[Congressional Record Volume 163, Number 154 (Tuesday, September 26, 2017)]
[Senate]
[Pages S6097-S6108]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2018--MOTION TO 
                                PROCEED

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of the motion to proceed to S. 1519, which the 
clerk will report.
  The senior assistant legislative clerk read as follows:

       Motion to proceed to Calendar No. 165, S. 1519, a bill to 
     authorize appropriations for fiscal year 2018 for military 
     activities of the Department of Defense, for military 
     construction, and for defense activities of the Department of 
     Energy, to prescribe military personnel strengths for such 
     fiscal year, and for other purposes.

  The PRESIDING OFFICER. The Senator from Illinois.


                               Healthcare

  Mr. DURBIN. Mr. President, over the last few days, three Republican 
Senators have publicly stated that they

[[Page S6098]]

will vote against the healthcare repeal bill that may come to the 
Senate this week.
  In announcing his opposition, one Republican Senator, John McCain of 
Arizona, issued the following statement: ``As I have repeatedly 
stressed, healthcare reform legislation ought to be the product of 
regular order in the Senate.''
  Last night, Republican Senator Susan Collins of Maine stated: ``This 
is simply not the way that we should be approaching an important and 
complex issue.''
  She went on to say: ``The fact that a new version of this bill was 
released the very week we are supposed to vote compounds the problem.''
  This should be the end of the Graham-Cassidy repeal debate. 
Republican leadership should finally scrap this one-sided effort to 
literally change the healthcare system for America.
  There was a hearing yesterday--the only hearing on the bill we are 
about to vote on. It was a lengthy hearing, but it, frankly, did not 
entertain all of the witnesses or any amendment process so that Members 
could really have input into the bill we are going to face.
  The Congressional Budget Office is supposed to tell us what this 
critical legislation will do for America. It issued a preliminary 
finding yesterday that millions of Americans would lose their health 
insurance and that those with preexisting conditions, as well as their 
families, if they could buy insurance, would find it very, very 
expensive.
  At the end of this week, funding for our Nation's community 
healthcare centers will run out, as will funding for the Children's 
Health Insurance Program. Shouldn't we be focused on reauthorizing 
those programs appropriately in a timely way? Let's allow the HELP 
Committee, which is the committee of jurisdiction when it comes to 
healthcare, to do its work. I have faith in two Senators--one 
Republican and one Democrat--to do the right thing on this. Senator 
Lamar Alexander of Tennessee, a Republican, and Senator Patty Murray of 
Washington, a Democrat, have proven before that they can take complex 
issues such as Federal funding for education and find a bipartisan 
compromise.
  What would America say if we announced at the end of next week or 
even this week that we have a bipartisan compromise to make healthcare 
stronger in the United States, that it is going to pass the Senate, 
that we are going to send to it the House, and that we are going to get 
something done this year in the Senate?
  First, most Americans would be amazed and skeptical, as they should 
be, but if we can prove that we are going to do it, they would applaud 
us for finally reaching a point at which we do something on a 
bipartisan basis.
  That was the process that was underway until last week. Senator 
Alexander was given orders by the leadership: Step back. Let's vote on 
Graham-Cassidy. Don't do anything more on a bipartisan basis.
  Well, this is the week for that vote, and I hope it is the week in 
which that vote ends in the basic defeat of the approach and a return 
to bipartisan compromise and bipartisan negotiation.
  I don't know what it will take for the Republicans in the Senate and 
the House to end this never-ending crusade against so-called ObamaCare. 
They have voted 50, 60, 70 times. We know how they feel about it, but 
the American people have said to them: It is not enough to oppose 
ObamaCare; give us a better alternative. And that is where they have 
stumbled each time.
  Over the weekend, rather than making improvements to fix what is 
wrong with their bill, many Republicans doubled down in secret 
meetings, negotiations, and with incentives that were built into the 
newest version of the bill.
  The latest Graham-Cassidy repeal measure would slash funding to the 
States, decimate the Medicaid Program, eliminate protections for people 
with preexisting conditions, and basically throw our entire healthcare 
system into chaos. A few special changes were made for special States, 
but the changes that have come to Graham-Cassidy in the closing days 
have not really changed the fundamental problem with the bill in that 
it diminishes Medicaid coverage.
  Medicaid is the health insurance program about which most people say: 
Well, that is for the poor people of America. To some extent, that is 
true, but it has reached far beyond that. Two out of three senior 
citizens in nursing homes and other institutional settings rely on 
Medicaid for basic healthcare. If the cutbacks in Medicaid take place 
that Graham-Cassidy calls for, what will these seniors do? What will 
you do for Mom, for your grandmother, or for your grandfather when it 
reaches a point at which they cannot any longer count on Medicaid to 
help them pay their medical bills? Will American families have to step 
up with their own savings? Will they have to look for alternative 
settings to those in which their parents and grandparents are today? 
That is the stark choice Graham-Cassidy will create for many families 
across America.
  No one has had time to properly review this latest proposal, in large 
part because it was drafted behind closed doors--no input from experts, 
no support from the medical community. You would think, after saying it 
over and over again, that the Republicans would challenge the following 
statement: There is no medical advocacy group in the United States of 
America who supports the Graham-Cassidy bill. That is the case in my 
State. The Illinois Hospital Association, doctors, nurses, surgeons, 
pediatricians, and community health are all opposed to this bill, every 
single one of them, as they were to the previous versions. It says 
something when the bill to change America's healthcare system is 
opposed by the people who provide healthcare to America. All of them 
oppose it. It is that bad.

  Republican leaders want to force a vote this week. If that is what it 
takes, then we have to move to that vote, but I wish they would save 
some time. I wish they would move to this bipartisan negotiation I 
referred to earlier.
  The Congressional Budget Office is a nonpartisan agency that is 
supposed to measure the impact of legislation so that, before we vote 
on it, we know if it is good or bad for the Nation and for the people 
we represent. Here is what it told us last night in a preliminary 
review, but it has not had time to review this bill in detail.
  In a preliminary review, the CBO told us: ``The number of people with 
comprehensive health insurance . . . would be reduced by millions each 
year.''
  How in the world can we as Senators make a proposal for the United 
States of America which we know will take health insurance coverage 
away from millions of Americans--exactly the opposite of what our goal 
should be?
  The CBO went on to write: ``Federal spending on Medicaid would be 
reduced by about $1 trillion.''
  There are some Republicans, fiscal conservatives who say that we have 
to stop the growth of this program, but none of them--not one of them--
can address the fundamental issue: Who will then take care in paying 
for the delivery of babies to low-income families? Half of the children 
who are born in my State of Illinois are paid for by Medicaid. Their 
moms are taken care of by Medicaid until the moment of birth. What will 
you replace that with if you eliminate Medicaid funding?
  What about the disabled who count on Medicaid as their health 
insurance? If you are blind or face a serious disability, Medicaid is 
the answer for basic health insurance for you. If you are going to cut 
$1 trillion out of Medicaid, what will you say to those disabled 
Americans who want the same peace of mind that we all want in having 
health insurance?
  School districts all over Illinois and all over the Nation receive 
Medicaid funds to care for special ed students--counselors, 
transportation, even feeding tubes. If you take the money out of 
Medicaid, what will we do for those school districts that are trying 
their best to give kids a fighting chance, even those with serious 
disabilities? That is the reality.
  The CBO went on to write: ``Coverage for people with preexisting 
conditions would be much more expensive . . . and could become 
unavailable for many more people.''
  This Republican proposal takes us back to that moment in history when 
health insurance was so expensive and so hard to find--almost 
impossible for those with preexisting conditions. Why would we ever 
want to go back to that? There is hardly a family in America

[[Page S6099]]

who does not have someone they love, who is part of the family, who has 
a preexisting condition.
  Let me remind those who do not have that circumstance that you are 
one accident or one diagnosis away from being part of this class of 
Americans who wants health insurance even though the health of those 
Americans has not been perfect.
  In sum, this bill does not do what its authors say it will. They like 
to tell the American public that States will magically be able to cover 
the same number of people and provide the same level of benefits with 
billions of dollars less in funding. The Governors--Democrats and 
Republicans--have stepped up and said: This is ridiculous. We cannot be 
asked to accept the burden of health insurance for generations to come, 
while the Federal Government continues to cut the money that is 
necessary to provide that protection.
  The CBO rejected the claims that are the basis for this Republican 
bill. Since the Republicans refuse to wait for the CBO to complete its 
full analysis, we have asked outside health experts what they think the 
impact would be of this legislation which is before us this week.
  Here is what they say: Within a few years, this bill would likely rip 
health insurance away from more than 20 million Americans, including 1 
million people in the State of Illinois. In a State of 12\1/2\ million 
people, which I represent, 1 million people would lose health insurance 
because of this Republican proposal that is before us this week.
  The average 60-year-old person in Illinois would see his health 
insurance premiums increase by $11,700 a year. Almost by $1,000 a month 
his health insurance would go up. Why? Because they change a basic 
formula. In the Affordable Care Act, we see that the disparity in 
premiums charged between the highest and lowest will be no more than 3 
to 1. They change the ratio in their Republican bill to 5 to 1. It 
means that those over the age of 50 and under 65 are going to see 
premium increases estimated to be almost $1,000 a month.
  By 2026, Illinois would see its healthcare funding slashed by $8 
billion. By 2036, this number would soar to $153 billion.
  Medicaid, which covers half of all children in Illinois and two out 
of three seniors in nursing homes, would be decimated. Also, the 
Medicaid expansion in Illinois, which helps us to combat the opioid 
epidemic, provide coverage for 650,000 Illinoisans, and bring stability 
to our hospitals all across the State, would be shut down.
  Here is what the Illinois Hospital Association said about this bill:

       Illinois cannot absorb additional financial burdens and 
     would be forced to reduce eligibility, covered services, and 
     payments to providers. The magnitude of these cuts and 
     changes to Medicaid is staggering.

  Let's also review what this does to people with preexisting 
conditions. The Republicans say that this is all about giving 
flexibility to States. We hear that over and over again. It sure sounds 
nice until you realize that it is a code word for there being massive 
funding cuts and the elimination of basic health protection.
  In the name of ``State flexibility,'' this bill would allow insurers 
to charge those with preexisting conditions sky-high premiums the 
moment they get sick.
  Under this bill, ``State flexibility'' means reimposing annual and 
lifetime limits on patients, including infants who are born with 
serious medical problems.
  Under TrumpCare, ``State flexibility'' means charging Americans over 
the age of 50 up to five times more than younger people. That is 
exactly why the American Association of Retired Persons, the AARP, has 
steadfastly opposed these Republican changes.
  To my Republican friends, ``State flexibility'' means tossing out 
essential health benefits, which is the guarantee that your insurance 
will cover the basic services your family may need--prescription drugs, 
maternity care, mental health and addiction treatment.
  I spoke to one of my Republican colleagues the other day and asked: 
What are you driving at here? Are you saying that we can reduce the 
cost of health insurance if we give people the option of saying that 
they will not buy coverage for mental illness and substance abuse 
treatment?
  He said: Yes, that is one thing they can do.
  I said: Then what happens next month when you discover that your 
daughter, a sophomore in high school, is now taking opioids and may 
move to heroin next? You want to intervene. You want to do it, but now 
you have to pay out of pocket because you didn't buy the essential 
coverage of mental illness and substance abuse treatment.
  It is a shortsighted game to reduce premiums and give up basic 
essential benefits, but that is what Republicans propose. That is why 
this measure is opposed by every major medical provider and patient 
organization nationwide: AARP, the American Hospital Association, the 
American Medical Association, the American Academy of Pediatrics, 
nurses, disability groups, the American Heart Association, the American 
Lung Association, the American Diabetes Association, and the 
Alzheimer's Association--the list goes on and on. But guess who also 
came out in opposition to this bill? Insurance commissioners and 
Medicaid directors. These are the officials who would actually have to 
implement these cuts. They agree with the Congressional Budget Office 
that you can't slash the healthcare budget by 20 to 30 percent and 
expect that States will have ``flexibility'' to make up the difference. 
The bipartisan association representing every Medicaid director in the 
country--every one of them--stated that Medicaid cuts would 
``constitute the largest transfer of financial risk from the federal 
government to the states in our country's history.''
  Show me a State that can cover as many people with the same benefits 
if one-third of the money is taken away. That is what the Republican 
bill does.
  Here is what Governor Sandoval, a Republican Governor in Nevada, 
said:

       Flexibility with reduced funding is a false choice. . . . I 
     will not pit seniors, children, families, the mentally ill, 
     hospitals, care providers, or any other Nevadan against each 
     other because of cuts to Nevada's health system proposed by 
     Graham-Cassidy.

  This is a Governor speaking in the same clear terms as Governors of 
both political parties about the impossible dilemma that would be 
created by this bill.
  Enough is enough. The law that we passed, the Affordable Care Act, 
helped 20 million people get health coverage. People with preexisting 
conditions were finally protected. Women are no longer discriminated 
against when it comes to health insurance. Americans get free 
preventive healthcare, such as cancer screenings. Is it a perfect law? 
Not by any means, but at 3 percent of the individual market, we need to 
do better, and we can. We need to improve that market.
  First, the Trump administration must do its best to help us, not hurt 
healthcare in America. If they are setting out to sabotage this 
healthcare system, they can do it, but I hope they will not. The 
President will not suffer if they do, but a lot of innocent American 
families will. It will make it harder for people to enroll in insurance 
groups. It will slash funding for outreach. It will actively discourage 
insurers to offer health plans to individuals.
  Mr. President, I am going to yield the floor to the Democratic 
leader.
  In closing, I ask unanimous consent that the September 22, 2017, 
article in the New Yorker by Dr. Atul Gawande be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                 [From the New Yorker, Sept. 22, 2017]

If the U.S. Adopts the G.O.P.'s Health-Care Bill, It Would Be an Act of 
                              Mass Suicide

                           (By Atul Gawande)

       The fundamental thing to understand about Senate 
     Republicans' latest attempt to repeal Obamacare is that the 
     bill under consideration would not just undo the Affordable 
     Care Act--it would also end Medicaid as we know it and our 
     federal government's half-century commitment to closing the 
     country's yawning gaps in health coverage. And it would do so 
     without putting in place any credible resources or policies 
     to replace the system it is overturning. If our country 
     enacts this bill, it would be an act of mass suicide.
       In my surgery practice in Boston, I see primarily cancer 
     patients. When I started out, in 2003, at least one in ten of 
     my patients was uninsured. Others, who had insurance, would 
     discover in the course of their treatment that their policies 
     had annual or lifetime caps that wouldn't cover their costs, 
     or that

[[Page S6100]]

     they would face unaffordable premiums going forward because 
     they now had a pre-existing condition. When he was governor 
     of Massachusetts, it was Mitt Romney, a conservative, who 
     brought Republicans and Democrats together to make a viable 
     state system of near-universal coverage. That system then 
     served as a model for the A.C.A. The results have been clear: 
     increases in coverage have markedly improved people's access 
     to care and their health. For the last four years, health-
     care costs in Massachusetts have risen more slowly than the 
     national average--while the national numbers themselves have 
     been at historic lows. I have not seen a single uninsured 
     patient--zero--in a decade. And now comes an utterly reckless 
     piece of legislation that would destroy these gains.
       To review how we got to this point: last spring, the House 
     passed a health-care-reform bill that proposed to hollow out 
     the A.C.A.'s funding, insurance mandates, and protections for 
     people with pre-existing conditions. It was immensely 
     unpopular with the public. The problem was not just that 
     twenty-three million Americans would lose their health 
     insurance if the bill becomes law but also the Republicans' 
     vision of a health system where insurance with deductibles of 
     five thousand dollars and more, and little or no primary-care 
     coverage, would become the norm.
       This summer, Senate Republicans failed to secure enough 
     votes to pass a modified version of the House bill. Later, in 
     a dramatic late-night session, the Senate also rejected, by a 
     single vote, a ``skinny'' repeal bill. That bill would have 
     repealed only the parts of the A.C.A. that required large 
     businesses to insure their workers and all Americans to carry 
     coverage. It would have resulted in a mere sixteen million 
     more uninsured people, according to estimates.
       The Republican bill currently being rushed to a vote was 
     put forward by a group of senators led by Lindsey Graham, of 
     South Carolina, and Bill Cassidy, of Louisiana. As has become 
     the apparent rule for Republican health-care bills, there 
     have been no hearings or committee reviews of the Graham-
     Cassidy bill. And, this time, lawmakers and the public do not 
     even have a Congressional Budget Office analysis of the 
     effects the bill would have on the budget, insurance costs, 
     or the uninsured rate.
       This is unprecedented: senators are moving ahead with a 
     vote on a bill that would alter the health care of every 
     American family and the condition of a sixth of our entire 
     economy, without waiting to hear any official, independent 
     estimates of the consequences. The irresponsibility is as 
     blithe as it is breathtaking. Before becoming a senator, 
     Cassidy spent twenty-five years working as a physician in 
     hospitals devoted to the uninsured. I find it baffling that a 
     person with his experience would not recognize the danger of 
     this bill. But here we are.
       The Graham-Cassidy bill goes even further than the bill 
     passed by the House. It would bring to a virtually immediate 
     end not only the individual and employer mandates but also 
     the whole edifice of the Medicaid expansion, insurance 
     exchanges, and income-based coverage subsidies set up under 
     the A.C.A. Graham-Cassidy expects all fifty states to then 
     pass, and implement, alternative health systems for tens of 
     millions of people within two years--with drastically less 
     money, in most states, than the current law provides. This is 
     not just impossible. It is delusional.
       Like the House bill, Graham-Cassidy would cut Medicaid 
     payments for traditional enrollees--the elderly in nursing 
     homes, pregnant women in poverty, disabled children, etc.--by 
     a third by 2026. A portion of the money saved would go into a 
     short-term fund for states to use for health-care costs. The 
     rationale is that this would give states ``flexibility'' to 
     design coverage for their residents as they see fit. But the 
     amount of funding provided is, by multiple estimates, 
     hundreds of billions of dollars below what the A.C.A. 
     provides.
       The bill also nakedly shifts funds from Democratic-leaning 
     states that expanded Medicaid under the A.C.A. to Republican-
     leaning states that didn't. Analyses indicate that states 
     like California, Massachusetts, and New York will receive 
     block-grant funding anywhere from thirty-five to almost sixty 
     per cent below the health-care funding their residents would 
     receive under current law. Much of those missing funds would 
     be transferred to states like Texas, Mississippi, and 
     Wisconsin. And special deals to make further shifts from blue 
     states to red states such as Alaska are being negotiated to 
     win votes.
       As for what states can do with the funds they do receive, 
     they would not be allowed to use them to enroll people in 
     Medicaid, or able to establish a single-payer system. And 
     states would not be receiving enough to continue Obamacare on 
     their own. The only options for spending are for commercial 
     coverage. States will be permitted to let insurers bring back 
     higher costs for people with pre-existing conditions and to 
     reinstate annual and lifetime limits on coverage. And then, 
     starting in 2026, the funding turns out to only be temporary. 
     Under the bill's provisions, unless further action is taken 
     then, four trillion dollars will be removed from health-care 
     systems over twenty years.
       With these massive sums being flung around, it is easy to 
     forget that this is about our health as human beings. The 
     evidence is that health-care programs like the A.C.A. save 
     lives. The way they do so is by increasing the number of 
     people who have affordable access to a regular source of care 
     and needed medications. Such coverage has been shown to 
     produce a substantial and increasing reduction in mortality--
     especially among those with chronic illnesses, such as heart 
     disease, cancer, or H.I.V.--in as little as five years.
       Virtually all of us, as we age, will develop serious health 
     conditions. A critical test of any health reform, therefore, 
     is whether it improves or reduces our prospects of having the 
     continuous care and medicines we need when we come to have a 
     chronic illness. The Graham-Cassidy bill fails this test. It 
     will terminate Medicaid coverage and insurance subsidies for 
     some twenty million people. The entire individual-insurance 
     market will be thrown into a tailspin. Federal protections 
     for insurance coverage will be gone.
       Every major group representing patients, health-care 
     professionals, health-care institutions, and insurers has 
     come out vociferously against this plan. Governors from 
     Alaska to Ohio to Virginia have opposed the bill. In a highly 
     unusual, bipartisan statement, the national association 
     representing the Medicaid directors of all fifty states has 
     also opposed the bill. The top health official in Louisiana, 
     Cassidy's home state, has opposed the new plan. There is not 
     a single metric of health or health care that the Graham-
     Cassidy plan makes better. This bill is a national calamity. 
     It should not even come to a vote.

  Mr. DURBIN. Mr. President, I ask unanimous consent that the statement 
of A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital 
Association also be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

  [From the Illinois Health and Hospital Association, Sept. 21, 2017]

         The Graham-Cassidy-Heller-Johnson ACA Repeal Proposal

                           (By A.J. Wilhelmi)

       The Illinois Health and Hospital Association opposes the 
     latest Senate proposal to repeal the Affordable Care Act, 
     which would do great harm to patients, hospitals, the 
     healthcare delivery system, and our state budget and economy. 
     The Graham-Cassidy-Heller-Johnson bill is even more damaging 
     than the previous Senate and House repeal proposals. Not only 
     will it result in the loss of healthcare coverage for up to 
     one million Illinoisans, but it will erode key protections 
     for patients and consumers and will cut federal healthcare 
     resources to Illinois by more than $150 Billion.
       IHA also opposes changing Medicaid to a capped funding 
     model. Illinois already ranks 50th in the country in federal 
     funding support per Medicaid beneficiary. Capped funding 
     would lock Illinois into low, insufficient federal funding 
     levels and shift costs to the state.
       Illinois cannot absorb additional financial burdens that 
     would be imposed on the state and would be forced to reduce 
     eligibility, covered services, and payments to providers. The 
     magnitude of these cuts and changes to Medicaid is 
     staggering.
       We were encouraged by recent bi-partisan negotiations to 
     stabilize the individual marketplace. The Graham-Cassidy-
     Heller-Johnson bill will do nothing in the short or long term 
     to create marketplace stability.
       We urge the Senate to reject this proposal, and we implore 
     the members of the Illinois House Delegation to oppose the 
     bill if it passes the Senate. There is a great deal at stake 
     for the health and well-being of the people of Illinois.

  Mr. DURBIN. Finally, I ask unanimous consent that the statement by 
the National Association of Medicaid Directors, to which I referred, be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

 [From the National Association of Medicaid Directors, Sept. 21, 2017]

                    NAMD Statement on Graham-Cassidy

       The Board of Directors of the National Association of 
     Medicaid Directors (NAMD) urges Congress to carefully 
     consider the significant challenges posed by the Graham-
     Cassidy legislation. State Medicaid Directors are strong 
     proponents of state innovation in the drive towards health 
     care system transformation. Our members are committed to 
     ensuring that the programs we operate improve health outcomes 
     while also being fiscally responsible to state and federal 
     taxpayers. In order to succeed, however, these efforts must 
     be undertaken in a thoughtful, deliberative, and responsible 
     way. We are concerned that this legislation would undermine 
     these efforts in many states and fail to deliver on our 
     collective goal of an improved health care system.
       1. Graham-Cassidy would completely restructure the Medicaid 
     program's financing, which by itself is three percent of the 
     nation's Gross Domestic Product and 25 percent of the average 
     state budget. Like BCRA, the legislation would convert the 
     traditional Medicaid program into a per-capita cap financing 
     system. All states will be impacted by this change, 
     regardless of their decisions to leverage the Medicaid 
     expansion option under the ACA. It would also incorporate

[[Page S6101]]

     Medicaid expansion funding and other ACA health funds into a 
     block grant, made available to all states. How these block 
     grants will be utilized, what programs they may fund, and the 
     overall impact they will have on state budgets, operations, 
     and citizens are all uncertain. Taken together, the per-
     capita caps and the envisioned block grant would constitute 
     the largest intergovernmental transfer of financial risk from 
     the federal government to the states in our country's 
     history. While the block grant portion is intended to create 
     maximum flexibility, the legislation does not provide clear 
     and powerful statutory reforms within the underlying Medicaid 
     program commensurate with proposed funding reductions of the 
     per capita cap.
       2. The Graham-Cassidy legislation would require states to 
     operationalize the block grant component by January 1, 2020. 
     The scope of this work, and the resources required to support 
     state planning and implementation activities, cannot be 
     overstated. States will need to develop overall strategies, 
     invest in infrastructure development, systems changes, 
     provider and managed care plan contracting, and perform a 
     host of other activities. The vast majority of states will 
     not be able to do so within the two-year timeframe envisioned 
     here, especially considering the apparent lack of federal 
     funding in the bill to support these critical activities.
       3. Any effort of this magnitude needs thorough discussion, 
     examination and analysis, and should not be rushed through 
     without proper deliberation. The legislative proposal would 
     not even have a full CBO score until after its scheduled 
     passage, which should be the bare minimum required for 
     beginning consideration. With only a few legislative days 
     left for the entire process to conclude, there clearly is not 
     sufficient time for policymakers, Governors, Medicaid 
     Directors, or other critical stakeholders to engage in the 
     thoughtful deliberation necessary to ensure successful long-
     term reforms.
       For these reasons, we encourage Congress to revisit the 
     topic of comprehensive Medicaid reform when it can be 
     addressed with the careful consideration merited by such a 
     complex undertaking--as we articulated in our June 26 
     statement on BCRA.

  Mr. DURBIN. Mr. President, what America wants is to solve problems, 
not create them. The Graham-Cassidy bill will create problems for every 
American family. Let's do something right. On a bipartisan basis, let's 
sit down and work out improvements to our healthcare system. Let's stop 
the partisanship when it comes to healthcare. Let's come together now.
  We each have our grievances against one another, one party or the 
other. The American people are tired of our grievances. They are 
expecting us to do something positive. We can do it. Let's return to 
the bipartisan negotiation process.
  I think that Senators Lamar Alexander and Patty Murray, Republican 
and Democrat, can lead us to a good path to strengthen our healthcare 
system.
  I yield the floor.


                   Recognition of the Minority Leader

  The PRESIDING OFFICER. The Democratic leader is recognized.


                   Thanking the Senator from Illinois

  Mr. SCHUMER. First, let me thank my dear friend and colleague from 
Illinois for his remarks. As usual, he is one of the most articulate 
Members of either side. He is also one of the most thoughtful and 
compassionate, and I hope people will listen to what he has to say.


                               Healthcare

  Mr. President, I would also like to respond to what the majority 
leader said this morning on healthcare. My good friend Senator 
McConnell continues to try and create this straw man because he has 
nothing good to say about his bill. He wants to make this healthcare 
debate about a false choice between Graham-Cassidy on their side and 
single payer on our side, but as Senators Sanders and Klobuchar made 
clear in an excellent debate last night on CNN, Democrats have a lot of 
ideas to improve healthcare. There is not just one; there are many, and 
many Democrats support a bunch of different ideas. Each of our ideas, 
however, endeavors to increase coverage, improve the quality of care, 
and lower the cost of care. None of the Republican plans achieve these 
goals. That is the difference.
  The difference is that one side wants to cut healthcare to average 
Americans, increase premiums, and give the insurance companies far more 
freedom, and one side wants to increase care to the number of people 
covered, lower premiums, and provide better coverage. That is the 
divide.
  Our colleagues can't stand and debate that issue. They believe in 
letting the market have more say. We have learned that, left alone, the 
poor little consumer against a big market gets crushed in healthcare 
because there are infirmities. It doesn't work like an ordinary market 
for a whole lot of reasons. So we are happy to have a debate on the 
real issues.
  Does Graham-Cassidy expand or reduce healthcare? They are rushing 
this through so we don't get a full CBO report. I am sure my colleagues 
on the other side of the aisle maybe breathed some relief there. CBO 
said that costs are likely to go way up for older Americans and 
Americans with preexisting conditions under Graham-Cassidy. They said 
that Graham-Cassidy would reduce coverage by gutting Medicaid and 
reducing subsidies that help Americans afford insurance. So there is, 
indeed, a contrast between the parties. It is a contrast we welcome.
  Every Republican plan this year would cause millions to lose 
insurance and costs to go up, whereas Democrats are looking at many 
different ideas about how to achieve the exact opposite.
  As my colleague said, we want to work in a bipartisan way to improve 
the existing system. Senator Alexander and Senator Murray have had 
great negotiations. Once this repeal effort is dead and gone--this 
repeal and replace--we are willing and eager to sit down and come up 
with bipartisan improvements and do it in the regular order, as some of 
our colleagues on the other side of the aisle have correctly and 
courageously recommended. Let's do it in regular order.
  Senators Alexander and Murray have had hearings, called in witnesses, 
and have had a lot of bipartisan discussions--just what this body is 
supposed to do. Let's realize that Graham-Cassidy is highly unpopular 
with the American people, doesn't do what some are saying it does, and 
cuts healthcare. Democrats don't want to do that, and neither do the 
American people. Let's move on and try to make our system better.


          Puerto Rico and U.S. Virgin Islands Recovery Effort

  Mr. President, the main subject I am going to speak on today is that 
instead of trying to take healthcare away from millions of Americans, 
the Senate and the White House should focus on a much more pressing 
matter this week: the desperate situation in Puerto Rico and the Virgin 
Islands.
  After suffering from the winds and rains of Hurricanes Irma and 
Maria, the island of Puerto Rico is completely devastated. I can't 
recall in my lifetime a hurricane wreaking such devastation on any part 
of the United States. There are 3.5 million American citizens facing 
one of the gravest humanitarian crises in recent memory.
  Listen to these facts. Nearly the entire island is without power. The 
reserves of gas and diesel fuel are dangerously low; there may be a 20-
day supply left. I read in the newspaper this morning that 80 percent 
of the major power lines--the big trunk lines that deliver power--are 
down. Without power, just think of what that does.
  The Governor of Puerto Rico said last night that 40 percent of the 
people on the island lack potable water; some estimates say it is as 
much as 65 percent. The food supply is dwindling, so people are without 
food. Fewer than 250 of the island's 1,600 cell phone towers are 
operational. People can't find their parents, children, or relatives. 
There is no way to reach them.
  I remember the day of 9/11 when cell phone service went out in New 
York and I couldn't reach my daughters. This has been going on for days 
and days and days.
  The damage to one of the largest dams on the island has created the 
need for another massive evacuation, but with 95 percent of the cell 
phones out of service in that part of the island, the evacuations have 
to be carried out by officials going door-to-door to the nearly 70,000 
residents in harm's way, telling them that they have to leave their 
homes. Worse still, the damage to Puerto Rico's roads, bridges, and 
ports have isolated communities and delayed the arrival of aid.
  It is not hyperbolic to say that the two storms together have set 
Puerto Rico back decades. The damage is apocalyptic. It is Biblical.
  The situation on the U.S. Virgin Islands is similar. Words and 
statistics can hardly begin to describe the devastation these Americans 
are beginning

[[Page S6102]]

to grapple with. It has hit home. One of my staffers couldn't find an 
uncle, and they found him dead on the Virgin Islands last night. So it 
hits home to all of us and to all Americans. Looking at the pictures 
and the news reports, the islands now resemble a war zone.
  What we need to do now is provide aid to Puerto Rico and the U.S. 
Virgin Islands as quickly as humanly possible--water, food, power, 
shelter. They need help and they need it now.
  Here is what should happen. First, President Trump must issue a full 
disaster declaration for all of Puerto Rico. Right now, 24 of the 78 
municipalities on the island are not eligible for FEMA grants to 
rebuild their homes.
  President Trump should also waive the local cost-share requirement 
for emergency funds so that Puerto Rico can rebuild without having to 
worry about falling even deeper into debt.
  While our Nation's Armed Forces--and we salute our Armed Forces all 
the time--are already assisting Puerto Rico, more needs to be done. As 
the most experienced part of our government in the movement of food, 
water, mobile power, and medical supplies, the Department of Defense 
should immediately determine what additional resources and capabilities 
can be deployed to aid Puerto Rico. If Secretary Mattis hasn't already 
met with the Director of FEMA, I hope he will do it today.
  Most importantly, the administration should prepare an immediate and 
interim emergency aid request, and the majority leader should put that 
package on the floor of the Senate before we leave this week. Anything 
less would be an abject failure of our duty to come to the aid of our 
fellow U.S. citizens.
  The administration submitted a request for Hurricane Harvey less than 
a week after the storm made landfall. We are rapidly closing in on that 
same marker for Maria having hit Puerto Rico. We need to move fast. We 
need to move now. Lives are at stake.
  This morning I saw that President Trump had tweeted that Puerto Rico 
was in ``deep trouble,'' but relief efforts were ``doing well.''
  With all due respect, President Trump, the relief efforts are not 
doing well. They are not close to good enough. All any American needs 
to do is open up a newspaper or turn on a TV to know that Puerto Rico 
is not doing well.

  In his tweets, President Trump also brought up the issue of Puerto 
Rico's debt. Now, that is a totally different issue, and it pales in 
comparison to the immediate humanitarian crisis faced on the island.
  Again, now is not the time, Mr. President. Puerto Rico needs help 
from aid workers, not debt collectors from Wall Street. Yes, Puerto 
Rico needs debt relief, but first they need humanitarian relief--water, 
food, medicine, fuel.
  But this fits a pattern of how our President unfortunately responds 
to natural disasters. He insists that relief and recovery efforts are 
``doing well'' or ``doing great,'' and sometimes it has no relation to 
the facts on the ground, as if this is a public relations campaign and 
not a rescue, recovery, and rebuilding operation. The time for tweets 
and talk is over.
  The American citizens in Puerto Rico and the Virgin Islands need 
action and results. The best thing the President can do is to get all 
of the relevant people in his administration together and come up with 
an aid package and deliver it to us in the next day or two so that we 
can pass it before we leave here this week.
  Again, instead of trying to take away healthcare from millions of 
Americans--that is what we are debating now, and that effort seems to 
be in real trouble--the Trump administration and the Republican 
majority should put an emergency aid package on the floor before the 
week is out.
  Carmen Yulin Cruz, the mayor of San Juan, said earlier today: ``We 
need to get our act together because people are dying.''
  The situation is desperate. The need is urgent. It is time to act 
now.
  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. SASSE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Flake). Without objection, it is so 
ordered.


                               Healthcare

  Mr. SASSE. Mr. President, until you arrived to relieve me, I had been 
presiding since the opening of the Senate this morning, and I had the 
opportunity to listen to lengthy speeches from the Democratic leader 
and the assistant Democratic leader this morning. I would like to 
correct the record on three brief items.
  First of all, as is common, almost an epidemic around here, there 
were repeated references to the Republican desire to cut Federal 
spending on healthcare for the poor and for the sickest among us. That 
is simply not true. It is an epidemic way of speaking around here, 
where people act as though, if you want to reduce the rate of growth, 
that is actually a cut. The fact that people in this body say it all 
the time doesn't make it true. No normal people ever talk that way. If 
you are having a debate at your house about your household budget and 
you are spending beyond your means and somebody proposes that next year 
you should spend 30 percent more than you spent this year, when this 
year you already spent more than you can afford, and you have big 
debate and you say ``No. Actually, next year, let's only spend 15 
percent more than we spent this year,'' that is not a cut. You will 
still spend more money next year than you will this year. Because you 
have a debate about the rate of growth--that is not the same thing as a 
cut. It is a fundamentally dishonest way of speaking, and we should 
stop doing it around here.
  The second thing that was said in these speeches that I listened to 
is that Republicans have a desire to give insurance companies more 
money. I would love it if some Democrat would come to the floor and 
explain why the stock prices of all the big health insurers in America 
have been through the roof since the passage of ObamaCare and why the 
big health insurance companies are the people lobbying the strongest to 
keep the current collapsing ObamaCare regime in place and actually 
asking for even more Federal money for insurance companies.
  It isn't the case that the proposals Republicans are making on 
reforming healthcare are something for which the insurance companies 
are cheering; rather, the insurance companies want to keep the 
ObamaCare regime in place and add yet more tax dollars to it.
  It would be great if we could have an honest debate around here 
instead of these sort of made-up stories that the Republican plans are 
in the interest of health insurance companies.
  I will readily admit and have often admitted to this body that the 
Republican Party has done a bad job of explaining what we are for in 
terms of replacing ObamaCare. We have done a bad job, and we have not 
spoken with a clear voice. But speaking for myself, I will say that I 
actually want to have insurance play a smaller role in the healthcare 
sector because there are all sorts of things that we are currently 
insuring against in healthcare that we don't ever conceivably think 
would be a rational way to build an insurance marketplace in other 
sectors. If you think of property and casualty insurance, for instance, 
we don't have any law that mandates that Allstate and State Farm have 
to buy my gas and schedule my Jiffy Lube appointments. If they did, I 
submit to you that we would all consume a lot more gas, we would do it 
less thoughtfully, and we would have Jiffy Lubes that are at the wrong 
locations, open at the wrong hours, with poor customer service, with a 
lack of clarity as to what services they are delivering and what 
quality metrics they have.
  We don't try to take in other sectors--the entire sector and swallow 
it by insurance. Insurance is supposed to be insulation and protection 
against catastrophic loss in the event of unforeseen, unpredictable, 
non-behaviorally driven events.
  To be clear, I don't think the Republican Party has spoken clearly 
and spoken with one voice. But for this conservative vocalist, I 
actually want American healthcare to work better by making clear what 
things we want to insure against and what parts of the healthcare 
delivery market we think might work better if moms and dads and local 
doctors and nurses were more empowered by having to mediate fewer

[[Page S6103]]

of their transactions through the insurance space.
  So while I am not in favor of cutting Federal spending for the 
poorest and sickest among us, I am in favor of having a debate about 
how we get to a sustainable growth rate, not the unsustainable growth 
rate we are on that is going to bankrupt the next generation.
  I am in favor of shrinking the amount of money that goes to insurance 
companies. The plans being debated here on the floor tend to be debates 
where a lot of the Democrats actually want to have a conversation about 
how we can give even more money to insurance companies. They often have 
Orwellian names like ``insurance marketplace stabilization funds,'' but 
make no mistake--what they are really talking about is giving more 
money to private health insurance companies that have had stock prices 
go through the roof since the passage of ObamaCare. That is the second 
falsehood in the speeches this morning.
  A third item on which it is important to correct the record--and this 
is not to pick on in particular the two most powerful Democrats in the 
body; those just happened to be the speeches I listened to this 
morning. We have a habit around here of people saying a lot of things 
that aren't true. You might ask: Why can you get away with saying 
things that aren't true? One of the ways we get away with it is, just 
as I am doing at this moment--I am speaking to an empty Chamber. The 
Senator from Arizona is here. He has the duty to preside over the 
Senate right now. But he is the only person in this Chamber. So 
everybody at home watching on C-SPAN--I know the camera angle is this 
wide, and so I am the guy on the screen, but this body has 99 empty 
desks.
  One thing that is very common--and was true of both speeches I 
listened to this morning--is that there is no one in the Chamber even 
though, as the speeches are made, there is a lot of gesturing as I beat 
down this debate partner, and I just one-upped you and I just persuaded 
you. There is a lot of motioning and gesturing and fake rhetoric that 
goes on around here where we try to masquerade for the American people 
and for the 50, 60, 70 people in the Gallery right now. I see people 
chuckling because they all know that it is true. They are sitting in a 
body, and there is no one here. Yet, when people come and make their 
speeches on the floor, they pretend they are winning some grand debate, 
and then their communication staff rips apart the video and sends it to 
the local TV stations back home, where people get lots of credit, as if 
they just won some big debate on the Senate floor. And maybe they said 
a whole bunch of stuff that wasn't actually true, but there was no one 
here to answer them because we are not actually debating big issues 
very often in this body.
  There are a lot of theatrics and a lot of charades and a lot of false 
deliberation. But right now, I am speaking to an empty Chamber, and 
both of the speeches that I heard this morning from the Democratic 
leaders--making up stuff about what the Republican healthcare proposals 
would do--those were speeches all delivered to an empty Chamber, even 
though the gestures implied somebody was winning a debate when that was 
happening.
  Once upon a time--there is no golden age in world history; we all 
live post fall. But once upon a time, this really was the greatest 
deliberative body in the world. Two hundred forty years ago when the 
Constitution built a system of three separate but equal branches that 
checked and balanced one another, the Senate had a unique role. The 
upper body of article I, of the legislative branch, was a place where 
debates were supposed to be long so that you could forge consensus--70, 
80, and 90 percent consensus--on issues, because people actually were 
in this body actually debating real issues.
  We are not the greatest deliberative body in the world right now, and 
a lot of people pretend we are. One of the ways we get away with that 
is by standing in here and pretending there are a lot of people 
listening to our speeches when no one is here. Again, I am the third 
speech of the day in the Senate today, and all three of them have had 
an audience of zero. I submit that most of today on C-SPAN is going to 
have an empty Chamber with a little ticker at the bottom that says 
``waiting for Senators to speak.'' When the Senator comes to speak, 
they are going to speak to an empty Chamber, and they are going to 
pretend they are winning a big debate. It is not a useful way to tackle 
the biggest public policy problems that face our people and not a great 
way to restore the Senate. We should make the Senate great again.
  Thank you, Mr. President, for the opportunity to correct these three 
items.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. KAINE. 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. KAINE. Mr. President, I rise to speak about the debate this week 
over the Graham-Cassidy proposal with respect to healthcare that is 
being considered by the body. I have high regard for both of these 
colleagues. I serve with each of them on different committees. I oppose 
the bill and want to talk a little bit about why I do but more 
specifically about an aspect of the bill that I find puzzling.
  It is no surprise to me that there are many in this body who would 
like to repeal and replace the Affordable Care Act. When the Democrats 
were in the majority for my first 2 years in the Senate, I often sat in 
the chair where the Presiding Officer sits. I heard a lot of people 
giving speeches on the floor. I was in the Chair during an all-night 
sort of filibuster by the Senator from Texas about the repeal and 
replacement of the Affordable Care Act. I get that there are arguments 
about it. While I support the Affordable Care Act--I strongly did in 
2010 and still do--I do want to work with my colleagues to find 
solutions to improve healthcare. There are differences of opinion about 
it.
  One thing I never heard during all of the speeches that I heard, 
either as a presider or paying attention on the floor, was Members 
getting up and saying they wanted to dramatically cut Medicaid. That is 
not anything that anybody has filibustered about. That is not anything 
that people speak about.
  When President Trump campaigned, he said: I am unique on the forum 
right now of all these candidates in that I will not cut the Medicaid 
Program. When the Senate started to consider versions of the ObamaCare 
repeal and replacement over the summer, after the House acted, what 
interested me was not the portions of the bill that attempted to 
replace the Affordable Care Act but the significant changes to the 
Medicaid Program that were never advertised. There was never this 
discussion: We are going to repeal ObamaCare, and we want to cut 
Medicaid. It was always about ObamaCare.
  I am puzzled, standing here today, considering a Graham-Cassidy 
proposal that not only would be a fundamental change of repeal and 
replacement of the Affordable Care Act but also contains a very 
significant revision of Medicaid that would hurt my State and would 
hurt a lot of people I care about. That never seems to be acknowledged, 
and I am puzzled about why.
  As to the Graham-Cassidy proposal, again, I respect my colleagues, 
and I think they are putting it on the table because they think it 
would be preferable to the current system. I don't question their 
motives. I was a Governor, and the notion of block grants and 
discretion and dollars back to the State can be a good thing. Quickly, 
before I get to the Medicaid piece, the problem is if you take the 
Graham-Cassidy proposal, it takes the dollars that are currently being 
delivered to the States through the Affordable Care Act, shrinks them 
by about $240 billion over 10 years, and then eliminates them. Even 
with the shuffling of the deck on a block grant that might benefit one 
State over another, you can't take $240 billion out of the system, in 
my view, without making people's premiums go up.
  The money that is being delivered to States is largely delivered to 
help people either get a tax credit premium or pay out-of-pocket costs. 
If you take that much out of the system over 10 years, people's 
premiums are going to go up. That breaks a promise of President 
Trump's, who said that nobody is

[[Page S6104]]

going to lose coverage and nobody is going to pay more. People will pay 
more, if Graham-Cassidy passes, in the short term, over the next 10 
years. Then, when all of the money expires after 10 years, they will 
pay a lot more. I oppose that.
  Second, I also oppose the way this bill treats preexisting 
conditions. By allowing States to waive essential health benefits, it 
might be technically true to say that you could get a policy even if 
you had a preexisting condition, but the insurance company could say to 
you: I will write you a policy, but you are a diabetic; so the policy 
will not cover insulin. Or I will write you a policy, but you are a 
woman of childbearing age; the policy will not cover maternity care.
  If the policy doesn't cover your preexisting condition, then 
preexisting conditions are not protected. To my read of the 141-page 
bill--which has been revised a little bit, or so I hear, since I got 
the most recent version Friday to read it over the weekend--that is 
exactly what States can do. Because 43 of 50 States did not protect 
people with preexisting conditions before the Affordable Care Act, 
handing this power back to the States and allowing them to waive these 
benefits, I think, would jeopardize the tens of millions of Americans 
who do have preexisting conditions.
  Finally, I don't like the fact that the current bill, as I understand 
it, ends funding for Planned Parenthood. Planned Parenthood doesn't 
have a line item in the budget. To the extent that Planned Parenthood 
gets funding, it gets funding for this reason: It provides primary 
medical care to women who are Medicaid-eligible, and they get services 
at Planned Parenthood that are Medicaid-eligible to be reimbursed.
  Since Federal funding cannot be used for abortion services, the 
defunding of Planned Parenthood basically says that if you serve a 
woman who chooses to go to you for her primary healthcare and she is 
Medicaid eligible, we will not pay you for that service. That seems, to 
me, to be wrong. If women are choosing to go to Planned Parenthood, and 
they think that is the best place to go for primary care, why would we 
disable them and force them to go elsewhere by disabling Planned 
Parenthood from reimbursement?
  All right. Those are some challenges I have, but I want to get to the 
real guts of my concern, which is the effort to go after Medicaid.
  The Graham-Cassidy bill--and it is similar to the skinny repeal bill 
and other bills that were on the table that the Senate considered--goes 
into the Medicaid Program that was passed in 1965, which was long 
before the Affordable Care Act--long before it--and it puts caps on the 
program to restrict the growth of Medicaid spending. The estimate is 
that over the next 10 years, it will take $1.2 billion out of Medicaid. 
Yet no description of Graham-Cassidy that I have ever heard a sponsor 
mention and no description of any of the bills that have been pending 
on the Senate floor say we are going to repeal ObamaCare and that we 
want to go into the Medicaid Act of 1965 and dramatically cut Medicaid.
  Why is that never made plain as it is a core feature of these bills? 
I would argue, it is sort of the core within the Trojan horse of the 
repeal of the Affordable Care Act to go in and change Medicaid. Yet it 
is never advertised that way, and it is never explained. You could have 
put a bill on the table to repeal the Affordable Care Act and could 
have left Medicaid alone. You would have touched the Medicaid expansion 
that was part of the Affordable Care Act, certainly, but you could have 
left the core Medicaid Program alone. Why was there an effort to both 
repeal the Affordable Care Act and cut Medicaid but not to say we are 
cutting Medicaid?
  Maybe it is because, if you were to say that, you would directly 
counter a promise the President made, ``I am not going to cut 
Medicaid.'' Maybe there is a concern about, boy, we are taking $1.2 
billion out of Medicaid, and we are about to come up with a big tax 
proposal that might give tax breaks for the wealthiest. We do not want 
to take money away from a program that is for the poor, elderly, 
disabled, or children and then immediately turn right around and 
increase the deficit by a tax cut.
  I find this to be the big mystery of this entire debate, in that 
every proposal that is on the floor makes massive cuts to the core 
Medicaid Program even though it has nothing to do with the Affordable 
Care Act. Nobody ever acknowledges it, and nobody ever explains it, but 
I am here to both say it is real and to challenge it.
  Who are Medicaid recipients? I think there tends to be a little bit 
of a misconception about who gets Medicaid in this country.
  In Virginia, 50 percent of Medicaid recipients are children. The 
proposal, under Graham-Cassidy, calls for a $1.2 billion cut in 
Medicaid in Virginia over the next 10 years and a $120 billion cut in 
Medicaid nationally. In Virginia, 50 percent of Medicaid recipients are 
kids. One in three births in Virginia--one in three births every year--
is compensated by Medicaid. Two in three nursing home residents are 
supported by Medicaid. There are a lot of people with disabilities in 
Virginia who are supported by Medicaid. The home and community-based 
waiver programs, under the core Medicaid bill, support nearly 50,000 
Virginians in community settings of their own choosing. Medicaid is 
also the primary payer for behavioral health services--mental health 
treatment, substance abuse prevention treatment.
  That is what this bill goes after even though that Medicaid funding 
has nothing to do with ObamaCare, nothing to do with the Affordable 
Care Act. So reducing Medicaid spending by the $120 billion-plus over 
10 years or more in the out-years would not hand more power to States. 
No, it would dramatically limit the States' ability to provide the 
kinds of services that are needed by our most vulnerable--kids, seniors 
in nursing homes, and people with disabilities.
  Later today, I am going to have a meeting in my office with folks who 
have communicated with me over the course of this debate--really since 
January when I was added to the HELP Committee. They are coming in to 
tell me how frightened they are about what will happen if Graham-
Cassidy passes.
  Samantha and Justin McGovern are parents. They have a girl, 
Josephine, who is 1\1/2\ years old. They are from Springfield, which is 
right here in Northern Virginia. Josephine is about 18 months old, and 
she was very premature--24 weeks gestation. She was 1 pound 12 ounces 
when she was born. That is the size of six sticks of butter. That is 
how tiny this little girl was. She was hospitalized, after her 
premature birth, for 407 days, across three units, in two hospitals, in 
two States. She is home and thriving now, but she is supported by a 
ventilator 24/7 via a tracheostomy, and she is fed primarily through a 
gastrointestinal tube.
  Her mother Samantha writes:

       We are fortunate that we get to focus on her health rather 
     than medical crippling bills. We estimate that her hospital 
     stay would have exceeded $4 million, and the cost for her 
     monthly medical expenses (baseline . . . not sick) is about 
     $26,000 a month (if we didn't have insurance or Medicaid 
     coverage).

  Here is what she writes:

       We are fortunate we have amazing private insurance through 
     our employer. However, if it were legal to have annual or 
     lifetime caps, I don't know what would happen to us. Part of 
     our Medicaid covers private duty nursing so that we can sleep 
     and go to work. Without nursing, one of us would have to 
     leave their job, and there would be no way we could continue 
     to live in our house [or pay our insurance]. If there are 
     caps and we lost our insurance, we would depend on Medicaid 
     even more than we do now, and we would have less coverage 
     than we currently have, making it virtually impossible for 
     Josephine to continue to be followed by the doctors who saved 
     her life.
       Basically, if [this bill] passes, life as we know it could 
     fall apart. I don't know how we would be able to support our 
     daughter, how we could keep her home and not in an 
     institution. She deserves to be home. She deserves to have 
     every opportunity to thrive.

  I met Rebecca Wood at a forum in Charlottesville. She has a 5-year-
old daughter, Charlie. I met them in July.
  Charlie's mom says:

       Charlie . . . is five-years-old and loves playing outdoors, 
     live music, things with numbers, and anything with animals. 
     Charlie was born more than three months early and, as a 
     result, is developmentally delayed. Currently, Charlie 
     requires physical therapy (PT), occupational therapy (OT), 
     and speech therapy. She has a . . . (feeding tube) and wears 
     orthotics. Affordable care is the difference between 
     independence as an adult or a permanent disability. Due to 
     a three month NICU stay [when she was born], Charlie would 
     have exceeded her lifetime cap before she ever came home 
     for the first time.

[[Page S6105]]

     Then, she would have been uninsurable due to her birth 
     being a preexisting condition. Also, Institutional 
     Medicaid paid for a large portion of her NICU stay. Upon 
     discharge, a Medicaid waiver helps with out of pocket 
     costs and provides services that [our private] insurance 
     doesn't cover. She would not be where she is without any 
     of these things. The changes in the proposed healthcare 
     bill would cause Charlie to drastically lose access to 
     these services. Receiving healthcare services is her 
     chance to leave a life-limiting disability behind.

  The last story I will tell is of Eric Young, from Norfolk, on behalf 
of his son, Ethan.
  Eric has major concerns about Graham-Cassidy. His son, Ethan, has 
what is called heterotaxy syndrome, which is an incredibly complex 
congenital heart defect. There are seven defects that are combined in 
this brave and thriving youngster. Eric said that Ethan has had two 
open heart surgeries and is having his third in November.
  Eric writes:

       I anticipate his healthcare charges to surpass the $1M mark 
     before the end of the year. It's not an ``if'' for Ethan--
     it's when. ``He'' will have spent more on healthcare in his 
     first 2 years of life than most people will during their 
     entire lives. He's the outlier. But he's exactly the type of 
     kid that needs protecting.
       Dealing with such a critical issue when your baby is first 
     born is overwhelming--having to worry about whether or not 
     your decisions to save your child will affect whether he . . 
     . [can] even obtain health insurance when he gets to be an 
     adult is just wrong.

  Eric writes about the ACA, as Eric works in the healthcare industry:

       The ACA is not perfect--it needs to be changed. I work in 
     healthcare--so I have the perspective of seeing it from my 
     job and as a parent. But, we need a real bill that is well 
     thought out, not something just for the sake of passing.

  I wanted to come and really just talk about these youngsters. One out 
of every three children born in Virginia is able to be born in a 
hospital because of Medicaid, and 50 percent of Medicaid recipients are 
kids. If you were a child and you needed a wheelchair, your private 
insurance likely would not cover it. If you get a wheelchair, it is 
usually Medicaid that pays for it. If you go to school and then you get 
an individualized education plan and your public school system provides 
you some services, it is Medicaid that is usually paying the school 
system to reimburse it for the services that are provided.
  My wife used to be a juvenile court judge, and this was the situation 
she would face all the time with kids in the court. It would be a 
heartbreaking situation, but there was an answer. You would have 
teenagers who were working so hard to be successful--not in court 
because of violating the law, not in court because of trouble but in 
court because their families were so dysfunctional nobody could take 
care of them. As a judge, my wife would have to grapple with this: 
Where is this child going to live? Who is going to help this child get 
to school? This kid is trying to succeed. Do I have to put the child in 
a group home or institutionalize the child because there is no family 
support there?
  What my wife could do as a juvenile court judge--and this happens all 
over Virginia every day and all over the country every day--is say: OK. 
The child is capable of success, but the family is dysfunctional. May I 
send a counselor to the home? May I find an aunt or uncle, and maybe 
with some support of counseling, provide some stability so this child 
does not have to be institutionalized and can be successful? When my 
wife would order that, it was Medicaid that was paying for it.
  Medicaid pays for your birth, Medicaid pays for your wheelchair, and 
Medicaid pays for the services a local school system will provide so 
you can have a life of independence. If your whole world is falling 
apart around you and you are doing everything you can to succeed, 
Medicaid can actually pay for counseling so you can keep it together 
and graduate from high school and go on and go to college and be 
successful.
  Medicaid is advancing these challenged kids toward lives of 
independence and success. Yet the bill that is on the floor before us 
would cut, by the most recent estimate, $120 billion out of Medicaid 
over the next 10 years and more beyond. Why? Why is that not 
acknowledged? Why would you use the bill to cut Medicaid when all of 
the rhetoric about it is that we have to repeal the Affordable Care 
Act?
  I think the right answer to this question is just staring us in the 
face, and it was what we gave Senator McCain a standing ovation for in 
July when he came back after getting his tough diagnosis. He came back, 
and he said: Look, healthcare is just too important. It is just too 
important. It is the most important expenditure anybody ever makes. It 
is the biggest sector of the American economy. It is the kind of thing 
that keeps parents up at night, worrying about what is going to happen 
to their children tomorrow or in 20 years, when the parents are 
deceased, and they want to know the children can have independent 
lives.
  We just cannot afford to get this wrong, and the answer about getting 
it right is staring us right in the face. Let the HELP Committee, on 
which I serve--the Health, Education, Labor, and Pensions Committee--
and let the Finance Committee, which has jurisdiction over Medicaid and 
Medicare, take up everybody's ideas: the Graham-Cassidy bill and Bernie 
Sanders' bill. I have a bill about reinsurance, but it is so wonky it 
is never going to be on a bumper sticker. I think it would be a good 
bill, but I have not been able to have a hearing on it.
  Let the committees that are of a Republican majority but with 
Democrats who know some things about healthcare take up these bills, 
hear from the parents, hear from the hospitals, hear from the doctors, 
and come up with a bipartisan set of solutions that will make 
healthcare better, not worse.
  We were on the verge of doing that in the HELP Committee. We had 4 
hearings with about 20 witnesses. We not only had committee members 
involved, but Chairman Lamar Alexander and Ranking Member Patty Murray 
did a good thing--they opened up a coffee before every hearing and 
said: Hey, if you are not on the committee but you want to meet these 
witnesses and hear what they have to say, come and talk and ask them 
questions. We had over 50 Senators participate. We were working on a 
bipartisan bill and basically had a handshake deal last week to 
stabilize the individual insurance market for a couple of years. In a 
deliberate way, in a careful way, we considered Republican and 
Democratic ideas for improving health insurance.
  Then, last Wednesday, the President tweeted out, in working with the 
Speaker and the majority leader, that they did not want the bipartisan 
effort to go forward. No. We have to push the Graham-Cassidy bill--the 
bill that is about the repeal of ObamaCare but that also has within the 
Trojan horse these massive cuts to Medicaid that will hurt kids.
  I don't know why we had to set aside the bipartisan effort. I don't 
know why we had to submarine the good-faith work of the committee under 
the leadership of a great chair and a great ranking member. It is my 
hope that at the end of the week, we will have defeated the Graham-
Cassidy bill and that we will go back to being the Senate we should be.
  I will just say what I have said a couple of times on this floor. 
This is one we cannot afford to get wrong. The parents of these kids 
already have enough to worry about. Why would we make it harder on 
them? We do not have to. We can be better than that. That is what I ask 
we do.
  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. FLAKE. 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. FLAKE. Mr. President, the Democrats talked this morning about the 
Affordable Care Act and what the reform efforts are trying to do and 
what they are not trying to do. I want to associate myself with the 
comments made by my colleague, the Senator from Nebraska, earlier 
today.
  A lot of talk has been thrown around about how the new effort would 
cut Medicaid spending. As my colleague from Nebraska mentioned, here in 
Washington a cut is not a cut anywhere else. But if you deal with the 
rate of growth, if you raise spending only by the Consumer Price Index 
rather than the medical Consumer Price Index--5

[[Page S6106]]

percent rather than 6 percent, for example--then you are somehow 
cutting the program.
  We know that the program as it currently stands is unsustainable. I 
think we all recognize that. So any efforts to deal with and to allow 
Governors and others at the local level to have more of a say on how 
these funds are spent and to gain efficiencies that way are frowned 
upon. It is said that we simply can't do that because it would be 
cutting Medicaid. That simply isn't the case.
  Arizona, for example, has a version of Medicaid called AHCCCS. It is 
done far more efficiently than some of the other States do it. That is 
because at the local level they have been able to do what local 
governments do best. The government that is closer to the people 
generally spends money more wisely and finds efficiencies that the 
Federal Government simply can't find.
  Let me mention that on the exchange, the Affordable Care Act dealt 
with a couple of different things. It is a so-called exchange where 
people who can't get insurance otherwise or don't get it through their 
employers will buy it on either a Federal exchange or a State exchange. 
Then you have the Medicaid side. Let me speak for a minute on the 
exchange side.
  Arizona has been ground zero for the failure of the ObamaCare 
exchange. We have 15 counties in Arizona. In all 15 counties, if you 
are a family of four and you are buying on the exchange, you are paying 
more on average for your healthcare premiums than you are for your 
mortgage. Think about that for a minute. You are paying more for your 
healthcare premiums than you are for your mortgage in every county in 
Arizona. In some counties in Arizona you are paying double. In every 
county it is more, in some counties significantly more, and in a couple 
of counties you are paying double for your healthcare premiums--much 
more than what you are paying for your mortgage.
  I spoke yesterday with an elected official from Arizona from one of 
the rural counties. He told me that his healthcare premium, which he 
simply can't afford anymore for his family of four children, would have 
been $2,800 a month. That is what it has gone up to. It has doubled 
virtually every year. In some counties in Arizona, we saw increases of 
116 percent. He owned insurance prior to ObamaCare, was paying a 
reasonable amount for a premium, and had copays and deductibles that 
were reasonable as well. But when the Affordable Care Act came in, the 
promise that you could keep your doctor or keep your plan simply wasn't 
the case. His premiums have gone up, up, and up until now; he has a 
premium of $2,800 monthly for his family of four children.
  Keep in mind, as well, that there are the deductibles on top of that. 
Were he to use that insurance, by the time he satisfies the family 
deductible, which is about $12,000, he has paid--or he will pay if he 
has any medical issues--between premiums and deductibles, more than 
$40,000 before the first insurance dollar kicks in.
  So when we hear from the other side of the aisle that there is no 
problem with ObamaCare, that the only thing we have to worry about is, 
for some people who have gained insurance, to make sure they keep 
that--I agree we have to make sure those with preexisting conditions 
have access to affordable care. But when you have people on the 
exchange who simply can't find affordable care and if they do have a 
policy they can't afford to use it because deductibles and copays are 
so high, we have a problem.
  The latest figures tell us that 155,000 Arizonans woke up this 
morning without any insurance. Most of them had insurance prior to the 
Affordable Care Act, but then insurance was priced out of their reach. 
So 155,000 people are paying a fine to the Federal Government because 
of their inability to find affordable insurance. They pay that fine, 
and they still have no insurance. Tell me that is not something we have 
to fix. We have to fix that. That is what we are responding to here.
  This notion that it is all hunky-dory--keep with the plan--belies the 
fact that 155,000 Arizonans woke up this morning and said: We are 
paying a fine to the Federal Government because we can't find 
affordable care, and still we have no care, and we are somehow supposed 
to be OK with that. Somehow we are supposed to wait until we can find a 
solution for it all before we address that specific situation.
  I submit that we have to fix this. People in Arizona and elsewhere 
are hurting. Let's stop with the rhetoric that this is somehow a cut 
and people will be left on the streets. We heard that back in 1996 with 
welfare reform. It was said that the Governors or others at the local 
level couldn't participate, couldn't be in charge of this program 
because people would be dying on the streets. Guess what. Within a 
couple of years, the welfare rolls had been cut in half. We are doing 
better, and the Federal Government's obligation in that regard has been 
sustainable, unlike the current situation we have with the so-called 
Affordable Care Act.
  I hope we can stop the outrageous rhetoric on this and actually fix 
the problem. Let's fix the problem for Arizonans who are hurting right 
now.
  With that, I yield back.
  The PRESIDING OFFICER. The Senator from Ohio.


                               CFPB Rule

  Mr. BROWN. Mr. President, we have the recent fake accounts scandal at 
Wells Fargo and the massive data breach at Equifax. I don't think any 
of us can go home and not hear, certainly, about the Equifax scandal 
that we found out about just a couple of weeks ago. The massive data 
breach at Equifax and the fake accounts scandal at Wells Fargo drive 
home the fact that so-called forced arbitration clauses have become 
almost unavoidable in everyday life.
  Whether it is a credit card or a bank account, whether it is a 
student loan or a college enrollment, whether it is a nursing home 
contract, your phone service, or even--now far too often--your job, you 
have probably signed a contract that forced you to give up your right 
to a day in court, usually, without even realizing it.
  Forced arbitration is a tool that big corporations use to silence 
victims of corporate fraud and corporate abuse. These victims never get 
to tell their stories to a judge or a jury of their peers. Why? Because 
of the small print in these contracts. Victims are pushed into a secret 
process behind closed doors, where corporations win about 90 percent of 
the time.
  Over the past couple of weeks, I have had an opportunity to hear from 
some of these victims. Let me tell you about George from Mentor, OH. 
George's wife suffered physical and mental abuse in a nursing home, but 
George and his wife have been denied a day in court. He said the 
lawyers he reached out to for help turned him away because they didn't 
think he had a chance fighting against the forced arbitration clause in 
his family's nursing home admittance agreement.
  Any family who has been through the transition of admitting a loved 
one into a nursing home will tell you it is a difficult time in the 
best of circumstances. Forcing these families to sign away their rights 
is not only wrong. It is dangerous. Typically, because of all the 
trauma of moving a family member into a nursing home, you are not even 
aware that you have signed away your rights.
  After the Equifax breach, my office was flooded with calls from 
scared consumers seeking help. Let me tell you about another one. Bill 
is from Hamilton, OH, which is at the other end of the State from 
Mentor. He and his wife are retired, and they worked hard to pay their 
bills on time. He has had excellent credit, and this is the story of 
millions of Americans. That was all put at risk when Equifax allowed 
his family's personal information to be stolen, along with that of 143 
million other Americans. It is pretty much half of the country.
  This breach was so huge and harmed so many people that the company's 
CEO, Richard Smith, retired suddenly today. Well, he will probably have 
a very comfortable retirement. His compensation was millions of dollars 
a year. The millions of people he has harmed will continue to struggle 
with the mess that he left behind.
  That is bad enough, but Equifax was also demanding that Bill in 
Hamilton, OH, give up his right to hold the company accountable in 
court if Bill signed up for their credit monitoring service. Do you 
remember, after the story broke--I believe it was in July when the 
executives found out about the 143 million Americans breached, or the 
140-

[[Page S6107]]

plus million Americans breached--that a couple of executives sold some 
of their stock. That is interesting. We will see what happens about 
that. Then it became public in September. So we know that.
  Now, we also know that Equifax, then, to make it up to their 
customers, said that they would give them a free year of credit 
monitoring. A year ago, I believe it was, when there was another 
situation like that of a data breech, Congress voted to protect Federal 
employees and to give them free credit monitoring for 10 years. But 
Equifax, generously--I believe some used that word, but they probably 
didn't--gave the 1 year, but they had a forced arbitration clause. It 
was only because of a staff person on the Banking, Housing, and Urban 
Affairs Committee, that Cory saw that they had that provision in these 
contracts--this free year of credit monitoring--and Equifax decided to 
back off of that.
  These forced arbitration clauses are incredibly powerful. To 
understand them better, big companies use the small print not just 
against regular families back in Ohio but even against people who could 
afford top-notch legal teams.
  Gretchen Carlson, a well-known news anchor, endured sexual harassment 
at FOX but was prevented from suing her employer by a forced 
arbitration clause. She didn't really know that or hadn't thought much 
about that when she signed her contract. She wrote of forced 
arbitration: It is ``often argued to be a quicker and cheaper method of 
dispute resolution for employees'' but, ``instead [it] has silenced 
millions of women who otherwise may have come forward.''
  The power of forced arbitration clauses to silence victims has 
allowed potentially millions of people to be harmed by big banks and 
other financial institutions.
  Let's take another one, Wells Fargo. In 2013, Wells Fargo used a 
forced arbitration clause to silence a customer who had accused the 
company of opening fake accounts in his name. You will remember that 
Wells Fargo opened as many as 3.5 million fake accounts, meaning they 
opened an account that the Senator from Texas or that I or others had 
not given permission to do so. They opened accounts in people's names. 
Obviously, I am not saying that personally of the Senator from Texas 
and me, but they opened 3 million fake accounts of customers who didn't 
even know these accounts had been opened. They subjected their 
employees to harsh sales goals. They threatened to fire anyone who 
didn't keep up.
  Think about how much damage could have been prevented if that 
customer was allowed to take Wells Fargo to open court 4 years ago, but 
they couldn't because of forced arbitration.
  Well, Equifax pulled back its use of forced arbitration clauses after 
the public shaming of what they did, but Wells Fargo seems to have no 
shame in continuing to hide behind arbitration following scandal after 
scandal. You will remember what Warren Buffet, who is a major 
stockholder in Wells Fargo, said: You rarely find just one cockroach in 
the kitchen. Well, with Wells Fargo, there was one case after they 
said: This is it. Then, there was another, and they said: Well, this is 
it. Then, there was another one. We don't know what is next.
  We know that many of the victims of Wells Fargo's scandal were 
servicemembers. In 2015, Santander Bank illegally repossessed cars from 
servicemembers and, then, used a forced arbitration clause to silence 
their claims. So they are willing to go against servicemembers, in the 
case of Santander. Wells Fargo is willing to do it against 
servicemembers. Wells Fargo is willing to do it against up to 3.5 
million customers for whom they opened fake accounts.
  Servicemembers and all Americans deserve to be protected from this 
shady legal fine print. That is what the Consumer Financial Protection 
Bureau has done with its new rule on the issue of forced arbitration--a 
rule that some in this body want to overturn.
  It is despicable that Congress is trying to cover for big 
corporations looking to cheat consumers and overturn this rule. Make no 
mistake. Voting to overturn the CFPB rule about forced arbitration is 
simply saying that we support corporations' ability and efforts to 
cheat their consumers. They simply don't have their day in court.
  The American Legion adopted a resolution at its national conference 
last month opposing repeal of the Consumer Financial Protection 
Bureau's rule. They understand that the Consumer Financial Protection 
Bureau did the right thing to protect servicemembers from forced 
arbitration.
  John Kamin, assistant director of the American Legion's veterans 
employment and education division, said: ``Our membership has stated 
unequivocally that we will not accept a future where our military 
veterans' financial protections are chipped away to increase the 
margins of the financial sector.''
  Let me say that again: ``We will not accept a future''--this is from 
the American Legion--``where our military veterans' financial 
protections are chipped away to increase the margins of the financial 
sector.''
  The right to have your day in court is enshrined in the Constitution 
that our servicemembers fight to uphold. The least we can do is to 
protect this right for the women and the men who protect our country--
to protect this right for the men and the women who protect our 
country.
  How can Members of this body, when this vote approaches, if they 
support the CRA to overturn the rule of the CFPB, look those servicemen 
and servicewomen in the eyes and explain that they chose to stand with 
Wall Street over these people who served their country and over their 
families and over hard-working people all across America?
  It is our job to protect the people we serve, not to protect Wall 
Street banks and corporations when they try to scam consumers. Big 
companies use small print to silence the hard-working Americans they 
have cheated.
  When a resolution to repeal the Consumer Financial Protection 
Bureau's rule comes to this floor, I urge my colleagues to speak up for 
the people whom we serve.
  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. Without objection, it is so ordered.


                       Hurricane Harvey Recovery

  Mr. CORNYN. Mr. President, I am particularly glad to see you 
presiding today because I came here to report on what you and I saw 
together in Texas during this last long weekend. Unfortunately, it 
didn't feel quite like home--not when parts of Texas battered by 
Hurricane Harvey aren't what they used to be and not when so many 
cities, towns, and wornout faces don't look like they otherwise would.
  As of this weekend, more than 8 million cubic yards of debris still 
needed to be cleared in Houston alone--the Presiding Officer's hometown 
and the city of my birth. More than 800,000 people have registered with 
FEMA for individual assistance. More than 24,000 hotel rooms are still 
occupied by victims of the flood. Fifty-two public and charter schools 
sustained ``catastrophic damage'' and are awaiting funding for repairs. 
Worst of all, 82 lives were lost as a result of this terrible storm.
  One news story that stuck with me came from Port Arthur, where the 
mayor, Mr. Derrick Ford Freeman, a man of truly steel resolve, can't 
stop yawning. Well, he is exhausted. He has a good reason. He has been 
sleeping upstairs in his child's second floor bunkbed because, unlike 
some other residents, he hasn't had time to strip the first floors of 
his house that flooded to remove the Sheetrock, destroyed furniture, 
and all of his personal effects. He has been too busy worrying about 
others and trying to help pull the pieces back together.
  Mayor Freeman spoke of the smell in his house at night. First, it is 
the flood. Then, it is the mold. Then, it is the mosquitoes. He spoke 
about the challenges his community faces, and he spoke about the more 
than 100 schoolteachers and 100 city employees in Port Arthur who still 
did not have homes ready to return to.
  What Mayor Freeman was most worried about, though, is that people 
will forget. Now, as other natural disasters and news stories begin to 
occupy the

[[Page S6108]]

coverage on television and turn people's gaze away from Texas, to 
Florida and now to the devastation in Puerto Rico, the mayor's concern 
makes some sense.
  But I want to assure Mayor Freeman--as I know the Presiding Officer 
would, and as we would to our friends in Florida and the east coast, 
who were hit by Hurricane Irma, or our friends in Puerto Rico, who were 
devastated by Hurricane Maria--that we will not forget and that we will 
stand together to make sure that the Federal Government plays its 
essential role in helping them recover and in helping them restore 
their lives.
  But I also remember another civic leader, Mayor Becky Ames of 
Beaumont, and what she said to me right after the storm. Smiling, she 
declared:

       We had a downpour; now we have an outpour. The outpour is 
     coming right into our city.

  That is what we saw time and again. Yes, the Federal Government 
responded. Yes, the State responded, led by Governor Abbott and 
emergency operations. Yes, the mayors and the county judges responded. 
But the truth is neighbors helped neighbors. We talked again. I sort of 
chuckle when I think about the Cajun Navy, but our friends from around 
the country, including next door in Louisiana, came to help pluck 
people off the tops of their flooded houses and places of business, and 
of course many people have lent a helping hand.

  I think it is best to combine Mayor Freeman's concerns with Mayor 
Ames's optimism. In other words, we need to make sure that outpour she 
was speaking about continues. I know the outpour hasn't dried up places 
like Friendswood, TX, where the Presiding Officer and I helped Team 
Rubicon clean up some of the houses that were trashed by Hurricane 
Harvey. We joined the Speaker of the House, Paul Ryan--and we are 
delighted he saw fit to come join us in this effort--as well as the 
chairman of the House Appropriations Committee and virtually the entire 
Houston congressional delegation.
  We also know the outpour has not stopped in places like Aloe 
Elementary in Victoria, a school that was severely damaged by the 
storm. There I saw second graders get packages from their counterparts 
in West Lafayette, LA. The school may have temporary walls. Certain 
classrooms and hallways had to be cordoned off as the building 
continues, but these ``Aloe-gators''--the school mascot--are 
permanently grateful for the help they are getting from children from 
Lafayette, LA, and Cumberland Elementary in Indiana.
  I think we owe it to these youngsters--and the many other Texans we 
met with in Victoria, Friendswood, and Houston--to explain what we here 
in Washington are doing to address the storm, which, let's not forget, 
rained down more water--34 trillion gallons--than any storm in U.S. 
history. I think they are wondering if we remember the sheer scale of 
the disaster zone--an area larger than West Virginia, Delaware, and 
Rhode Island combined. We want to assure them that the answer is yes.
  We have been working hard trying to match the scale of the storm with 
an appropriate congressional response. Here are just a few of the ways 
in which the Federal Government has responded:
  First, the President--and we thank him for his leadership and 
initiative--issued a major disaster declaration under the Stafford Act, 
which is the trigger for the Federal Emergency Management Agency's, or 
FEMA's, public assistance grants to be provided. This is, to be clear, 
not a handout. Each State is responsible for part of the cost. 
Secondly, the U.S. Army Corps of Engineers conducted infrastructure 
assessments and assisted with State debris management. Third, FEMA has 
coordinated with the American Red Cross and other local governments to 
find and provide temporary housing for the displaced.
  As I said, these are just a few of the ways the administration has 
been responding. I realize they are just on the first step. That is why 
last week I led a bipartisan letter, along with my colleague in the 
Chair, calling upon the Department of Housing and Urban Development to 
speed up allocation of relief funds. We were able to appropriate, and 
the President signed into law, a $7.4 billion allocation for community 
development block grants, or CDBG funds, that Congress has decided are 
appropriate as a downpayment on the recovery from Hurricane Harvey. 
These CDBG funds, community development block grant funds, will help 
Texas communities repair their infrastructure, rebuild schools, and 
reopen the businesses that are integral to recovery. I might add, given 
Texas's contribution to the national economy, it is really important 
not just to folks in Texas, this is important to the country that we 
get our businesses back on their own two feet, opening doors, and 
helping contribute to the economy while they continue to create jobs.
  I am grateful to my colleagues for moving with such dispatch in 
appropriating the funds. I know Congress's quick action can quickly be 
undone by delays at the bureaucracy level. We need to make sure that 
doesn't happen. On the State level, Governor Abbott has announced the 
Commission to Rebuild Texas, which will be led ably by Texas A&M System 
Chancellor John Sharp. I met with Chancellor Sharp last week in Texas, 
and he assured me the commission will be traveling around the State and 
working to prioritize projects to help restore roads, bridges, schools, 
government buildings, and impacted communities. The Texas delegation 
will be working with him as we focus on our response. I know we all 
look forward to working with the commission and Governor Abbott in the 
months to come. It will be months, if not years, before the recovery 
will be complete.
  One additional way we can help victims is through targeted tax 
relief. I want to highlight in this regard a noncontroversial section 
of the Federal Aviation Administration reauthorization bill that House 
Democrats blocked yesterday. It contained a number of disaster tax 
provisions, like those that were passed after Hurricane Katrina, that 
will help hurricane victims get back on their feet. It is 
unconscionable that the House minority leader held that relief hostage 
to cater to the most extreme elements of her own political party. If we 
were talking about earthquake victims in San Francisco instead of 
hurricane relief in Texas, Florida, and Puerto Rico, surely she 
wouldn't be playing politics like she is now with this important 
hurricane relief package.
  Spearheaded by Chairman Kevin Brady, the legislation would have 
helped victims keep more of their paycheck, deduct more of the cost of 
their property damage, and have more immediate access to their 
retirement savings without penalty. It would also have encouraged even 
more Americans to generously donate to hurricane relief.
  It is imperative the House act a second time later this week to 
overcome the objection of Ms. Pelosi, to make sure hurricane tax relief 
is delivered to those in need on a timely basis and without further 
delay. Shame on those who would play politics with the sort of relief 
the President and we have all committed would be forthcoming in 
response to these terrible hurricanes, whether it is Harvey, Irma, or 
Maria. The fact remains that Federal, State, and local actors will have 
to continue to work side by side to make sure Texas is made whole 
again.
  Colleagues, let's keep Mayor Ames and Mayor Freeman in mind. Let's 
remember that those still recovering in their communities and elsewhere 
need and deserve our support. Let's make sure Texas resembles the home 
we all have come to know and love following this terribly devastating 
hurricane.
  Mr. President, I yield the floor.

                          ____________________