[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.

[[Page S1737]]

  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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