[Congressional Record Volume 164, Number 84 (Tuesday, May 22, 2018)]
[Senate]
[Pages S2812-S2815]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Healthcare
Mr. JONES. Mr. President, I come to the floor today and rise to speak
on a challenge that our rural health communities face both in Alabama
and across the country. People living in rural areas often face
difficulty in finding healthcare providers. The challenges of
consistent, quality healthcare for rural America are exponentially more
difficult than in any other area in the country. These persistent gaps
in healthcare inevitably lead to poor health outcomes.
As a result, life expectancy for rural Alabamans is approximately 6
months lower than for those who reside in
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urban areas and 3\1/2\ years lower than for people living in the rest
of the country. In some parts of my State, the outlook is even worse.
In Wilcox County, for example, life expectancy is 9 years lower than
the national average. That is unacceptable. The county of your birth or
where you choose to live should not dictate the quality of your life,
much less your life expectancy.
Despite the prosperity some pockets of the country feel today,
outcomes don't seem to be improving in many areas in rural America.
Alabama's rural hospitals are at risk, and many are in immediate danger
of closing. Sadly, some already have. Just last week, yet another
hospital--this one in Jacksonville, AL--announced that they would
close; it is about the 12th, I think, since 2011. It has become an all-
too-familiar pattern in Alabama and in other rural areas in America.
That means the quality and number of treatment options in these rural
areas and in Alabama continue to decline. Fifty-two of Alabama's rural
counties are facing primary care shortages, and those numbers get worse
for specialty practitioners like dentistry and obstetrics.
Having spent nearly my entire life in Alabama--the only exception
being 1 year in Washington, DC, working for this body on the Senate
Judiciary Committee--I am acutely aware of the unique difficulties we
face in keeping folks healthy. As I have traveled across Alabama over
the last year, I have heard from folks who struggle to access medical
care. I have heard from expectant mothers who didn't know if they would
be able to make it to a hospital in time for delivery because the
closest one was more than an hour away. I have heard from people who
are impacted by the growing opioid epidemic and the lack of substance
abuse and mental health treatment options in their communities.
When I came to the Senate, I knew I needed and wanted to make
increasing access to quality, affordable healthcare one of my first
priorities. I also knew that finding the Holy Grail of true healthcare
reform in today's world of partisan politics is a difficult and complex
task. I am proud to say that we have made some progress since I got
here in January. For instance, through bipartisan efforts, the expired
Children's Health Insurance Program, CHIP, which provides coverage to
150,000 Alabama kids as well as community health centers that serve
350,000 Alabamans, was funded for an additional 10 years in the
future. I am proud that we secured an additional 3 years of funding for
community health centers in that bill, which provides the primary
source of healthcare in many underserved communities.
I was also a cosponsor of the Training the Next Generation of Primary
Care Doctors Act, which was signed into law as part of the bipartisan
budget deal. That legislation is critical for folks in my State, both
in the training it provides to doctors in community health centers and
in rural health clinics, but also because it ensures that talented
individuals who choose to stay in the healthcare professions stay and
practice in their community.
Bipartisan legislation like that bill is one of the many ways that we
can improve how folks receive healthcare in the United States. There
is, of course, another option, which leaders in Alabama have failed to
take, and that is to expand Medicaid. By failing to expand Medicaid,
many of Alabama's most vulnerable citizens have been denied access to
basic care, and we turned away literally billions of our own taxpayer
dollars in the process. That decision just doesn't make sense. While I
remain hopeful that my State's leadership will reconsider the
shortsighted decision made solely for political reasons, I am going to
continue to work to find ways to help. For example, I will continue to
advocate for changes in the Medicaid wage index, which has been
unfairly hurting Alabama healthcare providers and has been doing so for
years.
For my part, today, taking one additional step, I am proud to say
that my very first piece of original legislation will focus on
improving rural healthcare through making government more efficient.
Today, along with my colleagues Senators Mike Rounds and Tina Smith, I
am introducing the Rural Health Liaison Act. I wish to thank and
acknowledge Congresswoman Cheri Bustos for her leadership on this issue
in the House and her offer to partner in this important effort.
The bipartisan Rural Health Liaison Act will streamline Federal
investment in rural healthcare and improve coordination between Federal
agencies and other healthcare stakeholders by creating a Rural Health
Liaison within the U.S. Department of Agriculture.
I believe the USDA is an appropriate spot for such a position because
the Department plays a major role in rural development efforts. For
instance, the USDA has the capability to finance the construction of
hospitals, to implement telemedicine programs, and to carry out health
education initiatives. We want to make sure that these efforts are
fully coordinated and leveraged with the U.S. Department of Health and
Human Services and other Federal agencies, as well as other important
healthcare stakeholders.
Among other things, the Rural Health Liaison would consult with HHS
on rural health issues and improve communication with all Federal
agencies. It will provide expertise on rural healthcare issues. It will
lead and coordinate strategic planning on rural health activities
within the USDA, and it would advocate on behalf of the healthcare and
relevant infrastructure needs in rural areas.
I thank Senators Rounds and Smith for their support on this important
legislation, and I look forward to working together with them and other
colleagues to move this bill forward. This is a great example of how
Senators from both sides of the aisle can come together to propose
commonsense legislation to make government work better and more
efficiently. It is exactly the kind of work that I hoped to do when I
arrived here just a few months ago.
But this is just another step in a very complicated process. In the
months ahead, I hope to have the opportunity to continue to work with
colleagues on both sides of the aisle in this body to lower healthcare
costs, to increase access to quality healthcare, and to improve the
health and well-being of people living in rural Alabama, in rural
America, and, in fact, for people all across this great Nation.
Thank you, Mr. President.
Mr. NELSON. Mr. President, will the Senator yield?
Mr. JONES. Absolutely, yes.
The PRESIDING OFFICER. The Senator from Florida.
Mr. NELSON. This Senator from Florida wants to thank his neighbor and
colleague for his comments and to say how true it is that there is an
underserved part in healthcare that is not only the underserved in the
inner city but, clearly, also in rural America. This Senator wants to
thank the Senator from Alabama for coming forward with that piece of
legislation. I look forward to discussing it with him.
I also wish to thank the Senator for his comments about how
shortsighted it is that the government, as he stated, in his State of
Alabama, and, certainly, the government in my State of Florida, refuses
to expand Medicaid and has so for almost 7 years, when, in fact, in the
State of Florida, there is almost $5 billion a year that is sitting on
the shelf that is Florida taxpayer money that is going elsewhere if not
accessed, and it has not been accessed in my State of Florida. That is
800,000 people--almost 1 million people--poor people and disabled folks
who would be getting healthcare, and they otherwise are not getting
healthcare.
Would the Senator believe that when they don't get healthcare through
Medicaid, for which they are eligible under the law, when they get
sick, what do they do? They end up going to the emergency room. By not
having any preventive care, it is now an emergency. Of course, when
treated at the emergency room, it is the most expensive place at the
worst time. Lo and behold, it is uncompensated care, and the hospital
can't eat all of that uncompensated care. So what happens? All the rest
of us pay through increases in our premiums.
I thank the Senator for his statement about what is happening in my
neighboring State of Alabama.
Mr. JONES. I say thank you to Senator Nelson. I appreciate that.
Although our numbers are not as staggering in our State of Alabama,
they are still significant for the State of
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Alabama with regard to Medicaid. So I will state that I appreciate the
Senators comments very much, and I look forward to working with him on
this bill and helping to move it forward.
I yield the floor.
The PRESIDING OFFICER. The Senator from Florida.
Mr. NELSON. Mr. President, I rise today regarding the nomination of
Dana Baiocco to serve as a Commissioner on the Consumer Product Safety
Commission, or, as we refer to it, the CPSC. It is a small, safety-
focused agency. It has about 500 employees, but it has a critically
important mission to keep Americans safe from potential defects in
thousands of consumer products, many of which are imported from China.
We have seen the need to have a strong cop on the beat, and we have
seen that many times over the years. For example, back in 2007, we saw
what was referred to as a summer of recalls, when a number of
children's toys were recalled for high levels of lead and other toxic
substances.
In response to that summer of recalls in 2007, Congress almost
unanimously passed a law, the Consumer Product Safety Improvement Act
of 2008, to address the safety of toys and other children's products.
But there is still a lot more to do.
Last summer, another tragedy played out in Florida, involving
portable generators. People go and buy these portable generators in
anticipation that they are going to lose electricity in their home, as
is so often the case with a hurricane. In the wake of Hurricane Irma
last year, 12 Floridians died and a number of others were injured by
the use of portable generators because carbon monoxide poisoning is
emitted from these portable generators. In many cases, the victims were
just trying to clean up debris or provide power to their families after
the storm, unaware that these generators give off large amounts of
carbon monoxide, which is colorless, odorless, and deadly.
For years we have been calling on the CPSC to ensure that portable
generators are equipped with mechanisms that limit carbon monoxide
emissions and automatically shut off the generators when the carbon
monoxide level reaches a high, dangerous lethal level in an enclosed
area that could cause death. It is a small modification to generators
that would not affect the performance but definitely would save lives.
This happens after every hurricane. People get generators because it
is a number of days or weeks without electricity, and they still want
to have electricity, and, of course, there are untold deaths. In the
case of Florida, in the aftermath of Hurricane Irma, there were 12
deaths. If small modifications had been in place last summer, it is
very likely that some of those Floridians who lost their lives would
still be with us.
That brings me to Ms. Baiocco's nomination. She certainly has a
distinguished legal career. She has been a partner of a major law firm,
and I congratulate her on that.
When she was in front of our Commerce Committee, she was asked
whether she would support a mandatory standard requiring that
generators have mechanisms that limit carbon monoxide emissions or
other devices that switch the generators off when the carbon monoxide
level rises to dangerous levels. Her response was that we should defer
to a voluntary industry standard.
I ask the Presiding Officer: Do you think the industry is going to
voluntarily put on these shutoff mechanisms? Isn't the CPSC there for
the purpose of protecting the public?
When the next hurricane hits--perhaps in the Presiding Officer's
State--do we want another dozen deaths as has occurred in Florida? I
don't think so. I think that is the role of the CPSC, and yet Ms.
Baiocco said she wants it to be voluntary with the industry. Well, that
is exactly what we have been doing for years, and we just keep seeing
more deaths and more injuries because the industry doesn't change it.
In some cases, whole families have been wiped out. That is not a
pleasant thought.
Hurricane season starts June 1, and every day that the CPSC fails to
act on portable generators, more Americans will die, especially where
hurricanes hit. The place called ``hurricane highway'' is not only the
peninsula of Florida but also the Gulf States and the gulf coast, which
includes the Presiding Officer's State. The fact that Ms. Baiocco
cannot recognize the need for a mandatory standard in this area makes
me wonder if she is going to do anything about other hazards that
impact our families.
Mr. President, I ask for 60 more seconds.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. NELSON. Mr. President, this is serious. There are things like
potentially toxic flame-retardant chemicals in children's products.
Remember all of those Chinese toys that were defective? Or what about
recycled crumb rubber that is used in playgrounds that have high levels
of toxic substances?
Sadly, it seems that with the administration's recent appointments to
the CPSC, the Commission could soon become known as the ``commission to
protect shareholders and companies.''
This Senator believes that the people appointed to protect us have to
display a desire to protect the consumers first. The stakes are just
too high. Unfortunately, this Senator, a member of the Commerce
Committee, has concluded that Ms. Baiocco does not meet this standard.
Therefore, I must oppose her nomination.
I yield the floor.
The PRESIDING OFFICER. The Senator from South Dakota.
Mr. THUNE. Mr. President, I ask unanimous consent to be able to
conclude my remarks regarding this upcoming vote prior to the vote.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. THUNE. Mr. President, I rise today to voice my strong support for
the nomination of Dana Baiocco to be a Commissioner at the Consumer
Product Safety Commission. Ms. Baiocco has dedicated her career to
product safety and liability matters, and it is my firm belief that her
depth of experience and familiarity with consumer product safety issues
will bring an important perspective to the Commission once she is
confirmed.
Born and raised in Yorkville, OH, Ms. Baiocco attended the Duquesne
University School of Law, graduating cum laude in 1997. While still in
law school, Ms. Baiocco served as a law clerk for the U.S. District
Court for the Western District of Pennsylvania. In 1998, she joined the
law firm of Jones Day and became a partner in 2007, where she has
dedicated her legal career to counseling clients on product safety and
liability issues. In 2011, she became one of the founding partners of
Jones Day's Boston office, which opened that same year.
Currently, the CPSC retains a 3-to-1 Democratic majority. While the
Commerce Committee has favorably reported Ms. Baiocco's nomination, as
well as Acting Chairman Anne Marie Buerkle's nomination twice this
Congress, both have been unfairly held up by some on the other side.
The CPSC deserves a fully constituted Commission of Senate-confirmed
leaders. Ms. Baiocco's confirmation is a crucial measure of good
governance to restore balance to the Commission.
To date, I have not heard a single argument against Ms. Baiocco's
abilities. Notwithstanding her extensive qualifications to be an
effective Commissioner at the CPSC, however, some of our colleagues on
the other side have voiced concerns about her nomination on the grounds
that her career representing business clients in the consumer product
and liability space may impact her impartiality when considering issues
before the Commission. A few have also raised concerns about her
impartiality on the basis of her spouse's career as a litigator and
partner at the law firm of White and Williams.
Well, to my colleagues who harbor such concerns, I would note that
the Senate routinely confirms nominees who are lawyers with private
practice backgrounds, and we expect such officeholders to advocate for
the public interest just as zealously as they once advocated for their
clients.
I would also remind our colleagues of the role the Office of
Government Ethics plays in ensuring that nominees have resolved any
actual or apparent conflict of interests before they are even
considered by the Senate. The Office of Government Ethics has closely
scrutinized Ms. Baiocco's financial disclosures to ensure compliance
with all requirements and evaluated Ms. Baiocco's finances and
background for conflicts of interest.
[[Page S2815]]
Further, Ms. Baiocco has formerly pledged in her ethics agreement
that she would recuse herself from matters involving her firm, Jones
Day, or its clients unless issued a waiver. She also specifically
stated in her ethics agreement that she will not ``participate
personally or substantially in any particular matter involving specific
parties in which [she knows] a client of her spouse is a party or
represents a party'' unless authorized. Additionally, she has complied
with all matters concerning the management of her financial assets in
the future.
It is my firm belief that Ms. Baiocco's experience will afford a
unique perspective as a commissioner and serve the CPSC well. There is
no legitimate reason to delay her confirmation any further. I,
therefore, urge my colleagues to support her nomination.
I yield the floor.
The PRESIDING OFFICER (Mr. Cruz). All time has expired.
The question is, Will the Senate advise and consent to the Baiocco
nomination?
Mr. THUNE. Mr. President, 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 Colorado (Mr. Gardner) and the Senator from Arizona (Mr.
McCain).
Further, if present and voting, the Senator from Colorado (Mr.
Gardner) would have voted ``yea.''
Mr. DURBIN. I announce that the Senator from Colorado (Mr. Bennet),
the Senator from Maryland (Mr. Cardin), and the Senator from Illinois
(Ms. Duckworth) are necessarily absent.
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 50, nays 45, as follows:
[Rollcall Vote No. 103 Ex.]
YEAS--50
Alexander
Barrasso
Blunt
Boozman
Burr
Capito
Cassidy
Collins
Corker
Cornyn
Cotton
Crapo
Cruz
Daines
Enzi
Ernst
Fischer
Flake
Graham
Grassley
Hatch
Heller
Hoeven
Hyde-Smith
Inhofe
Isakson
Johnson
Kennedy
Lankford
Lee
Manchin
McConnell
Moran
Murkowski
Paul
Perdue
Portman
Risch
Roberts
Rounds
Rubio
Sasse
Scott
Shelby
Sullivan
Thune
Tillis
Toomey
Wicker
Young
NAYS--45
Baldwin
Blumenthal
Booker
Brown
Cantwell
Carper
Casey
Coons
Cortez Masto
Donnelly
Durbin
Feinstein
Gillibrand
Harris
Hassan
Heinrich
Heitkamp
Hirono
Jones
Kaine
King
Klobuchar
Leahy
Markey
McCaskill
Menendez
Merkley
Murphy
Murray
Nelson
Peters
Reed
Sanders
Schatz
Schumer
Shaheen
Smith
Stabenow
Tester
Udall
Van Hollen
Warner
Warren
Whitehouse
Wyden
NOT VOTING--5
Bennet
Cardin
Duckworth
Gardner
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.
____________________