[Congressional Record Volume 163, Number 202 (Tuesday, December 12, 2017)]
[Senate]
[Pages S7959-S7961]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Ms. KLOBUCHAR. Mr. President, I stand today to call for bipartisan 
action on several things that are really critical. One of them has 
become routine, since it started as a bill that Democrats and 
Republicans did together. That was the Children's Health Insurance 
Program, something that my colleague from Vermont has referenced.
  In my State, we have been a good-government State. We have had a 
budget surplus for years, and, believe it or not, we relied on the fact 
that Congress would come through and do what they were supposed to do 
and reauthorize the Children's Health Insurance Program, but that 
didn't happen. As a result, we have a slight budget deficit--something 
we haven't had for years. But it really hit home when I called our 
budget director in the State and I said: How did this happen when we 
have had these surpluses?
  He said: Well, we actually thought that you guys would reauthorize 
the Children's Health Insurance Program, but you didn't.
  Instead, what we have seen is a tax bill that adds over a trillion 
dollars to the debt. Even when you take into account any economic gain 
from that bill, a nonpartisan group said that it would, in fact, add $1 
trillion to the debt. That is what we are doing instead of 
reauthorizing the Children's Health Insurance Program, which makes no 
sense to me.
  Funding for CHIP expired more than 2 months ago, even though, as I 
said, it is one of the success stories out of this Congress. Both 
parties have come together for years to support this program that 
provides healthcare to millions of children across the country.
  In Minnesota, these funds support coverage for more than 125,000 
kids. Just last week, my State estimated that failing to reauthorize 
CHIP would cost us $178 million. That is why the

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deficit was at $188 million. So the CHIP funding that our State has 
come to rely on through Democratic Presidents and Republican Presidents 
has suddenly gone away--that is why we have a deficit--while at the 
same time, a decision has been made by my colleagues on the other side 
to add over $1 trillion to the debt. I don't know what to tell the 
people in my State, except that tax cuts for the wealthy appear to be a 
priority rather than reauthorizing this bill to help kids get their 
health insurance. Guess what. They don't understand that reasoning.
  States like mine are running out of ways to make Federal funding last 
a little bit longer. Every single day that we don't act puts coverage 
at risk for millions of kids. Some States have already been forced to 
tell parents to start making other plans for their kids' healthcare. No 
parent should ever have to worry about whether their child will have 
healthcare. We must keep this strong program going. I have also heard 
from families with kids who get treatment at the children's hospitals 
and clinics of Minnesota and who count on this program for the medical 
care they need. That is why we must pass the bipartisan bill Senators 
Hatch and Wyden have put together to extend CHIP for 5 years--so we can 
stop this nonsense and tell people back at home that actually something 
is working here.
  In 2015, the last time we renewed the program, it passed the Senate 
with 92 votes. We should demonstrate that same bipartisan spirit again. 
We should not hold these kids hostage with this bickering, and we 
certainly shouldn't be holding all of the States hostage either. This 
makes no sense. We must act before it is too late, or States like mine 
will not just have a deficit as a result of this, they will be forced 
to make difficult choices about insurance coverage for some of our most 
vulnerable constituents. CHIP is one part of our healthcare system that 
nearly everyone agrees works. We should be doing everything in our 
power to protect it.
  In addition to CHIP, the American people want us to work together to 
make fixes to the Affordable Care Act. They don't want us to repeal it; 
we have seen that in the numbers. They want us to make some sensible 
changes. You can never pass a bill with that kind of breadth and reach 
without making some changes to it. I said on the day that it passed 
that it was a beginning and not an end.
  I am a cosponsor of the bill Senator Alexander and Senator Murray 
have put together because it is an important step forward and exactly 
the type of sensible, bipartisan legislation that we should pass. The 
bill has 11 Republican cosponsors and 11 Democratic cosponsors. Patient 
groups, doctor groups, and consumer groups have praised it, including 
the American Cancer Society, the American Diabetes Association, the 
Arthritis Foundation--and those are just some of the A's. There are 
hundreds of national health groups who support this bill. They have 
Democratic members and they have Republican members. They just want to 
get something done.
  Senators Alexander and Murray held a series of hearings and 
discussions on commonsense solutions to bring down insurance costs with 
Senators on both sides of the aisle.
  I fought for a provision in this bipartisan legislation that would 
help States like mine apply for and receive waivers. This was put 
together, by the way, in our State by a Republican legislature and a 
Democratic Governor. It is a plan that would bring down premium costs, 
a plan that made sense across the board and was broadly supported in 
our State. Our Federal Government should be encouraging that kind of 
flexibility. The waiver we are asking for is actually something we 
would like to see other States do. The provision we included in the 
Murray-Alexander bill would encourage other States to do exactly what 
we did; that is, apply for waivers for flexibility to bring down rates 
without getting penalized.

  This bill would also expedite the review of waiver applications for 
proposals that have already been approved for other States.
  This legislation also shortens the overall time period that States 
have to wait for the Federal Government to decide whether to approve 
their waivers. The last time I checked, I thought this administration 
was touting the fact that they like to get things done, that they want 
to move things faster, and that they don't like the redtape of 
bureaucracy. Well, here we have a bill that actually says that States 
shouldn't have to wait for the Federal Government to make decisions. 
Why can't we get it passed?
  Not only does the bill improve the process for waivers--this is my 
favorite part because when you hear me talk about it, you might think, 
wow, this must be expensive. No. The nonpartisan Congressional Budget 
Office says that the Alexander-Murray bill would actually cut the 
deficit by $3.8 billion over the next 10 years because it simply gives 
States the flexibility to cope with the issues they are having in their 
own States, to adjust to their own particular circumstances, and to 
make it easier for people to afford healthcare, while saving money for 
the Federal Government. It makes no sense to delay by even 1 day the 
passage of this legislation, nor does it make any sense to cut all 
those kids off of health insurance.
  Renewing the Children's Health Insurance Program and passing Murray-
Alexander would be important steps forward, but we still must do more. 
I don't think we are going to get all my prescription drug bills passed 
by the end of the year, but we should. We won't, but we should. That 
doesn't mean I am giving up. I think the American people aren't giving 
up because they have been able to see clear-eyed what is going on 
because they are starting to see what is happening with the cost of 
their prescription drugs. The costs are skyrocketing.
  I have heard from people across Minnesota who are struggling to 
afford the medicine they need. This is about the woman in Duluth who 
told me that she chose not to fill her last prescription because that 
one drug would cost a full 25 percent of her income. This is about the 
woman in St. Paul who, even with Medicare, can't afford a $663-a-month 
cost for medicine that she needs. This is about a woman from Crystal, 
MN, who told me: ``I am practically going without food to pay for my 
prescriptions.'' It is heartbreaking that this is happening in America.
  Reducing the costs of prescription drugs has bipartisan support in 
Congress, and the President has said that he cares about this. So why 
can't we get this done?
  I have one bill that has 33 cosponsors that lifts the ban that makes 
it illegal for Medicare to negotiate prices for Part D prescription 
drugs for 41 million American seniors. Yes, right now, it is in law 
that we can't negotiate for 41 million seniors. Last time I checked, I 
think they would have a lot of bargaining power, but right now, we 
can't do that.
  A bill Senator McCain and I have would allow Americans to bring safe, 
less expensive drugs from Canada.
  A third bill that Republican Senator Grassley and I have is to stop 
something called pay-for-delay, where big pharmaceutical companies 
actually pay off their generic competitors to keep less expensive 
products off the market. How can that kind of practice be any good for 
American consumers? Guess what. It is not. We need to put an end to 
this outrageous practice. This bill would save taxpayers $2.9 billion.
  Senator Lee and I have a bill that would allow temporary importation 
of safe drugs that have been on the market in another country for at 
least 10 years when there isn't healthy competition for that drug in 
this country. Believe me, there are plenty of areas where we don't have 
healthy competition, where Americans aren't getting the kinds of deals 
they should get.
  I have a bipartisan bill with Senators Grassley, Leahy, Feinstein, 
Lee, and several others called the CREATES Act to put a stop to other 
pharmaceutical company tactics--such as refusing to provide samples--
that delay more affordable generic drugs from getting to consumers. 
According to the Congressional Budget Office, this legislation would 
save approximately $3.6 billion.
  People in this Chamber are talking about saving money. How are they 
doing it? On the backs of kids. They are talking about saving money. 
How are they doing it? On the backs of Americans who would like to 
afford premiums.

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  I have laid out a number of bills that actually have been scored to 
save money. Passing the Alexander-Murray bipartisan bill would save us 
money. We have the actual accounting to show it. Allowing for less 
expensive drugs from other countries would save money for consumers. It 
is pretty easy to understand. It is called capitalism. It creates 
competition.
  For our own American drug companies--we are proud that they have 
developed lifesaving cures. They are important employers in our 
country. But if they refuse to bring down those prices and if they have 
a monopoly on the market, we should be bringing in competition. There 
are two ways to do it. One is generic, and that is making it easier to 
produce generic drugs, and also stopping big pharma companies from 
paying off generic companies--their competition--to keep their 
competitive products off the market. The other is simply allowing drugs 
from less expensive places, but safe places, like Canada. That is a 
bill I have put forward with Senator McCain, but also Senator Bernie 
Sanders and I have worked on this, as well as many others. These are 
commonsense ideas. Yet we cannot even move to a vote. Why? Because the 
pharmaceutical companies don't want us to have that vote.
  So I am asking my colleagues, No. 1, let's end the year with some 
common sense and pass two commonsense bills to help the American people 
with their healthcare, and those are the children's health insurance 
bill and the Alexander-Murray compromise to make some fixes to the 
Affordable Care Act. Then, when people are home for a week over the 
holidays, maybe they should start talking to their constituents, as I 
have. Maybe they should talk to their friends and their neighbors and 
see what they think about what is going on with prescription drug 
prices. Maybe they will come back with a New Year's resolution that 
they are no longer going to be completely beholden to the 
pharmaceutical companies, that they are willing to give the American 
people some relief and take these companies on and create some 
competition for America.
  I thought this was supposed to be a capitalistic system. In a 
capitalistic system, you do not have monopolies for certain drugs. You 
do not have a drug like insulin, which has been around for decades, 
triple, so that one elderly constituent in my State actually saves the 
drops at the bottom of the injectors so they can use them the next day. 
That is what is happening, while at the pharmaceutical companies, they 
are taking home big bonuses at the end of the year.
  I implore my colleagues, let's get these commonsense things done so 
you can go home and not think, when you are sitting there at your 
holiday dinner, that you have basically left millions of kids without 
healthcare, and then on New Year's, the next week, make a resolution to 
do what is right for your constituents, not for the pharmaceutical 
companies.
  Thank you, Mr. President.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Hoeven). The Senator from Rhode Island.