[Congressional Record Volume 163, Number 41 (Thursday, March 9, 2017)]
[Senate]
[Pages S1736-S1738]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Homeland Security
Mr. BOOZMAN. Mr. President, when President Trump began his campaign
for the White House, he made national security and, in particular,
homeland security a cornerstone of his platform. His calls to secure
the border to keep terrorists off U.S. soil and to protect our
communities struck a chord with a large majority of Americans who for
years felt that Washington ignored their very real concerns about our
porous borders and broken immigration system.
As expected, the President moved quickly to deliver on his promises
to fix this broken system. This week, the Trump administration rolled
out a revised version of this Executive order aimed at restoring
confidence in the procedures we have used to vet refugees fleeing from
nations that are known to harbor radical and violent extremists.
The revised version appears to have benefited from the engagement of
the President's Cabinet, especially the key input of Homeland Security
Secretary Kelly. This valuable input underscores how important it is
for the President to have his team in place to govern effectively.
Senate Democrats have slowed the confirmation process at every turn.
I encourage them to abandon the political games so we can quickly fill
the remaining vacancies that require Senate confirmation.
It is vital that every affected agency is engaged in these types of
decisions. That isn't possible if the Senate is failing to do its duty
to confirm the President's nominees. Congress has many problems to
tackle, but protecting our Nation is at the top of that list. That
requires we work together to govern.
It also requires we take a step back from the heated rhetoric and
have honest conversations. Taking the fundamental steps to protect our
homeland does not diminish the fact that we are a welcoming nation that
strives to help the vulnerable.
It is no secret that ISIS and other volatile extremists want to
exploit our Nation's generosity and welcoming spirit to sneak
terrorists onto American soil. This plan has worked well in Europe.
ISIS believes it can work here as well. We can, and must, take
reasonable measures to prevent that.
It is reasonable, responsible, in fact, to put a pause on accepting
refugees from these nations in order to fix the flaws in the process
and instill confidence in the system. The revised order removes Iraq
from the list of countries. That is a move in the right direction. It
shows that the Iraqis have taken the right steps in agreeing to
increase their cooperation with us, and effecting positive outcomes in
our relations with these nations is what this pause is all about.
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Four of the countries on this list don't even have a U.S. Embassy. So
you can understand how difficult it is to get a complete picture of the
refugees seeking asylum from those countries when we don't even have a
means by which to communicate.
Once the President's Executive order goes into effect, every country
will be evaluated within 20 days. If a country comes up short of where
it needs to be, it will have 50 days to fix the failures and
communications with us.
The reasonable measures we are taking to reduce this threat in no way
run counter to the ideals our Nation is built upon. We can be proud of
the resources the United States has provided to support those fleeing
persecution in war-torn Syria. I have visited the refugee camps we
support in Jordan and Turkey. Our commitment to their well-being is
strong. The rhetoric doesn't match the realities when it comes to this
issue.
The administration's efforts to secure our borders has been met with
similar hyperbole. Again, there is nothing unreasonable about ensuring
that we know who is coming into our Nation. We are a nation of
immigrants and must remain welcoming to those who want to achieve the
American dream. We should be proud of our record to naturalize those
who immigrate here legally. We naturalize more new citizens per year
than the rest of the world combined. Enforcing the law, ensuring the
safety and security of our Nation, will not change our commitment to
being a welcoming society to those who seek a better life.
But you can't create policies to secure our homeland while wearing
rose-colored glasses. There are terrorists seeking to exploit our good
graces so they can attack us here at home. This is not a scare tactic;
this is reality, and we have to root our policies in reality.
As chairman of the Appropriations Homeland Security Subcommittee, I
strongly support President Trump's efforts to get Washington to uphold
our most important responsibility: protecting the American people. I
stand ready to work with him, Secretary Kelly, and my colleagues to
accomplish this goal.
I yield the floor.
The PRESIDING OFFICER. The Senator from Michigan.
Mr. PETERS. Mr. President, I rise today to express my opposition to
the confirmation of Seema Verma as Administrator of the Centers for
Medicare and Medicaid Services, known as CMS.
As CMS Administrator, Ms. Verma would oversee healthcare coverage for
more than 55 million seniors and disabled individuals in the Medicare
Program. In addition, she would be the primary authority for the
Medicaid Program, the Children's Health Insurance Program, and our
Nation's health insurance marketplace. Together, these programs cover
over 70 million Americans.
I have serious concerns that if confirmed, Ms. Verma will pursue
shortsighted changes to our healthcare system that could jeopardize
care for working families, while providing huge benefits to corporate
interests.
Ms. Verma has openly stated her desire to put insurance companies
back in charge of our healthcare by allowing insurers to deny women
maternity care coverage as an essential health benefit. She has also
expressed support for proposals that would weaken essential health
benefits that ensure coverage for mental healthcare, preventive
screenings, and comprehensive pediatric care for children. These
comprehensive services form the backbone of the healthcare system that
invests in preventive care, improving outcomes, lowering costs, and
puts consumers in charge of their own healthcare. Ms. Verma is
proposing to take us back to the days when insurance companies were in
control and when they would tell you what was best, not you or your
doctor.
She has also expressed support for dangerous and radical proposals
that would change Medicare as we know it. I believe that when it comes
to Medicare, our future CMS Administrator should be doing everything he
or she can to strengthen an incredibly successful program. Ms. Verma,
instead, supports policies that reduce the quality of care and increase
costs on older Americans.
Our Nation's seniors have worked hard their entire lives. We owe them
a secure and dignified retirement. When Congress was first debating the
Affordable Care Act in 2009, I heard from seniors who had split their
pills in half or would forgo their prescriptions altogether just to put
food on their table. This is simply unacceptable in this great country
of ours.
It is important to remember that the Affordable Care Act extended the
solvency of Medicare by more than a decade, while simultaneously
bringing down prescription drug costs for seniors. Because of
improvements to Medicare in the Affordable Care Act, the average senior
in Michigan saved over $1,000 on prescription drug costs in 2015.
While this shows the success the ACA has had in helping older
Americans, there is still much more work to do. We must keep moving
forward to strengthen and improve Medicare. I am concerned Ms. Verma
will move us backward.
During her confirmation hearing, she failed to express her opposition
to proposals that would increase Medicare's eligibility age. This means
that Michigan's construction workers, nurses, and autoworkers would
need to spend more years on their feet before they see the coverage
they have earned.
Ms. Verma provided no clear direction on what she will do to
strengthen the Medicare Program, and I am concerned that she sees older
Americans as just one more line on a budget. These Americans have
worked hard their entire lives, and the very last thing we should be
doing is making cuts at their expense. Instead, we should focus on
proven advances in technology that improve Medicare and cut costs
without jeopardizing care for seniors and disabled individuals.
I worked with my colleagues in Congress to introduce bipartisan
proposals that will do just that. For example, Medicare spends one out
of every three dollars on diabetes treatment. The total economic cost
of diabetes is estimated to be $245 billion every year. I have
introduced bipartisan legislation that allows Medicare to enroll
individuals at risk for developing diabetes into medical nutrition
therapy services proven to decrease the likelihood they will develop
diabetes in the first place. I have also introduced bipartisan
legislation that expands Medicare's use of telemedicine, increasing
access for patients in rural and underserved communities and bringing
down future health costs by ensuring patients get the preventive care
they need to stay healthy.
I will keep working to improve and modernize our healthcare system
without sacrificing care for the most vulnerable. Unfortunately, I do
not believe Ms. Verma shares this commitment. I am voting against Ms.
Verma's nomination because our seniors and working families deserve a
CMS Administrator who is fighting to improve their healthcare, not one
who merely sees them as a budgetary obligation.
I will oppose her confirmation, and I strongly urge my colleagues to
do the same.
Mr. President, I yield 35 minutes of my postcloture debate time to
Senator Wyden.
The PRESIDING OFFICER. The Senator has that right.
Mr. PETERS. I yield the floor.
Ms. CANTWELL. Mr. President, I rise to discuss the nomination of
Seema Verma for Administrator of the Centers for Medicare and Medicaid
Services, CMS.
We have before us a nominee that would run an agency responsible for
the healthcare of more than 100 million Americans, with an annual
budget of about $1 trillion. This is the agency that administers
Medicare, Medicaid, the Children's Health Insurance Program, and health
insurance exchanges. In short, CMS is the single most consequential
agency in health care.
Yes, I am deeply concerned about this administration's ideas on
Medicare and on the individual insurance market, over both of which CMS
has profound influence, but I am most concerned about their plans for
Medicaid.
Based on Ms. Verma's history, her actions, her statements, and her
testimony before the Senate Finance Committee, it is clear to me that
Mrs. Verma is not only complicit but is leading the charge to wage a
war on Medicaid.
Why do I say that? Let us look at Ms. Verma's record, actions, and
testimony on Medicaid. In Indiana, Ms. Verma made millions of dollars
in consulting
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fees by kicking poor working people off of Medicaid for failure to pay
monthly contributions similar to premiums. This plan forced people
making $10,000 a year, $5,000 a year, or even homeless people with
virtually no income to pay a monthly contribution or be penalized. As a
result of Ms. Verma's work, about 2,500 Hoosiers have been cut from
care. Evaluations of this plan by independent experts show it is
confusing to beneficiaries and has not demonstrated better results than
traditional Medicaid expansion. Meanwhile, enrollment is far lower than
projected.
During my meeting with her and in her testimony before the Senate
Finance Committee, Ms. Verma stated that Medicaid should not be an
option for able-bodied people. Ms. Verma seems to think the private
sector can serve this population on its own. Based on what we know
about the historical affordability challenges in the individual health
insurance market, I find this notion hard to believe.
My State is innovating in Medicaid through ``rebalancing'' from
nursing homes to home and community care, integrating behavioral health
and primary care, and adopting of innovative new waivers through
collaboration with the Federal Government. In fact, Washington State
realized more than $2.5 billion in savings over 15 years through
rebalancing efforts; yet Ms. Verma will not commit to a single delivery
system reform idea.
Ms. Verma claims Medicaid is a top-down Federal power grab. On the
contrary, Medicaid is an optional State program, with all States
participating. Every State participates because they know Medicaid is a
good strategy for covering a low-income and vulnerable population and
supporting their healthcare delivery system. Medicaid is highly
flexible right now, and States have wide latitude over eligibility,
benefits, provider reimbursements, and overall administration of their
Medicaid programs.
Ms. Verma claims Medicaid produces poor outcomes, but she cannot
offer a single credible clinical outcome or quality measure that the
program is not achieving. Meanwhile, data show that patient
satisfaction in Medicaid is high and the program achieves improved
public health and clinical outcomes for its patients.
Most concerning, Ms. Verma has repeatedly endorsed the administration
and Republicans' plan to permanently cap Medicaid, which would hurt
patients, States, health providers, and local economies.
I am voting no on Seema Verma's nomination for CMS Administrator
because I cannot endorse a full-scale assault on the Medicaid Program.
Mr. RUBIO. Mr. President, Seema Verma has a proven track record of
helping States create patient-centered healthcare systems that improve
quality and access and give individuals and families more control over
their healthcare. Due to a family commitment, I was unable to
participate in the cloture vote. However, I strongly support Ms.
Verma's nomination and look forward to working with her on the many
important healthcare issues facing Florida and our country.
The PRESIDING OFFICER. The Senator from Alaska.
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