[Congressional Record Volume 164, Number 17 (Wednesday, January 24, 2018)]
[Senate]
[Pages S492-S493]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Nomination of R.D. James
Mr. BARRASSO. Mr. President, I rise in support of the nomination of
R.D. James to serve as Assistant Secretary of the Army for Civil Works.
The Assistant Secretary establishes policy direction and provides
leadership for the Civil Works programs at the U.S. Army Corps of
Engineers.
In this position, Mr. James will play a central role ensuring the
navigability of America's ports and inland waterways. He will oversee
the Army Corps' flood and storm risk management and responses to
emergencies like the hurricanes we saw in Florida and Texas this past
fall.
Mr. James will also play a central role in modernizing America's
aging water infrastructure. This month, the Committee on Environment
and Public Works, which I chair, has held two hearings on the needs and
challenges facing America's water infrastructure. These hearings are
important steps as the committee works toward a new Water Resources
Development Act, which will be reauthorized this year.
It is critical to have Mr. James confirmed so he can partner with us
in this important process. I look forward to working with Mr. James on
projects and issues that are important to my home State of Wyoming. He
has already committed to me that he will work to find a permanent
solution to preventing ice-jam floods, like those that caused the Big
Horn River to flood the city of Worland, WY.
There is no reason this confirmation should be delayed any further.
His nomination was unanimously approved by voice vote in both the
Senate Armed Services Committee and the Environment and Public Works
Committee. Mr. James is well qualified for this position.
He has served as a civil engineer member of the Mississippi River
Commission since 1981. That is 37 years. He was appointed to that
position by both Democratic and Republican Presidents. Mr. James is
also an accomplished farmer and businessman. He is experienced,
qualified, and ready to start.
It is time for the Senate to confirm his nomination.
I yield the floor.
The PRESIDING OFFICER (Mr. Cotton). The Senator from Missouri.
Mr. BLUNT. Mr. President, I wish to thank Senator Barrasso and
Senator Carper for their bipartisan work to get this nomination to the
floor.
I have known R.D. James for a long time. He understands the projects
involved, the work involved, and the challenges involved. He is a civil
engineer and brings a lot of experience to this job.
The work of Senator Carper and Senator Barrasso is deeply
appreciated. I think it will be appreciated by the Corps and the
Department of Defense.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Mr. President, the Senate has been running a bit behind. I
wanted to accommodate my Republican colleagues.
I ask unanimous consent that the vote be moved to 2:20 p.m., rather
than 2:15 p.m., on Mr. Azar.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WYDEN. Mr. President, a year ago, the President stormed into
office promising better, cheaper healthcare for everyone. He said he
would bring prescription drug prices down because, in his words, drug
companies were ``getting away with murder.''
So as we move to this vote, as the senior Democrat on the Finance
Committee, I wanted to make sure we took stock after year 1. The Trump
record on healthcare is worse than your garden variety case of a
President failing to live up to his campaign promises. This President
has surely hurt the people he promised to help. Very shortly, the
Senate will vote on the nomination of Alex Azar to be the Secretary of
Health and Human Services. In this position, he would be the captain of
the President's healthcare team. So in my view, this debate is about a
lot more than Mr. Azar's resume. It is a referendum on a year of
healthcare failure, particularly on prescription drug costs, and it is
a referendum on what I consider to be a healthcare agenda of
discrimination.
I am going to begin with the skyrocketing prescription drug prices
because they are a gut punch for millions of Americans each time they
step up to the pharmacy window. Few promises the President made with
respect to healthcare resonated more than his promise to bring down
prescription drug prices, but now, a year later, he has chosen Alex
Azar, a drug company executive with a documented history of raising
drug prices.
From 2012 until last year, he was the head of Eli Lilly's American
subsidiary, Lilly USA. He chaired its U.S. pricing, reimbursement, and
access steering committee, which gave him a major role over drug price
increases for every product Lilly marketed in America. On Mr. Azar's
watch, Lilly more than doubled the prices of drugs used to treat
diabetes, osteoporosis, heart disease, and ADHD. And these are only
some of the drugs under his purview.
He told the Finance Committee staff that he had never once approved a
decrease in the price of a drug at Lilly. Mr. Azar said: That is just
how the system works. Prices always go up. I would say that Mr. Azar
may have had his facts straight about the system, but that doesn't make
it right. Mr. Azar was a part of this broken system, and despite the
cheerful overtures that he has made to Senators on both sides of the
aisle over the last few weeks about how he wants to work on the issue,
he has not offered even a single concrete example of how he would
actually change the system he said is broken. He will not give us an
example of how he would change it to make it better.
Members of this body, Democrats and Republicans, have come forward
with specifics about what they would do to help those Americans getting
clobbered at the prescription drug windows across the land. We have
colleagues who are for drug importation. We have colleagues who are for
more negotiating power for Medicare. We have colleagues who understand
the challenge with the pharmaceutical benefit managers, where there is
so little transparency. We asked Mr. Azar repeatedly for examples, but
all he had to say about this system that was so broken is that he would
be ``open'' to ideas.
As important as that is, there is a whole lot more for Senators to
reflect on as they think about this vote. After a year in office, the
Trump administration is steadily and relentlessly enacting a healthcare
agenda of discrimination--discrimination against those with preexisting
conditions, discrimination against women, discrimination against LGBTQ
Americans, discrimination against those struggling to get ahead. The
question up for debate today ought to be whether or not this nominee to
head this critical office of healthcare policy is going to end that
discrimination.
Colleagues, as you think about this vote, all I can tell you is that
when you review the record--in the face of an administration moving
relentlessly to promote discrimination in healthcare--there is not a
shred of evidence that Mr. Azar is going to try to stop it, reform it,
or in any way try to make sure that those Americans--all of them--get a
fair shake.
From day one, in addition to this pattern of discrimination, the
administration has been on a campaign of sabotage against the
Affordable Care Act and the private health insurance markets. They cut
the open enrollment period in half. They slashed the advertising
budgets. They made it harder for people to sign up in person. That is
the major reason why the number of Americans without insurance coverage
increased by more than 3 million last year. Our friends and our
neighbors are one sudden illness or injury away from the nightmare of
personal bankruptcy
[[Page S493]]
as a result of the healthcare policies this administration has pursued
and cheered.
Even worse--and I touched on this yesterday--the administration is
bringing back to life junk insurance, letting fraudsters get back into
the insurance business with health plans that aren't worth the paper
they are printed on. It takes me back to my days as codirector of the
Oregon Gray Panthers. Back then, I met older people who sometimes had
15 or even 20 private insurance policies to supplement their Medicare.
Those policies were junk. Some of them were just out-and-out scams.
So the Congress passed a law. I was proud to be a part of that
bipartisan coalition to change it to protect older people. The law
worked. We drained the swamp when it came to those fraudsters ripping
off seniors. Then 8 years ago, some of the key parts of the Affordable
Care Act put consumer protections in place so that nobody of working
age would get ripped off with junk insurance. It is those policies and
those people that the Trump administration would let the fraudsters
exploit because the Trump administration wants to undo those
protections against fraudsters who are ripping off those of working
age.
They have already taken steps on what are called Association Health
Plans. Next up are short-term plans that are likely to be even worse.
What this comes down to is the Trump administration's tradition of
turning back the clock on healthcare and allowing junk insurance to
discriminate over preexisting conditions and age. This is going to be a
big test for Mr. Azar if he is confirmed.
I would just ask my colleagues: We will see if Mr. Azar is going to
look the other way and allow scam artists to peddle junk coverage, or
is he going to protect Americans who need care and health coverage they
can count on?
There is also an array of discriminatory policies with respect to
women's health. They tried to take away guaranteed no-cost access to
contraception, essentially taxing women for their gender. Fortunately,
that move has been held up in the courts. They overturned longstanding
protections dealing with States and family planning--what amounts to an
attack on a woman's right to see the doctor of her choosing and an
attack on Planned Parenthood.
They are broadening exceptions that give employers and universities
say over what healthcare women can access. When asked on these issues
during his nomination hearing, Mr. Azar said: ``We have to balance, of
course, a woman's choice of insurance that she would want with the
conscience of employers and others.'' My counter to that is absolutely
not. There is no balancing women's choices against anything. In
America, a woman's choice of healthcare ought to be her choice and
nobody else's.
In much the same way as going after women's healthcare, this
administration is permitting discrimination against LGBTQ Americans in
need of healthcare.
Then, finally, there is Medicaid. In just the last few weeks, the
administration has been giving States a green light to slap punitive,
new requirements and limitations on Americans covered by State Medicaid
Programs. This action by Health and Human Services goes after people
across the country who are working on an economic tightrope. They are
people who are taking care of kids or elderly parents or who are
struggling with a chronic condition.
These punitive new requirements aren't going to improve anybody's
healthcare. As the first waivers are coming out from the Department of
Health and Human Services, the public is learning some disturbing
details. In Kentucky, the State is introducing what sounds a lot like a
literacy test for healthcare. Nobody in this body should have to be
reminded that the history of literacy tests is an ugly and
discriminatory one. That is the wrong direction to take on healthcare.
I close by saying that the record after 1 year shows that the Trump
agenda on healthcare isn't about improving care for all Americans. The
Trump agenda on healthcare is about discrimination and ideology.
So the question, as my colleagues come over to this floor to cast
their votes, is whether the Trump administration is going to be allowed
to continue to turn back the clock and advance discrimination. Given
the opportunity to demonstrate that he would actually lead the
Department in a new direction, he came up short. So I will not support
his nomination.
Through my time in public service, back from those early days working
with the senior citizens, I have always said: Healthcare has to be a
bipartisan issue. To do healthcare right, you have to find a way to
bring people together.
If Mr. Azar is confirmed, I hope he will make his stated willingness
to listen to ideas a reality and begin to work closely with colleagues
on both sides of the aisle to actually make some changes in these key
areas I have described. From policies where we just sit on the
sidelines with our skyrocketing drug prices, to sitting out in the
fight against opioids, to allowing discrimination against women, to
rolling back the protections on Medicaid--these are issues that go
right to the heart of the health and safety of millions of Americans.
Mr. Azar certainly does not carry the ethical baggage of his
predecessor, Tom Price. The question for the Senate this afternoon--
after we have asked him again and again and again to give any examples
of how he would break with these harmful policies of the last year, we
have come up short. So I regret to say to the Senate that I am going to
oppose this nomination.
I yield the floor.
The PRESIDING OFFICER. Without objection, all time is yielded back.
Under the previous order, all postcloture time has expired.
The question is, Will the Senate advise and consent to the Azar
nomination?
Mr. BURR. I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There appears to be a sufficient second.
The clerk will call the roll.
The bill clerk called the roll.
Mr. CORNYN. The following Senators are necessarily absent: the
Senator from Tennessee (Mr. Corker) and the Senator from Arizona (Mr.
McCain).
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 55, nays 43, as follows:
[Rollcall Vote No. 21 Ex.]
YEAS--55
Alexander
Barrasso
Blunt
Boozman
Burr
Capito
Carper
Cassidy
Cochran
Collins
Coons
Cornyn
Cotton
Crapo
Cruz
Daines
Donnelly
Enzi
Ernst
Fischer
Flake
Gardner
Graham
Grassley
Hatch
Heitkamp
Heller
Hoeven
Inhofe
Isakson
Johnson
Jones
Kennedy
King
Lankford
Lee
Manchin
McConnell
Moran
Murkowski
Perdue
Portman
Risch
Roberts
Rounds
Rubio
Sasse
Scott
Shelby
Sullivan
Thune
Tillis
Toomey
Wicker
Young
NAYS--43
Baldwin
Bennet
Blumenthal
Booker
Brown
Cantwell
Cardin
Casey
Cortez Masto
Duckworth
Durbin
Feinstein
Gillibrand
Harris
Hassan
Heinrich
Hirono
Kaine
Klobuchar
Leahy
Markey
McCaskill
Menendez
Merkley
Murphy
Murray
Nelson
Paul
Peters
Reed
Sanders
Schatz
Schumer
Shaheen
Smith
Stabenow
Tester
Udall
Van Hollen
Warner
Warren
Whitehouse
Wyden
NOT VOTING--2
Corker
McCain
The nomination was confirmed.
The PRESIDING OFFICER. Under the previous order, the motion to
reconsider is considered made and laid upon the table and the President
will be immediately notified of the Senate's action.
____________________