[Congressional Record Volume 163, Number 23 (Thursday, February 9, 2017)]
[Senate]
[Pages S994-S999]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                       Nomination of Neil Gorsuch

  Mr. SASSE. Mr. President, I say thank you to my colleague for 
yielding to me a little bit out of line.
  I think one thing we don't do nearly a good enough job at around 
here--and not just in Washington, DC, but in schools across America--is 
reflect on the basic civics we have inherited and the constitutional 
structure of checks and balances and why we have a limited government. 
I think Judge Gorsuch's nomination to the Supreme Court and, frankly, 
more narrowly, the media cycles of today, give us a special opportunity 
to pause and to do a little bit of civics again.
  Judge Gorsuch is tough, smart, fairminded, independent, and he is a 
person who has taken an oath of office to a Constitution of limits. 
That is exactly the sort of thing we should be affirming and 
celebrating around here. I think that everyone on both sides of the 
aisle in this body should be celebrating Judge Gorsuch and what he 
believes about a constitutional system that has limits. And defending 
your own branch--the Founders envisioned a world where these three 
branches would be jealous of their own prerogatives--defending your own 
branch is not to attack another branch.
  As I read the media reports this morning of who said what to whom and 
who shouted at whom and who argued about what, what if we just paused 
and reflected again on what it means to believe in a constitution that 
has three separate but equal branches that are supposed to check and 
balance one another?
  After seeing some media reports this morning, I looked and I happened 
to have on my desk the breast-pocket card that was in my suit 2 days 
ago when I met with the judge, and I asked him about the comments 
coming from the White House criticizing a so-called judge. I wish to 
share with this body some of the comments the judge made to me when I 
asked him what he thought about the criticism of the so-called judge, 
because we don't have so-called judges, we don't have so-called 
Presidents, and we don't have so-called Senators; we have people from 
three branches who have taken an oath to a constitution.
  So here is some of what the judge told me when I asked him what he 
thought about those comments. He got a little bit emotional, and he 
said that any attack or any criticism of his brothers and sisters of 
the robe is an attack or a criticism on everybody wearing the robe as a 
judge.
  I think that is something this body should be pretty excited to hear 
someone who has been nominated to the High Court say.
  He said that it is incredibly disheartening to hear things that might 
undermine the credibility and the independence of the judiciary. He 
said that it is completely legitimate for all of us to vigorously 
debate individual opinions. We should argue about opinions. We can 
argue as citizens about cases. We can argue in this legislative branch 
or the executive branch can argue about the merits of particular 
opinions and yet we want to affirm the three branches.
  So he said it is disheartening for us to do anything that would 
undermine that.
  He then pointed me back to his comments at the White House the night 
he was nominated, and so I went back and looked at his comments, and 
the very first people he thanked when he had been nominated to the 
Court were--he said: I want to celebrate the judges of America who are 
the ``unsung heroes of the rule of law'' in this country. He called the 
judges ``unsung heroes of the rule of law.''
  He said: An independent judiciary has got to be tough. It is not my 
job as a nominee to the Court and it is not the job of any other judge 
to comment on particular cases, and it is not the job of judges to play 
politics or to hold press conferences talking about politics, but we 
can recognize that historically the other two branches are often wary 
of times when the Court asserts its prerogatives.
  He said: For instance, Thomas Jefferson didn't like Marbury v. 
Madison, and it was completely legitimate for President Jefferson to 
criticize and argue about the merits of the Marbury v. Madison decision 
even as we do the important civics work of reaffirming these three 
separate but equal branches.
  Frankly, I think that everybody in this body ought to be celebrating 
the nomination of a guy who is out there affirming three separate but 
equal branches and the independence of the judiciary. We should want to 
see the executive branch checked, and, frankly, if we really love 
America, as I know people in this body do, we should want to see our 
own powers limited because it is fundamentally American to be skeptical 
of the consolidation of power.
  Our Founders divided power and checked and balanced each of the other 
branches because they were skeptical of what people in power might 
ultimately do.
  Sadly, there are some on the other side of the aisle today--and I 
think many are going to give him a fair shake, but there are some on 
the other side of the aisle who decided they want to reflexively attack 
Judge Gorsuch. So it is like the Keystone Kops trying to run around and 
figure out which story you want to label him with. I hear some people 
saying: Well, Gorsuch was nominated by this President and a bunch of 
people don't like this President; therefore, he couldn't possibly be 
independent, he would be a puppet. There are other people saying in 
these private meetings allegedly Gorsuch has rented a plane and taken 
out a skywriting script and he is out there saying ``I hate Donald 
Trump. I hate Donald Trump.'' That is nonsense. Neither of those things 
is true. He is not a puppet, and he is not out there attacking the 
President of the United States. He is meeting with us, trying to 
explain his view of an independent judiciary. He is trying to affirm 
the same constitutional oath of office that all of us in this body have 
taken.
  I think it is high-time in this body that we get beyond reflexive 
partisanship of ``Republicans are for Republicans if they have the same 
label'' and ``Democrats are against Republicans''

[[Page S995]]

and vice versa. Our job fundamentally in this body is an oath that we 
have taken to three separate but equal branches. I think what we are 
hearing in these private meetings with Judge Gorsuch and what I am sure 
he is going to say when he speaks for himself publicly before the 
Judiciary Committee--what we are hearing from him is a guy who believes 
in three separate but equal branches and is skeptical of the 
consolidation of power because he understands why America has limited 
government. That is the kind of person we should be celebrating having 
been nominated to the Court.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. WARNER. Mr. President, I am here to speak about Mr. Price, but I 
want to respond to my friend the Senator from Nebraska.
  I appreciate very much the independence the Senator has shown in his 
tenure in the Senate. My hope would be that his comments about civics, 
his comments about our three branches of government--I hope we will 
take that speech and actually send it down to 1600 Pennsylvania Avenue 
because I concur with him. I concur with him about the basic civics 
lessons he laid out. I concur with him about three equal branches of 
government. I concur with him about the fact that I look forward to 
hearing from Judge Gorsuch and having my chance to view him.
  But I would also think that in any kind of objective analysis of what 
our country is going through right now, we have currently a President 
of the United States who--I have real questions whether he has read 
that document, the Constitution, whether he understands the basic 
tenets of three coequal branches.
  We saw his activities during a campaign where he called out a judge 
because of his ethnic heritage and somehow impugned that judge's 
independence. At some point, he walked that back, and perhaps those of 
us who were kind of scratching our heads thought, well, that is just 
during the campaign, and candidates do strange things during the 
campaign.
  Then we saw the President get elected, and we saw throughout a 
transition period decrees by twitter that are, again, unprecedented in 
modern activity. I know the President wants to be a disrupter, but 
there is some level of comity and some level of civics and some level 
of recognition of coequal branches that--candidly, when the President 
of the United States attacks a judge because he doesn't like the ruling 
in a way that calls into substance not the substance of the ruling but 
the very nature of the judiciary, I think all of us--and I know the 
Senator from Nebraska would agree with this--all of us need to sit up 
and say this is not what the Founders intended.
  I look forward to giving Judge Gorsuch and everyone else the 
President might nominate a fair look, a fair appeal, and then making a 
judgment on whether I think one of the most important positions--a 
lifetime position of serving on our Nation's highest Court--whether he 
is appropriate or not. But this President makes that case harder for 
his nominee when he shows such blatant disregard of the fundamental 
basics of our Constitution.
  I would be more than happy and glad if we would all dial it back a 
bit, but we are in uncharted territory in a way that, as somebody who 
believes every bit as much in the Constitution as the Presiding Officer 
does, it makes me very concerned about making sure we maintain those 
basic liberties, making sure we have a government that can live within 
its means, making sure we maintain the independence of the judiciary, 
the independence of our legislative body, and an Executive who knows 
there are limits on Presidential powers.
  I appreciate his comments and particularly appreciate the fact that 
through his tenure in the Senate, he has shown a level of independence. 
I have taken some hits from my own team for showing similar levels of 
independence. I commend his words, but I do hope that those words would 
actually make their way down to 1600 Pennsylvania Avenue. I am curious 
to see what the President's tweeting response to that speech would be.
  Mr. President, I did come here, though, today to rise and talk about 
a need that Virginians and, for that matter, Americans have, about a 
health care system that is affordable and accessible and provides high-
quality health care.
  I voted for the Affordable Care Act back in 2010, and I have 
acknowledged, I think along with many of us, that just like every major 
reform--just like Medicare and Social Security and Medicaid--Congress 
never gets it 100 percent right the first time and that Congress needed 
to revisit and improve certain aspects of the ACA.
  As anybody who serves in the legislative body knows, you have to have 
partners in order to get to yes. Unfortunately, that is what we have 
heard from folks on the other side for the last 7 years. We have heard 
all the critiques, we have heard the screech of repeal, but we have not 
heard any kind of plan on what you replace.
  The fact is, like it or not, ACA has played a critical role in 
driving health care innovation, protecting consumers, and reducing 
overall health care spending. Those are just facts--not alternative 
facts, not alt acts; those are just facts. The increased coverage to 
more people now makes it all the more difficult to find some way to 
repeal and maintain all the things that people liked, yet replace it 
with a plan that is actually more cost-effective.
  So today we consider a candidate for Secretary of Health and Human 
Services, the lead Cabinet member who will oversee our critical health 
care programs. Congressman Price has advocated for dismantling the ACA, 
and he has made it clear that, as Secretary of HHS, he would seek to 
implement policies that, I believe, will make health care more 
expensive and less accessible to Virginians.
  Today, after a great deal of reflection, I join my colleagues in 
opposing Congressman Price's nomination to be Secretary of HHS. And 
rather than going through the statistics and facts--I know I have other 
colleagues who want to speak--I want to reflect briefly on a couple of 
stories I have heard from Virginians.
  One of the things that was a benefit but I don't think folks have 
focused on enough is that the ACA, with all its challenges, did allow 
people freedom from the trap of being caught in a dead-end job that 
they couldn't move from because of the fear of losing their health care 
benefits. This was the first move toward an affordable benefits system, 
something I think we are going to have to move beyond health care to 
retirement and other aspects, as well, as more and more workers work 
not in traditional full-time and long-term employment, but more and 
more--one-third of the workforce today already is in some form of 
contingent work: part-time work, independent contractors, gig work. 
They have no benefits, other than the fact that through the ACA they 
are able to maintain health care. The ACA has actually reduced this 
phenomenon of ``job lock.''
  A couple of weeks ago, I met Andrea in Richmond. She always dreamed 
of opening a software business, but she and her business partner were 
considered uninsurable because of preexisting conditions. The ACA 
changed everything. After obtaining insurance through the exchanges, 
Andrea and her business partner were able to take that risk. Today, 
that successful company has a staff of 12. As Andrea said: ``Simply 
put, my business would not exist without the security the Affordable 
Care Act provided.''
  The coverage gains we have seen are remarkable. That is clear from 
hundreds of Virginians who have contacted me with stories like 
Andrea's. In fact, never before in our Nation's history has the rate of 
uninsured dropped below 10 percent. In Virginia, a State where our 
legislature unfortunately would not expand Medicaid, we have still seen 
an uninsured rate drop from 15 percent to 9 percent, and 327,000 
Virginians got additional coverage. This is especially true in rural 
areas.
  Nationwide, the ACA lowered the percentage of uninsured by eight 
points in rural communities. Rural communities often struggle with 
hospitals that, without ACA, would be on the brink of financial 
extinction.
  Here is another quick example from Janet in Mosely, a rural area 
south of Richmond, who grows and sells organic vegetables to support 
her family, which includes four children. She said:

       We went through various attempts to manage the cost of 
     health insurance and health care in our finances before the 
     ACA--with no

[[Page S996]]

     good results. [Because of ACA], we have been able to have an 
     appropriate plan, with a realistic deductible, access to 
     quality doctors, and be able to go to preventative care 
     annual appointments. We are quite fearful about what life and 
     business may be like without the ACA, or an improved-upon 
     version of the ACA. A repeal would be disastrous.

  Unfortunately, not only has Congressman Price strongly opposed the 
ACA, but his plan--or what framework of a plan you see--and other 
proposals dramatically scale back the individual market reforms that 
allow people like Andrea and Janet to obtain meaningful coverage. As 
our workforce becomes more mobile than ever, Congressman Price has said 
people should have access to care, but access to care without 
affordable care isn't true access.
  For example, if you got rid of the ACA with no plan to replace it, we 
would see the reinstatement of lifetime and annual limits on coverage. 
They are what turned getting sick into a financial calamity for so many 
people. Plans would be required to cover far less in terms of 
conditions, moving away from the ACA's promise that insurance is worth 
more than the paper it is written on.
  As I mentioned already, the close to one-third of the workforce that 
is already in some level of nontraditional work and doesn't work full 
time in a long-term employment facility would lose that flexibility to 
move from job to job.
  We have also heard from Congressman Price plans to block-grant, for 
example, Medicare. We in Virginia have a very trim Medicaid program. We 
have also not expanded Medicare, which I think was a grave mistake of 
the legislature. The Governor and I agreed we should expand it. Putting 
a Block Grant Program in place for Virginia would be a disaster in 
terms of Medicaid. As well, Congressman Price has voted against the 
Children's Health Insurance Program, the CHIP program, one of the 
things I was proud to expand in Virginia, where we ended up signing up 
98 percent of all eligible children. Congressman Price called the CHIP 
program ``government-run socialized medicine.'' What he didn't say is 
what he would say to the 200,000-plus kids in Virginia who get their 
health care coverage through CHIP.
  So I believe that Congressman Price's approach--whether it is on 
Medicaid block-granting, whether it is on the ACA, whether it is on the 
CHIP program, whether it is his failure to come up with a sufficient 
plan to provide access and affordability--means that if we go forward 
with his nomination, the kind of chaos that would be created if you 
repeal the ACA without a replacement plan in place will not only affect 
the 20 million-plus Americans who got health care coverage through the 
ACA but literally everyone else because it will absolutely pull the 
bottom out of the overall insurance market. These are chances that we 
can't take.
  I have a series of other stories, but I see my friend the Senator 
from Connecticut, who spent a great deal of time on this issue back 
when there weren't that many people coming to the floor to defend the 
ACA. I guess it is better to be early and right, but Congressman Murphy 
has been a great leader on this issue. He was here, as I mentioned, on 
the floor, when many of us were active in other activities, an absolute 
native of the ACA, when we went through the bad rollout. But what we 
have seen in America, as we get closer now to the reality of the new 
administration, is that the new majority wants to actually repeal this 
program without fixing it--simply repeal. I think his forewarnings 
about what would happen are all coming to pass.
  I will personally be opposing the nomination of Congressman Price to 
be Secretary of HHS. I hope my colleagues will join me.
  I do want to yield the floor to the Senator from Connecticut, who has 
been such a great leader on this issue.
  The PRESIDING OFFICER (Mr. Sasse). The Senator from Connecticut.
  Mr. MURPHY. Mr. President, I am going to be brief. I want to build on 
some of the comments Senator Warner made. It is unclear what President 
Trump's position is on repeal and replacement of the Affordable Care 
Act. He has made all sorts of commitments all over the map, suggesting 
that he wants to deconstruct the act in full, suggesting that he wants 
to keep some elements of it, making promises that whatever comes next 
will be just as good, will be better than what consumers have today.
  I think what you are going to hear consistently from our side is a 
willingness, a desire, an enthusiasm to engage in a conversation with 
Republicans about how to strengthen our health care system, how to 
repair the parts of the Affordable Care Act that are broken, but keep 
the majority of that legislation, which is delivering lifesaving care 
to people as we speak, and not descend into health care chaos by 
repealing this legislation with no plan for what comes next.
  The genesis of our opposition, of my opposition, to Tom Price's 
nomination to be the Secretary of the Department of Health and Human 
Services is that he has been, in the House of Representatives, the face 
of the Republican effort to repeal the Affordable Care Act with 
absolutely no plan for what comes next.
  There were many other choices that could have been made for 
selections to head the Department and lead the conversation about the 
Affordable Care Act and its future that could have signaled that we 
were going to have an ability to come together. But when I was a Member 
of the House of Representatives, I watched my colleague, Tom Price, be 
the leader, the face of the campaign to repeal the Affordable Care Act, 
with absolutely no replacement, which would descend our entire health 
care marketplace into chaos.
  That is chiefly why I stand here in opposition to his nomination 
today. He did offer a token plan to replace it, but it had nothing of 
value to the people of Connecticut. It would have repealed Medicaid 
expansion with no plan for what came next. It would have repealed the 
insurance protections for people who are sick with a $3 billion high-
risk pool that would never have met the needs of those who have serious 
illness and disease and who cannot find insurance.
  Our worry is that we are on the precipice of repealing an act which 
has saved thousands of lives, which has insured 20 million people, and 
the results will be health care chaos for everyone, whether they are on 
the Affordable Care Act or not.
  Tom Price has been the face of the repeal effort in the House of 
Representatives. He has been the face of the irresponsible position of 
getting rid of this law with nothing that comes next. And it simply 
doesn't give us confidence that there is going to be a rational 
bipartisan conversation about how to improve our health care system.
  This isn't politics. I just want to underscore the point that Senator 
Warner made. This isn't about scoring political points. This isn't 
simply about numbers. This is about human lives that are affected if 
Tom Price gets what he has been asking for during the last 6 years, 
which is a full repeal of the Affordable Care Act without any plan for 
what comes next.
  This is a picture of Mark and his family from Westbrook. This is a 
picture of his daughter Dominique. Dominique has a profound 
intellectual disability. She also has cerebral palsy. She doesn't have 
the use of her left arm. She walks with an unsteady gait. She also 
cannot chew food, so she takes liquid nutrition. But she has an amazing 
spirit. She loves school. She loves music. She loves singing to Disney 
movies. She plays soccer, buddy baseball, and rides a horse for 
therapy, but Mark and his wife used to spend $40,000 a year out of 
their own pocket for her care. The Affordable Care Act saved this 
family from potential bankruptcy. The Affordable Care Act now, through 
Medicaid expansion, allows Dominique to get care that is socially 
insured. And Mark asks:

       After all, who are we as a people and a country if we 
     cannot take care of those who for no fault of their own 
     cannot take care of themselves? Dominique didn't do anything 
     wrong, she was born this way and deserves to have a 
     fulfilling life.

  That is the whole concept of insurance: The idea that we should 
socialize the cost of caring for kids and adults who, through no fault 
of their own, get sick. But without the Affordable Care Act, this 
family bears the burden of caring for Dominique by themselves. And 
there is no replacement. There is no plan on the table today--certainly 
not Tom Price's reputed replacement plan in the House of 
Representatives--that offers any help to this family if the Affordable 
Care Act goes away.
  Let me introduce you to one more family. This is a picture of Angela. 
She

[[Page S997]]

is hiding here--Angela from New Canaan. Angela is 49 years old. She was 
diagnosed with stage IV breast cancer in 2015. The good news is that 
Angela is winning the fight against breast cancer, but she would face 
the inability to get health care insurance if not for the Affordable 
Care Act because if this family ever lost continuous care, they would 
be uninsurable. So the protections built into the law allow them to pay 
reasonable prices. She says:

       Would President Trump or any member of Congress who voted 
     to repeal the ACA be willing to write to my 12 and 9 year old 
     boys, and explain to them why they let their Mommy die? I 
     doubt they even give a damn.

  I don't think she is right on that. I think that everybody in this 
Chamber cares about this family, but it is a reminder that there are 
really personal consequences for millions of Americans if Tom Price, as 
the leader of the Department of Health and Human Services, leads a 
campaign to repeal the Affordable Care Act without any replacement.
  We talked about the damage that will be done to these families, but 
for the entire marketplace, there is nothing but chaos if Tom Price 
gets his way. I opposed his nomination right from the start because I 
knew who he was in the House of Representatives. I knew that he had led 
this campaign of health care destruction for families like those that I 
just described.
  Frankly, his hearing just compounded my worries. These ethical lapses 
that have been raised over and over again just draw even more question 
as to whether he is going to use this position as the head of the 
Department of Health and Human Services to protect and advance the 
health care of my constituents or he is going to use that position to 
enrich himself and his family.
  Those are serious accusations. I get it, but these were serious 
ethical lapses that were uncovered, not by us but by an independent 
journalist raised as part of these hearings. I would hope this body 
would consider rejecting Tom Price's nomination so we can find someone 
to lead that agency and lead our conversation on the floor of the 
Senate about the future of health care, so that instead of continuing 
what has been a bitterly divisive issue over the last 6 years, we can 
finally find a way to come together and answer Angela's concerns that 
Donald Trump and the Republicans who support him don't care about her 
and her family, are willing to let her die.
  I don't think that is true, but by putting someone in this position 
as the head of the Department who has campaigned on repealing this act, 
taking away from Angela the protections that allow her to succeed and 
to live and to continue to beat cancer, without any idea for what comes 
next, it suggests that the division will continue and catastrophe will 
be in line for families like hers.
  I will oppose this nomination. I urge my colleagues to do the same.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas.
  Mr. COTTON. Mr. President, as I said before, we should not be holding 
up any of the President's nominees. There is far too much work to be 
done, but I think that is especially true for the man whose nomination 
is before us today, the next Secretary of Health and Human Services, 
Dr. Tom Price, who I am happy to say has my full support.
  It is especially important that we confirm Dr. Price because, as we 
all know, our health care has undergone some serious turmoil as of 
late. This was undoubtedly caused, at least in part, by the rolling 
calamity of ObamaCare. You can step back and you survey the wreckage, 
and it is sobering to see what that law has left in its wake: double-
digit premium hikes, very high deductibles, and millions of canceled 
plans.
  For all the fanfare over the law's passage, and all the arguments 
that followed, it seems we have forgotten the person who matters the 
most, the patient. That is what the next HHS Secretary is facing, a 
Herculean or perhaps you might say a Humpty-Dumpty-like task of picking 
up the pieces and rebuilding our health care system from the ground up.
  So as we consider this nomination, I think it is appropriate to ask 
ourselves: If we need someone who will focus on the needs of patients, 
why not pick a doctor? Dr. Price was an orthopedic surgeon in private 
practice for nearly 20 years. He taught and trained young doctors 
personally. So when he hears the phrase ``quality, affordable, 
personalized care,'' it is not an abstract notion to him. It is not 
something he dreamed up in the Halls of Congress because he himself has 
provided just that kind of care to real people.
  When we repeal and replace ObamaCare, we have to avoid the kind of 
thinking that gave rise to it. We need someone with on-the-ground 
understanding of what it takes to care for patients, someone who knows 
what it is like to stand at a bedside with a patient comforting her in 
a confusing and frightful moment.
  Dr. Tom Price is that man. Tom Price is also my friend. We served 
together in the House of Representatives. He is a good man. That is 
why, during his time in public service, he has earned the respect of 
his colleagues as he has worked his way up the ranks: chairman of the 
Republican study committee, chairman of the House Republican policy 
committee, and, most recently, chairman of the House Budget Committee.
  He has studied our health care system from top to bottom, and he is 
no stranger to the health care battles the last 8 years. You could say 
his chief qualification for the job of replacing ObamaCare is he had 
the good sense to oppose it in the first place, but Tom Price did not 
just vote no.
  Contrary to what you have heard from the Democrats, he also offered 
his own alternative, the Empowering Patients First Act. You may or may 
not like that bill, but I think you have to admire that he was willing 
to make a serious proposal. That is the kind of leadership we need at 
the Department of Health and Human Services.
  I want to express my support for Tom Price's nomination to be the 
next Secretary of Health and Human Services. I urge all Senators to 
vote for his confirmation.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Perdue). The Senator from Virginia.
  Mr. KAINE. Mr. President, I also rise to speak about the nomination 
of Congressman Price as HHS Secretary. I will oppose his nomination, 
principally because he has been an opponent of virtually every program 
that provides health care access to people with modest means in this 
country: Medicare, Medicaid, the S-CHIP program--which he called 
socialism--Planned Parenthood, which is the primary health care 
provider of choice for millions of women, and the Affordable Care Act.
  There is much to talk about, but I am going to focus my comments 
today on his repeated promises to repeal the Affordable Care Act. 
Repeal of the Affordable Care Act would be very unwise. It would be 
heartless, and it would be economically foolish. The Virginia stats are 
instructive. In Virginia, 179,000 Virginians have been able to enroll 
in Medicaid since the ACA was passed--an additional 179,000--and nearly 
380,000 Virginians have been able to get coverage through the 
marketplace.
  We have not done the Medicaid expansion program. If we did, another 
400,000 could receive care through the ACA. Nearly 4 million Virginians 
have protection against discrimination on the grounds of preexisting 
health conditions. They have such conditions, and they could be turned 
away from insurance companies, as they have been in the past, as my own 
family has been.
  Before the ACA, only those with employer coverage got tax benefits to 
help pay for health insurance. Now, 320,000 moderate- and low-income 
Virginians get tax credits averaging $275 a month to help. In addition, 
there are nearly 5 million Virginians with employer-sponsored 
insurance, and over 800,000 Virginians would lose access to free 
preventive care under Medicare if the ACA were to be repealed.
  Nationally, a repeal of the ACA--under an estimate of the Urban 
Institute--would cause 30 million people to lose their health 
insurance. That is the combined population of 19 States.
  We had a hearing last week in the Senate HELP Committee about the 
Affordable Care Act. It was called, by the majority, ``ObamaCare 
Emergency.'' I asked the witnesses, Democratic, Republican, and of no 
political identification--I asked them: Would a repeal of the 
Affordable Care Act with no replacement be an emergency? All of the

[[Page S998]]

witnesses agreed that it would. One of the witnesses said it is more 
than an emergency, it would be a catastrophe.
  So then I asked those witnesses--again, bipartisan witnesses: OK. We 
shouldn't repeal it. That means we should fix it or repair it or reform 
it or improve it. Should we do a fix or improvement hastily, 
carelessly, and secretly or should we do it openly, publicly, 
carefully, and deliberately?
  They all said: Of course, we should not rush. We should get this 
right. That is why many colleagues on our side have asked Republicans 
to sit down with us and let's make improvements, but don't push people 
off of health insurance.
  It would also lead to a significant economic catastrophe for 
hospitals, for providers, to have a repeal and not know what comes 
next. Remember that health care is one-sixth of the American economy. 
If you inject uncertainty into that, you have consequences that we 
could not now predict that would be negative.
  The real story is not any of these statistics, and I will pick up on 
what my friend, the Senator from Arkansas, said. The real story is 
about individuals, patients, and what happens. Three weeks ago, I put 
on my Web site a little section, kaine.senate.gov/acastory. I asked 
people to submit what it would mean to have a repeal of the Affordable 
Care Act.
  To date, I have had 1,654 submissions of what it would mean to them. 
We have been able to follow up on some of them and get permission from 
some so I could read their stories on the floor. So during the 
remainder of my speech, I am just going to tell you what a repeal of 
the ACA would mean to people all over my Commonwealth.
  Michael Dunkley lives in Alexandria VA.

       I was diagnosed with advanced Stage 4 non-Hodgkin's 
     lymphoma cancer in October of 2013 and was put immediately on 
     an extremely powerful 5-component chemotherapy treatment 
     program that would conclude in late January, 2014. My medical 
     insurance coverage at the time of my diagnosis was under the 
     terms of COBRA, and my monthly premium was $875, with a 
     $7,500 deductible and a $15,000 out-of-pocket limit.
       My COBRA coverage expired at midnight on December 31, 2013, 
     and was immediately [able to be] replaced [because of a] plan 
     that I had been issued through the provisions of the . . . 
     Affordable Care Act. Because of the new law, I could not be 
     denied coverage due to a pre-existing condition (advanced 
     cancer), and I was issued a new plan that was far superior in 
     coverage and cost me only $575 a month, with zero deductible 
     and an $1,850 out-of-pocket limit. 3 days after receiving my 
     new health insurance coverage, I was infused with my 5th-
     round of chemotherapy, for which I was charged $35,000. 
     Near the end of January, 2014, I received a 6th-dose of 
     chemotherapy and was billed another $35,000. . . . I was 
     given a PET-CT nuclear scan that cost $5,000, and 1 week 
     after that, on February 14, 2014, my wife and I were told 
     by my oncologist that my advanced cancer [was now in] 
     complete remission. As I am the sole caregiver for my 
     wife, who has advanced Multiple Sclerosis, the news of the 
     cancer's remission was a life-saver for her as well as 
     myself.
       Had it not been for the Patient Protection and Affordable 
     Care Act, I would not have been able to purchase [my] health-
     care insurance, for any price, due to my pre-existing 
     condition of having cancer. Had it not been for the income 
     subsidy, I would have not been able to afford to pay the 
     premium for a superior plan, a plan which saved my life. 
     Thank you, President Obama, and thanks to every member of 
     Congress that voted in favor of the lifesaving Patient 
     Protection and Affordable Care Act.

  Patricia Mills, Virginia Beach.

       My daughter, who has Lupus, and her husband, who has 
     juvenile diabetes have been struggling for the last six years 
     to keep their conditions under control. They have a gifted 
     seventeen year old daughter who has been in the IB academy in 
     Virginia Beach, and have had to sell their home to pay off 
     debts due to complications from their illnesses. My husband 
     and myself have made our home their home, but their struggles 
     have continued because of the enormity of their medical 
     expenses.
       Since they have been able to enter the Affordable Care Act 
     for their insurance, they have been able to stabilize their 
     lives financially. If the Affordable Care Act is repealed, I 
     don't know what will happen to them. Insulin is extremely 
     expensive and so are the supplies to inject and check blood 
     sugar to keep my son in law alive. There is NO option for a 
     diabetic to turn to to get life saving insulin a diabetic 
     individual needs who works hard every day, but falls above 
     the Medicare threshold. We are living in terror at the 
     thought of a repeal.

  Justine Jackson, Radford:

       As I type this, I am currently sitting in the office of the 
     Community Health Center of the New River Valley. I am 25 
     years old and the last doctor I had seen until today was my 
     pediatrician. Like many struggling Americans, I cannot afford 
     insurance and rely on low income/free clinics to receive 
     preventive care. The ACA helped programs like the one at the 
     Community Health Center [clinic] with funding.
       We cannot afford to lose clinics like this one with cuts to 
     funding public health. Americans should not be denied health 
     care. We should not have to file for bankruptcy for becoming 
     sick or avoiding a doctor all together because it costs too 
     much. The Affordable Care Act should be revised, not 
     repealed. If Congress repeals the ACA, 20 million Americans 
     risk losing insurance. That's 20 million Americans that may 
     stop going to doctors because they can't afford it. I plead 
     to Congress to care about your fellow Americans and give us 
     health coverage that is affordable or, better yet free. 
     Seeing the doctor should not revolve around a choice between 
     going hungry or not.

  Gabriella Falco, Alexandria, VA:

       Senator Kaine, my name is Gabriella, I'm a 26-year old 
     full-time student studying what she loves. I work part-time 
     in my field of study and make some money to live on, but my 
     school expenses are all covered by student loans. When I was 
     22, fresh out of college and unemployed, I was diagnosed with 
     hyperparathyroidism and many severe kidney stones. To prevent 
     kidney failure or worse, I required multiple surgeries, all 
     of which were covered by my parents' insurance through the 
     Affordable Care Act. Ever since, I have had twice yearly 
     check-ups and ultrasounds, as well as some scares with my 
     kidneys. There is no explanation for my medical history. All 
     the doctors can do is monitor and treat it when troubles 
     arise.
       When I turned 26, I chose my own healthcare plan through 
     the ACA. As I am a student, I have no way of working full 
     time for benefits. The ACA has allowed me to live and safely 
     and affordably monitor and treat my kidneys while finishing 
     my master's degree. Were it not for the ACA, I fear my health 
     would become a choice between death or bankruptcy. I don't 
     know what I'll do if I lose my health care. I could not 
     afford it without the ACA. I will fight for you, Senator 
     Kaine, and please fight for me and my health in Washington.

  Corwin Hammond, Williamsburg, VA:

       Senator Kaine, Before the ACA, my wife and I did not have 
     nor could we afford medical insurance. My wife is a business 
     owner and I'm a pastor of a small church in Toano, Virginia. 
     I left my . . . state job that provided full benefits, 
     because the ministry needs in my community were so great. I 
     am grateful for this legislation that has allowed us to have 
     peace of mind in knowing that we are covered and able to 
     visit the doctor without going bankrupt. Why not just fix the 
     components that need repairing; instead of throwing millions 
     of hard-working Americans to the wolves. We deserve 
     better. How about the congress and senate repealing their 
     health care and leaving ours alone? Thank You, Corwin 
     Hammond.

  Sarah Mullins-Spears, Prospect, VA:

       Senator Kaine, I have one perfectly imperfect child. He has 
     not one but two ``pre-existing'' conditions. . . . He was 
     diagnosed with Asperger's Syndrome . . . and he was also born 
     with a unicameral bone cyst, a hollow bone. . . .

  That affects one in four children.

       This year we were able to purchase our lifelong dream. . . 
     . A family farm. . . . 18 PERFECT acres of peace and promise. 
     This summer we endured a medical ordeal we could have NEVER 
     imagined. . . . My son broke his arm, due to the cyst, for 
     the 4th time in less than 3 years. . . . And we were finally 
     approved for surgery to place a titanium rod through the cyst 
     that would prevent any further breaks. On July 26th the 
     surgery was successfully completed and the next day we were 
     released with instructions on pain management and to not 
     remove the surgical bandages for 3 days. On July 30th we 
     removed the bandages to find a hot, swollen, bright red 
     nightmare. We were readmitted to the hospital. . . . I wasn't 
     truly afraid until I saw the face of the same nurse that 
     discharged us that night. . . . she was fighting back tears. 
     . . . Over the next 3 days there were 2 additional surgeries 
     including a PICC line, and after 6 days we were released to 
     home health care. . . . Suddenly I was a health care 
     provider, every 8 hours a dose of antibiotics had to be 
     attached to the PICC line, it took approximately 90 minutes 
     to administer, and then the line had to be cleaned and 
     prepped. There was NEVER a 6 hour window that I could be away 
     from my child. . . . Which meant I was not able to work the 6 
     hour schedule at my part time job. Which means after the 
     second week I was let go, told I could reapply when I was 
     ready to come back to work. . . . On August 26th my son slept 
     for almost 20 straight hours and then woke up vomiting and 
     with a fever. . . . So by lunch we were readmitted to the 
     hospital again. . . . The next day while in the hospital he 
     broke out in a mystery rash from head to toe, and had a white 
     blood cell count of a chemo patient. For me this was the 
     worst, because no one, not even the consult from UVA 
     infectious diseases, knew why. After 3 days, with the WBC 
     count trending up and more research, the leap of faith was 
     decided to end all antibiotics and see if they were the cause 
     for the reactions. They were and by October my child was 
     declared healed and eligible to start school. . . . Almost 5

[[Page S999]]

     weeks after he should have started his first day of middle 
     school. . . . By then the bills had also begun to arrive . . 
     . Daily. The first bill from the hospital was $105,547.12 
     before insurance and over $12,000 with benefits. We are still 
     receiving bills and our pre insurance totals are well over 
     $750,000 before insurance. . . . BUT because of ACA we were 
     capped at $7,500 out of pocket. This means $231 a month for 
     24 months which has an impact on our family but it also means 
     we can still afford our mortgage. I wake up every morning 
     thankful for my healthy child and amazed that we live on this 
     tiny piece of heaven. ACA made that possible for us. I have 
     kept all bills, x rays, and documents related to our journey.

  Sasha Baskin, Richmond:

       When I was seventeen I discovered I had a rare and highly 
     aggressive tumor in my jaw. It took three experimental 
     surgeries to remove and replace the tumor with a metal 
     implant and bone graft. I was fortunate enough to be 
     dependent on my parents' insurance when this medical event 
     first took place. With the Affordable Care Act I have been 
     able to stay on my parents' insurance into college and 
     graduate school and maintain my health status through regular 
     doctors' visits. I require a yearly check-up to make sure 
     that the medical implant is intact and that the bone graft is 
     growing successfully. Within the next 5-10 years I will need 
     another surgery to replace the metal implant with new 
     technology. If the implant breaks or I have any kind of 
     accident that injures my jaw I will require emergency surgery 
     and most likely to have my jaw wired shut. I will turn 26 in 
     October and no longer be eligible to be on my parents' 
     insurance. Thanks to the affordable care act I can rely on 
     being able to maintain affordable insurance and feel 
     comfortable about my health. I can trust that I will not be 
     turned away due to my pre-existing condition of a metal jaw 
     and history of aggressive tumors. I can be sure that I will 
     not reach a lifetime limit of coverage when I need another 
     surgery, (or if the worst happens and I need to have 
     emergency surgery). When the doctors first found this tumor 
     when I was seventeen, they told me not to go to college 
     because I needed so many surgeries. I was planning to attend 
     art school in Maryland, my parents lived in Connecticut and 
     my doctors were in Boston. I was determined not to let a 
     medical problem control my life. I went to and graduated from 
     college in Maryland and am now enrolled in graduate school 
     pursuing masters of fine arts in Richmond Virginia. I rely on 
     the affordable care act for safe and reliable access to 
     doctors all over the country. I have been able to live my 
     life independently because of the freedoms and access to 
     healthcare it has provided. I am a recent Virginia citizen, 
     but I love it here. I am proud of my representation and I 
     hope that my story will help you work towards saving health 
     care in our country.

  The PRESIDENT pro tempore. The Senator will suspend.
  Mr. KAINE. I will suspend and return following the swearing in.

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