[Congressional Record Volume 163, Number 116 (Tuesday, July 11, 2017)]
[Senate]
[Pages S3896-S3902]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mrs. MURRAY. Mr. President, from the moment President Trump and 
Republicans began trying to jam TrumpCare through Congress, I heard 
from family after family in my home State about the damage their 
efforts to undermine families' healthcare would do, and this last week 
was no different. Again and again, my constituents told me what a 
difference it makes to have affordable insurance, to know that benefits 
like substance abuse treatment are covered, or to worry about how they 
would manage if TrumpCare ever became law.
  I heard some of my Republican colleagues went out of their way to 
avoid those kinds of stories when they were home, so I wanted to make 
sure they heard a few examples now that they are back in town. And I 
appreciate that many of my Democratic colleagues will also be sharing 
stories they heard from their constituents over the past few days.
  Like many of my colleagues on both sides of the aisle, I come from a 
State in which the opioid epidemic has had a devastating impact. It has 
been both heartbreaking and inspiring to talk with patients and 
families who are doing everything they can to fight back. Right now, 
the message I am getting from them loud and clear is that they do not 
want TrumpCare.
  Daniel, one of my constituents, was injured in the military. He was 
given a prescription for painkillers. He was on them for 8 years, and 
he told me that during that time, his three daughters wondered why he 
wouldn't play with them. Eventually, Daniel changed doctors and was 
prescribed Suboxone, which made all the difference for him. He is now 
able to work again. He manages a grocery store. He relies on Medicaid 
for healthcare coverage, which covers the hundreds of dollars a month 
his prescriptions cost. Daniel told me that if he loses Medicaid under 
TrumpCare, he will not be able to make ends meet and all of the 
progress he has made will be threatened.
  I heard from a constituent named Rachel of Seattle who was addicted 
to opioids and living in her car when she found out she was eligible 
for Medicaid. She got connected with Swedish Medical Center in Seattle, 
where she received wraparound health services, including mental 
healthcare and primary healthcare. Now she and her husband are 
successfully in recovery. They are raising a family, and Rachel is 
going to school. But, just like Daniel, they do not know what they will 
do if TrumpCare becomes law and the Medicaid coverage that is keeping 
them going is taken away.
  Those are just two of the countless stories I heard from patients and 
families and doctors in my home State and nationwide. I have heard from 
cancer survivors who have fought back as hard as they can and are 
worried that TrumpCare will allow insurance companies to price them out 
of care because they are now labeled with a preexisting condition. I 
heard from young parents of medically fragile children who stay up at 
night worrying about how to afford care for their toddler if lifetime 
caps on coverage are imposed under TrumpCare. I heard from seniors who 
simply don't have the savings to cover the premium spikes TrumpCare 
would cost. I heard from women and men who are furious, and rightly so, 
that a group of 13 men wrote a bill in secret to defund Planned 
Parenthood--the Nation's largest provider of women's healthcare--
removing a quality, affordable provider from communities in which it is 
now very difficult to get care.
  These stories are powerful. They make it undeniably clear just how 
much TrumpCare would hurt people. So it is no wonder that Senate 
Republicans spent the last week lying low and avoiding defending, 
oddly, the indefensible. Senate Republicans have read the same 
independent Congressional Budget Office analysis as we all have. They 
have heard from countless doctors and nurses and hospitals and nursing 
homes and patient advocates about all of the ways TrumpCare would raise 
families' costs and take away coverage. They know that people across 
the country are completely, resoundingly rejecting TrumpCare. It is the 
least popular bill in three decades, according to one study.
  All in all, TrumpCare shatters every promise President Trump and 
Republicans made about providing insurance to everybody and making sure 
no one is worse off. And, incredibly, the extreme rightwing still 
thinks it leaves too much of the Affordable Care Act intact.
  Even though it seems one would be hard-pressed to find anyone who 
wants to stick up for TrumpCare--including, by the way, President 
Trump--Senate Republican leaders are still doing everything they can to 
jam this through Congress as quickly as they can. They are working on 
backroom deals as we speak and coming up with new ways to sweeten the 
deal for Senate Republicans who are rightly wary of voting for a bill 
that would so clearly do so much harm.
  In particular, this afternoon I wanted to address the ongoing effort 
by extreme conservative Senators to double

[[Page S3897]]

down on pulling the rug out from under patients with preexisting 
conditions. They put together this two-track plan to make middle-class 
workers and families pay more. If they get their way, insurance 
companies would be back in charge and could tell patients with 
preexisting conditions or anyone who happens to get sick in the middle 
of the year ``tough luck,'' and they will do that in a way that even 
conservative experts predict will cause premiums and deductibles to 
skyrocket. Senate Republicans are coming up with other ideas, too, such 
as an opioid fund that a Republican Governor said is like ``spitting in 
the ocean.''
  Let me be clear. There is no ``fixing'' TrumpCare. No tweak around 
the edges is going to turn TrumpCare--which, by the way, is just a tax 
break for special interests and the healthcare industry on the backs of 
patients--into a healthcare bill that actually helps people. There is 
just no way. TrumpCare, as the President said, is mean at its core, and 
unless it is dropped altogether, Senate Republicans are going to have 
to decide whether they stand with their party or the people they came 
here to represent.
  So to everyone out there who has called and written and rallied and 
tweeted, you are having an impact. You are why TrumpCare isn't already 
law. But you cannot give up now, and Democrats here in the Senate won't 
either. We are going to keep doing everything we can to make sure 
Senate Republicans can't hold their noses and vote for TrumpCare just 
to hand big corporations a tax break and President Trump a hollow 
political win, whether it is next week or the weeks into August.
  I also want to remind my Senate Republican colleagues again that we 
have made clear all along the way that there is a better way to do 
this. Democrats are ready. We are willing to work with you on policies 
that make healthcare more affordable and workable for patients and 
families.
  So I am here today to say I hope you all listen to the stories our 
Democratic colleagues are bringing to the floor. Think about how 
devastating TrumpCare would be, and do the right thing. Drop this mean 
bill once and for all so all of us can get to work on real healthcare 
solutions that actually help people afford care, get covered, and stay 
healthy. If you do, you won't have to defend this defenseless bill a 
minute longer.
  Thank you. I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, first of all, I wish to thank Senator 
Murray, a member of our leadership, for taking this time to talk about 
accounts from home, what we have heard from those we have the honor to 
represent, and I think this is exactly what is appropriate at the 
beginning of this work period.
  I just come off of eight open-to-all townhall meetings in my home 
State of Oregon. Five were in counties won by President Trump, three 
were in counties won by Hillary Clinton, and the single unifying issue 
that dominated each one is that TrumpCare is a loser. Across the 
political spectrum--Democrats, Republicans, liberals, and 
conservatives--what I was told is that the Congress ought to set this 
TrumpCare bill aside, that the one Mitch McConnell has been working on 
ought to be dropped, and after it is dropped, Democrats and Republicans 
ought to get together and look for the common ground by trying to show 
some common sense.
  I am going to spend a little time talking about what I heard, what 
people are concerned about, and then briefly talk about, as Senator 
Murray said, what we would like to do if our colleagues on the other 
side of the aisle will drop this ill-advised, ``our way or the 
highway'' approach and do what the Senate has traditionally done when 
we are talking about tackling a big issue, which is find common ground.
  It doesn't get much bigger than healthcare. We are spending $3.2 
trillion each year now on healthcare. It comes to something like 
$10,000 for every man, woman, and child. We are spending enough money; 
the real question is whether we spend it in the right place, and this 
very flawed TrumpCare bill will compound that problem.
  During those eight townhall meetings over the past week, Oregonians 
asked me: When is this flawed TrumpCare bill coming to a vote? How are 
my frail, not physically well, older parents supposed to get by if this 
bill passes and they lose their health care coverage?
  As I have talked about with Senator Murray, we know that Medicaid 
picks up the bill for what amounts to two out of three older people in 
nursing homes. What often is not mentioned is that it also covers home- 
and community-based services for seniors. I remember from my days as 
director of the Oregon Gray Panthers that the whole goal was to create 
this continuum of choices for older people and, as Senator Murray 
touched on, the older people who need nursing homes and nursing home 
benefits. She is absolutely right. We also need to protect the Medicaid 
guarantee for the seniors for whom care is appropriate in other 
settings, such as home- and community-based services.
  At those townhall meetings at community centers and auditoriums, 
folks knew that I am the senior Democrat on the Senate Finance 
Committee.
  We have another talented member from the committee, Senator Bennet, 
here, as well as my knowledgeable colleague from Oregon, Senator 
Merkley.
  I have worked on these issues with respect to taxes and healthcare 
for some time, and I have really dedicated my professional life to 
trying to find that common ground, show common sense in the areas of 
healthcare and taxes. But the fact is, this version of TrumpCare is a 
tax break for some of the most powerful special interests masquerading 
as a health plan, and when Oregonians heard that, whether it was in a 
Trump county or in a Clinton county, everybody started nodding.
  The secret is out. This is not a plan to fix anybody's healthcare or 
hold down the premiums; this is one big handout to the most powerful 
special interests. People heard that Republicans were saying those tax 
cuts were going to create jobs. That is not very likely when they have 
made the tax cuts retroactive. What that means--they made the big one 
retroactive to January 1--is that if you have a capital gain say in 
March, and if this bill is passed in its present form, if that capital 
gain is $1 million, you get a tax break of $38,000. That is not 
creating jobs, it is creating windfalls, and the American people have 
caught on.
  Now that the Senate is back in session, the public is reading about 
the newest proposal on offer. It is a Hail Mary pass from Senator Cruz 
and Republican leaders, trying to put together $50 billion for their 
version of TrumpCare. And we know in the Finance Committee, they have 
billions and billions of dollars that they can use to try to find those 
extra votes.
  I will tell you, this Senator Cruz proposal as it relates to 
healthcare is a prescription for mayhem in the private health insurance 
marketplace. It is going to mean misery for so many Americans dealing 
with illnesses. Forget the talk about bringing costs down. This plan is 
going to send health expenses into the stratosphere.
  The plan tells insurance companies: You are off the hook as it 
relates to basic consumer protections. You get to bring back annual and 
lifetime caps on coverage.
  Think about that. In the State of Alabama and everywhere else in 
America under the Affordable Care Act, the 160 million people who get 
their care through their employer heard about this bill and said: We 
are home free. It really does not affect us. They got a little extra 
bonus. The Affordable Care Act gave them a major catastrophic benefit 
if they had that employer coverage. With this Republican bill, all of 
those folks who thought they were home free with the employer coverage 
should know that once again there would be limits on what insurance 
companies could pay.
  I will tell you, for anyone who is listening to this, if someone gets 
cancer at home, they are going to bust that cap in a hurry. This bill 
means they are not automatically protected. You can forget about 
essential health benefits. You get to flood the market with bargain-
basement insurance plans as long as you offer one comprehensive option, 
and you get to price that plan through the roof.
  If you pass this bill--the Cruz fantasy proposal--it is going to be a 
tale of two health symptoms. The young and healthy will opt for the 
barebones insurance plans that don't cover much of

[[Page S3898]]

anything, but there are millions of people in the country who can't get 
by, can't make it with skimpy insurance that covers nothing but 
stitches and aromatherapy.
  There are people who have had a cancer scare or suffer from diabetes 
or people who get hurt on the ski slopes or slip off a ladder. The only 
coverage that works for them will come with an astronomical price tag.
  By the way, the people between 55 and 64, who can get charged five 
times as much as younger people, get fewer tax credits under this 
Republican proposal. They can't get by with skimpy coverage. A lot of 
them have really serious health problems. Skimpy coverage for them is 
just a prescription for trouble.
  The fact is, this new proposal basically starts marching America back 
to the days when healthcare was reserved for the healthy and wealthy. 
What I will say is that there would be plenty of opportunities for 
Democrats and Republicans to find common ground if this proposal is set 
aside.
  Nobody has said the Affordable Care Act is perfect. What we would do 
is go to work to stabilize the private insurance market. That would be 
business No. 1. We would look at ideas, as Senator Nelson has just 
thoughtfully outlined, like reinsurance. Then a special priority of 
mine is to clamp down on skyrocketing prescription drug prices. I think 
there are a number of ideas that are teed up for both sides to come 
together.
  I recently put in a bill called the SPIKE bill. What it says is that 
these big drug companies should have to justify their big price hikes. 
I don't think that is an extreme position to say they ought to have to 
publicly, justifiably make it part of the public record.
  In the last few years, we have had a whole new industry emerge. They 
represent States and companies and labor unions, and they are supposed 
to be negotiating a good deal for patients. They are called 
pharmaceutical benefit managers, but we don't know what they put in 
their pocket and what they put in our pocket.
  I have said: How about some transparency, folks? Sunlight is the best 
disinfectant.
  Those are the kinds of ideas--reinsurance, stabilizing the private 
insurance market, clamping down on prescription drug prices, 
particularly using the power in the marketplace--that both sides ought 
to be able to get together.
  The recess is over, but the healthcare debate is far from over. What 
I will say is what I told my constituents. I see my friend Senator 
Merkley here. We had rallies at home. I said: Folks, in stopping the 
McConnell bill before the July break, you proved that political change 
in America is not trickle-down; it is bottom-up.
  For weeks before that July break, Americans of all ages and political 
philosophies called and texted and wrote and came to rallies and town 
meetings. They said: This TrumpCare bill is a loser for us. It doesn't 
work. Drop it and move on to approaches that involve common sense. Look 
for common ground that both sides could support. It is absolutely 
vital.
  The events of the last few weeks have shown the power of the 
grassroots. I walked through for my constituents what could have 
happened if 2 weeks ago the Republican leader had brought his bill to 
the floor. It was in the morning. I described how the bill could have 
gotten through the Senate. Maybe the House would have stayed in; maybe 
the House would have passed it; maybe the President would have signed 
it. One of my constituents said that morning: If that had happened and 
we had lost the ACA, even though it is not perfect, that morning we 
would have been in mourning.
  Let us show today that we can tackle this in a way that the Senate 
historically has worked best. Let's block the deeply flawed bill, and 
then let's turn around immediately to show that we can come together, 
find common ground.
  I see one of our colleagues, the distinguished Senator from Virginia, 
who has one of the important reinsurance bills here. We have a variety 
of ideas that we can pursue, that I think would have appeal on both 
sides of the aisle, but there is a step you have to take before you get 
on to those commonsense ideas. You have to stop the flawed bill before 
the U.S. Senate at this point.
  I ask the people of this country to continue what they have done over 
the last few weeks and show political change, bottom-up rather than 
top-down.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Strange). The Senator from Colorado.
  Mr. BENNET. Mr. President, I thank the ranking member of the Finance 
Committee for his leadership not only on this bill but also healthcare 
over the decades. He knows something about the right way of doing it 
and the wrong way of doing it, which is partly what brings me to the 
floor today.
  I want to say something that I think will be uncontroversial to the 
people at home but may be news to some people here, and that is whether 
you support the Affordable Care Act or whether you don't support the 
Affordable Care Act, whether you have been a supporter of ObamaCare or 
whether you are not a supporter of what is called ObamaCare, in 
general, people are pretty dissatisfied with our healthcare system at 
home. In general, people are pretty dissatisfied with the rate their 
insurance goes up. They are pretty dissatisfied with the fact that a 
lot of people are still uncovered in this country. If they are a 
senior, they are pretty dissatisfied not just with the idea but with 
the practice that month after month, people have to cut their medicines 
in half just to get through the month. They are pretty dissatisfied 
with the fact that they call an insurance company to make a claim to 
say ``My child was sick'' and point out that month after month they 
have paid their premiums only to find that on the day they make that 
claim, there is someone at that insurance company who has more time 
than they do to stay on the phone, to keep them on that phone, to deny 
them their claim. They are pretty dissatisfied about that.
  As a whole, I think the American people are dissatisfied by the fact 
that we spend 16 percent of our gross domestic product, our entire 
economy, on healthcare when every other industrialized country in the 
world spends half of that or less than half of that on healthcare and--
this is going to come as news to some people in this Chamber--get 
better results. We are moving in the wrong direction on too many 
dimensions when it comes to our healthcare.
  I have said all of that as a proponent of the Affordable Care Act. I 
spent a year and a half in Colorado, in certain places, being called a 
Bolshevik or a socialist, being accused of advocating for a government 
takeover of our healthcare system. This was at a time when the tea 
party was very active, and people would come and say, quite rightly: 
Read the bill. Read the bill. We need to take our government back.
  We tried to do some things to help in that bill. For the first time 
in the country's history, we tried to say that it wasn't OK to 
discriminate against people who were sick or have what is called a 
preexisting condition when they went to buy health insurance. As the 
Senator from Oregon said, it wasn't OK that if you did get sick when 
you had insurance and you got something like cancer that an insurance 
company could just throw you off their rolls because you hit their cap.
  We said that we thought it wasn't OK that there were millions of 
people, many of them children, who didn't have access to primary care; 
that is, a doctor to be able to give you a checkup and see how you are 
doing so that you weren't getting treated in the emergency room--the 
most expensive, least intentional way of running a healthcare system 
that is imaginable. In fact, I would say that is the Bolshevik way of 
running a healthcare system: When you are sick, you get to show up at 
the emergency room, and somebody is going to take care of you. It gives 
you the results of a Bolshevik system because you are paying more for 
less of an outcome.
  We tried to address some of those things, and that became the 
Affordable Care Act. That became ObamaCare. That became something that 
was politicized for 7 years, as the House of Representatives cynically, 
month after month, voted to repeal the Affordable Care Act. Then the 
majority of the House went home to their districts and said: We 
repealed ObamaCare. We voted to repeal ObamaCare.
  You didn't repeal it.
  No, we voted to repeal it. If you send me back there next week, I 
will do the

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same thing. I will do it the week after that.
  Then at some point, people started to say: Well, you keep having the 
vote on repealing ObamaCare. Why haven't you actually done it?
  They said: Well, we didn't have the Senate.
  They have had the Senate now for two Congresses.
  Well, we didn't have the Presidency.
  Now we have the same party in Presidency, the Senate, and the House 
of Representatives. This terrible bill we are considering is not a bill 
that anybody--that is an exaggeration--virtually anybody in my State 
supports or has asked for. That is what we have in front of us.
  I know somebody else who knew that the American people were 
dissatisfied with their healthcare system, and that was Donald J. Trump 
when he was running for President of the United States.
  I hope, in particular, the people who voted for the President, as a 
way of keeping Washington accountable, will remember that he said he 
was going to provide the American people ``a terrific plan,'' to 
``cover everyone at a fraction of the cost.'' The President, when he 
was running--he still does it--was very fond of talking about--his 
words--how stupid everybody in Washington was and he knew how to make 
deals and he was going to come here and make great deals and he was 
going to cover everybody at a fraction of the price with a terrific 
plan. That is what he promised the American people. That is what he was 
peddling when he was running for President. He said: ``Everybody is 
going to be taken care of much better than you are taken care of now.'' 
That is what he said. This isn't fake news. This isn't CNN or the New 
York Times or the Wall Street Journal or whoever is in the crosshairs. 
This is what the President said on the campaign trail when he was 
running because he detected, quite rightly, that the American people 
are unhappy with the way our healthcare system works--unhappy in the 
richest country of the world to have a healthcare system where people 
have to make decisions about their lives and about their children's 
lives that no one in the industrialized world has to make about their 
lives or their children's lives--and they wonder why.
  I think the diagnosis has a lot to do with what some people have 
said, which is special interests having a grasp on Washington, DC. That 
is what the President said he was going to give to the American people. 
This is what his promise was to the American people. What did we get 
instead? We have a bill passed by the House that was a massive tax cut 
for the richest people in America, which, literally, nobody in my 
townhalls in red or blue parts of my State has ever said is something 
that would help with their healthcare. Not a single person has said 
what they want for healthcare is a massive tax cut for people making 
more than $250,000 a year--not one, not one person.
  There is a 25-percent cut to Medicaid in this bill. That was done in 
the name of, I guess, reforming entitlements. The argument has been 
made that there are a lot of lazy people who are on Medicaid, and if 
you cut Medicaid by 25 percent, they will go to work, and they should 
go to work. Well, there are two issues with that. The first is, it is 
important to understand who is on Medicaid.
  In my State, 50 percent of the people are children. Are they supposed 
to be at work or can they go to school? Then there are a whole bunch of 
people on Medicaid--in fact, it is a very large share of the population 
of Medicaid who have spent their entire life savings down for the 
privilege of being in a nursing home paid for by Medicaid. Are they 
supposed to work? Then there are a lot of people--I am ashamed to say 
this--there are a lot of people in this country who are working one 
job, two jobs and can't make enough money to buy private insurance in 
the United States of America. That is a shame. Do they need to get a 
third or fourth job before we are saying they are not lazy or should we 
fix this healthcare system so it is more affordable, more predictable, 
more transparent for American families? Those were the promises the 
President made. That is the content of the bill with one addition. They 
slipped in--between that tax cut and that 25-percent cut to Medicaid, 
which is paying for that tax cut for the wealthiest Americans--what my 
colleague Rand Paul, a Republican from Kentucky, has described 
accurately as ObamaCare lite. He is absolutely right about that. If you 
hate ObamaCare, you will hate ObamaCare lite. If you are looking in a 
rural part of my State or the country, and you already can't afford 
insurance because there is no market there and you can't get a subsidy 
that will help you because you are making too much money, you are going 
to hate that even more. Wait until they pass the Cruz amendment, which 
he is calling the freedom amendment--freedom to have to endure 
something no one else in the industrialized world has to put up with, 
which is buying lousy insurance that doesn't cover anything. You can 
create the worst product in the world and make it affordable. That is 
not hard to do.
  We have come a long way from Franklin Roosevelt's four freedoms, if 
we are talking about the freedom of insurance companies to be able to 
throw you off if you hit the lifetime cap, freedom not to give you 
insurance if you have a preexisting condition. We have come a long, 
long way.
  Finally, my colleagues are here so I am going to stop. I do want to 
say one word about the process. The majority leader today announced 
that he is going to keep the Senate in for 2 weeks in August because 
they have to finish their work on healthcare or maybe it is 3 weeks in 
August. I don't care if it is a month. I don't care if they cancel 
every recess we have between now and the end of the year. I don't care 
if we work on weekends if it will create a situation where we can 
actually improve healthcare for the American people. I am glad to stay. 
In fact, I think we should stay, but, unfortunately, that is not what 
he is trying to do. What he is trying to do is jam through a bill that 
is incredibly unpopular with the American people. That is why, until 2 
weeks ago, it was a secret. Until two Thursdays ago, it was a secret.
  I have to suspect that one reason they want to keep us in August is 
because they don't want to go home because they were just beaten to 
death over the July 4th recess because people came out in Republican 
and Democratic parts of their States and said: Are you out of your 
minds? This bill has nothing to do with our healthcare. They probably 
don't want to repeat that in August.
  I will close just by saying this, and I said this again to the people 
who came to my townhalls and were highly critical of the Affordable 
Care Act and the process: I want to remind you folks that back then--
the Senator from Oregon will remember this--back then, we spent over a 
year debating that bill here in the Congress. We had countless--
somebody could count them up--but countless committee hearings in the 
Health, Education, Labor, and Pensions Committee and the Finance 
Committee. We had almost 200 amendments that were Republican amendments 
that were adopted as part of that bill. Everybody remembers, no 
Republican voted for it, but there were 200 Republican amendments 
adopted as part of that bill. We have not had a single committee 
hearing in the Senate about this healthcare bill--not one.
  So you can keep us in for 2 weeks or 3 weeks longer in August, but a 
better idea might be to follow the regular order around this place. 
Talk about take our country back, take our government back, make it 
work, have hearings, have witnesses. I can think of 100 Coloradans, off 
the top of my head, who would like to come here and testify. I would 
even say 50 of them can be Republicans and 50 of them can be Democrats. 
Have them come testify what would make healthcare better for them. That 
is what this should be about: families all across this country who are 
struggling because of our healthcare system and who need relief from 
this Congress and who so far aren't getting it.
  I will close just by saying, if the President could submit a proposal 
that actually would meet the criteria he set out when he was running 
for President--instead of having a bill he couldn't pass with even 51 
Republican votes--he would have a bill he could pass with 100 votes 
here in the Senate, and that is what we should strive to do.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Mr. President, let's revisit recent history. Four weeks 
ago,

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my Republican colleagues were meeting secretly in this building, in a 
hallway that the press was not allowed in because they didn't want to 
have the press see them sneaking in and sneaking out of this completely 
undemocratic process--13 Republican men crafting a healthcare plan to 
destroy healthcare for 22 million Americans. That is where we were 4 
weeks ago.
  We made a big deal out of the fact that is not the way a Congress is 
supposed to operate. You are supposed to have committee hearings. You 
are supposed to have committee debate and invite experts in. You are 
supposed to have time to consult with your constituents back home, but 
none of that was happening. No, we had the Republican zero-zero-zero 
process: Zero committee meetings. How does that compare to more than 
100 committee meetings and roundtables and walkthroughs from 8 years 
ago? Zero committee amendments. How does that compare to more than 400 
amendments that were considered 8 years ago and more than 100 minority 
amendments, Republican amendments, that were adopted in this process? 
Zero exposure of the bill to the folks back home and to the healthcare 
stakeholders.
  Then, 2 weeks ago, we had a draft, and we had a chance to circulate 
that draft and get a few folks from home to weigh in on what it looked 
like. We received a CBO analysis. Yes, it looked a lot like the House 
bill. The House bill was going to eliminate 14 million healthcare 
policies in a year, and the Senate was going to best that by 
eliminating healthcare for 15 million Americans and 22 million 
Americans over a 10-year period.
  The President had called the House bill mean, but we had the even 
meaner Senate bill. Fortunately, we were able to create such a fuss 
that the majority leader canceled the vote--the vote that was going to 
take place with the zero committee hearings and zero amendments and 
that would give my colleagues the opportunity to go home and talk to 
their constituents. But what happened?
  Well, in the course of this entire year, two-thirds of my Republican 
colleagues haven't held a single townhall, and last week, when they had 
a full opportunity to finally take their secret 13 bill--zero-zero-zero 
bill--and ask their constituents what they thought, they didn't hold 
townhalls. By best count, 2 Senators across the aisle held a townhall 
out of 52.
  Why are my colleagues so terrified of their constituents? Is it 
because wiping out health insurance for struggling Americans is a 
travesty? Is it because wiping out healthcare for working Americans is 
a crime--a crime against decency? Is it because their bill proceeds to 
give $33 billion to the richest 400 Americans? No, that is not $33,000 
or $33 million, that is $33 billion to the richest 400 Americans--more 
than several hundred billion dollars to the richest Americans overall. 
You know, the money they want to give to the top 400 richest Americans 
would fund healthcare for more than 700,000 Americans under Medicaid.
  Well, I went home. I went to a lot of places. I went to three cities 
in what you might call blue Oregon. I went to 13 towns in what can 
clearly be called red Oregon--predominantly Republican Oregon. I went 
to towns like Echo and Helix; Adams and Athena; Weston and Sumpter; 
Granite and Greenhorn, with 37 individuals; and Adams, with a 
population of 348. I went to larger towns like North Powder and 
Wallowa; and Baker City, Burns and Nyssa.
  In six of those Republican towns, I held full townhalls, and what did 
I hear? I heard that the top concern was healthcare because 
constituents in red America across this country are terrified of the 
secret 13's bill and all that it involves. What would it do in my home 
State? Well, 400,000 Oregonians under the Oregon Health Plan would lose 
their care. At least another 100,000 would lose their care because of 
the changes in the way the exchange operates. They kind of put their 
minds to work at what the picture looks like from the draft the 
Republicans were willing to circulate after we applied extensive 
pressure. And what did we hear? Well, we heard that they are very 
concerned about extinguishing the expansion of Medicaid. Those are 
folks who are working hard but struggling, often in multiple part-time 
jobs.

  We heard about the fact that Medicaid pays for more than two out of 
three individuals on long-term care in rural America. In fact, I went 
to one nursing home and asked: Does Medicaid--Oregon Health Plan--pay 
for two-thirds of your residents?
  They said: No, Senator. Here in Klamath Falls, it is nearly 100 
percent.
  Realize that an individual who is getting paid-for, long-term care 
under Medicaid has to have assets of less than $2,000. So there is no 
backup plan. You wipe out healthcare for those 400,000 individuals who 
are on expanded Medicaid, many of whom are in long-term care, and they 
have no backup plan.
  One woman, Debra, said to me: Senator, I am paid for by Medicaid, and 
if they cut Medicaid, I will be out on the street. That will be a 
problem because I can't walk.
  That is right, Debra, you are in trouble, and so is every other 
individual who is funded through Medicaid for long-term care.
  What about maternity care? One out of three individuals in rural 
Oregon and rural America who is preparing to have a baby is funded 
through Medicaid. Children and the disabled are funded through 
Medicaid.
  What do we get as an alternative now that the Republicans are back, 
having ducked their constituents? They want a new plan to offer? Well, 
they are talking about the Cruz plan. Now, this is interesting. It is a 
plan that says an insurance company can offer policies that cover 
nothing as long as they have at least one policy that covers quite a 
bit, which means the young and the healthy buy the policy that covers 
almost nothing, and then the policy that covers quite a bit that older 
Americans and those with preexisting conditions need becomes incredibly 
expensive because the group in that pool are people with lots of 
healthcare problems, and it creates a death spiral in insurance.
  Well, at the one end of the spectrum, you have a death spiral for 
insurance policies that cover a lot; at the other end of the spectrum, 
you have fake insurance because it covers virtually nothing. Oh, maybe 
it only costs $50 a month. Oh, isn't that wonderful--until you find out 
it doesn't cover a day in the hospital; doesn't cover a trip to the 
emergency room; doesn't cover maternity care; doesn't cover drugs. In 
fact, it doesn't cover anything.
  Why is it that a President who is so concerned about fake news is so 
interested in supporting fake insurance?
  My constituents back home told me a lot of stories. These are stories 
that I hope to share in the next couple of days, but right now, I think 
it is important that we hear from my colleague from Virginia, Senator 
Tim Kaine, because he has also been looking in detail at this bill. He 
also understands what a devastating consequence TrumpCare will have for 
American healthcare.
  Can't we come together with a better vision? Can't we come together 
and make the marketplace work better, restore the reinsurance that has 
ripped apart the ability of insurance companies to go into new markets? 
Can't we restore the cost-sharing payments that buy down the premiums, 
in fact improve them, so there are lower premiums and lower 
deductibles? Can't we come together and do a better job of funding 
opioid treatment? Can't we come together and take on the high costs of 
drugs in general, which is driving costs in the healthcare system? Just 
those four things would be something very positive to make our current 
healthcare system even better.
  Let's work together to make healthcare here in the United States of 
America even better, not tear it down and destroy it, as is being 
proposed by my Republican colleagues.
  Thank you, Mr. President.
  The PRESIDING OFFICER (Mr. Johnson). The Senator from Virginia.
  Mr. KAINE. Mr. President, I also rise to talk about the healthcare 
proposal on the floor, and I thank my colleague from Oregon and all my 
colleagues who have taken the floor on this issue.
  I will just state at the top a punch line: I will vote for any 
healthcare bill that meets President Trump's promises. He said that in 
his replacement, no one would lose coverage, no one would pay more, no 
one would get kicked around because of a preexisting condition, and he 
wouldn't cut Medicaid. And any bill that meets those criteria, I am 
voting for, but I won't

[[Page S3901]]

vote for a bill that shatters all those promises, and that is what this 
current proposal does.
  There is a lot to talk about with the bill, and I just want to talk 
about one thing--the proposed cuts to the Medicaid Program and 
especially the effect of those cuts on children.
  In the current Senate proposal, which is being sort of adjusted and 
modified, there is a slashing of Medicaid by about $770 billion over 10 
years. And if you add to that additional cuts to Medicaid proposed by 
the President's budget, we are now north of $1 trillion of cuts to 
Medicaid in the next 10 years.
  Who receives Medicaid? In Virginia, between 50 and 60 percent of 
those who receive Medicaid are children. In Virginia, 600,000 young 
people are Medicaid recipients.
  If you go to school and you are receiving an individualized education 
plan because you have a designated disability, Medicaid is paying for 
it.
  About 50 percent of childbirths in Virginia are paid for by Medicaid.
  If you are a kid who is doing everything right, but your family is 
dysfunctional and a juvenile court judge has to decide whether to keep 
you with your family or put you in a group home, if the judge decides 
to send a social worker to your house 5 hours a week, Medicaid pays for 
that.
  If you are a child with autism and you are getting services for your 
autism after school so you can succeed in school, Medicaid pays for 
that.
  In Virginia, 600,000 children receive Medicaid.
  We recently had the administration's OMB--Office of Management and 
Budget--Director, Mick Mulvaney, before us, and I asked him about these 
Medicaid cuts. These cuts are catastrophic. How can you say these cuts 
are a good thing? This is his quote:

       We are no longer going to measure compassion by the number 
     of programs or the number of people on programs like 
     Medicaid. We are going to measure compassion . . . by the 
     number of people we get off those programs and back in charge 
     of their own lives.

  So the philosophy that drives this is, we want to get people off 
Medicaid and back in charge of their own lives--600,000 kids.
  I had a roundtable yesterday in Springfield, VA, here in Northern 
Virginia, and I had five families, parents and children, come to talk 
about what Medicaid cuts would mean to them.
  Angie and Anna are from Haymarket, VA. Anna is a little 5-year-old 
and, her mom says, typical in so many ways. She loves to play with her 
brothers, and she loves to play with dolls. But she has cerebral palsy 
and tracheal bronchial malacia and subglottic stenosis and chronic lung 
disease. In 2014, she developed a condition that caused her to have 30 
bone breaks in 18 months.

  Anna is in school. Anna is in school with a wheelchair that Medicaid 
pays for. Anna is in school with some home health that Medicaid pays 
for. Medicaid enables this child who has so many needs to actually go 
to school so she can be all that she can be. Her family has TRICARE 
through the military because the dad is in the military, but they 
couldn't make it without Medicaid.
  Jen and Cailyn are from Sterling, VA, also in Northern Virginia. 
Cailyn is about 9\1/2\. Within a week after she was born, the family 
knew there were some things wrong. She was finally diagnosed at age 
3\1/2\ with a very rare, noninherited genetic anomaly. The family was 
able to get her qualified for a Medicaid waiver when she was about a 
year old. And this is secondary insurance. The family works and they 
have private insurance, but it doesn't cover a wheelchair, a hospital 
bed, and things that she needs to succeed. Again, this little girl who 
is 9\1/2\--and her mother testified that she functions on about the 
range of a 6-month old--she is able to go to school because Medicaid 
can pay for some of the technology she needs.
  Kim and Isaac are from Ashburn, VA, in Loudoun County. Isaac is a 
youngster, a very active kid, but he has a tracheotomy. He is feeding-
tube dependent. His family has private insurance, but they couldn't get 
along without Medicaid. He is in the Loudoun County schools succeeding 
because of Medicaid.
  Dylan is another kid in Loudoun County schools. Corinne is his 
mother. Dylan has a rare neuromuscular disease called spinal muscular 
atrophy with respiratory distress. He has a tracheotomy tube. He relies 
on a ventilator to breathe. Little Dylan was at this meeting. The 
family has private insurance, but they couldn't succeed without 
Medicaid. Dylan is able to go to school because of Medicaid.
  Finally, there is a family from Richmond--Amy is the mom, and the son 
is Declan. Declan is not in school because he is only 18 months old. He 
has cerebral palsy, and his medical needs are intense. With Medicaid, 
he is able to get some home nursing help, and he is able to get some 
machinery at home that helps him succeed.
  These are beautiful parents, one of whom had adopted her child--first 
as a foster care and then adopted knowing the special needs of this 
child. This was Angie and Anna. These parents are the saints of the 
world, and these kids are fighting so hard. They are fighting so hard 
just to try to develop every talent they have, every capacity they 
have, but with Medicaid cuts, they would be in deep, deep jeopardy.
  Why would we vote for a bill that slashes Medicaid to families like 
these when President Trump said we are not going to cut Medicaid? Why 
would we vote for a bill that shatters those promises, that takes 
health insurance away from 20 million people, that increases premiums 
for seniors, that subjects those with preexisting conditions to being 
cast in the shadows yet again? That is what this bill would do.
  I had a conclusion written, but I will tell you, one of my moms 
yesterday gave me a better one. She gave me a better conclusion.
  We had this roundtable with five families. We had some great folks 
from the American Academy of Pediatricians who were there, too, saying 
what a bad bill this would be for kids.
  After the hearing was over, one of the moms looked at me and said: 
You know, they kind of picked the wrong group of people to fight with--
talking about this bill.
  I said: What you do mean by that, wrong group of people to fight 
with?
  She said: Parents of kids with disabilities.
  I said: I don't get where you are going.
  And this is what she said to me: From the moment our children are 
born, all we do is fight. We fight so that our kids can survive. We 
fight so that our kids can have as normal a life as possible. We have 
to fight with hospitals. We have to fight with insurance companies. We 
have to fight with school systems. We have to fight with cultural 
stigmas about people with disabilities. If you are a parent of a child 
with a disability, from the day they are born, all you do is fight. And 
if they think that we are going to pass a bill to cut Medicaid to these 
kids and their families and that we are not going to fight about it, 
that we are not going to stand up and be heard, they have seriously 
underestimated us.
  I think we can do the right thing, as my colleagues have said, if we 
will get together. I am on the HELP Committee, Health, Education, 
Labor, and Pensions, and the only topic that has been taboo on my 
committee this year is health. We have had hearings about nominees. We 
have had hearings about the FDA. We have not been allowed to have a 
hearing about this health proposal--either the House bill or the Senate 
bill.
  Let's have a hearing, listen to patients, listen to parents, listen 
to hospitals, listen to doctors, listen to people who are worried about 
their premium costs, listen to insurance companies, and listen to 
medical innovators. If we listen, we will get this right. But if we 
shut down a process, if we don't allow the public in, don't listen, 
don't have hearings, and rush it through, we will get it wrong.
  This is the biggest sector of the American economy, and it is the 
most important expenditure that anybody ever makes in their life. On 
behalf of the 600,000 children in Virginia and the 30 million children 
in this country who receive Medicaid, let's get this right.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. CRAPO. Mr. President, I rise today with my colleague, Senator 
Risch, to speak on the nomination of Judge David Nye to be a U.S. 
district judge for the Federal district of Idaho.
  First, let me acknowledge the diligent work of Judiciary Committee

[[Page S3902]]

Chairman Grassley and Ranking Member Feinstein in expediting the 
confirmation process for Judge Nye's renomination.
  I also thank both President Obama and President Trump for nominating 
Judge Nye to the Federal bench. It is rare to be nominated by 
Presidents of two different parties, but it is a fitting testament to 
Judge Nye's sterling reputation that he has secured that distinction.
  Finally, I appreciate the majority leader giving Judge Nye the honor 
of being the first U.S. district judge by the 115th Congress.
  Judge Nye is supremely qualified as a candidate for the Federal 
district court seat, having a unanimous ``well qualified'' rating from 
the American Bar Association and having received approval from the 
Senate Judiciary Committee without dissent twice in a little less than 
a year.
  Judge Nye has long been ready to assume this high office. A longtime 
member of Idaho's legal community, Judge Nye has been a law clerk, a 
practicing lawyer, and since 2007 a judge on Idaho's Sixth Judicial 
District Court. This court handles all felony criminal cases, major 
civil cases, and appeals from the magistrate court from six counties 
throughout the southeast portion of Idaho. He also served from 2009 to 
2012 as the administrative district judge for the Idaho Sixth Judicial 
District, elected by his peers on the court for the 3-year term to this 
position.

  He is not just a well-respected jurist in Idaho. Judge Nye is heavily 
involved in the training and orientation of new Idaho judges, and he 
serves on the Idaho Supreme Court's committees on judicial education 
and felony sentencing.
  Action on Judge Nye's nomination is critical and timely. Idaho is one 
of only three States having just two authorized district court 
judgeships. The nonpartisan Judicial Conference of the United States 
has declared a judicial emergency for Idaho and has recommended in 
every one of its reports to Congress since 2003 that Idaho be 
authorized a third district judge position. For the past 2 years, Idaho 
has had a three-judge caseload handled by just one active judge. What 
is even more challenging is that our lone remaining active judge is 
already eligible to take senior status since this past March. Even with 
Judge Nye's confirmation, Idaho still needs another U.S. district court 
judge.
  Confirmation of Judge Nye today or tomorrow is undoubtedly a proud 
day for the entire Nye family, including Judge Nye's wife Katre and 
their eight children. Knowing that a successful public servant draws so 
much strength from the family surrounding him or her, I salute their 
partnership with Judge Nye in making this important occasion possible.
  Again, I strongly endorse Judge Nye's nomination and appreciate the 
Senate's confirmation of him.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. RISCH. Mr. President, I want to associate myself with the remarks 
from my distinguished colleague and close personal friend, Senator 
Crapo, and join him in urging our fellow Senators to quickly confirm 
Judge Nye.
  As pointed out by Senator Crapo, this will be the first district 
judge to be confirmed by this Congress. So it should be an honor for 
Judge Nye, and I am sure he views it that way.
  This has been, literally, years in the making. As Senator Crapo 
pointed out, we have only one active Federal judge right now, and he is 
handling what is essentially a three-judge load. Some time ago, when 
this vacancy occurred, Senator Crapo and I went to work on this. Most 
Americans don't understand how this works, but to become a U.S. 
district judge, it takes essentially the concurrence of three people--
that is, the President of the United States and the two Senators from 
that particular State, be they two Republicans, two Democrats, or one 
of each--because we have what is called a blue slip process, where if 
any one of the three can and do object to a person, then that person 
will not be permitted to go forward.
  In this particular case, we negotiated with the Obama White House for 
literally months and months, and it turned into years. I believe we 
acted in good faith on both sides in trying to find a person who would 
be the right fit for Idaho. Again, we literally vetted well over 50 
individuals for this position, and for one reason or another, we were 
unable to get any of those across the finish line.
  Finally, we settled on Judge Nye. I shouldn't say ``settled'' on him. 
He had not really applied. After going through the 50 being vetted and 
not really getting where we wanted to be, we sought out Judge Nye and 
talked with him about it, and we went forward on that basis. The White 
House came along, and before President Obama left office, he nominated 
Judge Nye, pursuant to my and Senator Crapo's request. Unfortunately, 
that was just about the time that we ran out of time processing judges. 
The election came and went. President Trump was inaugurated, and we 
started all over again. I want to personally thank the White House for 
very quickly renominating Judge Nye for this position, again, at the 
request of myself and Senator Crapo.
  Too many States have a shortage of judges, and there is a movement 
afoot right now to attempt to boost the Federal judgeship load, which 
is in bad need. For instance, in the last seven surveys that the 
Judicial Conference has undertaken, they recommended that Idaho get a 
third judge. Senator Crapo and my predecessor before me and, I think, 
even Senator Crapo's predecessor before him have also been pushing for 
this judge. We continue to do that, and I am seeing some green sprouts 
that perhaps we will be moving somewhere in that direction.
  In any event, yesterday we had the vote on moving forward on his 
nomination, and that vote was 97 to 0, which certainly is a testament 
to Judge Nye himself. I would urge our fellow Senators, when we get to 
this vote, which will either be later today or midday tomorrow, to 
proceed with the same kind of vote. It was a bipartisan vote on 
cloture, and we hope it will remain a bipartisan vote as we move 
forward on this confirmation.
  With that, I want to thank Senator Grassley, who obviously is pressed 
by everyone who has a vacancy, and Senator McConnell, who has lots of 
things on his mind these days and is struggling with challenges that 
come at him from all directions, for choosing Judge Nye at our constant 
and gentle urging over the recent months and years and moving him to 
the front of the line. I want to personally thank Senator McConnell for 
doing that. Of course, I want to thank my distinguished colleague for 
his work on the Judiciary Committee and moving it through the Judiciary 
Committee.
  I think Judge Nye will be a person who will make us all proud. 
Certainly, we are going to be very happy to have this judgeship filled 
in Idaho and, particularly, with someone of the quality of Judge Nye.
  With that, 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. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.