[Congressional Record Volume 163, Number 121 (Tuesday, July 18, 2017)]
[Senate]
[Pages S4036-S4038]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                   Unanimous Consent Request--S. 1462

  Mrs. SHAHEEN. Mr. President, I am really pleased to have been joined 
by my colleagues to talk about the importance of addressing healthcare 
for all Americans, especially my colleague from New Hampshire. She and 
I have been touring the State for months now, talking with people in 
hospitals, with patients, with physicians, with providers, with people 
with substance use disorders, with providers who are providing 
treatment for people with substance use disorders, with people all over 
New Hampshire about what we can do to make sure people get healthcare 
when they need it.
  That should be the goal of this body. It should not be throwing 
people off their healthcare, which a repeal of the Affordable Care Act 
would do. It would throw 32 million people off their healthcare.
  We can address the instability in the marketplaces. We can do that 
pretty quickly. Senators Kaine and Carper talked about reinsurance, 
something which has worked very well for the first 3 years of the 
Affordable Care Act, and the reason it doesn't work now is because they 
have stopped. That is why we are seeing some of these rate increases.
  We can address the uncertainty by being clear that we are not going 
to repeal the Affordable Care Act, by addressing those cost-sharing 
reduction payments. The ACA already stipulates that CSR--those payments 
which reduce the costs of copays and deductibles--are to be made 
pursuant to 31 U.S.C. 1324.
  My bill provides for payments to be made jointly from a permanent 
appropriation rather than subject to the year-to-year whims of the 
annual appropriations process. The Marketplace Certainty Act removes 
all bases for any further questions about what is already clear from a 
fair reading of the Affordable Care Act as a whole; that both those CSR 
payments and the advanced premium tax credit subsidies are to be funded 
from the same permanent appropriation.
  I see my colleague from Texas on the floor, and I am sure he is going 
to object to the unanimous consent request I am going to be proposing 
in a couple of minutes. He objected last Thursday when I asked for 
unanimous consent to pass the Marketplace Certainty Act, and he 
justified the objection by asserting that the cost-sharing reduction 
payments are--I think he called it a bailout of the insurance 
companies. That is an inflammatory term, and I think we ought to be 
careful with how we use it because the truth is, the cost-sharing 
reduction payments are in no way, shape, or form a bailout. They are 
orderly payments built into the law to go directly to keep premiums, 
copays, and deductibles affordable for lower income Americans. In fact, 
those same payments were included in the bill Majority Leader McConnell 
just said he is not going to go forward with, the Republican bill. It 
included those very same cost-sharing reduction payments. I think they 
were included because there was a recognition that these are important 
to help address the cost of healthcare for all Americans.
  As I said earlier, we have had statements by the chairman of the 
Health, Education, Labor, and Pensions Committee, Lamar Alexander, 
talking about that these payments should be continued. We have heard 
from House Ways and Means Chairman Kevin Brady, who said we need to 
continue these payments to help stabilize the insurance market. It is 
the uncertainty that is causing the current problem, and we could 
address that today--this week--if people were willing to work together.
  As Democrats, we have come to the floor to say we want to work 
together. We think we can address the challenges we face with the 
Affordable Care Act. We can do it in a bipartisan way. I know we can 
because Tim Scott and I have done it. We passed a bill several years 
ago by unanimous consent, which basically gave States the ability to 
control group size for people and for companies in the marketplaces so 
I know it can be done, and I know we could do it today if there were a 
willingness on the part of all of our colleagues to work together. That 
is what the American people want. They don't want 32 million people 
thrown off their health insurance. We don't want rural hospitals to 
close in New Hampshire. We don't want nursing homes to close. We don't 
want people to be thrown out of their nursing homes.
  I was up in northern New Hampshire at a nursing home over the 
weekend, where I talked to a group of women in their eighties and 
older. One woman said to me: You know, I worked my whole life. I paid 
my taxes. I did everything I was supposed to do. I sold my house so I 
could get into this nursing home so I could qualify under Medicaid. I 
got rid of all my assets. Now they are telling me I am going to get 
thrown out? She said: What would I do? I have no place to go. I have no 
family to help me.
  People don't want that. What they want is for us to work together, to 
help fix healthcare so people can get what they need when they need it.
  Mr. President, I ask unanimous consent that the Committee on Health, 
Education, Labor, and Pensions be discharged from further consideration 
of S. 1462; that the Senate proceed to its immediate consideration; 
that the bill be considered read a third time and passed, and the 
motion to reconsider be considered made and laid upon the table with no 
intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Texas.
  Mr. CORNYN. Mr. President, reserving the right to object.
  The Senator from New Hampshire has acknowledged that she had made 
this previous request last week. The Kaiser Family Foundation, among 
other publications, has clearly stated that the cost-sharing reductions 
she is asking for are paid directly by the Federal Government to 
insurance companies. Thus, when I call this an insurance company 
bailout, I believe that is literally true.
  The Congressional Budget Office estimates the cost of these payments 
at $7 billion in 2017, $10 billion in 2018, and $16 billion by 2027.
  So what my friend, the Senator from New Hampshire, is proposing is an 
insurance company bailout in the tens of billions of dollars with no 
reform, throwing more money at a broken Affordable Care Act, which has 
been in existence 7 years now.
  I know they would like to blame this on President Trump, who has been 
in office just a short time--about a half a year--but this is built 
into the very structure of the Affordable Care Act, and it isn't 
working.
  I, personally, will not be part of any bailout of insurance companies 
without reforms. That is why we were trying to structure something 
under the Better Care Act, which unfortunately we haven't been 
successful with so far. We are going to keep on trying, but this is not 
the answer.
  I object.
  The PRESIDING OFFICER. Objection is heard.

[[Page S4037]]

  

  Mrs. SHAHEEN. Mr. President, I am disappointed but not surprised that 
my colleague has objected. I don't believe he objected because of the 
effort to help pay these subsidies, which are passthroughs to insurance 
companies.
  Reforming how we do those, I am certainly happy to sit down and talk 
about that, but the fact is, that is not the issue right now. The issue 
is, this is a way we could address the current uncertainty in the 
marketplaces in a way that will be good for maintaining stability of 
healthcare for all Americans. I am disappointed there isn't a 
willingness to work together to do that.
  I hope, as this debate continues, we will finally see people come 
together to get something done to address, not just healthcare for 
Americans but to address the one-sixth of the economy that depends on 
the healthcare industry.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. REED. Mr. President, I rise to discuss the nomination of Mr. 
Patrick Shanahan to serve as the 33rd Deputy Secretary of Defense. The 
Senate Armed Services Committee held a hearing on his nomination on 
June 20, and he was voted out of committee by voice vote.
  Mr. Shanahan was born and raised in the State of Washington. He 
received his undergraduate degree from the University of Washington and 
then a master's degree and MBA from the Massachusetts Institute of 
Technology. Mr. Shanahan then embarked on a 30-year career at the 
Boeing Company, where he rose to the most senior echelons of 
management, working on both the company's defense and commercial 
programs. Most recently, Mr. Shanahan served as the senior vice 
president for supply chain & operations.
  The Deputy Secretary of Defense is one of the most important 
positions within the entire national security system. The Deputy serves 
as the number 2 official at the Department of Defense, as well as the 
Department's Chief Management Officer. As the second in command to the 
Secretary of Defense, the Deputy oftentimes is assigned a broad 
spectrum of responsibilities which require strong management skills.
  The Department currently faces challenges on multiple fronts. For 
more than 16 years, our military has been consumed by two prolonged 
wars against violent extremist groups like ISIS. As a result, the 
military has faced a generational fight which has sapped readiness and 
precluded our military personnel from training for full spectrum 
operations. However, violent extremist groups are only one of the many 
challenges facing our country.
  The past several years have seen the rise of near-peer competitors, 
most notably Russia and China. Russia has been a resurgent force bent 
on disrupting Europe and undercutting our own Nation and our 
Presidential election process. China continues its saber-rattling in 
the Asia-Pacific region by undermining the freedom of navigation and 
using economic coercion of its smaller, more vulnerable neighbors. When 
we factor in the destabilizing actions of North Korea and the long 
shadow of Iran, it becomes urgently clear that we need strong 
leadership at the Department of Defense. If Mr. Shanahan is confirmed, 
he will need to contend with all these challenges. It will not be easy 
and hard decisions on policy and strategy will need to be made.
  Perhaps one of the hardest decisions facing the Deputy Secretary of 
Defense is the allocation of budget resources within the Department. In 
an ideal world, a cogent defense strategy that takes into consideration 
the multitude of concerns facing our Nation would inform how the 
Department invests resources in weapons platforms and advanced 
technologies to confront these challenges. However, the reality is that 
the spending caps imposed by the Budget Control Act determine the level 
of funding for most of these budget decisions.
  The current budgetary crisis is compounded by the fact that the 
President's most recent budget request adds much needed funding to 
defense activities, but it shortchanges nondefense spending accounts in 
order to increase spending for our military. Furthermore, the budget 
request fails to recognize that the BCA budget caps are law. If these 
spending levels are enacted, the President's budget request would 
trigger sequestration, effectively wiping out increased defense 
spending with mandatory across-the-board cuts.
  This would be the worst of all worlds. Not only would we be giving 
the money on the one hand and taking it back with the other hand, but 
it would not be in any systematic way. We would be making cuts to 
readiness. We would be making cuts to personnel. We would make cuts to 
all sorts of things which are much more valuable than some programs 
which would receive an additional cut.
  Unless we resolve ourselves to act--which is going to take a 
bipartisan effort to repeal the BCA--we can't effectively fund not only 
the Department of Defense but every other Federal department. That is 
one of the great challenges Mr. Shanahan will face. Indeed, these 
multiple challenges will require strong leadership and the ability to 
make tough decisions. Mr. Shanahan has developed a strong reputation 
during his tenure at Boeing as someone capable of taking on challenging 
programs, fixing problems, and turning them into successes.

  When I met with Mr. Shanahan to discuss his nomination, he emphasized 
that the public sector needed to work closer with the private sector to 
get more cost-effective results while ensuring our warfighters have the 
best equipment at their disposal. It is that kind of leadership that 
the Department of Defense needs as our Nation faces as diverse an array 
of threats and challenges to our national security as at any point in 
our history.
  Based on Mr. Shanahan's qualifications and experience, as well as his 
testimony before the Senate Armed Services Committee, I believe he is 
fully qualified for the job. Therefore, I will vote in favor of his 
nomination to be the next Deputy Secretary of Defense, and I trust he 
will do his best to lead the men and women who ably and courageously 
serve this Nation.
  On a final note, if confirmed, Mr. Shanahan will be relieving Bob 
Work, who has served this Nation ably and selflessly for most of his 
life. Bob Work served in the U.S. Marine Corps for 27 years, rising to 
the rank of colonel. In 2009, he was confirmed as Undersecretary of the 
Navy, where he shepherded the service through many challenges for the 
next 4 years.
  He tried to return to the private sector, but in 2014 he was then 
nominated and confirmed as Deputy Secretary of Defense. Bob Work was 
the continuity in the Defense Department through three Secretaries of 
Defense. He stayed more than 6 months into the new administration in 
order to aid Secretary Mattis. There is no task, no matter how 
difficult or how big or small, that Bob Work would not devote all of 
his energy to until it was resolved. Bob Work personifies his name. He 
works, tirelessly. Our Nation owes him a great debt of gratitude, and I 
hope he takes some well-deserved vacation time and enjoys the company 
of his wife and daughter.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Cruz). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. ALEXANDER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Under the previous order, all time has expired.
  The question is, Will the Senate advise and consent to the Shanahan 
nomination?
  Mr. ALEXANDER. Mr. President, 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 Arizona (Mr. McCain).
  Further, if present and voting, the Senator from Arizona (Mr. McCain) 
would have voted ``yea''.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 92, nays 7, as follows:

[[Page S4038]]

  


                      [Rollcall Vote No. 162 Ex.]

                                YEAS--92

     Alexander
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Boozman
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cortez Masto
     Cotton
     Crapo
     Cruz
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gardner
     Graham
     Grassley
     Hassan
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     Kennedy
     King
     Klobuchar
     Lankford
     Leahy
     Lee
     Manchin
     McCaskill
     McConnell
     Menendez
     Merkley
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Portman
     Reed
     Risch
     Roberts
     Rounds
     Rubio
     Sasse
     Schatz
     Schumer
     Scott
     Shaheen
     Shelby
     Stabenow
     Strange
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Van Hollen
     Warner
     Whitehouse
     Wicker
     Wyden
     Young

                                NAYS--7

     Booker
     Duckworth
     Gillibrand
     Harris
     Markey
     Sanders
     Warren

                             NOT VOTING--1

       
     McCain
       
  The nomination was confirmed.
  The PRESIDING OFFICER. Under the previous order, the motion to 
reconsider is considered made and laid upon the table and the President 
will be immediately notified of the Senate's action.

                          ____________________