[Congressional Record Volume 164, Number 25 (Thursday, February 8, 2018)]
[Senate]
[Pages S794-S799]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILD PROTECTION IMPROVEMENTS ACT OF 2017
The ACTING PRESIDENT pro tempore. Under the previous order, the
Senate will resume consideration of the House message to accompany H.R.
695, which the clerk will report.
The senior assistant legislative clerk read as follows:
House message to accompany H.R. 695, a bill to amend the
National Child Protection Act of 1993 to establish a national
criminal history background check system and criminal history
review program for certain individuals who, related to their
employment, have access to children, the elderly, or
individuals with disabilities, and for other purposes.
Pending:
McConnell motion to concur in the amendment of the House to
the amendment of the Senate to the bill.
McConnell motion to refer the message of the House on the
bill to the Committee on Appropriations, with instructions,
McConnell amendment No. 1922, to change the enactment date.
McConnell amendment No. 1923 (to (the instructions)
amendment No. 1922), of a perfecting nature.
McConnell amendment No. 1924 (to amendment No. 1923), of a
perfecting nature.
The ACTING PRESIDENT pro tempore. Under the previous order, the time
until 11:30 a.m. will be equally divided between the two leaders or
their designees.
Mr. McCONNELL. Mr. President, I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The senior assistant legislative clerk proceeded to call the roll.
Mr. SCHUMER. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Recognition of the Minority Leader
The Democratic leader is recognized.
Budget Agreement
Mr. SCHUMER. Mr. President, yesterday, after months of painstaking
negotiations, the Republican leader and I reached a 2-year budget deal.
Not only will it end the series of fiscal crises that have gridlocked
this body, it will also deliver large investments in our military and
robust funding of middle-class programs. It will also give a
significant boost to our Nation's healthcare and provide long-overdue
relief to disaster-stricken parts of our country.
As I said yesterday, it doesn't include everything that Democrats
want nor everything that Republicans want, but it is a good deal for
the American people, and it is a strong signal that we can break the
gridlock that has overwhelmed this body and work together for the good
of the country.
Let me run through a few of the benefits this agreement will provide.
Our military has suffered from the uncertainty of endless short-term
spending bills. This budget deal puts that to an end. It gives the
military a significant boost in support and allows the Pentagon to make
long-term decisions about its budget. It is the right thing to do.
I want to credit two people--first, my dear friend Senator McCain. He
talked to me repeatedly, even when he was ill, about the need for
funding defense. He also talked about the need for doing immigration
and tried to make them go hand in hand. Senator McCain has been our
leader in this Chamber on both sides of the aisle in terms of making
sure defense is funded, and I know that today he is proud of what we
are doing for the military.
I would also like to thank Secretary Mattis. He visited me
repeatedly. He is a Cabinet Secretary who seems to be doing his job,
rather than focusing on an ideological path that divides people. He
worked hard for this and deserves a great deal of credit.
We Democrats have always argued that we want to fund our military and
our middle-class programs. We need good help on both. A mother whose
child has died from opioid addiction, a veteran who is waiting in line
to get help, college students with great debt on their shoulders,
pensioners whose pensions might be greatly diminished need help too. To
say that our military needs help to the exclusion of all of these other
worthy causes is not fair to them and not good for America. I have
always argued that we can do both, and this budget shows we can. We can
do both--fund the military and help fund the middle class. For those
naysayers who said it could not be done, it sure can with this budget.
I am proud of what it does for the middle class.
For a decade--we all know this; we all talk about it--our middle
class has suffered from a needless and self-imposed austerity in
Congress that has limited investments in jobs and education,
infrastructure, scientific research, and more. This deal puts that to
an end as well. For those who say we cannot do both, we can. I am proud
of this budget, because it does. Let me go into a few specifics.
There are billions of dollars of support for childcare, for helping
middle-class families shoulder the very heavy burden of childcare. They
need to take care of their kids in a way that they can have confidence
when both parents
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work, and so often that happens. In single-parent families, that
happens so often.
What about college affordability? The debt burden on the shoulders of
those who have just gotten out of college and graduate school is huge.
We are focusing on providing help here.
In this budget, we focus on police officers, teachers, and
firefighters.
What about infrastructure? Our infrastructure is crumbling throughout
America. Much of it was built 50 or even 100 years ago--roads and
bridges and water and wastewater. We need to help those, and then we
need new infrastructure.
How about broadband to rural areas and inner cities that are not
getting it? Broadband is a necessity today. Kids cannot learn. Often,
you cannot hold a job unless you can get broadband at home. In large
parts of America, particularly rural parts, you cannot get it. We
provide help, and rural America is very happy that we are doing this.
We provide billions to rebuild and improve veterans hospitals and
clinics so that when our brave soldiers come home, bearing the scars of
war, their country serves them just as well as they served us.
I mentioned opioids earlier. There is $6 billion, finally, to guard
against the opioid-mental health crisis. The opioid crisis is
widespread. The President has set up a whole bunch of commissions and
given a whole bunch of speeches, but he hasn't funded it. We in this
body have. We Democrats have led the charge. We have so many Members,
like Senators Shaheen and Manchin; we have so many Senators, like
Senators Heitkamp and Baldwin; we have so many Senators, like
McCaskill, Donnelly, and Hassan, who have been talking about the opioid
crisis for a long time. Their hard work has now produced the dollars
that will give the treatment that so many who are addicted need and the
infrastructure to prevent these bad drugs, particularly fentanyl, from
coming into this country.
My guest at the State of the Union was a woman named Stephanie
Keegan, from Putnam County. She was the brave mother of a veteran who
got hooked on opioids in the depths of PTSD. He waited 16 months for
his first appointment at the VA, but he died of an overdose 2 weeks
before he could get treatment. Stephanie Keegan has been fighting for
this. She is a brave, strong woman who is lighting the candle. She was
my guest at the State of the Union, and she is a happy woman this
morning because all of her hard work after her son's passing is coming
to fruition.
Of course, there is so much more in this proposal that we can all be
proud of as Americans, in that we will not be neglecting people who
have been neglected for so long: support for community health centers,
which serve over 25 million Americans; a full decade of funding for
CHIP, or the Children's Health Insurance Program; an effort to lower
prescription drug costs for millions of American seniors who are caught
in the Medicare Part D doughnut hole; disaster relief and recovery
funding, not just for Texas, Louisiana, and Florida--important as they
may be and are--but for Puerto Rico and the U.S. Virgin Islands and the
Western States; and a special select committee--we don't do this
often--that will be empowered and under a deadline to deliver a
legislative fix to the pension issue by the end of the year. It is this
issue which has plagued so many working and middle-class Americans in
many States, people who have paid into their pensions day after day,
week after week, month after month, and who are now finding those
pensions vanishing. We should provide relief for them just as we should
provide relief for others. This commission is a strong, bright light
that will focus on this issue and will create a path to a solution.
I salute so many of my colleagues who have worked so hard on so many
of these pieces: Senators Murray, Wyden, and Tester, on healthcare;
Senators Brown, Casey, Stabenow, Manchin, Heitkamp, Donnelly,
Klobuchar, Baldwin, and Smith, on the pension's piece; Senator Nelson,
on the disaster package. Senator Leahy, the ranking member of
Appropriations, has done a great job on the whole thing. A lot of
credit is due to each of them and to so many more of our Members
because the final product is something that will benefit so many
Americans over the next decade. Senator McCaskill was also very much
involved in the pension issue, as well as many others.
I hope this budget agreement will pass the Senate in large numbers on
both sides of the aisle. It will be easy to say: Well, I didn't like
this, and I didn't like that. Yet this is the time to come together.
This is the time to stand up for our soldiers, our middle class, and
those aspiring to the middle class. I hope we will get a large
bipartisan vote.
To that point, I have some pointed words for some in the House's
Freedom Caucus--the hard right--who are starting to squawk about this
budget deal. They say it raises the deficit. They just voted and
cheered a bill that would add $1.5 trillion to the deficit in the form
of tax breaks for mammoth corporations. They were willing to increase
the deficit on the defense side of the budget, but all of a sudden,
when it comes to our schools or our roads or our scientific research:
Oh, we can't do it because of the deficit. It is blatantly hypocritical
to ignore the deficit when it favors corporate America but raise the
alarm when it comes to helping our veterans, our students, and those
addicted to opioids. That is selective enforcement. That doesn't fly.
There is a lot of sophistry going on. Oh, when we reduce taxes, we
will not have a deficit because it will keep the economy growing. Does
anyone doubt that education keeps the economy growing, that scientific
research keeps the economy growing, that building infrastructure keeps
the economy growing? There is a lot of hokum flying around here that
only when you cut taxes for big corporations do you grow the economy.
What is good for the goose is good for the gander, and I think
Americans are tired of the hypocrisy on the hard right, which treats a
$1.5 trillion hole in the deficit by cutting corporate taxes with
cheers--primarily taxes on the wealthy--and then says you cannot spend
money on those who need relief from the student debt loans they have or
who need help for healthcare or food stamps. It is utter, sheer
hypocrisy.
Let this budget go forward through both Chambers and go to the
President's desk, where President Trump seems willing and ready to
sign. President Trump was not involved in this process. He was not
constructive when he spoke and tweeted. He asked for a shutdown. I
think, in this body--and I hope my colleagues on the other side of the
aisle are learning this--oftentimes, we can get a lot more done when
working with one another and letting the White House just sit on the
sidelines, because you do not know what its positions are. As I once
said, negotiating with the President is like negotiating with Jell-O,
and, oftentimes, his positions are just so far over to one side of the
political spectrum--Koch brothers-type positions--that they would never
pass. So this is a good motto.
Immigration
Mr. President, now I have one more word on immigration.
Based on my continued conversations with the Republican leader, once
we pass this budget agreement, we are ready to proceed to a neutral
bill--a shell bill--on immigration next week. The Republican leader has
guaranteed an amendment process, fair on all sides, where we will
alternate amendments. That means some of the people who are on the very
conservative side will get amendments and some on the very liberal side
will, but so will there be an opportunity for a bipartisan compromise
that will focus on the Dreamers and border security that will have a
real chance of getting 60 votes. We should all be working hard to get
that done in this Chamber.
I would say to my friends in America who care about the Dreamers to
please let their Senators know, particularly those Senators who have
not committed to helping the Dreamers, how important this is.
Next week will be one of the most vital weeks when we will be able to
deal with the Dreamer issue in a fair, compassionate way. It has been
swept under the rug for too long, but because of the agreement the
leader and I came to a few weeks ago--and he has confirmed to keep his
commitment--we will be able to deal with it. The House should be able
to deal with it as well.
What Leader McConnell and I have agreed to should be something that
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Speaker Ryan agrees to. To just put President Trump's bill on the floor
means no immigration bill and no help for the Dreamers. We all know
that. It will lose Republican votes as well as Democratic votes. It
will not pass in the House.
I say to Speaker Ryan: Allow a fair and open process to debate
Dreamers on the floor of the House, just as we are allowing in the
Senate.
Leader Pelosi shouldn't have to stand and speak for 8 hours--I
respect her for doing it--just to secure a vote on an issue as
compelling and pressing as the Dreamers. What Leader Pelosi is asking
for is the same thing that we have here in the Senate--no more, no
less--a vote and an open process. That is undeniably fair. I hope
Speaker Ryan will relent and promise a vote. There is an appetite on
both sides and in both Chambers to get this done--both to help the
Dreamers and do border security.
In the Senate, I know that everyone on the Democratic side and many
on the Republican side are working hard to find a bill that can protect
Dreamers and provide border security that can pass next week. We know
this is a difficult task, and we know immigration is one of the more
volatile issues in America, but we have to do it for the good of this
country. The budget was a difficult process, but we came to an
agreement. Let's do the same on immigration with a bipartisan
agreement, where each side gives some, and we can all be proud that we
got it done. The same effort and spirit that forged the budget deal
should carry forward to the issue of the Dreamers. Let's get it done
next week.
I yield the floor.
The PRESIDING OFFICER (Mr. Sullivan). The Senator from Indiana.
Mr. YOUNG. Mr. President, I ask unanimous consent to be recognized
for up to 10 minutes.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. YOUNG. Mr. President, I would like to take a moment to speak in
support of two pieces of legislation I introduced that are included in
the continuing resolution we will vote on today: the Social Impact
Partnerships to Pay for Results Act and the Modernizing the Interstate
Placement of Children in Foster Care Act. Both of these bills are very
important to Hoosiers, and I am glad we will finally see them become
law after 6 years of working in a bipartisan way to get them across the
finish line.
Let me tell you why these two measures are so important to Hoosiers
and really to all Americans. The Social Impact Partnerships to Pay for
Results Act empowers our public and private sectors to implement
evidence-based social and public health interventions to address some
of our Nation's most pressing social challenges.
America has a celebrated and vibrant civil society. We have a history
of not turning first to government to solve some of our thorniest
social and public health challenges but instead turning to our
neighbors, turning to our local communities, perhaps our local not-for-
profit groups or our community heroes, and we discover that oftentimes
they are better situated to address these thorny challenges than are
government programs. That is not to suggest in the slightest that
government doesn't have a very important role in addressing these broad
social challenges. Government can indeed make a difference but so can
these other organizations.
We have a growing evidence base without any partisan tinge to it. It
is broadly agreed that we have a growing evidence base of those things
that are working to address challenges such as homelessness, asthma in
low-income communities, and getting the long-term unemployed back into
the workforce. Name the social ill, and there is likely a not-for-
profit group or even a for-profit group in each of our individual
States which is making a meaningful difference on this front.
The challenge is, how do we scale up these evidence-based
interventions in an era of scarce resources? Well, because social
impact partnerships are focused on achieving results, taxpayer money is
only paid out when desired outcomes are met. Government payments are
made possible because when we really help somebody, when we really are
able to help them achieve their goals and turn around their lives, that
frees up government money. So we use those avoided costs and future
government savings to pay back those who invest in scaling up things
that really work to improve lives.
Let me give an example of what has also been called pay for success.
There is a service in Indianapolis that connects registered nurses with
low-income pregnant women. The Nurse-Family Partnership helps ensure
both mom and baby are healthy throughout the pregnancy and through the
infant's life. They hit specific metrics that save the Federal
Government money. Under this legislation, a philanthropic organization
like Indiana's Lilly Endowment could invest in the Nurse-Family
Partnership to scale up their work. As long as the metrics continue to
be met, as long as success is achieved, the investor is paid a return
out of those future government savings.
It makes a whole lot of sense, which is why it passed unanimously out
of the House of Representatives previously and why I believe it will be
passed into law after passing this Chamber and be signed into law by
the President in the coming days.
Social impact partnerships address our moral responsibilities to
ensure that social programs actually improve recipients' lives and do
so in a fiscally prudent manner. They also respond to the imperative of
improving our economic health by harnessing the capabilities of every
able-bodied citizen.
We ought to be treating every American like they are an asset to be
realized, not a liability to be written off, not a consumer of programs
but somebody with real potential. We want every American to achieve
their full human potential.
To recap, who is going to benefit? Well, the recipients of these
services, through the public-private partnership, will benefit--the
least among us--taxpayers will benefit, and every American will benefit
as our communities become strengthened, as more enter the workforce, as
public health is improved, and so forth.
The next bipartisan measure, which I expect to get across the finish
line today, is the Modernizing the Interstate Placement of Children in
Foster Care Act. This bill expedites the time it takes to place
children into loving homes, and we will see why it is so important and
so timely that we pass this legislation today as well.
Thousands of children in my State of Indiana have lost loving parents
to opioid addiction. I have seen it up close and personal. I used to
represent Scott County, IN. This was ground zero in our State for the
opioid epidemic. It made national news, not in a good way. So many good
people have been adversely impacted in this community, and I know there
are communities like this across the country that are being impacted to
varying degrees by the opioid crisis. I fear that if we do nothing, we
will lose thousands in the next generation as well.
Modernizing the outdated interstate child placement process is one of
a number of proposals that are urgently needed. This legislation will
incentivize States to connect to an electronic interstate case-
processing system that has already achieved substantial reductions in
the time it takes to place these children into homes.
Frankly, before I dove into this, I just assumed that our foster care
system was digitized; that it had found its way into the 21st century;
that we weren't using paper files that were being mailed back and forth
several times to process adoptions, especially under these very trying
circumstances, but that is not the case. We need to make sure a child
will spend less time being shuffled from foster home to foster home,
and this legislation will achieve that.
We need to make sure a situation where children are taken in and out
of school without a set routine is put to an end. For children caught
up in a system struggling to meet community needs, we should do
everything possible to get them immediately placed in a setting that is
best for them, regardless of State boundary lines.
In summary, these bipartisan, bicameral bills were developed over 6
years, beginning during my time in the House of Representatives. I
consulted with key stakeholders to make sure there would be broad
support, and
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there is. I have had countless discussions with Hoosiers and other
experts about how to tackle these challenges.
The continuing resolution we will vote on today isn't perfect. I
remain concerned about our spending levels, and I maintain that we need
to take long-term action for the fiscal health of our country. However,
with our commitment to our military and the inclusion of these two
important pieces of legislation, I will be voting for the CR for the
good of all Hoosier children, families, and communities.
I yield the floor.
The PRESIDING OFFICER. The Senator from Massachusetts.
Mr. MARKEY. Mr. President, I ask unanimous consent that I be
recognized to speak for up to 10 minutes followed by Senator Cardin for
up to 10 minutes.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
DACA
Mr. MARKEY. Mr. President, I rise to speak about the need to protect
our Dreamers from deportation. When we talk about Dreamers, we are
talking about immigrants who came to this country as children. We are
talking about immigrants whose parents brought them here when they were
young to give them a better chance than they had in their own
countries. We are talking about young immigrants who, when they were
children, had no choice in the decision to come to the United States.
These Dreamers know no other home than these United States. Many of
them have spent their lives in limbo, identifying as Americans but
lacking legal status and under the constant threat of being sent back
to countries that are completely foreign to them.
In 2012, President Obama took steps to protect some of these Dreamers
from deportation. Through an Executive order, he established the
program known as DACA or the Deferred Action for Childhood Arrivals
Program. DACA created security and opportunity for hundreds of
thousands of young Dreamers, allowing them to live and work in our
great Nation without the threat of deportation. So what DACA really
stands for is ``Deserving a Chance in America,'' DACA, and a protection
for these innocent young people who deserve a shot at the American
dream.
I would like to take a moment to speak about one of these
Massachusetts Dreamers who benefited from DACA. Her name is Estefany.
She came to the United States at 9 years of age to escape violence in
El Salvador. She was brought here by her grandmother, along with her
two sisters and a baby cousin. The journey took 22 days. It was
arduous. Estefany was so scared at one point she asked to be left
behind. When she finally got to the United States, she found it
difficult to adjust to this whole new world, but Estefany was overjoyed
to be reunited with her mother, who had come to the United States a few
years before the rest of the family was able to come.
Estefany was grateful for the opportunity she was given and did not
want to squander it. She wanted to succeed in school and live up to her
mother's sacrifice. Estefany, who only spoke Spanish when she arrived,
struggled with elementary school and tried to do her homework every
night. Working as hard as she could, in 2 years she was moved on from
her English as a Second Language class. Her hard work paid off in even
greater dividends when she was accepted into the prestigious Boston
Latin Academy for high school.
Her work ethic and desire to deserve her family's sacrifices were
what motivated Estefany and got her through the many hardships that
come with being undocumented--fear, uncertainty, anxiety. When Estefany
began her college application process, she fully understood, for the
first time, what it meant to be undocumented.
Although she wanted to go to college and have a career, she was
afraid to tell her guidance counselor and her teachers of her fears
about her legal status. Once Estefany opened up to them, she confronted
applying and attending college the same way she had always faced up to
the other struggles in her life--with strength, courage, and
perseverance. She fought the battle that many aspiring college students
wage--figuring out how to pay for it. It wasn't easy. As she researched
and applied for scholarships, she found out that most were for citizens
only. Because of scholarships provided by immigrant support
organizations like the wonderful Massachusetts Immigrant and Refugee
Advocacy Coalition, MIRA, Estefany is now attending the University of
Massachusetts in Boston, where she is pursuing a degree in
international relations and a minor in public policy.
So it sounds like a happy ending, but, sadly, it is not. On
Estefany's first day as a freshman at UMass Boston, President Trump
repealed DACA. He callously terminated the program, with no guidance on
what should be done next for these young Dreamers. That heartless
action by the President left Estefany unable to focus on school. She no
longer had any certainty about her future here in the United States and
at UMass Boston. As Estefany put it, ``After so many tears and
sleepless nights, it felt like all my hard work was being thrown
away.''
Estefany is a fighter, and she is not giving up on her college
education or career. I know she will succeed if she is just given the
chance because she, like so many other Dreamers, deserves that chance.
Over the 5 years that DACA was in effect, the program protected some
800,000 Dreamers, nearly 8,000 in Massachusetts. These are young people
like Estefany who study, who serve, who work, and who live next door to
us every single day. They are our friends, our neighbors, and our loved
ones. They are not ``too lazy.'' They are not ``bad hombres.'' They are
some of the best and brightest in our country.
Now, because of President Trump's unconscionable decision to end
DACA, Estefany and so many young people like her are living in darkness
again. It is heartbreaking to watch this administration strip
protections away from people who are Americans in every way that should
matter. Leaving them to live under a threat of deportation is
unconscionable.
We should not abandon these young people whom we urged to come out of
the shadows. We should not abandon the larger community of Dreamers who
have no other home than the United States. The American people
understand this. In January, a poll found that 87 percent of Americans
favor allowing immigrants who were brought to the United States
illegally as children to stay here--87 percent; nearly all Americans
are with our Dreamers.
You would think that extending these protections would be a no-
brainer for the Republicans. Right here, right now, we could pass a
bill to protect these young immigrants, but, instead, the Republicans
have decided to use the Dreamers as a bargaining chip in budget
negotiations. They hope that by leveraging the lives and futures of
Dreamers, they will get their laundry list of hard-liner immigration
demands.
I am so glad that Senator McConnell has agreed with Senator Schumer
that we are going to open up a debate here on the floor of the U.S.
Senate. We are going to try to find a way to resolve this issue,
although there is no guarantee that President Trump will, in fact,
agree with any resolution here. There is no guarantee that the tea
party Freedom Caucus Republicans in the House of Representatives will
agree with any understanding that is reached here on a bipartisan
basis, if we can reach one on the floor of the U.S. Senate.
I just think, for better or worse, the Dreamers should know that we
are going to continue to fight for them and that we are going to
continue to work toward creating a pathway for them to be able to live
in our country without fear. I think that is going to be the signature
moment we can create for our country this year. Yes, we have a budget
agreement, but we have so much more work to do to help these young
people who will be great Americans once we create a path to citizenship
for them.
At this point, I yield the floor.
The PRESIDING OFFICER. The Senator from Maryland.
Mr. CARDIN. Mr. President, first, I want to thank Senator Markey and
concur in his comments in regard to the Dreamers. Yes, we are pleased
that we have a bipartisan agreement today. I am still in the process of
reading all the details before making a final judgment, but it is
certainly good news that the Democrats and Republicans--
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the leadership--have come together in an agreement.
I join Senator Markey and am pleased that the majority leader is
going to bring before the floor of the Senate in a fair manner next
week the immigration issue to protect Dreamers. I would also add that
those in temporary protective status, TPS, should also be considered.
We have a process, and I hope that the spirit that we have seen on
the budget agreement will continue next week as the Senate works, as it
should, in a bipartisan manner to protect the Dreamers and do what is
right. I also want to acknowledge that there is no such commitment from
the Republican leadership in the House. I join with Leader Pelosi in
urging Speaker Ryan to set up a similar process in the House so that we
can get a bill to the President and signed into law to protect the
Dreamers. The President created this problem by putting a date on their
backs, and it is our responsibility to respond in a timely way. I am
glad to see that the Senate is prepared to take action.
Prudent Layperson Standard
Mr. President, I took this time because I want to talk about one
specific provision in healthcare that was passed by Congress in the
nineties, but let me just preface that by saying that in this budget
agreement, I am pleased to see there are bipartisan agreements on
advancing healthcare in America. A bill that I have worked on since we
imposed the therapy caps way back in the nineties, which made no sense
at all, will finally correct that mistake permanently and allow those
who are in need of the most severe therapy services--those who are
stroke victims or in similar situations--to be able to get that care
without a cap as to the amount of services they need.
I am also pleased to see that we are going to be dealing with
telemedicine--an issue I have worked on and many Members have worked
on--improving dialysis treatment. Some of the issues we have all worked
on include community health centers, the 10-year extension of the
Children's Health Insurance Program, and rural healthcare. There are a
lot of good things in this bipartisan agreement to advance healthcare,
and I am pleased about them.
I just want to remind my colleagues that if we are successful in
getting that enacted into law, we still have to make sure it is
implemented in the manner in which we intended. I give as an example
the prudent layperson standard on emergency medical treatment. I was
involved in that process in the 1990s. The reason this came to our
attention is that insurance practices in the 1990s were such that it
was not unusual for an insurance company to deny payment for emergency
services. An individual would have the classic symptoms, for example,
of a heart attack--the pain, the sweating--and then did what a prudent
layperson would do, which is go to the nearest emergency room to get
treatment. Well, after the examination was complete, if they found out
the person did not have a heart attack, the person would be discharged
from the hospital and go home. A few days later they would get the bill
for that visit and then almost have a heart attack when the insurance
company would not pay the bill. We recognized that as not being right,
so we took action to change that.
In response to these dangerous and unfair requirements, Maryland
enacted the prudent layperson standard in 1992. If it was prudent to go
to the emergency room for care, the insurance company had to reimburse
it. Later, in 1997, I led the national effort to extend the prudent
layperson standard to all Medicare plans and Medicaid managed care
plans as part of the Balanced Budget Act of 1997. I worked with
President Clinton, who eventually signed an Executive order in 1998 to
have the standard apply to all government insurance programs.
Then I fought to have my patient's bill of rights amendment, which
included the prudent layperson standard, enacted as part the Patient
Protection and Affordable Care Act for individual and group health
plans. So now it is effective for all plans in this country. There is a
definition of what an emergency medical condition is and when it is
prudent to do that. It is spelled out in the statute dealing with the
seriousness of the symptoms, as it could deal with bodily harm, et
cetera.
Despite the Federal law, private insurers are, once again, using
tactics to prevent people from seeking care in an emergency room.
Several newspapers, from the Los Angeles Times to the Columbus
Dispatch, have reported that Anthem--one of the Nation's largest
insurers--has implemented an avoidable emergency room program to reduce
what it deems as unnecessary ER visits and address rising healthcare
costs. This program has been rolled out in several States, including
Kentucky, Missouri, Ohio, Indiana, Georgia, and New Hampshire.
According to these news reports, patients who believe they have
emergency symptoms go to the ER for emergency medical care. After
several tests, the physicians and nurses determine there is no
emergency medical condition. The patient returns home, relieved to be
OK. A few weeks later, they receive a letter from the insurance company
refusing to cover the care received in the hospital. This is wrong. We
said it was wrong in the 1990s, and we took steps to change that. We
now have laws that make it very clear.
The Anthem avoidable ER policy forces people who are in some sort of
acute distress to determine, before they even leave their homes, if
their symptoms are really serious enough to go to an emergency room.
What we had back in the 1990s was preauthorization for emergency care.
Can you imagine trying to make a phone call before you go to an
emergency room to talk to somebody as to whether you should go there or
not, wasting valuable time, or being told to go to a hospital different
from the closest hospital, again, causing really serious jeopardy? That
is what we had. People should not be forced to act as their own doctor
and second-guess themselves when they truly believe they are having a
medical emergency.
A wrong decision based upon economic considerations--the ability to
pay the bill--could be deadly. We should not discourage people from
seeking necessary medical treatment, and we should not allow insurance
companies to return to the time when they could callously refuse to
cover emergency care provided to individuals who genuinely and
reasonably believe they need it.
As we will be considering shortly additional improvements in our
healthcare system to eliminate the cap that we have on therapy caps, to
make it clear that we want to make telemedicine more available, to help
dialysis patients, to deal with our children in the Children's Health
Insurance Program, to deal with rural healthcare, let us also make sure
that we set up the ability to make sure that our policies, in fact, are
carried out. We should not allow an insurance company such as Anthem to
act as if what Congress did does not exist. I think that is our
responsibility.
I look forward to working with our colleagues in a bipartisan way to
improve healthcare and access for all Americans.
With that, I yield the floor.
Cloture Motion
The PRESIDING OFFICER. Pursuant to rule XXII, the Chair lays before
the Senate the pending cloture motion, which the clerk will state.
The legislative clerk read as follows:
Cloture Motion
We, the undersigned Senators, in accordance with the
provisions of rule XXII of the Standing Rules of the Senate,
do hereby move to bring to a close debate on the motion to
concur in the House amendment to the Senate amendment to H.R.
695, a bill to amend the National Child Protection Act of
1993 to establish a national criminal history background
check system and criminal history review program for certain
individuals who, related to their employment, have access to
children, the elderly, or individuals with disabilities, and
for other purposes.
Mitch McConnell, John Cornyn, Mike Crapo, Jerry Moran,
Richard Burr, David Perdue, Tom Cotton, Shelley Moore
Capito, Deb Fischer, James M. Inhofe, Pat Roberts,
Roger F. Wicker, John Hoeven, John Barrasso, John
Boozman, Steve Daines, Mike Rounds.
Mr. GARDNER. Mr. President, I ask unanimous consent that the
mandatory quorum call be waived.
The PRESIDING OFFICER. Without objection, it is so ordered.
By unanimous consent, the mandatory quorum call has been waived.
The question is, Is it the sense of the Senate that debate on the
motion to
[[Page S799]]
concur in the House amendment to the Senate amendment to H.R. 695 shall
be brought to a close?
The yeas and nays are mandatory under the rule.
The clerk will call the roll.
The legislative clerk called the roll.
Mr. CORNYN. The following Senator is necessarily absent: the Senator
from Arizona (Mr. McCain).
The PRESIDING OFFICER (Mr. Perdue). Are there any other Senators in
the Chamber desiring to vote?
The yeas and nays resulted--yeas 55, nays 44, as follows:
[Rollcall Vote No. 29 Leg.]
YEAS--55
Alexander
Barrasso
Blunt
Boozman
Burr
Capito
Cassidy
Cochran
Collins
Corker
Cornyn
Cortez Masto
Cotton
Crapo
Cruz
Daines
Donnelly
Enzi
Ernst
Fischer
Flake
Gardner
Graham
Grassley
Hatch
Heitkamp
Heller
Hoeven
Inhofe
Isakson
Johnson
Kennedy
Lankford
Lee
Manchin
McCaskill
McConnell
Moran
Murkowski
Nelson
Perdue
Portman
Risch
Roberts
Rounds
Rubio
Sasse
Scott
Shelby
Sullivan
Thune
Tillis
Toomey
Wicker
Young
NAYS--44
Baldwin
Bennet
Blumenthal
Booker
Brown
Cantwell
Cardin
Carper
Casey
Coons
Duckworth
Durbin
Feinstein
Gillibrand
Harris
Hassan
Heinrich
Hirono
Jones
Kaine
King
Klobuchar
Leahy
Markey
Menendez
Merkley
Murphy
Murray
Paul
Peters
Reed
Sanders
Schatz
Schumer
Shaheen
Smith
Stabenow
Tester
Udall
Van Hollen
Warner
Warren
Whitehouse
Wyden
NOT VOTING--1
McCain
The PRESIDING OFFICER. On this vote, the yeas are 55, the nays are
44.
Three-fifths of the Senators duly chosen and sworn not having voted
in the affirmative, the motion is rejected.
The majority leader.
____________________