up. We need coverage so that we can, first and foremost, stop people 
from using it in the beginning--an education program, a prevention 
program; we have to do more of that. We also have to keep people alive 
and get them into treatment and save their lives, and the Affordable 
Care Act helps us get that done.
  You repeal these essential health benefits, I really worry as to 
whether--mental health and drug addiction have never been a priority 
for private insurance companies or, for that matter, the Medicaid 
system. So we have to make sure that we maintain that type of coverage, 
and the repeal of the Affordable Care Act puts all of that at risk.
  One of the areas I worked on very carefully when I was in the House, 
and now in the Senate, was preventive health care services. 
Immunization, cancer screenings, contraception--those types of services 
are critically important. We had a meeting at lunch today. I found out 
that unwanted pregnancies are at a historically low level. Are we going 
to go back to the day where women cannot afford contraceptive services? 
That makes no sense at all. It is counterproductive to what we all 
agree we need to do.
  I want to talk about one or two other issues which I think are 
important which are also in jeopardy with the repeal the Affordable 
Care Act or policies that have been espoused by Mr. Price. One is the 
Medicaid expansion.
  The Medicaid expansion covers our most vulnerable. These are people 
who don't really have a strong voice in our political system. They are 
people who really depend upon us, every one of us in the Senate, to 
protect their health care needs. These are people who are desperate, 
who can't afford health care other than through our medical assistance 
program, the Medicaid Program. Yet there has been talk about block-
granting that program to the States. Have you looked at State budgets 
recently? Do you really believe our States have the financial capacity 
to deal with the Medicaid population without a partnership with the 
Federal government?
  Maryland has been a pretty strong State with Medicaid expansion. My 
Governor is doing the right thing. I am proud of what Maryland has 
done, but if you withdraw the Federal partnership, the Governor doesn't 
have that type of flexibility in the budget to make up the difference. 
It is going to hurt. It is going to hurt our health care system, hurt 
our most vulnerable.
  It has been estimated that a block grant--that by 2019, Maryland will 
lose close to $2 billion. We can't make that up. Would we still cover 
substance abuse under Medicaid? We didn't before. If we don't cover 
that, are we going to now be denying those centers that are located for 
substance abuse? All this is put at great risk.
  We know that Mr. Price, in his fiscal year 2017 budget proposal, 
looked at this proposal, and I believe it was at $1 trillion at that 
time.
  There is a provision in the Affordable Care Act that I authored that 
sets up Offices of Minority Health and Health Disparities within all 
our health departments and sets up the National Institute for Minority 
Health and Health Disparities. We elevated it in the Affordable Care 
Act. I would certainly hope that we would not be repealing that, 
although it is in the Affordable Care Act. But I can tell you that the 
mission of Minority Health and Health Disparities will be severely 
restricted if we repeal the Affordable Care Act or we block-grant the 
Medicaid Program because it is the minority population who had been 
discriminated against historically in our health care system who are 
most at risk.
  I can give you one example of that: our qualified health centers. We 
significantly increase the resources in the qualified health centers as 
part of the Affordable Care Act. I have been to our qualified health 
centers in Maryland, and I have seen that they now have dental services 
that they didn't have before the Affordable Care Act. They now have 
mental health facilities. It is one thing to have third-party coverage 
but another thing to have access to a facility. We know that in rural 
areas, it is very challenging. In poor neighborhoods, it is also 
challenging. Qualified health centers help fill that void.
  I was talking to our qualified health centers in Maryland. I said: 
What happens now if we repeal the Affordable Care Act? They literally 
told me that they can't stay in business because they would lose so 
much of their reimbursement because it is now being reimbursed under 
the Medicaid system because these people enrolled; that it would 
jeopardize their ability to provide the types of services they are 
providing today. So you are not only denying people third-party 
reimbursement, you are denying them access to care by the repeal of the 
Affordable Care Act.
  Lastly, let me talk about our Medicare population. Medicare was part 
of the Affordable Care Act. We don't hear too much talk about that 
today. We extended the solvency of Medicare as a

[[Page S1020]]

result of the Affordable Care Act. We brought down the cost of Part B 
premiums as a result of the Affordable Care Act. And we are closing the 
doughnut hole coverage gap for prescription medicines within the 
Medicare system. Before the Affordable Care Act, how many times would 
we go to a senior center and someone would tell us they didn't pick up 
their prescriptions from the counter because they didn't have the money 
to pay for the cost because they were in the doughnut hole? Well, that 
is coming to an end. It has already closed enough so people are not in 
that vulnerable situation. But it is now coming to an end as a result 
of the passage of the Affordable Care Act.

  So I take this time today because of Mr. Price's nomination. I care 
deeply about the principle Senator Van Hollen talked about and others 
have talked about; that is, health care in America should be a right 
not a privilege. The Affordable Care Act has helped us in achieving 
that.
  Somehow I believe that if we ask the American people, some would say: 
Well, we don't like this ObamaCare, but we like this Affordable Care 
Act. Let us be honest with the American people. Let us recognize that 
this bill has changed the landscape of health care in America for the 
better: reduced costs, extended coverage, more quality coverage, 
insurance companies now have to spend at least 80 percent of their 
premiums on benefits.
  So much of that has been done as a result of the Affordable Care Act. 
Can we do it better? Absolutely. Let's work together, Democrats and 
Republicans, to improve the health care system in this country without 
scaring Americans that they are going to lose the benefits they already 
have.
  For those reasons, I believe Mr. Price does not represent what we 
need, and I will, unfortunately, be voting against his confirmation.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Georgia.
  Mr. PERDUE. Mr. President, I rise tonight actually to support the 
confirmation of my friend and fellow Georgian and our next Health and 
Human Services Secretary, Dr. Tom Price. I have known Dr. Price 
personally and worked with him for quite some time. He is a remarkable 
individual, and we should take comfort in his nomination to this 
important position because he has years of service and years of 
experience working with our Nation's health care system.
  He has been a practicing physician, a state legislator, and a Member 
of the House of Representatives. Dr. Price knows that government 
intrusion has already negatively impacted patient care in the last few 
years. He has years of professional experience as a physician and he is 
seen as a leading voice in health care policy. My colleagues across the 
aisle oppose him, they say primarily because of his opposition to the 
Affordable Care Act. Well, the truth is, ObamaCare is collapsing under 
its own weight today. In my State of Georgia, this year alone, after 
double-digit increases last year, premiums are up 33 percent this year. 
Nationwide, premiums are up 26 percent. So the other side talks about 
it being affordable. People back home--I am getting letters every week 
about the fact that people are withdrawing from ObamaCare because of 
the increase in premiums, and most insidious are the increases in 
deductibles. Some two-thirds increase--67 percent--increase in 
deductibles.
  You know, we don't have to worry about repealing ObamaCare because it 
is collapsing under its own weight. We just have to sit back and watch 
it die of its own volition. Here is how it is going to happen. It is 
very simple. In my State, out of 159 counties, we have 99 counties that 
only have one health care provider because of the Affordable Care Act. 
Even in that carrier, there are limited insurance programs available to 
their customers.
  What happens if that carrier decides they cannot profitably afford to 
be in Georgia? Then 99 counties will lose any health care carrier. 
Where do they go? They will be fined under the Affordable Care Act for 
not having insurance. Where do they go? Well, the Federal Government 
has an answer, obviously. The U.S. Government can always step in and be 
the insurer of last resort. Is that not the single-payer strategy that 
was behind this all along? It is not what American mainstream voters 
want.
  The fearmongering that is going on right now about any potential 
repeal is just hypocrisy. I believe there is no question that there is 
a plan. We know there is, but to fix ObamaCare is very difficult 
relatively to the way it was built to begin with. It was based on the 
wrong premise; that is, that the Federal Government is going to step in 
and take care of everybody's health care.
  If you like the Veterans' Administration, you are going to love 
health care done by the Federal Government in the Affordable Care Act. 
By the way, if you like the way the post office is run, you are going 
to love the way the Federal Government runs our health care.
  With all of that in mind, the No. 1 objective of Dr. Price that I 
have heard today and throughout this week has been nothing more than 
the vitriolic argument that he opposes ObamaCare. That is sad. I think 
we are taking a great American who is willing to volunteer and become a 
member of this President's Cabinet and try to make health care better 
for every American.
  I can't think of another person in this country who is more qualified 
for this timely responsibility. Dr. Price will work to end Washington's 
takeover of our health care system, and I know he will work tirelessly 
for a health care system that compassionately improves the lives of 
every American. Truly, there is no one more qualified to serve as our 
next Health and Human Services Secretary than my good friend, Dr. Tom 
Price.
  I am proud to support him. I am glad we are finally grinding our way 
to his confirmation later tonight, but while we talk about his 
confirmation, we also need to talk about this frog walk that the 
opposition is making us go through to get these nominees confirmed in 
this Cabinet. This is taking the longest time to confirm a Cabinet 
since George Washington.
  We see extreme delays, longer delays than we have seen at any time 
since the first President was in office. Imagine if Hillary Clinton was 
President right now. Imagine. Imagine if Republicans in the Senate were 
doing what the people across the aisle are doing today. Imagine if we 
were delaying her Cabinet nominees to the point where we are now 
confirming them at a pace slower than any time since George Washington 
was in office in 1789.
  Imagine. Imagine how the mainstream media would be screaming about 
that story and how it would be a very different story than what is 
being told today. This last week, the Senate demonstrated exactly the 
type of behavior that folks in my home State of Georgia, and I must say 
around the country, are absolutely fed up with and sick and tired 
after.
  They know this is exactly why Washington is gridlocked and why we are 
not getting results for the American people. We are wasting time. 
People are out of work. The other side says this is very real. Of 
course it is very real. It is time to move on. We have a new President. 
Put his team in place. The American people are being hurt by and paying 
attention to this failure of responsibility.
  Real results can only be achieved if Washington politicians 
prioritize the well-being of Americans, rather than their own 
individual political careers and their next election cycle. The 
minority party is well within their rights, of course, to dissent and 
oppose the President's nominees on solid ground. Republicans have done 
that in the past, but at no time in history have we seen this sort of 
frog-walk delay being perpetrated on the people of America.
  They are using the rules of the Senate inappropriately, in my mind, 
to slow down and bring to a halt the confirmation process of a 
President they don't support. No President since George Washington has 
had to endure this sort of historic delay, obstruction, and slow-
walking we have seen here since President Trump was inaugurated.
  If the minority party had its way, all Cabinet-level nominees would 
not be confirmed until June or July of this year. By the way, that is 
one-eighth of the first term of this President--12 percent is being 
wasted right now--if, in fact, the Republican leadership in this Senate 
were not doing what it is doing. The minority party knows it can't stop 
any of these nominees on their own

[[Page S1021]]

merits individually. So they are grinding the entire process to a halt 
using procedural delays. This is a clear abuse, in my mind, of the 
intent of the rules to protect the minority, authored by James Madison. 
To combat that, the Republican leadership has kept the doors of the 
Senate open 24/7. The people of America should know that we are here 
doing their business and doing their bidding to make sure we proceed as 
fast as we can to the confirmation of this President's nominees.
  We have to move past these delays perpetrated by the minority party 
intended to do nothing but to delay the potential impact of this new 
President. It is time to get results. The American people have spoken. 
President Trump has named his team. He is ready to get to work. He is 
already showing that he is willing to move at a business pace, not a 
government pace.
  The people in Washington, looking at this President through the lens 
of the political establishment, are having a hard time dealing with 
him, but I have to say, the quality of nominees is something we have 
not seen for decades, if ever. It is time to put these people in their 
responsible positions and let them go to work. He is already moving at 
a pace that we have not seen in many Presidencies.
  Like me, President Trump came here to focus on getting results and 
changing the direction of the country. He has a plan to do just that. 
We need to get on with that business, debate those issues, come to some 
conclusion, compromise where necessary, but get government moving, as 
the Senate has done for every previous President.
  We should confirm this President's nominees now and spend our time 
debating those critical issues that will get our country moving again, 
to change the direction of our country, to put people back to work. 
Things like growing our economy, updating our antiquated tax system, 
unleashing our full energy potential, updating our antiquated and 
unnecessary regulatory regime, fixing the broken budget process, 
changing our outdated immigration system, saving Social Security and 
Medicare, and, yes, addressing the spiraling health care costs that, 
no, the Affordable Care Act did not even attempt to address.
  The American people elected a new President. That President has named 
his slate of potential nominees to be Cabinet members. It is time to 
cut the foolishness and get down to business.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. Mr. President, my distinguished friend, Senator 
Perdue, is actually right. There is something unprecedented going on 
around here with these nominations, but it is not the Democratic effort 
to try to make sure that those nominees get a fair hearing and some 
light on them before they get into office.
  What is unprecedented around here with these nominees is, first of 
all, what a hash the Trump administration made of getting them ready. 
They were not ready to go. They were not prepared for the ethics 
reviews. They were dead in the water, and they have a lot of 
responsibility just in terms of the simple incompetence of getting a 
Cabinet ready to go.
  That is not the Senate's fault. The Senate should not roll over in 
its advice and consent role because an executive branch can't prepare 
nominees. Then you get behind the incompetence of the executive branch 
in preparing nominees and you start looking at the nominees.
  What else is unprecedented about them is the huge array of conflicts 
of interest they bring. We have never seen anything like this. We call 
it the ``swamp cabinet'' because it is, in fact, swampy with conflicts 
of interest. Many of these candidates have such massive financial 
complexities--because it is billionaire after billionaire after 
billionaire--that they have had to do all sorts of business contortions 
to try to get ready for their appointment.
  That also is not our fault. That actually makes our responsibility 
greater so we can do our constitutional job in the Senate, as providing 
advice and consent, to look at potential conflicts of interest. It is 
part of why we have advice and consent, so we can screen for that. When 
we are not getting disclosure, we can't even do that.
  There are still disclosure gaps for a lot of these nominees. The 
controversy and special interest connections of some of them are, 
frankly, appalling. So there are, indeed, nominees whom we would love 
to stop. If we could stop them, we would do it because we think they 
are going to do damage to the American people; damage to Medicare, 
which seniors rely on; damage to Medicaid, which so many sick kids rely 
on; damage to clean air, which I think everybody tends to rely on if 
they breathe; damage to clean water, which fishermen and sailors and 
people count on across the country. It is not a question here of doing 
the people's business, it is a question of trying to prevent these 
people from giving the people business because this looks like the 
special interest Cabinet of all time. If you go down one by one through 
the civilian Cabinet, you can more or less pick who the most influenced 
special interest is, the one who is most harmful to the American people 
in that particular area, and bingo, there is your nominee. So we should 
not slow down the advice and consent process just for the sake of 
slowing down the advice and consent process, but we should slow down 
the advice and consent process when we are not getting the basic 
information necessary to do our jobs, and we should slow down the 
advice and consent process when we are handing over agencies of 
government to big special interests. Those are two very good reasons to 
have the Senate's noble tradition of advice and consent followed 
scrupulously.

  As to the nominee for HHS, Dr. Price, he is right in that list. He 
has conflicts of interest. He has real harm that he proposes to the 
American public.
  I think Medicare is one of the great things the United States has 
done. It is one of our signal achievements. It has lifted seniors out 
of poverty in a way that very few other countries can match and that 
the United States had never seen before we did Medicare. It is probably 
the most efficient health care delivery system in the United States of 
America, and our seniors count on it and love it.
  That is not good enough for the good Dr. Price, though. He wants to 
voucherize Medicare. What do you do if you are a Medicare patient who 
is elderly and infirm? How do you go shopping for health insurance? I 
can remember when I was quite capable as a fit lawyer, and I was given 
the H.R. forms by the U.S. attorney's office to make my choice. It is a 
complicated mess. And you expect some woman who may be in a hospital 
bed to sort through that? Great job giving her a voucher. It is just so 
unfair and so wrong.
  Medicaid. Children across Rhode Island depend on Medicaid. If you are 
a family and you have a child with a significant illness, you are very 
likely to have that support for that child come through the Medicaid 
Program. This is a man who wants to block-grant Medicare and projects 
trillion-dollar cuts--trillion-dollar cuts? Who is going to make up the 
trillion dollars if we are not taking care of these kids? Is it going 
to go back to the families or the care just isn't going to be there for 
the Medicaid children? That is just wrong.
  These are ideological candidates who want ideological victories that 
will hurt real people like Henry, from Warwick. A woman named Lisa 
wrote to me. She is a teacher and lifelong resident of Warwick, RI. She 
has a son, Henry. Henry was just born last year, and before he was even 
1 month old, Henry was diagnosed with cystic fibrosis.
  Cystic fibrosis, as I am sure we all know, is a genetic disorder. It 
affects more than 30,000 people in the United States, and it is one of 
the crueler diseases on the face of the planet. As cystic fibrosis 
progresses, it can cause infections, it causes difficulty breathing, 
and eventually it renders the child unable to breathe and respiratory 
failure results. There have been important advances and treatment for 
this disease, but there is no cure.
  So Henry needs regular tests and treatment. He will need them for the 
rest of his life as doctors fight to extend his life as long as they 
can in hopes that a cure will arise. His parents are extremely grateful 
for the wonderful work of our doctors at Hasbro Children's Hospital who 
take care of Henry. But Lisa and her husband are also worried about 
their health insurance, and Henry's, because

[[Page S1022]]

Henry has a preexisting condition. If Secretary Price were to have his 
way, the Affordable Care Act would be repealed, and without it there 
would be no protection for people like Henry--a child like Henry with a 
preexisting condition. Either he would face outrageous health care 
premiums or be denied coverage altogether. Since then, having to face 
the scrutiny of confirmation, he has said: Oh, no, that part we are 
going to try to save. But when you go through the parts that my 
Republican friends are going to try to save, you end up with pretty 
much the whole bill. If you are going to try to save every part of the 
bill, why bother repealing it? Why not make it better and move on?
  How irresponsible it was to say, ``Repeal,'' when all these points 
were in it. When repeal was the great mantra, nobody said: ``Repeal. 
Oh, but not that.'' ``Repeal. Oh, but let's protect the seniors from 
the doughnut hole.'' No, it was just ``Repeal ObamaCare. Repeal 
ObamaCare.'' Frankly, chanting ``Repeal ObamaCare'' I think is about as 
disqualifying to lead Medicare and Medicaid as chanting ``Lock her up'' 
would be to be Attorney General of the United States.
  Catherine is a constituent of mine who lives in Cranston. She is a 
breast cancer survivor. She owns a small family business. Her family 
had health insurance before the Affordable Care Act, but their 
insurance company decided that their little company had too few 
employees to qualify as a small business, and it dropped them from 
their coverage. So it was thanks to the Affordable Care Act that 
Catherine and her husband could get affordable and quality health 
insurance through our exchange that we call HealthSourceRI. With this 
coverage, they go on about their business. They don't have to worry 
about whether their insurance company is going to change the rules and 
pitch them out again. Catherine and her husband tell me they don't 
understand how anyone could say they support small business and want to 
repeal the Affordable Care Act.
  Timothy wrote to me. He is a freelance writer in Rumford, RI. He has 
affordable health care for the first time in his life. There is no big 
company to help you if you are a freelance writer; you are on your own. 
But the Affordable Care Act has been there for Timothy. He has multiple 
chronic health conditions that require medication. Before he had 
coverage under the Affordable Care Act, Timothy was hospitalized for a 
heart problem. He couldn't afford the resulting hospital bills. Without 
health insurance, he couldn't pay for his prescriptions. Having health 
insurance, Timothy told me, has changed his life. He feels dignity, he 
feels peace, he feels assurance, and a lot of that is simply the 
reassurance that you can afford the medications you need to stay 
healthy. His chances of having to be hospitalized in the future are 
down. If the ACA is repealed, Timothy may be forced to forgo care that 
he needs, endangering his health, and potentially, by the way, costing 
the system a lot more.
  Martha, who lives in Cranston, RI, knows well the dangers of being 
uninsured. Before the Affordable Care Act, Martha went several years 
without health insurance, gambling that she could get away with it 
because she couldn't afford it. A gall bladder infection required 
emergency surgery. She was taken to the hospital, the surgery was 
performed. It went well, but she was left with a $60,000 hospital bill. 
Unable to pay the bill, she declared bankruptcy.
  Now she can have coverage, and by the way, when the hospital has to 
do the surgery, it gets paid with her insurance. That is why the 
American Hospital Association and the Hospital Association of Rhode 
Island are saying: Don't repeal ObamaCare. That would be reckless.
  Martha and her husband and her 24-year-old son have all been able to 
purchase insurance through the Rhode Island exchange. By the way, our 
exchange is doing great. People may complain about exchanges in other 
States. We are seeing costs steady; we are seeing costs going down. One 
of our major insurers, Neighborhood Health Plan of Rhode Island, is 
advertising on TV. Whoa. Our rates are going down, and their coverage 
is fine, and Rhode Island is a success story under the Affordable Care 
Act. The $283 per month that Martha and her family now pay in total for 
insurance certainly beats the $500 a month that she and her husband 
each faced for individual coverage before the ACA.
  Paula wrote to me from Cranston about how the Affordable Care Act has 
helped her and her husband bridge the gap until they get to the safe 
haven, finally, of Medicare. Paula is 63 years old. She works part 
time. Her husband who is 64 years old and retired has health insurance 
through our exchange, HealthSourceRI. Paula has beaten breast cancer 
once, but she is at high risk of recurrence.
  If the Affordable Care Act is repealed, Paula would be at risk to 
lose her health insurance and the ability to have tests that would help 
her catch a recurrence of cancer in time. Paula and her husband worked 
hard and saved well, but as Martha's story shows, one illness can wipe 
you out if you don't have health insurance, and they are so content and 
comforted knowing they have a good health insurance plan through our 
exchange.
  Travis is a social worker in Providence. He provides psychotherapy 
and counseling to recovering addicts who are receiving medication and 
assisted treatment. This is a particularly touching point in Rhode 
Island because we lost 239 Rhode Islanders to opioid-related overdoses 
last year. That is 239 fatalities in Rhode Island last year.
  The Affordable Care Act, Travis believes, is the reason that many of 
his patients are actually able to get care and stay away from the risk 
of overdose. He wrote of his patients, many of them never accessed 
methadone treatment prior to the passage of the Affordable Care Act, 
let alone sought treatment for their psychiatric conditions which may 
underlie the substance abuse disorders. By the way, a recent report 
came out that said if you repeal the Affordable Care Act and its 
coverage requirements for mental health and substance abuse, you pull 
about $5.5 billion worth of coverage out from American families. Is 
that really what this Congress wants to be responsible for doing? I 
certainly hope not, not after all the fine statements we heard about 
the Comprehensive Addiction and Recovery Act and the funding for it.
  Let me make one last point because I see the Senator from Michigan 
here and I know she wants to add her thoughts. You can talk about the 
personal stories, and it shows how poignant and important having the 
Affordable Care Act around is in the lives of real actual people, but 
we also have to deal with budget issues in Washington, and I just want 
to show this chart.
  This chart shows the spending projections for Federal health care 
spending. The red line on the top was the projection in 2010 done by 
the CBO, the Congressional Budget Office. In 2010, they said: Here is 
how we think our spending is going to be in Federal health care. They 
predicted that. Then they came back and they did another prediction in 
2017.
  One thing that happened is that after the passage of the Affordable 
Care Act back here, we came in well below predicted expense for Federal 
health care. We saved a lot of money in that period. Then when they 
rebooted the prediction in 2017, they started off actual and they did a 
new prediction right here. The difference in this 10-year period in 
Federal health care costs between what they expected to have happen in 
that 10-year period before the Affordable Care Act came along and what 
experience and the new projections show the savings are since the 
Affordable Care Act are $3.3 trillion--$3.3 trillion--and we have this 
person who wants to be the Secretary who wants to cut the program? We 
are saving money in the program under this. It doesn't make any sense 
fiscally, and it is cruel to the individuals and families who have 
found comfort and peace and security from the Affordable Care Act.
  So I will leave us with that, but if we are going to be responsible 
about doing something about our outyear health care costs, find me 
something else that shows $3.3 trillion in savings during the period of 
2017 to 2027, over 10 years. For these costs, we sometimes look out 30 
years, and that number would grow even greater. We have saved trillions 
of dollars as a result of the Affordable Care Act, and CBO shows it.
  Thank you very much. I yield the floor.

[[Page S1023]]

  The PRESIDING OFFICER (Mr. Young). The Senator from Michigan.
  Ms. STABENOW. Thank you very much, Mr. President.
  The decisions made by the next Secretary of Health and Human Services 
will affect all of us, and that is why we are here. That is why we have 
spent so much time and will continue to talk about the issues. This is 
not personal with the individual, this is about everyone in our country 
and how they are impacted by the ideas and the policies of this 
individual as well as the person who has nominated him.
  This particular individual has a very clear record as to what he 
believes should happen as it relates to Medicare and Medicaid, and our 
entire health care system. More than 100 million people rely on 
programs like Medicare--seniors, people with disabilities on Medicare. 
With Medicaid, the majority of money spent through the Medicaid health 
care system goes to seniors in nursing homes. That is where the 
majority of dollars go, long-term care for seniors. So Congressman 
Price's ideas, his proposals, the things he has pushed in the House 
matter because they show us what he believes should happen to Medicaid 
and to Medicare.
  We need to make sure the next Health and Human Services Secretary 
will fight for the health care of families in Michigan--at least I need 
to be sure. That is where my vote goes, based on what is best for 
families in Michigan. That is what is best for our communities, rural 
communities, where the hospital, like where I grew up in Clare, was the 
largest employer in the community, greatly affected and impacted by 
what happens to Medicare and Medicaid funding. If the hospital is not 
there, chances are the doctors aren't there either or the nurses. Our 
larger communities are where, obviously, our hospitals are critically 
important as well.

  So when we look at communities and hospitals and doctors, families, 
children, seniors, and the broad economy--and, by the way, one-sixth of 
the whole economy in our country is connected to health care. So who is 
in charge as Secretary of Health and Human Services is a big deal. That 
is why we have focused so much on this individual, his policies, his 
ideas, and his own background as well.
  As we have gone through the confirmation process, it is clear to me 
that Congressman Price's policies do not--do not--have the best 
interests of the people I represent in Michigan at heart, which is why 
I will be voting no on his confirmation.
  I have heard from thousands of people around Michigan. I have heard 
from people who like our hospitals and live in the community, and 
businesspeople and nurses and doctors with great concerns. I have also 
heard from people around the country and have helped to lead a forum 
for people to come and speak, people who were not invited into the 
actual hearing for the confirmation hearing. I thought it was 
important, as did my Democratic colleagues, to have a forum where 
people could speak about the ideas, the bills, the policies that 
Congressman Price has passed in the House of Representatives.
  So we heard a lot of stories and, overwhelmingly, people were opposed 
to this nominee.
  One of the people who shared her story was from Michigan. I was very 
appreciative that she came in from Michigan. Ann was diagnosed with 
multiple sclerosis when she was 4 years old. It resulted in functional 
quadriplegia. She has limited use of her right arm and no use of her 
left arm. She was fortunate to have strong employee benefits and to be 
covered until she went on Medicare at 65. By the way, this nominee 
thinks the age should go up--66 or 67, I am not sure how far. But Ann 
made it to 65 and, like so many people I know, was holding her breath 
to get there so she could have comprehensive quality health care that 
she paid into her whole life called Medicare.
  Over the course of the last few decades, the price of her 
prescription drugs have skyrocketed and would cost her tens of 
thousands of dollars a year without Medicare and Medicaid. For her, the 
decision about our Health and Human Services Secretary makes an 
enormous impact on her life.
  She told us: Without Medicare and Medicaid, things would have been 
very different for my family. I don't know how I could have cared for 
my mom on top of managing my own care. My family would have lost our 
home, all of our savings, trying to keep up with the bills. So many 
families are squeezed like ours, having to afford care for their aging 
parents and their own care, or childcare at the same time. But with 
support, we don't have to suffer to just be alive.
  If these programs are cut, if we see the kinds of proposals on 
Medicare and Medicaid that Congressman Price has put forward in the 
House, in the Budget Committee, people will face more catastrophes than 
ever before.
  Our new President campaigned on a promise not to cut Medicare and 
Medicaid. He said himself: ``I am not going to cut Social Security like 
every other Republican, and I am not going to cut Medicare and 
Medicaid.'' But it doesn't square with the person he has nominated for 
this critical position, who will be making administrative decisions as 
well as leading his efforts on health care. So actions speak louder 
than words, at least that is what we say in Michigan.
  Just this fall, Congressman Price said he expects Medicare to be 
overhauled--overhauled within the first 6 to 8 months of Trump's 
administration. He also believes the age of eligibility needs to 
increase--his words--and that ``the better solution is premium 
support.'' What does that mean? That is another word for voucher. Some 
people say privatization. But basically instead of having an insurance 
card and a health care system where you can go to the doctor and know 
that you are covered with insurance, you get some kind of a voucher or 
an amount of money, and then you would be able to go find your own 
insurance, I guess, or figure out a way to pay for your insurance.
  Before Medicare, seniors were trying to figure that out and couldn't 
find affordable insurance in the private market, which is why, in 1965, 
Medicare was created. There is no way in the world I will support going 
backward to that kind of approach.
  As chair of the Budget Committee, Congressman Price proposed a budget 
that would have cut Medicare by nearly $500 million, not counting what 
he wants to do with Medicaid, the majority of which goes to fund senior 
citizens in nursing homes.
  We need to have a Secretary who supports making it easier and more 
affordable for people to get care, not less.
  Let's talk about health care for a moment in the broader sense. We 
know more and more people--some 30 million people--would be affected, 
their health insurance ripped away, if the repeal is passed that has 
begun--the process has begun by Republicans in the House and in the 
Senate. The Affordable Care Act has provided health care and the 
opportunity for people to get care for children to be able to see a 
doctor. There are parts of the country where we need more competition, 
where prices are too high. I want very much to work on that. I am 
committed to working to make that system better, and we can do that 
without ripping the entire system apart.
  There is also another part of the Affordable Care Act that affects 
every single person with insurance--things that I know have made a 
tremendous difference to anybody with employer-based insurance; first 
of all, being allowed to have your child on your insurance until age 
26; secondly, knowing that if you get sick, you can't get dropped by 
your insurance company, and if you have a chronic disease, something 
has happened to your health, you can't be blocked from getting 
insurance; and we also know things like making sure you can get all the 
cancer treatments your doctor says you need, not just those up to the 
cap that the insurance company will pay for. I had pediatric cancer 
physicians tell me they have been able to save children's lives who 
have cancer because there was no longer a cap on the amount of care.
  Mental health and substance abuse services, where if they were 
covered at all before the Affordable Care Act, it always cost more 
money: higher copays, higher premiums. Now you can't do that. You have 
to have the same kinds of copays and the same kinds of premiums.
  So many patient protections have basically said to insurance 
companies: You don't get, just based on profits, to decide what is 
going to happen; that when you buy insurance, you actually

[[Page S1024]]

get health care. And that is something true for everyone today.
  So we have a Secretary nominee who supports doing away with all that, 
changing all that, who is not someone who is interested in having a 
basic set of services identified in health care, like maternity care. I 
talked with him, questioned him in the Finance Committee. This is an 
area I had championed when we passed the Affordable Care Act to make 
sure that basic services for women were viewed as basic services in 
health care, and it starts with prenatal care and maternity care. Prior 
to the Affordable Care Act, it was very hard to find private insurance 
that covered maternity care, unless you wanted to pay for--some 70 
percent of the plans out in the private market require women to pay 
more. So I asked Congressman Price, did he believe maternity care was a 
basic service and should be covered under basic insurance. He said: 
Well, women can purchase that if they need it, which is exactly what 
happened before--which is, no, it is not basic care, but you can 
purchase it on top of your regular premium, if you need maternity care.
  So right now the law says you can't discriminate and charge women 
more than men, and in fact being a woman is no longer a preexisting 
condition.
  But the person whom the President has nominated for Health and Human 
Services would take us back there, and he would take us back there on a 
whole range of areas that create access for people to be able to have 
the care they need.
  Here is an example from a doctor in west Michigan who wrote me 
regarding just basic medical care for someone in need. He said:

       In December, a young man arrived in our emergency room with 
     a badly mangled hand from a machining accident. He knew the 
     hand was seriously injured and was willing to allow his 
     coworker to bring him into the hospital so that it could be 
     stitched up. When our physician studied the wound, they knew 
     he needed surgery to repair the bone and blood vessel damage. 
     The patient refused, thinking the only thing he could 
     possibly afford was stitches.

  They then connected this man with a financial services specialist who 
took a few minutes to find out that he was eligible for Medicaid, 
working; now, because of the expansion, able to receive health care 
under Medicaid. He was then able to get the surgery he needed.
  Beaumont physicians said that if the surgery hadn't happened, the man 
could have had an open wound for an indefinite amount of time, been 
prone to infection, and possibly lost his hand entirely, making him 
unable to ever work at his job or maybe any job again.
  Expanding Medicaid health care to working people is a good idea, and 
millions of people have been impacted and have been able to get the 
care they need for themselves and for their children.
  Access to health care saved this man's arm and possibly his life, and 
that is really what is at stake here, both with this nominee and the 
larger debate on where we are going to go in our great country on the 
whole issue of health care.
  We all know that the advice of the Secretary of Health and Human 
Services will be a strong influence on the President's decision to 
promote, to sign, to veto legislation. We know he has the ability 
administratively to do a number of things--to cut off care, to cut off 
access to women's health care, to change the system that we have now, 
to destabilize it so that the Affordable Care Act will not work. I am 
extremely concerned that because of Congressman Price's record and his 
actual proposals and decisions and votes, he will be willing to 
actually do that. Whether it is cutting Medicare or Medicaid or 
removing some of the critical policies that keep people healthy and 
care affordable, I am deeply concerned about the decisions this nominee 
will make and the recommendations he will make to the President of the 
United States.
  Again, we don't have to speculate about this. He has put these plans 
on paper. He has supported them. He has passed them. It is very clear. 
We don't have to guess where he wants to go: to dismantle Medicare as 
we know it, to gut Medicaid, most of which goes for seniors in nursing 
homes, and to unravel the entire health care system and the patient 
protections that every American who has insurance has right now that 
allow them to get the health care they are actually paying for.
  I need to raise one other thing because this is very serious and goes 
to serious issues surrounding conflicts of interest and likely ethics 
violations that relate to this nominee.
  There are a lot of unanswered questions and serious concerns related 
to Congressman Price's investments in health care and pharmaceutical 
companies. Frankly, he misled the Finance and the HELP Committees with 
answers to questions, and just the night before he was to have a 
confirmation hearing and vote, we learned from company officials that 
he got a privileged offer to buy stock at a discount. In other words, 
he got a special deal on health care stock. He told us he had not; they 
had paid fair market value, even though it was already an issue that he 
had purchased stock and then put legislation in related to similar 
companies or the same companies involved. But then we found out it was 
even worse because he got a special deal.
  As Democrats, we asked for answers. We did not want to move forward 
without asking the Congressman to come back before us so we could ask 
questions about what he had said to the committee versus what the 
business that sold him the stock said afterwards. Unfortunately, that 
did not happen, requiring the Finance Committee to be in a situation 
where the rules ended up being broken and the nomination was forced 
through the committee without having bipartisan participation.
  I have a number of concerns related to the ethics and possible legal 
violations of this nominee. On multiple occasions, he did purchase 
stock within days of introducing legislation that would have affected 
that company's bottom line and his investment. Despite multiple 
requests over several weeks, we still don't have the answers and, more 
importantly, the American people don't have the answers from the person 
who will oversee health insurance, oversee Medicare, Medicaid--the 
entire system. Someone who has invested and then helped the same 
companies indicated he didn't get a special deal, and now we have 
information that says otherwise. I think that is very concerning and 
should have been addressed before we were asked to vote on this 
particular nominee.
  There are a number of reasons--policy, track record, questions that 
have been raised that I find extraordinary that they haven't been 
answered and shocking that folks haven't felt they should be answered 
at this point. But for many reasons, it is my intention to vote no on 
behalf of the people in Michigan who care deeply about a strong, 
effective Medicare system, about making sure Medicaid is there for our 
children as well as our seniors and nursing homes, and for everyone who 
believes that in this great country, all should have the ability to see 
a doctor and get the medical care you need for your child or yourself.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. FRANKEN. Mr. President, my understanding was that the Democratic 
leader wanted to come and speak for 5 minutes between Senator Stabenow 
and myself. But he is not here, so I am going to speak.
  Before I start my remarks that I have prepared, I want to say 
something specifically to the Presiding Officer because he is a new 
Senator from Indiana.
  I read a front-page article in the New York Times just a few weeks 
ago. It featured Indiana University Hospital and the health physicians 
there. It was an article about the savings and the delivery reform that 
have been driven by the Affordable Care Act, things that will be 
staying with us even if this is repealed, which I hope it isn't. But 
this is a quote I would like to read for the Presiding Officer from Dr. 
Gregory Kira, cochief of primary care, Indiana University Health 
Physicians.
  I would ask the Presiding Officer for his attention for a second. 
This is what it says: `` `I've been a registered Republican my whole 
life, but I support the Affordable Care Act,' said Dr. Gregory C. 
Kiray, co-chief of primary care for IU Health Physicians, `because it 
allows patients to be taken care of.' ''
  I admit, I didn't have 49 others for every State, but I had 
remembered reading this.

[[Page S1025]]

  On February 3, 2009, Tom Daschle, President Obama's nominee for 
Secretary of Health and Human Services, withdrew his nomination because 
he hadn't paid his taxes on his car service. On January 9, 2001, Linda 
Chavez, President George W. Bush's nominee for the Department of Labor, 
withdrew her nomination after questions were raised about her decision 
to shelter an undocumented immigrant. Most recently, Vincent Viola, 
President Trump's nominee to be--
  Would the leader like me to yield to him for a few minutes?
  Mr. SCHUMER. That would be great.
  Mr. FRANKEN. Really?
  Mr. SCHUMER. I would appreciate it.
  Mr. FRANKEN. Would that be good for me and my career?
  Mr. SCHUMER. Your career is so great, you don't need me.
  Mr. FRANKEN. Well, I am going to yield to our leader in just a 
moment, when he manages to get there, and it will be the esteemed 
Senator from New York, Charles Schumer. I will narrate as he is 
stepping over there, walking now to the podium--the leader, whom I will 
yield to.
  Mr. SCHUMER. First, let me thank my colleague from Minnesota.
  The PRESIDING OFFICER. The Democratic leader.
  Mr. SCHUMER. And I meant what I said: He doesn't need any help. He 
does it so well on his own. So I will regard this not as a quid pro 
quo--although he can get what he wants--but as an act of kindness and 
generosity.
  Mr. President, I rise this evening to oppose the confirmation of 
Representative Tom Price to be Secretary of HHS and urge my colleagues 
to vote no on his nomination.
  Representative Price might be the quintessence of President Trump's 
Cabinet: a creature of Washington, deeply conflicted, and far out of 
the mainstream when it comes to his views on health care.
  Like other nominees, philosophically he seems completely opposed to 
the very purpose of his Department: the good governance of the health 
programs that cover tens of millions of Americans.
  Candidate Trump promised he would not cut Medicare or Medicaid, but 
Congressman Price has spent his entire career trying to cut Medicare 
and Medicaid and dismantle the Affordable Care Act. Just listen to 
these quotes:
  The nominee for Secretary of Health and Human Services has said, 
``Nothing has had a greater negative effect on the delivery of health 
care than the federal government's intrusion into medicine through 
Medicare.'' That one might have come out of the 1890s, if we had had 
Medicare then.
  He said he expects lawmakers to push forward with an overhaul of 
Medicare, ``within the first six to eight months'' of this new 
administration. Does that sound like someone who doesn't want to cut 
Medicare and Medicaid? It doesn't to me. It doesn't to the American 
people. In fact, if you could pick someone who in either House of 
Congress was most likely to cut Medicare and Medicaid, you would pick 
Congressman Price. It could not be more of a contradiction to what 
Candidate Trump promised in the campaign.
  So here is what worries me: From what I know of the President, he 
will cede great authority to Cabinet officials, content to jump from 
one topic to the next, one tweet to the next. I would put much greater 
stock in Representative Price's record than anything the President 
promised during the campaign, and that is very bad news for seniors and 
the American people generally.
  For that reason, every American who receives benefits from those 
programs--the millions of American seniors, women, families, and people 
with disabilities--should be gravely concerned about what the tenure of 
a Secretary Tom Price will mean for their health.
  Make no mistake, in the dark hours of the early morning, with the 
confirmation of Secretary Price, the Republicans launch the first 
assault in their war on seniors. The war on seniors begins when we 
select Representative Price over our votes as Secretary of Health and 
Human Services.
  When it comes to the health care of older Americans, confirming 
Representative Price to be Secretary of HHS is akin to asking the fox 
to guard the henhouse. It has been revealed that in his time in the 
House, Representative Price engaged in a number of questionable 
practices related to the trading of stocks in issues that his 
legislation impacted. There are many instances.
  There were reports late last year that Congressman Price had traded 
stocks in dozens of health care companies valued at hundreds of 
thousands of dollars during a time when he introduced, sponsored, or 
cosponsored several pieces of legislation that potentially impacted 
those companies. In one instance, Congressman Price bought shares in a 
medical device manufacturing company just days before introducing 
legislation in the House that would directly benefit that company.
  These were far from isolated incidents. Just yesterday, USA Today 
reported that Congressman Price ``bought and sold health care company 
stocks often enough as a member of Congress to warrant probes by both 
federal securities regulators and the House ethics committee.''
  These allegations alone might be enough to sink a nominee in another 
administration, but it seems this Cabinet is so rife with ethics 
challenges and conflicts of interest that Representative Price's 
conduct in the House doesn't place him too far outside this unethical 
norm. But that should be no excuse. When you are a Congressman or a 
Senator, you must endeavor to avoid even the hint of a conflict of 
interest, let alone a situation where you are actively trading stocks 
that may be impacted.
  So this is a sad evening. The war on seniors by the Trump 
administration begins when we confirm Representative Price. People will 
look back and say that the public war on seniors began at 2 a.m. Friday 
morning when the Senate, unfortunately, confirmed Representative Price.

  I urge my colleagues to vote no.
  I yield the floor and once again thank my colleague.
  Mr. FRANKEN. Thank you, Mr. Leader.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. FRANKEN. Mr. President, I have to start this over fresh. I don't 
know if the Congressional Record needs to have this first half 
paragraph twice, but so be it.
  On February 3, 2009, Tom Daschle, President Obama's nominee for 
Secretary of Health and Human Services, withdrew his nomination because 
he hadn't paid his taxes on his car service. On January 9, 2001, Linda 
Chavez, President George W. Bush's nominee for the Department of Labor, 
withdrew her nomination after questions were raised about her decision 
to shelter an undocumented immigrant. Most recently, Vincent Viola, 
President Trump's nominee to be the Secretary of the Army, withdrew his 
nomination after it proved too difficult for him to distance himself 
from his business ties.
  Congressman Price's conflicted financial investments and his 
affiliation with conspiracy-theory-peddling extremists should be enough 
to disqualify his nomination. On top of that, Congressman Price's 
policy agenda squarely contradicts what the majority of the American 
people want and the key promises President Trump made during his 
campaign. It is, frankly, hard to believe that we are seriously 
considering someone who has advanced policies that would privatize 
Medicare, gut Medicaid, and rip coverage away from millions of 
Americans.
  For all of these reasons, I strongly oppose Congressman Price's 
nomination for Secretary of Health and Human Services.
  Let's take these issues one by one.
  First, Congressman Price's stock trades. Public documents show that 
between 1993 and 2012, Congressman Price owned shares in tobacco 
companies worth tens of thousands of dollars. At the same time, 
Congressman Price voted against landmark legislation in 2009 that gave 
the Food and Drug Administration the authority to regulate tobacco and 
bring down the death toll inflicted by tobacco products. That means 
Congressman Price, a physician who swore to uphold the Hippocratic oath 
of ``do no harm,'' voted against public health and for Big Tobacco. 
This is the person who is slated to become the next Secretary of Health 
and Human Services, someone who personally profited from increased 
sales of deadly, addictive products.

[[Page S1026]]

  When asked about this during his hearing in the Health, Education, 
Labor, and Pensions Committee, Congressman Price's best defense was 
that his broker made the stock trades on behalf without his knowledge.
  Here is the problem with that defense:
  First, Congressman Price annually reported his financial holdings, 
signing off on documents acknowledging his investments in tobacco 
companies, meaning that he would have knowledge of the fact that his 
vote to block tobacco regulation could have a direct financial benefit 
to him.
  Second, these were not investments in diversified funds; these were 
individual stocks that he owned for nearly 20 years and that he 
reported paid him dividends. Let me repeat that. Congressman Price, 
medical doctor, owned individual tobacco company stocks that paid him 
dividends.
  Owning tens of thousands of dollars of tobacco stocks while voting to 
help tobacco companies was not Congressman Price's only questionable 
investment. In late December, the Wall Street Journal reported that 
over the past 4 years, Congressman Price has traded stocks worth more 
than $300,000 in about 40 health-related companies while at the same 
time serving on the House Ways and Means Committee, where he drafted 
and cosponsored legislation that could affect his investments.
  Let's talk about one example that is particularly troubling. 
Congressman Price made his largest ever stock purchase in a company 
called Innate Immunotherapeutics, a small biotech company based in 
Australia. This is a company that has only one experimental therapy in 
the early stages of testing, has never generated revenues from drug 
sales. It is not exactly a household name. How did Congressman Price 
get in on this sweetheart deal? He was told about Innate by Congressman 
Chris Collins, who, in addition to being a Member of the House of 
Representatives, serves on the board of directors for Innate 
Immunotherapeutics and is the company's largest shareholder.
  The Wall Street Journal reported that Congressman Price was part of a 
small group of fewer than 20 U.S. investors who participated in the 
private stock sale. The New York Times and the Buffalo News reported 
that many of those people had close ties to Congressman Collins, 
including Collins' chief of staff, a prominent DC lobbyist, and several 
of Congressman Collins' campaign contributors.
  On August 31, Congressman Price reported that as part of this special 
private stock sale, he bought about 400,000 shares of Innate stock for 
as little as 18 cents a share. That same day, the stock was trading on 
the Australian Stock Exchange for the equivalent of 31 cents per share. 
That is a 42-percent difference--42 percent below the market price--and 
Congressman Price now stands to make a profit of more than $200,000. 
That is quite a stock tip.
  Richard Painter, George W. Bush's chief ethics lawyer, describes 
Price's stock trades as ``crazy. . . . We wouldn't have put up with 
anybody in the Bush administration buying and selling health care 
stocks.'' Painter went on to explain that ``if you, as a member of 
Congress, buy and sell health care stocks at the same time you are 
possessing non-public information about that legislation, you are 
taking the risk of being charged with criminal insider trading.''
  Let me repeat that. Mr. Painter, who was George W. Bush's chief 
ethics official, suggested that Mr. Price's actions risk a criminal 
insider trading charge.
  Congressman Price could have directed his broker to stay away from 
tobacco stocks. He could have directed his broker to stay away from 
health care stocks or individual stocks altogether given that health 
care was one of his legislative priorities. But he did not. Why would 
Congressman Price take this risk?
  My colleagues and I have sent Congressman Price a number of letters 
asking for more information about his stock trades and investments. If 
this is all aboveboard, then Congressman Price should have nothing to 
hide. I also submitted questions for the record as a member of the HELP 
Committee. In response to all of these questions, I have received 
nothing. It makes no sense that his nomination has been brought to the 
floor despite his refusal to respond to committee questions.
  Congressman Price has demonstrated a lack of judgment with his stock 
trades and now is stonewalling the committee, refusing to answer our 
inquiries, but Congressman Price's questionable stock trades aren't the 
only area raising red flags.
  My second set of concerns stems from Congressman Price's longstanding 
association with conspiracy-peddling, anti-science extremists. For more 
than 25 years, Congressman Price has been a dues-paying member of the 
Association of American Physicians and Surgeons. He has spoken at the 
organization's conferences and even described the organization's 
executive director as one of his personal heroes. This organization is 
way out of the mainstream. It promotes anti-vaccine pseudoscience and 
denies the scientific fact that HIV causes AIDS. It is an organization 
that blames ``swarms'' of immigrant children for disease and has 
published scientifically discredited theories linking abortion to 
breast cancer. At one point, it even accused President Barack Obama of 
hypnotizing voters with ``neuro-linguistic programming.''
  Let me repeat that. It accused President Barack Obama of hypnotizing 
voters with ``neuro-linguistic programming.''
  That is not all. The statement of principles for the Association of 
American Physicians and Surgeons has an entire section devoted to 
urging doctors to refuse to participate in Medicare, in which it says 
the effect of such government-run programs is ``evil, and participation 
in carrying out his provisions is, in our opinion, immoral.'' 
Congressman Price--the person poised to become the next Secretary of 
Health and Human Services, the person responsible for leading 
Medicare--has been an active, engaged member of this organization for 
25 years.
  Just in case you don't think he has bought into these ideas, let me 
read you what Congressman Price wrote in 2009 in an op-ed: ``I can 
attest that nothing has had a greater negative effect on the delivery 
of health care than the federal government's intrusion into medicine 
through Medicare.''
  Since Congressman Price will not answer my questions, I will pose 
this to one of my Republican colleagues: How are the American people 
supposed to trust Congressman Price as Secretary of Health and Human 
Services given that he has belonged to an organization for over 25 
years that has such blatant disregard for science and a propensity for 
putting partisanship and ideology above evidence?
  Lastly and most importantly, the policy reforms that Congressman 
Price has put forward are so extreme that they should be disqualifying 
in and of themselves. As an editorial recently published in the New 
England Journal of Medicine stated, ``As compared with his 
predecessors' actions, Price's record demonstrates less concern for the 
sick, the poor, and the health of the public and much greater concern 
for the economic well-being of their physician caregivers.'' That is 
from the New England Journal of Medicine.
  Mr. President, I ask unanimous consent to have the article printed in 
the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       [From the New England Journal of Medicine; Jan. 12, 2017]

Care for the Vulnerable vs. Cash for the Powerful--Trump's Pick for HHS

         (By Sherry A. Glied, Ph.D. and Richard G. Frank, Ph.D)

       Representative Tom Price of Georgia, an orthopedic surgeon, 
     will be President-elect Donald Trump's nominee for secretary 
     of health and human services (HHS). In the 63-year history of 
     the HHS Department and its predecessor, the Department of 
     Health, Education, and Welfare, only two previous secretaries 
     have been physicians. Otis Bowen, President Ronald Reagan's 
     second HHS secretary, engineered the first major expansion of 
     Medicare, championed comparative effectiveness research and, 
     with Surgeon General C. Everett Koop, led the fight against 
     HIV-AIDS. Louis Sullivan, HHS secretary under President 
     George H.W. Bush, focused his attention on care for 
     vulnerable populations, campaigned against tobacco use, led 
     the development of federally sponsored clinical guidelines, 
     and introduced President Bush's health insurance plan, which 
     incorporated income-related tax credits and a system of risk 
     adjustment. In their work at HMS, both men, serving in 
     Republican administrations, drew on a long tradition of 
     physicians as advocates for the most vulnerable, defenders of

[[Page S1027]]

     public health, and enthusiastic proponents of scientific 
     approaches to clinical care.
       Tom Price represents a different tradition. Ostensibly, he 
     emphasizes the importance of making our health care system 
     ``more responsive and affordable to meet the needs of 
     America's patients and those who care for them. But as 
     compared with his predecessors' actions, Price's record 
     demonstrates less concern for the sick, the poor, and the 
     health of the public and much greater concern for the 
     economic wellbeing of their physician caregivers.
       Price has sponsored legislation that supports making armor-
     piercing bullets more accessible and opposing regulations on 
     cigars, and he has voted against regulating tobacco as a 
     drug. His voting record shows long-standing opposition to 
     policies aimed at improving access to care for the most 
     vulnerable Americans. In 2007-2008, during the presidency of 
     George W. Bush, he was one of only 47 representatives to 
     vote against the Domenici Wellstone Mental Health Parity 
     and Addiction Equity Act, which improved coverage for 
     mental health care in private insurance plans. He also 
     voted against funding for combating AIDS, malaria, and 
     tuberculosis; against expansion of the State Children's 
     Health Insurance Program; and in favor of allowing 
     hospitals to turn away Medicaid and Medicare patients 
     seeking nonemergency care if they could not afford 
     copayments.
       Price favors converting Medicare to a premium-support 
     system and changing the structure of Medicaid to a block 
     grant--policy options that shift financial risk from the 
     federal government to vulnerable populations. He also opposed 
     reauthorization of the Violence Against Women Act and has 
     voted against legislation prohibiting job discrimination 
     against lesbian, gay, bisexual, and transgender (LGBT) people 
     and against enforcement of laws against anti-LGBT hate 
     crimes. He favors amending the Constitution to outlaw same-
     sex marriage.
       In addition, he has been inconsistent in supporting 
     investments in biomedical science. He opposes stem-cell 
     research and voted against expanding the National Institutes 
     of Health budget and against the recently enacted 21st 
     Century Cures Act, showing particular animus toward the 
     Cancer Moonshot.
       Price has also been a vociferous opponent of the Affordable 
     Care Act (ACA) and a leader of the repeal-and-replace 
     movement. His proposal for replacing the ACA is H.R. 2300, 
     the Empowering Patients First Act, which would eliminate the 
     ACA's Medicaid expansion and replace its subsidies with flat 
     tax credits based on age, not income ($1,200 per year for 
     someone 18 to 35 years of age; $3,000 for someone 50 or 
     older, with an additional one-time credit of $1,000 toward a 
     health savings account). Price's plan is regressive: it 
     offers much greater subsidies relative to income for 
     purchasers with high incomes and much more meager subsidies 
     for those with low incomes. In today's market, these credits 
     would pay only about one third of the premium of a low-cost 
     plan, leaving a 30-year-old with a premium bill for $2,532, 
     and a 60-year-old with a bill for $5,916--along with a 
     potential out-of-pocket liability of as much as $7,000. By 
     contrast, subsidies under the ACA are based on income and the 
     price of health insurance. Today, a low-income person (with 
     an income of 200% of the federal poverty level) pays, on 
     average, a premium of $1,528 per year (regardless of age) for 
     a plan with an out-of-pocket maximum of $2,350, and that 
     payment does not change even if health insurance premiums 
     rise.
       To put the plan's subsidies into perspective, consider that 
     in 1992, when per capita health expenditures were just one 
     third of what they are today, President Bush and HHS 
     Secretary Sullivan proposed a slightly larger individual tax 
     credit ($1,250) for the purchase of insurance than Price 
     proposes today. Even in 1992, analysts reported that the 
     credit would be insufficient to induce most people to buy 
     coverage.
       The Price plan would eliminate the guaranteed-issue and 
     community-rating requirements in the ACA and create anemic 
     substitutes for these commitments to access to comprehensive 
     coverage for Americans with preexisting conditions. These 
     replacements include an extension to the nongroup market of 
     the continuous-coverage rules that have long existed in the 
     group market with little benefit; penalties on reentering the 
     market for anyone who has had a break in coverage; and a very 
     limited offer of funding for states to establish high-risk 
     pools. In combination with relatively small tax credits, 
     these provisions are likely to lead low-income and even 
     middle-class healthy people to forgo seeking coverage until a 
     serious health problem develops. Without the income- and 
     premium-based subsidies in the ACA acting as market 
     stabilizers, Price's provisions would erode the non-group 
     health insurance market.
       Price's plan would withdraw almost all the ACA's federal 
     consumer-protection regulations, including limits on insurer 
     profits and requirements that plans cover essential health 
     benefits. By allowing the sale of health insurance across 
     state lines, the plan would also effectively eliminate all 
     state regulation of health insurance plans, encouraging a 
     race to the bottom among insurance carriers. Finally, Price 
     would fund his plan by capping the tax exclusion for 
     employer-sponsored health insurance at $8,000 per individual 
     or $20,000 per family. These caps are well below those 
     legislated through the Cadillac tax in the ACA, a provision 
     that Price himself has voted to repeal.
       In sum, Price's replacement proposal would make it much 
     more difficult for low-income Americans to afford health 
     insurance. It would divert federal tax dollars to people who 
     can already buy individual coverage without subsidies and 
     substantially reduce protections for those with preexisting 
     conditions. The end result would be a shaky market dominated 
     by health plans that offer limited coverage and high cost 
     sharing.
       Whereas Price's actions to date have not reflected the 
     tradition of the physician as advocate for the poor and 
     vulnerable, they do harken back to an earlier tradition in 
     American medicine: the physician advocate as protector of the 
     guild. His Empowering Patients First Act would directly 
     advance physicians' economic interests by permitting them to 
     bill Medicare patients for amounts above those covered by the 
     Medicare fee schedule and allowing them to join together and 
     negotiate with insurance carriers without violating antitrust 
     statutes. Both these provisions would increase physicians' 
     incomes at the expense of patients. Price has consistently 
     fought strategies for value-based purchasing and guideline 
     development, opposing the use of bundled payments for lower-
     extremity joint replacements and proposing that physician 
     specialty societies hold veto power over the release of 
     comparative effectiveness findings. These positions reduce 
     regulatory burdens on physicians at the cost of increased 
     inefficiency and reduced quality of care--and reflect a 
     striking departure from the ethos of his physician 
     predecessors, Secretaries Bowen and Sullivan.
       The HHS Department oversees a broad set of health programs 
     that touch about half of all Americans. Over five decades and 
     the administrations of nine presidents, both Democratic and 
     Republican secretaries have used these programs to protect 
     the most vulnerable Americans. The proposed nomination of Tom 
     Price to HHS highlights a sharp contrast between this 
     tradition of compassionate leadership and the priorities of 
     the incoming administration.

  Mr. FRANKEN. This article cites his votes against mental health 
parity--think about what that means in terms of treatment during this 
opioid crisis--against funding for AIDS, malaria and tuberculosis, 
against the expansion of the State Children's Health Insurance Program, 
against tobacco regulation, against the reauthorization of the Violence 
Against Women Act, and more.
  Price has also been a champion of efforts to repeal the Affordable 
Care Act. The Congressional Budget Office recently estimated that if 
the ACA is repealed, nearly 20 million Americans will lose their health 
care coverage immediately, with the number growing to 32 million over 
the next 10 years, and 300,000 of those individuals live in my State of 
Minnesota. Let me tell you about at least two of them.
  Leanna has a 3-year-old son named Henry. Henry has been diagnosed 
with acute lymphoblastic leukemia, and his treatment will last at least 
until April of 2018. Henry often needs around-the-clock care to manage 
his nausea, vomiting, pain, and sleepless nights. This is a 3-year-old 
boy. Henry's immune system is so compromised that he is not supposed to 
go to daycare. So Leanna left her job to take care of him. Leanna's 
family is supported by her spouse, but they couldn't pay for Henry's 
treatment on one salary. Leanna says:

       It is because of the ACA that Henry gets proper health 
     care. Henry can get therapy and the things he needs to 
     maintain his health and work toward beating cancer. Henry is 
     still with us because of the ACA.

  Let me say that again: ``Henry is still with us because of the ACA.''
  I have asked Republicans repeatedly to show me the plan they have to 
make sure Leanna and her son Henry and the hundreds of thousands of 
Minnesotans who have gained coverage don't lose the care they need. I 
have yet to see their plan. What I have seen Congressman Price advocate 
for so far is pretty awful. His proposals would strip away coverage for 
people with preexisting conditions, strip away preventive health 
benefits, strip away protections from annual and lifetime limits, strip 
away coverage for young adults. Moreover, Congressman Price views 
Medicaid and Medicare as government expenditures to be cut, rather than 
lifelines to millions of seniors, disabled populations, children and 
families. As chairman of the House Budget Committee, Congressman Price 
introduced proposals to cut funding for Medicaid by more than $2 
trillion.
  In my State, Medicaid provides health insurance to 14 percent of the 
residents. That includes two out of five low-income individuals, one in 
four children, one in two people with disabilities, and one in two 
nursing home residents. Think about that. One in two

[[Page S1028]]

people in nursing homes are covered by Medicaid in my State.
  What is going to happen to these people--our parents, our children, 
our spouses, our families--if Congressman Price and his colleagues 
succeed in slashing Medicaid's budget? I can guarantee you, it will not 
be kind and it will not be just and Americans are going to lose out.
  Congressman Price's assault on our health care system doesn't end 
there. He wants to slash Medicare's budget by hundreds of billions of 
dollars, undermining our basic guarantee of coverage to our Nation's 
seniors, and no wonder. Let me remind you, this is the same person who 
wrote: ``I can attest that nothing has had a greater negative effect on 
the delivery of health care than the Federal government's intrusion 
into medicine through Medicare.''
  Do we really want the person who wrote this to be running Medicare? 
Price's determination to gut Medicaid and Medicare is directly opposed 
by the vast majority of Americans and in direct opposition to President 
Trump's campaign promise never to cut Medicaid or Medicare.
  When Tom Daschle withdrew from consideration for HHS Secretary, he 
talked about the challenges of health care reform and said:

       This work will require a leader who can operate with the 
     full faith of Congress and the American people, and without 
     distraction. Right now, I am not that leader, and will not be 
     a distraction.

  So I say to Congressman Price, you do not have the full faith of the 
Congress, and you do not have the full faith of the American people. 
You are not the leader this country needs, and you should not be a 
distraction. Since you have not withdrawn your nomination, I urge my 
colleagues to do the right thing and oppose this controversial 
nomination.
  I yield the floor to my colleague from Hawaii.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Ms. HIRONO. Mr. President, I rise to address the deep anxiety in 
Hawaii and across the country about President Trump's choice to lead 
the Department of Health and Human Services, HHS, Congressman Tom 
Price.
  I am particularly concerned about this nominee because of the mixed 
messages President Trump has been sending about health care. During the 
campaign, President Trump promised to protect Medicare and Medicaid. 
Yet he has nominated Congressman Price to head HHS. Congressman Price 
has led the effort to privatize Medicare and dismantle Medicaid in the 
U.S. House. This is hardly someone who would protect Medicare and 
Medicaid.
  Shortly before taking the oath of office, President Trump said he 
supported the concept of universal coverage. He said:

       We are going to have insurance for everybody. They can 
     expect to have great health care.
  Yet he nominated Congressman Price, who has spent the past 6 years 
trying to end universal health care coverage by repealing the 
Affordable Care Act.
  President Trump says a lot of things. He tweets his thoughts daily, 
but at this point, instead of listening to what President Trump says, 
we should pay attention to what he does. By nominating Congressman 
Price, the President demonstrated he does not intend to protect access 
to quality, affordable health care for all Americans--not by protecting 
Medicare and Medicaid, not by protecting health insurance fraud. 
President Trump's health care agenda would have far-reaching, negative, 
painful consequences for tens of thousands of people in Hawaii and 
millions all across the country. Maybe President Trump should tweet 
less and listen more.
  Over the past few months, I have heard from thousands of Hawaii 
residents concerned that they will no longer be able to afford health 
care if President Trump succeeds in repealing the Affordable Care Act 
and privatizing Medicare. I would like to read a few of the messages I 
have received.
  Catherine from Honolulu wrote:

       I am writing to you to express serious concern over the 
     repealing of ACA and other health insurance changes. As a 
     working (teacher) and single parent of two young children I 
     am very afraid for our future. I am afraid my insurance will 
     not cover my psoriatic arthritis if I change jobs, they 
     change companies, or for some reason I should lose my job or 
     coverage. My medicine without insurance would cost more than 
     my mortgage payment, and would thus be cost prohibitive.
       If I don't have my medication I would be in so much pain. I 
     would be unable to work and would therefore lose my insurance 
     which would mean I would never be able to get coverage 
     because of a preexisting condition. I am certain there are 
     many other people out there with similar stories.
       Please do everything you can to make sure this scenario 
     doesn't happen to us. If there is anything I can do, please 
     don't hesitate to let me know. I just don't know who else to 
     turn to.

  Next, I would like to share a note I received from Julie from 
Papaaloa on the Big Island.

       My husband and I are on Medicare, together with a 
     supplemental plan. We are totally dependent on Social 
     Security for our income and Medicare for our health plan. 
     Many millions of seniors are in the same situation as we are. 
     Please continue to fight for us as this abominable horror of 
     an administration goes forward. I shudder to think what would 
     happen if these programs are repealed or privatized.

  Finally, I would like to share a heartbreaking story from Desi from 
Mililani on Oahu. Desi is an extremely hard-working, self-employed 
teacher and the single mother of two daughters. Her youngest daughter 
has Down syndrome, autism, and is hearing impaired. Desi is self-
employed because she needs the flexibility to work and care for her 
daughter. This year, as a sole proprietor over the age of 55, Desi's 
premiums for her HMO plan rose to over $680 per month for 2016.
  In a letter she wrote to me, Desi said:

       Paying this high monthly premium was no longer possible and 
     was jeopardizing our family's ability to pay our mortgage, 
     food, and other essentials alone.

  Desi successfully found a cheaper plan in the ACA marketplace for 
2017. In her letter she went on to say:

       If the ACA is successfully repealed, we will no longer be 
     able to afford medical coverage! Families like ours are the 
     reasons why it is so important to defend the Affordable Care 
     Act.

  These letters and stories demonstrate what is at stake for our 
200,000 seniors on Medicare in Hawaii and millions more across the 
country. That is why I will continue to fight tooth and nail to prevent 
any cuts that would jeopardize our crucial social safety net progress.
  The fight has already begun. Last month, Republicans in Congress 
pushed through a partisan budget resolution that would give them the 
tools they need to repeal the Affordable Care Act. This assault on the 
Affordable Care Act is also an assault on Medicare and Medicaid because 
the ACA strengthened Medicare and Medicaid through, for example, 
closing the prescription doughnut hole and providing free preventive 
checkups for seniors. This is why I joined with my colleague from 
Indiana, Senator Donnelly, to introduce an amendment that would block 
congressional Republicans from privatizing Medicare or increasing 
eligibility standards for Medicare. It would also prevent changes that 
reduce funding for Medicaid.
  During the debate on our amendment, one of our Republican colleagues, 
in his opposition to the amendment, basically made our point for us. He 
said something to the effect of, a vote in favor of our amendment to 
protect Medicare and Medicaid is a vote against repealing the 
Affordable Care Act. Exactly. In the end, it was a close vote on our 
amendment. While the amendment lost, I was encouraged that two of our 
Republican colleagues, Senator Heller of Nevada and Senator Collins of 
Maine, voted in favor of the amendment.
  In the coming weeks and months, there will be other battles to 
protect Medicare and Medicaid. It is going to be a daunting fight, but 
I am not going to shy away from it. I am going to do whatever I can, 
whenever I can to protect the Affordable Care Act, Medicare, and 
Medicaid. In this fight, I strongly urge my colleagues to vote no on 
Tom Price's nomination to serve as Secretary of Health and Human 
Services. Tom Price is not the champion that millions of people in our 
country are counting on to protect their health and welfare.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MENENDEZ. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.

[[Page S1029]]

  The PRESIDING OFFICER. Without objection, it is so ordered.