[Congressional Record Volume 164, Number 17 (Wednesday, January 24, 2018)]
[Senate]
[Pages S482-S485]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Republican Tax Bill

  Mr. President, finally, a word on the Republican tax bill. 
Republicans promised that the massive corporate tax cut they passed 
would unleash unprecedented economic growth, raise wages, and boost 
jobs. We already have evidence that big corporations are not turning 
their new tax cut into jobs for the middle class.
  There was a lot of hoopla when AT&T said they would give bonuses. Do 
you know what they did at the same time? They announced plans to fire 
more than 1,000 workers, starting early this year, despite the tax cut. 
Macy's announced that it would be cutting 5,000 jobs, despite the tax 
bill. Kimberly-Clark plans to cut up to 5,500 jobs and close or sell 
about 10 plants, saying the savings from the tax bill gave them 
flexibility to make these reductions. Is President Trump going to claim 
credit for that one? Carrier--a company the President promised to 
save--continues to bleed jobs. They are a metaphor. A lot of nice 
announcements, a lot of blitz and glitz, but actually the condition of 
the American worker is getting no better and many times, worse.
  Meanwhile, what are most companies doing--so many of them--with these 
big tax breaks, these massive tax breaks they got? They are announcing 
stock buybacks. That benefits the CEO. It raises their stock and 
doesn't help anybody else. Mastercard, $4 billion; Bank of America, $5 
billion; Pfizer, $10 billion; Wells Fargo, $22 billion; and many, many 
more. One hundred billion dollars has been announced in stock buybacks 
since the Senate passed its tax bill.
  When the American people learn that some of them are not getting 
anything, that some of them are getting raises and the rest are getting 
crumbs and big corporations and wealthy individuals are getting nice, 
fat pieces of pie, they are going to be outraged. They are already.
  My friend the majority leader will not come to the floor and brag 
about the stock buybacks. He will, however, announce when a company 
gives a bonus to its workers. Let's hear both sides and let the 
American people judge. The bonuses are a good thing, but the truth is, 
these one-time bonuses are a drop in the bucket compared to what 
corporations could be doing for their workers.
  By the way, let me announce a few other things these corporations did 
after they got the tax breaks. When Bank of America announced $5 
billion in stock buybacks, it also announced that it started charging 
low-income customers for free checking. When Pfizer announced its $10 
billion buyback, it said it would no longer research for Alzheimer's or 
Parkinson's, laying off 300 people. Wells Fargo announced $22 billion 
in stock buybacks, helping its wealthy shareholders at the same time it 
is closing 800 branches.
  Here is a paragraph from yesterday's New York Times.

       Bank of America's bonuses will cost the bank $145 million 
     in 2018, or about 5 percent of the nearly $2.7 billion in 
     savings it is expected to reap in 2018 from a lower, 21 
     percent corporate tax rate. Apple's bonuses will cost $300 
     million, a fraction of the $40 billion, at least, that the 
     tech giant is saving from a single provision in the law, 
     which allows it to return earnings held overseas at less than 
     half the rate it would have paid under the old system. And 
     two days before Walmart snagged glowing headlines for handing 
     out $400 million in bonuses and lifting its minimum wage at a 
     cost of $300 million, the nation's largest retailer by sales 
     unveiled a plan to buy back company-issued debt. . . . $4 
     billion.

  Minimum wage, they pay out $300 million; stock buyback, $4 billion.
  I am glad these workers are getting bonuses. They deserve them. But 
it seems that recently, these bonuses are token efforts to give 
corporate executives something to point to while they reap huge 
benefits for themselves and their shareholders.
  A CNBC survey found that ``cuts in corporate taxes haven't yet had a 
meaningful impact on American companies' plans to boost investment or 
raise workers' pay.'' That is CNBC.
  Yes, we could have imagined tax reform that was deficit neutral, that 
closed loopholes while lowering rates, that lowered corporate taxes but 
actually stipulated that the money be put into wage increases and new 
jobs instead of what many companies are doing now--one-time bonuses and 
massive stock repurchasing programs. Many middle-class families have 
waited so long for better wages and more jobs. A tax bill properly 
constructed could have helped deliver that to them. Instead, 
Republicans squandered their once-in-a-generation opportunity on an 
extraordinary tax break for big corporations and the already wealthy, 
and we are already seeing the consequences.

  I yield the floor.
  The PRESIDING OFFICER (Mr. Sullivan). The Senator from Washington.
  Mrs. MURRAY. Mr. President, almost a year ago, as Republicans were 
jamming through the confirmation of Tom Price as Secretary of Health 
and Human Services, I rose to object to his nomination. I voiced my 
very deep concerns about whether Secretary Price would be committed to 
protecting healthcare for our families, committed to putting evidence 
and sound policy over partisanship and ideology, and whether he would 
be committed to addressing the many ethical questions about his 
investments Republicans allowed to go unanswered. Well, he was not.
  Today, Secretary Price is infamous for two signature accomplishments: 
first of all, undermining healthcare access for millions of people; 
and, second, resigning in scandal and disgrace.
  In the wake of Secretary Price's resignation, President Trump had 
another opportunity to get this right. I believe families in Washington 
State deserve a Health and Human Services Secretary who will finally 
put patients ahead of politics.
  Unfortunately, after meeting with Alex Azar, hearing his testimony, 
and carefully reviewing his record and his qualifications, I do not 
believe Mr. Azar is an acceptable choice to lead the Department, and I 
will be voting against his confirmation.

[[Page S483]]

  From President Trump's first day in office, he has been focused on 
undermining healthcare coverage by putting up barriers to obtaining 
care, shortening our enrollment period, expanding loopholes for 
corporations, and making every effort to throw the entire system into 
chaos. After a year of President Trump's healthcare sabotage, there 
were over 3 million more people uninsured in our country. We need a 
voice to stand up and defend the healthcare our families rely on.
  I am alarmed by Mr. Azar's statements, including cheerleading 
healthcare repeal efforts, predicting that the Affordable Care Act was 
``circling the drain,'' even though enrollment stayed strong across the 
country this year, and detailing specific steps to, as he said, hasten 
the demise of patients' and families' healthcare.
  While President Trump continues to call the opioid crisis a public 
health emergency, he has yet to treat it like one. So far, his 
administration has proposed cutting the budget for the Office of 
National Drug Control Policy by 95 percent. It is focused on gutting 
Medicaid, which provides critically needed substance use disorder 
treatment, and they have failed to provide any new funding or resources 
to support the communities that are fighting this crisis.
  Local leaders in my home State of Washington and across the country 
need a voice at the Department of Health and Human Services committed 
to bringing more resources, not fewer, to address the opioid epidemic. 
I am alarmed by Mr. Azar's refusal to support more funding for 
communities that are hard hit by the opioid epidemic.
  President Trump's Department has also shown a concerning pattern of 
undermining evidence-based policies in favor of ideology. When it comes 
to undermining evidence, political appointees at Health and Human 
Services have asked their career staff not to use the terms ``evidence-
based'' and ``science-based'' because they view them as ``essentially 
meaningless.''
  When it comes to favoring ideology, not only has the Department taken 
steps to restrict access to care for women and transgender patients, 
leaders have also sought to effectively ban words like ``transgender'' 
and ``diversity'' and ``vulnerable'' among their Department employees--
ban the words, and they have not just cut important words, they have 
gutted valuable, evidence-based programs like the Teen Pregnancy 
Prevention Program.
  This program has provided useful insight on what works to address 
high teen pregnancy rates. It has been recognized by the bipartisan 
Commission on Evidence-Based Policymaking for its rigorous approach to 
evaluation. Yet President Trump's administration chose to unilaterally 
shorten that program's grants.
  We need a voice there who will reject such damaging ideology 
decisions and to champion evidence and science and sound policymaking. 
I do not believe Mr. Azar is that champion--quite the opposite, in 
fact.
  I am alarmed Mr. Azar believes a woman's employer should be able to 
decide, based on ideology, whether or not her birth control should be 
covered. I am alarmed by his extreme and out-of-touch views on Roe v. 
Wade, as shown by his support for legislation and political candidates 
who would undermine the constitutional rights enshrined in this 
important decision, and his use of ideological rhetoric in discussing 
the rights guaranteed to women by that landmark case.
  Unfortunately, Mr. Azar is the latest in a string of ideologically 
driven healthcare appointees from President Trump. We cannot tolerate 
one more nominee overseeing a woman's healthcare programs who is more 
focused on undermining them than on advancing them.
  Finally, I am alarmed by his track record at the pharmaceutical 
company Eli Lilly. As a nominee, Mr. Azar has said we need to fight to 
lower drug prices, but during his time as president of Lilly, that 
company tripled the price of insulin, and Mr. Azar personally approved 
significant price increases for dozens of the company's drugs.
  As a nominee, Mr. Azar may try to assure us that he will fight for 
patients and protect the health of our communities, but after looking 
at his record, after reading his past statements, and after discussing 
these issues with him, I am alarmed he might not stand up for women and 
families, I am alarmed he might not stand up to the pharmaceutical 
industry, and I am alarmed he might not stand up to President Trump's 
agenda, driven by sabotage and ideology.
  After months of Republicans putting politics ahead of funding 
healthcare for children, and as Republicans continue to put politics 
ahead of funding for community health centers like those in rural 
Washington State and those across the country that help to serve 
underserved communities, and as they continue to ignore other primary 
care programs that bring medical professionals to populations in need 
like teaching health centers in Spokane, we have to have strong 
leadership at the Department of Health and Human Services that will 
demand that we put public health first, not partisanship.
  I urge my colleagues today to vote against this nomination.
  I thank the Chair.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. MENENDEZ. Mr. President, I come to the floor to voice my concerns 
about the nomination of Alex Azar to lead the U.S. Department of Health 
and Human Services.
  The American people deserve a Secretary of Health and Human Services 
who actually believes in the agency's work and mission, which is to 
help America's families, children, and seniors lead healthier and more 
productive lives.
  Nothing in Mr. Azar's record gives me any reason to believe he will 
do anything other than advance the Trump administration's mission to 
take healthcare coverage away from millions of Americans and leave 
everyone else with higher costs.
  Instead of working to help more families get the care they need, I 
fear he will devote most of his time to imposing a harmful, rightwing 
ideology on patients, on women, and on families.
  Mr. Azar will continue the Trump administration's reckless assault on 
the reproductive rights of women; he will support the far right's 
relentless war on science- and evidence-based health policy; and he 
will put the needs of powerful special interests ahead of patients and 
families.
  It is hard to believe the Trump administration has only been in 
office a year because already it has broken so many of the promises the 
American people were fed on the campaign trail. During his campaign, 
President Trump promised he would replace the Affordable Care Act with 
something truly great, something way better, but under President 
Trump's watch, things have only gotten worse. Premiums are up, 
deductibles are up, and for the first time since 2012, the number of 
Americans with healthcare coverage has gone down.
  Now, this is no accident. It is the result of the Trump 
administration's relentless assault on the Affordable Care Act. That is 
right. Thanks to this administration's deliberate efforts to sow chaos 
in our health insurance markets, and subsidies that reduce sky-high 
deductibles, and give consumers less time to shop for insurance, 3.5 
million fewer Americans have coverage compared to 1 year ago. In my 
State, the number of New Jerseyans enrolled in the marketplace dropped 
by 5 percent.
  Mr. Azar says the Affordable Care Act is ``circling [down] the 
drain,'' when the reality is, Republicans have done their best to drown 
it. The Trump administration has no plan to help the growing number of 
Americans without coverage, and Mr. Azar has offered no solutions to 
protect their health and financial security. In fact, he believes the 
paltry tax credits Republicans propose in their Affordable Care Act 
alternative to buy insurance are too generous--too generous. If I said 
that to any one of my constituents, they would laugh in my face.
  Nothing in Mr. Azar's record gives me any confidence that he will 
change course. That is because, like former Secretary Tom Price, Mr. 
Azar lives in an alternative universe, where health insurers will 
suddenly put the well-being of patients ahead of their stock prices; 
that if we just scrap the Affordable Care Act, the free market will 
magically begin covering the sick, caring for families, and protecting 
our seniors.

[[Page S484]]

  Well, we know that is patently false. We already tried letting health 
insurance companies run the show, and it didn't work because, in 
America, healthcare doesn't ever go on sale. If it did, people would be 
banging down doors like Best Buy on black Friday to schedule their 
heart surgeries and cancer treatments.
  Mr. Azar seems to forget that we need commonsense protections to 
ensure Americans with preexisting conditions have access to coverage; 
that before the Affordable Care Act, health insurance companies 
routinely denied coverage for cancer survivors and people with chronic 
challenges like MS; that children with preexisting conditions like 
asthma or heart murmurs were blacklisted by insurers for life; that 
thousands of people were bankrupted by medical bills each and every 
year, and women were charged higher premiums for the same exact 
insurance policies as men.
  Mr. Azar seems to forget that before programs like Medicare and 
Medicaid, seniors who worked hard their entire lives languished without 
care and lived in abject poverty. Do we really want to see seniors 
backsliding into poverty in 2018?
  Now, I know Mr. Azar is a very wealthy man--it almost seems to be a 
prerequisite in order to serve in the Trump Cabinet--but I encourage 
him to try to imagine what it is like to work a low-wage job that 
doesn't provide healthcare benefits and what it is like for parents in 
New Jersey to go to work every day knowing they are one illness or 
injury away from ruining their family's financial future.
  These men and women are among the 11 million Americans who depend on 
the Affordable Care Act's Medicaid expansion, including well over half 
a million in New Jersey alone. Yet Mr. Azar believes he has a mandate 
to turn programs like Medicare into vouchers that shortchange seniors. 
He supports turning Medicaid into a block program, which is a way of 
ultimately dramatically cutting the program and a fancy way of saying 
States should be allowed to block millions of people from getting the 
care they need--no matter how much money they make, what ZIP Code they 
come from, or what healthcare challenges they face.
  The American people deserve a Secretary of Health and Human Services 
who is prepared not only to defend these stalwart programs but is 
committed to building on their success. After a year of higher costs, 
less coverage, and empty promises by the Trump administration, the 
American people want Congress to turn the page. We have the chance to 
do that by rejecting Mr. Azar's nomination.
  It is time we demanded the administration nominate a leader who is 
truly devoted to helping all Americans get the care they need no matter 
how much money they make, what Zip Codes they come from, or what 
healthcare challenges they face.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I join my colleagues on the floor to 
speak in opposition to the nomination of Alex Azar to head the 
Department of Health and Human Services.
  I believe Mr. Azar is, first and foremost, a product of the 
pharmaceutical industry, with a long, consistent track record of 
sharply increasing drug prices during his tenure at Lilly USA.
  Furthermore, his nomination makes clear that President Trump did not 
mean it when he said repeatedly during the campaign that pharmaceutical 
companies are ``getting away with murder'' and that he as President 
would dramatically reduce drug prices for seniors and all Americans. 
Mr. Azar's nomination is yet one more example of the Trump 
administration putting special interests above the public interest and 
public safety.
  Mr. Azar has long opposed any Federal intervention in prescription 
drug pricing, things like allowing Medicare to negotiate for drug 
prices. Of course, his former company has profited handsomely from the 
government's hands-off approach. When Mr. Azar became the president of 
Lilly USA, he also became the chair of its pricing committee and had a 
major say in price increases for all domestically sold Lilly drugs from 
2012 to 2014. During that time, the list and net prices of Lilly's 
drugs that were sold in the United States increased by double-digit 
percentages each year.
  As cochair of the Senate's Diabetes Caucus, I am especially troubled 
that during Mr. Azar's time with the company, Lilly more than tripled 
the price of insulin--jacking up the price from $74 to $269. Much of 
that increase occurred during Mr. Azar's years as chair of the pricing 
committee. These price increases are not only exorbitant but have 
caused real hardship to many of the nearly 30 million Americans who 
live with diabetes. As Candidate Trump would have put it, Lilly, under 
Mr. Azar's leadership, was ``getting away with murder.''
  I am also concerned that Mr. Azar will continue and even ramp up the 
Trump administration's across-the-board campaign to sabotage our 
healthcare system. We are now 1 year into this administration's efforts 
to undermine the Affordable Care Act. Regrettably, it is working. The 
uninsured rate rose in 2017 by 1.3 percentage points. That was nearly 
3.2 million more people who were without health insurance.
  Already, the administration has eliminated those payments that allow 
insurance companies to keep down premiums and reduce copays and 
deductibles, and that has created further hardship on people who 
desperately need health insurance. Without reason or justification, the 
administration cut the open enrollment period by half. It slashed the 
budget for open enrollment ads on TV, radio, and the internet by 90 
percent, which shut down most efforts to inform consumers about their 
enrollment options.
  Despite these efforts, they were not successful in dramatically 
reducing the number of people who tried to enroll in the Affordable 
Care Act because enrollment for 2018 was 8.8 million people compared to 
9.2 million the year before. It shows how desperately people want to 
have health insurance. Of course, we know that since that enrollment 
period, the Republican leaders in Congress have used the tax bill to 
repeal the individual mandate. Meanwhile, in an interview, Mr. Azar 
spoke of his desire to ``hasten [the Affordable Care Act's] demise.'' 
Apparently, he doesn't appreciate that the Affordable Care Act and 
Medicaid expansion, in particular, have been absolutely critical tools 
in the fight against the opioid epidemic.

  I urge Mr. Azar and President Trump to read the front page story in 
Sunday's New York Times. The story is about the devastating 
consequences of the opioid epidemic in my State of New Hampshire. The 
article is titled ``How a `Perfect Storm' in New Hampshire Has Fueled 
an Opioid Crisis.'' It was accompanied by an even more compelling 
article, titled ``1 Son, 4 Overdoses, 6 Hours,'' which profiles the 
life of Patrick Griffin of Pembroke, NH. In shocking detail, the 
article documents how Mr. Griffin, who has struggled for years with a 
substance misuse disorder, overdosed four times within a 6-hour period. 
Twice within those 6 hours, emergency medical responders came to his 
house and revived him with Narcan, the antidote that reverses opioid 
overdoses.
  In reading that article, some people will ask: Why can't he just 
control his substance use disorder? They don't understand this is a 
disease, that it changes people's brain makeups--the chemistry of an 
individual's brain. Just like heart disease or diabetes or any other 
chronic illness, there is a physiology that is involved with that that 
affects a person's ability to get better.
  One of the things that saves people like Patrick when one is 
overdosing is the drug Narcan, or naloxone, which is the official name. 
It has been used so much in New Hampshire that most people refer to it 
as Narcan. We have seen that the pharmaceutical industry has 
dramatically increased the price of Narcan as this epidemic has spread.
  The price of the drug that is needed by so many to save their lives 
has increased dramatically. A two-dose package of Narcan, manufactured 
by Evzio, cost $690 in 2014. It is $4,500 today. Generic doses of 
Narcan have increased between 95 and 129 percent since 2012. Bear in 
mind, it often takes multiple doses to revive people who have 
overdosed, so this has an impact on our healthcare system. In New 
Hampshire, it has had an impact on families, on municipalities, on 
first responders--all of those people who are trying to save people who 
have overdosed.

[[Page S485]]

  As we all know, the opioid epidemic is a nationwide crisis, with some 
63,000 Americans having been killed by drug overdoses in 2016. New 
Hampshire has been especially hard hit. The demise of the Affordable 
Care Act, which Mr. Azar says he wants, would mean that thousands of 
Granite Staters would lose access to treatment, with there being 
devastating consequences. That is true not just in New Hampshire but in 
States across this country. I think it is unconscionable that a 
Secretary of Health and Human Services would take away one of our most 
valuable tools for combating substance use disorders and that he would 
actively oppose access to healthcare for millions of Americans.
  For me, between Mr. Azar's coziness with the pharmaceutical industry 
and his disdain for the Affordable Care Act, which is the law of the 
land and which Mr. Azar would be charged with administering as 
Secretary, I think he is the wrong person to serve in the critically 
important post of Secretary of Health and Human Services. I intend to 
vote against his confirmation, and I hope my colleagues will do the 
same.
  I thank the Presiding Officer.
  I yield the floor.
  The PRESIDING OFFICER. The President pro tempore.
  (The remarks of Mr. Hatch and Mr. Alexander pertaining to the 
introduction of S. 2334 are printed in today's Record under 
``Statements on Introduced Bills and Joint Resolutions.'')