[Congressional Record Volume 164, Number 168 (Wednesday, October 10, 2018)]
[Senate]
[Pages S6738-S6747]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  PROVIDING FOR CONGRESSIONAL DISAPPROVAL UNDER CHAPTER 8 OF TITLE 5, 
   UNITED STATES CODE, OF THE RULE SUBMITTED BY THE SECRETARY OF THE 
    TREASURY, SECRETARY OF LABOR, AND SECRETARY OF HEALTH AND HUMAN 
    SERVICES RELATING TO ``SHORT-TERM, LIMITED DURATION INSURANCE''

  Ms. BALDWIN. Mr. President, I move to proceed to Calendar No. 627, 
S.J. Res. 63.
  The PRESIDING OFFICER. The question is on agreeing to the motion.
  The motion was agreed to.
  The clerk will report the joint resolution by title.
  The senior assistant legislative clerk read the joint resolution by 
title:

       A joint resolution (S.J. Res. 63) providing for 
     congressional disapproval under chapter 8 of title 5, United 
     States Code, of the rule submitted by the Secretary of the 
     Treasury, Secretary of Labor, and Secretary of Health and 
     Human Services relating to ``Short-Term, Limited Duration 
     Insurance.''



 =========================== NOTE =========================== 

  
  On page S6738, October 10, 2018, in the first column, the 
following appears: The clerk will report the joint resolution by 
title. The senior assistant legislative clerk read the joint 
resolution by title: A joint resolution (S.J. Res. 673) providing 
for congressional disapproval under chapter 8 of title 5, United 
States Code, of the rule submitted by the Secretary of the 
Treasury, Secretary of Labor, and Secretary of Health and Human 
Services relating to ``Short-Term, Limited Duration Insurance.''
  
  The online Record has been corrected to read: The clerk will 
report the joint resolution by title. The senior assistant 
legislative clerk read the joint resolution by title: A joint 
resolution (S.J. Res. 63) providing for congressional disapproval 
under chapter 8 of title 5, United States Code, of the rule 
submitted by the Secretary of the Treasury, Secretary of Labor, 
and Secretary of Health and Human Services relating to ``Short-
Term, Limited Duration Insurance.''


 ========================= END NOTE ========================= 

  The PRESIDING OFFICER. The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, just over a year ago in this Chamber, 
three brave Republican colleagues--Senator John McCain, Senator Susan 
Collins, and Senator Lisa Murkowski--joined all Democrats in voting 
against healthcare repeal legislation. They listened to the families of 
their States.
  I, too, voted against that repeal legislation because the people of 
Wisconsin did not send me to Washington to take away their healthcare. 
When congressional Republicans tried to pass repeal plans that would 
allow insurance companies to charge more for preexisting conditions, 
families across our country fought back.
  When the Republican majority tried to charge older Americans an age 
tax and make people pay more for less care, people let their voices be 
heard and sent a loud message to Washington: Protect our care. They 
sent us all a clear message that they want us to work across party 
lines to protect the healthcare guarantees they depend on and to stand 
up for those with preexisting health conditions. Yet defeating the 
legislative efforts that would have made things worse for families 
didn't end the threat to the American people.
  The Trump administration has been trying to do what congressional 
Republicans couldn't. They have been sabotaging our healthcare system 
and rewriting the rules on guaranteed health protections and access to 
affordable care that millions of Americans have today. This sabotage 
has created instability in the healthcare market, contributing to 
widespread premium spikes in 2018.
  This administration ended the critical cost-sharing reduction 
payments that made healthcare more affordable for almost 90,000 
Wisconsinites. The Trump administration again slashed funding for 
outreach efforts to help people sign up for healthcare.
  Trusted navigator programs like those in Wisconsin have had their 
funding cut by nearly 90 percent in the past 2 years. This will mean 
fewer people in rural Wisconsin will receive the support they need to 
obtain affordable coverage this year.
  It doesn't stop there. The Trump administration has even joined 
Wisconsin's Governor and Wisconsin's attorney general and other States 
in going to court to support a lawsuit that would take away guaranteed 
protections for people with preexisting conditions. If they succeed, 
insurance companies will again be able to deny coverage or charge 
higher premiums for the more than 130 million Americans with a 
preexisting health condition. In fact, if the Affordable Care Act's 
protections for people with preexisting conditions are struck down in 
court, Wisconsin is among the States that has the most to lose.
  According to the Kaiser Family Foundation, one out of every four 
Wisconsinites has some sort of preexisting health condition, and they 
simply cannot afford to have the healthcare they depend on threatened 
with higher costs or coverage denials.
  The Trump administration has expanded junk insurance plans. These 
plans are cheap for a reason; they do not have to provide essential 
health benefits like hospitalization, prescription drugs, and maternity 
care.
  According to the fine print of one of the plans sold in several 
States, including my home State of Wisconsin--marketed by the Golden 
Rule Company--the plan doesn't even have to cover hospital care on a 
Friday or Saturday. It will be just your bad luck if you happen to get 
sick and need healthcare on the weekend. The very first exclusion 
states that it provides no benefits for a preexisting health condition. 
The fine print also notes if you are pregnant, that will be considered 
a preexisting health condition.
  These junk insurance plans can deny healthcare coverage to people 
with preexisting conditions when they need it the most, and that is why 
I am leading this effort in the U.S. Senate to take action and stop 
this sabotage.
  This is personal to me. When I was 9 years old, I got sick. I was 
really sick. I was in the hospital for 3 months. I eventually 
recovered. When it came to health insurance, it was as if I had some 
sort of scarlet letter. My grandparents, who raised me, couldn't find a 
policy at any price that would cover me--not from any insurer--all 
because I was a childhood branded with those words: ``preexisting 
condition.''
  This is also personal for Chelsey from Seymour, WI, whose daughter 
was born with a congenital heart defect. Right now, Zoe is guaranteed 
access to coverage without being denied or charged more because of her 
preexisting condition.
  Chelsey wrote me during that debate last year: ``I'm pleading to you 
as a mother to fight for the kids in Wisconsin with pre-existing 
conditions that are counting on you to protect that right.''
  No parent or grandparent should have to lie awake at night wondering 
if the healthcare they have today for themselves and their families 
will be there tomorrow. With the expansion of these junk plans, that 
fear could become a new reality for far too many families as healthy 
people leave the market, increasing premiums for everyone.
  Children like Zoe may not be able to find any plan that her parents 
can afford or that will cover the care she needs. No family should be 
forced to choose between helping a loved one get better or going 
bankrupt.
  Before the Affordable Care Act, too many families had to make that 
choice. Before the healthcare law, I heard from Sue from Beloit, WI. 
Sue's husband was diagnosed with lung cancer. They quickly found out 
their insurance plan had a $13,000 limit on radiation and chemotherapy. 
That covered about one round of chemotherapy. When they needed to 
continue treatment, Sue and her family used all of their savings, and 
then they maxed out all of their credit cards. When they were facing 
insurmountable credit card debt, she told me: ``I had no choice but to 
file bankruptcy.'' Sue's husband later died.
  We can't go back to the days when insurance companies wrote the 
rules, just as we cannot allow the Trump administration to rewrite the 
rules on guaranteed healthcare protections that millions of Americans 
depend on.
  More than 20 of the leading healthcare organizations in America, 
representing our Nation's physicians, patients, medical students, and 
other health experts, are supporting this resolution to overturn the 
Trump administration's expansion of junk insurance plans. They are 
doing so because these junk plans will reduce access to quality 
coverage for millions and increase costs.
  These junk plans will charge people more for coverage based on their 
preexisting conditions or deny them coverage outright. These junk plans 
will leave cancer patients and survivors with higher premiums and fewer 
insurance options. These junk plans will force premium increases on 
older Americans.
  I have heard my colleagues on the other side of the aisle say that 
they are committed to protecting people with preexisting conditions. 
Now is your chance to prove it. Anyone who says they support coverage 
for people with

[[Page S6739]]

preexisting conditions should support this resolution to overturn the 
Trump administration's expansion of these junk insurance plans.
  This is an opportunity for Democrats and Republicans to come together 
to protect people's access to quality, affordable healthcare when they 
need it the most. Let us join in seizing the opportunity to do what is 
right by the American people.
  I yield.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, the resolution by the distinguished 
Senator from Wisconsin is a resolution to say to the plumber who is 
making $60,000 a year in Wisconsin or Tennessee: We want to keep your 
insurance prices high. We don't want to reduce them by 70 percent, and 
we want to keep 1.7 million people, according to the Urban Institute, 
uninsured.
  Let me say that again. If this resolution passes--if you vote yes--
you are saying to the plumber who makes $60,000 a year, who can't 
afford to buy ObamaCare because his insurance premium is $20,000: We 
are going to do everything we can to keep your insurance costs so high 
that you can't afford it, and we are going to do everything we can to 
keep 1.7 million Americans, according to the Urban Institute, from 
having the option this short-term rule allows.
  Let's see what we are talking about. We just heard eloquent comments 
about preexisting conditions. This resolution has nothing to do with 
preexisting conditions. It doesn't change one single word in the 
Affordable Care Act, which guarantees that if you have a preexisting 
condition, you have a right to buy ObamaCare, and you can't be charged 
more because of it.
  Let me say that again. This rule, which the Senator from Wisconsin 
seeks to overturn, not only keeps you from lowering your cost 70 
percent, but it has nothing to do with preexisting conditions because 
it doesn't change one single word of the Affordable Care Act guarantee 
that if you have a preexisting condition you can buy insurance and you 
can't be charged more. A rule can't change a law. It couldn't if it 
tried. That is one thing.
  The second thing is that the rule that the Senator from Wisconsin 
seeks to overturn is the same rule that was in effect during all of 
President Obama's term. President Obama's administration allowed 1 year 
of short-term plans for people who couldn't afford insurance, couldn't 
find it anywhere else, or who might be between jobs. Even after the 
Affordable Care Act passed in 2010, President Obama and the Democratic 
Congress thought it was a good enough idea to allow these short-term 
plans to continue that they kept them in the law. The law supporting 
these plans has nothing to do with the Affordable Care Act. It was 
passed in the 1990s for the purpose of giving people who need a short-
term option, which might cost less because it has less coverage, the 
chance to buy insurance.
  States can regulate these plans. States may decide what protections 
they should have. States may decide what the price should be, but, 
typically, in 2016, the difference between the cost of an ObamaCare 
plan was $393 a month for an unsubsidized ObamaCare plan and for a 
short-term plan it was $124. In other words, the short-term plan, which 
the Democrats and the Senator from Wisconsin seek to overturn, which 
was in existence all during the Obama administration and was authorized 
in the 1990s, would cut the plumber's insurance cost by 70 percent.
  Now, why should we put up with that? Why should we put up with that? 
The Urban Institute, not known as a conservative organization, has said 
that up to 1.7 million Americans will take advantage of President 
Trump's short-term plan, which was the same as the Obama short-term 
plan, except that under the Trump rule, you may do it for as much as 3 
years instead of just 1 year. It says that 1.7 million Americans will 
take advantage of that. That is a lot of people.
  Eighty-three percent of Americans who buy ObamaCare have a subsidy to 
help them pay for it. It is the 17 percent who don't have a subsidy who 
are most likely to be helped by this. Many simply can't afford a 
$20,000 health insurance plan if they don't qualify for a subsidy, and 
this says: We understand that. You can buy a different sort of plan if 
your State permits it. You can pay less with less coverage and at least 
you will have some insurance. At least you will have some insurance.
  But our Democratic friends say: Oh, no, we don't want to do anything 
that would lower the cost of health insurance.
  Sometimes I think our Democratic friends have elevated to the level 
of the status of the 67th book of the Bible the Affordable Care Act, or 
ObamaCare. They will not even change parts of it that they agree with.
  Earlier this year, Senator Murray and I, and then Senator Nelson and 
Senator Collins, all worked together with many Senators in a great 
bipartisan way to come up with a piece of legislation that would 
temporarily help with the high prices of health insurance. Make no 
mistake about it. In Tennessee, health insurance has gone up about 170 
percent since ObamaCare was passed. That means the plumber or the 
farmer or the person making 50, 60, or $70,000 a year can't afford to 
pay the $20,000 premium they might be required to pay.
  So we had this temporary Alexander-Murray-Collins-Nelson proposal. I 
can still see Senator Collins standing on the floor offering it saying, 
as she said: Oliver Wyman--the respected Oliver Wyman agency--says this 
will lower insurance premiums by 40 percent over 3 years for people in 
the individual market--people who don't get a subsidy, hardworking 
people who can't afford health insurance.
  What happened? Even though the Democratic leader said it contained 
provisions that every single Democrat could support, the Democrats 
pulled the rug out from under it at the last minute by insisting on a 
radical version of abortion funding that they had not required since 
1976, except in the ObamaCare law.
  In other words, they deliberately kept health insurance prices 40 
percent higher than they otherwise would have been. Was it to have an 
issue in the Presidential election or in the election this year? I have 
no idea, but I could think of no reason why not to do that.
  Then, there is another example. Secretary of Labor Acosta has come up 
with another very good idea that has been talked about a lot within 
this body before: Why not give employees of smaller companies the right 
to buy the same kind of insurance that employees of IBM or big 
companies buy?
  About half of all of us who have insurance get it on the job. We are 
pretty happy with it. It has a lot of protections in it--not as many as 
ObamaCare but, apparently, Democrats thought those protections were 
sufficiently strong, including preexisting condition, and sufficiently 
strong not to tamper with it. So the idea was this: Let's let the 
people who work in the company with 10 or 15 or 20 employees in Alaska, 
Tennessee, or Wisconsin have the same opportunity to buy insurance as 
the employee of a big company has.
  Democrats said absolutely not.
  So we don't want to lower rates by 40 percent by a temporary proposal 
supported by President Trump, Speaker Ryan, Senator McConnell, and let 
the Democratic leaders say all Democrats could vote for that policy. We 
don't want to let employees of smaller companies have the same options 
that employees of big companies have that would lower their insurance 
and give them more choices. And now we are being asked to say you can't 
have a 70-percent reduction in your health insurance--the same kind of 
proposal you had all during the Obama years. Let me say that again. 
President Obama thought it was just fine to have short-term healthcare 
plans for up to 1 year during the entire Obama administration. They 
changed the rules 22 days before the end of his term and reduced it to 
3 months that you could buy these plans, but that wasn't enforced until 
April.
  So let's keep it simple. If you needed insurance, if you lost your 
job, if you couldn't afford insurance during the Obama years, if 
ObamaCare got too expensive for you during the Obama years, you could 
buy short-term insurance for up to 1 year if your State allowed it.
  What the Democrats are saying is this: No, we are not even going to 
do what President Obama would do. So we are going to keep your 
insurance high today with a yes vote. We are going to

[[Page S6740]]

say to 1.7 million people who are uninsured: No, you can't buy this 
insurance because we know more than you do.
  Some people who might know more than we do is the National 
Association of Insurance Commissioners. Senate Democrats wrote to them 
asking them about these short-term plans and raising questions about 
them.
  Here is what the National Association of Insurance Commissioners, a 
bipartisan organization, wrote back:

       Short-term, limited duration insurance meets the needs of 
     consumers for whom other types of coverage may not be 
     appropriate, affordable, or available.

  State Insurance Commissioners say short-term limited duration 
insurance, the type that a ``yes'' vote today would ban--those are my 
words--meets the needs of consumers for whom other types of coverage 
may not be appropriate, affordable, or available.
  I hope that across this country, as Americans look at this today, you 
would ask the Senator from Wisconsin and her Democratic colleagues: Why 
do you want to kill a rule that President Obama favored, that existed 
all during ObamaCare while he was there, that gave people who might 
lose their jobs or couldn't afford ObamaCare a chance to buy insurance 
that might be 70-percent cheaper? Why would you want to keep 1.7 
million Americans who don't have insurance, according to the Urban 
Institute, from being able to afford this short-term rule? What do you 
have against lower cost insurance that doesn't change one word of the 
Affordable Care Act's protection guarantee of preexisting conditions?
  In other words, with this rule, if you still want to buy ObamaCare 
and need preexisting insurance protection, you have it. This could not 
possibly change that because it is a rule, not a law.
  I hope today that we vote no and that we affirm the Trump rule, which 
is the Obama rule, which is the rule that supports the Wisconsin, 
Oklahoma, and Alaska plumber who makes $60,000 a year, can't afford 
$20,000-a-year ObamaCare, gets no government subsidy, and needs this in 
order to insure his family.
  I yield the floor.
  Ms. BALDWIN. Mr. President, I ask unanimous consent that the 
following documents concerning the rule submitted by the Secretary of 
the Treasury, Secretary of Labor, and Secretary of Health and Human 
Services relating to short-term, limited duration insurance be entered 
into the Record: a letter to Congress from 113 health organizations 
expressing concerns with the rule, a letter from the National 
Association of Insurance Commissioners requesting a delay in 
implementation of the rule, a short-term medical plan brochure from the 
Golden Rule Insurance Company outlining the policy's coverage 
exclusions, and a news article from 2014 illustrating the lack of 
consumer protections in short-term limited duration plans.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                   April 17, 2018.
       Dear Speaker Ryan, Leader McConnell, Leader McCarthy, 
     Leader Schumer and Leader Pelosi: Our 113 organizations 
     represent millions of people with serious, acute, and chronic 
     diseases and disabilities, as well as their caregivers. These 
     individuals, and all Americans, need access to comprehensive, 
     affordable health coverage in order to meet their medical 
     needs.
       We write to express our concerns about the impact the 
     proposed rule regarding short-term limited duration plans 
     (STLDs) (CMS-9924-P) will have both on the health insurance 
     marketplaces and the individuals we represent. While short 
     term plans can offer less expensive coverage, they are not 
     required to adhere to important standards, including the ten 
     essential health benefit categories, guaranteed issue, out-
     of-pocket maximums, age-rating protections, and many other 
     critical consumer protections These policies are also allowed 
     to charge much higher premiums, deny coverage altogether for 
     consumers who cannot meet medical underwriting standards, and 
     impose lifetime and annual limits on services. If the 
     proposed rule put forward by the Administration is finalized 
     in its current form, it will limit access to quality and 
     affordable health insurance coverage for all Americans, and 
     disproportionately harm individuals with pre-existing 
     conditions and people with disabilities.
       Expanding access to these policies will likely cause 
     premiums in the individual insurance marketplace to increase 
     dramatically, as younger and healthier individuals choose to 
     enroll in cheap short-term plans. Allowing STLDs to 
     proliferate would force individuals, including those with 
     serious or chronic diseases and disabilities, into a smaller, 
     sicker market to obtain the coverage they need to manage 
     their health. Premiums for comprehensive plans that meet 
     federal standards would likely skyrocket, and plans would 
     likely exit the market. This will make insurance either 
     unavailable or unaffordable for those who rely on the 
     marketplace to get coverage
       Our organizations are dedicated to identifying and 
     promoting improvements to our health insurance markets that 
     control costs, stabilize the market, and positively impact 
     coverage and care for millions of Americans. Expanding access 
     to STLDs will move us away from--not towards--achieving these 
     goals. As advocates for our communities, we implore you to 
     protect patients and consumers, including individuals with 
     pre-existing conditions and persons with disabilities, by 
     asking the Administration to withdraw this proposed rule 
     until it adequately protects patients and consumers, as well 
     as any rules that do not increase stability, improve 
     affordability, and secure access to quality coverage in our 
     insurance markets.
           Sincerely,
       AARP, Adrenal Insufficiency United, Adult Congenital Heart 
     Association, Adult Polyglucasan Body Disease Research 
     Foundation, Advocacy & Awareness for Immune Disorders 
     Association (AAIDA), Alliance for Aging Research, Alpha-1 
     Foundation, American Association of People with Disabilities, 
     American Association on Health & Disability, American Cancer 
     Society Cancer Action Network, American Diabetes Association, 
     American Heart Association, American Kidney Fund, American 
     Liver Foundation, American Lung Association, American 
     Multiple Endocrine Neoplasia Support, American Physical 
     Therapy Association, American Therapeutic Recreation 
     Association, Amyloidosis Support Groups.
       Arthritis Foundation, Association of Oncology Social Work, 
     Autism Society, Autism Speaks, Autistic Self Advocacy 
     Network, Bazelon Center for Mental Health Law, Benign 
     Essential Blepharospasm Research Foundation, Brain Injury 
     Association of America, CancerCare, Caregiver Action Network, 
     Celiac Disease Foundation, Children's PKU Network, Consortium 
     of MS Centers, Crohn's & Colitis Foundation, Cutaneous 
     Lymphoma Foundation, Cystic Fibrosis Foundation, Disability 
     Rights Legal Center, Dystonia Advocacy Network, Dystonia 
     Medical Research Foundation, Easterseals.
       Epilepsy Foundation, Family Voices, Fibrolamellar Cancer 
     Foundation, Fight Colorectal Cancer, FORCE: Facing Our Risk 
     of Cancer Empowered, GBS/CIDP Foundation International, 
     Global Colon Cancer Alliance, Hemophilia Federation of 
     America, Hyper IgM Foundation, Immune Deficiency Foundation, 
     Indian Organization for Rare Diseases, International Myeloma 
     Foundation, International Pemphigus and Pemphigoid 
     Foundation, International Waldenstrom's, Macroglobulinemia 
     Foundation, Interstitial Cystitis Association, Jack McGovern 
     Coats' Disease Foundation, Justice in Aging, LAL Solace, 
     Leukemia & Lymphoma Society.
       Lung Transplant Foundation, Lupus Foundation of America, 
     Lutheran Services in America, Lymphangiomatosis & Gorham's 
     Disease Alliance, Lymphatic Education & Research Network, M-
     CM Network, Malecare Cancer Support, March of Dimes, Mended 
     Little Hearts, Mental Health America, METAvivor, Muscular 
     Dystrophy Association, National Alliance on Mental Illness, 
     National Alopecia Areata Foundation, National Association for 
     Hearing and Speech Action, National Association of Councils 
     on Developmental Disabilities, National Association of State 
     Head Injury Administrators, National Comprehensive Cancer 
     Network, National Consumers League.
       National Eosinophilia Myalgia Syndrome Network, National 
     Health Council, National Hemophilia Foundation, National LGBT 
     Cancer Project, National Multiple Sclerosis Society, National 
     Organization for Rare Disorders (NORD), National Patient 
     Advocate Foundation, National PKU Alliance, Inc., National 
     Spasmodic Dysphonia Association, NBIA Disorders Association, 
     NephCure Kidney International, Oncology Nursing Society, 
     Paralyzed Veterans of America, Parent Project Muscular 
     Dystrophy (PPMD), PKD Foundation, Platelet Disorder Support 
     Association, Prevent Cancer Foundation, PRP (Pityriasis Rubra 
     Pilaris) Alliance, Pulmonary Hypertension Association, Rare 
     and Undiagnosed Network (RUN).
       Restless Legs Syndrome Foundation, Scleroderma Foundation, 
     Susan G. Komen, Tarlov Cyst Disease Foundation, TASH, The 
     American Liver Foundation, The APS Type 1 Foundation, Inc., 
     The Desmoid Tumor Research Foundation, The Global Foundation 
     for Peroxisomal Disorders, The Guthy-Jackson Charitable 
     Foundation, The Lymphatic Malformation Institute, The Marfan 
     Foundation, United Ostomy Associations of America, US 
     Hereditary Angioedema Association, Vasculitis Foundation, 
     Worldwide Syringomyelia & Chiari Task Force.

[[Page S6741]]

     
                                  ____
         National Association of Insurance Commissioners & The 
           Center for Insurance Policy and Research,
                                   Washington, DC, April 23, 2018.
     Re Short-Term, Limited-Duration Insurance CMS-9924-P.

     Centers for Medicare & Medicaid Services, Department of 
       Health and Human Services,
     Attention: CMS-9924-P,
     Baltimore, MD.
       To Whom It May Concern: Thank you for the opportunity to 
     comment on the proposed regulations on Short-Term, Limited 
     Duration Insurance published in the Federal Register on 
     February 21, 2018. These comments are submitted on behalf of 
     the members of the National Association of Insurance 
     Commissioners (NAIC), which represents the chief insurance 
     regulators in the 50 states, the District of Columbia, and 
     the 5 United States territories.
       As state insurance regulators we have the primary 
     responsibility of regulating our insurance markets and 
     ensuring consumers are protected and the markets are 
     competitive. As we stated in our comments on the current 
     short-term, limited duration regulation, ``Federal 
     interference can, and often does, have unintended 
     consequences and may not be effective in addressing the 
     underlying issues.'' We argued that the arbitrary 3-month 
     limitation set by the Federal government could harm some 
     consumers and limit choices. Returning the Federal definition 
     to ``less than 12 months,'' as proposed, is consistent not 
     only with longstanding federal law but also with how this 
     term has been long defined by most states.
       In the analysis of Economic Impact and Paperwork Burden 
     related to federalism, the proposed rule states:
       Federal officials have discussed the issue of the term 
     length of short-term, limited duration insurance with State 
     regulatory officials. This proposed rule has no federalism 
     implications to the extent that current State law 
     requirements for short-term, limited duration insurance are 
     the same as or more restrictive than the Federal standard 
     proposed in this proposed rule. States may continue to apply 
     such State law requirements.
       Consistent with this statement, any further requirements, 
     including but not limited to restrictions related to the 
     sale, design, rating or duration of these plans, must be left 
     to the States, which have the primary authority under our 
     federal system to regulate the business of insurance, so that 
     they can address the unique conditions and needs of their 
     respective insurance markets. It is critical that state 
     regulators maintain the flexibility to determine whether, and 
     under what conditions, these plans are appropriate for their 
     state. We urge continued state flexibility on this issue.
       We also agree that educating consumers and ensuring that 
     they are aware of the limitations of these plans is 
     paramount. Some of these plans may provide significantly less 
     coverage and consumer protections than comprehensive plans. 
     We supported the disclosure requirements in the current 
     regulations and support the expansions in this proposed rule.
       States have received several consumer complaints about 
     confusion and misinformation regarding their short-term or 
     excepted benefit plans. Because of the real risk that 
     consumers may confuse short-term policies with comprehensive 
     health insurance that complies with the Affordable Care Act 
     (ACA), it is important that they be made aware of any 
     limitations to these policies during the sales process. We 
     are pleased that the proposed rule retains these important 
     disclosure requirements and adds valuable additional 
     disclosures.
       As drafted, this rulemaking does not address the impact of 
     Section 1557 of the ACA on the issuance of short-term, 
     limited duration plans. Specifically, it is unclear whether 
     or not these plans will be considered to be a ``health 
     program or activity'' under 45 C.F.R. Sec. 92.4 This 
     distinction is critical.
       If these plans are not exempt from the definition of 
     ``health plan or activity,'' the implication would be that 
     carriers could not offer these plans and also participate on 
     the Marketplace, Medicare, or Medicaid. In many states 
     throughout the country, carriers are deciding whether or not 
     to participate in the ACA-compliant marketplace, and if 
     clarifying language is not included carriers will be forced 
     to choose either to offer short-term, limited duration plans 
     or participate in the Exchange. We would ask for 
     clarification on this issue, and specifically advise that CMS 
     include language in the proposed definition of ``short-term, 
     limited duration insurance'' providing that such insurance is 
     ``not a health program or activity as defined in 45 C.F.R. 
     Sec. 92.4.''
       As to the issue of renewability, the members of the NAIC 
     concur that any decision over whether and when these plans 
     should be renewable should be left up to the States, not 
     dictated by the Federal government.
       Finally, states are concerned about the timing of this 
     rule, and some states may want to modify existing laws and 
     regulations to protect consumers and state markets. 
     Therefore, we recommend that the final regulation allow 
     states, if they so choose, to begin enforcing the new rules 
     in 2020, thus giving them time to review their rules and seek 
     statutory or regulatory changes to facilitate a smooth 
     transition.
       Thank you for this opportunity to comment. We are available 
     to discuss these or other issues as the Short-Term, Limited 
     Duration Proposed Rule is finalized.
           Sincerely,
     Julie Mix McPeak,
       NAIC President, Commissioner, Tennessee Department of 
     Commerce & Insurance.
     Raymond G. Farmer,
       NAIC Vice President, Director, South Carolina Department of 
     Insurance.
     Eric A. Cioppa,
       NAIC President-Elect, Superintendent, Maine Bureau of 
     Insurance.
     Gordon I. Ito,
       NAIC Secretary-Treasurer, Commissioner, Insurance Division, 
     Hawaii Department of Commerce and Consumer Affairs.
                                  ____


            UnitedHealthcare, Golden Rule Insurance Company

                        Short Term Medical Plans


       STATES: AZ, FL, IA, IL, IN, MI, MS, NE, PA, TN, TX, WI, WV

       This coverage is not required to comply with certain 
     federal market requirements for health insurance, principally 
     those contained in the Affordable Care Act. Be sure to check 
     your certificate carefully to make sure you are aware of any 
     exclusions or limitations regarding coverage of preexisting 
     conditions or health benefits (such as hospitalization, 
     emergency services, maternity care, preventive care, 
     prescription drugs, and mental health and substance use 
     disorder services). Your certificate might also have lifetime 
     and/or annual dollar limits on health benefits. If this 
     coverage expires or you lose eligibility for this coverage, 
     you might have to wait until an open enrollment period to get 
     other health insurance coverage. Also, this coverage is not 
     ``minimum essential coverage.'' If you don't have minimum 
     essential coverage for any month in 2018, you may have to 
     make a payment when you file your tax return unless you 
     qualify for an exemption from the requirement that you have 
     health coverage for that month.

                     What's Not Covered (all plans)

       This is only a general outline of the coverage provisions 
     and exclusions. It is not an insurance contract, nor part of 
     the insurance policy/certificate. You will find complete 
     coverage details in the policy/certificate Also see state 
     variations on pages 10-13.


                           general exclusions

       Benefits will not be paid for services or supplies that are 
     not administered or ordered by a doctor and medically 
     necessary to the diagnosis or treatment of an illness or 
     injury, as defined in the policy.
     No benefits are payable for expenses:
       For non-emergency services or supplies received from a 
     provider who is not a network provider, except as 
     specifically provided for by the policy.
       For a preexisting condition--A condition:
       (1) for which medical advice, diagnosis, care, or treatment 
     was recommended or received within the 24 months immediately 
     preceding the date the covered person became insured under 
     the policy/certificate; or (2) that had manifested itself in 
     such a manner that would have caused an ordinarily prudent 
     person to seek medical advice, diagnosis, care, or treatment 
     within the 12 months immediately preceding the date the 
     covered person became insured under the policy/certificate.
       A pregnancy existing on the effective date of coverage will 
     also be considered a preexisting condition.
       Note: Even if you have had prior Golden Rule coverage and 
     your preexisting conditions were covered under that plan, 
     they will not be covered under this plan.
       That would not have been charged if you did not have 
     insurance.
       Incurred while your coverage is not in force.
       Imposed on you by a provider (including a hospital) that 
     are actually the responsibility of the provider to pay.
       For services performed by an immediate family member.
       That are not identified and included as covered expenses 
     under the policy/certificate or are in excess of the eligible 
     expenses.
       For services that are not covered expenses.
       For services or supplies that are provided prior to the 
     effective date or after the termination date of the coverage.
       For weight modification or surgical treatment of obesity, 
     including wiring of the teeth and all forms of intestinal 
     bypass surgery.
       For breast reduction or augmentation.
       For drugs, treatment, or procedures that promote 
     conception.
       For sterilization or reversals of sterilization.
       For fetal reduction surgery or abortion (unless life of 
     mother would be endangered).
       For treatment of malocclusions, disorders of the 
     temporomandibular Joint (TMJ) or craniomandibular disorders.
       For modification of the physical body in order to improve 
     psychological, mental, or emotional well-being, such as sex-
     change surgery.

[[Page S6742]]

       Not specifically provided for in the policy, including 
     telephone consultations, failure to keep an appointment, 
     television expenses, or telephone expenses.
       For marriage, family, or child counseling.
       For standby availability of a medical practitioner when no 
     treatment is rendered.
       For hospital room and board and nursing services if 
     admitted on a Friday or Saturday, unless for an emergency, or 
     for medically necessary surgery that is scheduled for the 
     next day.
       For dental expenses, including braces and oral surgery, 
     except as provided for in the policy/certificate.
       For cosmetic treatment.
       For reconstructive surgery unless incidental to or 
     following surgery or for a covered injury, or to correct a 
     birth defect in a child who has been a covered person since 
     childbirth until the surgery.
       For diagnosis or treatment of learning disabilities, 
     attitudinal disorders, or disciplinary problems.
       For diagnosis or treatment of nicotine addiction.
       For charges related to, or in preparation for, tissue or 
     organ transplants, except as expressly provided for under 
     Transplant Services.
       For high-dose chemotherapy prior to, in conjunction with, 
     or supported by ABMT/BMT, except as specifically provided 
     under the Transplant Expense Benefits provision.
       For eye refractive surgery, when the primary purpose is to 
     correct nearsightedness, farsightedness, or astigmatism.
       While confined for rehabilitation, custodial care, 
     educational care, nursing services, or while at a residential 
     treatment facility, except as provided for in the policy/
     certificate.
       For eyeglasses, contact lenses, hearing aids, eye 
     refraction, visual therapy, or any exam or fitting related to 
     these devices, except as provided for in the policy/
     certificate.
       Due to pregnancy (except complications), except as provided 
     in the policy/certificate.
       For diagnostic testing while confined primarily for well-
     baby care, except as provided in the policy/certificate.
       For treatment of mental disorders or substance abuse 
     including court-ordered treatment for programs, except as 
     provided in the policy/certificate.
       For preventive care or prophylactic care, including routine 
     physical examinations, premarital examinations, and 
     educational programs, except as provided in the policy/ 
     certificate.
       Incurred outside of the U.S., except for emergency 
     treatment.
       Resulting from declared or undeclared war, intentionally 
     self-inflicted bodily harm (whether sane or insane); or 
     participation in a riot or felony (whether or not charged).
       For or related to durable medical equipment or for its 
     fitting, implantation, adjustment or removal or for 
     complications therefrom, except as provided for in the 
     policy/certificate.
       For outpatient prescription drugs, except as provided for 
     in the policy/certificate.
       For surrogate parenting.
       For treatments of hyperhidrosis (excessive sweating).
       For alternative treatments, except as specifically covered 
     by the policy/certificate, including: acupressure, 
     acupuncture, aromatherapy, hypnotism, massage therapy, 
     rolfing, and other alternative treatments defined by the 
     Office of Alternative Medicine of the National Institutes of 
     Health.
       Resulting from or during employment for wage or profit, if 
     covered or required to be covered by workers' compensation 
     insurance under state or federal law. If you entered into a 
     settlement that waives your right to recover future medical 
     benefits under a workers' compensation law or insurance plan, 
     this exclusion will still apply.
       Resulting from intoxication, as defined by state law where 
     the illness or injury occurred, or while under the influence 
     of illegal narcotics or controlled substances, unless 
     administered or prescribed by a doctor.
       For joint replacement, unless related to an injury covered 
     by the policy/certificate.
       For non-emergency treatment of tonsils, adenoids, 
     hemorrhoids or hernia.
       For injuries sustained during or due to participating, 
     instructing, demonstrating, guiding, or accompanying others 
     in any of the following: sports (professional, or semi-
     professional, or intercollegiate except for intramural), 
     parachute jumping, hang-gliding, racing or speed testing any 
     motorized vehicle or conveyance, scuba/skin diving (when 
     diving 60 or more feet in depth), skydiving, bungee jumping, 
     or rodeo sports.
       For injuries sustained during or due to participating, 
     instructing, demonstrating, guiding, or accompanying others 
     in any of the following if the covered person is paid to 
     participate or to instruct: operating or riding on a 
     motorcycle, racing or speed testing any non-motorized vehicle 
     or conveyance, horseback riding, rock or mountain climbing, 
     or skiing.
       For injuries sustained while performing the duties of an 
     aircraft crew member, including giving or receiving training 
     on an aircraft.
       For vocational or recreational therapy, vocational 
     rehabilitation, or occupational therapy, except as provided 
     for in the policy/certificate.
       Resulting from experimental or investigational treatments, 
     or unproven services.
                                  ____


               [From Bloomberg Businessweek, 2014-01-10]

    The Trouble With Short-Term Health Plans in the Age of Obamacare

                            (By John Tozzi)

       If you're shopping for health insurance, you may get a 
     pitch for something called a short-term medical plan. These 
     policies have been around forever and are aimed at recent 
     college grads, people between jobs, and new employees waiting 
     for group benefits to kick in. They're marketed by major 
     insurers including UnitedHealthcare Services, Humana, some 
     Blue Cross and Blue Shield carriers, and many smaller 
     companies.
       Short-term plans have become more visible as some insurers 
     and brokers take advantage of the hoopla surrounding the 
     Affordable Care Act to market them as alternatives to the 
     policies available on the state and federal exchanges. 
     Although the plans look a little like those approved under 
     Obamacare, they provide less coverage and don't have to 
     adhere to the same rules. The companies are allowed to turn 
     away patients who are sick and refuse to cover preexisting 
     conditions. They don't have to pay for preventative care and 
     aren't required to renew a policy if a patient needs a lot of 
     medical care. ``If you get sick, it's not going to take care 
     of you,'' says Karen Pollitz, a senior fellow at the Kaiser 
     Family Foundation, a health researcher.
       The short-term plans also don't satisfy the Obamacare 
     requirement that people have adequate coverage, so people who 
     buy them face the same tax penalties as the uninsured. Twenty 
     percent of short-term policyholders believed, wrongly, that 
     their coverage would be adequate under the ACA, according to 
     a survey published in September by EHealth, an online 
     brokerage that sells conventional and short-term policies. An 
     additional 64 percent said they weren't sure.
       There's plenty of cause for the confusion. Assurant, one of 
     the larger sellers of the temporary medical plans, says on 
     its website that ``these plans do not meet minimum essential 
     coverage requirements'' and customers may face tax penalties. 
     But insurance agency Liberty Medicare in Wynnewood, Pa., 
     called short-term plans ``a viable alternative to Obamacare 
     plans'' in a recent blog post, although the company also 
     noted that ``their benefits are not as broad as Obamacare 
     benefits.'' Even if the policies exclude preexisting 
     conditions, says president Gregory Lazarev, for ``healthy 
     people who are not entitled to subsidies, it makes perfect 
     sense to go and buy a short-term plan.''
       20 Percent of short-term policy holders wrongly believe 
     their plan meets Obamacare standards.
       ``There definitely are some companies out there that are 
     aggressively marketing these and [similar] policies,'' 
     Pollitz says. One making expansive claims is Health Insurance 
     Innovations, which connects consumers with short-term 
     policies from third-party insurers. The Tampa company, which 
     raised $65 million in an initial offering about a year ago, 
     is expecting a boost from the ACA, even though its plans 
     don't meet the law's requirements for adequate coverage. ``We 
     want to be ready to take full advantage of this unprecedented 
     degree of market expansion,'' Chief Executive Officer Michael 
     Kosloske said in a November earnings call. In an interview, 
     Kosloske says: ``Our benefits are the same or better than 
     what you're going to find, for example, on the exchanges.''
       A sample policy sold by Kosloske's company suggests 
     otherwise. Unlike ACA plans, it doesn't cover immunizations 
     and routine physicals, outpatient prescription drugs, 
     preexisting conditions, pregnancy or childbirth, sports 
     injuries, substance abuse treatment, allergies, or kidney 
     disease. It also comes with a $2 million lifetime limit on 
     benefits, a provision banned under Obamacare rules.
       Buying the stripped-down, short-term policy could save a 
     30-year-old Florida man $1,123 in premiums over a year, 
     compared with a typical bronze-level HMO plan from Humana. If 
     he earns $46,000 a year, he'd have to pay about 41 percent of 
     the savings in tax penalties for not having coverage 
     authorized by the ACA. The penalty rate will double in 2015. 
     If the hypothetical consumer earns $23,000 or less, federal 
     subsidies would make up the difference between the price of 
     the bronze plan and the short-term policy.
       Kosloske points out that the bronze plan has exclusions, 
     too, and a limited network--it doesn't pay anything if you 
     see a doctor outside the plan. In the plan his company sells, 
     ``covered benefits are paid the same way whether in or 
     outside the broad and highly accessible provider network,'' 
     he says. Pollitz advises consumers to stay away from short-
     term plans. ``It may cover your claims until your term of 
     coverage runs out,'' she says. But for anyone who gets sick 
     and hopes to renew, ``it's junk.''
       The bottom line: Consumers buying cheaper, short-term 
     health plans get limited benefits and still have to pay 
     Obamacare penalties.

  The PRESIDING OFFICER (Mr. Sullivan). The time of the majority has 
expired.
  Mr. INHOFE. Mr. President, I ask unanimous consent that I be 
acknowledged to speak for 10 minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                                S. 3021

  Mr. INHOFE. Mr. President, I don't think that is necessary because I 
think I was scheduled to do that anyway.
  What we are going to be addressing here in just a few minutes is a 
very significant piece of legislation. We do a

[[Page S6743]]

lot of things around here that some people think are important, but 
this is something that really is important. It is something that has a 
long history behind it.
  America's water infrastructure bill, known as the WRDA bill, was 
started about 20 years ago, and we made a commitment at that time that 
we would actually have a WRDA bill every 2 years. We didn't do that up 
until 2014. In 2014, we had gone since 2007 since we had had one, and 
this needs to be done to keep our water infrastructure going and the 
things that we are supposed to be doing. So we did it in 2014 and 2016, 
and now we will do the 2018 bill. That is what we are supposed to be 
doing.
  It is a great way to keep up the productive momentum that we have 
seen in Congress leading up to the midterm election and delivering on 
President Trump's promises.
  The WRDA bill is another great example of what can happen when we 
work with our friends across the aisle on issues that affect every 
State of our Nation.
  I was privileged to chair the Environment and Public Works Committee 
during that timeframe, when we went back to every other year, and it is 
something that has worked very well. People can depend on the resources 
being there when the time comes. So I think right now it is a bill that 
is sponsored by ourselves, along with the ranking members and the 
Senators of that committee, the EPW Committee, and the Transportation 
Subcommittee.
  I want to take a moment to thank the members I just mentioned and 
their staffs. The staffs are the ones who do the heavy lifting because 
without our willingness to work together on this legislation, we 
wouldn't be able to discuss it here on the floor today, and I 
appreciate that dedication. It is going to happen today.
  There are a lot of provisions in the bill that advance our Nation's 
infrastructure priorities. In addition, the State of Oklahoma would 
benefit in many ways as well.
  One of the big secrets around the world and around America is that 
Oklahoma is actually navigable. We have a navigation way that goes from 
the Mississippi River all the way up to my hometown of Tulsa, with the 
Port of Catoosa.
  I can remember many years ago, when I was in the State legislature, 
and some people came to me who were World War II veterans--one of the 
groups that was doing a very good job--and they said: We would like to 
be able to show and to demonstrate that we are navigable in Oklahoma. 
If you will get us a submarine, we will take it all the way up to 
Oklahoma.
  So I went down to Orange, TX, and found the USS Batfish. This is a 
World War II submarine. They were able to do it without any help at 
all--without any help from government. They had to get on there, and 
they had to reduce it to get under bridges and lift it up in shallow 
places. All of my adversaries were saying: We will sink Inhofe and his 
submarine. But we did it, and it is there today.
  So we do have the McClellan-Kerr Arkansas River Navigation System. We 
have some items in there under this to protect that resource from what 
they call the Three Rivers report, which provides a permanent solution 
for the situation we are experiencing near the mouth of the system, 
where the White River and the Arkansas River are trying to merge. If 
left alone, they would merge. That would destroy everything that goes 
up from that area in Arkansas. It includes language for Bartlesville to 
navigate the murky waters of water supply contracts and to change those 
contracts with everyone to get away from the idea that the Army Corps 
of Engineers is going to be able to do something that would be 
prohibitive cost-wise to the communities like Bartlesville, OK.
  We support our Nation's economic competitiveness by increasing access 
to water storage and supply, providing protection from dangerous flood 
waters, deepening the nationally significant ports, and maintaining 
navigability in the inland waterways.
  Since hurricane season is upon us, we have recently seen the cruel 
aftermath of these storms and the flooding that followed Hurricane 
Harvey, Irma, Florence, and now Michael. Right now they are preparing 
down there to evacuate as we speak. It could become a mandatory 
evacuation. This is something that is happening. Events like this show 
why it is utterly critical to maintain flood control and be able to 
protect against the floodwaters as much as possible.

  That is what this bill we will be considering in a few minutes is all 
about. It will also further address the need for repairing our aging 
drinking water, wastewater and irrigation systems, improving conditions 
all across the United States in homes, farms, and businesses.
  We have reauthorized WIFIA and authorized a new tool by including 
Senator Boozman's SRF WIN Act, of which I am a very proud cosponsor. 
These provisions, along with technical assistance for our small and 
rural systems, will provide more help to our communities struggling to 
finance and upgrade our hidden infrastructure needs.
  Maintaining critical infrastructure is one of the most important 
constitutionally required duties we have as Members of Congress. I 
sometimes have to remind people who often disregard a document called 
the Constitution that this is what we are supposed to be doing and what 
we are carrying out with the bill we are about to pass in the next few 
minutes.
  I look forward to passing this legislation and sending it to the 
President to sign into law. It is another win for America.
  I have to say, the committee has done so well. People are criticizing 
the Senate all the time, saying nothing is being done. Our Environment 
and Public Works Committee gets things done--the FAST Act, the chemical 
act, the last WRDA bill, and now the 2018 WRDA bill. It is what we are 
supposed to be doing here, and it is a very significant vote.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mrs. MURRAY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                              S.J. Res. 63

  Mrs. MURRAY. Mr. President, I come to the floor to support Senator 
Baldwin's resolution to overturn President Trump's junk plans rule.
  Since day one, President Trump has been relentless in his efforts to 
sabotage healthcare for people in our Nation. He has worked to drive up 
the costs, given power back to big insurance companies, and despite his 
recent campaign promise to fight for people with preexisting 
conditions, almost every single step he has taken has been in the 
opposite direction.
  President Trump's awful junk plan rule, which went into effect last 
week, is the latest example. His decision to expand junk insurance 
plans actually gives insurance companies more power to sell plans that 
ignore protections for people with preexisting conditions. It gives 
insurance companies more power to discriminate based on age or on sex. 
It gives insurance companies even more power to avoid covering 
important medical needs like emergency care, mental health care, 
prescription drugs, or even maternity care. This rule also lets 
insurance companies spend less money on patients directly and more 
money on excessive administrative costs and executive bonuses. This new 
rule shows how empty President Trump's promises are when it comes to 
preexisting conditions.
  It is not just President Trump. A lot of Republicans are claiming to 
stand for protections for preexisting conditions. However, when you 
compare how Democrats are fighting for these protections and how some 
Republicans are undermining them, the difference is as clear as night 
and day.
  When President Trump tried to pass his TrumpCare bill and undermine 
preexisting condition protection, Democrats stood with families across 
the country and fought tirelessly to stop that awful bill. However, 
most of our Republican colleagues championed it. When President Trump's 
Justice Department chose to abandon these protections in court against 
the Republican-led lawsuit to strike them down, Democrats rallied 
around the bill to let the Senate join the lawsuit and defend 
protections for preexisting conditions. Not a single Republican joined 
in that

[[Page S6744]]

effort. Now President Trump is undermining these protections through 
the junk plan rule, and Democrats are again on the floor leading the 
charge against him with the resolution that is before us today.
  Where are those Republican colleagues who have claimed to care so 
much about this issue but have done so little to fight for it? So far 
they have offered empty promises and even gimmicks, like a bill they 
claim protects people with preexisting conditions but actually allows 
insurance companies to discriminate based on age and sex.
  If Republicans are serious about standing up for people with 
preexisting conditions, they will join us to pass this bill and fight 
for them. I am not holding my breath, but I am not giving up. Democrats 
are going to keep fighting for people across the country, for people 
with preexisting conditions. We are going to keep fighting for cancer 
patients and survivors, people living with diabetes and arthritis and 
other chronic diseases, and we are going to keep fighting for women who 
are pregnant or seniors who are facing the challenges of old age and 
for so many other families who might not be able to get the care they 
need without these important protections for people with preexisting 
conditions.
  Finally, I thank Ms. Baldwin for her leadership on this very 
important effort. I know this fight is personal for her, like it is for 
so many families across the country. I am grateful for her leading the 
charge.
  Thank you.
  I yield the floor.
  Mrs. FEINSTEIN. Mr. President, I rise today in support of S.J. Res. 
63, a resolution of disapproval on the Trump administration's final 
rule allowing the expansion of short-term junk health insurance plans.
  My home State of California recently passed a law prohibiting these 
short-term plans to protect consumers because these plans do not offer 
real coverage and are allowed to only take healthy consumers.
  One hundred thirty million non-elderly Americans have a preexisting 
condition, including 16 million in California. Among the most important 
provisions in the Affordable Care Act are the consumer protection 
requirements for health insurance plans that ensure preexisting 
conditions no longer dictate access to health coverage and essential 
benefits that ensure coverage is meaningful and comprehensive.
  It does a cancer patient little good to have health insurance that 
doesn't cover chemotherapy, just as coverage without maternal care is 
meaningless to an expectant mother. In fact, before the Affordable Care 
Act was passed, three out of four plans on the individual market did 
not cover labor and delivery.
  An analysis by Kaiser Family Foundation just this last April found 
that of the more than 600 short-term plans offered through two major 
insurance websites, eHealth and Agile Health Insurance, across 45 
States, none included maternity care. It gets worse: 71 percent offered 
no prescription drug coverage, and 43 percent of these plans didn't 
cover mental healthcare services.
  To be frank, these plans are junk insurance. The major protections in 
the Affordable Care Act are basically tossed out the window, and we are 
reminded of why health reform was needed so badly in the first place. 
These plans can include annual and lifetime limits on care, meaning 
that, if you need an expensive medical treatment, you may be out of 
luck, even after paying your premiums. Women can once again be charged 
more than men for the same plan.
  Insurance companies don't have to comply with medical loss ratio 
rules that limit administrative costs. In fact, short-term plans 
covering 80 percent of the market in 2016 only spent half of premium 
dollars on actual medical care.
  Short-term plans have traditionally been used by some consumers for 
what the name implies, to bridge short gaps between long-term coverage 
for a matter of months. The final rule changes this to years. Given the 
severe shortfalls these plans have and significant consumer risk, they 
are simply not meant to be a substitute for real health insurance.
  I urge my colleagues to support this resolution to protect consumers 
and look forward to working together to improve health coverage, not 
make it worse.
  Mr. CARDIN. Mr. President, today I wish to discuss American's access 
to healthcare and the patient protections that are currently being 
threatened by the Trump administration, specifically expanding the 
availability of junk health insurance, also known as short-term limited 
duration plans.
  Short-term limited duration insurance is a type of health insurance 
that was designed to fill temporary gaps in coverage, such as when an 
individual is transitioning from one plan or coverage to another plan 
or coverage.
  The Obama administration limited these plans to 3 months to ensure 
they would be used only as a backstop for those who truly need 
temporary, limited duration coverage.
  A major flaw of this insurance is that it is exempt from certain 
consumer protections provided through the Affordable Care Act.
  Because of the Affordable Care Act, health insurance companies are 
required to offer essential health benefits such as emergency services, 
maternity care, mental health and substance use disorder services, and 
preventative services. Additionally, insurance companies are no longer 
allowed to place annual or lifetime dollar limits on coverage and 
cannot refuse to cover someone or charge someone more just because they 
have a preexisting condition.
  Among the most common preexisting conditions are high blood pressure, 
behavioral health disorders, high cholesterol, asthma/chronic lung 
disease, heart conditions, diabetes, and cancer.
  In 2017, HHS released a report stating that as many as 133 million 
non-elderly Americans have a preexisting condition. The Maryland Health 
Benefit Exchange estimates that there are approximately 2.5 million 
non-elderly Marylanders with a preexisting condition, 320,000 of which 
are children.
  Expanding access to short-term limited duration plans is another in a 
long line of GOP healthcare sabotage efforts since President Trump took 
office. Short-term plans are allowed to have annual or lifetime dollar 
limits on coverage, and do not have to provide coverage of essential 
health benefits or provide coverage to those with preexisting 
conditions. These plans will lead to increased health insurance 
premiums for people buying insurance on the ACA marketplace. Healthy 
individuals may be deceived to leave the marketplace and buy these junk 
plans instead.
  Short-term plans will impose an ``age tax'' on seniors because they 
are allowed to charge seniors more for coverage. Currently, the ACA 
limits how much more plans are allowed to charge seniors.
  Short-term plans are junk insurance, plain and simple. People believe 
they have coverage, but when they get sick and need medical care, they 
suddenly realize the plan that they paid for won't allow them to 
receive the care they require.
  These actions by the Trump administration to expand access to short-
term plans is wrong. Not only do these actions directly threatens the 
133 million Americans with preexisting conditions, but also any 
American who wishes to have strong, affordable, and comprehensive 
coverage.


                                S. 3021

  Mrs. FEINSTEIN. Mr. President, I rise today to speak in support of 
the pending bill, America's Water Infrastructure Act.
  I congratulate Chairman Barrasso and Ranking Member Carper of the 
Environment and Public Works Committee for completing this vitally 
important bill on time. It is critical that we reauthorize Army Corps 
projects and other water financing authorities every 2 years, as they 
have done.
  The bill before us authorizes construction of 12 new water resource 
development projects and 65 studies.
  America's Water Infrastructure Act also includes a number of 
provisions that will benefit California.
  The bill includes a provision I authored that will require EPA and 
the Bureau of Reclamation to enter into an agreement within a year. The 
agreement must specify how the two agencies will jointly administer a 
Treasury-rate loan program for storage, water recycling, groundwater 
recharge, and other water supply projects.

[[Page S6745]]

  This provision builds off EPA's success using Treasury-rate loans to 
fund projects under the Water Infrastructure Finance and Innovation 
Act, WIFIA. The idea is to extend these Treasury-rate loans to water 
supply projects.
  There are three significant ways WIFIA loans will lower costs for 
local agencies wanting to build storage, water recycling, groundwater 
recharge, or other water supply projects:
  No. 1, they will pay only 3.2 percent interest rate on their loans 
based on today's rates, versus 4 percent or greater rates for municipal 
bond financing;
  No. 2, the districts would not need to start paying interest until 5 
years after substantial completion of the project; and No. 3, loans are 
for 35 rather than 30 years, lowering annual debt service costs.
  The combination of these benefits could reduce the costs of building 
a project by as much as 25 percent. For example, if a consortium of 
water districts takes out a loan to build Sites Reservoir, they would 
pay only $512/acre-foot instead of $682/acre-foot, a 25 percent saving.
  These water district savings of up to 25 percent are a highly cost-
effective use of taxpayer dollars because they can be obtained by 
appropriations of only 1-1.5 percent of the cost of the loan, as 
validated by OMB.
  OMB has approved loans of $5 billion backed only by appropriations of 
only 1 percent of that amount, or $50 million for WIFIA, because there 
is a virtually nonexistent default rate for water projects.
  Only four in a thousand water infrastructure projects default, based 
on a study conducted by Fitch credit rating agency.
  Moreover, WIFIA loans include substantial taxpayer protections. 
Private sector loans have to cover at least 51 percent of the project 
cost, and the Federal loans would have senior status in the event of 
any default. These provisions protect the taxpayer in the event of any 
default.
  The provision in the bill before us is a compromise, different in 
some significant ways from the provision I included in the Senate bill. 
Like the Senate bill, the bill before us requires EPA and the Bureau of 
Reclamation to enter into an agreement within a year on how they would 
jointly administer a Treasury-rate loan program for water supply 
projects.

  However, the House was unwilling to allow the Bureau of Reclamation 
to recommend water supply projects for loans within EPA's existing 
WIFIA authority. As a result, additional legislation will be needed to 
authorize Reclamation loans for water supply projects once EPA and 
Reclamation reach their agreement.
  While further legislation will be needed, the legislation before us 
today provides an important step forward. EPA has developed expertise 
in processing and administering water supply loans, so it is more 
efficient if Reclamation can recommend the loans and EPA can administer 
them. Without the legislation before us, EPA and Reclamation would not 
reach an agreement on how they would jointly administer these water 
supply loans.
  Now that we know that Reclamation and EPA will reach this agreement 
within a year, Congress can shortly thereafter move legislation with 
both agencies' support to extend the successful and cost-effective 
WIFIA loan program to water supply projects. I look forward to working 
with my colleagues on this additional legislation.
  I am also pleased that this bill authorizes construction and studies 
and provides other needed modifications for many important water 
infrastructure projects in California.
  One such project that received a construction authorization is the 
Lower San Joaquin River project, which provides critical flood control 
to the Stockton metropolitan area.
  Additionally, this bill doubles Federal funding for the Harbor South 
Bay water recycling project, authorizing up to $70 million in Federal 
funds.
  This increase in Federal funding will meaningfully expand this 
project's capability to provide recycled water to surrounding 
communities. I am pleased to see Army Corps funding utilized for water 
recycling, which is truly a key for sustainability and water security 
in drought-prone California.
  Other key California projects in this bill include authorization for 
a flood risk management, navigation, and ecosystem restoration project 
in the San Diego River and directing the Army Corps to expedite flood 
risk management, water conservation and ecosystem restoration studies 
at the Coyote Valley Dam, Lower Cache Creek, Lower San Joaquin River, 
South San Francisco, Tijuana River, Westminster-East Garden Grove, and 
San Luis Rey River.
  Lastly, I would like to mention the two other very important 
provisions for California as well as the Nation that I strongly 
support.
  This bill increases funding for the Army Corps' dam rehabilitation 
program for structures built before 1940 from $10 million to $40 
million until fiscal year 2026. The United States is facing many 
challenges due to aging infrastructure, and in California, we saw the 
serious ramifications of that with the Oroville Dam disaster.
  Additionally, this legislation reauthorizes and expands the Drinking 
Water State Revolving Loan Fund for the first time in 22 years to 
address aging or damaged drinking water infrastructure in communities 
across the country.
  For all these reasons, I support the America's Water Infrastructure 
Act before us today. Thank you.
  Mrs. MURRAY. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CARPER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARPER. Mr. President, I don't know what it is like in Alaska, 
Wyoming, or Tennessee these days, but a lot of times, when I am going 
home or back and forth, people are saying to me: I wouldn't want your 
job for all the tea in China.
  I say: Well, I actually feel lucky to do this job. They ask: What do 
you like about it? I say: I like helping people. They say: Really? And 
they ask for examples.
  Today is a good example. One of the best ways to help people is to 
make sure they have a job. There are a lot of different ways we provide 
that nurturing environment for job creation and preservation, and one 
of those ways is in the area of infrastructure. Sometimes an overlooked 
part of our infrastructure is the one we address directly in the Water 
Resources Development Act before us today.
  Our water infrastructure is actually the forgotten leg on the 
infrastructure stool. We rightly worry about the infrastructure we can 
see: our bridges, highways, airports, and railroads, but our Nation's 
water infrastructure: our pipes, shipping channels, flood control 
structures, and the infrastructure we don't see, as we have learned, is 
in desperate need of investment.
  Our Nation's drinking water systems, dams, reservoirs, levees, 
shipping lanes, and ports support and promote economic growth and job 
creation. These systems provide water for everything from families to 
agriculture to small businesses. This is infrastructure that Americans 
rely on every day, and it keeps our economy moving.

  America's Water Infrastructure Act of 2018, the legislation that we 
will soon be voting on, makes water a priority from coast to coast. As 
my good friend, the chairman of our committee, John Barrasso, has said, 
America needs comprehensive water infrastructure legislation that will 
create jobs, keep communities safe, and make the Army Corps of 
Engineers and the EPA more accessible to stakeholders.
  The legislation before the Senate today has received endorsement from 
industry, from environmental protection groups, and from everything in 
between. The U.S. Conference of Mayors, the National League of Cities, 
and the National Association of Counties say that this bill drives 
investment in navigation, flood protection, and ecosystem restoration 
in communities and that it protects public health and safety and our 
natural resources. It is critical in helping our communities to build, 
maintain, and improve this critical infrastructure while growing our 
national and local economies.

[[Page S6746]]

  I am here to applaud and thank, once again, our chairman, our staffs, 
and everyone who has worked on this from Alaska to Wyoming.
  Mr. President, I ask unanimous consent that a list of congressional 
staff who deserve recognition for their work on S. 3021 be printed in 
the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       Thanks to the staff who worked tirelessly on this bill 
     throughout the year, including the staff of Chairman John 
     Barrasso: Richard Russell, Brian Clifford, Elizabeth Olsen, 
     Andy Harding, Pauline Thorndike, Craig Thomas; Ranking Member 
     Tom Carper: Mary Frances Repko, John Kane, Christina 
     Baysinger, Skylar Bayer, Ashley Morgan, Avery Mulligan, 
     Andrew Rogers; Subcommittee Chairman Jim Inhofe: Jennie 
     Wright; Subcommittee Ranking Member Benjamin L. Cardin: Mae 
     Stevens; Chairman Bill Shuster: Ian Bennitt, Victor 
     Sarmiento, Elizabeth Fox, Jon Pawlow, Geoff Gosselin, Peter 
     Como, Chris Vieson; Ranking Member Peter A. DeFazio: Ryan 
     Seiger, Michael Brain, Kathy Dedrick, David Napoliello; 
     Chairman Greg Walden: Jerry Couri; and Ranking Member Frank 
     Pallone: Jackie Cohen, Jean Fruci, Rick Kessler, Tuley 
     Wright.

  Mr. CARPER. I yield my time.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. BARRASSO. Mr. President, I ask unanimous consent to complete my 
brief statement before the rollcall is taken.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. BARRASSO. Mr. President, it is time to vote on America's Water 
Infrastructure Act.
  I thank my friend and colleague from Delaware, the senior Senator, 
Mr. Carper, for his great contributions to this piece of legislation.
  It is an important bill that has broad bipartisan, bicameral support. 
There are 95 groups that have endorsed it. They represent a broad 
cross-section of stakeholders from a wide variety of backgrounds. From 
the Sierra Club to the American Petroleum Institute to the U.S. Chamber 
of Commerce, they all agree that this important infrastructure 
legislation is good for our country, good for our communities, good for 
our economy, and good for our environment. The Wyoming Wool Growers 
Association, the Arkansas Rural Water Association, and the Milwaukee 
Metropolitan Sewerage District have all united in praise for a bill 
that will help all 50 States.
  The water infrastructure bill passed our committee 21 to nothing, and 
it passed the House with a unanimous voice vote. It is time to send it 
to the President for his signature. I would just ask our Members to 
join us in supporting this important bipartisan infrastructure bill.
  Mr. President, along with Ranking Member Carper, I ask unanimous 
consent to have an explanatory statement to accompany S. 3021, 
America's Water Infrastructure Act, printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

  Senate Explanatory Statement to Accompany S. 3021, America's Water 
                       Infrastructure Act of 2018

       The following explanatory statement from the Senate 
     supplements and provides additional views on the Managers' 
     Joint Explanatory Statement accompanying S. 3021: America's 
     Water Infrastructure Act of 2018 (AWIA), that was submitted 
     as part of the Congressional Record during consideration in 
     the House of Representatives on September 13, 2018.


                              section 1144

       Section 1144 on Levee Safety Initiative Reauthorization 
     extends by five years the authorization of appropriations for 
     the National Levee Safety Program, which includes the 
     committee on levee safety, inventory and inspection of 
     levees, and levee safety initiative. The Senate Managers urge 
     the Army Corps of Engineers (the Corps) to improve the 
     current levels of levee safety program transparency and local 
     levee sponsor involvement.
       By law and policy, local levee sponsors assure the day-to-
     day performance of levee systems. As such, local sponsors 
     typically maintain abundant familiarity with localized flood 
     and levee system conditions as well as local risk management 
     and communication needs. For the levee safety program to be 
     successful in achieving cost-beneficial flood damage 
     reduction, the Corps must to the maximum extent practicable 
     involve local sponsor expertise and rely on scientifically 
     sound and technically rigorous analysis. The Senate Managers 
     are aware of internal guidance drafted by the Corps to direct 
     its district offices to engage public sponsors as 
     participants in all levee safety program activities. The 
     Corps is encouraged to execute this directive fully so that 
     local sponsors and affected citizens derive maximum benefit 
     from the levee safety program.
       The Senate Managers arc additionally concerned about the 
     agency's decision to formulate and publicize Levee Safety 
     Action Classification (LSAC) assignments for levee systems in 
     the absence of site-specific solutions and corresponding cost 
     estimates. It is difficult to perform effective risk 
     characterization and communication about levee systems in the 
     absence of identified corrective actions and their associated 
     costs and benefits. The levee safety program must improve 
     flood protection by driving requisite cooperation with local 
     sponsors, transparency, objectivity, rigorous technical 
     justification, and development of actual solutions that focus 
     on the imperative of identifying cost-beneficial, engineered 
     solutions. The Corps noted in a March 2018 Levee Portfolio 
     Report that, ``there may be reluctance to share risk 
     information with the public when an immediate and viable risk 
     management solution has not been identified.'' The Senate 
     Managers urge the Corps to immediately rectify this shortfall 
     by cooperating with local levee sponsors to produce viable 
     levee system corrective actions and corresponding cost 
     estimates along with LSAC assignments. Given the scope and 
     potential impact of these levee system risk assessments, 
     which could involve levee accreditation status by FEMA under 
     the National Flood Insurance Program, the Corps should also 
     seek out external peer review of the reliability and 
     usefulness of the overall LSAC process.


                              section 1170

       Section 1170 contains a drafting error that was identified 
     following the passage of S. 3021 as amended by the House of 
     Representatives. The Senate Managers intend to initiate 
     legislation to make a technical correction in the language of 
     this section to replace the words ``Arizona River Basin'' 
     with ``Arkansas River Basin'' to ensure the work is conducted 
     in the Arkansas River Basin, located in Colorado and three 
     other States. Further, the Senate Managers ask that the Corps 
     prepare to implement this section as so modified pending the 
     correction.


                              section 1229

       Section 1229 directs the Secretary to do a report on the 
     status of a water supply contract for Wright Patman Lake, 
     Texas. In addition to that provision, the Senate Managers 
     believe that the Secretary should implement the Department of 
     the Army, Civil Works Contract No. 29-68-A-0130, at Wright 
     Patman Lake, Texas, in an expeditious manner and in 
     accordance with all applicable Federal and State water laws. 
     This includes the acceptance and expenditure of funds 
     contributed by a non-Federal interest for any study required 
     by law to implement the contract.


                              section 1318

       Section 1318 directs the Secretary of the Army to align the 
     schedules of and ensure coordination between the Argentine, 
     East Bottoms, Fairfax-Jersey Creek, and North Kansas Levees 
     Units, Missouri River and Tributaries at Kansas Cities, 
     Missouri and Kansas, project and the project for flood risk 
     management in Armourdale and Central Industrial District 
     Levee Units, Missouri River and Tributaries at Kansas Cities, 
     Missouri arid Kansas. It is the Senate Managers' intent that 
     these two flood control projects be considered to be a single 
     project for budgeting purposes despite separate 
     authorizations, and for the purposes of the Supplemental 
     Appropriations in the Bipartisan Budget Act of 2018, P.L. 
     115-123, it is an ongoing construction project.


                              section 2010

       Section 2010 provides new authority to permit a State to 
     require the owner or operator of certain public water systems 
     to assess its options for consolidation, transfer of 
     ownership, or other activities in order to get that system 
     into compliance. The Senate Managers believe there is no 
     requirement for systems to adhere to the results of these 
     assessments.


                              section 4103

       Section 4103 provides technical assistance for treatment 
     works in the Clean Water Act (CWA). It is the Senate 
     Managers' view that, when determining which qualified and 
     experienced nonprofit organizations will provide on-site 
     training and technical assistance, the EPA should consult 
     with the relevant State and the publicly owned treatment 
     works to determine the forms of training and technical 
     assistance they believe will be most effective and 
     beneficial.

 Additional Views of the Senate Managers on Water Resource Issues and 
                       the Development of S. 3021

       EPA's ``Water Transfer Rule,'' 40 CFR Sec. 122.3(i), 
     excludes discharges from ``an activity that conveys or 
     connects waters of the United States without subjecting the 
     transferred water to intervening industrial, municipal, or 
     commercial use'' from the National Pollutant Discharge 
     Elimination System (NPDES) wastewater permitting requirements 
     of the Clean Water Act, 33 USC Sec. 1342. The Second Circuit 
     Court of Appeals held that EPA's interpretation of CWA is 
     reasonable and EPA is entitled to Chevron deference in 
     Catskill Mountain Chapter of Trout Unlimited v. EPA, 846 F.3d 
     492 (2nd Cir., 2017); cert denied, 138 S. CT. 1164-1165 (Feb. 
     26, 2018). The Supreme Court's denial of certiorari resolves 
     the question of whether EPA's Rule complies with the CWA.

[[Page S6747]]

       The Senate Managers encourage the Secretary to conduct a 
     study on impediments to the U.S. Army Corps of Engineers' 
     Water Infrastructure Finance and Innovation Act (33 U.S.C. 
     3901 et seq.) (WIFIA) program implementation. In the study, 
     the Secretary should examine obstacles to the implementation 
     of the Corps WIFIA program and to identify all projects that 
     the Secretary determines are potentially viable to receive 
     assistance. Additionally, the study should describe any 
     amendments to the Act or other legislative or regulatory 
     changes that would improve the Secretary's ability to 
     implement the Corps' WIFIA program. The report should be 
     submitted to the Committee on Environment and Public Works of 
     the Senate and the Committee on Transportation and 
     Infrastructure of the House of Representatives no later than 
     one year after enactment of AWIA 2018.
       Water resources projects have historically not been able to 
     be completed after construction commences due to the use of 
     benefit-cost analyses in the budgeting of water resources 
     development projects. During construction, costs accrue while 
     benefits are not yet realized, which lowers the benefit-cost 
     ratio stalling projects. The Senate Managers continue to be 
     concerned with this matter, and ask that the Corps provide 
     recommendations to Congress on how to address this concern 
     within 180 days of enactment of this Act.
       Several Chief's Reports were neither completed nor received 
     by Congress before negotiations closed on AWIA, and the bill 
     was passed by the United States House of Representatives. The 
     final bill did not include these projects for that reason. 
     The Senate Managers believe that the Corps should expedite 
     the completion of these reports in an expedient manner so 
     these projects can be included in the next Water Resources 
     Development Act.
       The Senate Managers believe that the Secretary should 
     expedite the expected Chief's Report for the Souris River 
     Basin, Minot, North Dakota, flood risk management project 
     that was authorized by section 209 of the Flood Control Act 
     of 1966 (80 Stat. 1423).
       The Senate Managers believe that the Secretary should 
     expedite the expected Chief's Report for the Delta Islands 
     and Levees, California, ecosystem restoration project. It was 
     authorized by a June 1, 1948, Committee on Public Works of 
     the Senate resolution; the resolution adopted by the 
     Committee on Public Works of the House of Representatives on 
     May 8, 1948; and House Report 108-357 accompanying the Energy 
     and Water Development Appropriations Act, 2004 (Public Law 
     108-137; 117 Stat. 1827).
       The Senate Managers believe that the Secretary should 
     expedite the expected Chief's Report for the Anacostia 
     Watershed, Prince George's County, Maryland, for flood 
     control, navigation, and ecosystem restoration. The project 
     was authorized by a resolution adopted by the Committee on 
     Public Works and Transportation of the House of 
     Representatives on. September 8, 1988.
       The Senate Managers believe that the Secretary should 
     expedite the expected Chiefs Report for the Hashamomuck Cove, 
     New York, project for coastal storm risk management, which 
     was authorized in title X of division A of the Disaster 
     Relief Appropriations Act, 2013 (Public Law 113-2; 127 Stat. 
     23).
       The Senate Managers encourage the Secretary to expedite the 
     completion of the post authorization change report (PACR) for 
     the Howard A. Hanson Dam, Washington project for water supply 
     and ecosystem restoration. This project was authorized by 
     section 204 of the Flood Control Act of 1950 (64 Stat. 180) 
     and modified by section 101(b)(15) of WRDA 1999.
       The Senate Managers encourage the Secretary to expedite the 
     completion of the PACR for the Port Pierce, Florida, shore 
     protection and harbor mitigation project. The project was 
     authorized by section 301 of the River and Harbor Act of 1965 
     (79 Stat. 1092), section 102 of the River and Harbor Act of 
     1968 (82 Stat. 732), and section 506(a)(2) of the Water 
     Resources Development Act of 1996 (110 Stat. 3757), and 
     modified by section 313 of the Water Resources Development 
     Act of 1999 (113 Stat. 301).
       The Senate Managers encourage the Secretary to expedite the 
     completion of the PACR for the Port of Iberia navigation 
     project, authorized by section 1001(25) of WRDA 2007 (121 
     Stat. 1053; 128 Stat. 1351).
       The Senate Managers encourage the Secretary to expedite the 
     completion of PACR for the Wrightsville Beach, North 
     Carolina, hurricane and storm damage risk reduction project. 
     It was authorized by section 203 of the Flood Control Act of 
     1962 (76 Stat. 1182) and section 501 of WRDA 1986 (100 Stat. 
     4135).
       The Senate Managers also encourage the Secretary to 
     expedite the completion of the PACR for the Carolina Beach, 
     North Carolina, hurricane and storm damage risk reduction 
     that was authorized by section 203 of the Flood Control Act 
     of 1962 (76 Stat. 1182).
       The Senate Managers note that a number of environmental 
     infrastructure projects were unable to be included in the 
     final text of AWIA due to the statutory requirements of the 
     project vetting process established in WRDA 2014. As noted in 
     the Joint Managers Statement on September 13, 2018, AWIA 
     amends the WRDA 2014 project vetting process to allow for the 
     consideration of environmental infrastructure projects 
     prospectively. Although the requirements of WRDA 2014 limited 
     the consideration of environmental infrastructure projects 
     during the development of S. 3021, the Senate Managers 
     encourage the Corps to vet such projects using the updated 
     review process and resubmit them for inclusion in the next 
     water resources authorization.
       Though not authorized in S. 3021, the Senate Managers have 
     also agreed to request and support a National Academies study 
     on the Rio Grande River Basin. Such study should examine the 
     Rio Grande River Basin as a holistic system to better 
     understand how the Corps should manage this river system in 
     the face of extreme weather events to better meet water needs 
     of the region. The National Academies should conduct an 
     evaluation of the capacity, operation and state of existing 
     basin reservoirs; look for opportunities to promote water 
     conservation through operation, regulation or physical 
     improvements of the reservoirs; and examine the impacts of 
     reservoir operation and management on species and habitats to 
     the region. The study is expected to provide recommendations 
     for future management scenarios and recommendations in 
     accordance with the Rio Grande Compact to assist in 
     establishing more flexible operation procedures to meet the 
     water needs of the Rio Grande River Basin. The Corps is 
     encouraged to initiate this study with the National Academies 
     as soon as practicable.

  Mr. BARRASSO. I yield the floor.

                          ____________________