[Congressional Record Volume 163, Number 23 (Thursday, February 9, 2017)]
[Senate]
[Pages S1029-S1048]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Travel Ban Decision

  Mr. MENENDEZ. Mr. President, I have come to the floor to speak on the 
nomination of Congressman Price to be the Secretary of Health and Human 
Services. But before I do, I must speak to the decision that the U.S. 
Court of Appeals for the Ninth Circuit just decided in the case of the 
State of Washington and the State of Minnesota v. the President and the 
Department of Homeland Security.
  I am pleased to see that the courts of the United States are still 
part of the separate coequal branch of government that the Founders 
dictated when they ultimately created an ingenious document, the 
Constitution of the United States, which served the Nation well for so 
long, even though it seems the President may need a review of history 
and an understanding of the Constitution as it relates to the separate 
coequal branches of government, because he seems to be willing to try 
to disparage the judiciary in an effort to try to either effect their 
decisionmaking or to call into question the legality of their decisions 
or the righteousness of their decisions.
  I am glad to see that that has not affected our judicial system. I 
just want to read some elements of the court's decision, which I think 
are pretty extraordinary. Of course, this is far from a final decision 
on the merits, but it was on a motion for a stay of the order of the 
district court that said, basically, that the Muslim ban could not be 
continued to be enforced.
  The court said--and I am quoting--in a unanimous opinion which speaks 
very powerfully to their decision:

       We therefore conclude that the States--

  Meaning the State that brought forth--Washington, as well as the 
State of Minnesota--

     that the States have alleged harms to their proprietary 
     interests traceable to the Executive Order. The necessary 
     connection can be drawn in at most two very logical steps: 
     (1) the Executive Order prevents nationals of seven countries 
     from entering Washington and Minnesota; (2) as a result, some 
     of these people will not enter state universities, some of 
     them will not join those universities as faculty, some will 
     be prevented from performing research, and some will not be 
     permitted to return if they leave.
       We therefore hold that the States have standing.

  That was one of the critical legal bars.
  Secondly, they opined on the reviewability of the Executive order. 
This is, I think, extraordinarily important. The Court went on to say--
I am paraphrasing at this point: Yes, the courts owe substantial 
deference to the immigration and national security policy 
determinations of the political branches--legislative and executive. 
But it went further to say:

       Instead, the Government has taken the position--

  This is on behalf of the executive branch--

     that the President's decisions about immigration policy, 
     particularly when motivated by national security concerns, 
     are unreviewable--

  Unreviewable--

     even if those actions potentially contravene constitutional 
     rights and protections. The Government indeed asserts that it 
     violates separation of powers for the judiciary to entertain 
     a constitutional challenge to executive actions such as this 
     one.

  I did not really capture that the government had made that argument. 
But that is an extraordinary argument. The court went on to say:

       There is no precedent to support this claimed 
     unreviewability, which runs contrary to the fundamental 
     structure of our constitutional democracy. Within our system, 
     it is the role of the judiciary to interpret the law, a duty 
     that will sometimes require the ``[r]esolution of litigation 
     challenging the constitutional authority of one of the three 
     branches.'' We are called upon to perform that duty in this 
     case.

  Further they say: ``Although our jurisprudence has long counseled 
deference to the political branches on matters of immigration and 
national security, neither the Supreme Court nor our court has ever 
held that courts lack the authority to review executive action in those 
arenas for compliance with the Constitution.''
  That is an extraordinary set of statements that the government made, 
saying that the President's actions are unreviewable in this regard.
  They further go on to say: ``Nonetheless, `courts are not powerless 
to review the political branches' actions' with respect to matters of 
national security.''
  It would indeed be ironic if, in the name of national defense, we 
would sanction the subversion of one of those liberties which make the 
defense of the Nation worthwhile.
  Well, I fully agreed with the circuit court's determination in that 
regard.
  It goes on to say: ``In short, although courts owe considerable 
deference to the President's policy determinations with respect to 
immigration and national security, it is beyond question that the 
Federal judiciary retains the authority to adjudicate constitutional 
challenges to executive action.''
  Well, all I can say is, thank God. Thank God that the courts of the 
United States feel that they are not controlled by the executive branch 
in pursuing the decisions that are made. This is a great day for 
democracy in our country and for the preservation of the separation of 
powers. This is a great day, I think, from my own perspective, that a 
ban that does not help the United States but harms us and is against 
every fiber of our being and the nature of the history of our Nation, 
which was founded by those fleeing religious persecution--ultimately, 
today, we restore that sense of our history, and we restore who we are 
as a nation both at home and across the world.
  But today's decisions in this regard are also important as we 
consider the nomination of Congressman Price, so I want to rise today, 
along with so many of my colleagues, to voice my strong opposition to 
the confirmation of Congressman Price to be the Secretary of Health and 
Human Services.
  I am deeply concerned about his views on what is the core mission of 
Health and Human Services, not only his career-long opposition to the 
very existence of Medicaid and Medicare but his wavering fidelity in 
science and his regressive views of women's health care and the social 
safety net.
  The Secretary of Health and Human Services is one of the few Cabinet 
positions that affect virtually every single man, woman, and child in 
America. It affects the health care of 56 million seniors on Medicare, 
of 74 million low-income individuals and children on Medicaid, and of 
12 million Americans who have enrolled in the Affordable Care Act 
coverage. But more than that, the Department of Health and Human 
Services is home to the world's leading institutions of research at the 
National Institutes of Health, of advancing public health and 
epidemiology at the Centers for Disease Control and Prevention, known 
worldwide, of working to ensure that we have access to the most 
advanced, most effective, and safest medications at the Food and Drug 
Administration, and many other critical departments and agencies that 
we as Americans rely on.
  Many of our Republican colleagues have pointed out that Congressman 
Price's history as an orthopedic surgeon is enough evidence that he is 
someone who should be in charge of the Department of Health and Human 
Services. I can't speak to his credentials and qualifications in the 
operating room, but I do have a constitutional obligation to speak 
about his credentials and qualifications to be the Secretary of Health 
and Human Services. So I can say without hesitation that his career in 
Congress and his positions on key issues of policy have proven to me 
that he is not the right person for the job.
  Throughout his time as a congressman--most recently as the chairman 
of the House Budget Committee and during his confirmation process 
through the Senate Finance Committee, on which I am privileged to 
serve--it has become abundantly clear that Congressman Price views 
patients, including seniors on Medicare and even those with private 
employer coverage, as nothing more than a source of revenue or a budget 
line item. The characteristics that had defined Congressman Price's 
career run contrary--contrary--to the fundamental mission of the 
Department of Health and Human Services, and it should be a cause for 
concern across the aisle and across the country.
  Despite the alternative reality portrayed during his confirmation 
hearings in both the Finance Committee and the Health, Education, 
Labor, and Pensions Committee, Congressman Price's vision for our 
Nation's health

[[Page S1030]]

care system has been laid bare for the public to see for years. All one 
has to do is look at the legislation he has introduced and the radical 
budget proposals he, along with Speaker Ryan, has been pushing through 
the House of Representatives. Let's look at some of them.
  Let's start by taking a look at his plan for Medicare, which is, by 
all intents and purposes, a plan to fundamentally end Medicare as we 
know it, end Medicare as we know it. Despite Congressman Price's 
seeming denial of this fact, when I asked him about it directly during 
his confirmation hearing, there is absolutely no other way to 
characterize his plan: It ends Medicare as we know it.
  Currently and for more than 50 years, Medicare has provided a 
guarantee--a guarantee; that word is critical--to seniors that they 
will have coverage, access to care, and the ability to rest assured 
that their health care needs will be taken care of. It is a system into 
which they paid their entire working lives and a compact that has been 
made with the Federal Government that we will uphold our end of the 
deal and ensure that they have quality coverage to stay healthy.
  The Affordable Care Act, despite the years-long gnashing of teeth and 
fake tears shed by some of my Republican colleagues, has improved upon 
this deal and made Medicare stronger. It has extended the life of the 
Medicare trust fund by more than a decade. It has saved seniors $27 
billion on prescription drugs and last year alone provided more than 40 
million seniors access to no-cost preventive services--no-cost 
preventive services. In my home State of New Jersey last year, seniors 
on Medicare saved more than $263 million on prescription drugs, and 
nearly 1 million seniors were able to receive free preventive services.
  Additionally, thanks to the law's health care delivery system 
reforms, we are seeing far fewer hospital-acquired conditions and 
greater coordination of care that has resulted in a healthier 
population and a more efficient health care delivery system. That 
reality stands in stark contrast to Tom Price's vision of what he 
thinks Medicare should be and in stark contrast with the vast majority 
of seniors who want to protect the program for their loved ones and for 
themselves.
  Unfortunately, President Trump, who himself spent an entire campaign 
promising that he is ``not going to cut Medicare or Medicaid,'' 
nominated a leading member of this radical anti-Medicare movement to 
impose devastating cuts to the program, force seniors to pay higher 
costs, and lower the quality of care throughout the health care system.
  Congressman Price's destructive legislative history on Medicare does 
not lie. It is there. It is in the record. It is there for anybody who 
wants to see it. It tells a stark truth about his desire to increase 
the eligibility age, about ending the guarantee--the guarantee of 
coverage.
  You know, that is why we call it an entitlement. If you meet the 
criteria under the law, you are entitled to those health care services; 
you are guaranteed those health care services. But his whole 
legislative history is about ending the guarantee of coverage we 
currently have and replacing it with the possibility of coverage. The 
difference between a guarantee and a possibility is a far, far too 
significant gulf to be able to overcome--but only if you can afford the 
difference between Congressman Price's coupon and the actual cost of 
care under his vision. The Congressional Budget Office has shown that 
this will unquestionably increase costs for seniors.
  His dark view of Medicare, that--to quote Congressman Price--
``nothing has a greater negative impact on . . . health care than the 
Federal Government's intrusion . . . through Medicare''--that is an 
extraordinary statement. I am going to quote it again. ``Nothing has a 
greater negative impact on . . . health care than the Federal 
Government's intrusion''--intrusion, mind you--``through Medicare.'' 
That is understandably causing a lot of concern back home in New 
Jersey. Many people have been calling and writing me to express their 
thoughts.
  Dr. William Thar of Summit, NJ, himself a retired physician of more 
than 50 years, wrote in that Price's ``willingness to privatize 
Medicare indicates a lack of concern for Americans who need health care 
coverage.''
  I also heard from Cara Davis of Glen Ridge, NJ, who wrote in on 
behalf of her uncle, who has end-stage renal disease and requires 
dialysis, saying, ``If [Price] and the Trump administration 
successfully move Medicare to a voucher program''--again, that is 
different from a guarantee--``I fear that my uncle will not be able to 
afford the necessary coverage for his dialysis treatments.''
  For me, the battle to protect Medicare is more than a political 
battle; it is more than a theoretical battle; it is a deeply personal 
battle to protect a program that allows seniors to live with dignity 
during the twilight of their lives.
  My personal connection to the value of the Medicare Program stems not 
from my experience but that of my late mother, Evangelina. For 18 long, 
difficult years, my mother suffered from Alzheimer's disease. During 
those years, we watched as this strong, courageous woman drifted 
further and further away from us. After her diagnosis, I, like so many 
families across our Nation, hoped for the best, but we expected the 
worst. And while there were times early on when she seemed just fine, 
those times turned into lost moments, and those lost moments eventually 
lasted forever.
  At this point, I had to wonder if all the moments of her life--her 
struggle to flee her homeland and seek freedom in the United States, of 
my youth and all of the time spent together--were still in there, still 
with her somehow, or whether those memories were lost forever.
  As her illness progressed, she lost her cognitive abilities, and 
eventually we had to admit to ourselves that our mother was no longer 
with us, until, mercifully, the Good Lord took her, and the long 
goodbye came to an end.
  Throughout this experience, throughout her struggle of fighting back 
against the progress of Alzheimer's, our family knew that Medicare 
would be there to provide her with access to the health care she 
needed. I learned that Medicare wasn't just there for her; it was there 
for the rest of us, too, providing her with access to care, while 
granting us the ability to focus on making the most of the limited time 
we had together.
  Medicare was there to meet the challenges of her illness as well as 
the intergenerational challenges that arise when caring for a parent in 
the twilight of their lives while simultaneously working to put your 
own children through college. I lived it, I saw it, and I understand 
it. My mother would not have lived with the dignity that she deserved 
in the twilight of her life after working a lifetime and paying for 
Medicare, but for Medicare as a guarantee.
  I know all too well that an underfunded voucher would undermine 
Medicare's ability to live up to the responsibility that we have to 
care for one another and to provide that same dignity to seniors as 
they and their families prepare to say good-bye for the last time.
  That is why I couldn't agree with Dr. Thar or Ms. Davis more, and I 
share their concerns about what Congressman Price has in mind, despite 
the repeated pledges from President Trump to the contrary for the 
future of Medicare.
  My concerns about Congressman Price don't stop with his desires to 
end Medicare, because those desires also extend to end Medicaid, as we 
know it, as well. His desires to end Medicaid are really a two-front 
war. The first is to repeal the highly successful expansion of Medicaid 
provided for under the Affordable Care Act, which has extended 
lifesaving care and coverage to over 200,000 New Jerseyans, many of 
whom are covered for the first time.
  Nationwide, the Affordable Care Act's Medicaid expansion is one of 
the most successful aspects of health reform. Currently, 32 States and 
the District of Columbia have taken advantage of Medicaid expansion, 
making coverage available to 11 million people, because they recognize 
the value in providing people with coverage, with access to preventive 
care, with the ability to manage chronic conditions--all of which lead 
to a healthier, more productive population.
  The second is to eviscerate funding from Medicaid by taking away the 
current funding structure and replacing it

[[Page S1031]]

with a block grant or some other form of arbitrary underfunding that 
they mask as allowing for ``state flexibility.''
  We have seen this picture before. Take away an obligation, an 
entitlement, move it to a block grant, underfund it, and ultimately 
slay that opportunity for people to have a guarantee.
  We all know what is meant when Congressman Price talks about State 
flexibility. He means the flexibility to slash enrollment and deny 
people access to coverage. He means forcing States to choose between 
cutting payments to doctors for treating low-income Medicaid patients 
or cutting other vital State services like education and 
infrastructure. He means unraveling Medicaid benefits so that for those 
few still able to enroll, they won't have adequate coverage for most of 
the health care issues they need treated. It means simply putting his 
radical ideological opposition of the Federal Government being involved 
in health care ahead of the lives of millions of men, women, children, 
and seniors and the disabled across the Nation. That is truly 
remarkable for a man who took the oath to ``first do no harm.''
  As with his views on Medicare, his desire to end Medicaid expansion 
has caused a lot of people from New Jersey to write me about their 
concerns. I would ask Congressman Price and other like-minded 
Republicans to consider carefully the stress and potentially 
devastating impacts these policies have on real people--real people 
like Jolie Bonnette from Brick, NJ, who wrote to me about how she was 
able to finally gain access to health coverage, thanks to Medicaid 
expansion. She wrote: ``Without this care and my Medicaid medication 
coverage, I would have died, because I would have no access to doctors 
or medications.''
  Jill Stasium from Jersey City wrote in saying that thanks to 
Medicaid, ``[I] have been receiving top quality health care for the 
first time in my life.''
  I ask my colleagues how the mantra of State flexibility, which is 
just another way of ensuring funding for Medicaid is slashed and access 
to life-enhancing treatment is denied, is going to impact Ms. Bonnette 
and Ms. Stasium. I ask how they can justify taking away their 
coverage--coverage that has provided, for the first time in their 
lives, not only the peace of mind of having health insurance, but also 
it is the first time they have had regular access to the doctors and 
medication necessary to live.
  How do we justify that? We can't do it on the basis of State 
flexibility and surely not on the basis of a 6-year-long political 
vendetta against the Affordable Care Act. Yet somehow, with this 
nominee and this Republican Congress, this is something that we are all 
going to have to justify to every single one of our constituents.
  Unfortunately, the list of destructive policies supported by Tom 
Price doesn't end with his desires to end Medicare as we know it and to 
dismantle Medicaid. This is also not surprising given the Republican 
agenda for the last 7 years to repeal the Affordable Care Act, throw 
millions of Americans off their health insurance, and return us to the 
dark ages where insurance companies have free rein to deny coverage for 
preexisting conditions, cancel coverage after a devastating diagnosis, 
limit what benefits are covered, and discriminate against women. That 
is what the marketplace was before the Affordable Care Act.
  Now, this is not new. The Republicans have been trying to repeal 
health care reform and deny millions of Americans health care coverage 
since before the law was even passed. It has sadly become dogma for 
Republicans--dogma to repeal ObamaCare, which they voted to do 60-some 
odd times. But now, after 7 long years, the chickens have come home to 
roost.
  They now have the ability to live up to their dream of repealing the 
law, but are starting to realize what the implications are--starting to 
realize that real people will face real life-and-death situations that 
result from Republicans putting partisan ideology ahead of the well-
being of their constituents, starting to realize that on-the-ground 
implications of the Affordable Care Act mean real people receiving real 
treatment for real health conditions.
  One of these people is David Konopacki from South River, NJ. David is 
a diabetic who, thanks to the Affordable Care Act, no longer has to 
choose between paying for college and paying for the medication he 
needs. David put it so succinctly: ``The Affordable Care Act is 
literally the difference between life and death for so many.''
  The same holds true for Mrs. Lori Wilson from Morristown, NJ. Her 
son, like David, has diabetes and has had diabetes since birth. As she 
writes, her son ``is just one citizen among millions whose life, 
literally, depends on access'' to care, and under the Price Republican 
plan, that access is denied.
  I mentioned that repealing the Affordable Care Act means reinstating 
the ability of insurance companies to deny coverage for preexisting 
conditions. As diabetics, these folks would find it impossible--
certainly, financially impossible--to find coverage that would allow 
them to get their medications and see their physicians. That is what is 
shocking about Tom Price. Despite knowing full well that the ban on 
preexisting conditions is one of the most widely supported and 
critically important aspects of the Affordable Care Act, he considers 
it to be a ``terrible idea.''
  Let me say that again. Tom Price's views on health care are so 
radical that he thinks insuring people with preexisting health 
conditions--like diabetes from birth--and guaranteed access to coverage 
is a ``terrible idea.'' That is an extremely callous way to put 
ideology above people's lives.
  Let me close on this. I have spoken about the many reasons I am 
opposed to Congressman Price's nomination to run the Department of 
Health and Human Services, including his long-held opposition to 
Medicare. But above all else, one of the reasons I am opposing 
Congressman Price is because of the seeming lack of fidelity to the one 
thing that runs at the heart of health care and the heart of the Health 
and Human Services Department, which is science.
  For years Congressman Price has been a member of a group called the 
Association of American Physicians and Surgeons. This is a group of so-
called doctors who push dangerous conspiracy theories and widely 
debunked claims that have serious implications for the public health. 
The prime example of this is their assertion, despite all evidence to 
the contrary, that vaccines aren't safe and that they cause autism. 
Nothing could be further from the truth. In fact, this week I received 
a letter signed by 350 organizations, including several from New Jersey 
and several representing the autism community, restating the fact that 
``vaccines are the safest and most cost-effective way of preventing 
disease, disability, and death'' but unfortunately, because of 
widespread misinformation, the United States ``still witnesses 
outbreaks of vaccine-preventable diseases,'' including the biggest 
outbreak of whooping cough since 1955, and the fact that we have 
upwards of 50,000 deaths a year from complications of vaccine-
preventable influenza.
  While Tom Price, personally and as a physician, might understand 
these basic facts, what worries me most is that the President of the 
United States does not, posting on Twitter for years that vaccines are 
dangerous and appointing anti-vaccine conspiracy theorists to critical 
posts in the White House and possibly to key positions within the 
Department of Health and Human Services.
  When I asked Congressman Price directly about his fidelity to science 
and his willingness to stand up to the President about adhering to 
science as the guiding principle at the Department of Health and Human 
Services, his answers were far less than satisfactory, and he left me 
with the impression that he is unwilling to counter the President when 
he touts untrue claims about health care and ensure that personnel 
within HHS are stewards of sound science and not ideology.
  For the Department that oversees the Centers for Disease Control, 
which is the global beacon of health care that must be focused on 
science, that is simply incredible.
  I rise today to give my voice in opposition to Nominee Tom Price as 
the next Secretary of Health and Human Services, and I rise to be the 
voice of Dr. William Thar, Cara Davis, Jolie Bonnette, Jill Stasium, 
David Konopacki, Lori Wilson and the over 6,000 New Jerseyans who have 
called

[[Page S1032]]

and emailed me to vote in opposition to Tom Price's nomination. I will 
do that when it comes time for a vote.
  With that, I yield the floor.
  Mr. LEAHY. Mr. President, the Cabinet nomination we are considering 
today is one of great consequence. The reach of the Department of 
Health and Human Services is extensive, with direct and indirect 
consequences for the health and well-being of all Americans. Like many 
other nominations that this body is rushing to confirm, Representative 
Price has not satisfied the many questions that have been raised about 
his ability to defend programs that are vital to so many Americans. In 
fact, his record in Congress runs counter to these goals.
  I have always believed that all Americans deserve access to quality, 
affordable health care. We made a tremendous step in this direction 
through the Affordable Care Act, ACA, which has extended health 
insurance coverage to more than 20 million Americans and their families 
through cancer screenings, immunizations, and preventative health care 
at little or no cost-share. The law has ensured that vulnerable 
populations have access to quality care through State expansions of 
Medicaid. The ACA stopped insurance companies from discriminating 
against women, seniors, and individuals with preexisting conditions. 
And it has already saved taxpayers billions in Federal health care 
costs, while bolstering reserves for our Nation's Medicare and Social 
Security Trust funds.
  Unfortunately, Representative Price does not see it this way. As one 
of the first lawmakers to draft legislation calling for the full repeal 
of the ACA, Representative Price believes that health care should once 
again be under the largely unfettered control of big businesses and 
insurance companies. He may say that he wants more Americans to have 
``access to affordable coverage,'' but his record in the House shows 
otherwise.
  It is not only the Affordable Care Act that Representative Price has 
put in the crosshairs, but virtually every Federal, health program. 
Representative Price's track record in opposing programs like Medicaid, 
Medicare, and Social Security is extensive. As Congressman, he has 
proposed dissolving or block granting Medicaid and replacing Medicare 
with vouchers, unadjusted for income, for consumers to purchase private 
plans on the market. In November, he released an agenda proposing 
across-the-board cuts to Medicare, Medicaid, and Social Security. He 
has also long fought against women's healthcare and access to family 
planning services. And he has advocated banning abortions and 
abolishing funding for Planned Parenthood, which would make it far more 
difficult for women to have access to health care.
  Medicare, Social Security, and Medicaid are crucially important to 
patients and their families. Medicaid provides vulnerable populations, 
including children, with essential and comprehensive health benefits, 
like mental health care and substance abuse treatment, which are 
required to be covered by Medicaid under the ACA. And for decades, 
Medicare and Social Security have offered health care protections to 
low-income Americans and seniors, offering guaranteed resources in 
retirement. These are earned benefits that hard-working Americans have 
paid into throughout their lives. It is only fair that these people 
should expect to have these resources when they enter retirement.
  We cannot deny the vital health protections of Medicaid, Medicare, 
and Social Security to our Nation's families. And I cannot in good 
conscience support someone who does not share this game goal. Lives, 
literally, are at stake.
  I am also deeply concerned about allegations of Representative 
Price's violation of the STOCK Act, which prohibits Members of Congress 
from making investment decisions based on information they receive as a 
result of their roles in Congress. Serious questions of his all-too-
coincidental trading with medical companies, after introducing 
legislation that supports these very companies, are troubling, and 
signal that this nominee is unfit to lead the very agency responsible 
for protecting the health of Americans.
  I am glad the minority members of the Senate Finance Committee 
refused to join the business meeting scheduled to move Representative 
Price's nomination last month. There remain serious questions relating 
to potential conflicts he would have as Secretary. Despite these 
concerns, Republicans on the Finance Committee made the unprecedented 
decision to change the rules and confirm Congressman Price without even 
one Democratic member present. This move runs counter to the majority's 
own rules. But more importantly, it contradicts what we stand for in 
promoting the interests of Americans as their elected officials.
  If confirmed, there are valid reasons for the American people to be 
concerned that Representative Price's agenda will make its way into the 
Department of Health and Human Services, and Americans will suffer for 
that. It is the responsibility of this agency to uphold and protect the 
well-being of the people of this great and good country, and it would 
be counter to this goal to allow someone like Representative Price to 
oversee such efforts. That is why I will strongly oppose his 
nomination, and I encourage all in the Senate to do the same.
  Mr. UDALL. Mr. President, I rise today to oppose the nomination of 
Congressman Tom Price to be Secretary of the Department of Health and 
Human Services.
  I oppose the nomination because Mr. Price wants to dismantle 
America's health care system--with no guarantee that Americans will 
continue to receive the health care coverage they now enjoy. He is part 
of the Trump ``repeal with no plan'' contingent.
  In my view, any repeal of the Affordable Care Act must be coupled 
with a program that has rock solid guarantees to the American public, 
guarantees that Americans will not lose the health care benefits they 
now have.
  Further, I oppose any vote on Mr. Price's nomination until there has 
been a full investigation and disclosure to the American public of his 
conflicts of interest. Mr. Price has invested in companies just prior 
to introducing legislation that would benefit those very companies. 
Before we vote on Mr. Price, the American public needs a full 
accounting whether his investments comply with Federal insider trading 
laws and ethical provisions.
  The President's first order of business was an attack on Americans' 
health care. His Executive order gives Federal agencies broad authority 
to grant waivers, exemptions, and delays of provisions in the ACA. As 
Secretary of Health and Human Services, Mr. Price will be given rein 
not only to grant waivers but to not enforce key ACA provisions and to 
pass regulations that undercut ACA protections. For example, 
undermining the individual mandate--a key target of Mr. Price's--could 
lead to collapse of the individual health insurance market and drive up 
premiums for everyone.
  The ACA has resulted in the broadest health care coverage Americans 
have ever known. Now over 91 percent of Americans have health 
insurance.
  In my own State of New Mexico, the number of uninsured has dropped by 
over 50 percent. New Mexico is not a wealthy State. We had one of the 
highest rates of uninsured in the country before the ACA--19.6 percent. 
That's almost one in five people. Now, only 8.9 percent of New Mexicans 
do not have insurance. This is still too high, but it is a big 
improvement.
  Americans strongly support ACA protections. Almost 70 percent of 
Americans think insurance companies should not be able to deny 
insurance because of a preexisting condition. Eighty-five percent of 
Americans want their young adult children to be able to get coverage on 
their insurance policies. Eighty-three percent think preventative 
services should be free.
  The Republicans and Mr. Price have no plan to make sure Americans do 
not lose these rights and benefit.
  Now, the ACA is not perfect. We all know this. It needs improvement. 
It needs work. But the solution is not to throw the health care system 
into chaos with no plan. The solution is to work together on a 
bipartisan basis and fix the ACA's problems.
  Hundreds of my constituents have called and written asking me to 
protect the ACA. New Mexicans are scared--really scared--that their 
health care will be taken away. People are scared their health is in 
jeopardy. For some, they are scared their lives will be put at risk.

[[Page S1033]]

  I am angry that the President, Mr. Price, and the Republicans have 
created so much fear and worry among my constituents and around the 
Nation. None of them has to worry whether their children will get the 
health care they need. My constituents now do.
  Kevin, from Albuquerque, now has to worry whether his 33-year-old 
daughter Amber will get the health care she needs. Amber has multiple 
sclerosis. That is a tough disease. I talked about Amber once before 
here, and her story bears retelling.
  Amber's annual medical costs are high. Her medications alone are 
$60,000 a year. Her doctor visits and MRIs run into the thousands of 
dollars.
  But Amber now has health insurance through the open market thanks to 
the ACA. And, thanks to the ACA, she is healthy. She works. She leads a 
productive life.
  Without the ACA, Kevin worries his daughter will be kicked off her 
health insurance plan because her medical expenses are so high and that 
she will not be able to get new health insurance--because of her 
preexisting MS. For Amber and Kevin, the ACA's protections mean 
everything.
  There are literally hundreds of thousands of New Mexicans and 
millions of Americans like Amber. This one ACA provision--prohibiting 
discrimination based on preexisting illness--protects an estimated 
861,000 New Mexicans and 134 million Americans. If we ourselves don't 
have a serious illness like Amber, we have a family member or friend 
who does.
  Same with people who have high medical costs. These are the people 
who need medical care the most. The ACA provision--prohibiting lifetime 
benefit limits--protects an estimated 555,000 New Mexicans and 105 
million Americans.
  Why is there even any discussion about jeopardizing millions of 
Americans' health care?
  The ACA saves lives. It saved Mike's life. Mike and his wife, Pam, 
are from Placitas, NM. Before the ACA, they didn't have insurance. They 
couldn't afford it and probably couldn't get it for Pam because she had 
a preexisting illness.
  As soon as they could, they signed up for an insurance plan under the 
ACA. Using their new preventive care services, they found out Mike had 
an aggressive form of cancer. Thankfully, they caught it early. Mike 
was treated at the University of New Mexico Cancer Center and is cured.
  Pam says there is ``no question'' that the ACA saved her husband's 
life.
  Hundreds of thousands of New Mexicans and millions of Americans 
benefit because the ACA requires health insurance companies to provide 
free preventatives services. It is well documented that such services 
prevent illness, save lives, and save money in the long run.
  I am also concerned about the impact ACA repeal would have in Indian 
Country. During his confirmation hearings, Congressman Price was asked 
specifically about the devastating consequences Medicaid expansion 
repeal would have on Indian health providers. These providers depend 
heavily on this Federal funding to provide lifesaving services to our 
Native communities. Any reduction in Federal funding to these 
facilities would be unconscionable.
  But Congressman Price has a clear record of voting to support the 
elimination of the Medicaid expansion and, when asked directly, could 
offer no solution for making Indian Country whole if this funding were 
to be cut. Nothing in his hearing or written answers has assured me 
that Congressman Price intends to protect Native communities from the 
negative impact of ACA repeal.
  And, finally, ACA repeal would be devastating to my State's economy. 
That is what a Ph.D. economist from New Mexico State University told 
the New Mexico Legislature last week. Dr. Jim Peach said ACA repeal 
would be ``devastating'' to our State.
  As I said, New Mexico is not a wealthy State. We have one of the 
highest unemployment rates in the country, at 6.6 percent.
  But the ACA has been an economic boon for us. Seven of the 10 
fastest-growing job categories in New Mexico are in health care. In 
fact, boosts from health care and tourism actually led to positive job 
growth for the last 2 months. So health care jobs are of critical 
importance in New Mexico.
  But, if the ACA is repealed, it is estimated New Mexico could lose 
between 19,000 and 32,000 jobs. I can tell you right now New Mexico 
cannot take that kind of hit in its employment numbers.
  And, the loss in spending in New Mexico would be astronomical.
  ACA repeal would mean a loss of $93 million in Federal marketplace 
spending in 2019 in New Mexico and $1 billion between 2019 and 2028.
  It would mean a loss of $2.2 billion in Federal Medicaid funding in 
2019 and almost $27 billion between 2019 and 2028.
  This hit to our economy would be immediate and would be sustained. 
Tax revenues would decrease. And the New Mexico legislature is 
struggling mightily now how to balance the State budget.
  The fact is no State budget is ready to take on the extra load if the 
ACA is repealed and health care gets pushed back to the States. We will 
go back to the days of no care, uncompensated care, and use of 
taxpayer-subsidized ER services as a last resort.
  But Mr. Price and the Republicans are not talking about any of the 
damage in human or fiscal terms if the ACA is repealed.
  In fact, they are already moving to undermine the Affordable Care 
Act, roll back its protections, reduce assistance to families, create 
chaos in the insurance markets--by executive action alone.
  President Trump's Executive order directed his government not to 
implement the Affordable Care Act wherever possible under existing law. 
And we cannot be confident they will not bend the law in pursuit of 
this Presidential decree.
  I cannot support a nominee to head our health care system who is not 
firmly committed to maintaining the health care coverage Americans now 
have. And who will not push--and push hard--for the right of every 
American to have health care.
  Finally, I cannot support holding a vote on Mr. Price until all 
financial conflicts of interest of his have been fully vetted and the 
American public knows there has been no violation of law or ethical 
responsibilities.
  Mr. Price is a wealthy man, like so many of Mr. Trump's cabinet 
nominees. And he has tried to increase his wealth by investing in 
health-related companies. It is widely reported--in the Wall Street 
Journal and elsewhere--that Mr. Price has made over $300,000 worth of 
investments in health-related companies--companies that could benefit 
from his legislation.
  We are all familiar with the STOCK Act. It applies directly to us and 
prohibits us from using inside information that we obtain through our 
positions as Members of Congress for personal gain.
  There are serious questions whether Mr. Price's investments ran afoul 
of the STOCK Act.
  I would like to refer to a February 7, 2017, column from the New York 
Times discussing Mr. Price's widely reported investments. So, a first 
example, in March of last year, Congressman Price announced opposition 
to a Medicare measure that would limit the money doctors could make 
from drugs they prescribe their patients. The proposal was meant to 
reduce doctors' financial incentives to prescribe expensive drugs.
  Makes sense--we don't want doctors to prescribe more costly drugs 
because they would personally benefit.
  But, just 1 week later, Mr. Price bought stock in six pharmaceutical 
companies that would benefit if this consumer protection measure were 
defeated.
  And then, at the very same time, those very same companies were 
lobbying Congress to block the measure. And Big Pharma succeeded.
  A second example--last year, he purchased shares in Zimmer Biomet, a 
company that makes hip and knee implants.
  Six days later, he introduced a bill that would have directly helped 
Zimmer. His legislation sought to delay a Federal regulation that would 
have changed payment procedures for Zimmer. In fact, Zimmer was one of 
two companies that would have been hit the hardest by the regulation.
  Mr. Price has said his broker bought the Zimmer stock. But these 
circumstances warrant investigation.

[[Page S1034]]

And, bottom line, Mr. Price is responsible for his investments.
  A third example--last summer, Mr. Price was offered a special deal--
to purchase shares at deeply discounted price from Innate 
Immunotherapeutics, an Australian drug company. He got in at 18 cents a 
share--at a time the stock value was increasing rapidly, rising to more 
than 90 cents a share. The value of his shares rose more than 400 
percent.
  At the same time, Innate Immuno needs Federal Drug Administration 
approval for one of its drugs.
  This deal raises questions whether Mr. Price gained from an 
investment opportunity--unavailable to the public--from a company whose 
profits could be influenced by his political decisions.
  A Cabinet nominee should not come into office under a cloud of 
conflicts. A vote on his nomination before there is full inquiry into 
his investments and ethical behavior is premature.
  For these reasons, I will vote no on the nomination of Mr. Price as 
Secretary of Health and Human Services.
  I ask unanimous consent that the New York Times column I referred to 
be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the New York Times, Feb. 7, 2017]

                   Tom Price, Dr. Personal Enrichment

                          (By David Leonhardt)

       Each year, a publication called Medscape creates a portrait 
     of the medical profession. It surveys thousands of doctors 
     about their job satisfaction, salaries and the like and 
     breaks down the results by specialty, allowing for 
     comparisons between, say, dermatologists and oncologists.
       As I read the most recent survey, I was struck by the 
     answers from orthopedic surgeons. They are the highest-paid 
     doctors, with an average salary of $443,000 in 2015--which, 
     coincidentally, was almost the exact cutoff for the famed top 
     1 percent of the income distribution.
       Yet many orthopedists are not happy with their pay. Only 44 
     percent feel ``fairly compensated,'' a smaller share than in 
     almost every other specialty. A lot of orthopedists aren't 
     even happy being doctors. Just 49 percent say they would go 
     into medicine if they had to make the decision again, 
     compared with 64 percent of all doctors.
       I know that many orthopedists have a very different view: 
     They take pride in helping patients and feel fortunate to 
     enjoy comfortable lives. But despite those doctors, it's 
     clear that orthopedics suffers from a professional culture 
     that does not live up to medicine's highest ideals. Too many 
     orthopedists are rich and think it's an injustice that 
     they're not richer.
       This culture helped shape Dr. Tom Price, the orthopedic 
     surgeon and Georgia congressman who is Donald Trump's nominee 
     for secretary of health and human services.
       Price had a thriving practice near Atlanta before being 
     elected to Congress in 2004. His estimated net worth of more 
     than $10 million (and possibly a lot more) makes him one of 
     the House's wealthier members.
       Yet he hasn't been content to make money in the standard 
     ways. He has also pushed, and crossed, ethical boundaries. 
     Again and again, Price has mingled his power as a congressman 
     with his desire to make money.
       So far, the nominee receiving the most attention is Betsy 
     DeVos, Trump's choice for education secretary, and she 
     definitely deserves scrutiny. Still, I think Democrats have 
     made a mistake focusing so much on her rather than on Price. 
     He could do more damage--and his transgressions are worse 
     than those that have defeated prior nominees.
       Last March, Price announced his opposition to a sensible 
     Medicare proposal to limit the money doctors could make from 
     drugs they prescribe their patients. The proposal was meant 
     to reduce doctors' financial incentives to prescribe 
     expensive drugs. (And, yes, if you're bothered that your 
     doctor has any stake in choosing one drug over another, you 
     should be.)
       One week after Price came out against the proposal, he 
     bought stocks in six pharmaceutical companies that would 
     benefit from its defeat, as Time magazine reported. At the 
     time, those same companies were lobbying Congress to block 
     the change. They succeeded.
       It's a pattern, too. Price has put the interests of drug 
     companies above those of taxpayers and patients--and invested 
     in those drug companies on the side.
       Last year, he also bought shares in Zimmer Biomet, a maker 
     of hip and knee implants. Six days later, according to CNN, 
     he introduced a bill that would that have directly helped 
     Zimmer.
       In his defense, a spokesman for Price has said that his 
     broker bought the Zimmer stock and Price didn't find out 
     until later. That's certainly possible, but still not 
     acceptable. Members of Congress bear responsibility for their 
     personal stock transactions, period.
       A third episode may be the worst. Price accepted a special 
     offer from an Australian drug company to buy discounted 
     shares, as The Wall Street Journal and Kaiser Health News 
     reported.
       He told the Senate that the offer was open to all 
     investors, although fewer than 20 Americans actually received 
     an invitation to buy at the discounted price. The stock has 
     since jumped in value, and Price underreported the worth of 
     his investment in his nomination filings. It was a ``clerical 
     error,'' he says.
       Even without any larger context, his actions are 
     disqualifying. He's repeatedly placed personal enrichment 
     above the credibility of Congress. The behavior is 
     substantially worse than giving money to an illegal immigrant 
     (which defeated a George W. Bush nominee) or failing to pay 
     nanny taxes (which scuffled a Bill Clinton nominee).
       But of course there is a larger context. Price has devoted 
     much of his political career opposing expansion of health 
     insurance. His preferred replacement of Obamacare would 
     reduce health care benefits for sicker, poorer and older 
     Americans.
       His views have a long history within the medical 
     profession. For decades, doctors used their political clout 
     to help block universal health insurance. They offered many 
     rationales, but money was the main reason. Many doctors 
     feared that a less laissez-faire health care system would 
     reduce their pay.
       It's to the great credit of today's doctors that they have 
     moved their lobbying groups away from that position and 
     helped extend insurance to some 20 million people. They 
     understand that some principles matter more than a paycheck.
       Or at least many of them do.

  The PRESIDING OFFICER. The Senator from Washington.
  Ms. CANTWELL. Mr. President, I come to the floor this evening to 
continue my remarks from earlier today in opposition to the nomination 
of Congressman Price to be Secretary of Health and Human Services and 
to continue talking about the Medicaid program.
  My colleague from New Jersey was talking about the affordability of 
health care in general and some of the critique about where we are 
going with health care in the future. That is really what I think the 
next few years here in the Senate are going to be about--the future of 
health care.
  Unfortunately, the nominee before us is more about the past of health 
care, focusing on issues like fee-for-service instead of the patient-
centric health care that we need.
  Earlier today, I was talking about the innovation that is happening 
in Medicaid through the Affordable Care Act and, specifically, what is 
happening in Midwestern States, Eastern States, Southern States, and 
Western States--how the expansion of Medicaid is not just giving more 
people access to health care but how innovative programs that are 
reaching that population are allowing people, instead of going into 
nursing home care and costing States more and having more expense, 
going into community-based care and home-based care that will help us 
keep costs down and give patients what they want: the ability to stay 
at home and have care.
  I also talked about how, on top of the Medicaid expansion, we put a 
program like the Basic Health Plan into place, which drove down the 
costs of premiums for people in that program.
  Through Medicaid, not only have we expanded health insurance by 
helping states cover their citizens, but the uninsured rate has also 
dropped. I mentioned that in our State of Washington, it dropped to 
just 6 percent. Through delivery system reforms, we are also driving a 
better way for us to improve the Medicaid Program.
  Now I want to contrast that to the position of this administration 
and to Congressman Price, because it is a very different view. As I 
said, I think it is a very backwards-looking view about what we need to 
improve our health care system. I want to make sure that our colleagues 
on both sides of the aisle understand this.
  Now, my biggest concern is that the current administration and 
members of that administration are talking about what they want to do 
with Medicaid. I know that Speaker Ryan has said that he would like to 
block-grant Medicaid back to the States. This may sound like some great 
idea until you realize that, right now, Medicaid is already a state 
option. Medicaid is a voluntary program for States to participate in. 
The money goes back to the State based on the need. It is not block-
granted.
  I talked earlier today about when you block-grant it and cap it at a 
certain level, you are asking people to do more with less. Instead of 
addressing their needs and improving the system,

[[Page S1035]]

like I mentioned on rebalancing to community-based care versus nursing 
home care, or making it more affordable like in the Basic Health Plan, 
all you are doing is capping it and continuing to give an amount of 
money that doesn't meet the needs of individual citizens. So I did not 
like the fact that Speaker Ryan seems to be on this parade of saying: 
Let's block-grant Medicaid.

  The reason we came to this is that my dear colleague from Vermont 
came to the Senate floor one night and showed a tweet from--I think it 
was actually then-Candidate Trump, but it might have been President 
Trump--that said: No, I am not touching Medicare or Social Security or 
Medicaid. My colleague from Vermont wanted to know whether the 
President was going to stick to that promise. What has happened since 
then is we have seen that there has been a promise, so to speak, on 
some of these programs, but not on others.
  I know Vice President Pence said that he and Donald Trump will give 
States new freedom and flexibility through block-granting Medicaid. So 
they are for this idea of block-granting Medicaid.
  In fact, White House Counselor Kellyanne Conway said: block-grant 
Medicaid to the States.
  So many on the other side are saying you are going to keep your 
health care; don't worry, it is going to be there for you; no one is 
going to lose it. I guarantee that if we block-grant Medicaid, which is 
the premise that Mr. Price has been rallying on, not just once but many 
times, it is not going to work out for many Washingtonians in my State, 
and it certainly is not going to work out for many people all across 
this country.
  Mr. Price wrote a budget that would block-grant Medicaid. And he 
wrote a bill that would repeal the Medicaid expansion in its entirety 
and repeal all of the Affordable Care Act. So I know for some people, 
as I said, that might sound like giving the States flexibility, but 
right now, that dollar goes up and down based on need. When Medicaid is 
block-granted, you are going to give States a set amount of money and, 
as I said, that set amount of money may not keep pace with the cost of 
care.
  Through Medicaid waivers authorized by Congress and approved by the 
Centers for Medicare and Medicaid Services, States can work with the 
Federal Government to deliver flexibility. I just mentioned two 
programs that are already in the Affordable Care Act.
  Earlier today I mentioned all of the States that were utilizing 
rebalancing programs and the shift they are seeing in keeping people 
out of nursing home care and putting them in community-based services. 
So that is a huge win.
  A number of States have pursued these Medicaid waivers through a 
section of the Social Security Act called 1115. It is really not 
necessary for anybody to know the number, but basically those 
innovations are allowing States to continue to improve the delivery of 
health care. In the State of Washington, that means we are delivering 
better care, better outcomes, at lower cost. That should be our 
target--not taking a hatchet to Medicaid and chopping it and saying we 
are going to give you less and less money.
  We know that our health care delivery system is going to be 
challenged in the future, and we know Mr. Price's budget would cut one-
third of Medicaid funding within 10 years. That is a huge cost to the 
Medicaid program. So what would it mean? It would mean millions of 
Americans would lose their health insurance because States will not 
have the investments to cover them. Uncompensated care will skyrocket, 
and that would really hurt the safety net that hospitals provide. 
People don't go without health care just because Medicaid doesn't cover 
them. They show up in the emergency rooms, they get uncompensated care, 
it is more expensive, or they ignore their health care needs until they 
can absolutely afford it. We are seeing this across America even now. 
We have had physicians tell us stories of people who are just waiting 
until they can afford coverage.
  So that is why it is so important to get affordable coverage like the 
Affordable Care Act has been able to provide and to unleash innovative 
programs within these systems, like the Basic Health Plan that I 
mentioned earlier today, which allows us to buy in bulk, like a Costco 
model. Costco delivers Americans a lot of cheaper products because they 
buy in bulk; it drives down the price. The consumer wins and the 
insurer wins because they know they are going to get big purchases, and 
that provides flexibility. I mentioned how New York has more than 
600,000 people on the Basic Health Plan, and instead of paying a yearly 
premium of about $1,500, they were basically saving about $1,000 or 
more on their annual insurance premiums. Why? Because the State was 
able to offer up a bundle to New York residents and drive down costs. 
That is the kind of flexibility we need in the health care system. We 
don't need to just say we are going to cut one-third over a 10-year 
period of time.
  Let me again contrast this progress with Mr. Price's ideas. 
Congressman Price's budget would cut $1 trillion from States over 10 
years through Medicaid block grants--$1 trillion, leaving States with a 
hole in their budget that I know, if they are like our State and are 
challenged with other issues, they would not be able to cover. The 
notion that block-granting Medicaid and repealing the Medicaid 
expansion is the way forward is absolutely not what the people of 
Washington State think. I am here to represent the viewpoint that 
innovations in the Affordable Care Act are working, and we shouldn't 
just simply block-grant and cut Medicaid.
  So instead of improving the delivery system of health care and 
instead of expanding coverage and giving peace of mind, here is what 
Mr. Price's Medicaid cuts would do, according to some of the 
independent experts who study Medicaid.
  The National Council on Disability says about block grants: ``Older 
Americans and people with disabilities would be at special risk. . . . 
States would face strong financial pressure to reduce services to low-
income seniors and people with disabilities if the Federal Medicaid 
funds were capped.''
  The Center on Budget and Priorities says: ``To compensate for the 
federal Medicaid funding cuts a block grant would institute, states 
would either have to contribute much more of their own funding or, as 
is far more likely, use the greater flexibility the block grant would 
give them to make draconian cuts to eligibility, benefits, and provider 
payments.''
  The Commonwealth Fund says that ``the federal contribution under a 
block grant program would remain the same, or grow only according to a 
present formula, no matter how large the population in need becomes or 
how much a State actually must spend on health care for Medicaid 
recipients.''
  So we can see that people understand that block-granting Medicaid is 
nothing more than a war on Medicaid--nothing more than a war on 
Medicaid.
  That is why I cannot support Mr. Price's nomination. We gave him 
chances in the hearing to talk about why this kind of approach is not 
acceptable and why the programs within the Affordable Care Act that are 
driving down costs, giving people access, making improvements, working 
all across the United States in various parts of our Nation are 
actually the right ways to improve the delivery system, but we couldn't 
get commitments.
  So if my colleagues are being honest with themselves or if they 
actually understand this, they should be very afraid of the notion that 
Mr. Price is putting forward in wanting to block-grant Medicaid. I 
think some of them do understand. It is why the Governor of Nevada, 
Brian Sandoval, and the Governor of Michigan, Rick Snyder, and others, 
are asking Congress to let them keep the Medicaid gains already in the 
Affordable Care Act and not shift those costs to the States.
  So while shifting costs to the States might be exactly what some 
people want to do, this is exactly why we need to fight to make sure 
that the Medicaid expansion remains supported, and that we have the 
right focus moving forward--a delivery system, that is, that works for 
the patients and improves outcome and lowers costs. That is why I 
mentioned two aspects of the Affordable Care Act. We did the Medicaid 
expansion, and then, for a working family just above the Medicaid 
eligibility level, which is 138 percent of the federal poverty level, 
they were able to buy in bulk and get the kind of cost savings in 
health care that, as I said, let more than 600,000 New Yorkers

[[Page S1036]]

sign up for truly affordable health care in impressive numbers.
  So that kind of progress being made in Medicaid and in the income 
levels just above it is exactly the kind of progress we must keep 
pursuing. Our colleagues seem to want to turn back the clock on this 
plan.
  We did not get a single commitment from Mr. Price on keeping Medicaid 
healthy for more than the 70 million Americans that depend on it. 
Therefore, all I can do is go back to his record, his votes, and his 
comments to understand his desire to block-grant Medicaid, which is a 
war on Medicaid. It will not make that population healthier. It 
certainly will not really control health care costs for the future, and 
it is certainly the reason I will be voting no on Mr. Price.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Ms. WARREN. Mr. President, I rise today to urge my colleagues to vote 
against the nomination of Tom Price to be the Secretary of the 
Department of Health and Human Services.
  The decisions made at HHS touch the lives of every family in America. 
The Secretary who runs this agency makes decisions about everything 
from safety of the food we eat to the drugs we take, to the health 
insurance we buy and the quality of nursing homes we live in. This is 
an extremely important job, and we should not hand over the keys to 
this agency unless we are certain that the person will put the American 
people first every minute of every day.
  President Trump has nominated Congressman Tom Price to serve in this 
job. Unlike many of the President's other nominees who are stunningly 
inexperienced in areas where they will be setting policy, Congressman 
Price has a lot of experience in health care policy. Yes, he has 
experience, but it is the kind of experience that should horrify us if 
we care about Medicare, if we care about Medicaid, or if we care about 
our own insurance coverage.
  Congressman Price's record is perfectly clear. He wants to destroy 
fundamental protections that millions of Americans depend on for their 
health and economic security, and, frankly, he isn't very subtle about 
it. He has described ACA's ban on discriminating against individuals 
with preexisting conditions as ``a terrible idea.'' He has voted 10 
times to defund Planned Parenthood--voted 10 times against a group that 
provides lifesaving cancer and sexually transmitted infection 
screenings to millions of patients a year. He has tried to privatize 
Medicare and raise the age of eligibility. Privatize Medicare; think 
about that. And he has been one of the chief boosters in Congress for 
gutting the Medicaid program--the Medicaid program, which provides 
health care for millions of kids, for people with disabilities, for 
families with parents in nursing homes--cut money to keep people in 
nursing homes.
  Nonpartisan analyses of these plans are not pretty. Millions of 
people in this country, young and old, children and grandparents, poor 
and middle-class workers would be denied access to lifesaving care.
  Congressman Price touts his own magic numbers that say differently, 
but make no mistake, this is the record of someone who wants to use his 
position at HHS to advance a radical, reckless agenda that puts 
rightwing, anti-government ideology ahead of the health and safety of 
the American people.
  During his hearing before the HELP Committee, I asked Congressman 
Price some pretty simple questions. I asked him about more than $1 
trillion in cuts that he has proposed to Medicare and Medicaid. I asked 
him if he would keep or undermine President Trump's campaign claim that 
he would protect these programs. I asked him to guarantee that not one 
dollar in cuts to Medicare would take place on his watch. I asked him 
to guarantee that not one dollar in cuts for Medicaid to help people 
living in nursing homes would happen on his watch. I asked him to 
guarantee that not one dollar in cuts for people with disabilities 
would happen on his watch.
  I asked him three separate times to make this commitment, and three 
separate times he refused to do so. Think about that--cut Medicare for 
millions of seniors, cut help for people with disabilities, cut 
Medicaid for people living in nursing homes. This is the person Donald 
Trump wants to put in charge of those programs.

  We have a lot of work we need to do on health care. We need to reduce 
the cost of insurance. We need to make sure insurance is available to 
small business owners, gig workers, and part-time workers. We need to 
make sure insurance continues to cover health care for women and people 
with preexisting conditions who otherwise are not going to be able to 
get insurance. What we don't need is to put someone in charge who is 
hell-bent on destroying health care in America.
  For me, this is easy. When someone says he wants to cut Medicare, I 
am done with him. When someone says let's take away the money that 
people rely on to pay for nursing homes, this guy is finished. When 
someone says that protecting people with preexisting conditions is a 
bad idea, they don't get the job. This should be easy for everyone in 
Congress. This is a moment for Senator Republicans to step up and say 
no.
  There is another reason to reject Congressman Price's nomination, a 
reason that has nothing to do with his terrible ideas, a reason that 
would disqualify him even if we agreed on every single issue. The 
reason is basic ethics.
  During his time in Congress, Mr. Price has made money by trading 
hundreds of thousands of dollars' worth of stock in healthcare-related 
companies at exactly the same time that he pushed legislation that 
could affect the value of these stocks. His formula has been pretty 
simple. First he buys the stock, then he pushes bills to help the 
company, which helps the stock price go up.
  For example, Congressman Price bought stock in a company that makes 
hip and knee replacements, and then he introduced a bill to suspend a 
Federal rule affecting Medicare reimbursements for hip and knee 
replacements. Congressman Price bought stock in a bunch of 
pharmaceutical companies, then cosponsored a bill to suspend a Federal 
rule that would hold down drug prices for the drugs that these 
companies manufacture. Congressman Price bought stock in an Australian 
biotech company with an experimental drug to treat multiple sclerosis, 
and then he voted for a bill that would make it easier for the FDA to 
approve these drugs.
  So what does Congressman Price have to say for himself? How does he 
explain this connection between buying stock, then supporting changes 
in the law that would boost the value of the stock he just bought? 
Well, he has his excuses lined up, and I have to say they are doozies.
  He says he didn't know about the trades; his broker made them without 
asking him first. Oh, wait. He did know about the trades. He just 
happened to know about an obscure Australian biotech firm, and he just 
happened to decide to invest as much as $100,000 in it because it was a 
good investment. Then he hit his last excuse: It is all OK because he 
paid the same price as anyone else who bought the stock.
  Wow, that is really a heaping, steaming pile of excuses, and the 
excuses stink. These are Congressman Price's stock trades, not anyone 
else's. He made those decisions to buy those stocks, and then he 
repeatedly pressed for rules that would increase the value of those 
stocks. In fact, with one of the deals, it isn't just a question of 
stinkiness; it is a question about whether he broke the law.
  By his own account, Congressman Price found out about an Australian 
biotech company called Innate Immunotherapeutics from a fellow House 
Member who, it just so happens, sits on the company's board and holds 
the largest stake in the company. So when he decided to buy his latest 
batch of stock, Congressman Price got access to a private sweetheart 
deal, meaning he got a discount on the price of the shares the general 
public couldn't get.
  This sequence of events might break the law. That is not good at all. 
And getting special access to a sweetheart deal doesn't help your claim 
that you are just an ordinary guy with a boring stock portfolio. So 
when Congressman Price appeared before the Finance and HELP Committees, 
he said he had not paid a lower price than had been available to other 
investors. That is just not true. The company itself pointed it out. In 
fact, Congressman Price got a

[[Page S1037]]

special discount that went to only 20 people in the country--20 special 
friends, including the Congressman who could help write the laws that 
would make the company even more valuable.
  An outside watchdog has called for an SEC investigation into whether 
Congressman Price committed insider trading. Price lied to Congress 
about his trades, and that should be the end of it. No more nomination 
for Secretary of HHS. The Congressman should have the decency to 
withdraw his nomination. It should have happened weeks ago. And if he 
didn't go voluntarily, the President and his friends in Congress 
should have quietly but forcefully pushed him out, but that is not what 
happened either. Instead, Republicans barreled straight ahead, and they 
changed the rules to do it.

  Since Congressman Price lied to the committee, Democrats wanted him 
back for another hearing to ask him about it. Republicans refused, and 
Democrats boycotted the Finance Committee to try to force Price to 
explain why he lied. So the Republican response was to just suspend the 
Senate rules so they can run around the Democrats and move forward 
Price's nomination anyway.
  Do we do not care about basic ethics anymore? Is that just gone? A 
Congressman should not be buying stocks then pushing laws to help the 
company, and that Congressman sure shouldn't be lying to the United 
States Senate about it.
  Because Congressman Price has no shame, it will take three Senate 
Republicans to reject his nomination. Where are the three Republicans 
who will say no to a man who bought stock and then tried to get the 
rules changed in Washington so the companies would be more profitable? 
Where are three Republicans who will say no to a man who got a special 
stock deal that went to only 20 people in the whole country? Where are 
three Republicans who will say no to a man who lied to a Senate 
committee? This has nothing to do with politics. It is about basic 
ethics. It is about potentially illegal behavior. Where are three 
Republicans who will say no to this man?
  When Donald Trump selected Congressman Price for this job, he said 
Price was part of a ``dream team that will transform our healthcare 
system for the benefit of all Americans.'' Over the past few weeks, I 
have been trying to understand exactly what that dream looks like.
  For families all over this country, the dream is pretty simple. They 
want to know that when they get sick, they can go to the doctor and not 
be hit with a surprise bill they can't pay. When they buy insurance, 
they want to be sure it covers birth control or cancer screenings and 
preexisting conditions. They want to be able to fight cancer and not 
lose their house or declare bankruptcy because their insurance company 
imposes a lifetime limit on benefits.
  President Trump does not share this dream for health care in America, 
and neither does Congressman Price. From his first day in office, 
President Trump has acted to undermine access to health care. Now he 
has nominated an HHS Secretary who will help him sabotage our Nation's 
health care system from inside the Department of Health and Human 
Services.
  Yes, we have our differences over health care, and, yes, there are 
fixes we need to make, but where are three Republicans who will say no 
to a man who wants to cut Medicare? Where are three Republicans who 
will say no to a man who wants to cut nursing home care? Where are 
three Republicans who will say no to a man who wants to cut insurance 
coverage? Democrats can't do this alone. Three Republicans need to put 
aside partisanship and stand up for the American people. We need you. 
The American people need you.
  With my remaining time, I want to share some of the letters I have 
been getting from families in Massachusetts who have seen the reckless, 
radical plans that President Trump, Congressman Price, and Republicans 
in Congress have put forth for the Nation's health care system. These 
families know exactly what is at stake in this debate. Congressman 
Price didn't have an answer when I asked him to protect Medicare and 
Medicaid, but these letters are from constituents and they show just 
how important these programs are.
  Lee from Holliston wrote to me, concerned about cuts to Medicare and 
Medicaid. I am just going to read an excerpt from his letter:

       I am a 65 year old disabled woman who depends on the 
     generosity of MassHealth and Medicare to survive. I am 
     terrified that Medicare and Medicaid will be so drastically 
     cut that I will no longer be able to maintain my life. I live 
     in HUD housing, receive Medicare and MassHealth which covers 
     all of my healthcare and allows me to continue to live on my 
     own through senior services and the Personal Care Attendant 
     program.
       I guess I am just feeling scared and hopeless as I realize 
     the potential for destroying the lives of seniors who live on 
     Social Security and nothing else. I wear an insulin pump, 
     have type 1 diabetes going on 53 years, and I have multiple 
     complications--including an amputation 11 years ago.
       My healthcare costs are just unaffordable without all the 
     assistance. Medicare and MassHealth covers everything for me 
     so that the $1,050 per month I receive is doable for living 
     expenses.
       I just need to know it is going to be OK.

  Lee, we need three Republicans to help out here. Congressman Price 
has made it clear that he wants more than $1 trillion in cuts to 
Medicare and Medicaid, and that affects you. We have to find three 
Republicans to help out and to help stand up for you and the rest of 
America.
  I also heard from Alan from South Shore, who is worried about his 
daughter Meg. Here is what he wrote:

       My daughter Meg is 29. She was born with a condition called 
     neurofibromatosis. As a result of this, she has benign but 
     inoperable tumors on her spine. They cause her chronic pain 
     and problems walking. On some days, she cannot walk even one 
     step. On other days, she might begin walking with a walker, 
     then suddenly collapse on the floor.
       Meg cannot hold down a job: She spent the last quarter of 
     2016 in and out of hospitals. She receives about $700/month 
     from Social Security Disability. She has no savings. She pays 
     for her Medicare prescription drug Part D supplement out of 
     her Social Security. MassHealth is free for her, and it pays 
     for Meg's Medicare Part B. I am retired, so I can only help 
     her a bit.
       If Trump's first idea about TrumpCare goes into law--where 
     he assumes you will buy your health insurance out of 
     savings--I fear Meg will live in her bed, watching repeats of 
     quiz shows on her television. And her network of care--
     including emergency services, rehab physical therapy, chronic 
     disease management prescription drugs--will be reduced.

  I understand why you are worried, Alan. I am worried, too, because I 
think that is exactly the path we are on with Congressman Price's 
nomination to head up HHS. That is why we are fighting back.
  Boston Center for Independent Living also shared with me a story from 
a constituent named Jill who receives health care from the State's 
Medicaid Program. Let me tell you a little bit about Jill.
  Jill is 62 years old. She has a heart defect, a seizure disorder, and 
serious osteoporosis. She had a varied career as a manager of a women's 
clothing company a decade ago, and in the 1980s, she installed some of 
the first computer networks in public schools. In the past several 
years, Jill has had significant health problems: surgery for her heart 
condition and multiple broken bones due to her worsening osteoporosis.
  MassHealth, the State's Medicaid Program, has covered hospital bills, 
appointments with specialists, rehab stays, and an affordable 
medication plan.
  Jill is now hoping to use a personal care assistant to give her 
support with shopping, making meals, and basic housekeeping.
  Jill said: ``For me, Medicaid is a lifeline--any cuts from Washington 
would be a disaster.''
  I hear you on that, Jill. I just hope that Congressman Price, 
President Trump, and the Republicans hear you as well.
  Medicaid helps a lot of people in Massachusetts, including the very 
youngest. I got a very powerful letter from Marika from Duxbury, who 
wrote to me about giving birth to her son Jack after just 28 weeks of 
pregnancy. I want to read parts of her letter:

       I'm writing to you today because I am horrified about the 
     changes that may be happening to healthcare in the United 
     States.
       My husband and I welcomed our son, Jack, at 28 weeks in 
     July of 2015. I had a very normal, healthy pregnancy--until 
     suddenly it wasn't. I ended up with rapid onset of HELLP, a 
     rare and life-threatening syndrome, and an emergency C-
     section saved both my life and Jack's.
       Jack was 1 pound, 14 ounces when he was born. We were both 
     in the ICU for some time,

[[Page S1038]]

     my son Jack for 110 days. He had all the issues you'd imagine 
     at 28 weeks--cardiac, pulmonary, feeding.
       Today, at 18 months old, Jack is a fighter--my hero 
     really--and despite still needing oxygen and a continuous 
     feeding tube that is surgically inserted into his intestines, 
     he is cruising, talking, and ALIVE.
       He is alive, and quite frankly, I'm alive because of our 
     amazing healthcare. I have the benefit of an exceptional 
     employer plan from Harvard University. But Jack also 
     qualified (because of his birth weight) for MassHealth. And 
     our public health insurance has been an incredible resource:
       Jack's hospital bills were in the millions after his 110 
     day stay in the NICU. This doesn't even include my own 
     hospital costs for my stay. Despite having excellent jobs and 
     resources, my husband and I would have been bankrupt, and 
     immediately so, without our private health insurance and 
     MassHealth benefits.
       Since coming home from the NICU, Jack is still on a feeding 
     tube and oxygen, and he cannot be accepted into regular 
     daycare. He would go to a medical day care, but he has no 
     cognitive delays, and so placing him in such a facility would 
     not ensure that he gets the regular developmentally 
     appropriate engagement that he needs. And so MassHealth pays 
     for skilled nursing care in our home with no out of pocket 
     costs. This means that Jack gets the care that he needs, and 
     my husband and I can still work at the jobs that we love.
       Jack participates in early intervention programs and 
     receives feeding therapy, physical therapy and occupational 
     therapy free of charge.
       Jack's Synagis shots cost zero dollars. Synagis is a 
     prescription medication that is used to prevent a serious 
     lung disease caused by respiratory syncytial virus, RSV, in 
     children at high risk for severe lung disease from RSV. The 
     average wholesale price is $780.15 for the 50 milligram 
     Synagis vial, and $1,416.48 for the 100 milligram vial. Jack 
     gets a 150 milliliter shot every month.
       I cannot imagine this life without my son's public health 
     insurance. I recently enjoyed the NICU Family Advisory Board 
     at Beth Israel Deaconess Medical Hospital in Boston (where 
     Jack and I were cared for) as a way to give back. Today, I 
     mentor other families who have unexpectedly found themselves 
     the parent to a tiny premature baby fighting for life. In 
     nearly every case, navigating the insurance system and fears 
     about money are top of mind.

  I am glad to hear that Jack is doing well, but I understand why it is 
that you want to hang on to MassHealth and why it is that we cannot 
take the cuts Congressman Price has proposed.
  Families in Massachusetts are also deeply worried about the future of 
the Affordable Care Act. Jackie from Norwood wrote to me about how the 
ACA helped her get coverage for therapy after her mother was killed. 
She wrote:

       My mother was murdered when I was 24. I was on her 
     healthcare, which kicked me off the day after she died. I had 
     recently accepted a new job and I was set to start that 
     Monday (she was killed on Saturday). I had already left my 
     previous full-time job the Friday before.
       Due to having to move states after her death, I couldn't 
     start my new job. I didn't know when I'd have work again that 
     could provide insurance, nor did I have another parent whose 
     plan I could join. I also had no way of affording COBRA 
     payments.
       So in the matter of one night, I was left helpless in so 
     many ways. Not having health insurance was one of many side 
     effect issues that no homicide victim's family should have to 
     worry about. Especially the next day and when planning a 
     funeral.
       Thanks to the Affordable Care Act, I was able to get 
     covered almost immediately, which meant I could still afford 
     my current medications and I was able to get into needed 
     therapy right away. If it weren't for the ACA, I would have 
     been left struggling and sick as a result of something FAR 
     out of my control.

  Very true, Jackie.
  Jackie goes on to say:

       I ended up finding work within a couple of months, and I am 
     still in treatment for PTSD. I was lucky enough to find 
     employment at Harvard University and no longer needed 
     coverage through the ACA. I have generous health benefits 
     provided to me. However, I never want a fellow citizen or 
     victim of homicide to be without medical care due to cost, 
     preexisting conditions, or other setbacks. I am happy my tax 
     dollars go to help programs like MassHealth and the ACA. We 
     all work hard, but that doesn't mean we are all as fortunate.
       I am not the typical poster child for a homicide victim/
     survivor. I am white and college educated. I work for an Ivy 
     League school. I still needed help when disaster struck, and 
     so many others less privileged than me need help finding 
     affordable health care.
       Please continue fighting for me and other victims and 
     survivors of homicide.

  That is what we are here for, Jackie. That is what we are supposed to 
do. We just need three Republicans to help us out on this.
  I also heard from Jennifer from Northampton, who is terrified for her 
family if the ACA is repealed. She says:

       I suppose I can't say when our story starts. Maybe the day 
     I met my then-life partner (now wife) of 16 years. Maybe it 
     begins when she had to have emergency surgery in Maryland 
     when she wasn't covered under my insurance, because our union 
     wasn't legally recognized. Maybe it begins with the tens of 
     thousands of dollars of debt we incurred in uncovered medical 
     expenses when we tried to get pregnant with our son.
       Or maybe it started two days ago when the unthinkable 
     happened. My wife got laid off. After seven years of 
     exemplary services to a large human services agency whose 
     mission is supporting individuals and families affected by 
     homelessness, my wife was given no warning, no severance and 
     no compassion in her sudden dismissal from the agency. For 
     any family this would be devastating. Now we come to the dire 
     part.
       About a year ago, my younger sister, Stephanie, was 
     diagnosed with an aggressive form of Triple Negative Breast 
     Cancer at 35 years of age. But this story isn't about that.
       Six months later, my mother got diagnosed with Stage 4 
     Metastatic Breast Cancer.
       I didn't have to be an over-educated lesbian to know that 
     there was something genetic going on in my family. I got 
     tested for the BRCA gene and was found positive for the 
     mutation that causes breast cancer, specifically Triple 
     Negative (like my sister had) and am currently looking at an 
     80% chance of developing Breast Cancer in my lifetime.
       I need a double mastectomy and I need it soon. It's 
     scheduled, in fact, for March 6th, 2017. And now, my wife 
     doesn't have a job. I am a Behavior Analyst who specializes 
     in the treatment of children with Autism Spectrum Disorder. I 
     have a small private practice and don't make enough money to 
     support our household. I also don't have access to health 
     insurance through any of my contracts.
       That is why it's dire.
       One laid-off spouse, one four year old son, one self-
     employed wife with an 80% chance of developing breast cancer 
     and fear of the ACA being repealed. This is dire.
       We are terrified, I am terrified.
       This isn't a ``wait and see'' situation for my family. This 
     is us. This is now. And this is real.

  Yes, Jennifer, and that is why we are here tonight, in the U.S. 
Senate, to debate whether or not Congressman Price--a man who wants to 
cut Medicare, cut Medicaid, repeal the Affordable Care Act--is going to 
be the next head of Health and Human Services. That is why we are 
fighting. That is why we are looking for three Republicans to step up 
with the Democrats and turn him down. We must protect the Affordable 
Care Act.
  I also got a letter from Olivia, a college student from North 
Reading. Olivia wrote me about what the ACA means to her as someone 
living with multiple chronic illnesses. She wrote:

       I am a twenty-two year old white woman from a middle-class 
     suburb of Boston. I attend the University of Massachusetts 
     Amherst and will be applying to graduate school next year. I 
     eat an anti-inflammatory diet, I exercise regularly, do not 
     smoke, and drink lots of water. I am on my parents' 
     insurance, which they receive through their employer. I am a 
     patient at some of the best hospitals in the world.
       I am so fortunate to live in a state that protects my right 
     to affordable health care. I was also hopeful when I heard 
     that President Trump was considering modifying ObamaCare 
     rather than repealing it. However, I am still worried about 
     the actions that will be taken in 2017 by his administration 
     and by Congress.
       If you met me you would see a ``young, vibrant, and 
     ambitious woman''--other people's words, not mine. Many 
     people and politicians in this country would meet me and not 
     assume that I rely on the ACA. I am not from a low-income 
     family, I don't live in an area that doesn't have adequate 
     medical facilities, and I appear well. I am, however, living 
     with multiple chronic illnesses. I suffer from asthma, 
     fibromyalgia, chronic urticaria, chronic migraines, 
     irritable bowel system, gastro-esophageal reflux disease, 
     and a rare-genetic kidney disorder.
       I take multiple medications daily that keep me alive, 
     prevent further health complications, and that allow me to 
     take care of myself. I also seek other therapies to manage my 
     conditions, such as chiropractic care and physical therapy. I 
     currently have great health insurance, yet I still pay 
     hundreds of dollars a month just to give myself any quality 
     of life.
       I read the Trump/Pence administration's health care plan 
     and I am aware of the efforts by the GOP to repeal Obamacare 
     and their readiness to do so now that President Trump has 
     taken office. I don't believe I have to explain to you why 
     this worries me.

  No, you don't.

       I won't go on a rant about why health care reform should be 
     about the people not the money (though I could). I will also 
     not talk about why we should have universal health care 
     (though I could). I am hoping that my story offers a slightly 
     different perspective on why certain aspects of the ACA 
     cannot be modified.
       Please remind your fellow senators that millions of 
     Americans suffer from multiple chronic illnesses, many of 
     which are invisible, and that we are a minority that is often

[[Page S1039]]

     forgotten. Many people are just like me. We are college 
     students and new graduates who have to learn to manage our 
     medical conditions before going out into the real world.
       To do this, we may have to stay on our parents' insurance 
     until we are twenty-six years old. We are people who can only 
     work part-time jobs and will need insurance to help keep our 
     medical costs down. We may require expensive prescriptions 
     and numerous doctor visits a year; we cannot have a cap on 
     our care because our conditions are chronic and 
     unpredictable. We are people who will have to apply for 
     insurance with pre-existing conditions which should not be 
     held against us. We are thankful for preventative care 
     because it prevents illnesses that would exacerbate our other 
     conditions.
       Health care is a business that we need but that we didn't 
     ask to be a part of. It is a business we all take part in, 
     whether we plan to or not. We are NOT burned-down houses--we 
     are citizens who provide meaningful contributions to our 
     country.
       I hope that Congress can work together to continue to give 
     people like me a fighting chance.

  I am with you on that. I hope Congress can work together to give 
people like you a fighting chance.
  I also got a letter from Christine in Canton, who wrote to me about 
her son. She writes:

       My oldest child is a 21-year-old college student (soon to 
     turn 22 in February), who is also transgender. He suffers 
     from anxiety and depression. He's been working very hard to 
     complete college while also seeking treatment for his mental 
     health issues. He sees a therapist weekly and has also been 
     hospitalized twice for mental health issues since he's been 
     in college.
       Luckily, due to the Affordable Care Act, he is able to 
     remain on our insurance, where the co-payments for both 
     therapy and hospitalization are at least manageable. If he 
     were not to have coverage through our insurance, I'm not sure 
     that we could afford to pay for his treatment--and as a 
     college student, he certainly could not afford to pay for it. 
     It frightens me to think of what will happen to him if he is 
     not able to receive treatment to keep him healthy.
       Like so many others covered by the Affordable Care Act, it 
     is a life or death situation. I need to know that you will 
     fight by any means possible to keep the Affordable Care Act 
     from getting repealed.
       I also have a 19-year old college freshman and a 17-year 
     old high school senior. While they do not have the same 
     health issues as their brother, we all know how that can 
     change in an instant. The repeal of the Affordable Care Act 
     will also have consequences for them down the line.

  I guarantee, Christine, I will be here to fight for you, to fight for 
keeping the Affordable Care Act for you and for families like yours.
  Denise from southeastern Massachusetts wrote to me about how her 
family is fighting cancer. Here is what she said:

       We are family of four, with three cancer survivors. My 
     husband is a childhood cancer survivor who is now fighting a 
     blood disorder and is a patient at Dana Farber. I am a three-
     time cancer survivor. Having been diagnosed with breast 
     cancer at age 42 (with no family history), I have since had 
     two recurrences.
       I have had radiation, five years of tamoxifen therapy, a 
     bilateral mastectomy, and reconstruction. My reconstruction 
     has been difficult, with five surgeries within 18 months. I 
     have been postponing another surgery due to cost, since my 
     insurance has changed for the worse. At age 23, my daughter 
     was diagnosed with Hodgkin's lymphoma and underwent surgery 
     and seven months of chemotherapy.
       We are a family that has always been proactive and 
     responsible in receiving regular health care. Now, my husband 
     and I have been rejected for long-term care. My daughter, who 
     has two children, pays a higher premium for life insurance 
     and has been denied cancer insurance. We are in a position 
     where we cannot even succeed in our attempts to take 
     responsibility for ourselves.
       This outreach to you is a further attempt to do just that; 
     to maybe give you one more example of reality in your fight 
     for us. We are not whining; we are fortunate to be a close, 
     loving family that has had the strength to rally every time 
     adversity has struck.
       But we are tired from the fight and very afraid for the 
     future. It is shocking to us that, in the richest country in 
     the world, after years of working, planning and saving, that 
     we are at the point of fearing a possible bankruptcy in our 
     later years. We also fear financial destruction for our hard-
     working children due to uncovered medical expenses or the 
     possible exorbitant premiums of a high-risk insurance pool.
       Please, please never tire in the fight for access to 
     comprehensive affordable healthcare. Good medical care should 
     not be a privilege for the rich, but a fundamental right for 
     all.

  Boy, I am with you on that one, Denise. It is a fundamental right for 
all, and that is what we will continue to fight for.
  I also received a letter from Jenny in Worthington. And I want to 
read you Jenny's entire letter because she really underlines what is at 
stake in this fight.

       My husband and I have spent our entire careers in the arts. 
     I write music for the theater; my husband is a novelist, 
     playwright, and freelance medical writer. We have two 
     children. We own a home. We paid back every dime on our 
     student loans and we contribute regularly to our self-funded 
     retirement accounts. We have no consumer debt. In short, we 
     are hardworking, fiscally responsible people.
       We recognize the trade-offs that come with being our own 
     bosses. We enjoy the freedoms of self-employment, and take 
     seriously the extra burden that society imposes on us, 
     including making our own Social Security payments, 
     contributing to Medicare, and buying health care on the 
     individual market, something we have done our entire adult 
     lives.
       When the Affordable Care Act was passed, we were thrilled. 
     For the first time, we had adequate coverage for our family. 
     Our deductibles shrank. We lost the dreaded co-insurance 
     provision and began to think that we could prepare 
     financially should we face the worst.
       Or so we believed.
       Our difficulties began in late 2014, when I was diagnosed 
     with breast cancer. Over the weeks that followed, I endured 5 
     surgeries, including a unilateral mastectomy and 
     reconstruction. Almost immediately after, I began to 
     experience complications. Since then, I've come to learn that 
     I was having a reaction to the silicone implant used in my 
     reconstruction and that was just the early stage of a complex 
     autoimmune condition that still lacks a name.
       Back then, all I knew was that I was wracked with constant, 
     severe pain. I lost the ability to walk. I could no longer 
     think straight and I lost sight in my right eye. Luckily, we 
     stumbled upon an article by a Dutch team that had examined a 
     cohort of women suffering from the same condition. After 
     consulting with the lead author of the paper, we decided that 
     my implant was to blame, and we determined to have it 
     removed.
       Although I experienced some relief immediately after ex-
     plantation, I have never fully recovered. The joint pain and 
     exhaustion persist. I have shed more than a third of my body 
     weight. The battery of medications I take do little more than 
     keep my pain at bay, permitting me to drive my son to school 
     or shop for groceries, but not much more.
       As for my artistic life, it has been put on hold. I have 
     unfinished commissions from two theaters--Chicago Shakespeare 
     Theater and Playwrights Horizons, in New York City--and both 
     institutions have been incredibly patient. Yet the truth is 
     that I have been unable to work for more than two years.
       Severe cognitive impairment is a hallmark of my condition, 
     and I have serious problems with my short-term memory. 
     Holding the thread of conversation is incredibly difficult, 
     and I experience blinding headaches if I write music for more 
     than a couple of hours. Frequently, it feels as though 
     someone has reorganized my brain but forgotten to leave me 
     the instructions. It is frustrating; it's terrifying.
       Only one thing has made it possible for me to survive this 
     at all: the coverage I receive through the ACA.
       The day I got my cancer diagnosis, I was in the process of 
     re-certifying through the Massachusetts Health Connector. I 
     was thrilled when my local Navigator told me that thanks to 
     my new diagnosis, I qualify for Massachusetts' Breast and 
     Cervical Cancer Treatment Program, a Medicaid-backed 
     initiative designed to cover middle and low-income women 
     through their treatments. Not only would I be covered, but 
     our two children would also be insured by MassHealth, our 
     state's Medicaid program. Though my husband continued to 
     purchase care through a separate plan, this single event 
     saved our family from financial ruin.
       Now, all of that stands to change. With the repeal of the 
     life-saving provisions guaranteed by the ACA, we are faced 
     with the complete erosion of our savings. The Republican 
     Congress has already voted to eliminate the ban on denying 
     individuals coverage on the basis of previously existing 
     conditions, meaning that I will most likely be uninsurable. 
     What will happen then? Will we go bankrupt? Will we lose our 
     home? How will I cope without my medications when we can no 
     longer afford to pay for them?
       The passage of the ACA did more to shore up our little 
     family than any other piece of legislation in my lifetime. It 
     has enabled me to face my grave illness without worrying 
     whether cost would be a factor in my treatment or whether I 
     could try the next medication my doctors prescribed to 
     relieve my pain.
       In sharing our story on social media, I have been 
     overwhelmed by the outpouring of concern from our tiny 
     community of theater professionals. The President of the 
     Dramatists' Guild, a professional association for theatre 
     artists, called me to offer the assistance of their Emergency 
     Fund should we need it. And while it is heartwarming to 
     receive the support of my professional community, the hard 
     truth is that even the most doggedly determined not-for-
     profits can't possibly replace the broad social safety net of 
     the Federal government--a safety net Republicans are 
     determined to shred.
       In every industrialized country but ours, health care is 
     considered an inalienable human right. It is abhorrent to 
     claim that

[[Page S1040]]

     care is something Americans should have to ``shop for.'' 
     Price-comparison shopping may seem like a wonderful market-
     driven design, but in reality it forces us to confront the 
     terrifying arithmetic of balancing how much care we need 
     against what we can afford. The sicker one grows, the harder 
     it becomes to solve that equation.
       We have no idea what the Republicans intend by way of a 
     replacement to the ACA. They refuse to specify, despite their 
     years of claiming that the ACA is a failure. They talk of 
     expanding Health Savings Accounts (HSAs), though such 
     accounts represent nothing but a disingenuous transfer of the 
     cost to the consumer. Even if such an approach made sense, 
     how far would $6,750 (the current HSA limit) go in meeting 
     actual health care costs? That amount would be wiped out 
     after a single visit to the emergency room.
       What's more, where do they expect sick Americans--those 
     fighting for their lives and unable to work precisely because 
     of their illnesses--to suddenly uncover $6,750 to sink into a 
     tax-sheltered HSA?
       Clearly, this idea has been put forward by people who do 
     not depend on their health insurance for their very lives. 
     They pretend that this sort of thing will save ``our 
     system,'' but their proposal is like offering a patient an 
     Advil for an amputation--laughably inadequate at best; an 
     utter horror at worst.
       What's more, efforts like the expansion of Medicaid under 
     the ACA have already saved us. Or many of us. Certainly me, 
     in any case. A Republican friend wrote me recently, venting 
     about the ``third-world'' coverage Medicaid provides. What he 
     had to say was ignorant and false. Medicaid isn't failing. To 
     the contrary, it has saved my life and the lives of many 
     others who have simply had the misfortune of falling ill. And 
     isn't that, after all, one of the primary functions of 
     government? To care for its citizens and return them to the 
     ranks of the healthy and productive?
       We have no idea what the year ahead holds for us. It is 
     likely we will face health premiums of $24,000 or more for a 
     low-level plan. Our premiums will consume 30% of our income, 
     more than our mortgage. Despite MassHealth, we shelled out 
     nearly $15,000 for uncovered medical expenses in 2016, and we 
     are already on track to surpass that number this year. On top 
     of everything else, this is the year our daughter starts 
     college. I'm not the typical Medicaid patient that people 
     seem so fond of demonizing, nor am I some poster child of the 
     ACA. I am simply one of the countless individuals whose story 
     does not fit the narrative the Republicans are attempting to 
     feed us about the ACA and about what it means to be sick in 
     America. Medicaid is on the chopping block not because it is 
     failing, but because the people who benefit from it too often 
     fail to speak up on their own behalf. Their silence has 
     nothing do with a lack of will or words. They are simply too 
     busy struggling to survive.
       Medicaid benefits our poorest, yet it also assists those 
     slightly higher on the income ladder--people like me who 
     would vastly prefer to be thriving without it. Many more 
     people than you suspect have turned to it in a time of need. 
     They aren't merely characters in some musical or play. Trust 
     me, I know. They are your friends and neighbors. They are 
     families whose lives have been unended by illness. This is 
     what happened to my family. And, with a single diagnosis, it 
     could be your family too.

  Thank you. Thank you for writing. This is why we are here to fight.
  I also heard from Kaitlyn, from Cambridge, who said the ACA has 
allowed her to continue pursuing her postdoctoral research. She says:

       I am postdoctoral fellow at MIT, and I have a pre-existing 
     condition. In 2012, during my second year of grad school, I 
     started having debilitating pain in my abdomen. The pain was 
     so bad I couldn't eat or sleep, and I lost 30 pounds over two 
     months. The pain was so bad I couldn't wait the full 3 months 
     to see a specialist, and I went to the ER and finally got a 
     diagnosis for an autoimmune disease and began treatment.
       However, my condition was so advanced that a little over a 
     year later I needed an emergency surgery while I was visiting 
     family out of state. I spent six nights in the hospital and 
     rang up a bill in excess of $50,000. Luckily, I was 25 and 
     still on my parent's insurance. Additionally, I was doubly 
     insured by the student health insurance from the University 
     of California, for which I was automatically enrolled through 
     my graduate program. Other than a $200 deductible, my 
     hospital bill was paid in full.
       Now that I have a chronic illness, having quality 
     healthcare and regular checkups is vital to staying healthy 
     and productive. My medication, Humira, costs $5,000 a month 
     out-of-pocket, which was more than double my grad school 
     stipend. With insurance, I only pay $25 a month. Though 
     surgery helped me tame the inflation in my intestines, my 
     disease began to express itself as arthritis in my joints. 
     The pain was so bad that one Christmas I canceled my trip 
     home to see my family and spent the whole time alone on my 
     couch. I had a bad reaction to some of the medications and 
     became so severely anemic that I needed a blood transfusion. 
     Additionally, one of the medications I take causes severe 
     birth defects. So I needed an IUD to prevent pregnancy.
       Easily, all these conditions could become overwhelmingly 
     expensive. But with my student health insurance through the 
     University of California, I could afford it. The premium was 
     $300 per month, part of which was covered by the university. 
     My medications cost $110 a month, and I had a yearly out-of-
     pocket maximum of $2,000. While I didn't get my insurance 
     through the exchanges, the other conditions of the ACA which 
     determine the minimum quality of care made it possible for my 
     care to be affordable.
       By having proper treatment and care, I can be a productive 
     member of society. I have received my PhD in Applied 
     Mathematics and my research contributes to the design of 
     medical devices that can be used for cancer screening. I am 
     able to mentor young girls and encourage them to study math 
     and science. And who knows--one of them may cure cancer one 
     day! Since I am no longer in pain and I am not in debt, I was 
     able to find a prestigious job after graduation. When a state 
     provides for the health of its people, they can thrive at 
     home and at work. It is not only the moral choice, but also a 
     good choice for the economy.

  Kaitlyn, thanks for writing and thanks for being one of the big 
success stories under the Affordable Care Act. This is what we are 
fighting for tonight.
  I also heard from a young woman in Somerville named Samantha. Here is 
what she wrote:

       I've been dealing with severe mental health issues since I 
     was a kid. I am now 27. In that time, I have been through 
     numerous hospitalizations, residential treatment, day 
     treatment, intensive outpatient treatment, and outpatient 
     treatment.
       When I was 18, I had to drop out of college and spent 3 
     months in residential treatment for my eating disorder. The 
     year prior, I spent 2 months in residential treatment and 6 
     months between day and intensive outpatient treatment, and I 
     had been in therapy for 4 years.
       Due to Massachusetts law, I was still covered by my 
     parent's insurance, but the Massachusetts health care reform 
     didn't stop insurance companies from imposing lifetime 
     limits. At 18 years old, fighting for my life, I overheard my 
     parents discussing lifetime limits in regard to my health 
     care. I don't know how much all that treatment cost, or how 
     much of my lifetime limit I had consumed. For the next 7 
     years, I was in and out of treatment at various levels.

  Mr. President, I ask unanimous consent to extend my time by 10 
minutes, if I might, to finish my stories.
  The PRESIDING OFFICER (Mr. Johnson). Without objection, it is so 
ordered.
  Ms. WARREN. Thank you.

       In 2014, when I had my own health care, I had a bad 
     relapse. For the first time I was paying for my own 
     treatment. I had health insurance through my employer that 
     was really good, but even with that, for 1 month of 
     residential treatment, 1 month of day treatment, and 3 months 
     of intensive outpatient, plus therapy, a nutritionist, a 
     psychiatrist and medication--all crucial to my recovery--my 
     out-of-pocket health care costs reached almost $10,000.
       These days, I am much more stable and have remained in 
     relatively good health, but all because of the continued 
     support I get from my therapist, psychiatrist, and doctor. I 
     can only imagine how much money has been spent and how close 
     I'd be to my lifetime limit if those were still in place. And 
     of course, all that adds up to being a ``pre-existing'' 
     condition.
       The simple fact is that I would most likely be dead today 
     were it were not for the protections provided by the ACA, and 
     if I lose those protections, if I have another relapse, I 
     will either end up dead or unemployed and mired in debt.

  Samantha, thank you for writing. Thank you for fighting. That is why 
we are on the floor of the Senate tonight, to continue to fight for the 
Affordable Care Act and to continue to fight against cuts to Medicare 
and Medicaid. This is what is at stake for families in Massachusetts.
  As Jennifer said in her letter: This is us. This is now, and this is 
real. Congressman Price wants to cut more than $1 trillion from 
Medicare and Medicaid. But I am not giving up, because I am here to 
fight for Lee and Meg and Jill and Marika's baby Jack.
  Congressman Price wants to rip up the behavioral health protections 
in the Affordable Care Act. But I am not giving up, because I am here 
to fight for Christine's son and Jackie and Samantha.
  Congressman Price wants to get rid of the ACA's ban on discriminating 
against individuals with preexisting conditions. But I am not giving 
up, because I am here to fight for Jenny and Kaitlyn and Olivia and 
Denise and Jennifer.
  I will fight for every one of them and for the tens of millions of 
people who are counting on Medicare and who are in need of Medicaid to 
pay nursing home bills and to help with home health care for people 
with disabilities and who need that Medicaid money for children with 
serious problems. I will

[[Page S1041]]

fight for every one of them. Where are three Republicans who will do 
the right thing and fight alongside me? That is what tonight is all 
about.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. SANDERS. Mr. President, I rise in strong opposition to the 
nomination of Congressman Tom Price to be the next Secretary of Health 
and Human Services. My opposition to Mr. Price has less to do with his 
well-known, extreme, rightwing economic views than it has to do with 
the hypocrisy and dishonesty of President Trump.
  The simple truth is, Congressman Price's record is the exact opposite 
of what President Trump promised to working families and for senior 
citizens all over this country. If President Trump had run his campaign 
for President by saying: OK, Americans, I am going to cut Social 
Security, and I am going to cut Medicare, and I am going to cut 
Medicaid, and I am going to put together a Cabinet that will do just 
that, I think Congressman Price would have been the perfect candidate 
for Secretary of HHS, but that is not the kind of campaign Donald Trump 
ran.
  He ran a campaign in which he said over and over again: I am a 
different type of Republican. I am not going to cut Social Security, I 
am not going to cut Medicare, and I am not going to cut Medicaid. Yet 
he has nominated individuals like Congressman Price, who have spent 
their entire career doing the exact opposite of what Donald Trump 
promised the American people he would do.
  If Mr. Trump had said: I want to prevent the American people from 
getting low-cost prescription drugs from Canada, and I want to continue 
to prohibit Medicare from negotiating for lower drug prices, 
Congressman Price would have been a great choice, but that is not what 
Donald Trump said during his campaign.
  This is what President Trump said. During the campaign on May 7, 
2015, Mr. Trump tweeted:

       I was the first and only GOP candidate to state there will 
     be no cuts to Social Security, Medicare, and Medicaid.

  On August 10, 2015, Mr. Trump said:

       [I will] save Medicare, Medicaid, and Social Security 
     without cuts.

  Without cuts.

       [We] have to do it. . . . People have been paying in for 
     years, and now many of these candidates want to cut it.

  On November 3, 2015, Mr. Trump said:

       I'll save Social Security. I'll save Medicare. . . . People 
     love Medicare. . . . I am not going to cut it.

  On May 21, 2015, Mr. Trump tweeted:

       I am going to save Social Security without any cuts. I know 
     where to get the money from. Nobody else does.

  On January 24, 2015, Mr. Trump said:

       I'm not a cutter. I'll probably be the only Republican that 
     doesn't want to cut Social Security.

  Mr. Trump did not make these statements in the middle of the night. 
It wasn't an ambush interview with some reporter who caught him off-
guard. This was one of the centerpieces of his campaign for President. 
And I think whether you are a Republican or a Democrat or Independent 
or whatever you are, you will acknowledge that Mr. Trump said: I am not 
a conventional Republican. I am going to do it differently. Everybody 
else, all the Republicans, they want to cut Social Security, Medicare, 
and Medicaid. And he is absolutely right. They do. But he made a 
promise to the American people that he would be different, that he 
would not cut Social Security, Medicare, and Medicaid.
  President Trump sends out tweets every single day, but the American 
people are waiting, are still waiting for that one tweet which says: I 
will keep my promise. I will not cut Social Security, Medicare, and 
Medicaid, and if Republicans give me legislation to do that, I will 
veto that legislation.
  In fact, the President could save us all a whole lot of time if he 
would get on the phone now with the Republicans in the House and some 
here in the Senate and say: Hey, save your efforts. Don't waste your 
time because if you bring me legislation that will cut Social Security, 
cut Medicare, cut Medicaid, I am going to veto it.
  If President Trump sent that tweet, it would save us all a whole lot 
of time but, more importantly, it would tell millions of seniors who 
today cannot make it on $13, $14, $15,000 a year in Social Security 
that he will not make their lives more difficult. He will tell seniors 
who are struggling with difficult, painful, costly illnesses that he is 
not going to devastate Medicare.
  He will tell low-income people who are trying to survive on minimum 
incomes that he will not take away the health insurance they have 
through Medicaid, and he will tell middle-class families and working-
class families that, no, they do not have to worry that their parents 
can remain in nursing homes and have those bills paid by Medicaid.
  What I think the American people are worried about is not just that 
Mr. Trump has not yet sent out that tweet. We did get a tweet about 
Arnold Schwarzenegger and how well he is doing on his TV show--we got 
several tweets about that--but we did not get the tweet that tells 
seniors and working people they do not have to worry about their 
future; that this President was not lying but was telling the truth 
when he said he will not cut Social Security, Medicare, and Medicaid.

  The problem is, President Trump has nominated people like Congressman 
Price whose views are absolutely contradictory to what he campaigned 
on. So why would you appoint somebody whose views run exactly opposite 
to what you told the American people during your campaign?
  The truth is, in the House of Representatives, Congressman Price has 
led the effort to end Medicare as we know it by giving seniors 
inadequate vouchers to purchase private health insurance.
  In 2009, Congressman Price said, and I quote--and I hope people 
listen to this quote and try to ask yourselves: How could somebody who 
ran on a campaign of not cutting Medicare appoint this gentleman to be 
Secretary of Health and Human Services? This is what Congressman Price 
said:

       Nothing has had a greater negative effect on the delivery 
     of health care than the Federal Government's intrusion into 
     medicine through Medicare. . . . We will not rest until we 
     make certain that government-run health care is ended.

  Now, how does that tally with Candidate Donald Trump saying: I will 
not cut Medicare and Medicaid.
  We don't need an HHS Secretary who will end Medicare as we know it. 
We need an HHS Secretary who will protect and expand Medicare. The idea 
of this voucher program, of ending Medicare as we know it, as a defined 
benefit plan and converting it into a voucher plan, not only 
contradicts what Candidate Donald Trump said, but it will be a disaster 
for millions of seniors.
  Right now, if you are a senior and you are diagnosed with a serious 
and costly illness, you have the comfort of knowing that Medicare will 
be there throughout your illness. It will pay your bills.
  The Republican plan, led by Congressman Paul Ryan, has a very 
different approach, and what that plan is about is a voucher plan which 
says that we will end Medicare as we know it. We will give seniors a 
voucher of an undetermined amount--the last number I heard was $8,000; 
it may go up, it may be lower--and give that check to a senior who then 
goes out into the private insurance market looking for the best policy 
that he or she can get.
  I would like the American people to think for a moment what kind of 
policy an 80-year-old person who is struggling with cancer and who has 
a check for $8,000 can get. The answer is, when you go into a private 
insurance company.
  Also, if the Republicans are successful in doing away with the 
Affordable Care Act and the patient protections within the Affordable 
Care Act, including a ban on the insurance companies' ability not to 
insure you if you have a preexisting condition--now let's assume they 
got rid of that.
  Now you are 80 years old. You walk into an insurance company, and you 
say: I have been diagnosed with cancer, and here is my check for 
$8,000.
  The insurance agent looks at you and says: Are you kidding? Don't be 
absurd. Why would we cover you? What do you think we are going to give 
you for $8,000 when you are about to run up some enormous health care 
costs related to cancer? You are going to be in the hospital. You are 
going to undergo all kinds of treatment. You are going to need 
expensive drugs, and you expect us to take you with an $8,000

[[Page S1042]]

check. How are we going to make any money out of you? Because that is 
what our job is. We are an insurance company. We don't care about 
health care. We care about making money. That is our function. We don't 
make money on $8,000 for taking care of somebody who is 80 years of age 
who has cancer. Furthermore, because the Republicans got rid of the law 
protecting people with preexisting conditions, we don't even have to 
take you. Or maybe we will take you, but you are going to have to add 
another $10,000 on top of that $8,000 because that is the only way we 
make money.
  Oh, by the way, also, so there is no confusion, they want to raise 
the retirement age to make sure you keep working until 67 years of age.
  So not only is that a disaster, but maybe in a deeper sense, if we 
take democracy seriously, if we think candidates should run for office 
based on what they really believe, all of that stuff is a direct 
contradiction to what Candidate Donald Trump talked about.
  I have heard many Republicans say: Look, what he was talking about 
was really absurd. It was ridiculous. Of course we are not going to do 
that.
  Well, then, that takes us to a whole other discussion: What does it 
mean if you have a candidate who runs for office who simply lies to the 
American people and really doesn't mean anything he says?
  I have no problems getting up and debating or disagreeing with my 
colleagues who have a very conservative point of view. That is their 
point of view. This is a democracy, and we have different perspectives. 
And many of those candidates ran on positions. They were honest enough 
to say: Hey, if you elect me, I think we have to cut Social Security, 
and they gave their reasons. I think we have to cut Medicare; they gave 
their reasons. I think we have to cut Medicaid; they gave their 
reasons. I think we have to give huge tax breaks to billionaire; they 
gave their reasons.
  Well, for some reason or another, the people in their State elected 
them. That is fine. It is called democracy.
  But that is not what Donald Trump did as a candidate. So I rise in 
opposition to Congressman Price becoming Secretary of HHS because his 
appointment would go in diametrical opposition to what Candidate Donald 
Trump told the American people. I think that is a bad thing for 
democracy. If you run for office, keep your word, you know? Do what you 
told the American people you would do. The profound disgust so many 
millions of people feel for the American political process is not just 
of what we believe, it is that we don't keep our word, the promises we 
make to them, and this is exactly where Donald Trump is today.

  Let me touch on another area where I think President Trump has not 
been clear with the American people, and that is, we pay today by far 
the highest prices in the world for prescription drugs. One out of five 
Americans between 18 and 65 cannot afford to fill the prescriptions 
that their doctors write for them. The numbers go down after 65 because 
of Medicare Part D. But can you imagine living in a nation where one 
out of five people cannot afford to fill the prescriptions their 
doctors write?
  Mr. Trump campaigned on taking on the pharmaceutical industry. Well, 
the record of Congressman Price is very different from the rhetoric 
that Candidate Donald Trump used during his campaign.
  So I eagerly await Mr. Trump's statement--he can do it through a 
tweet; that would be fine with me--that says he will support concrete 
legislation that some of us are going to be offering very shortly which 
does two fundamental things that will substantially lower prescription 
drug costs in America today.
  No. 1, at a time when you can buy many medicines for far less cost in 
Canada or in many other countries around the world, at a time when we 
have free trade agreements so that the lettuce and tomatoes you are 
having dinner can come from Mexico or Latin America or anyplace all 
over the world, the fish you eat can come from anyplace all over the 
world, we will introduce legislation that says that individuals, 
pharmacists, and prescription drug distributors will be able to 
purchase lower cost medicine in Canada and eventually in other 
countries around the world.
  Mr. Trump--President Trump had talked during his campaign about 
taking on the pharmaceutical industry. I hope very much that he will at 
least keep his word on that issue and that he will join us in 
supporting legislation to allow for the reimportation of brand-name 
prescription drugs from Canada and many other countries around the 
world. If he is prepared to do that, we will pass it. We will pass it 
because there are a number of Republicans who support it, and the vast 
majority of Democrats support it. We have the votes to pass it, and if 
President Trump signs that bill, we will go a long way in ending the 
burden that so many elderly people and working people and people with 
chronic illnesses are facing today, and that is the outrageously high 
cost of prescription drugs.
  By the way, this huge increase in prescription drug costs takes place 
at a time when, in 2015, the five largest pharmaceutical companies in 
this country made $50 billion in profit--$50 billion in profit in 
2015--yet one out of five Americans under 65 cannot afford the medicine 
they need. The top 10 CEOs or executives in the pharmaceutical industry 
that year made over $300 million in salary.
  Passing reimportation is one mechanism to lower the cost of 
prescription drugs, but it is not the only one. We have a totally 
insane prescription drug pricing system in America right now. If you 
are Kaiser Permanente, you will pay a certain amount for a drug. And by 
the way, of course, we don't know what that amount is that you are 
paying; that is secret. If you are Medicare, you will pay a different 
amount. If you are the Veterans' Administration, you will pay a 
different amount than Medicare. And if you are Medicaid, you will pay a 
different amount than Medicare or the Veterans' Administration. We have 
a situation today where by law the Veterans' Administration is able to 
negotiate drug prices with the pharmaceutical industry. Today we have a 
situation where Medicaid, by law, is guaranteed a significant rebate 
over list price. But in terms of Medicare, which spends over $4 billion 
a year for prescription drugs, a number of years ago Republicans 
insisted that Medicare would not be able to negotiate drug prices with 
the pharmaceutical industry.
  President Trump has indicated in vague language that perhaps he would 
support the ability of Medicare to negotiate prices with the 
pharmaceutical industry. Given all of the tweets he has sent out on so 
many subjects, I would hope that he has the time to send out a very 
simple tweet which says: If Congress passes legislation allowing 
Medicare to negotiate drug prices with the pharmaceutical industry, I 
will sign that bill. That tweet will have a profound impact on 
taxpayers because we can save very substantial sums of money, and it 
will also result in lowering the cost of prescription drugs.
  Unfortunately, once again Congressman Price is coming from a 
different place than Candidate Trump came from--again, that 
contradiction of a President appointing somebody whose views are 
diametrically opposed to the views he raised during the campaign.

  I think the American people are growing increasingly concerned about 
the contradictions in general, not just on health care, of what 
Candidate Trump said and what President Trump is doing. During the 
course of his campaign, not only did Candidate Trump say he would not 
cut Social Security or Medicare or Medicaid, he also said that he 
thought Wall Street was causing all kinds of problems and that you 
can't clean up the swamp by bringing people in who are a part of the 
swamp, in so many words. You can't bring people in to clean up the 
problem who have caused the problem in the first place. And you know 
what, he is exactly right. He is exactly right. You can't bring in 
people whose greed and recklessness and illegal behavior on Wall Street 
caused us the worst economic downturn in modern history of this 
country. You can't bring those people in and then say: We are going to 
solve the problem that Wall Street caused.
  But in an exactly similar way to what he has done with the Secretary 
of Health and Human Services, he is bringing in top Wall Street 
executives. His main financial adviser comes from Goldman Sachs, one of 
the largest financial institutions in this country, a

[[Page S1043]]

financial institution that required a multibillion-dollar bailout from 
the taxpayers, an institution whose illegal behavior caused them to 
have to pay a $5 billion fine to the Federal Government. Those are the 
people he is bringing in to regulate, to take on Wall Street. He is 
bringing Wall Street executives who caused the worst financial crisis 
in modern history of this country to take on Wall Street. Well, I don't 
think most Americans believe that.
  So, Mr. President, let me close by saying that I hope that tonight 
the Senate stands up for the American people, demands that President 
Trump keep the campaign promises he made, and that we reject the 
nomination of Congressman Price to be the next Secretary of Health and 
Human Services.
  With that, Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I am very honored to follow my 
distinguished colleague from Vermont on issues that he has worked so 
long and so hard and so well, and that is health care for our Nation 
and focusing on the fight for women's health, for access to affordable 
care for all Americans, and for a Cabinet truly free of conflict and 
corruption--a cause that we share in opposing Tom Price as the 
Secretary of the Department of Health and Human Services.
  What is so painfully apparent to him and me and many of our 
colleagues is that Representative Price's nomination is a doubling down 
of the ongoing blatant attack on women's health by his administration. 
His radical anti-choice policies, antiquated views on reproductive 
health, and demands to repeal the women's health provisions of the 
Affordable Care Act disqualify him from serving as the next Secretary 
of Health and Human Services.
  Before the ACA was signed into law, being a woman meant higher health 
care costs for simply being a woman. It is estimated that this 
discrimination cost them about $1 billion more every year. They had to 
pay higher costs simply because they were women.
  Representative Price has been clarion clear about where he stands on 
this issue, with his policy effectively eliminating important 
protections against discrimination that were guaranteed under the 
Affordable Care Act. Under Representative Price's reckless proposal, 
all women, including healthy women, could see their insurance costs 
rise--and rise astronomically. His plan also means guaranteed coverage 
of maternity care services could be lost. It means well-woman visits, 
birth control, domestic violence screening, and breastfeeding support--
all provided now without any out-of-pocket costs--would be lost. The 
simple truth is, with Representative Price's policies, many women will 
go without necessary care.
  More than a quarter of all women and 44 percent of low-income women 
already rely on publicly funded health clinics like Planned Parenthood 
for contraception. Without guaranteed access to birth control, without 
cost-sharing, this number will certainly climb.
  It isn't hard to see why, despite the lonely opposition of 
Representative Price and the Republican Party, 70 percent of Americans 
support a birth control benefit. Representative Price callously asked 
to see one woman who couldn't afford birth control, one woman who was 
left behind. If he is confirmed and if the policies he vigorously 
supports are enacted, he will see millions without necessary health 
care and particularly birth control.
  As many know, Representative Price's attempt to defund Planned 
Parenthood means more than just losing access to birth control; it 
means cutting off preventive care, cancer screenings, and STD testing 
for millions of low-income women. The women who get their care from 
Planned Parenthood seek what all of us want, what all of us should have 
a right to receive--trusted, compassionate, and medically sound health 
care. Representative Price's politically motivated tax on Planned 
Parenthood put this care, and their lives, at risk.

  Clearly, Representative Price is one of the most extreme Members of 
his party on issues of women's health, and that includes his views on 
women's reproductive rights--a woman's right to choose. He has 
supported radical legislation that would ban virtually all safe 
abortions and even some forms of birth control, which, in essence, 
would send our country back to a time when women died because the care 
they needed was outlawed. It was made unlawful; it was banned. That 
time has gone. We do not want it to come again.
  Simply put, Representative Price's anti-choice views are not only 
ill-informed and unconstitutional, but they are downright dangerous.
  Representative Price has also shown remarkable indifference to the 
concerns of the millions who will see their health insurance 
disappear--vanish--following repeal of the Affordable Care Act, if that 
disgrace should occur. For millions, the Affordable Care Act has been 
the difference between seeing a doctor at the first signs of disease 
and waiting until treatment is no longer an option. It has been the 
difference between financial security and bankruptcy. Much of the 
bankruptcy in the United States of America has to do with medical 
costs.
  For many, it has been the difference--no exaggeration--between life 
and death.
  The numbers support this point, whether or not Representative Price 
wants to believe them. Since the passage of the Affordable Care Act in 
2010, the percentage of uninsured Americans is the lowest it has been 
in 50 years or more. The positive impact of this law is felt every 
single day in the State of Connecticut. It has reduced our uninsured 
rate by a massive 34 percent, resulting in 110,000 Connecticut 
residents gaining coverage. Many of my constituents have felt emphatic 
about--and have told me so--exactly how the Affordable Care Act has 
changed their lives and their family's lives for the better.
  Representative Price refuses to guarantee that these families will be 
covered following repeal. So I hope he hears their stories and 
understands what the Affordable Care Act means to them and the millions 
of other Americans whom he chooses not to see, not to hear, not to know 
exist.
  Representative Price refuses to guarantee that these families will be 
covered. For example, I point to a woman in Connecticut named Colleen 
who told me that before the ACA was passed, her medications alone cost 
$250,000 each year. That is a quarter of a million dollars. Thanks to 
this law, she has affordable care, no lifetime limits, and knows she 
will not be a victim of discrimination or denied coverage of her 
preexisting condition. Colleen said the Affordable Care Act has been 
the difference for her between life and death.
  I have also heard from a father whose daughter has a chronic illness. 
He asked that I emphasize to all of you, my colleagues, that health 
insurance is ``not a luxury, but a necessity'' for his family. His 
daughter represents one of the 1.5 million people in Connecticut who 
are now protected from discrimination based on preexisting conditions, 
thanks to the Affordable Care Act.
  I have heard from a retired pastor who counts on the Affordable Care 
Act for coverage, a farmer who fears for his family's health after 
repeal, a young woman who was able to start her own business because of 
the assurances promised by health reform, and a veteran who is scared 
for his wife.
  Representative Price cannot promise that these people will keep their 
coverage, and he has said that outlawing discrimination because of 
preexisting conditions is ``a terrible idea.'' He thinks it is a 
terrible idea to outlaw preexisting conditions. I saw the effects of 
preexisting conditions year after year when I was attorney general, and 
I went to bat and fought for people who were denied health care because 
their insurance companies told them that health care isn't to take care 
of a preexisting condition not covered by their policy. His proposals 
do not expand access to affordable care, and they do not protect 
patients.
  Representative Price's nomination is wrong for the people of 
Connecticut and for the people of this Nation.
  Representative Price's plans would also do away with the expansion of 
Medicaid under the Affordable Care Act, disrupting the lives and health 
of nearly 15 million Americans. This would leave so many people without 
access to preventive care, lifesaving medications, and necessary 
medical interventions. This is simply unacceptable and cannot be the 
policies of the

[[Page S1044]]

Secretary of Health and Human Services.
  In fact, instead of expansion, Representative Price wants to block-
grant Medicaid and cap the program, resulting in higher costs, less 
coverage, and devastation for millions of Americans, half of them 
children who rely on this program.
  In Connecticut, we have been hit hard by the opioid addiction 
epidemic. It is a national scourge, a public health crisis, and we have 
relied heavily on Medicaid to fill the gaps. At a time when this 
epidemic needs more resources, not less, Representative Price would 
work to strip that away, leaving people who rely on Medicaid without 
treatment.
  His plan for our Nation's seniors is just as dismal. He champions 
privatizing Medicare by turning it into a voucher system and ending the 
promise of guaranteed health benefits.
  Giving seniors a fixed amount of funds to buy health insurance would 
result in high premiums, increased out-of-pocket costs for seniors, 
many of them already on a fixed income. And for many Americans, 
Representative Price may mean the difference between being able to 
purchase lifesaving medications and putting food on the table or 
heating their homes.
  Finally, like many of my colleagues--and Senator Sanders made this 
point so well--I have serious concerns over Representative Price's 
potential conflicts of interest. Having repeatedly purchased stock in 
health care and pharmaceutical companies that would directly benefit 
from his legislative efforts and advocacy on the company's behalf, he 
nonetheless made those investments and kept them.

  In the face of these allegations, Representative Price has simply 
refused to provide information that could disprove violations, which 
has led many Americans to question whether Representative Price will 
truly put their best interests before crony capitalism.
  The American people know better. These potential conflicts of 
interest and views on the Affordable Care Act, Medicaid, and Medicare 
are out of touch and out of line with what Americans want and our 
Nation needs. We should be building on the success of these programs, 
not tearing them down, and we should be working with one another to 
improve the health of all Americans, not fostering divisions. Sadly, 
Representative Price's views and policies make this very attainable 
goal really impossible. Simply put, his proposals are dangerous, they 
are disgraceful, and they are disqualifying.
  I cannot vote for Representative Price to lead the Department of 
Health and Human Services. I will oppose his nomination and I urge my 
colleagues to do the same.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. BOOKER. Mr. President, we have had a lot of long nights here, and 
I just want to take a moment again to really give my gratitude to the 
staff. A lot of folks go into making the Senate work. We can see a lot 
of them down here. I can't imagine the days that they have been 
pulling, as we have been pulling long nights. Many of them get here 
early in the morning and they go a long way. So I want to thank them, 
from the stenographers to many of the Senate staff who make it work.
  I also want to thank the pages again. These are young folks who have 
to carry a full load of classes and course work--hard stuff. I don't 
understand why they haven't come to me to help them with their calculus 
homework. But the reality is they are working a full class load of 
courses as well as being here with us around the clock. They probably 
aren't caught by cameras. They aren't even getting C-SPAN glory. But 
your presence here really means a lot, and I am grateful for that as 
well.
  I rise specifically to speak about the President's nomination of 
Congressman Price to be his Secretary of Health and Human Services.
  I want to take a step back and talk about the profound history that 
the United States of America has in terms of our bringing together the 
resources of this country to combat public health crises. We have a 
country where every generation has been able to step up and take on 
things that threaten the common health.
  There was a time in this Nation when we had actual child death rates 
that were tragically high, and that for an industrializing nation, our 
water, the quality of our milk, women dying in child birth, and 
children dying was a common thing. But we had this bold understanding 
that in America, a Nation that believes in life, liberty, and the 
pursuit of happiness, the common health is important. And we took steps 
that, frankly, in a booming industrial economy, the private sector 
couldn't do. We took steps to protect the public health, and we made 
great strides.
  It was a Republican President, actually, in 1953, Dwight D. 
Eisenhower, who actually created what was then a version of what is now 
the Department of Health and Human Services. Specifically, it was 
called the Department of Health, Education, and Welfare.
  Now, the very first Secretary was a woman, and her name was Colonel 
Oveta Hobby. She had served as the director of the Women's Army 
Auxiliary Corps during the Second World War. She was, in my just great 
reverence, someone who served and fought for health and safety and 
security during World War II.
  As Secretary, Secretary Hobby had an expansive and expanding role. It 
was a demanding role. She was coordinating the distribution of polio 
vaccine, overseeing countrywide hospital expansions, overseeing Social 
Security and the Federal education policy. She had a huge role, one 
that was so full that one newspaper joked that ``when she [actually] 
learns her job, Oveta Hobby may trim her week to just 70 hours.'' This 
was someone who went out there as an agent of the government to lift up 
the welfare of all of our citizenry, the health and well-being of 
everyone, again pushing toward those ideals.
  In the United States, we really do believe in this idea of life, 
liberty, and the pursuit of happiness, freedom from deprivation, 
freedom from illness, the belief that we can have life and have it more 
abundantly. To Secretary Hobby, this was her duty to her country--
someone, again, who served valiantly in World War II.
  In the collection of papers from Secretary Hobby's lifetime, Rice 
University includes that she was a great humanitarian and that she 
believed there was a role--a ``common thread,'' to use her words--to 
service to her country toward the empowerment of health for all. She 
set a standard, a powerful standard, as the first Secretary of Health 
for the greater good that we, acting collectively, could do to ensure 
the health and well-being of our Nation.
  In fact, it was an understanding from President Dwight D. Eisenhower 
all the way down to Secretary Hobby that if we ensure people's health 
and access to health care, it is not just an individual concern, but 
actually, societally, we become better and we become stronger. The 
healthier all children are, the more likely they are to go out there 
and compete. If you are battling sickness, it undermines your economic 
well-being. In the world of infectious diseases, the words of Martin 
Luther King are true: Injustice anywhere is a threat to justice 
everywhere; in fact, an illness somewhere is the threat of an illness 
to people everywhere. This was the brilliance of Republican President 
Dwight D. Eisenhower, and it is how this great Department began, 
setting the standard, understanding that in many ways we are all in 
this together when it comes to our health.
  So for me, this is another point in history. It is a challenge to us 
as to who we will be as a Nation. Will we continue to be a country that 
believes, as a fundamental birthright in the richest Nation on the 
Planet Earth, that everyone can access the highest quality health care, 
the best access to quality doctors with wide avenues to pursue the rich 
abundance of life because we have the best health care system on the 
Planet Earth?
  I actually was happy to hear President Trump on the campaign trail 
talk specifically about this issue, tell us we were going to have a 
health care system better than the one we have now, specifically 
calling it ObamaCare; that we were going to have one that is amazing, 
one that is going to be covering more people. I think the word that was 
used was ``terrific''; it was going to be terrific. He specifically 
spoke about some of the bedrock elements of our current health care 
system that Republicans and Democrats

[[Page S1045]]

both agree are things we want to preserve, protect, and in fact make 
better. He specifically talked about Medicare and Medicaid, defending 
them: They wouldn't be taken away; they wouldn't be undermined; people 
wouldn't be kicked off.
  So with this excitement, hearing that we have a President committed 
to these ideals, creating a terrific health care system, we stand on 
this history in our country where we know our greatness, and it is an 
affront if we don't have a system that takes care of our most valuable 
natural resources: the people of this country and a global, knowledge-
based economy. What helps us compete is the quality of our workforce.
  I am telling you right now, I have learned in my professional life 
that when children are sick, they don't learn; when a mother is sick, 
it throws the whole family into crisis; if someone can't afford their 
medication, it is not just a sin to this country's values, it is a sin 
morally.
  So when President Trump nominated his person to be Health and Human 
Services Secretary, we might imagine they would reflect the values that 
he espoused during his campaign and reflect the values he has talked 
about as President. But instead, he has chosen someone who is 
diametrically opposed to the things he says he is for--preservation of 
Medicare. More than this, he has advocated a view on health care that 
unequivocally would take millions of Americans off of health coverage, 
thrust millions of Americans into economic crisis, and put the health 
of many millions of Americans in jeopardy. Usually people say these 
things hyperbolically, but this is quite clearly a matter of life or 
death.
  For years, Congressman Price has told us who he is. He has led the 
charge in the House of Representatives to repeal the Affordable Care 
Act and take coverage away from millions of Americans while advocating 
specifically for the privatization of Medicare and the gutting of 
Medicaid. For years, Congressman Price has advocated for anti-choice, 
anti-contraception access, anti-commonsense measures, and supported 
efforts to defund and eliminate proven programs like title X family 
planning, programs like Planned Parenthood which, through their 
Medicare reimbursements, often in many communities is the only access 
women have in their communities for cancer screenings or to get 
contraception.
  Congressman Price has been one of the loudest voices on tearing down 
many of the things that now Americans overwhelmingly say ``Hey, now 
that we've got this, we don't want to lose it,'' whether that is not 
having insurance companies dictating to you whether you get health 
insurance or not having pharmaceutical companies ratchet up prices so 
much that your lifesaving drugs are out of reach.
  Then finally, at a time when we cannot afford to have people who have 
conflicts, we have a Congressman right now for whom other House Members 
are calling for ethics investigations because his personal financial 
interests clearly have been in conflict. In fact, he seems to be 
building a career as a Congressman working on health policy on one hand 
while building a fortune trading health stocks directly related to that 
work. This is a man who is so conflicted, a man who is so contrary to 
what our President says he believes, a man who has been leading the 
charge to take our health care back in an affront to the ideals that 
literally stem from the founding history of our Department of Health. I 
cannot support this individual.

  But let me quickly go through some of these things. We now have to 
have an honest conversation in our country about this idea of repealing 
the Affordable Care Act without replacing it because objective 
organizations like the Congressional Budget Office, conservative 
organizations like the American Enterprise Institute, and fellow 
Republican Senators of mine have acknowledged that to repeal the 
Affordable Care Act would throw into crisis millions of hard-working 
Americans who have been able to get coverage because of the health 
insurance marketplace and the Medicaid expansion. Millions of Americans 
can now go to a doctor when they feel sick instead of going to an 
emergency room. By the way, as a local mayor--when people use emergency 
rooms as their primary care facility, it is extraordinarily more 
expensive; it is fiscally irresponsible.
  Because of the ACA, millions more Americans can now access basic 
health and preventive services that can lead to lifesaving 
opportunities that did not exist before. Millions more Americans have 
the peace of mind of knowing that they are no longer one illness away 
from financial ruin.
  Let me put up a chart for a second about the history of people having 
insurance.
  This is the percentage of uninsured in the United States--going 
along, about 18 million uninsured. And then what happens? The uninsured 
rate has been driven down. Enrollment in the individual market 
continues to rise but has now decreased since 2014.
  In late December 2016, Standard & Poor's--hardly a Democratic 
organization, but a market-based organization--released an incredibly 
optimistic report for the future of the individual market in the 
Affordable Care Act. But Congressman Price, on the other hand, has 
repeatedly introduced legislation and resolutions to repeal critical 
elements or the entirety of the law responsible for these successes 
without any regard for consequences. He has done this again and again 
and again and again, eight times. He authored a bill last year that 
would repeal critical parts, like the Medicaid expansion provision that 
has expanded access to care for millions, tax credits that would help 
millions buy insurance. And Congressman Price has introduced 
legislation that would fully repeal the Affordable Care Act.
  I want to let you all understand that, to me, this is a point in our 
American history where this isn't arguing over opinion; these are facts 
about what Congressman Price has done. If he were successful in any of 
those eight attempts to rip down the Affordable Care Act, we now know 
objectively from organizations like the independent Congressional 
Budget Office that it would mean 18 million people losing their health 
insurance in the first year alone, 32 million of our fellow Americans 
by 2026. Objectively, there would be increases in premiums in the 
market by 20 to 25 percent; 4.4 million of those Americans who would 
lose coverage would be children; and 11 million of the most vulnerable 
would lose their Medicaid coverage.
  There is a man named Andy Slavitt who is a former Acting 
Administrator of the Centers for Medicare and Medicaid--again, what our 
President says he wants to preserve. He put together a list because so 
many people were calling him, writing him: What are going to be the 
consequences if they repeal the Affordable Care Act without replacing 
it? What are the consequences? And he just went through a list: Small 
businesses, farms, self-employed Americans represent 20 percent of the 
coverage of the exchange. These are individual entrepreneurs, many of 
whom, by the way, experience something called job lock, where they are 
afraid to become entrepreneurs because if they lose their jobs, they 
lose health insurance. Twenty percent are covered by the exchange, and 
127 million Americans--127 million Americans--have preexisting 
conditions. They would be put at jeopardy, and insurance companies 
would be able to deny them coverage.
  Seniors, Medicare beneficiaries, have saved $2,000 on prescription 
drugs because of the ACA--$2,000; 30 million Americans are on 
individual policies and Medicaid; 2.8 million Americans with drug 
disorders would lose coverage; 1.25 million Americans with mental 
health disorders would lose coverage--1.25 million Americans with 
mental health disorders. In other words, the ACA put mental health care 
on parity with physical health care. A 42-percent reduction in 
uninsured rates for veterans has resulted. He said that bad debt--bad 
debt, bankruptcy--would go up by $1.1 trillion because health care 
bills would again be the lead cause in this country of bankruptcy. In 
other words, before the ACA, the No. 1 reason people were declaring 
bankruptcy was because of medical bills. After the ACA, that can't 
happen. There are steps to prevent that from happening, at least to the 
extent of $1.1 trillion.
  The Medicare trust fund, which has been extended, will have several 
years reduced off its life expectancy. Taxpayers will lose $350 billion 
added to the deficit and $9 trillion would be added to the debt if it 
is repealed--2.6 million jobs lost, especially in communities like 
rural hospitals, where they

[[Page S1046]]

depend upon the ACA to keep doors open and hospitals running. Anyone 
who likes free preventive services like mammograms and better cancer 
treatment, preventive services that literally save lives by early 
detection, gone.
  Young adults, 3.1 million right now on their parent's plan because of 
extending the years. Women who want to buy health insurance will pay 
more than men in premiums because, amazingly, at times insurance 
companies would be charging you more simply because of your gender and 
105 million people had lifetime limits on what insurance companies pay.
  This is a list from one of the great experts who knows factually what 
would happen if we were to turn back the clock. Let me drill down a 
little bit more. As head of Health and Human Services, Congressman 
Price would be responsible for insuring the continuance of Medicaid.
  Americans like Kelley from New Jersey are able to access care right 
now because of the Medicaid expansions under the ACA. I want to read 
what she said. She said:

       Thank you for supporting the ACA. I hope that you will 
     continue to fight hard for it. It's the ACA and Medicaid that 
     allow me to be able to seek medical treatments for my 
     scoliosis (which causes me to suffer from chronic pain) and 
     ensure that my newborn receives appropriate medical care when 
     need be.
       I work full time and go to college but I still struggle to 
     pay the bills, as I'm only 18 and fast food doesn't pay much 
     even at 35 to 40 hours a week.

  Here is someone going to college, raising a child, working full time, 
and relying on the ACA so she can inch toward her American dream, being 
a college graduate, getting a better paying job.
  She concludes by saying:

       I want my baby to have the health care she deserves so she 
     can be happy and healthy.

  The Medicaid expansion under the ACA has extended access for millions 
in our country, millions of hard-working people like Kelly and their 
children, like her baby, across the country.
  In New Jersey alone, hundreds of thousands of people gained coverage. 
Uncompensated costs were driven down, and my State saved a billion 
dollars, all because of Medicaid expansion.
  Republican Governor of New Jersey: Medicaid expansion was the right 
fiscal decision for our State and for our communities' families who 
live in our State.
  In Price's efforts to undo ACA Medicaid expansion, he has indicated 
people like Kelly and her newborn baby are not a priority.
  I know for a fact that hard-working people across the country and in 
my community will suffer if Price is able to do what he intends to do 
and has tried to do.
  Let me go to another issue; that is, Medicaid. How about Medicare? As 
Secretary Price, he will be responsible for overseeing Medicare, the 
health care program that services 57 million American seniors and those 
with disabilities.
  Under the Affordable Care Act, we know that the quality of Medicare 
coverage has improved. The life of the Medicare trust fund has been 
extended, and we have begun to close the gap in prescription drug 
coverage that too many seniors and people with disabilities--they know 
about this. It is known as a doughnut hole. There is more work to do to 
strengthen Medicare and to make prescription drugs more affordable for 
everyone, including our seniors.
  The changes we have done already have had real positive impacts on 
the daily lives of Americans. Let me read another letter from Myra in 
Willingboro, NJ. She wrote to tell me about the difference that 
Medicare is having for her family as they live with chronic illness. 
She said:

       As your constituent and an advocate of affordable, 
     accessible health insurance, I would like to share how 
     adjustments to the health care system could impact me. As you 
     consider policy changes, I urge you to think about how your 
     constituents living with chronic conditions will be affected.
       It is so important to my husband who lives with Parkinson's 
     disease and myself who is being treated for Chronic Lymphatic 
     Leukemia that our Medicare benefits continue without any cuts 
     in benefits. It is most important that we continue to be able 
     to visit doctors able to care for our specific needs and have 
     the expensive medications covered that are needed as we live 
     with these diseases.
       As a support group leader for people living with 
     Parkinson's disease--

  I pause here to say, my father suffered for years with Parkinson's, 
died from Parkinson's. The support groups are essential, and the 
medical challenges that this chronic disease brings are great.
  I continue with her letter.

       As a support group leader for people living with 
     Parkinson's disease and their caregivers, I know all the 
     members would echo my requests. Many people actually need 
     further assistance to purchase the needed drugs as their 
     policies do not cover them adequately presently. Often the 
     medication prices are prohibitive for folks. They have to 
     constantly check to see which drug plan will allow their 
     medication at an affordable price.
       In addition, specific supports for caregivers is another 
     very important need for the Parkinson disease population. 
     Please consider assistance for these people who require 
     assistance throughout the day.

  Let me tell you, this is a person writing to say keep what we have 
and make it better because it is still not enough to meet the 
challenges. Instead, we are considering making someone the Secretary of 
Health and Human Services who doesn't want to improve, build upon, get 
better but wants to throw out.

  Take Tom, who believes that for his family, their lifeline to health 
care access is an intrusion. This is Tom Price--excuse me, who believes 
that this is an intrusion. He writes: ``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.''
  I want to put these words up. This is what the nominee to Health and 
Human Services is saying about one of the most valued parts of our 
health care in America. He is saying: ``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.''
  I would like to tell you that is an insult to Myra and her husband, 
millions of American seniors, those on disabilities who rely on what he 
calls an intrusion. Someone who is calling for an end to a program that 
millions of Americans rely on, that the President himself swore that he 
would do nothing to disturb, we are now putting the chief architect of 
the destruction of Medicare from the House into a position where they 
can wreak havoc on the health care of millions.
  I want to go into that area of preexisting conditions. Imagine 
yourself as someone who has a child with diabetes or that you are a 
survivor of cancer and an insurance company can now look at you and 
say: I am sorry. I am not going to cover you. The people driven by the 
market, driven by profits, driven by the bottom line are going to look 
at you and your humanity and simply say: Sorry, I am not going to cover 
you. And you live in that place in America, that dark, painful place 
where you know you are one illness away from destitution.
  This is what Maureen wrote to me recently. She said:

       Please do not repeal the Affordable Care Act. My 18-year-
     old son has been fighting cancer for over a year. I am scared 
     to death of what his future will hold without the protections 
     of the ACA. He may be subject to a lifetime cap on insurance 
     payments or be rejected for health insurance entirely on the 
     basis of a preexisting condition. He is only 18. He could be 
     financially ruined before he even gets his adult life 
     started. After fighting cancer as a teen, it scares and 
     upsets me to think that his battles will continue throughout 
     his life in the form of financial hardships from the loss of 
     protections he currently has through the ACA.

  She ends saying:

       Please consider my family when voting on the ACA.

  Please consider my family. There are millions of Americans who now 
are living in this state of fear, looking at the rising and the 
ascendancy of Congressman Price to a position--someone who has tried 
again and again to end insurance for people with preexisting 
conditions.
  I don't understand what we are trying to achieve with putting someone 
who believes that somehow the free market will take care of these 
folks. I began with our history as a country: booming industrial 
economy. The free market didn't take care of ensuring that our waters 
and rivers were cleaned up. The free market didn't take care of 
eradicating polio. We are a nation that has learned from our history 
that we have a responsibility to each other, and in our common civic 
space and in the

[[Page S1047]]

governments that are established amongst men and women, we have to do 
better for folks who are victims or vulnerable to the vicissitudes of 
the free market.
  That is why we are stepping up to say that we can create a system 
that serves all. We are the richest country on the planet Earth. What 
even makes this worse than Medicaid under assault, Medicare under 
assault, people with preexisting conditions, which are issues that are 
simply around contraception.
  Congressman Price would be expected to uphold protections currently 
in place that prohibit insurance companies from charging women more 
because of their gender and ensuring that insurance companies abide by 
the Affordable Care Act's contraceptive care.
  All that talk about preexisting conditions, many insurance companies 
saw gender as a preexisting condition. As something as critical as 
having access to contraception, Tom Price has voted time and time again 
to restrict access to essential health care services and limit 
reproductive rights.
  Before the Affordable Care Act was passed, cost was a major barrier 
for women seeking access to birth control. Congressman Price has 
repeatedly opposed the provision requiring insurance plans to cover 
contraception. This is what he said in an interview in 2012:

       Obviously one of the main sticking points is whether 
     contraception coverage is going to be covered under health 
     insurance plans and at hospitals, and whether or not they're 
     going to be able to pay for it, especially low-income women, 
     where do we leave these women if this rule is rescinded?''

  That is the question. Price's response was simple:

       Bring me one woman who's been left behind. Bring me one. 
     There's not one.

  I am sorry, in this case, Price is not right; Price is wrong. There 
is not just one you could bring. There are millions of women who were 
left behind and struggled with access to coverage before the Affordable 
Care Act. For this man to stand there and cast a shadow over the basic 
commonsense understanding that when you allow women to make their 
reproductive health decisions and have access to contraception, you 
give them power over their lives and their destinies. You actually 
reduce unwanted pregnancies dramatically. This is an economic issue. 
This is an empowerment issue. This goes to the core freedoms as a 
country.
  The Center for American Progress reported in 2012 that before the ACA 
contraceptive provision went into effect, that ``a recent study shows 
that women with private insurance paid about 50 percent of the total 
costs for oral contraceptives, even though the typical out-of-pocket 
cost of non-contraceptive drugs is only 33 percent. Surveys show that 
nearly one in four women with household incomes of less than $75,000 
have put off a doctor's visit for birth control to save money in the 
past year.'' Because of the ACA's contraceptive provision, America has 
changed. According to the National Women's Law Center, 55 million women 
have saved $1.4 billion on birth control pills alone since 2013.

  Listen to Rachel from West Orange, NJ, a couple towns over from where 
I live. She benefited from the contraception provision of the ACA as 
well as access to Planned Parenthood. This is what she wrote:

       The Affordable Care Act is something that has made a huge 
     impact on my life. I come from a poor background, and there 
     is no additional money to spare on things like birth control, 
     which I take for my independence and legitimate medical 
     issues. Without birth control, I'm unable to get out of bed 
     for days at a time because of painful periods. This means 
     losing out time off work and opportunities because of a 
     serious medical malady.
       I never thought I would be able to normalize my life 
     because I can't afford a $40 copay every month, in addition 
     to my expensive transportation passes, student loan payments, 
     and helping my parents pay their bills. However, with the 
     Affordable Care Act, I have access to free birth control that 
     allows me to live my life and succeed. It enables my 
     independence, and makes me a healthier individual. I am 
     terrified that any repeal of the Affordable Care Act will 
     harm my health, my career and my ability to lead a normal 
     life.

  We want people to lead the life of their dreams--their health, their 
careers. What she is asking for is not a luxury. It actually benefits 
us all because we are empowering her to succeed. That makes this 
country greater. Yet Tom Price, this nominee, has voted 38 times on 
measures that would restrict women's access, including 10 times voting 
to defund Planned Parenthood. At a time when there are fewer unwanted 
pregnancies, when women have more power, more control over their lives, 
Tom Price wants to roll things back.
  Struggling women are fighting to raise families and go to college and 
pay the bills and run businesses or be entrepreneurs, that they are 
having constrictions placed on their lives--you empower women, you 
empower this Nation.
  In New Jersey, Planned Parenthood's 26 health centers provide access 
to lifesaving care for women across the socioeconomic spectrum. I will 
fight tooth and nail with all that I have for not rolling things back. 
We are not going back. And a Congressman who has pledged to do just 
that should not be the Secretary of Health and Human Services.
  Tom Price has spoken out against sex education. I am a believer. I 
said this when I was mayor, all the time. In God we trust--I am a man 
of faith--but everybody else, bring me data. Sex education is actually 
something that has a powerful economic benefit. When it comes to 
advocating for better health options and outcomes, we know this is not 
an idea or theory, but there is a connection between poor, incomplete, 
or absent sexual education and increasing rates of teen pregnancy, 
sexually transmitted diseases, sexual assault. Young people are also 
disproportionately infected, without sex education, with HIV, and HIV 
rates among young adults are truly problematic in this country. Kids 
who are granted full information live healthier lives. But Congressman 
Price advocates against that. He thinks sex education doesn't reduce 
rates of teen pregnancies--it does; doesn't reduce rates of sexually 
transmitted diseases--it does; doesn't reduce rates of sexual assault--
it does; doesn't reduce rates of HIV--it does. But he thinks that it 
promotes promiscuity among young people.
  I want to end with my last point. All of this is enough, but this is 
the more astonishing part of my opposition because in this, I would at 
least think we could get my Republican colleagues to join with me 
because if you look at past Presidents, something less than this has 
sunk nominations before. This doesn't have to do with health policy; 
this has to do with conflicts of interest.
  There was a great Senator who pulled himself out of consideration for 
what, compared to this, is a mild issue that he moved to correct on 
paying taxes on a benefit that he received. He pulled himself out of 
consideration. He had that kind of dignity to say: You know what, I 
have this small issue. I am pulling myself out of consideration.
  But Tom Price is charging right ahead, while people in the House are 
calling for his investigation. Some of my colleagues have already 
addressed this, so I won't go into it much, but the SEC investigation 
should be there. An independent watchdog from the Office of 
Congressional Ethics should be there. We don't know because these 
organizations, the SEC and the Office of Congressional Ethics, don't 
announce when they are investigating somebody. But there are a whole 
bunch of people saying that Congressman Price has potentially violated 
something called the Stock Act, which was basically put in place so 
that Congresspeople, who know things about regulations or issues 
affecting companies, can't benefit off of that insider information to 
profit themselves. I don't understand why, at a time that this is all 
hanging over his head, that there should be an investigation, that we 
should get to the bottom of it before we put him in the President's 
Cabinet, Democrats and Republicans here, given past history and past 
nominees who had to withdraw, why aren't we joining in a bipartisan way 
and saying: Hey, there is a lot of smoke here, and the facts are kind 
of screaming for attention.
  Let me just be clear. As an example, last March Congressman Price 
bought between $1,000 and $15,000 worth of shares in a company called 
Zimmer Biomet. They are a medical manufacturer that specializes in hip 
and knee devices. House ethics disclosures show that he invested in the 
company just 6 days before introducing a bill that would have directly 
benefited hip and knee replacement companies like Zimmer Biomet, H.R. 
4848. Let's do this

[[Page S1048]]

again. He invests in a company 6 days before he introduces legislation 
that would have benefited such a company. That is astounding, to me, 
and it should raise alarms in terms of the codes of conduct of a 
potential Cabinet nominee. He invested in a medical manufacturer of hip 
and knee devices and shortly thereafter introduces a bill, the HIP Act.
  What is more, though, is while Congressman Price has said that he was 
unaware of the stock purchase because it was bought by a broker, his 
financial disclosure forms show that he initialed the purchase to note 
an error. He initialed the purchase. So to say he had no knowledge of 
it is a stretch.
  Congressman Price then added nearly two dozen cosponsors to the bill 
over the next 3\1/2\ months. I am sorry, if a Senator here did that--
knowingly buying stock, then introducing a bill--I know this body would 
look askance on that. More than that, I don't think you need to explain 
much of this because it is so obvious that American folks at home are 
knowing that you should not introduce legislation to self-deal to 
yourself.
  Let me give another example. Price also bought stock in an obscure 
Australian biopharmaceutical firm called Innate Immunotherapeutics 
through a private offering that was not made available to the public. 
The private stock offering gave Congressman Price access to hundreds of 
thousands of discounted stock.
  At his Senate confirmation hearing, he asserted the stocks were 
``available to every single individual that was an investor at the 
time,'' but this is how the Wall Street Journal reported it--not quite 
a liberal periodical. It said:

       In fact, the cabinet nominee was one of fewer than 20 U.S. 
     investors who were invited last year to buy discounted shares 
     of the company--an opportunity that, for Mr. Price, arose 
     from an invitation from a company director and a fellow 
     Congressman.
       The shares were discounted at 12 percent off the traded 
     price in mid-June only for investors who participated in a 
     private placement arranged to raise money to complete a 
     clinical trial. The company's shares have since tripled 
     during the offering.

  I am sure that Americans at home who are saving for their retirement 
would love to have an insider deal like this, would love to be clued in 
by company heads to an opportunity to triple their money, but clearly 
something is wrong when a Congressman is doing that. That should cause 
us to pause as a nation before we put him in as a Cabinet Secretary 
over all of our health care.
  It is a disturbing pattern when Congresspeople use their position of 
power for personal gain with no regard for public interest. This type 
of behavior would be unacceptable in most industries. It should be 
unacceptable to Congress, to Senators on both sides of the aisle who 
have to advise and consent.
  Look, we are at a point in our country where we have taken steps 
forward on health care. It has been controversial, I understand, but 
there is no arguing with the fact that we are now at a point in America 
where someone with a preexisting condition is not stopped from having 
health insurance, where young people all over our country have the 
security of knowing they can stay on their parents' health insurance 
until they hit 27. We are at a point now where being a woman is not a 
preexisting condition, where we have expanded access to contraception. 
We are at a point in our country where the uninsured population has 
gone down dramatically.
  We cannot have someone whose attitude is not what I would hope it 
would be, one of ``Hey, we accomplished a lot. Let's figure out a way 
to make it better. Let's build on it.'' Instead, they not only want to 
take back the gains I just mentioned, but they want to go further and 
take back Medicaid and Medicare, privatize them, gut them, block-grant 
them.
  So this is not a close call. This is a Congressperson who for years 
has told America what his intentions are. He just didn't have the power 
to do it then because he was 1 out of 435. Frankly, if you include the 
Senate, he was 1 out of 535 and had a Democratic President also to get 
through. He couldn't get done what he wanted to get done. Now he is 
going to go from being one voice on the fringe, yelling for getting rid 
of Medicaid and Medicare, yelling against women's access to 
contraception, yelling to put insurance companies back in charge of 
your life, your destiny, and your health care--he is going to go from a 
fringe voice, 1 out of 435, to now being the head of the Department of 
Health, advising the President on things, frankly, that he has said, at 
least, that he doesn't want to do: gutting Medicare, gutting health 
care for seniors.
  So I go back to where we came from--a Republican President, Dwight D. 
Eisenhower, and the first head of the Health Department, an incredible 
woman, World War II--served soldiers in World War II. And they had a 
vision for this country, that, hey, what we have is not good enough. 
Let's figure out a way to do better because a healthy society is an 
economically strong society. A healthy society is a prosperous society. 
A healthy society lives up to our common values.
  We are the United States of America. We should set the national 
standard for health care. When it comes to the most vulnerable amongst 
us, whether it is a poor kid on a farm, whether it is someone in an 
inner city, whether it is an immigrant, we are a country that 
believes--like the old African proverb: If you want to go fast, go 
alone, but if you want to go far, go together.
  One of the great singers and artists and inspirations in my State is 
a guy named Bruce Springsteen. He has a song where he says: We take 
care of our own. Well, we have done well on that idea. We have gotten 
better. We have made strides toward that standard.
  We have work to do. We should be working together, both sides of the 
aisle, to make our health care better, more inclusive, more accessible, 
and more affordable. We have a lot more work to do. But I don't want to 
go back. So help me, I will fight every day to prevent us from going 
backward where there will be fewer people covered, more people, because 
they can't afford things, suffering untold health crises.
  I don't want to go backward to where women are denied coverage or 
access to empowering things, basic things, fundamental things like 
contraception.
  I don't want to go backward with senior citizens who are in the 
sunsetting years of their lives, when they should be free of stress and 
worry and strain but suddenly are worried again and struggling and 
suffering. I don't want to go back to those days; therefore I will vote 
a resounding, full-throated no on Congressman Price because, as the 
poet Maya Angelou said, if someone tells you who they are, believe 
them. He is someone who has told us what he wants to do. We should stop 
him from doing it.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Perdue). The Senator from Florida.