[Congressional Record Volume 165, Number 94 (Wednesday, June 5, 2019)]
[Senate]
[Pages S3242-S3245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                                Ukraine

  Mr. PORTMAN. Mr. President, I want to spend a few moments talking 
about a trip I took overseas last week. After honoring our fallen 
soldiers here at home in Central Ohio and in Southwest Ohio, I traveled 
to Ukraine, where I had a meeting scheduled with Ukraine's new 
President, Volodymyr Zelensky. On my way there, I stopped in London for 
trade meetings and briefings by our Ambassador and our excellent U.S. 
Embassy personnel there.
  I was very eager to meet President Zelensky. First of all, along with 
my colleagues on both sides of the aisle, I have been a longtime 
supporter of Ukraine's quest for self-determination, democracy, and 
freedom from Russian aggression. As cochair and cofounder of the Senate 
Ukraine Caucus, along with my colleague Dick Durbin of Illinois, I have 
been proud to take the lead since the Revolution of Dignity in 2014 in 
giving Ukrainians the lethal and nonlethal aid they need to defend 
themselves from aggression in Crimea and the Donbass region.
  Second, I share that enthusiasm for Ukraine that is held by so many 
of my constituents, friends of mine, particularly in Cleveland and that 
area, who are proud members of the Ukrainian diaspora.
  Third, I was very impressed with President Zelensky's election 
victory, in part because he received a remarkable 73 percent of the 
vote. I also thought his focus on reform and change was important for 
the country. I wanted to meet with him and learn more about how and why 
his appeals for unity largely succeeded.
  Fourth, I wanted to hear more about his plans to fight the aggression 
from Russia on his eastern border, fight corruption at home, and put in 
place the reforms that will make his country stronger.
  Finally, I wanted to tell him we are with him. The United States 
stands by Ukraine, and the ties between our two countries can deepen 
even further. We want to help Ukraine succeed in this historic moment.
  I can report to my colleagues that I came away impressed from the 
meeting with President Zelensky. I was encouraged. We talked for about 
an hour and covered a broad range of topics. He is smart, engaging, and 
determined.
  We had a good discussion about Russian aggression in Crimea and in 
the Donbass region. President Zelensky has been out to the contact 
line, which is where the fighting is occurring. I was there last year. 
There is a real war going on, and 13,000 people have been killed on the 
eastern border of Ukraine, on that contact line. He spoke frankly about 
the bravery of his troops but also about their needs in terms of the 
weapons systems and basic conditions. We talked about the Russian 
propaganda along the eastern border and the efforts to jam Ukrainian TV 
signals to sow the seeds for dissension for the people of the Donbass 
region. We talked about some ideas that would help to counter that 
propaganda, the jamming, and the disinformation, and I have already 
been in touch with the State Department about those ideas.
  We also talked about the 24 Ukrainian sailors who were captured by 
the Russians last November 25 in the Kerch Strait in the Azov Sea. At 
that time, President Trump rightly refused to meet with President Putin 
until those sailors were free. President Zelensky and I talked about 
how to keep the pressure on Moscow to do the right thing. I gave 
President Zelensky my commitment to do everything in our power here in 
the Senate to keep these 24 sailors front and center until the crisis 
is resolved.
  Recently, the United Nations issued a statement about these sailors, 
by the way. It read that they should be sent back to Ukraine, that 
their taking was wrong.
  I told President Zelensky that he is now the face of reform in 
Ukraine and, indeed, for those of us who are watching around the world. 
He acknowledged that with a smile. He said that his commitment to 
reform is real, but he also had no illusions about how hard reform will 
be. Whether we are talking about fighting corruption, fighting for 
transparency in government, or fighting for civilian control of the 
military, I am very hopeful he will have the continued courage to see 
it through. He understands it is the only path forward and, frankly, is 
a linchpin of the U.S. partnership with Ukraine. As a matter of law, it 
is also a condition on our future defense assistance.
  Finally, we talked about the importance of the Ukrainian diaspora in 
the United States--about 2 million people strong, thousands of whom 
live in Ohio, my constituents--and about how they are putting great 
hopes in his leadership and are willing to do all they can to help.
  As I said, it was a very productive meeting, and I am grateful for 
his time. Of all of the messages of that discussion, the one that was 
the most important to me was when I asked him how he could win by 73 
percent of the vote. He said:

       It was not about me. It was about change and reform and the 
     betterment of the people of Ukraine.

  It was a modest and appropriate response.
  The messages of our discussion were reinforced in my meetings 
afterward with Lieutenant General Ruslan Khomchak. He is the new chief 
of the general staff of the Armed Forces of Ukraine--a man with great 
experience and knowledge. He was confident and well informed, and we 
had an open and detailed talk about how the United States can be 
helpful.
  I have already begun to talk to my colleagues on the Armed Services 
Committee and in the Trump administration about those specifics and 
some requests that he had.
  So, my colleagues, I return from this brief trip to Ukraine hopeful--
hopeful that Ukraine is ready to write the next chapter of its long 
history and that it will be a chapter of freedom with a government and 
society that benefits all of its citizens. The United States of America 
must continue to be a good friend and ally in that quest. I am 
certainly determined to do my part to make it so.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Ms. BALDWIN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Unanimous Consent Request--S. 1556

  Ms. BALDWIN. I rise today to once again speak about the ongoing 
threat in the Trump administration to the healthcare and guaranteed 
protections that millions of American families depend upon. President 
Trump has tried to pass through the Congress repeal plans that would 
take people's healthcare away and allow insurance companies to 
discriminate against people with preexisting health conditions or 
refuse to serve them at all.
  When that legislative repeal effort failed in 2017, instead of 
working in a bipartisan way to lower healthcare costs and improve 
access to care for all Americans, President Trump turned to another 
tactic--sabotaging our healthcare system--and there are more Americans 
uninsured today than there were when he took office.
  The Trump administration has even gone to court. They have gone to 
court to support a lawsuit that would overturn the Affordable Care Act, 
including its provisions that protect people with preexisting health 
conditions from discrimination. Just think about that. He is asking a 
court to strike down healthcare protections for Americans. If he 
succeeds, insurance companies will once again be able to deny coverage 
or charge much higher premiums

[[Page S3243]]

for the more than 130 million Americans who have some sort of 
preexisting health condition, including more than 2 million who live in 
the State of Wisconsin.
  What is the President's plan to protect people with preexisting 
conditions? He doesn't have one. He never has. And I have to say that I 
doubt he ever will. In fact, this administration has expanded what I 
call junk insurance plans. These are insurance plans that can deny 
coverage to people with preexisting health conditions, and they don't 
have to cover basic and essential health services, like prescription 
drugs or emergency room visits or maternity care. Most of these junk 
plans don't cover those things.
  When I spoke about this expansion of what I call junk insurance on 
the Senate floor 2 weeks ago, one of my Republican colleagues responded 
and claimed that these plans preserve preexisting conditions 
protections and essential health benefits. So today I wanted to clarify 
the record, and let's look at the fine print together.
  One of the junk plans currently available in my home State of 
Wisconsin reads, ``This plan has a preexisting limitation provision 
that may prevent coverage from applying to medical conditions that 
existed prior to this plan's effective date.''
  Another junk plan that is sold in Wisconsin states that the plan does 
not comply with the guaranteed essential benefits provided by the 
Affordable Care Act. To quote directly, the description reads: ``This 
coverage is not required to comply with certain federal market 
requirements for health insurance, principally those contained in the 
Affordable Care Act.'' The tiny fine print on this particular junk plan 
instructs individuals to check their coverage carefully to make sure 
they are ``aware of any exclusions or limitation regarding coverage of 
pre-existing 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.''
  The Affordable Care Act protects people against these insurance 
company abuses. Yet the expansion of these junk plans puts the power 
back in the hands of big insurance companies.
  Let me be clear. American families do not want to go back to the days 
when health insurers could discriminate against people with preexisting 
health conditions, women, and seniors by denying them coverage or 
charging them higher premiums simply because they get sick.
  As I have said in this Chamber many times, the people of Wisconsin 
want both parties in Congress to work together to make things better by 
making healthcare more affordable.
  I have heard from several Wisconsinites who want to know why the 
President is working to repeal the Affordable Care Act and take away 
their protections by expanding these junk plans. They are frightened 
that if this sabotage of our health system continues, insurance 
companies will again be able to deny coverage or charge higher premiums 
for the more than 130 million Americans who have preexisting health 
conditions, again, including more than 2 million in my home State of 
Wisconsin.
  I heard from Keri from Baraboo. Keri is a three-time cancer 
survivor--two breast cancer diagnoses and one melanoma. She experienced 
her first diagnosis at age 29. Now at age 61, Keri is able to get the 
healthcare she needs without being punished financially for having a 
preexisting condition. Keri is worried that if the Affordable Care Act 
is repealed, she could lose her health coverage or could be charged 
more because of her preexisting condition.
  Another Wisconsinite, Keith in Brookfield, recently wrote in to my 
office about what healthcare means to him and his family. Keith and his 
son both have type 1 diabetes. Both of them have health insurance 
through the Affordable Care marketplace that allows them to afford the 
insulin, glucose test strips, and other medications they need. If the 
Affordable Care Act is repealed, Keith and his son likely would not 
even be eligible to purchase one of these junk insurance plans. They 
could be denied coverage entirely due to their preexisting condition.
  We really need to act to stop this sabotage now. I want to protect 
the guaranteed healthcare protections that millions of Americans depend 
on. That is why I have introduced legislation, with my colleague, 
Senator Doug Jones of Alabama, to overturn the Trump administration's 
expansion of junk insurance plans, because we should be increasing 
access to affordable, high-quality healthcare options.
  The entire Senate Democratic caucus supports this legislation, along 
with the two Independents who caucus with us. The Nation's top 
healthcare organizations, representing tens of thousands of the 
Nation's physicians, patients, medical students, and other health 
experts, support this legislation.
  Anyone who says they support healthcare coverage for people with 
preexisting conditions should support this bill.
  Mr. President, as in legislative session, I ask unanimous consent 
that the HELP Committee be discharged from further consideration of S. 
1556; that the Senate proceed to its immediate consideration; that the 
bill be considered read a third time and passed; and that the motions 
to reconsider be considered made and laid upon the table with no 
intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  Mr. THUNE. Mr. President, reserving the right to object, let me just 
say that the plans to which the Senator from Wisconsin is referring are 
plans that tens of thousands of people are buying, and one of the 
reasons they are buying them is because it allows them to buy the 
insurance they want at a price they can afford.
  I can tell you, as I am sure the Presiding Officer can and probably 
everybody here can, when they travel across the country and talk with 
the farmers and ranchers and people who are buying their insurance on 
the individual market, the individual market has blown up. It has 
exploded. People are paying $3,000 a month in premiums--$36,000 a 
year--and have huge deductibles. So what they are doing is they are 
dropping coverage because they can't afford it. One of the reasons they 
can't afford it is because, under ObamaCare, there were so many 
mandates and requirements, it drove up the price. So they have these 
skyrocketing premiums, higher deductibles, and higher copays.
  I think that is precisely why the administration decided that, let's 
take these plans and give people an opportunity to buy the insurance 
they want at a price they can afford.
  Literally tens of thousands of Americans are now in these plans. What 
the Senator from Wisconsin is saying is, we are going to throw all 
these people off these plans. What does that do? That puts them back 
out, probably uninsured, which is what a lot of farmers and ranchers in 
places in South Dakota are doing--they are just dropping coverage 
because they can't afford it. Who can afford to pay $3,000 a month? 
That is what ObamaCare has left us. That is why we need new solutions. 
This solution is one that allows people to buy a plan they want at a 
price they can afford, coupled with association health plans--which 
Democrats, I think, here in the Senate are also objecting to and 
opposing--which are also giving individuals opportunities to join 
larger groups and spread their risk and drive down their premiums. We 
need plans that people in this country can afford, or more and more 
people are going to be in the ranks of the uninsured.
  So, Mr. President, I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Wisconsin.
  Ms. BALDWIN. Mr. President, I am disappointed that my Republican 
colleagues have once again chosen to object to protecting people with 
preexisting conditions.
  Mr. WYDEN. Mr. President, would my colleague yield?
  Ms. BALDWIN. Senator, I would be happy to yield.
  Mr. WYDEN. Mr. President, I appreciate my colleague. I am in such 
strong support of her legislation, the No Junk Plans Act. I will speak 
briefly on it after the Senator has concluded her important remarks. 
But apropos of what the distinguished Senator from South Dakota just 
said, isn't it correct that of course a plan is more affordable if it 
doesn't cover anything? I would be interested in my colleague's 
reaction to that, as she is the lead sponsor.

[[Page S3244]]

  I remember being in Wisconsin and seeing the wonderful support folks 
there have from my colleague because she has been a leader on these 
issues.
  I am just curious, because certainly my friend from South Dakota, who 
is a distinguished member of the Finance Committee and works with 
Senator Cortez Masto and me, often works with us on matters. But unless 
I am missing something, he said that what he is interested in is care 
that is more affordable. But it doesn't cover anything. What are my 
colleague's thoughts on that?
  Ms. BALDWIN. I would concur and say that the reason they have earned 
the nickname ``junk plans'' is because, frankly, some of them are 
hardly worth the paper they are written on.
  First of all, they do not have to comply with some of the very 
important protections we included as part of the Affordable Care Act--
otherwise known as ObamaCare--especially to protect people who have 
been ill once before or have been injured once before, people who have 
a preexisting health condition, maybe a chronic condition that will 
require medical care throughout their lives.
  In the old days, which apparently the Republican Senator wants to 
return to, there were all sorts of abuses, I would argue, that 
insurance companies could employ in order to limit their exposure, if 
you will. They had annual limits. They had lifetime limits. They had 
the capacity to drop somebody from coverage after an illness developed. 
They had the capacity to say: No, we are not going to offer you 
insurance. They certainly had the capacity to charge discriminatory 
premiums based on the preexisting condition. That causes great concern.
  I just recently saw a report about how much a typical--put it this 
way: a woman with a breast cancer diagnosis who requires chemotherapy 
and radiation treatment and medication--how much she would be 
anticipated to spend out-of-pocket if she had a junk plan at the time 
that diagnosis was made. It was, on average, $40,000.
  We also need to talk about another impact these junk plans have, and 
that is, if you think you have a really good chance of being healthy 
for the next year, and you decide ``This is a risk I can take,'' you 
are then fundamentally changing the structure of the marketplace for 
everyone else. You can anticipate that this is a choice healthier, 
maybe younger people will make, and it has a distorting impact on 
premiums in the marketplace. In fact, that is why these plans were 
curtailed under the previous administration. Now, this administration 
is greatly expanding these. They are no longer short term. They are 
long term, and a lot of harm will come.
  I want to conclude and say that when we have an administration that 
first fought legislatively to repeal the Affordable Care Act and then 
acted administratively to undermine and sabotage the Affordable Care 
Act through all sorts of administrative Executive actions, including 
defunding the State navigators who helped people make wise selections 
for their insurance and also limiting the open enrollment period, and 
when we have an administration that has decided to go to court and 
asked the court to strike down a U.S. law in its entirety, we know 
there is sabotage going on.
  I think the choice for the American people couldn't be clearer. We 
want to make things better, and the administration--enabled by some of 
my Senate Republican colleagues--is walking down a path that has led to 
2 million people losing their health insurance and others at grave risk 
of losing it in the future.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, before she leaves the floor, I want to tell 
my colleague from Wisconsin--and I think I speak for the distinguished 
Senator from Nevada as well--we are counting on our colleague from 
Wisconsin to come back to this floor again and again to try to pass her 
bill. I just want to tell her I will be with her every step of the way 
because I think, colleagues, without the bill from the distinguished 
Senator from Wisconsin, what we are looking at is a new golden age for 
scam artists peddling insurance that isn't worth much more than the 
paper it is written on.
  I was struck by my friend from Wisconsin's mentioning the old days of 
junk insurance.
  Well, I was around for those old days. I remember when the health 
insurance system in this country was basically for the healthy and 
wealthy. If you were healthy, no sweat, you could get insurance. If you 
were wealthy, you just went off and paid the bills. But the insurance 
companies could go out there and clobber people with preexisting 
conditions. So that was junk insurance.
  But I am even older than that. I remember when I was director of the 
Oregon Gray Panthers. I would go to a senior's house, and they would 
pull out a shoebox full of policies--10 or 15 policies. The 
distinguished Senator from Nevada, who has done so much consumer 
advocacy for consumers, I am sure knows about this challenge with 
seniors. These policies weren't worth the paper they were written on. 
They had--because I am kind of a lawyer in name only--what were called 
subrogation clauses. So if you had two policies, and they basically 
covered the same thing, both of them would try to squirm out of 
covering it. Talk about junk insurance.
  Finally, I got elected to Congress, like my colleague activist, and 
we passed a law that said we are going to get rid of that system and 
that you could have really only one policy, except in unusual 
situations. There were strong consumer protections.
  But if you look at what the Trump golden age of scams is going to 
bring back, there are going to be lots of people who are going to get 
clobbered, and, as my colleagues know, the people who are really going 
to get hit by this are, for example, older women who are pre-Medicare, 
because very often, in their late fifties and early sixties, they have 
a lot of difficulty trying to find jobs that pay good salaries and jobs 
that have good healthcare coverage.
  I am so appreciative of what my colleague is talking about.
  We are going to hear a lot of buzz words. Opponents of the Baldwin 
legislation are going to talk about how they are offering flexibility 
and they are offering patient-centered care. But that is just a bunch 
of eyewash because what they really do, as you touched on, is to fail 
to give patients care when they most need care.
  Today, Americans ought to be protected from these worthless, 
predatory scams. One of the things that I was proudest of, really, 
before my colleagues came here, is a piece of legislation I wrote, the 
Healthy Americans Act. A number of Republican Senators were cosponsors 
of this bill. It had airtight, loophole-free protection to ensure that 
people with preexisting conditions didn't face discrimination.
  By and large, we got that provision into the Affordable Care Act. It 
meant, as John McCain knew--we often talked about it--that healthcare 
would no longer be there just for the healthy and the wealthy. There 
would be real protections for those with preexisting conditions.
  For all practical purposes, that was really one of the two or three 
centerpieces of the Affordable Care Act, because, talk about a new age 
in insurance, that was it. Healthcare insurance would no longer be 
there for the healthy and wealthy only.
  Senator Baldwin is here, and what she is trying to do--I am looking 
at that clock--is trying to keep the Trump people from turning it back. 
That is what they want to do when Senator Baldwin talks about the old 
days--a forced march back to the days when the insurance companies 
could really, in many instances, just beat the stuffing out of 
vulnerable people.
  I thank my colleague for what she is doing. I heard just a little bit 
about it before I came over. I basically said: Let's hold off on things 
for a couple of hours so I can go out there and stand with Senator 
Baldwin and her allies.
  I say to the Senator: To me, what is important is that you have been 
here today, and it is going to be even more important that you come 
back again and again and again so that that clock continues to move 
forward in terms of American healthcare and not go backward. I thank my 
colleague.
  We are really delighted to have Senator Cortez Masto on the Senate 
Finance Committee, where she has been doing a lot of good work in 
healthcare

[[Page S3245]]

for consumers and seniors. I look forward to her remarks and to working 
with both of my colleagues.
  The PRESIDING OFFICER. The Senator from Nevada.
  Ms. CORTEZ MASTO. Mr. President, let me just say, on behalf of the 
State of Nevada, that I am so appreciative that I get to work with my 
colleagues from Wisconsin and Oregon. I thank them for their commitment 
because this is the No. 1 issue in the State of Nevada.
  I say to Senator Baldwin: What you are doing is really standing up 
for people and their right to have access to affordable healthcare in 
this country when they need it, access to medication when they need it, 
and the comfort in knowing that if they purchase a plan, if something, 
God forbid, should happen to them, then, they will have access to that 
medication and those doctors when they need it. Thank you for your hard 
work.
  I stand today because I want to tell you about one of these people in 
the State of Nevada. Her name is Carol Elewski. She is from Reno, NV. 
Carol has chronic asthma. She manages it with medications that cost up 
to $400 a month--$400 a month.
  In October of 2016, Carol had such a bad asthma attack that she was 
admitted to the hospital for 10 days as doctors struggled to get her 
breathing under control. Thankfully, today Carol's health is stable, 
but because of her preexisting condition and high prescription drug 
costs, she depends on the protections of the Affordable Care Act to 
keep her healthcare costs in check.
  This administration, as we have heard today from my colleagues, keeps 
chipping away at those protections. Literally, we have heard from the 
President that he is proud of sabotaging the Affordable Care Act. He 
has weakened the ACA by expanding access to these junk plans. These 
short-term, limited-duration plans don't cover essential services, like 
prescription drugs, emergency rooms visits, and maternity care.
  Today, I am joining my colleagues to, once again, urge that we do 
away with these scam insurance policies. These plans appeal to 
consumers because they are low cost, but they are also low benefit, as 
we have heard. Many people who purchase them don't realize just how 
limited the coverage is. All those details are in the fine print of the 
policies in dense legal jargon, and it is nearly impossible to 
understand. I am an attorney, and I will tell you that even attorneys 
have difficulty understanding that dense legal jargon in some of these 
policies. Consumers don't know that the plans they are signing up for--
because of the dense legal jargon and because they are not given 
specifics, and there is not enough transparency--don't even cover their 
preexisting conditions. Consumers may not realize that their coverage 
has annual or lifetime spending caps.
  Take Carol, for instance. Let's say she had signed up for a junk plan 
instead of an ACA-compliant plan--an easy mistake to make, since 
companies hide the differences between the two. With the junk plan, 
Carol's insurance could have refused to cover her healthcare costs 
because of her asthma. They could have denied payment for the emergency 
treatment she needed when she literally could not breathe, and they 
could have declined coverage for the essential medications she needs to 
keep the asthma in check.
  Under these junk plans, women who get pregnant don't get coverage for 
prenatal care or for delivering their babies. People with lifelong 
genetic conditions, like cystic fibrosis, can be denied coverage, as 
can those facing mental health issues.
  What is more, even if you don't buy a junk healthcare plan, these 
plans' very existence drives up our healthcare costs in this country. 
That is because younger, healthier people are more likely to risk 
choosing a limited junk plan because those plans are cheaper. That 
leaves the rest of the population, including many women and children, 
in a much more expensive insurance pool.
  Estimates say that junk plans could cost a family of four with an ACA 
plan over $3,000 in increased insurance premiums every year. The No 
Junk Plans Act that Senator Baldwin has introduced undoes the 
administration's order that allowed insurance companies to offer 
consumers up to 3 years of deceptive, skimpy coverage.
  Under the No Junk Plans Act, customers can only use these short-term 
plans for 90 days. The plans would work the way they were intended--as 
a bridge between coverage at one job and the next.
  I hear this all the time in Nevada. Americans have told us time and 
again what they want their healthcare to do: to cover preexisting 
conditions, keep down prescription drug costs, include women's health, 
cover mental health, and pay for emergency rooms visits.
  I am going to continue to fight for what the American people want, 
and that is the comprehensive coverage of the Affordable Care Act.
  We cannot let the administration succeed in doing an end-run around 
the ACA. The House has already passed legislation to do away with these 
flimsy and deceptive junk plans. Now it is time for the Senate to step 
up and do the same.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.
  (The remarks of Senator Udall pertaining to the submission of S. 1753 
are printed in today's Record under ``Submitted Resolutions.'')
  Mr. LEE. I yield the floor.
  The PRESIDING OFFICER. The majority leader.