[Congressional Record Volume 165, Number 168 (Wednesday, October 23, 2019)]
[Senate]
[Pages S6080-S6086]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 COMMERCE, JUSTICE, SCIENCE, AGRICULTURE, RURAL DEVELOPMENT, FOOD AND 
  DRUG ADMINISTRATION, INTERIOR, ENVIRONMENT, MILITARY CONSTRUCTION, 
  VETERANS AFFAIRS, TRANSPORTATION, AND HOUSING AND URBAN DEVELOPMENT 
                   APPROPRIATIONS ACT, 2020--Resumed

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of H.R. 3055, which the clerk will report.
  The senior assistant legislative clerk read as follows:

       A bill (H.R. 3055) making appropriations for the 
     Departments of Commerce and Justice, Science, and Related 
     Agencies for the fiscal year ending September 30, 2020, and 
     for other purposes.

  Pending:

       Shelby amendment No. 948, in the nature of a substitute.
       McConnell (for Shelby) amendment No. 950, to make a 
     technical correction.

  The PRESIDING OFFICER. The Senator from Maryland.


                   Unanimous Consent Request--S. 1834

  Mr. CARDIN. Mr. President, I think everyone in this Chamber would 
agree that free and fair elections are the bedrock of our democracy. We 
know it has been under attack. We know, from the Mueller report, that 
Russia, in 2016, used a systematic and comprehensive attack on our free 
election system to try to undermine our democracy.
  That attack occurred in the State of Maryland. Let me just quote, if 
I might, from the Washington Post article that said:

       Maryland was never in play in 2016. The Russians targeted 
     it anyway.

  The article states:

       Russia's Twitter campaign to influence the 2016 
     presidential election in Maryland began in June 2015, 17 
     months before Election Day, when the St. Petersburg-based 
     Internet Research Agency opened an account it called 
     @BaltimoreOnline and began tweeting about local news events.
       Yet, the IRA, the Russian troll factory that U.S. 
     prosecutors blame for the massive disinformation efforts 
     during the 2016 campaign, devoted enormous attention and 
     preparation to its Maryland operation, all in a likely 
     effort, experts say, to widen racial divisions and demoralize 
     African American voters.

  That is what happened in 2016. Our intelligence community tells us 
that Russia is active today trying to influence our 2020 elections, and 
they are using technology to try to undermine our free election system. 
We must do more to protect our system.
  It was for that reason and many others that I introduced S. 1834, the 
Deceptive Practices and Voter Intimidation Prevention Act of 2019. It 
is cosponsored by Senator Klobuchar, Senator Leahy, Senator Feinstein, 
and others. This bill is an effort to try to protect us from this type 
of international interference in our elections, as well as local 
efforts that are aimed at trying to intimidate voters targeted at 
minority voters. That should have no place in American politics.
  This bill did pass the House of Representatives in March of this year 
in H.R. 1.
  Very quickly, let me tell you what this bill does. It prohibits 
individuals from knowingly deceiving others about the time, place, 
eligibility, or procedures for participating in a Federal election; 
addresses new digital challenges that pose a threat to citizens 
exercising their right to vote, particularly the use of digital 
platforms to disseminate false information regarding Federal elections; 
and combating voter intimidation, especially efforts aimed at 
suppressing voter rights.
  I would hope every Member of this Chamber would support these 
efforts. Unfortunately, the majority leader has failed to bring any of 
these issues to the floor or give us any time to take up legislation in 
order to protect our free election system. Time is running out. The 
election primaries will start early next year. We need to take action 
now.
  That is why I am going to make this unanimous consent request. I hope 
we can agree to it.
  I ask unanimous consent that the Judiciary Committee be discharged 
from further consideration of S. 1834, the Deceptive Practices and 
Voter Intimidation Prevention Act of 2019; that the Senate proceed to 
its immediate consideration; that the bill be 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?
  The Senator from North Dakota.
  Mr. CRAMER. Mr. President, reserving the right to object, I don't 
disagree with everything that is in the Senator's bill--far from it. I 
agree with much of it, but it does have several critical flaws, and it 
is not ready for prime time.
  In most, if not all, States, it is already illegal to prevent or try 
to prevent lawful voters from trying to register to vote. We all agree 
that every qualified voter should have an opportunity to register for 
an election. But this proposal is written so broadly that it would 
prevent election officials from rejecting the registration of an 
illegal immigrant. It could prevent poll workers from stopping a 16-
year-old from voting in an election. In other words, this would 
seemingly make it illegal for voting registration officials to actually 
do their job.
  I assume it is not intentional, but it is obviously a big problem. 
Other sections of the bill create significant First Amendment concerns. 
It would create criminal penalties for political speech that misstates 
endorsements a candidate has received. Nobody approves of lying, but 
there are enormous problems when the Federal Government starts sending 
people to jail for what they say. Even the ACLU opposes my colleague's 
bill because this bill is so anti-First Amendment.
  Just a few days ago, Secretary Hillary Clinton claimed that a former 
third-party candidate was a Russian asset and that a Democratic 
Presidential candidate she doesn't like is Russia's preferred candidate 
in the upcoming election. Should Mrs. Clinton have violated Federal law 
because she perhaps misstated a political endorsement as a way of 
making a political point? We don't want to start down the road where 
the Federal Government referees free speech.
  I believe there is an appetite on both sides of the aisle for making 
good policy that honors the principle behind my colleague's bill, but 
this version has enormous problems, is nowhere near ready to pass by 
unanimous consent, and I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Maryland.
  Mr. CARDIN. Mr. President, I regret that my colleague has raised the 
objection. Let me point out that this bill has been pending in previous 
Congresses. We have gone through all of the challenges my friend has 
already talked about. There are real problems that are occurring in our 
States.
  We had billboards in minority communities highlighting voter fraud in 
an effort to intimidate African-American voters. We have seen 
information sent out with wrong dates of elections. We have seen 
robocalls pretending to be from a particular campaign when they are 
from the opposite campaign in an effort to intimidate voters from 
participating.

[[Page S6081]]

  We can always find reasons why we shouldn't consider legislation, but 
the truth of the matter is that we have given the OK in our system for 
some to say it is all right to try to intimidate voters from voting--
something I would hope this Congress would want to go on record to say 
it should have no place in America, particularly when it is targeted at 
minority communities in an effort to reduce their numbers.
  I regret my colleague has objected, and I hope that we will have a 
chance to take up election security legislation.
  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.
  Mr. CRAMER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


              United States-Mexico-Canada Trade Agreement

  Mr. CRAMER. Mr. President, it has been a year since the United 
States, Mexico, and Canada agreed to the U.S.-Mexico-Canada Trade 
Agreement, the replacement for NAFTA and the modernization for the 
NAFTA agreement that has been so important to all three of our 
countries. In fact, we are coming up on 1 year since it was signed by 
leaders of all three countries. In fact, the country of Mexico has 
ratified the USMCA. Canada is waiting for the United States to take the 
next step so they, too, can ratify this very important trade agreement.
  This agreement between the three countries on the North American 
continent is estimated to add $68.2 billion to the U.S. economy and 
create 176,000 new jobs. The USMCA would also increase exports to 
Canada by 5.9 percent, to a total of $19.1 billion, and shipments to 
Mexico by 6.7 percent, or $14.2 billion. Imports from Canada and Mexico 
would rise by 4.8 and 3.8 percent, respectively.
  But the ratification process has to begin with the Democrats in the 
House under the trade promotion authority with which this deal was 
struck. The Democrats leading the House seem to be more focused on 
taking away one person's job than creating 176,000 new ones here in the 
United States. It is time for Speaker Pelosi to act on something that 
is nearly unanimously agreed to.
  While not every person agrees to it, I don't think there is any 
question that if she would bring up the USMCA for a vote in the House, 
it would pass. We know that when it comes over to the Senate, it will 
pass here for many good reasons--for the reasons I already stated, for 
economic reasons and job creation reasons.
  But I also want to add that passage of the USMCA is important to 
negotiations with other countries. Having Mexico, Canada, and the 
United States in one accord adds leverage to the President's 
negotiations with China, especially now that we have a bilateral trade 
deal with Japan that President Trump has negotiated so effectively, and 
when working with other neighbors and allies on other bilateral trade 
agreements. All of this adds to leverage in negotiating with China.
  I want to speak for a couple of minutes about the specifics to my 
State of North Dakota. We are a border State with Manitoba and 
Saskatchewan in Canada, and our northern border is by far our biggest 
trading partner. In 2017, my State of North Dakota exported $5.8 
billion worth of goods to the global marketplace. Those exports 
contributed to 28,000 jobs. Of that $5.8 billion, we exported $4.9 
billion of goods to Canada. That is 84 percent of North Dakota's 
exports that go to our northern neighbor, Canada. When adding Mexico 
into that equation, that is 88 percent of the value of North Dakota's 
exported goods and services going to USMCA countries.
  Farmers and manufacturers can be very pleased with the renegotiated 
terms that will now benefit them directly with a commitment from Canada 
to reduce trade distorting policies and improve transparency, something 
that we have a little issue with in the original NAFTA.
  In addition, the new agreement assures nondiscriminatory treatment 
for agricultural products standards--a major win for our farmers. 
Specifically for North Dakota, I spoke directly with President Trump 
concerning the biased Canada grain grading issue and wrote a line he 
actually used in a speech.
  I worked closely with U.S. Trade Representative Lighthizer and chief 
agriculture negotiator Doud to ensure that our grain growers were 
relieved of the unfair practice of grading North Dakota grain as sub-
par feed. This is estimated to double U.S. exports of grain to Canada.
  North Dakota grain growers deserve better, and they will now be 
recognized properly if we can get the House of Representatives to bring 
the USMCA up for a vote.
  Our manufacturing workforce will be pleased with the automotive and 
machinery provisions that are included in this deal. Going forward, 
vehicles are mandated to have 75 percent of North American content to 
be imported without tariffs, compared to 62.5 percent. Also, at least 
40 percent of a vehicle eligible for duty-free importing must have been 
built by workers earning at least $16 an hour. This is a big win for 
labor. This wage requirement will ensure that the market is not being 
flooded by cheap labor, particularly from south of the border.
  Renegotiating and reorganizing NAFTA into the USMCA was an essential 
move for our State, given the economic relationship and mutual reliance 
North Dakota and Canada share as neighbors. I applaud President Trump 
for securing his promise to approve a superior deal for our State and 
our country. It is my sincere hope that the House and Senate will act 
to ratify this agreement as soon as possible in order to cement this 
win for our country.
  We must demand that Speaker Pelosi set petty partisan politics aside, 
even if just for a day, to bring this important ratification up to the 
House so it can be passed and sent to the Senate so we can be on our 
way to a new, improved, modern U.S.-Mexico-Canada Trade Agreement.
  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.
  Mr. WYDEN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mrs. Blackburn). Without objection, it is so 
ordered.
  Mr. WYDEN. Madam President, I understand that several of our 
colleagues today have been on the Senate floor calling for an immediate 
vote on the President's new North American Free Trade Agreement.
  Setting aside the fact that there have not yet been the hearings or 
the markups necessary to allow that to happen, it would be a major 
mistake for the Trump administration to seek a vote on a trade deal 
until it is a good deal. While the new North American Free Trade 
Agreement includes some improvements to the existing agreement, there 
is still work to be done to get the best deal for American workers and 
consumers.
  Updating NAFTA, for example, means confronting the areas where older 
trade agreements continually have fallen short: fighting to protect 
labor rights in the interests of working families, preventing a race to 
the bottom when it comes to the environment, and making sure there are 
vigorous enforcements of our trade agreements so that other countries 
can't treat a trade deal as an empty document that gives them yet more 
time and more opportunities to rip off American jobs.
  I do have real concerns about the current trade enforcement because 
the new NAFTA carries over too much of the weak enforcement system of 
the old NAFTA. It is too easy on trade cheats, and it is not good 
enough for American workers, particularly on the issue of protecting 
our working families and labor rights.
  Now, I and our colleague Senator Brown have proposed several 
additional tools to address specific challenges in Mexico. It is my 
view, in having talked to trade officials and in having gathered 
information elsewhere, that by all accounts, there has been good 
progress on this front. Additionally, one of the bigger challenges that 
has to be confronted is that of identifying the hundreds of thousands 
of sham labor contracts in Mexico that

[[Page S6082]]

have exploited workers there and harmed workers here in our country. 
Mexico must remain on track to get those contracts renegotiated on 
behalf of the interests of our workers.
  To my colleagues who say this deal must be passed in the name of 
certainty, I want to make a point that, I think, is very important. 
During this overhaul, the original North American Free Trade Agreement 
remains in place. Workers, farmers, ranchers, and businesses should not 
have to go to bed at night fearing that economic uncertainty is going 
to rob them of their livelihoods. The uncertainty arises only when the 
President acts out and makes impulsive threats regarding our trade 
relationships. When the President threatened new tariffs on Mexico this 
June over immigration policy, that created far more uncertainty than 
our taking the time that would be necessary to get this deal right. 
American workers and farmers have already been hurt by the President's 
impulses. More are going to get hurt if Trump threatens and produces 
chaos, causing the Congress to accept a bad deal on the North American 
Free Trade Agreement.
  Passing a trade deal that would allow the President to unilaterally 
change trade rules and jerk around entire industries would be a 
substantial mistake and would be one that would produce still more 
uncertainty. That is not how you get trade done right. Based on that, I 
do have some real concerns about how the administration wants NAFTA 2.0 
to be implemented.
  I am just going to close by mentioning a fact or two about my State.
  In my State, trade and global commerce are priority business. One in 
five jobs in Oregon depends on international trade, and the trade jobs 
often pay better than do the nontrade jobs because they reflect a level 
of added value. When I am asked at a town meeting what my views are on 
trade, I always say: Let's grow it in Oregon. Let's make it in Oregon. 
Let's add value to it in Oregon and then ship it around the world. I 
don't take a back seat to anybody in talking about the importance of 
trade, particularly in my State.
  I sat and listened to a number of my colleagues who talked about 
their views and that we ought to just have an immediate vote, that we 
just should vote now. I don't know what they thought with respect to 
hearings and markups and the kinds of things that are required. They 
just said that we have to move now. As the ranking Democrat on the 
Committee on Finance, I just want to make it clear that you go when a 
trade deal is a good deal. There are issues still to be resolved on 
that matter, and I am interested in working with both sides in good 
faith in order to get a good deal.
  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.
  Mr. WARNER. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                         Health Insurance Plans

  Mr. WARNER. Madam President, I am here today because protections for 
Americans with preexisting medical conditions are under attack from 
this administration. For the last 3 years, this President has used 
every tool at his disposal to try to undermine the ACA. He tried to 
repeal it twice through Congress. When that failed, the administration 
joined a lawsuit that would strike down the ACA with no plan to replace 
it.
  The truth is, this administration is, unfortunately, actively working 
to destabilize the insurance market. One way the administration is 
attempting to undermine the ACA is with the so-called ``short-term 
plans,'' which I would refer to--and, frankly, I think most Americans 
if they saw the criteria in these plans would not call them short-term 
plans--and I would call them junk plans. Thanks to this administration, 
these junk plans allow insurance companies to once again discriminate 
against Americans with preexisting conditions.
  Make no mistake, these plans are a threat to the stability of the 
insurance market and to every American with a preexisting condition. 
That is why I have introduced a resolution that will force an up-or-
down vote on the administration's rule that pushes more of these junk 
plans on unsuspecting consumers and, consequently, significantly 
increases costs for other Americans.
  I fear some Members of this body have forgotten what it was like 
before the Affordable Care Act, when an unexpected surgery or a 
diagnosis of a chronic illness could mean a one-way ticket out of the 
middle class.
  Unfortunately, this is not a hypothetical. Recently, one of my 
constituents, a man named Jesse, received a $230,000 medical bill for 
his back surgery. Unbeknownst to him, he had purchased a plan that he 
thought would cover this, but this plan, unfortunately, was a junk plan 
that considered his back injury as preexisting.
  Jesse is one of the more than 3 million Virginians with a preexisting 
medical condition.
  I have three daughters. Two of my three daughters have preexisting 
medical conditions that would not be covered under these junk plans.
  Today I want to share some of those stories to remind my colleagues 
of what real people will face if we allow the administration to 
continue dismantling these protections that folks count on.
  Recently I got an email from Linda in Warren County, VA. She is a 
cancer survivor with multiple preexisting conditions. She wrote:

       Due to the housing fallout in 2008, we lost our healthcare 
     coverage and I could no longer get health coverage because of 
     my cancer diagnosis.

  Mindy from Henrico, around Richmond, is also a cancer survivor. She 
writes:

       Even though my cancer is in partial remission, I remain on 
     treatment for fear of the cancer returning again. As I 
     prepare for retirement, it scares me to think that this 
     cancer would be considered a pre-existing condition and I 
     could be denied healthcare or would be required to pay 
     through the nose for insurance.

  Sharon in Norfolk told me about her struggle with behavioral health 
issues. She wrote:

       I am a functioning member of society, however that will not 
     last long if I lose this access to medical help. I went off 
     my medications in 2000 as I couldn't afford a doctor and 
     medication . . . and it was a very thin line between me and 
     homelessness.

  Justine from Loudon County is worried that she could lose coverage 
for her diabetes care. Here is her message for the Members of this 
body:

       What if you or a loved one was diagnosed with a ``pre-
     existing condition?'' How would you feel about being denied 
     health coverage?

  It is a good question that Justine asks, and that we should all ask 
ourselves. As a father, as I mentioned, I have dealt with the scary 
reality of having a child with juvenile diabetes and a child with 
asthma, but I am also an extraordinarily lucky individual, and I knew 
that because of the insurance and because I had the resources, they 
would be taken care of. That is not the case for many of the 3 million 
Virginians who have preexisting conditions or the countless tens of 
millions of Americans.
  Katherine in Blacksburg, VA, told me about her daughter who was 
diagnosed at age 3 with juvenile diabetes. She wrote:

       Until there is a cure for diabetes, I cannot imagine how 
     costly it would be for her to stay alive and manage her 
     health if there are limitations on coverage for people with 
     pre-existing conditions.

  Katherine's daughter deserves access to healthcare just as much as my 
daughter does.
  I got a letter from a pharmacist in Abingdon, in far southwest 
Virginia, named Michael. He treats diabetics every day, and he also 
knows what it is like because he has lived with the disease for 38 
years.
  He writes:

       Without insulin we will die. . . . If coverage for pre-
     existing conditions goes away, you will see a large decline 
     in the health of type 1 diabetics, and more dependence upon 
     Medicaid.

  This is not only somebody who has dealt with diabetes for 38 years, 
but he is also a knowledgeable consumer. He is a pharmacist.
  I have too many of these stories to share them all today, and I see 
my friend, the Senator from Washington State. She and other of my 
colleagues will be coming to the floor today and over the next few days 
until we have a

[[Page S6083]]

chance to vote on this CRA, to share stories as well of what we will do 
to Virginians, Washingtonians, Tennesseans, and Americans all across 
this Nation if we go back to a time when we did not protect people with 
preexisting conditions.
  One or two more quick stories. James from Danville, VA, told me about 
his 10 separate preexisting conditions. Lynn from Lynchburg is on three 
separate medications due to a brain tumor. She could die if her 
insurance coverage didn't cover those medications, and the list goes 
on.
  In closing, when we talk about preexisting conditions, we are talking 
about people's lives. That is why we must pass the resolution I have 
introduced to reverse the administration's harmful rule changes and 
defend protections for folks with preexisting conditions.
  I think virtually every one of my colleagues on both sides of the 
aisle have said they absolutely want to protect folks with preexisting 
conditions. Even for folks who otherwise completely don't agree with 
the ACA, that is the one part of the ACA that folks have agreed upon.
  Well, next week we are going to have a chance to move past talk, to 
move past statements, to actually go on the record with an up-or-down 
vote, to go on the record to say that we are going to protect 
provisions of the ACA that made sure that folks with preexisting 
conditions weren't discriminated against, or we will go on the record 
saying: No, what the administration is doing is all right.
  These short-term or junk plans sound good until you realize you are 
not getting the kind of coverage that you thought you were buying. We 
will have that decision point come next week.
  I ask my colleagues across the aisle who believe and say they support 
protections for folks with preexisting conditions, well, they will have 
a chance to go on the record next week. I hope they will. I hope we 
will pass overwhelmingly this CRA and make sure that protections for 
folks with preexisting conditions are maintained.
  I can't think of an issue that is more important to so many families 
all across Virginia, and, for that matter, all across the country.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Madam President, I want to thank the Senator from 
Virginia for bringing forward this CRA that we will be voting on that 
will allow us to affirmatively from the Senate say: We want to protect 
people with preexisting conditions and people from these junk plans 
that really take away the protections that are so important and that 
every family counts on. So I really appreciate that from the Senator.
  When it comes to healthcare, families across our country have 
repeatedly seen President Trump and Republicans say one thing and do 
the exact opposite. Despite proclaiming themselves somewhere along the 
line as the ``party of healthcare,'' despite making empty promises to 
fight for families and people with preexisting conditions, the 
cornerstone of Republicans' healthcare policy has been to attack the 
care families really rely on with their massively harmful TrumpCare 
proposals--the junk plans that you just heard about--and waivers that 
chip away at patient protections, and, of course, that partisan lawsuit 
which the court could rule on any day.
  Let's make it clear. If Republicans get their way in court, they are 
going to throw the lives of patients across the country into chaos and 
uncertainty by striking down those protections for preexisting 
conditions by stripping away health insurance from tens of millions of 
people covered through Medicaid expansion or the exchanges.
  It will get rid of the lifetime and annual caps that are on patients' 
out-of-pocket costs, while bringing back caps on their benefits, even 
for those who are insured through their own employers--so this applies 
to everyone--and ending essential health benefits that require insurers 
to cover things like prescription drugs or maternity care, mental 
healthcare, emergency care, and a lot more.
  While Republicans have been advancing their attacks on families' 
healthcare, they have also been blocking commonsense solutions that 
Democrats are out here pushing for--like legislation to bring down drug 
prices through impactful steps like Medicare negotiation or making 
coverage more affordable for our working families and protecting 
patients with preexisting conditions from the Republicans' reckless 
lawsuit.
  Now, Democrats in the House have also passed legislation to restore 
funding that President Trump cut, to help people find the right care 
for themselves, to reverse President Trump's harmful junk insurance 
rule, and to actually defend patients from that partisan lawsuit that 
Republicans are pushing to upend healthcare as we know it.
  Now, what have Leader McConnell and Senate Republicans done with 
those solutions that have come over here from the House? Well, they 
have buried each and every one of them in a legislative graveyard, 
while brazenly and inaccurately claiming they care about fighting for 
patients or protecting preexisting conditions.
  I am here to say today that Republicans' transparent healthcare 
charade is coming to an end. Soon, as you heard, Democrats will force a 
vote on legislation that Senator McConnell cannot bury in their 
legislative graveyard, meaning every Senator here is going to have to 
go on the record as to where they really stand on healthcare--whether 
they stand with families or with President Trump and his schemes that 
take power away from patients and give it back to the insurance 
companies.
  Our legislation will reverse a step that President Trump took to warp 
a tool meant to encourage innovation into one that encourages States to 
eliminate protections for patients with preexisting conditions, 
increases costs, and promotes those harmful junk insurance plans that 
can charge vulnerable patients more and cover less.
  President Trump's junk plans can flout protections for preexisting 
conditions, meaning that they can discriminate against patients--
patients like Lily. She is a high school student from Gig Harbor, WA, 
and has cystic fibrosis; or Julie, who is a four-time cancer survivor 
from Mercer Island; or Javi, who is a college student in Seattle with 
mental health needs; and millions of other patients across the country 
with preexisting conditions.
  Letting President Trump expand the use of these junk plans will leave 
patients with higher premiums, higher out-of-pocket costs, and fewer 
affordable options to get the healthcare that they need, and President 
Trump's rule could even be used to cut financial help for patients who 
need it the most and take benefits away from the sickest patients, even 
if they don't buy that junk insurance.
  This is absolutely unacceptable and exactly why the vote Democrats 
are going to be forcing is so important. These patients across the 
country and in my State deserve to know that we have their backs, that 
we are fighting against President Trump's efforts to undermine their 
healthcare, not cheering him on and blocking efforts to stop them.
  Democrats are going to be out here a lot to talk about this because 
we know families in the country care about this a lot. We are going to 
be putting pressure on Republicans to do the right thing--the thing 
patients and families sent them here to do. If they don't, if they 
continue their relentless attacks on family healthcare, if Republicans 
continue to side with President Trump and his efforts to take 
protections away from patients and give that power back to the 
insurance companies, we are not going to give up. Democrats are not 
going to let up. We will double down. We are going to make sure that 
families know which party is offering solutions to protect their care 
and which one is blocking them, which party is trying to repair the 
damage President Trump has caused and which party is trying to cause 
even more harm, which party is fighting for their healthcare and which 
one is fighting against it. We are going to be out here day after day 
to keep pushing Republicans to do the right thing, to stand up for 
patients and families even if it means standing against President 
Trump.
  Madam President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.

[[Page S6084]]

  The senior assistant legislative clerk proceeded to call the roll.
  Mr. WYDEN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WYDEN. Madam President, our colleagues, Senator Warner and 
Senator Murray, have come to the floor over the course of the day to 
speak about the importance of protecting Americans who have preexisting 
health conditions, and I want to see if I can put this in a bit of 
context so that people understand why those of us on this side feel so 
strongly, why I think Senator Warner and Senator Murray were spot-on, 
and I want to put it in the context of the way I came up.
  When I got out of law school, I set up a legal aid program for senior 
citizens. I was codirector of the Oregon Gray Panthers, and I saw what 
it meant when the big insurance companies could just clobber those 
people with preexisting health conditions. They would just throw all 
kinds of extra costs on them, heap extra expenses, and pretty much beat 
the stuffing out of anybody who had a preexisting health condition. We 
tried as hard as we could to push back. This was all before I was in 
public life.
  At the time, I said: If I ever have the opportunity in the Congress, 
I am going to make this priority business to make sure that everybody 
in America could go to bed at night knowing that they wouldn't be wiped 
out in the morning if they have a preexisting condition.
  So in the course of the whole debate about the Affordable Care Act, I 
produced a piece of legislation called the Healthy Americans Act. Seven 
Democrats and seven Republicans were cosponsors. Some of the Republican 
cosponsors are still serving in the U.S. Senate today.
  What we had in it was airtight, loophole-free protection for anybody 
with a preexisting condition. We were thrilled that, by and large, our 
provision from the Healthy Americans Act became the provision in the 
Affordable Care Act that ensured that there would be a new generation 
of consumer protection and security for the millions of Americans who 
had these preexisting conditions.
  Now, as my colleagues have said, there is a very real threat to that 
protection that is now in the Affordable Care Act that really does 
provide airtight, loophole-free protection for those with preexisting 
conditions. I just want to make sure that we get on the record, for 
those who are following the debate, what it means if you roll back 
these protections for those with preexisting conditions.
  In a sentence, what it means is America goes back to the days--those 
days when I was codirector of the Gray Panthers--when healthcare was 
for the healthy and the wealthy. That is what you have if you allow 
discrimination against those with a preexisting condition. If you are 
healthy, you don't have an issue with preexisting conditions. If you 
are wealthy, you don't have an issue with preexisting conditions. But 
if you are not healthy and you are not wealthy and you get rid of these 
protections, you are in a world of hurt. That is what we are looking at 
should the Republicans prevail.
  The Republican's official position is ironclad: Preexisting consumer 
protections ought to be pretty much thrown in the trash can. I am going 
to spend a few minutes outlining the examples of why that is the case.
  First, we saw the TrumpCare disaster of 2017. The Republicans tried 
to repeal the Affordable Care Act with its protection for preexisting 
conditions. They failed, and preexisting conditions lived to fight 
another day. Enough said there.
  Second, my colleagues have chosen to stand idly by while Republican-
led States and the President tried to maneuver through the courts to 
toss out the entire Affordable Care Act overall with the protection for 
people with preexisting conditions. The so-called Texas lawsuit relies 
on an argument that wouldn't hold up in law class 101 on the 
Constitution. But thanks to a cadre of ideological judges, it does seem 
that this case may make its way to the Supreme Court.
  I do want to be clear for those who are following this. Republican 
Members of this body are not just some kind of innocent bystander when 
it comes to this court case. They could, if they wanted to, join 
Democrats to take steps that would prevent this lawsuit from going 
forward, and, again, we can have protections for people with 
preexisting conditions. Instead, all the arguments are about why the 
Republicans just can't be involved and a lot of excuses and deflection.
  Third, the so-called ``fix-it'' bills that my Republican colleagues 
have offered to--what they claim--``protect'' preexisting conditions 
are just so full of disclaimers that they look as if they might have 
been written by one of those insurance company lawyers from the old 
days who was only interested in finding ways in which the insurance 
company could win and the consumer would lose. Any healthcare 
legislation that doesn't provide an ironclad guarantee of health 
coverage, no matter your health status, age, or gender, amounts to a 
huge loophole that leaves hard-working, middle-class people emptyhanded 
when they need health coverage the most. If insurance companies can 
make coverage for your preexisting conditions so expensive that it is 
unaffordable, it is no different than being denied coverage in the 
first place.

  Next, the Trump administration has given the States the green light 
to use taxpayer dollars to push junk plans that aren't worth the paper 
they are written on. I will have more to say about that in the days 
ahead, but not only does this approach amount to federally funded 
fraud, this is a gross misreading of current law that is going to 
disproportionately hurt vulnerable Americans with preexisting 
conditions who need comprehensive healthcare.
  Under these rules, unscrupulous insurance companies can charge people 
more if they have a preexisting condition, deny benefits for specific 
types of treatment, or even deny coverage altogether. This rule change 
is--and we are going to talk some more about it--a grotesque perversion 
of the provision I authored in the Affordable Care Act that would let 
States build on the strong protections in the law but not go out and, 
basically, completely undermine them.
  Despite this parade of grim tidings, next Friday, November 1, is the 
beginning of open enrollment for individual, private health insurance 
coverage on healthcare.gov, so there is a little bit of encouraging 
news. Even as the Trump administration has done everything they can to 
fuel the fires of uncertainty for people about where healthcare is 
going to be and what is going to be available, millions of families are 
going to be able to shop for plans that provide them with health 
coverage. That is because, yesterday, Americans got the news that the 
average premium for the so-called ``benchmark plan'' for the individual 
market--part of the Affordable Care Act--is going down by 4 percent. 
Make no mistake, this reduction is in spite of all of the things the 
President has done to make it harder to get affordable coverage under 
the Affordable Care Act. Attributing this reduction to the President is 
about as believable as saying that Trump University is going to make a 
comeback any day now.
  In fact, one insurer who posted a premium decrease last year crunched 
the numbers and said that they could have reduced premiums by over 22 
percent if it weren't for congressional Republicans and sabotage by the 
Trump administration.
  Americans should still sign up for health coverage if they need it 
before the deadline on December 15, even if the President hasn't done 
you or your family any favors on healthcare.
  One last point on healthcare: While Americans are looking for 
affordable healthcare plans on healthcare.gov, there are going to be a 
lot of scam artists on the prowl outside of the official website. These 
hucksters are going to be trying to pawn what are called junk plans 
onto unsuspecting families. The junk plans might sound attractive. They 
always seem to be advertising promotional materials that say: ``Low 
premiums! Affordable coverage!'' But I just want to make clear that if 
you or a loved one gets sick, chances are the fine print says that the 
carrier of this junk plan will not cover what you need. So despite the 
low premium, the real bill comes due right when you need your coverage 
the most.
  I am also struck by how similar these junk plans are that are being 
offered

[[Page S6085]]

now by these rip-off insurers--how similar they are to another part of 
what we dealt with when I was codirector of the Gray Panthers, legal 
aid for senior citizens. Back then, we saw that fast-talking insurance 
salespeople would sell older people 10, 15, sometimes even 20 private 
policies that were supposed to supplement their Medicare, and a lot of 
them weren't worth the paper they were written on. If you had one, 
often, the others wouldn't offer you coverage because they would say 
that you already had coverage.
  Finally, we outlawed that. We wrote a law that streamlined the 
Medigap market, and it basically is still the law today.
  With respect to the law on preexisting conditions, I hope we can 
protect that. We shouldn't be creating new problems for patients and 
consumers. And, particularly, when we make progress, such as we did 
with the Affordable Care Act so that we now have in it airtight, 
loophole-free protections for those with preexisting conditions, we 
certainly shouldn't turn back the clock to the days when healthcare was 
for the healthy and wealthy.
  I am going to have more to say about these junk plans and how they 
have really unsavory, historical roots, particularly when the 
equivalent was sold to the elderly. These junk plans are now just a 
backdoor to denying care to Americans with preexisting conditions, and 
people ought to know about the dangers. People deserve to know whether 
their elected officials are going to fight to protect their rights or 
whether they are going to let a bunch of con artists weaken the core 
protections for preexisting conditions that Senators Warner and Murray 
talked about today that are so important to keeping families healthy.
  I urge my Republican colleagues to change course and stand with 
Democrats in defense of the law and real protection for vulnerable 
patients, against discrimination if they have a preexisting condition.
  With that, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Cramer).
  The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Ms. STABENOW. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                               Healthcare

  Ms. STABENOW. Mr. President, I think you have heard me say before on 
the floor that healthcare is personal--not political. I think it is for 
all of us and our families.
  Healthcare affects everybody, whether they are Republican or 
Democrat, urban or rural, cheer for the Washington Nationals--go Nats--
or the Houston Astros or my Detroit Tigers that didn't make it this 
year.
  When people tell me their healthcare stories, I can assure you they 
don't start with their political affiliation or with anything else. 
They start with what is happening with them and their family. That is 
because, when it comes to their health and the health of their 
families, none of those other things matter. People in Michigan simply 
want to know that if they or their loved ones get hurt or sick, they 
are going to be able to go to the doctor and that they are going to be 
able to get the healthcare they need.
  Unfortunately, Michigan families have reason to be concerned right 
now. Any day now, the Fifth Circuit Court of Appeals will rule on the 
Texas v. United States case. Everything is at stake--everything--
including coverage for 17 million people through the Medicaid 
expansion. People earning minimum wage will not have to pick between 
having healthcare and not working or working, not getting healthcare or 
not working, getting healthcare--now they can work and get healthcare--
or the ability for children to remain on their parent's health 
insurance plans until age 26, coverage for preventive services like 
cancer screenings and flu shots, and protections for people with 
preexisting conditions.
  Misty, who runs a consulting company in Leslie, MI, knows all about 
preexisting conditions. She was diagnosed with breast cancer at age 52. 
Her diagnosis came entirely out of the blue, 3 days after her husband 
lost his job. She said:

       We were the lucky ones. He found another job 3 months later 
     before our COBRA ran out.

  She added this:

       Insurance loss and job loss at the same time as a cancer 
     diagnosis are stresses that I wonder if any of those people 
     who are looking to get rid of coverage for people with 
     preexisting conditions have ever thought they would have to 
     confront. I doubt it.

  It is estimated that about half of Michigan families includes someone 
with a preexisting condition--about half--everything from heart 
disease, asthma, to breast cancer. Nationwide, we are talking about 130 
million people who could lose their ability to have health insurance if 
healthcare reform is overturned. Think about that--130 million people.
  There is another side effect of overturning healthcare reform. 
Prescription drug costs could skyrocket. Now, 43 million seniors 
enrolled in Medicare Part D prescription drug plans are saving money 
thanks to healthcare reform and thanks to the Affordable Care Act, 
which helped close the prescription drug doughnut hole--what we call 
the gap in coverage where you are able to get coverage. Then the 
coverage is not there for a certain amount of time, and then you can 
get it once your drug costs get at a higher level.
  In fact, healthcare reform saved more than 11.8 million Medicare 
beneficiaries almost $27 billion on their prescription drugs--almost 
$27 billion on the cost of their medicine. Instead of attacking 
healthcare reform, we should be working hard to reduce the ridiculous 
cost of medicine, as I have talked about many times on the floor of the 
Senate.
  In 2017 alone, the average price of brand-name drugs that seniors 
often take, just in 2017 alone, rose four times the rate of inflation--
four times the rate of inflation according to the AARP. That is one of 
the reasons why 72 percent of seniors in a recent poll said they are 
concerned about the cost of their medicine, whether they are going to 
be able to get the lifesaving medicine they need and that the doctor is 
prescribing for them.

  It is absolutely shameful that people in America, one of the richest 
countries in the world, are going without medicine they need to 
survive. How is that happening? How are we allowing that to happen? I 
have always believed that healthcare is a basic human right, and, yes, 
that includes medications.
  We need to do something about this. We know the No. 1 thing we can do 
to lower prices is to let Medicare negotiate. Let Medicare negotiate. 
The fact is, when Medicare Part D was passed, the language that the 
drug companies got into the bill--specific language--to ban negotiation 
slipped into the middle of that bill.
  We originally were excited about it because we thought it was going 
to help get Medicare prescription drug coverage, and then, of course, 
the lobbying force--the largest lobbying force in DC--prescription drug 
companies snuck in some language to make sure we couldn't have the 
bargaining power of Medicare insurance to lower prices.
  So it is real simple. We want to do something that can lower prices. 
Let Medicare negotiate. Just let them negotiate like every other 
insurance company. We know it works because the VA does it for 
veterans. We know it works. The VA is allowed to negotiate the price of 
prescription drugs, and, surprise, surprise, it saves money. It saves 
40 percent compared to Medicare. Medicare could have saved $14.4 
billion on just 50 drugs if it paid the same price as the VA--$14.4 
billion if they paid the same price for seniors and people with 
disabilities as our veterans are able to receive.
  So what is stopping us? Well, we can't get the bill passed to take 
off the prohibition. I offered it in the Senate Finance Committee. 
Unfortunately, not one Republican colleague voted for it. We are going 
to bring it up again on the floor. We are going to bring it up every 
opportunity we have to make it clear that we, as Democrats, know--we 
know the best way to bring down prescription drug prices. Let Medicare 
negotiate. Just let them negotiate.
  We know the reason we can't ever get a vote on this. In 2018, there 
were 1,451 lobbyists for the pharmaceutical and health product 
industry. That is almost 15 for every Member of the Senate. Think about 
that. There are 100

[[Page S6086]]

Members, and there are almost 15 pharmaceutical lobbyists for every 1 
Senator, and they are doing everything they can. Their job is to stop 
competition, keep prices high, and they have done a very good job of 
it. It is wrong for people, but they have done a very good job of what 
they were assigned to do.
  As I mentioned before, back in 2003, when Medicare Part D was signed 
into law, they blocked Medicare from harnessing the bargaining power of 
43 million American seniors to bring down the cost of their 
prescription medicines. Now, 16 years later, pharmaceutical companies 
are still doing everything they can to put their company profits before 
people.
  It is time--it is past time to help people afford their prescription 
medications and protect people with preexisting conditions. People in 
America, right now, shouldn't be worried about a court case in the 
Fifth Circuit and what is going to happen and what that will mean for 
their family and their healthcare.
  We could do something about that right now--today. We could do 
something right now if people wanted to. Let me remind you that it has 
now been 167 days since the House passed legislation protecting people 
with preexisting conditions. It has been 167 days ago the U.S. House of 
Representatives passed a bill and sent it over to the Senate, and we 
have not been allowed to vote on that. It has not been brought up for a 
vote. It needs to come up for a vote. It needs to be taken out of the 
legislative graveyard and walked to the floor of the U.S. Senate so we 
can vote to really protect people with preexisting health conditions.
  Misty and other cancer survivors across Michigan and across the 
country shouldn't have to wait a day longer. This isn't about politics. 
It is about saving lives.
  Misty closed her letter to me with this: ``If [these elected 
officials] are truly as concerned about life as many of them claim to 
be, they need to be concerned about my life and the life of millions of 
others with cancer.''
  Here is my question for the majority leader: What are you waiting 
for? It is time for us to act. Healthcare is personal. It should not be 
political on the floor of the U.S. Senate. It is time to act in 
protecting people with preexisting conditions and lowering the cost of 
prescription drugs.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________