[Congressional Record Volume 163, Number 44 (Tuesday, March 14, 2017)]
[Senate]
[Pages S1784-S1799]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DISAPPROVING A RULE SUBMITTED BY THE DEPARTMENT OF LABOR
The PRESIDING OFFICER. Under the previous order, the Senate will
resume consideration of H.J. Res. 42, which the clerk will report.
The senior assistant legislative clerk read as follows:
A joint resolution (H.J. Res. 42) disapproving the rule
submitted by the Department of Labor relating to drug testing
of unemployment compensation applicants.
Mr. McCONNELL. Mr. President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. DURBIN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
TrumpCare
Mr. DURBIN. Mr. President, last week congressional Republicans
finally unveiled their proposal to replace the Affordable Care Act. The
Affordable Care Act is a law passed by Congress a little over 6 years
ago with the express goal of expanding the number of Americans with the
protection of health insurance. It has been successful. We have the
lowest percentage of uninsured Americans in history. What it means is
that through offering Medicaid to those in low-income categories,
offering help to pay premiums for those in middle-income categories,
and offering choices in the insurance exchange, we have really changed
health insurance in America in 6 years.
Now Americans realize that when they take a look at their actual
health insurance policy, it is worth something. It may be hard to
remember--but we should--that only 6 years ago, if you happened to have
a child with a preexisting condition and you were not lucky enough to
have your insurance through your employer and you went out on the open
market, you were in for a rough ride. Many health insurance companies
would not insure a family with a child who had a history of diabetes or
surviving cancer. We changed that. We said that no health insurance
company in America can discriminate against a person or family because
of a preexisting medical condition. Is there one of us who lives in a
family which doesn't have a relative, a close relative, with a
preexisting condition? That was an important reform that was part of
the Affordable Care Act, ObamaCare.
We also came to realize they were selling health insurance to people
with some fine print that made a difference--lifetime limits on
coverage. Well, I have $1 million coverage. That sounds great, until
the next diagnosis or the next accident. Now, $1 million doesn't seem
like such a large amount of money, and God forbid you end up with a
chronic illness.
One of my constituents came by to visit me 2 weeks ago. She was a
guest of one of the Members of Congress during the President's speech
to the joint session. She was diagnosed a few years ago with an unusual
disease, one that is life-threatening at any given moment. She told me
that in the past 3 years, she has spent more than $700,000 on
medication--$700,000--and that will be a burden she faces for the rest
of her life.
If her health insurance had a limit on how much it paid, there would
reach a point where she couldn't buy the medicine she needs to save her
life. We did away with that, and we said: You can't discriminate
against people by putting these limits. We also said: When it comes to
charging premiums, you can't discriminate against a person applying for
health insurance solely because they happen to be a woman.
There has been a lot of controversy over that in the House in their
debate over the last week or so, but what we said basically is that
when it comes to insurance risk, put everyone in together, make this a
bigger pool of people seeking health insurance so insurance can be
profitable and affordable at the same time.
We also said: When it comes to the premiums charged on health
insurance--and I call attention to all of us over the age of 50--we
said you cannot discriminate in premiums you charge in health
insurance. There can't be a disparity of more than 3 to 1 for the most
expensive health insurance policy to the least expensive. We also said,
in addition to that, if you have a child, son or daughter, graduating
college and looking for a job but has no healthcare benefits, keep them
on your family plan until they reach the age of 26. I have been through
that. Most families have.
I had a recent college graduate, no longer with student health
insurance, and I said: Jennifer, do you have health insurance?
Dad, I feel just great.
No father wants to hear that answer. So we changed the law.
When it came to Medicare, under the Affordable Care Act, we said: We
are going to eliminate the gap in coverage for prescription drugs for
seniors. They used to call it the doughnut hole. It made no sense. It
was something only Congress could dream up. We closed it and said: We
are going to give seamless coverage to Medicare prescription drugs.
That was part of the Affordable Care Act.
We put in incentives for people providing medical care to find ways
to give us good quality care and reduce the cost. What was the net
result? The slowest growth in hospitalization premiums for employer-
based healthcare that we have seen in modern times.
When they put this new model for healthcare against the Medicare
Program--that is a program for seniors and disabled--guess what. It
bought 10 years of solvency for Medicare. That
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meant a program that is critically important for 60 million Americans
had 10 more years of solvency.
Did this program have problems? Of course it did. When you take on
the healthcare system of America, you are not going to get it
completely right the first time. I believed--and many others did--that
as important and valuable as that vote was, we had to be prepared to
return to this program to make sure we addressed problems as they would
arise.
For example, there is nothing in the Affordable Care Act of substance
when it comes to controlling the price of pharmaceuticals--prescription
drugs.
Well, I can tell you what has happened. Blue Cross Blue Shield in
Chicago came to see me, and the CEO said: Blue Cross Blue Shield is now
paying more for prescription drugs than we are paying for inpatient
hospital care. The cost of drugs has gone through the roof. The net
result of that, of course, is the cost of healthcare goes up too. The
Affordable Care Act should have addressed that but did not.
We also had to find a way to make sure there was health insurance
available all around the United States. Some companies jumped in; some
jumped out. Many of us believe we should have a single-payer plan
available in every part of America so you could choose for your family
a Medicare-type plan if you wish. Otherwise, you would go to a private
health insurance company, if you wish. It is your choice.
The Republicans opposed the Affordable Care Act. In the House, they
voted against it 57, 58 times--I lose count. Then came the day when
they had the majority in the Senate, in the House, and in the White
House--the answer to their prayers. Now, once and for all, they can get
rid of the Affordable Care Act. They have the votes, but then there was
a problem.
People across America started asking: If you repeal it, what will
happen next? Will I still be able to get health insurance? Will I be
protected if I have a preexisting condition? Will there be limits on
what the policy covers?
Well, they hadn't quite thought that far ahead to look for the
substitute, to look for the replacement. So they went to work in a
matter of 5 or 6 weeks and created what is now being considered by the
House of Representatives--the Republican replacement plan.
The Congressional Budget Office is a nonpartisan office that takes a
look at our bills and legislation and puts a score on them. How much is
it going to cost? What is it going to do?
We waited for Congressional Budget Office scores over and over again
when we wrote the Affordable Care Act. They would come in and say:
Nope, you have to go back to the drawing board. You have to change this
and change that.
Well, just this week, they came out with the score on the Republican
replacement plan, the one to replace the Affordable Care Act. They took
a look at it, and here is what they told us.
To start off with, the Republican replacement plan throws people off
health insurance coverage. How many? Remember when President Trump said
the GOP healthcare bill would have ``insurance for everybody''? Under
TrumpCare, the new Republican plan, TrumpCare, 14 million people would
lose their health coverage next year. By 2026, 24 million people will
have lost their healthcare coverage.
Is this what we were looking for in the replacement plan for the
Affordable Care Act, to say to 24 million Americans, you will no longer
have health insurance coverage? Think about the outcome of that. Think
about someone with a chronically ill child or someone who faces a
chronic illness themself with no health insurance.
Think about a working person who has no health insurance where they
work. At least they had coverage through Medicaid and perhaps through
the insurance exchange with a subsidy. Now they are losing it.
Think about those same people without health insurance. They will
still get sick and will still go to the hospital but will be unable to
pay. Incidentally, their bills they can't pay, we pay. Those bills are
passed on to everyone else.
So the first plank of the Republican TrumpCare, according to the
Congressional Budget Office, is to eliminate health insurance for 24
million Americans. In addition, the Republican TrumpCare plan
significantly raises premium costs on seniors.
According to the official Congressional Budget Office estimate, the
bill will ``substantially raise premiums for older people.'' How does
that happen? Well, in addition to cutting back on the financial
assistance for seniors to buy health insurance, TrumpCare would allow
insurance companies to charge older people significantly more than the
Affordable Care Act. Remember the limit, the 3-to-1 limit on premiums
that we built into the Affordable Care Act? TrumpCare says: No, make
that 5 to 1. So it means, if you are over the age of 50, buying health
insurance, your premiums can go up dramatically, according to the
Congressional Budget Office.
There is another thing too. As we take more and more people off of
health insurance coverage, it really, in a way, dampens the incentive
for affordable healthcare so the costs are not contained as they are
today, and the solvency of Medicare--which we said was 10 years more,
remember that--they reduce it by 4 years.
What the Republican TrumpCare plan has done is it threatens the
solvency of Medicare. Is that what we were looking for on the repeal of
the Affordable Care Act? I don't think so.
TrumpCare also raises costs for lower and middle-income families. By
repealing the cost-sharing subsidies and lowering the bar on health
plans, the Congressional Budget Office says that lower and middle-class
families shopping in the individual market should expect to see--and I
quote from the report--``substantially increasing out-of-pocket
costs.''
The bill also defunds Planned Parenthood, which was to be expected.
We expected it in many bills. According to the Congressional Budget
Office, defunding of Planned Parenthood would ``affect services that
help women avert pregnancies . . . most likely residing in areas
without other health care clinics or medical practitioners who serve
low-income populations.'' The Congressional Budget Office projects that
15 percent of those people--again, these are lower income women in
medically underserved areas of America--would lose access to care.
Also, TrumpCare, at the same time it does this--eliminates health
insurance for 24 million, raises the premium costs, and defunds Planned
Parenthood. For good measure, TrumpCare also provides tax cuts to the
wealthiest people in America. Is that what we were looking for? Was
that part of the bargain? Those making over $1 million a year in income
will get a $50,000 tax cut from the TrumpCare bill. The wealthiest one-
tenth of 1 percent get a tax cut of nearly $200,000.
Finally, while cutting taxes for the very rich, TrumpCare also
slashes $880 billion in Medicaid spending over the next 10 years.
Medicaid is a vital healthcare program. Most people think about
Medicaid--oh, that is health insurance for the poor. It is. But who are
the poor? Overwhelmingly in numbers, they are children and their moms
who are in low-income groups. That is the biggest number, but the
biggest expense for Medicaid isn't kids and their moms. It is grandma
and grandpa. It is our families and parents who are in an assisted care
home who have Social Security, Medicare, and Medicaid to get by.
These cuts by the Republicans and TrumpCare to Medicaid will be felt
by families across the board. In addition, it means that those who
represent States like mine and the Presiding Officer's, with rural
populations that have small hospitals that depend on patients paying
something when they come through the door--many of them are paying
through Medicaid, and if Medicaid is reduced, the payments to the
hospitals are reduced.
That is why the Illinois Hospital Association warns us against
TrumpCare. The Illinois Hospital Association says it will threaten the
hospitals of my State. They will not be receiving the Medicaid
reimbursement. They believe that up to 90,000 jobs at these hospitals
will be lost in Illinois. I will tell you, as a downstater, those are
some of the best paying jobs in the community. Many of my small towns
trying to keep businesses or attract businesses brag up their hospital,
as they should, and now TrumpCare threatens the future of these
hospitals.
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Medicaid is a vital healthcare program for 65 million Americans--
seniors, persons with disabilities, children, and low-income families
nationwide, 3 million of them in my State. TrumpCare would devastate
the program. By 2026, according to the Congressional Budget Office, 14
million fewer people would have Medicaid.
The Affordable Care Act took a lot of good steps toward improving
healthcare for seniors. Before the Affordable Care Act, the number of
uninsured adults ages 50 to 64 rose substantially--growing from 3.7
million in 2000 to 8.9 million in 2010. Insurance companies were
rejecting more than one in five applications from individuals between
the ages of 50 and 64.
Thanks to the Affordable Care Act, the rate of uninsured adults ages
50 to 64 dropped 47.4 percent, from 11.6 percent to 6.1 percent. The
largest reduction in the uninsured rate occurred in the States that
chose to expand Medicaid.
The Affordable Care Act also prohibited insurers from denying
coverage, as I said earlier, to people with preexisting conditions. It
limited how much insurers can charge older enrollees, closed the
doughnut hole, and made important preventive services available for
free, such as colonoscopies and annual checkups.
Let's look at what the TrumpCare program--the Republican program--
does to seniors. It allows insurers to charge older people
significantly more than younger people, it reduces tax credits to
seniors who pay their premiums, and it would devastate the Medicaid
Program, which helps to pay for two out of every three seniors in
nursing home care.
There is another thing I want to make a note of. Many years ago in
the Senate, back at that corner desk, sat a Senator from Minnesota
named Paul Wellstone, a Democrat. Over here on the aisle sat Pete
Domenici of New Mexico, a Republican. For years they argued that we
should include in every health insurance plan in America coverage for
mental health, and the insurance companies fought them. Because many
mental health conditions are chronic and long-term and may, in some
cases, be expensive, they didn't want them. But Wellstone and Domenici
had family members who struggled with mental illness, and they said we
need to include this in every health insurance plan. Thank goodness
they finally prevailed. Every health insurance plan in this country has
to treat physical health issues and mental health issues the same,
thanks to Wellstone and thanks to Domenici.
In addition they added something that many of us overlooked: It said
mental health and substance abuse treatment. What does that mean? It
means that if some member of your family is addicted, your health
insurance plan can help pay for the help they need to get rid of their
addiction. For a lot of people it was the only place for them to turn,
and it worked, and thank goodness it did, because we are at that moment
in American history where because of opioids, heroin, and fentanyl, we
have dramatic increases in addiction.
Now what is going to happen under the TrumpCare approach when it
comes to mental illness and substance abuse treatment? Are we going to
require--mandate--every health insurance plan to include mental health
treatment as well as substance abuse? Over and over we hear from our
Republican friends: We want competition. We want choice. We want to
eliminate mandates.
They can take that approach, but we are going to lose coverage for 24
million Americans. If they take that approach, we are going to be
offering health insurance plans that aren't there when families need
them.
We had a roundtable discussion in Rockford, IL, last Friday. When I
go to these communities, I bring in people who are administrators of
the hospitals, the doctors, the nurses, the clinics, the substance
abuse treatment centers. To a person, they oppose TrumpCare. Every
single one of them said that it is the wrong thing to do at this moment
in time. It will leave people more vulnerable. It will leave families
with health insurance that is worthless when they need it. Those are
the bad old days we finally escaped 6 years ago, and now Republicans
want us to return to this competition-choice access to healthcare. I
have access to a Rolls Royce dealership, too, but I am not going to be
buying a Rolls Royce because I can't afford it. If you give a person
access to health insurance that they can't afford, you are not giving
them anything.
What we tried to do with the Affordable Care Act is to make sure we
gave people not only access but protection with health insurance. From
the beginning, the Republicans have said: Let's repeal the Affordable
Care Act. Now they have found that replacing it is a lot harder than
they ever expected.
I said from the beginning, as well, if the Republicans are willing to
take repeal off the table, I am going to pull up a chair. If they want
a bipartisan approach, an honest approach to making the Affordable Care
Act better, let's sit down and talk. Sign me up. If the goal is to give
more people good health insurance that they can afford to protect their
families, if the goal is to find ways to give us better healthcare,
quality results at a lower cost, I want to be a part of that
conversation. But if the goal is to deny health insurance coverage to
24 million Americans, count me out. That to me is a step backward in
time.
What comes next? If the Republicans do this to the Affordable Care
Act, what is next--Medicare? Well, we happen to know the Secretary of
Health and Human Services believes in privatizing Medicare. I don't. I
think that is a step in the wrong direction, and it will reduce the
protection of Medicare. But if they will do this to the Affordable Care
Act, then can Medicare or Social Security be far behind?
It is important that we maintain our values when it comes to critical
programs that America and its families count on.
I hope the House of Representatives defeats TrumpCare, puts it out of
its misery, and then invites all of us to come together on a bipartisan
basis to talk about what we really need for healthcare in this country.
I find it incredible that there is no major medical group in America
today that supports TrumpCare--none, not one. All we have is some
conservative think tanks that believe this is a wonderful model. But
the people on the ground--the administrators in the hospitals, the
doctors, the clinicians, the nurses, the people in the healthcare
clinics--all tell us TrumpCare is a disaster. It is a step in the wrong
direction. It is going to decrease coverage and increase costs. That is
not something that America needs for its future.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. GRASSLEY. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Portman). Without objection, it is so
ordered.
Mr. GRASSLEY. Mr. President, I ask unanimous consent to enter into a
colloquy with the junior Senator from Utah and the junior Senator from
Nebraska.
The PRESIDING OFFICER. Without objection, it is so ordered.
Separation of Powers
Mr. GRASSLEY. Mr. President, I have come to the floor several times
over the past 8 years to discuss the constitutional principle of
separation of powers between the legislative, executive, and the
judicial branches. President Obama promised that he would act
independently of Congress where he had to; his quote: ``Where they
won't act, I will.'' I have come to the floor to discuss the many
examples of Executive overreach that we have witnessed, from unilateral
pursuit of climate change regulations to unconstitutional recess
appointments.
As I have said before, the structure of our Constitution is a
critical safeguard of our liberty. As Justice Scalia famously said:
Every banana republic in the world has a bill of rights.
Every President for life has a bill of rights. The real key
to the distinctiveness of America is the structure of our
government.
Now, I have served in the Senate for 36 years, so I have a deep
appreciation of the different roles of the coordinate branches and for
the fact that the people govern themselves through their
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elected representatives, and my accountability to them is the defining
characteristic of my role as one of their representatives in the U.S.
Senate.
That is not true of judges in our Federal system who are not elected,
and it is certainly not true of the executive agencies that administer
the laws we write here in the Congress.
Judge Gorsuch is the President's nominee to serve as the next Justice
of the Supreme Court. It seems to me that he really understands the
important differences in these roles. Reflecting on the legacy of
Justice Scalia, he remarked that ``the great project of Justice
Scalia's career was to remind us of the differences between judges and
legislators.''
So I am now going to turn to Senator Lee. I would like to have him
discuss a question I put before him: How do you understand Judge
Gorsuch to view differences between judges, legislators, and the
executive under our Constitution?
Mr. LEE. I thank Senator Grassley. The Senator's question really cuts
to the heart of the issue. It cuts to the heart of the very reasons why
we have an independent judiciary and exactly why it is that our system
of government that operates under the U.S. Constitution depends so
critically on individuals just like Judge Gorsuch. It depends on people
like Judge Gorsuch sitting on the Federal bench.
There are, I believe, two fundamental differences between the
judiciary on the one hand and the two political branches on the other
hand; that is, the two branches in which people serve after being
elected to office, meaning the legislative branch where we work, and
the executive branch headed by the President.
First, the legislative and executive powers sweep far more broadly
than does the judicial power. Article I enumerates a list of lawmaking
powers that are granted to Congress, and article II vests executive
power in the President. By comparison, the judiciary's power is far
more circumscribed. It is far more limited.
The judiciary has the power to decide only a limited and defined set
of disputes--those that qualify as cases and controversies under
article III of the Constitution. To be clear, in the context of
deciding a particular case, the judiciary has the power to invalidate
an act put in place by the elected branches of government--the power to
say what the law is, as Chief Justice John Marshall explained it in the
landmark case Marbury v. Madison.
But that power is limited. It is limited, among other things, by
article III of the Constitution and by jurisdictional requirements like
standing and mootness and ripeness as explained in greater detail by
Supreme Court precedent.
The judiciary's authority to say what the law is points to the second
major difference between the courts on the one hand and the political
branches on the other. While the function of the judiciary is an
exercise in reasoned judgment, the functions of the executive and
legislative branches are exercises of power.
There are many ways in which the Constitution and the political
theory underlying it limit the exercise of that power. The Constitution
protects minority rights, and it conditions the exercise of legislative
or executive power on winning elections, and that, in turn, means
winning the trust of the American people--of the voters throughout the
country.
These twin ideas--the consent of the governed and the protection of
minority rights within an essentially majority-rule system--are pillars
of our constitutional order. But make no mistake, coercion underlies
the laws that we make in this body and their enforcement by the
executive branch.
By contrast, the judicial function is ultimately an exercise in
reasoned judgment. As Alexander Hamilton explained in Federalist 78:
``neither Force nor Will, but merely judgment'' are exercised by the
judiciary. This is the essential difference between the judiciary and
the other branches: The judiciary exercises judgment while all the rest
of us exercise will.
The Framers, of course, understood this well. And as Hamilton
continued in his explanation of Federalist 78:
Courts must declare the sense of the law, and if they
should be disposed to exercise Will instead of Judgment, the
consequence would equally be the substitution of their
pleasure to that of the legislative body. The observation, if
it proves anything, would prove that there ought to be no
judges distinct from that body.
Put another way, a judge who chooses to exercise will instead of
judgment is no longer acting as a judge. That person is instead
functioning essentially as a superlegislator.
It should be clear to all fair-minded people that Judge Gorsuch is
someone--and has established himself as someone--who understands these
distinctive features of the Federal judiciary. When you read his
opinions, you see that his only agenda is to understand the governing
law and then to apply that law to the set of facts in the case before
him.
As we will see next week during his confirmation hearings, his
opinions carefully analyze the statutes and applicable precedents to
determine the outcome of each and every case. In some cases, that means
Judge Gorsuch reaches results that Senator Gorsuch or President Gorsuch
or King Gorsuch probably wouldn't choose, were he deciding cases in any
of those capacities. But Judge Gorsuch understands, of course, that he
is a judge and not a king and not a President, not a Senator, not a
Congressman, and he understands that this means his only job is to
adjudicate cases based on the law according to the facts before him. As
he said the night he was nominated: ``A judge who likes every outcome
he reaches is very likely a bad judge--stretching for results he
prefers rather than those the law demands.''
When you examine his record, you see that one of the defining
characteristics of Judge Gorsuch is his independence--his judicial
independence. That is distinctively the hallmark of a good judge. You
see that he decides cases based on the law, not based on the parties
before him and not based on his own political or ideological
preferences.
In the coming weeks, some of our colleagues may try to argue that
Judge Gorsuch hasn't done enough to prove his independence since being
nominated to the Supreme Court. If this criticism is raised against
him, it will be a weak one. It will be one that doesn't apply here. The
fact is that Judge Gorsuch has spent his entire career as a judge, and
as a lawyer before that, proving his independence.
To his would-be critics, I would say, read and analyze his opinions.
They speak for him. They speak for themselves. They speak for the rule
of law. Study his approach to judging. Listen to what he says about
judicial independence and, just as importantly, look at his actions.
His actions prove his independence.
I have done these things. I have examined Judge Gorsuch's record. And
on that basis, I am confident that he will not hesitate to apply the
law appropriately in every case. There is absolutely no reason--no
reason that I can find anywhere in his record--to prove otherwise.
I think I have only scratched the surface here today. I look forward
to hearing Judge Gorsuch's testimony before the Judiciary Committee
next week.
Mr. GRASSLEY. Mr. President, I thank the Senator for his very
thoughtful explanation. I know both as a Senator and as a lawyer, he
takes the study of constitutional law very seriously. His point of view
ought to be seen as an authority on the separation of powers,
particularly. I think the way Senator Lee sees Judge Gorsuch is similar
to how I do, but he knows the law a lot better than I.
It is clear that the questions about separation of power can arise in
very complex and legally technical cases in the courts. But I think the
principle is also a fundamental one. Judge Gorsuch has made this point
himself, and I would like to quote a little of what he has said.
Recent Supreme Court cases ``permit executive bureaucracies to
swallow huge amounts of core judicial and legislative power and
concentrate federal power in a way that seems more than a little
difficult to square with the Constitution of the framers' design.''
To quote again, on the role of the prosecutor and the role of
Congress, he said: ``If the separation of powers means anything, it
must mean that the prosecutor isn't allowed to define the crimes that
he gets to enforce.''
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So I want to ask my other colleague here for this colloquy, the
Senator from Nebraska, a question that I am sure he can answer and has
thought about a lot. These are not just legal technicalities that we
are talking about, but the very fabric of our Constitution. I hope the
Senator would agree.
Mr. SASSE. I thank Chairman Grassley for that question and the
invitation to join him in the colloquy. As two of the only non-
attorneys on the Judiciary Committee, it is important that we, on
behalf of the majority of Americans, who are non-lawyers, do reclaim
the separation of powers as a basic American inheritance. So I thank
the Senator for the chance to discuss it here today.
Starting the morning after President Trump's victory last November,
there has actually been something of a renaissance of separation of
powers talk among many folks around this body, and that is a good
thing. After 8 years of legislative atrophy, many on the other side of
the aisle are now remembering the old ``Schoolhouse Rock'' distinction
among the three separate and coequal branches, and this is good news
for Americans' civic health.
If Democrats are serious--frankly, if all of us are serious, for we
in this body have taken an oath not to a political party but to a
constitutional structure of limits where power is intentionally
separated and divided because our forefathers and foremothers were
skeptical of the consolidation of power--if we take this seriously and
we would like to reclaim some of the Congress's responsibility and
ability and authority to check and balance the other two branches, the
debate around Judge Gorsuch's nomination and the hearings we will have
beginning in the chairman's committee next month are a great place to
start. So I wish to offer a little bit of what I think is an important
historical backdrop for this debate.
Any discussion of the separation of powers must be rooted in a solid
understanding of what we mean and what the Founders meant by the phrase
``the consent of the governed.'' Historically speaking, this is still a
bold idea which must be constantly defined, reclaimed, renewed, and
passed on to the next generation, for over the course of human history,
we can put every form of government into one of two categories: You are
ruled either by people you didn't choose or by people you did choose.
One of these groups has taken many forms through the centuries--
Kings, elites, political parties, and technocrats. Indeed, most
governments throughout human history fit this mold, where the people
were ruled by a form of government that they had no say in and that
they didn't choose. But there is another group, and these are people
who rule themselves through the leaders they have chosen and
continually get to choose. When the leaders fail to serve the will of
the people, those leaders can be removed. This describes our form of
government and its historical anomaly. We should recognize that, and
our kids should understand what a special blessing it is to live under
this form of government.
The point is elegantly simple: Either people are ruled, or the people
are ultimately and fundamentally the rulers. Why does this matter? This
isn't a question to take flippantly but, rather, each generation of
Americans should reexamine and reclaim and reteach it. So why is it so
important that ``the people'' are actually the rulers in their
government? It comes down to a profound truth about human dignity.
Human beings cannot thrive when they are stripped of basic liberties.
Human flourishing requires the freedom to make basic choices about how
you will live your life in community: Who are your friends? Whom will
you marry? Where will you work? What do you believe? Whom do you
worship? How do you worship? These are the things the Founders meant
when they said that we are all born with the right to life, to liberty,
and to the pursuit of happiness.
Notice that the Founders were not referring to life, liberty, and the
pursuit of happiness as a bunch of vague platitudes or as aspirational
pleasantries for a bumper sticker; they were talking about rights.
These are not given to us by any other man or woman. They are rights we
have from God via nature, and so they can't be taken away from us by
some other mere man or woman.
Here is what is great about this idea: We are all born equals in the
eyes of God and history, and we have certain rights. As a group of
equals, it requires people to get permission to serve for a time--for a
limited time--as our rulers. This equality is what the Founders called
the self-evident truth--something so obvious that it didn't need to be
proven; a truth so true that denying it would be denying something
essential and true about human nature itself. Once we understand this,
our expectations of our government begin to change. We expect
responsiveness and transparency. We expect equality before the law.
Government's primary purpose is not to solve every human problem,
like a King or some all-powerful technocrat; rather, the government's
job is to provide a framework for ordered liberty so that we can live
our lives in our communities, in our families, in our businesses, and
in our places of worship. Government's job is to secure the rights of a
free and sovereign people.
But what does this have to do with Judge Gorsuch? What does this have
to do with the confirmation hearing for the Supreme Court next week?
What does this have to do with separation of powers?
As Americans, we secure our rights by separating the functions of
government into what our Founders called the three different
departments: There is a Congress to write the laws, and this is article
I of the Constitution; there is a President--or Presiding Officer, as
he was first called--to execute the laws; and there is a court to
decide the controversies under the law. This system of checks and
balances keeps too much power from falling into any one set of hands,
and it keeps the American people in charge.
We sometimes talk euphemistically about judicial activism, and that
is a big problem, but we don't attack it enough. A judge who takes it
as his or her job to do anything other than settle cases is not just
being an activist, they are becoming an untouchable, unfireable ruler.
They are becoming a lawmaker who is not accountable to the people
because our judges have lifetime tenure. A judge who uses his or her
position to write the law fundamentally undermines the foundation of
government, which is that the will of the people should rule.
That is why I am so strongly supporting Judge Neil Gorsuch to be the
next Justice on the U.S. Supreme Court. He fully understands the place
in the government and his place in the government as a servant of the
people, not as some unchosen ruler with lifetime tenure.
When you listen to Judge Gorsuch, when you read his speeches, when
you read his opinions, it is clear that he is not interested in making
laws. He knows that is not his calling. He is interested in
interpreting law. He is interested in upholding and defending the
Constitution. He is not interested, when he has his robe on, in
specific policy outcomes; he is interested in justice. He is not
interested in the laws that he as a private citizen might want; he is
focused on the laws that are actually written in the books. He is a
judge's judge, and that is exactly what the Constitution calls for.
In closing, I wish to read three quotes from Judge Gorsuch into the
Record to demonstrate how he conceives of his job. Again, this is Judge
Gorsuch paying tribute to Justice Scalia:
Tonight I want to . . . suggest that perhaps the great
project of Justice Scalia's career was to remind us of the
differences between judges and legislators. To remind us that
legislators may appeal to their own moral convictions and to
claims about social utility to reshape the law as they think
it should be in the future. But that judges should do none of
these things in a democratic society. That judges should
strive (if humanly and so imperfectly) to apply the law as it
is, focusing backward, not forward, and looking to the text,
structure, and history to decide what a reasonable reader at
the time of the events in question would have understood the
law to be--not to decide cases based on [a judge's] own moral
convictions or the policy consequences they believe might
serve society best.
Again, he is saying a judge is not a superlegislator. If a judge
wants to be a legislator, that is a completely fine thing to do. Take
off your robe, resign your position, and run for office so the
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people can decide whether to hire you or fire you. But a judge who has
lifetime tenure doesn't get to make their policy preferences the will
of the people somehow.
The second quote:
When the political branches disagree with a judicial
interpretation of existing law, the Constitution prescribes
the appropriate remedial process. It's called legislation.
Admittedly, the legislative process can be an arduous one.
But that's no bug in the constitutional design: It is the
very point of the design.
Third and finally:
To the founders, the legislative and judicial powers were
distinct by nature and their separation was among the most
important liberty-protecting devices of the constitutional
design, an independent right of the people essential to the
preservation of all other rights later enumerated in the
Constitution and its amendments.
If my colleagues in this body are serious, if the hundred of us are
serious, if we want to defend our role as legislators, if we are
serious about doing our job as lawmakers, if we are concerned about
overreaching Executives, if we are concerned about the lack of
accountability in the administrative bureaucracies of the government,
if we honestly want to make Congress great again, we should start by
confirming Judge Neil Gorsuch.
Mr. GRASSLEY. Mr. President, I thank the Senator for his very
thoughtful explanation. Senator Sasse and Senator Lee have laid out
very clearly the Constitution's separation of powers, the proper role
for judges, the proper role for Members of Congress, and when one can't
interfere with the other. I think the Senator has laid out very
clearly, and I agree, that Judge Gorsuch fits in very well with what
judges are supposed to do, what the Supreme Court is supposed to do--
obviously not legislate. Members of the judiciary have a lifetime
appointment. They can't be voted out of office. That is why, when
people don't like what the Congress does, every 2 or 6 years as far as
the House and the Senate are concerned, they get a chance to express
that opposition and send somebody else to do the job, and they can't do
that with whoever is on the Supreme Court.
I thank my colleagues for participating with me in this conversation
we have had about the separation of powers and about their thoughts on
Judge Gorsuch on the issue of judges judging and not legislating. His
record demonstrates a firm grasp on the separation of powers that
animates our Constitution. He is an independent judge who properly
understands the judicial role. At a time when we hear renewed calls for
an independent judiciary, I don't think we could have a better nominee
to fit the bill.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Maryland.
TrumpCare
Mr. VAN HOLLEN. Mr. President, I rise today to talk about the so-
called healthcare bill coming out of the House of Representatives which
has been supported by the President.
We just yesterday got the report from the Congressional Budget Office
which analyzes this legislation and its impact on Americans. What we
find in great detail and with great clarity is that this TrumpCare
legislation is a huge tax windfall to the wealthiest Americans at the
expense of affordable healthcare for tens of millions of our fellow
citizens. It is time the Senate begin to pay attention to what is
happening in this legislation.
Someone might look at this and now call it not ``TrumpCare'' but
``Trump doesn't care'' because what we find out is that in the very
first year, in 2018, 14 million Americans will lose their health
coverage--14 million in the very first year this is implemented. Those
are moms, dads, kids, people of all ages--our fellow Americans. Just 2
years after that, beginning in 2020, we are going to see 21 million of
our fellow citizens lose their access to health coverage. Let me be
clear. When we say they lose their access to affordable care, we are
talking about compared to what they have right now under the Affordable
Care Act, under ObamaCare. So in the year 2020, 21 million Americans
who have access to affordable care through the Affordable Care Act are
going to lose it, and within 10 years, that will rise to 24 million of
our fellow citizens.
Not only are those millions of Americans going to lose their health
care in the early years of this new plan, people are going to see their
premiums spike in the individual market. We have heard understandable
complaints about the increase in premiums in the Affordable Care Act
exchanges. There are commonsense things we can do to fix it. Many of us
have put forward proposals to do that, but this will actually
dramatically spike up to 20 percent premiums in those markets in the
early years. Who gets especially hard hit? Well, older Americans.
Americans between 47 years old and 64 years old, before they are old
enough to receive Medicare but when they are old enough to be
potentially experiencing many healthcare issues.
In fact, if you look at the Congressional Budget Office report, and I
know people sometimes gloss over the fine print, but table 4 indicates
that if you are a 64-year-old with an income of $26,000 a year, your
premium is going to increase from $1,700 a year to a whopping $14,600
per year. That is in the Congressional Budget Office report, but you
know what, AARP, they believe it. They are on full alert, letting
Americans throughout the country know how damaging this will be to
older Americans who will, all of a sudden, see their premiums, their
copays, and their deductibles going through the roof. It is going to
become absolutely unaffordable for those older Americans to get health
insurance.
On top of that, despite what we all know is an opioid crisis in the
country, an epidemic of substance abuse and addiction, despite that,
this TrumpCare bill actually eliminates the Medicaid funding
specifically to deal with opioid addiction. I know many members of the
Senate and the House have been going back home, going to all parts of
their States, urban areas, suburban and rural areas, to talk about the
scourge of opioid addiction, and many have been talking about the fact
that the Senate was able to work to increase funding to address those
addiction issues, but this House bill, this TrumpCare bill, actually
eliminates the Medicaid Program for opioid abuse and addiction.
The list of horribles goes on and on. They claim you are going to be
able to get coverage--no problem if you have preexisting conditions or
whatever. The reality is, let's say you have a job, let's say you lose
your job, let's say you lose your income because you lost your job, you
only have 63 days to turn around and get insurance, which may not be
affordable. If you are not able to find your insurance, an affordable
insurance plan in those 63 days, when you finally do, they are going to
charge you a 30-percent penalty. So you lost your job. You have no
income so you can't afford insurance. Yet, when you are finally in a
position to do it, they are going to charge you a penalty of 30
percent.
The more you dig into this TrumpCare legislation, the more things
like that you find out. It is really important that the American people
know what is in it as we debate this important issue.
Women's health. The TrumpCare bill directly goes after women's access
to affordable healthcare, including their defunding of Planned
Parenthood. I think all of us know that in many parts of our country,
Planned Parenthood clinics are the only viable source of healthcare for
women who are looking for cancer screening, breast cancer screening,
cervical cancer screening, and other preventive healthcare measures.
As we read this report from the Congressional Budget Office that just
came out yesterday, we are getting a better idea of why the House of
Representatives was so eager to rush this through the committees--
rushed it through the Ways and Means Committee, rushed it through the
Energy and Commerce Committee in the House--because apparently it is a
lot easier to vote for a piece of legislation when you don't know the
consequences. Apparently it is easier to say yes to this bill when you
don't know that it will deny healthcare coverage to 24 million
Americans, spike premiums over the next couple of years, eliminate
other important coverages for our fellow Americans, but people don't
have that excuse anymore.
They tried to rush it through. They got it through those two
committees. Willful ignorance allowed them to have those votes and it
passed those committees, but now we have, from the
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Congressional Budget Office, a comprehensive and thorough analysis of
the impact on our fellow Americans. It hurts. It hurts a lot. Now, I
recall, and I think the American public recalls, that during the
campaign on ``60 Minutes,'' Candidate Trump said:
I'm going to take care of everybody. I don't care if it
costs me votes or not. Everybody is going to be taken care of
much better than they are taken care of now.
Well, you tell that to the 14 million Americans who are going to lose
their health insurance in 2018. You tell that to the 64-year-old who
would be paying $14,000 in premiums a year, up from $1,700 under the
Affordable Care Act. You tell that to people who are suffering from
opioid abuse in all parts of our country when the Medicaid Program no
longer has to provide coverage for substance abuse.
That is not taking care of ``everybody.'' That is leaving tens of
millions of Americans behind. That was during the campaign. Here is
what we heard from President Trump in January, this year. He is going
to provide ``insurance for everybody.'' That is just not so, unless
what you are saying is we are going to offer you a totally unaffordable
insurance plan.
By the way, if you happen to have enough money, you can pay for it.
It is kind of like saying to somebody: You know what, that Rolls Royce
or that Lamborghini, that is available for purchase, but most of us
just don't have the money to afford that kind of purchase. In that
theoretical sense, you may argue that health insurance is available,
but the Congressional Budget Office did not look at theories. They
looked at facts. They looked at the impact on real Americans and
concluded that 14 million would lose their access in 2018, rising to 24
million over the next decade.
Despite the fact that on March 9 President Trump tweeted that ``it
will end in a beautiful picture,'' that is not a beautiful picture for
tens of millions of Americans who will be left behind by this series of
broken promises, broken promises and betrayal from President Trump. As
he campaigned around the country, he promised coverage for everybody,
affordable coverage. We would all love it.
Now we have the hard facts. So it was quite a spectacle to see the
Secretary of the Department of Health and Human Services, Tom Price,
trying to run away from the facts in the Congressional Budget Office
report. He got up and said, you know, he does not really believe the
Congressional Budget Office report.
Well, the reality is that Tom Price, when he was Congressman Price,
when he was the chairman on the House Budget Committee, along with
Senator Enzi, helped pick the current Director of the Congressional
Budget Office, Keith Hall. I know that because I was the senior
Democrat on the House Budget Committee. I was part of the interview
process. You know, they let us come along, but the reality is, at the
end of the day, he was picked by Secretary Tom Price.
Here is what Tom Price said about the Director of the Congressional
Budget Office. He said:
Keith Hall--
That is the Director--
will bring an impressive level of economic expertise and
experience to the Congressional Budget Office. Throughout his
career, he has served in both the public and private sector
under Presidents of both parties and in roles that make him
well suited to lead the Congressional Budget Office.
He goes on to praise the Director of the Congressional Budget Office.
I know the Presiding Officer and our colleagues have experience
understanding how important it is to have a nonpartisan referee in the
Congressional Budget Office. Otherwise, it is anything goes. Senators
get to make up their own facts. I know we have a White House and a
President that has invented the term ``alternative facts'' and
``alternative reality'' and ``alternative universe,'' but here in the
Congress, we have prided ourselves in knowing there is some referee on
the field when it comes to the Congressional Budget Office. We don't
agree with every single conclusion they have, but we don't work to
discredit them. It really is a discredit to the Secretary of HHS that
having praised and picked the current Director of CBO, he would now
attack that institution simply because he does not like the results of
their analysis.
I would not like the results either because they show how devastating
TrumpCare is for the American people. It shows what a total betrayal of
the President's promises TrumpCare is to the American people. It is not
just the Congressional Budget Office analysis that has reached that
conclusion. He is going to also go after AARP because they are on full
alert, and they are calling all their members to say this is a really
bad bill for tens of millions of Americans, especially older Americans,
people in the range of 47 years old to 64 years old, before they get on
Medicare.
The American Hospital Association and hospitals in all parts of our
country, and especially rural hospitals, areas Candidate Trump
campaigned heavily in, are letting their members know the devastating
consequences of this TrumpCare bill. The American Medical Association,
the people who are providing health care to our fellow citizens, they
are letting people know how damaging this will be.
So we have a wide array of Americans who are in the position, and it
is their job to provide health care to the American public, who say:
Whoa, this is harmful to your health. This is a danger to the
healthcare of the American people. It is not simply the numbers, it is
also the people and faces behind those numbers.
From Maryland, I got a note from Jenny from Salisbury. That is in
Eastern Maryland. That is a rural part of our State. She said:
I have a rare progressive lung disease. With good care I
may live 30 more years. Without it, I may live 5 or 10, sick
and disabled. I remember high-risk pools and preexisting
conditions exclusions. I need the ACA. I may die without it
and I am afraid for my life.
Here is Gail from Annapolis:
I'm very concerned with the repeal of the Affordable Care
Act. It helps the disability community. Our adult daughter
who has a severe cognitive disability will be relying on
Medicaid for health services after my husband retires this
summer at age 70 with a second-time recurrence of lymphoma. I
don't know what you can do, but this is a concern as aging
parents find their special-needs adult child may not have
coverage as she loses her family's ability to support her
healthcare.
The letters go on and on from all parts of Maryland and all parts of
the country. What adds insult to injury is that all these Americans are
going to be harmed, the 24 million who will lose their healthcare
coverage, those who will experience spikes in their premiums and
copays, the older Americans--47 to 64--who are going to see gigantic
increases in their costs so they are not going to be able to afford
healthcare anymore, those in rural areas and urban areas in all parts
of our country who are suffering from opioid abuse but Medicaid is no
longer going to cover it. All of that harm is being done to tens of
millions of our fellow citizens in order to give this huge tax break to
the wealthiest Americans and special interests, including insurance
companies and the pharmaceutical industry.
The Congressional Budget Office report is pretty clear--$590 billion
in tax cuts. Do you know what the top one-tenth of 1 percent income
earners will get in terms of tax cuts? An average tax cut of $200,000.
Millionaires will get an average tax cut of $50,000. There is even a
provision in here that says to insurance companies: We are going to
subsidize the bonuses you pay to CEOs. You are now going to be able to
deduct the multimillion-dollar bonuses you pay to your CEOs. We are
going to do that so that fewer people can have health coverage.
We get rid of the fee on insurance companies that helps to provide
access to millions of Americans.
It is simply grotesque that we see this legislation getting as far as
it has. We know why they tried to move it so quickly without a
Congressional Budget Office report--because this report is devastating.
It should be the final nail in the coffin of TrumpCare, and we should
all, frankly, be a little embarrassed by a proposal that provides $590
billion in tax cuts to the wealthiest Americans and some of the most
powerful special interests at the expense of healthcare for so many of
our fellow citizens.
We have to say no to this plan. We have to say no to TrumpCare. And
let's get about doing our business. There are some issues we can deal
with, with the Affordable Care Act, but you don't destroy it while
giving these tax breaks
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to the wealthiest Americans in order to do our job.
The PRESIDING OFFICER. The Senator from Michigan.
Ms. STABENOW. Mr. President, before the distinguished Senator from
Maryland leaves the floor, I want to thank him for his powerful
advocacy on behalf of his citizens. And I would only say ``amen'' as he
was speaking because there is so much at stake for the moms and dads
and kids and grandpas and grandmas in Michigan and Maryland. And that
is why we are on the floor speaking out so strongly and fighting so
hard to defeat a very bad proposal.
Let me start by indicating that what is being debated right now in
the House, the TrumpCare proposal, is not what President Trump
promised. It is just not what he promised. He said it would be great.
He said that people would get as good healthcare or better healthcare
and that it would cost less. We know that is simply not true.
According to a FOX News report on the increase of people who would no
longer have healthcare, be able to get medical care, be able to go to a
doctor under the new TrumpCare plan, 14 million people would lose their
healthcare, be unable to take their children to a doctor, just in the
next year, by next year. People will have to go to the emergency room
rather than a family doctor. Rather than being able to take care of a
cold or something minor for their children, chances are that it would
become something very serious before they would be able to be in a
position to take them to a doctor or, more likely, an emergency room.
We know that in the next 10 years, we are talking about 24 million
Americans--moms, dads, grandpas, grandmas, kids who would no longer be
able to see a doctor and no longer have health insurance.
TrumpCare would also cost 7 million people who have an employer right
now who is providing them health insurance so that they can get to the
doctor and care for their family--7 million people would lose the
insurance they have through their employer right now. That is not
making things better. There would be 7 million people in that
situation.
This is really a triple-whammy for middle-class families across our
country and certainly for people in Michigan. There would be higher
costs, less coverage, and more taxes.
I believe we need to join with AARP and our doctors, hospitals,
nurses, people who treat cancer, Alzheimer's, breast cancer, juvenile
diabetes, and all of the other people who care for and advocate on
behalf of loved ones or themselves, people who need to be able to see a
doctor and get healthcare coverage. We need to say no to the TrumpCare
plan that is being proposed in the House.
One thing that is really outrageous in this proposal is a senior tax
that allows insurance companies to hike up rates on older Americans. It
is right in the budget report. This is in the budget report we have now
received. They are saying that in 2026--in 10 years--a single woman or
man 64 years of age making $26,500 a year who currently pays $1,700 for
their health insurance would suddenly get a bill for $14,600. So under
this plan, that 64-year-old is going to go from $1,700 out-of-pocket to
see a doctor to get their treatments, to be able to get the care they
need, to $14,600. If you compare that to somebody who is 64 and makes
$3.7 million a year, the good news for them is that they are going to
get a $200,000 tax cut. Unbelievable. Unbelievable.
Most people in Michigan work hard every single day, get up and go to
work, maybe take a shower after work, maybe take a shower before work,
but most of the people I represent don't make $200,000 a year. Yet we
are talking about a $200,000 tax cut for multimillionaires, which is in
this proposal.
That is why the AARP, a nonpartisan organization representing
millions of people across the country, is actively working to defeat
this.
We also know that this creates what I call a voucher under Medicaid,
meaning that instead of paying for whatever nursing home care is
needed--if your mom or dad has Alzheimer's, Parkinson's disease, or
they are simply in a nursing home for a variety of reasons, right now
they get whatever care they need. There is not a cap on the amount of
care. There is not a limit on the amount of care. Under this proposal,
there would be X amount of dollars put aside for your mom or dad or
grandpa or grandma, and if the care they needed because of their
Alzheimer's disease was more than that, you would pay for it or your
elderly parent in some way would have to figure out how to pay for it.
This is outrageous.
Medicaid for families and for seniors in nursing homes has been a
critical part of making sure people can get the medical care they need.
I, frankly, celebrate today the fact that under the Medicaid expansion,
under the Affordable Care Act, 97 percent of the children in Michigan
can see a doctor. Imagine that. Ninety-seven percent of the children,
almost all of our children, can go to a family doctor. Their moms and
dads know that they are going to be able to take them to the doctor
when they get sick. I don't want to roll that back, but that is what
the TrumpCare proposal does.
We also know--because this was reported on FOX News as well--that the
new plan would add a 15- to 20-percent premium increase for individuals
starting next year--a 15- to 20-percent premium increase for
individuals starting next year at the same time as big tax cuts for
multimillionaires.
I have to say, as somebody who worked very, very hard on the women's
healthcare provisions and authored the maternity care provisions, I
find it outrageous that the TrumpCare proposal would mean that
maternity care is not covered as part of basic healthcare for women.
Prior to the Affordable Care Act being passed, only 12 percent of the
plans in Michigan--12 plans out of 100--offered maternity care. If you
tried to buy maternity care as part of the basic coverage, you would
have to get a rider. You would have to pay more.
Let's say maybe you gambled. Well, you weren't planning on getting
pregnant and you weren't sure what was going to happen, so you didn't
pay extra. Then you get pregnant. Guess what. You had a preexisting
condition, and you couldn't get insurance. We don't want to go back to
the time where being a woman was, in fact, a preexisting condition. And
speaking of preexisting conditions, this plan puts them back in the
hands of the insurance companies and creates penalties for people.
The truth is, under the Affordable Care Act, we made sure that when
you purchase insurance, it is a real plan. It is not a junk plan. You
can't get dropped when you get sick. If you have a preexisting
condition, they can't block you. If you are a woman, you don't have to
pay more. If you have a mental illness rather than a physical illness,
you don't have to pay more. If you need cancer treatments, the
insurance company can't tell your doctor how many treatments you are
going to get or how much they will pay for your treatments. Everybody
has benefited from that. Everybody who has insurance in this country
has benefited from that.
One of the most important provisions relates to preexisting
conditions, and that, in fact, is not continued, as it should be for
American families.
Finally, let me just say that while we are talking about people
paying more, getting less coverage, middle-class families paying more
in taxes, guess what. Wealthy people do not. So if you are a
multimillionaire, you are going to get big tax cuts in this provision,
and the middle-class family, the working family, is going to pay for
it. They are going to pay for it in higher premiums. They are going to
pay for it in less healthcare for their family. That is absolutely
unacceptable.
In addition to that, there is a tax break for insurance company CEOs
so that they can, in fact, get a raise up to $1 million. So in this
proposal, very wealthy people--insurance and drug companies' CEOs--are
taken care of. Vast amounts of money are put back in their pockets,
while money is taken out of yours. Absolutely unacceptable.
That is why we, as Democrats, are fighting so hard to make sure this
does not happen, is not passed, and that, in fact, we will work
together to strengthen our healthcare system.
We know there are areas where premiums are too high, copays are too
high, and we need to work together on a bipartisan basis to fix that.
But unraveling our entire system, ripping it apart, creating chaos,
more cost, less
[[Page S1792]]
ability to go to the doctor, and less medical care for people is
absolutely unacceptable.
The bottom line is that TrumpCare means more money out of your pocket
and less healthcare for you and your family. That is just wrong in the
greatest country in the world.
Recognition of the Minority Leader
The PRESIDING OFFICER. The Democratic leader is recognized.
TrumpCare
Mr. SCHUMER. Mr. President, I want to first thank my colleague from
Michigan for her outstanding presentation. It was succinct. It was on
point. It showed all the problems with TrumpCare. I hope we will see a
lot more not only of her speaking about this--and I know we will--but
those great charts she put together.
I, too, rise this afternoon again on the Republican plan to repeal
and replace the Affordable Care Act. There has been some confusion
about what to call it. Speaker Ryan, one of the principal authors of
the bill, doesn't want it called RyanCare. President Trump doesn't want
it called TrumpCare. President Trump slapped his name on buildings,
ties, steaks, hotels, and golf clubs, but not on a bill that he says he
supports. If it is so good, why doesn't any Republican want to put
their name on it? I think the reason is because every single day, as we
learn more and more about the bill, more and more Americans are turning
against it. Doctors don't like it. Patients don't like it. Hospitals
don't like it. Women don't like it. Millennials don't like it. Seniors
don't like it. More and more Republicans don't like it. And Democrats
are totally united against it.
So I just want to ask one question. TrumpCare has been public for 1
week now. Is there any group left in the country who actually likes it?
I am not sure there is. So Republicans have resorted to their usual
talking points.
They like to talk about access to healthcare. That is what Dr. Price
said over and over again. He didn't talk about people getting
healthcare, just having access to healthcare.
They say they want universal access to healthcare. Well, every
American has universal access to a Lamborghini. You can walk into the
Lamborghini showroom and say: I would like to purchase one. The
proprietor says: Well, that will be a couple hundred thousand dollars.
And you can't buy it. Access is not enough. Access is not enough.
Every single American would like a huge mansion worth $10 million.
They have access. They can go to a real estate agent and say: Show me a
list of $10 million mansions in my community. That is access, but they
can't afford it. We know when Dr. Price and others talk about access,
they are trying to actually verbally trick the American people because
people can't afford this healthcare. They will not have the healthcare,
but they can inquire about it. That is all access is.
Americans are smarter than that. They know having good health
insurance is what leads to affordable healthcare. Access to care will
not make us well and will not save our lives if we can't afford it.
So what is the real effect of this TrumpCare bill? Last night the
Congressional Budget Office made clear that 24 million fewer Americans
will have health insurance if TrumpCare becomes the law of the land. It
is one of the biggest broken promises that this President has made, and
he has broken a lot of them. In an interview with the Washington Post,
here's what the President said: ``We're going to have insurance for
everybody.'' President Trump: ``We're going to have insurance for
everybody'' that is ``much less expensive and better.''
Well, the CBO report confirms that TrumpCare does not even remotely
come close to that pledge. The President was off by only 24 million
Americans. That is more than the population of my entire State.
Seniors will also get crushed with higher premiums. Americans of all
ages will have to pay more out-of-pocket costs with deductibles and
copays. Let me give you one example from the CBO report. A 64-year-old
American not eligible for Medicare who makes maybe $26,500 a year would
have to pay a premium of $14,600. That is more than half of that
senior's entire income. How is that even possible? If there were ever a
war on seniors, this bill, TrumpCare, is it.
The CBO report also showed that TrumpCare spends more on tax breaks
for the very wealthy and for insurance companies than it does on tax
credits to help middle-class Americans afford health insurance. In the
final tally, TrumpCare would erase more than $1 trillion from programs
that help poor and middle-class families in order to fund an almost
$900 billion tax break aimed largely at the wealthy and corporations.
That would constitute one of the greatest transfers of wealth from the
middle class and the poor to the very rich in the last few decades. As
my friend Leader Pelosi said this morning: It is reverse Robin Hood,
taking from the poor and giving it to the rich. I would say that this
bill, TrumpCare, is reverse Robin Hood on steroids.
Rather than going back to the drawing board to solve these problems,
what are our Republican friends doing? Attacking CBO, the messenger.
There is just one problem: This messenger they are attacking is their
own messenger. Who appointed Dr. Hall as the head of CBO? Who was the
person most responsible? None other than Secretary Price, now the head
of HHS, handpicked him.
Dr. Hall has great conservative Republican credentials. Not only was
he picked by Dr. Tom Price, but he worked at the Mercatus Center, which
we all know is funded in good part by the Koch brothers. He is a man
chosen by one of the most conservative Republicans in the House, who is
now HHS Secretary. He taught at an institute funded by the Koch
brothers, the leading funders of the hard right, and they are attacking
him. They don't like his honest answers.
Republicans are attacking the referee because they are losing the
game, plain and simple. Everyone from second grade on was taught by
their parents not to attack the referee because it is unsportsmanlike.
In this case it is a lot worse. It has life and death consequences,
unlike a softball game for a second grader.
If we look at the CBO's score, it is hard to call this a healthcare
bill. A healthcare bill actually intends to provide insurance to more
Americans; this bill results in 24 million fewer Americans with health
insurance. A healthcare bill would help people afford health insurance;
this bill would likely increase costs on middle-class and working
families while making it cheaper for the top 1 percent and much cheaper
for the top 0.1 percent. They get the biggest benefit. They get a huge
tax break. A healthcare bill would seek to protect older and sicker
Americans who need health insurance the most; this bill jacks up the
price on older Americans the most. A healthcare bill would make it
easier for Americans to shop for health insurance, but the CBO says
that under this bill, plans would be harder to compare, ``making
shopping for a plan on the basis of price more difficult.'' That is
their quote.
By no measure can we call TrumpCare an actual healthcare bill. The
only thing this bill makes healthier is bank accounts for the
wealthiest Americans. People who make above $250,000 would get an
average tax break of $200,000. People who make $1 million would get an
average tax break of $57,000. That is what this bill is all about.
Our Republican friends have cut taxes on the rich. That is what their
tax reform bill will be about. That is what this is all about. At a
time when Donald Trump was campaigning to help the middle class, the
working people, he gets into office, and boom: The first big, big, big
proposal reduces taxes on the wealthiest people. This is not going to
play well in Peoria, Brooklyn, or Charlotte.
We Democrats are going to stand strong, stay united, and fight tooth
and nail against TrumpCare until our Republican friends drop their
repeal efforts for good.
Mr. President, I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER (Mr. Tillis). The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. SCHATZ. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. SCHATZ. Mr. President, what should we call it? What do we call
this new bill the Republicans are rushing
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through to take away healthcare from millions of Americans? Is it
TrumpCare? Is it RyanCare?
It is important to remember that both Paul Ryan and President Trump
are branding experts. The President put his name on a line of steaks.
He put his name on a magazine, on hotels. Then, here is the Speaker of
the House, who has worked pretty hard to be thought of, at least in
this town, as a policy wonk and serious thinker, who has branded
everything he has worked on from the Ryan budget to ``A Better Way.''
Yet neither leader of the Republican Party wants to own this thing.
That is because TrumpCare is one of the worst pieces of legislation I
have ever seen.
The process has been a total mess, and this is despite the fact that
the Republicans had 7 years to work on a plan. At first, they were
thinking about doing this without getting a score from the
Congressional Budget Office, the CBO. Then they realized that even
their own Members--even their loyal soldiers--did not want to vote on
something without knowing how much it would cost or how many people
would lose healthcare.
Now they are saying the score either does not matter or it is wrong
except for the areas in which they like the score. They spent the last
48 hours trashing the CBO, when there is plenty of evidence that for
the last 8 years, they referred to the CBO as an expert source when it
fit their needs.
Look, the legislative process requires hearings, expert testimony,
and that is not a mere formality. That is how you get a decent product.
For all of the complaints about the way the ACA was passed, they did
have hearings; they had discussions. It took over a year. President
Obama, himself, even went to the Republican retreat and personally
engaged in policy.
Moving this fast without having hearings is the kind of thing you do
when naming a post office or doing some other noncontroversial measure,
or it is the kind of thing you do for something that you don't want
people to look at very closely because, with every moment that passes,
this coalition frays, if it ever existed in the first place.
Now you have criticism from literally the left, right, and center.
That is, in part, because no one saw this coming. No one expected a
bill that would look like this because during the campaign this
administration promised not to cut Medicaid. It promised that
everyone--every single American--would have health insurance, but here
we are. If TrumpCare becomes law, 14 million people will lose their
healthcare next year. Let me repeat that. In just 1 year, 14 million
Americans will no longer have the health insurance they were promised.
I want to talk about what that means, what will it mean if people no
longer have healthcare.
This week, the Washington Post featured the stories of people in a
single county whose lives have changed for the better because of
Medicaid. In McDowell County, WV, Medicaid has helped thousands of
people get access to physical therapy and immunizations. It has allowed
them to see counselors for mental health problems and opioid addiction.
It has helped them to afford the medication they need instead of
relying on free samples from clinics.
These services do not just benefit the individuals, they benefit the
whole community by making sure people are healthy enough so they can
work and contribute to the economy. They allow us to save money by
focusing on prevention instead of treatment. This is what is at stake.
These are the services that will go away because TrumpCare is going to
cut Medicaid by $880 billion.
Here is another thing. TrumpCare is also going to impose an age tax
that will allow insurance companies to charge older people more money
for health insurance--a lot more. I want to be clear. We are not just
talking about senior citizens here, we are talking about people who are
pre-Medicare; in other words, anyone under the age of 65 but not
exactly young. For example, a 64-year-old will be charged up to five
times the amount a 21-year-old will be charged. Starting at age 25, the
older you get, the more money you will get charged. That is why AARP
has come out against this bill, because every year you get older they
will charge you more. This is an age tax. This is a penalty for getting
older.
There is an important point to be made about process, and that is
this: This is actually not a healthcare bill. That is not a political
statement. That is not a rhetorical flourish. Here is what is going on.
If this were a healthcare bill, it would be new legislation. In order
to pass legislation, under the rules of the U.S. Senate, which were
agreed upon by both parties over many years, you need 60 votes. The
reason we are working this through reconciliation is, they have nowhere
near 60 votes.
So what can you do within the reconciliation process? They are
basically stuck with dealing with taxes and subsidies because they only
require 51 votes. That is all they can do. This is a tax vehicle.
Then, the question becomes, Who is getting money, and who is getting
charged more money? On that count, this tax bill is one of the biggest
wealth transfers in American history. It is a transfer from working-
class Americans to rich Americans. That is what this bill does. It
takes money from the people who need help the most and gives it to the
very wealthy.
Here we are in 2017, just a few months out from an election in which
income inequality was one of the driving issues on both sides of the
aisle. What the Republicans in the House seem to take from that
experience is that their mandate is to go in and reduce taxes for
insurance executives who make more than $500,000 a year and for the
investor class in order to cut Medicaid by $880 billion. It is like
they were asleep all of last year or maybe they were never very serious
about income inequality. We do not need another election to know this
is not what the American people expect from the Congress. They expect
bipartisan compromise. They expect results that will make their
healthcare better.
My own view is, we can work together on healthcare, but it requires
three things: first, good faith; second, bipartisanship; third,
legislative hearings. Frankly, we have seen none of these things
because the process has been a mess. We need to have a conversation in
the light of day and let the American people weigh in. What is the
rush?
There is no doubt there is plenty of room for improvement in the
existing healthcare law, but TrumpCare makes it much worse. It will
cause chaos in the American economy and in 24 million Americans' lives.
That is a threat to the progress we have made over the last 7 years. It
is a threat to one-sixth of the American economy. Most of all, it is a
threat to at least 24 million Americans who stand to lose their
healthcare.
These threats are the reasons the Senate needs to come together and
say: Slow down. Let's work together. Let's work on forming a bipartisan
foundation. Let's have hearings. Most importantly, let's not impose
this catastrophe in a hurry on the American people.
I yield the floor.
Mr. DURBIN. Mr. President, I come to the floor today to talk about
another rule the Republicans want to overturn instead of working with
Democrats to create jobs. This rule outlines when State unemployment
agencies can drug test applicants for unemployment benefits.
Today there are roughly 7.6 million Americans who are unemployed, and
over 2 million of these unemployed Americans are collecting
unemployment insurance. About 150,000 of these people live in Illinois.
Unemployment insurance benefits provide a lifeline to many workers
and families who are struggling to make ends meet. If this resolution
passes, my Republican colleagues will succeed in preventing hard-
working Americans from receiving these benefits, and they will succeed
in making it more difficult for unemployed Americans to find work.
This past August, the Department of Labor finalized a rule that
explains when State unemployment agencies can subject unemployment
benefit applicants to a drug test. The rule clarifies which occupations
regularly conduct drug testing, as established by the Department of
Labor, to help State programs that conduct drug testing.
This rule makes sure States have the guidance they need to implement
drug testing requirements in a fair and legal
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mariner, but if this partisan CRA is signed into law, it will undo a
bipartisan compromise that was created to ensure equitable access to
unemployment benefits.
Unemployed Americans have paid into the unemployment insurance
program, and they are entitled to receive that insurance when they lose
their job to circumstances beyond their control. By supporting blanket
drug testing of unemployment insurance applicants, my Republican
colleagues are targeting hard-working Americans who in many cases have
fallen on hard times.
And let me be clear, this will make it more difficult for them to
receive the benefits they have earned.
Millions of Americans around the country voted for leaders who would
fight for the working class. Repealing this rule will be another broken
promise to those families.
Drug testing is also expensive. In 2011, the Texas Legislative Budget
Board estimated it would cost Texas $30 million over the course of just
1 year if they moved forward with a universal drug-testing policy for
unemployment benefits.
When States have conducted drug testing of applicants for other
government programs, like the Temporary Assistance for Needy Families
program, very few claimants have tested positive for drug use.
My Republican colleagues say that this resolution will help save
taxpayer money, but overturning the Department of Labor's rule will
lead to millions of wasted taxpayer dollars on drug tests that come
back negative.
This resolution isn't about saving money. It is about paving the way
for lawmakers who want to drug test every American who has to file for
unemployment insurance; yet these same lawmakers aren't calling for
drug testing Americans that claim other Federal benefits, like tax
credits or deductions on their tax returns.
I urge my colleagues on the other side of the aisle to remember: the
Department of Labor's drug-testing rule is about real people who depend
on unemployment insurance to live in America.
They need these benefits to put food on the table, to make a rent or
mortgage payment, or to pay for gas to allow them to continue their job
search.
When people become unemployed, it is often a result of company
downsizing or outsourcing American jobs, not drug use. We should not
and cannot unfairly stigmatize these workers and make it even more
difficult for them to get back on their feet after becoming unemployed
by undoing this regulation.
I urge my colleagues to join me in voting against this resolution.
Mr. VAN HOLLEN. Mr. President, I rise in opposition to H.J. Res. 42
today, a bill in search of a problem. Back in 2012, Congress passed
legislation to extend temporary unemployment insurance as our country
worked to recover from the recession. That legislation included a
bipartisan compromise that allowed States to drug test people applying
for unemployment compensation if they were fired from their previous
job for drug use or they were pursuing employment in a field that
regularly required drug testing for safety reasons. The Department of
Labor was charged with determining those occupations.
This guidance is critical because courts have twice ruled against
States who implemented blanket testing for TANF benefits. Without
probably cause, they ruled that such testing violated constitutional
rights. By overriding the Department of Labor's rule, States are left
in confusion.
My colleagues on the other side of the aisle might argue that the
authority to drug test is important to help save money in the program.
There is no clear evidence that this is the case. There is also no
convincing evidence of rampant drug use among beneficiaries. States
have engaged in drug testing for TANF recipients with remarkably few
results. In Oklahoma in 2015, nearly 90 percent of those required to
take a drug test had a negative result for drug use. In fiscal year
2014, Utah's drug testing returned just 18 positive results. As of
2016, only 0.1 percent of all applicants for Tennessee's cash
assistance program tested positive.
We all acknowledge an opioid crisis in our communities. Instead of
using resources to help people access treatment programs, we are
debating creating costly drug testing programs that have failed to
produce significant results in States where they have been tried. Over
in the House, they are considering TrumpCare, which would erode drug
treatment coverage. We should be working to address this tragedy, not
spending time on wasteful and damaging measures like these. I urge a
``no'' vote.
Mr. SCHATZ. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. CORNYN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Boozman). Without objection, it is so
ordered.
Mr. CORNYN. Mr. President, I ask unanimous consent that the time
until 5:45 p.m. today, including quorum calls, be equally divided in
the usual form, with 15 minutes of the Democratic time being reserved
for the use of Senator Wyden or his designee; further, that at 5:45
p.m., the remaining time on H.J. Res. 42 be considered expired, the
resolution be read a third time, and the Senate vote on the resolution
with no intervening action or debate.
The PRESIDING OFFICER. Without objection, it is so ordered.
Nomination of Robert Lighthizer
Mr. CORNYN. Mr. President, today the Senate Finance Committee has
considered the nomination of Mr. Robert Lighthizer to be the country's
next Trade Representative. This position serves as a vital role in our
country's economic policy by negotiating trade agreements on behalf of
the American people and making sure they are enforced according to
their terms.
President Trump has made clear that his administration will be
devoted to getting the very best trade deals possible for the American
people. For Texas, my State--the Nation's top exporting State--trade is
incredibly important. Many of our jobs and industries rely on trade
agreements, like NAFTA, so that our goods and services can find new
markets and more customers. As a matter of fact, 5 million American
jobs depend on binational trade with Mexico alone, which gives us a
sense of how important trade is to our economy at large.
I am happy to support Mr. Lighthizer for this important post. He has
served in the Senate as a staffer on the Senate Finance Committee for
the former chairman of the Finance Committee, Senator Bob Dole, and as
the Deputy U.S. Trade Representative during the Reagan administration
as well. In his nearly three decades in the private sector, Mr.
Lighthizer has represented a number of U.S. commercial interests
through trade enforcement cases, while also focusing on opening up
foreign markets to American ranchers, farmers, and small businesses. I
look forward to working with him to improve existing trade deals and to
cut better ones for the benefit of the American people.
American Health Care Act
Mr. President, last week the House of Representatives unveiled a plan
to repeal and replace ObamaCare with one that provides more options for
the American people at a price they can afford. This was in direct
response to what has been an ObamaCare disaster--one that led to
skyrocketing healthcare costs, insurers leaving markets left and right,
and a big government solution to a complicated problem that fails to
actually deliver on its promises.
We have all heard it a hundred times if we have heard it once.
President Obama said: If you like your policy, you can keep it; if you
like your doctor, you can keep your doctor; and a family of four would
see a decrease in their premium costs by $2,500. Obviously, that did
not prove to be the case.
There is really no denying that ObamaCare isn't working, and the
status quo is unacceptable. Under ObamaCare, tens of millions are
uninsured--almost 30 million people now in America, which, to me, is
one of the most supreme ironies of ObamaCare. It was sold to us on the
premise that everyone would have insurance. Yet 30 million people are
uninsured, and 20 million of those 30 million are either people who
have paid a penalty because they haven't bought the government-
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approved healthcare and thus are not complying with the individual
mandate or they are people who claimed a hardship exemption, saying
they simply can't afford to buy the policy that the government mandates
they purchase, so the government has supplied them an exemption. So 30
million are uninsured under ObamaCare, and 20 million of those 30
million have either paid the penalty or have been otherwise excused
from complying with the mandate.
We know that under ObamaCare, tens of millions are uninsured,
premiums have skyrocketed, and mandates have crushed job creators.
I remember several conversations with employers--restaurant owners
and one gentleman in an architectural firm--saying: When does the
employer mandate kick in? In other words, when do you get penalized for
not complying with the ObamaCare requirements?
He said: I am going to hire fewer people because I don't want to come
within the ambit of that employer mandate.
Then I remember one restaurant in East Texas where a single mom
basically was laid off of her full-time job and forced to work two
part-time jobs to make up for that lost pay because her employer
couldn't comply with the employer mandate under ObamaCare, so what he
decided to do was lay off his full-time workers and hire people on a
part-time basis. ObamaCare is riddled with stories like that, which
demonstrate its flaws.
Consider that a 24-year-old individual in Texas could spend up to 30
percent of their gross income just paying for their healthcare premiums
and their out-of-pocket costs--hardly affordable healthcare. We really
should have called it the un-Affordable Care Act. We have begun the
first step to repeal and replace it.
Yesterday, the Congressional Budget Office offered us a glimpse into
the impact the legislation would have. But I hasten to add that this is
just the first step out of multiple steps, and there is additional work
to be done, first of all, by the Secretary of Health and Human
Services, who has enormous discretion in terms of how to administer
healthcare policy at the national level and the authority to delegate a
lot of that responsibility, along with the money that goes with it,
back to the States where it historically has been done, to offer people
lower cost health insurance that suits their needs--not a government
mandate--and offers them more choices.
There is a number of additional things in the Congressional Budget
Office report yesterday which are important to consider.
First, the CBO estimates the American Health Care Act would lower
premiums by 10 percent over time. We know ObamaCare raised premiums for
many families across the country; they skyrocketed to an unaffordable
level. So this is a start in the right direction, but I hasten again to
add that it is just a start.
The Congressional Budget Office also confirmed that the American
Health Care Act is a fiscally conservative bill that puts forward
responsible solutions to our Nation's healthcare woes. CBO estimates
that we could reduce the Federal deficit by $337 billion by passing the
American Health Care Act.
It also reforms Medicaid. Many of our most vulnerable population get
their healthcare through Medicaid. This bill provides a way of sending
that money and authority back to the States and lets them manage the
growth of the Medicaid Program according to a Consumer Price Index. So
people who are on Medicaid now, including those in the expansion
States, can stay on Medicaid, but ultimately the responsibility is
going to be sent back to the States, along with the money to pay for
it, and grow--not to cut it, but to grow--according to a Consumer Price
Index, which makes sense. That change alone saves taxpayers another
$880 billion--$880 billion. This is the most significant entitlement
reform in certainly a generation.
The bill repeals ObamaCare's job-killing taxes like the individual
employer mandate and the medical device tax, which has moved jobs
offshore to places like Costa Rica because of its impact on innovation.
We also repeal the payroll tax, the tax on investments, and the tax on
prescription drugs. The fact is, middle-income Americans and our job
creators will find massive tax relief as a result of this legislation--
to the tune of more than $800 billion.
Put simply, the American Health Care Act dismantles, repeals, and
stops ObamaCare in its tracks.
I should point out that the CBO doesn't take into account other steps
Congress and the administration will take in order to make our Nation's
healthcare system a vibrant marketplace where more options and better
quality healthcare exist.
I might say that a lot of the news yesterday on the CBO report had to
do with the reduction in the number of people who would actually buy
health insurance under this new legislation, but the reason for the
change is in large part, as the Congressional Budget Office said, that
when you don't punish people through a penalty for not buying
government-approved health insurance, as ObamaCare did, people may well
decide in their own economic self-interest not to purchase that
government policy, particularly when their choices are so limited.
I believe this is a first step in unraveling this convoluted puzzle
called ObamaCare and getting our Nation's healthcare back on track. The
American people have demanded better than ObamaCare. Families are
forced to pay for insurance they can't afford that provides subpar
care, and they are tired of being forced to pay a penalty because they
don't want to opt into a government program that fails to deliver on
its most basic promises.
Let me just say this in closing: I know some of our friends across
the aisle have a dim view of this proposal. They say the CBO score
demonstrates that not enough people will be covered by this alternative
to ObamaCare. But my question to them is, What are you going to do
about the current meltdown in ObamaCare that is forcing people into
insurance they don't want and denying them any real choice, where the
premiums are skyrocketing, and where the deductibles are so high you
are effectively denied the benefit of any health insurance coverage?
What are they going to do about that? I would simply say that if they
don't like the alternative we have offered, I invite them to join us in
trying to solve this problem.
One of the lessons of ObamaCare is that partisan healthcare
legislation isn't very durable and doesn't survive. I hope at some
point the fever will break, and Democrats and Republicans alike will
find a way to work in the best interests of our constituents, the
people we serve--the American people.
We can't afford another one-size-fits-all approach to healthcare. The
American Health Care Act will provide the first important steps of
relief from this unworkable, unsustainable system that was created
based on false promises made to the American people. At the end of the
day, our goal is to deliver more access, more options, and better
quality care for families across the country. I look forward to getting
it done soon.
In the House, the Budget Committee will take up the healthcare bill,
which passed the Ways and Means Committee and the Energy and Commerce
Committee, and then it will move to the floor of the House where I
presume it will be open to some amendments. Then it will come to the
Senate where, under the Senate rules, it will also be open to
amendments.
If people have a better idea, I hope they will join us in trying to
come up with the very best solutions possible. But to simply hang back
and sort of enjoy the difficulty of trying to reform this broken
ObamaCare system for partisan reasons, to me, seems to be beneath the
dignity of what we are sent here to do by our constituents.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Rhode Island.
Mr. WHITEHOUSE. Mr. President, before I get into my ``Time to Wake
Up'' speech, let me say I appreciate the concern of the Senator from
Texas that the Affordable Care Act leaves too many Americans uninsured.
I am not sure the solution to that problem is to throw another 24
million people off of their insurance. I appreciate his concern that
premiums for many are too high. I am not sure the solution is to
dramatically increase premiums on the elderly. I appreciate his concern
that Medicaid can be managed by the States--and I think I used his
words correctly--along with the money to
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pay for it. But when the bill has $800 billion in Medicaid savings but
will not cure or prevent a single illness, you are not reducing those
$800 billion in savings; you are just moving it to the States. You are
just putting that burden on the States. Ask Arizona how that worked
when they tried to do Medicaid as they dealt with the mortgage
meltdown.
The American people do perhaps demand better than ObamaCare, but the
solution to offer them something that is far, far worse does not seem
very sensible. I believe we are willing to work together. Indeed, in
the HELP Committee our chairman has already said that as soon as we
start talking about repair, we can get to work. But the notion that
there is an invitation out to us to work in a bipartisan fashion when
the majority party is jamming this bill through without negotiation,
using reconciliation as an extraordinary process to try to put it
through under arcane budget rules that were never designed for this--
that is not exactly much of a signal. So as soon as we get to regular
order and 60 votes, I think we will be able to actually work and serve
our constituents very well.
Climate Change
Mr. President, I am here today for my 160th ``Time to Wake Up''
speech, this one focused on the security consequences of our failure to
deal with carbon emissions and climate change.
My remarks at the Munich Security Conference this year pointed out
that climate change presents several orders of security risk to
society. The first order of security risk is just physical damage,
damage that science and our senses are already perceiving and measuring
in our atmosphere, our oceans, and our environment.
This security risk, risks to the Earth's present national state, will
hurt farming communities, coastal communities, fishing communities, and
of course anyone vulnerable to wildfires, droughts, and extreme
weather. Of course, the poorer you are in this world, the more
vulnerable you are to this peril.
The second order of security risk from climate change is the
consequences in human society from that physical, biological, and
chemical damage in our environment. As farms and fisheries fail, people
are impoverished and dislocated. Scarce resources lead to conflicts and
confrontations. Storms and fires can make suffering acute, and people
who are hungry or dislocated or torn from their roots can become
desperate, radicalized, and violent. That is why the U.S. Department of
Defense has for years called climate change a catalyst of conflict.
Drought in Syria, for instance, has been described as a root cause of
the conflict there, a conflict that has killed more than 400,000
people, according to some estimates, and displaced more than 11
million. Researchers from NASA and the University of Arizona have
determined that drought was very likely the worst in a millennium.
Massive crop failures and livestock losses moved farmers into stressed
cities, where popular protests met with brutal violence from the Assad
regime and the tide of refugees from that chaos swamped Europe.
Nigeria, Sudan, and Central America are other areas where violence
and flight are driven by scarce resources. So the second order of
national security risk is the societal damage that cascades from the
natural damage caused by climate change.
The third order of security risk is perhaps the most dangerous for
our country; that is, reputational damage to the keystone institutions
of our present world order: market capitalism and democratic
government. People around the world who have been harmed by the first-
order environmental effects of climate change, or people around the
world who get swept up in the second-order societal effects of climate
change will want answers, as will many who are witness to the global
suffering and harm caused by climate change.
When that reckoning comes, as it will, the discredit to institutions
like capitalism and democracy which failed to act, even when loudly and
clearly warned, could be profound. This failure of action by these
institutions is compounded by the moral failure. Fossil fuel companies
are knowingly causing this harm. They are aggressively fighting
solutions to this problem. Their weapons are as disreputable as their
conduct: professionally administered misinformation--climate denial,
after all, is the original fake news--and massive, massive floods of
political money.
As a result, the Congress has shown itself utterly unable to resist
the threats and blandishments of this industry, despite the fact that
we know very clearly of the industry's enormous conflict of interest.
This all stands to be a lasting blot on both democracy and capitalism,
a blot that will worsen as the consequences of our climate failure
worsen. If you believe, as Daniel Webster did, in the power of
America's example, that we are, indeed, a city on a hill, then you
should worry about this terrible example of greed, ignorance, and
corruption triumphant.
It is not like we have not been warned. The National Intelligence
Council has estimated that worldwide demand for food, water, and energy
will grow by approximately 35, 40, and 50 percent respectively in
coming decades. This increased resource demand is on a collision course
with those first-order harms--disrupting fisheries and agriculture
around the globe.
The U.S. Institute for Peace has warned that ``poor responses to
climatic shifts create shortages of resources such as land and water.
Shortages are followed by negative secondary impacts, such as more
sickness, hunger and joblessness. Poor responses to these, in turn,
open the door to conflict.''
For those who discount this as a bunch of peaceniks' prattle, let me
add that in 2013, our National Intelligence Council put climate change
alongside events like nuclear war and a severe pandemic among the eight
events with the greatest potential for global disruption--noting for
climate change that ``dramatic and unforeseen changes are occurring at
a faster rate than expected.'' The Department of Defense 2014
Quadrennial Defense Review described climate change as a ``global
threat multiplier.'' That report warned that ``the pressures caused by
climate change will influence resource competition while placing
additional burdens on economies, societies, and governance institutions
around the world.''
As head of U.S. Pacific Command, ADM Samuel Locklear warned in 2013
that climate change was the biggest long-term security threat in his
area of operation, noting the need to organize the military for ``when
the effects of climate change start to impact these massive
populations.''
Again, I will quote him. ``If it goes bad,'' he said, ``you could
have hundreds of thousands or millions of people displaced and then
security will start to crumble pretty quickly.''
Operation Free, a coalition of national security and veterans
organizations, has continually pointed out the national security threat
posed by climate change, as has the American Security Project,
comprised of retired military flag officers. The Government
Accountability Office, GAO, has warned that climate change is affecting
defense infrastructure around the world, from sea level rise at Naval
Station Norfolk to heavy rain and flooding at Fort Irwin, CA, to
thawing permafrost affecting Air Force radar installations in Alaska,
to faraway effects, even at Diego Garcia in the Indian Ocean.
The Coast Guard, of course, must meet entirely new demands of the
icecap's melt in the Arctic for transportation and shipping, for new
fishing grounds, for resource exploration, and of course the
possibility there of conflict. In 2005, when Defense Secretary Mattis
led Marine Corps Combat Development Command, he called on Navy
researchers to find ways to make the military more energy efficient, to
``unleash''--to use his words--U.S. military forces from the ``tether
[of] fuel.''
Ask Senator Tammy Duckworth about the casualties sustained among her
comrades in arms defending fuel supply lines if you want to see a
passionate conversation. The military funds research into alternative
energy and studies how climate change affects military capability
because in the real world, where real lives are at risk, they can't
afford to believe the false facts peddled by the fossil fuel industry.
The people we entrust to keep us safe, who have to deal with real
threats in the real world, recognize the danger
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climate change represents. The National Intelligence Council said in
January that ``issues like . . . climate change invoke high stakes and
will require sustained collaboration.'' Instead of that, we get a
Congress and an administration that has deliberately let the fossil
fuel industry occupy and sabotage the orderly operation of the
Government of the United States to deal with this problem.
So I am going to start to push back. When these tools of the fossil
fuel industry, to whom we in the Senate gave advice and consent, go too
egregiously about their dirty business of climate denial, expect that I
may come to the floor and object to consent requests.
Last week, Administrator Pruitt said carbon dioxide does not cause
climate change. That is nonsense. That is somewhere between ignorant
and fraudulent. He gets that one lie for free but no more--not next
time with the stakes this high. It can't be free to have these fossil
fuel tools spouting their fossil fuel nonsense from Senate-confirmed
positions of governmental authority. Starting now, it will not be.
I yield the floor.
The PRESIDING OFFICER (Mr. Flake). The Senator from Utah.
Mr. HATCH. Mr. President, later today, the Senate will vote on H.J.
Res. 42, the resolution of disapproval under the Congressional Review
Act relating to a Department of Labor regulation on the drug testing of
unemployment insurance applicants. I rise to speak in support of that
resolution and to urge my colleagues to vote in favor of its passage.
Let's put this resolution and the regulation it would repeal in
proper context. In 2012, Congress passed and President Obama signed the
Middle Class Tax Relief and Job Creation Act. Among many other things,
that law included a number of carefully negotiated provisions relating
to the unemployment insurance program, including a number of reforms to
address program efficiency and integrity issues.
One of those provisions overturned a DOL ban on drug screening for UI
applicants. Specifically, the law allowed States to test UI applicants
who either lost their job due to drug use or were seeking employment in
an occupation that generally required drug tests as a condition of
employment.
It did not require States to begin drug testing; it only gave them
that option. In addition, the law required DOL to issue regulations to
define those occupations that regularly conduct drug tests. States
would not be allowed to implement any drug testing policies pursuant to
the law until the regulations were finalized. DOL issued its proposed
regulation in 2014.
At that time, Members of Congress and stakeholders at the State level
argued that the proposal fell far short of Congress's intent. The final
rule was issued in August of last year, about 4\1/2\ years after the
provision was signed into law. As before, the final regulation defined
the relevant occupations so narrowly that it basically makes it
impossible for States to implement any meaningful drug testing policy.
So here we are, debating a CRA resolution that would wipe this
regulation off the books and give DOL an opportunity to put forward
something new that better reflects Congress's intent.
Let's talk about why this drug testing provision is important. The UI
Program requires beneficiaries to be able and available to work and be
actively seeking work. This is a condition of eligibility for UI
benefits. This is what it boils down to. If a worker loses his or her
job due to drug use, he or she cannot affirmatively establish that they
are fully able to work. Likewise, if an unemployed individual is unable
to accept a new job because they cannot pass a required drug test, they
are not available for work.
Congress intended to give States the power to withhold benefits in
these cases because, by definition, individuals in these situations are
not eligible for unemployment insurance benefits.
Keep in mind that, according to recent surveys, more than half of all
U.S. employers require prospective employees to take a drug test. It
isn't some fringe or mean-spirited notion that there is a connection
between the use of illegal drugs and the ability to obtain and maintain
employment.
Furthermore, 20 States already limit UI benefits for applicants who
have refused to take or who fail a drug test required by an employer or
who have previous employment issues relating to drugs. The next logical
step really is to allow States to conduct the tests themselves in order
to maintain program integrity and to improve the solvency of their UI
trust funds. Once again, that was what Congress intended with the
passage of the 2012 statute.
Unfortunately, the Obama administration took it upon themselves to
undo congressional intent. We have heard from a number of Governors on
this issue--including the Governor of Utah, who will support this CRA
resolution--who want to see new and better regulations.
A number of organizations, including the National Association of
State Workforce Agencies, have chimed in as well, expressing their
strong support for State flexibility in governing their UI programs.
Ultimately, that is what this is about--State flexibility. Do we want
States to have the freedom to run their own programs as they see fit,
or do we believe that bureaucrats in Washington have all the answers?
It is probably pretty clear where I come down on this particular
issue. The law we drafted and passed in 2012--the one that passed with
bipartisan support--struck a careful balance on these issues. It was
the right balance and the right approach. Hopefully, a majority of our
colleagues will share that view and vote today to restore that balance.
Once again, I urge all Senators to vote in favor of H.J. Res. 42.
With that, I suggest the absence of a quorum.
The PRESIDING OFFICER. Will the Senator withhold?
Mr. HATCH. I withhold that suggestion.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Mr. President, the Senate has been digging into the legal
quagmire of drug testing the unemployed. I would like to begin by
saying that no matter where a Senator comes down on the issue of drug
testing, my view is that this measure before us is simply bizarre.
If, like me, you believe that drug testing is ineffective and mean-
spirited, you ought to oppose this measure because it simply vilifies
unemployed workers who are actually less likely to use drugs than the
general population.
For those Senators who support drug testing, this measure blows up
what has been a bipartisan compromise and a Labor Department rule
allowing select testing to go forward. The result of this measure
passing would actually be to block testing from going forward.
The fact is that the courts have ruled that suspicionless drug
testing violates the Fourth Amendment's protection against unreasonable
searches and seizures. That is why there is now actually a rule that is
narrow.
We have the courts expressing skepticism about this, and there is
actually a rule that is narrow so that, in effect, States that are
doing this drug testing have what amounts to guardrails to avoid
running afoul of the Constitution. If you pass this measure, you will
throw out the guardrails, opening up, in my view, the possibility of
yet more litigation on Fourth Amendment grounds.
Now, as I touched on in my opening comments, there isn't evidence
that unemployment insurance recipients use drugs any more frequently
than the general population. In fact, studies actually indicate that
they are less likely to use illegal drugs than the general population.
So this idea that somehow there is a presumption of irresponsible
conduct and guilt is just baseless.
To be eligible for unemployment insurance, workers have to have
substantial recent work experience. They have to be unemployed through
no fault of their own. Workers can only collect unemployment benefits
if they are actively searching for work and available to work.
For States that have implemented drug testing policies, there is
evidence that the costs dwarf the potential savings. The costs of
operating drug testing programs are charged to State health and human
services accounts, and I think we all understand that those have been
squeezed mightily by the effort to treat opioid addiction. In my view,
instead of wasting money by drug testing Americans who are looking for
jobs, the States ought to be putting those very same dollars toward
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substance abuse treatment, given the fact that opioid addiction has hit
our country like a wrecking ball.
Moreover, we have said that fighting opioid addiction ought to be a
bipartisan cause. If Republicans wanted to do everything possible to
fight addiction, they shouldn't be going forward with TrumpCare, a bill
that would be a disastrous setback when it comes to fighting opioid
addiction. The fact is that colleagues on the other side of the aisle
here in the Senate--colleagues not from my side but colleagues from the
other side--have expressed their concern about what TrumpCare means for
the fight against opioid addiction.
The hard numbers are actually out now on TrumpCare, and they show
that the majority is going into overdrive to pass a bill that strips
millions of Americans of their access to treatment for substance abuse.
Today Medicaid is strengthening our mental health network, expanding
access to substance use disorder treatment, and is at the forefront of
some promising new work to fight opioid addiction. So TrumpCare hits
the cause of treating opioid addiction in a devastating way. It slashes
the healthcare safety net, and, in my view, it would inflame the
epidemic of drug abuse deaths across the country.
At the same time, there is this partisan effort to slash funding for
addiction treatment. Republicans have dredged up an old head-scratcher
of an argument that drug testing Americans and denying them earned
benefits somehow just magically helps to overcome addiction. This is an
important point.
Just like Social Security, unemployment insurance is an earned
benefit. It is an earned benefit that ought to be there for workers who
fall on hard times.
So what the majority is pushing for in this debate looks to me like
light years away from what was discussed last year when there was
discussion before the election about helping Americans in every part of
the Nation who are struggling with opioid addiction.
You have to ask this question: What earned benefits are my colleagues
on the other side of the aisle going to crusade against next? Is the
drug testing crusade going to turn next to Social Security and Medicare
recipients as an excuse to deny seniors benefits that they have
earned--earned benefits that they worked hard for through a lifetime of
work?
I am going to wrap up by way of saying that, if this measure passes,
I think States are just going to be thrown into bedlam. The current
law, based on a compromise--a bipartisan compromise reached in 2012--
says States can drug test recipients of unemployed benefits in two
cases: first, if the unemployment insurance recipient lost their job
for drug-related reasons and, second, if the unemployment insurance
recipient is applying for a type of occupation that requires drug
testing, as defined by the rules of the Department of Labor.
Let's say, for example, that two unemployment benefits recipients are
specifically applying for jobs as schoolbus drivers or air traffic
controllers. The rule that is on the books now says that States can
drug test those individuals because they are applying for work in
occupations that require drug testing.
Now, as far as I can tell, my colleagues on the other side of the
aisle want to eliminate the rule that defined those occupations. States
would be blocked from performing any occupation-based drug testing for
unemployment recipients, and the States would just be walking into a
legal minefield if they wanted to go ahead with testing programs
anyway.
Make no mistake about it. When this passes--if it does--drug testing
policies go on hold until the Congress passes a new law, rather than
our continuing a carefully put together bipartisan compromise of just a
couple of years ago.
I have been trying to see this from my colleagues' perspective. I
have listened to the arguments from the other side. I just find this a
baffling, bizarre kind of analysis. All this measure does is create a
huge amount of new uncertainty. That doesn't strike me as a good way to
reduce bureaucracy and make government more efficient.
If the majority decides to take another crack at this issue down the
road, I can only guess at what kind of new ideas they might have that
would, again, miss the point of making sure we had a narrow, defined,
and bipartisan approach to deal with this issue.
My view is that this is an ill-conceived campaign against working
people built on a completely false premise. The premise is that if you
are looking for work, you are guilty of drug use until proven innocent.
My view is that we ought to keep trying, as I have said, on major
issues involving health and taxes and infrastructure and trade. When
you are dealing with important questions, we should work to find the
common ground. It is not about taking each other's bad ideas. It is
about taking each other's good ideas.
My view is that what was done a few years ago was a good and narrowly
tailored bipartisan idea. What the Senate may choose to do is basically
to throw that in the trash can, create bedlam, and make it impossible
for States to move because they are in a sort of legal limbo. I don't
see how that meets the test of sound policy.
This measure before us today sets back the cause of strengthening the
unemployment insurance system. It sets back the cause of advocating for
Americans struggling with addiction. I urge my colleagues to vote
against this measure when we vote here in a little bit.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER (Mr. Rubio). The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. McCONNELL. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Unanimous Consent Agreement--Executive Calendar
Mr. McCONNELL. Mr. President, I ask unanimous consent that,
notwithstanding rule XXII, following leader remarks on Wednesday, March
15, the Senate proceed to executive session for the consideration of
Executive Calendar No. 23, Daniel Coats to be Director of National
Intelligence; that the time until 10 a.m. be equally divided in the
usual form; and that at 10 a.m., the Senate vote on the motion to
invoke cloture.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
The joint resolution was ordered to a third reading and was read the
third time.
The PRESIDING OFFICER. The joint resolution having been read the
third time, the question is, Shall the joint resolution pass?
Mr. BURR. I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There appears to be a sufficient second.
The clerk will call the roll.
The bill clerk called the roll.
Mr. CORNYN. The following Senator is necessarily absent: The Senator
from Georgia (Mr. Isakson).
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 51, nays 48, as follows:
[Rollcall Vote No. 87 Leg.]
YEAS--51
Alexander
Barrasso
Blunt
Boozman
Burr
Capito
Cassidy
Cochran
Collins
Corker
Cornyn
Cotton
Crapo
Cruz
Daines
Enzi
Ernst
Fischer
Flake
Gardner
Graham
Grassley
Hatch
Heller
Hoeven
Inhofe
Johnson
Kennedy
Lankford
Lee
McCain
McConnell
Moran
Murkowski
Paul
Perdue
Portman
Risch
Roberts
Rounds
Rubio
Sasse
Scott
Shelby
Strange
Sullivan
Thune
Tillis
Toomey
Wicker
Young
NAYS--48
Baldwin
Bennet
Blumenthal
Booker
Brown
Cantwell
Cardin
Carper
Casey
Coons
Cortez Masto
Donnelly
Duckworth
Durbin
Feinstein
Franken
Gillibrand
Harris
Hassan
Heinrich
Heitkamp
Hirono
Kaine
King
Klobuchar
Leahy
Manchin
Markey
McCaskill
Menendez
Merkley
Murphy
Murray
Nelson
Peters
Reed
Sanders
Schatz
Schumer
Shaheen
Stabenow
Tester
Udall
Van Hollen
Warner
Warren
Whitehouse
Wyden
[[Page S1799]]
NOT VOTING--1
Isakson
The joint resolution (H.J. Res. 42) was passed.
The PRESIDING OFFICER. The Senator from Texas.
____________________