[Congressional Record Volume 164, Number 17 (Wednesday, January 24, 2018)]
[Senate]
[Pages S485-S486]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                  Children's Health Insurance Program

  Mr. HATCH. Mr. President, earlier this week, the Senate voted to pass 
a continuing resolution to reopen the government. This came after weeks 
of acrimony and no shortage of hostility here on the Senate floor and 
elsewhere. While most of the recent debate has been focused on the 
future of immigration policy, another vitally important priority--and a 
bipartisan priority, no less--was also addressed this week.
  I am talking, of course, about the 6-year extension of the Children's 
Health Insurance Program, which was included in the funding bill. It is 
a shame, really, that this bipartisan accomplishment has, in some 
respects, been overlooked while more attention has been given to 
partisan squabbling over other divisive issues.
  Since its inception, CHIP has been a bipartisan program. In 1997, 
Senator Kennedy and I came together to create CHIP in order to provide 
health insurance to vulnerable children. It was a Republican-controlled 
Congress working with a Democratic President that brought this program 
into existence.
  The year before, that same Republican Congress and Democratic 
President worked together to produce another landmark welfare reform 
bill that sought to replace a culture of dependency with an emphasis on 
work. S-CHIP became a necessity for those families making the 
transition.
  Prior to the introduction of the original CHIP bill, I came across a 
number of families with parents who worked but still could not afford 
private coverage for their children. Yet they made too much to qualify 
for Medicaid. Senator Kennedy and I designed our bill to fill this gap 
and meet those needs.
  Today, the CHIP program provides health insurance for about 9 million 
needy children every year. While the program isn't perfectly designed--
though few programs are--it is widely considered to be one of the most 
efficient and cost-effective healthcare programs. For that reason, 
Members from both parties have been supportive of the program since the 
day it was signed into law.
  Last year, with an extension deadline approaching, Senator Wyden, the 
ranking member of the Finance Committee, and I went to work on drafting 
another bipartisan CHIP bill, one that would make needed improvements 
to the program and extend it for an additional 5 years. We were 
successful. We introduced our bill in September and, shortly 
thereafter, the Finance Committee marked it up and reported it by voice 
vote.
  We have been working to pass our bill since last September, and, 
thankfully, that time came earlier this week. When we voted to pass the 
CR, we also voted to successfully extend CHIP for 6 years. That is the 
longest CHIP extension in the history of this program.
  Other than that extra year of funding, the bill we passed was 
identical to the one Senator Wyden and I introduced last year. I know 
we have colleagues already talking about adding additional years, and I 
know a number of stakeholders would like to see that as well. I am 
definitely open to having a conversation with my colleagues on how we 
might move forward to support an additional 4 years of funding for 
CHIP.
  In my view, if we can work together to pass a bill adding 4 years to 
the 6 already in place, that would be simply fantastic, but for this 
moment, let us not overlook the success we have achieved this week. A 
6-year CHIP extension gives security and certainty to millions of 
American families and allows States to plan their budgets for several 
years into the future. That is a big deal. Let us keep that in mind as 
we look for ways to do more.
  I would like to thank Senator Wyden, my partner on the Finance 
Committee, for his efforts in developing this legislation. I would like 
to thank other members of the Senate Finance Committee who supported us 
all the way. Thank you to our distinguished majority leader and his 
team, as well as the leaders in the House who worked alongside us. I 
also thank the stakeholders across the country--the Governors, care 
providers, and of course the families who depend on CHIP for making 
their voices heard throughout this endeavor. I look forward to working 
with all of you going forward so we can make sure we do right by the 
children who benefit from CHIP.
  Now, Mr. President, I would like to turn to a related issue in the 
healthcare space. The Senate will soon vote on President Trump's 
nominee for Secretary of Health and Human Services. I can think of very 
few others--and I have only been here 42 years--but I can think of very 
few others as qualified to take the helm of this very large ship than 
Mr. Alex Azar.
  As Secretary of Health and Human Services, Mr. Azar would be 
responsible for trillions of dollars in spending, liabilities, and 
contracts that make up the backbone of our healthcare system.
  What is more, Health and Human Services is still in the process of 
off-ramping many of the poor decisions made throughout the 8 years of 
the Obama administration. Unfortunately, many of those policies, 
regulations, procedures, and practices remain in place, continuing to 
undermine the sustainability of programs like Medicare and Medicaid, 
and artificially propping up the so-called Affordable Care Act.
  The good news is, Mr. Azar brings with him nearly two decades of 
experience in the healthcare system, working in both the private and 
public sectors. Mr. Azar spent several years as a senior official at 
Health and Human Services, holding key positions overseeing Medicare 
Part D and Medicare Advantage. He also led Health and Human Service's 
responses to the anthrax victims shortly after 9/11, the SARS and 
monkeypox crises, Hurricane Katrina, and many others.
  Clearly, Mr. Azar has seen both the good and the bad at Health and 
Human Services and knows how to manage them. I don't think there is 
anyone here, even on the other side of the aisle, who would contest 
that. In fact, in the past, Mr. Azar has actually been confirmed twice. 
With experience both on the company side and the government side of 
healthcare, he is now only more experienced and knowledgeable.
  I think the broad exercise will serve him well, particularly at this 
critical time when the Health and Human Services Secretary will need to 
be intensely focused on the opioid epidemic and other major problems 
facing our country. No doubt all of these are reasons why we reported 
Mr. Azar out of the Finance Committee with a bipartisan vote. If we set 
aside the partisan and the preconceived notions some have about certain 
industries, Mr. Azar would likely get a near-unanimous vote.
  I hope at least some of our Democratic colleagues will vote to 
confirm him. I urge all of my colleagues to join me in doing so.
  I yield the floor.
  Ms. CANTWELL. Mr. President, today the Senate will vote on the 
nomination of Alex Azar, President Trump's nominee for Secretary of 
Health and Human Services. I join many of my colleagues in expressing 
concerns about this nominee.
  First, I believe Mr. Azar will accelerate the Trump administration 
and

[[Page S486]]

congressional Republicans' harmful agenda on Medicaid, which I view as 
nothing less than a war on Medicaid.
  Medicaid is a lifeline for millions of Americans and a smart 
healthcare and economic strategy for our country. Last year, I spent 
hours on the Senate floor presenting data and information to my 
colleagues showing why cutting and capping Medicaid is a very bad idea. 
I met with Medicaid patients, safety net hospitals, community health 
centers, and local elected officials in every corner of my State. They 
had a crystal-clear message for me: Cutting and capping Medicaid will 
be bad for patients, bad for the healthcare delivery system, bad for 
local economies, and bad for our State. They expressed a consensus view 
that capping Medicaid is not healthcare reform, nor is it innovation; 
it is simply a budget mechanism to throw people off of healthcare.
  Mr. Azar has stated that he favors a block grant or per-capita cap 
financing approach for Medicaid. He speaks highly of the current 
Centers for Medicare and Medicaid Services, CMS, Administrator and 
their troubling regulatory agenda for Medicaid. Mr. Azar has been a 
cheerleader for the partisan legislation we debated last year that 
would permanently eviscerate Medicaid. These bills, depending on each 
iteration, would take Medicaid coverage from 14 million Americans, 
sunset the successful Medicaid expansion, and eliminate up to one-third 
of Federal Medicaid investment over the next two decades, according to 
the Congressional Budget Office. I have every reason to believe that 
Mr. Azar would continue and accelerate the Trump administration's war 
on Medicaid.
  Second, I have no evidence to suggest that Mr. Azar will stop the 
Trump administration's track record of throwing needless chaos into the 
individual health insurance markets.
  There is bipartisan agreement that we need to make health insurance 
more affordable, particularly in the individual market, where about 7 
percent of Americans buy coverage; yet the Trump administration has 
rejected bipartisan consensus and moved us backwards. This 
administration has proposed to unleash ``junk insurance'' under the 
guise of association health plans, cancelled cost-sharing reduction 
payments, created roadblocks to insurance enrollment, and pursued 
backdoor schemes to rescind protections for people with preexisting 
conditions. I have every indication that Mr. Azar will continue this 
trajectory of higher costs, less coverage, and more uncertainty.
  I believe we can and must tackle rising healthcare costs by 
innovating in the delivery of healthcare, instead of simply capping 
programs and kicking people off coverage. To that end, I hope that Mr. 
Azar will advance true delivery system change in the Medicare Program, 
as he says he wants to, and engage with Senators of both parties to 
work on good ideas to bring more value and efficiency to our healthcare 
system.
  For these reasons, I will oppose Mr. Azar's confirmation to be 
Secretary of Health and Human Services.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mrs. Ernst). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. GRASSLEY. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.